Objective To study the effect of different dose fractionation on overall survival in patients with limited-stage small cell lung cancer (LS-SCLC). Methods LS-SCLC patients treated with radical combined chemotherapy and radiotherapy (RT) between January 2001 and Dec 2007 were analyzed retrospectively. According to the dose fractionation schemes, patients were divided into three groups:conventional fractionated RT (1. 8 -2.0 Gy,once daily), hyperfractionated RT (1.4 Gy, twice daily) and hypofractionated RT (2. 5 Gy,once daily). Overall survival, disease free survival and pattern of failures of the three groups were compared. A total of 177 patients were enrolled, including 63 patients in conventional fractionated RT group, 79 in hyperfractionated RT group and 35 in hypofractionated RT group. Results The overall follow-up rate was 96. 6%. The patient numbers with follow-up of more than 2 and 5 years were 153 and 92, respectively. The median survival time of the entire group was 22. 4 months, and the 2-and 5-year survival rates were 43.4% and 23. 5%, respectively. The 2-year survival rates for three groups were 31%, 46% and 59% (x2 =7.94,P=0.019), respectively. The 2-year disease free survival for three groups were 20%, 31% and 40% ( x2 = 4. 86, P = 0. 088 ), respectively. In the pairwise comparisons,patients in hypofractionated RT group have better survival than those in conventional fractionated RT group ( x2 = 7. 81, P = 0. 005 ), the effect of hyperfractionated RT group lies between the hypo-and the conventional fractionated RT groups, but no significant differences were detected ( x2 = 2. 31, P = 0. 128; x2 = 2. 95, P =0. 086). The mildest side effect was found in the hypofractionated RT group. No statistically significant differences were found in the patterns of first failure. Conclusion The hypofractionated RT scheme showed potential survival benefits for patients with LS-SCLC and should be considered in the setting of randomized clinical trials.

BACKGROUND:Maxil ofacial malformation limits the function of the mandible, produces the overload of the temporalmandibular joint leading to oral diseases. OBJECTIVE:To measure the characteristics of mandibular movement in populations with various types of dental occlusion. METHODS:Thirty-three volunteers (1 male and 32 females, mean age 21.71 years) meeting the inclusion criteria were enrol ed from Dalian Medical University, China and divided into four groups:normal control (n=10), Angle’s class I, II, III malocclusion (n=10, 8, 5). The protrusion, lateral, opening motion trace of mandibular central incisor and the right mandibular first molar, and the trace from mandibular postural position to intercuspal position were measured using the mandibular kinesiograph. The features of different occlusal patterns were analyzed using SPSS 17.0 software. RESULTS AND CONCLUSION:In the trace of protrusion, lateral, opening and closing motion, there were significant differences in the trace of the right mandibular first molar’s Max.Slant between Angle’s class II malocclusion group and the other three groups (P<0.05). In the trace of open wide and close fast, there were significant differences in the trace of mandibular central incisor in vertical distances between normal control group and Angle’s class I, III malocclusion groups (P<0.05);there were significant differences in the trace of mandibular central incisor in Max.Slant between normal control group and Angle’s class I malocclusion group (P<0.05);there were significant differences in the trace of the right mandibular first molar in vertical distances between Angle’s class II malocclusion group and the other three groups (P<0.05);there were significant differences in the trace of the right mandibular first molar in Max.Opening velocity between normal control group and Angle’s class II, III malocclusion groups (P<0.05). There were no significant differences in free space between the four groups (P>0.05). These results indicate that there are differences in the trace of mandibular central incisor and the trace of the right mandibular first molar in range and speed between different occlusal patterns. We can draw a conclusion that malocclusion has effects on the direction, range and speed of mandibular movement.

Nursing skill competitions are the wind vane for clinical nursing development, and the teaching concepts, proposition forms, and evaluation systems demonstrated by competitions have a strong reference value for nursing teaching. This article introduces the knowledge selection and integration from nursing-related courses according to the problems and objectives to be solved by drawing on the STEM education concept in comprehensive nursing practical training in the context of integration of competition and education. Realistic problem scenarios can be created with clinical cases as the carrier or main line, and then the Tanner clinical judgment model is used to guide students to conduct a comprehensive analysis of cases, thereby helping students to develop clinical thinking ability and comprehensive practical skills, so as to bridge the gap between the contents learned at school and nursing work in clinical practice and help nursing students adapt to clinical practice as soon as possible.

ObjectiveTo investigate the effect of Yunkang oral liquid on postpartum kidney deficiency in mice. MethodPostpartum mice were randomized into model and low-dose （6 mL·kg^-1）， medium-dose （9 mL·kg^-1）， and high-dose （12 mL·kg^-1） Yunkang oral liquid groups. The mouse model of postpartum kidney deficiency was established by sleep deprivation combined with forced swimming. Another 9 female ICR mice were selected as the normal control group. The mice were administrated with Yunkang oral liquid during the period of modeling. The levels of estradiol （E₂）， progesterone （P）， follicle-stimulating hormone （FSH）， and luteinizing hormone （LH） in the serum were measured by the enzyme-linked immunosorbent assay. The morphological changes of ovaries and uterus were observed by hematoxylin-eosin （HE） staining， and the expression of transforming growth factor （TGF）-β and Smad2/3 was determined by immunohistochemistry and Western blotting. ResultThe mice in the model group showed prolonged estrous cycle， reduced voluntary activity， dorsal temperature， grip strength， and bone strength， and whitening tongue coating. Compared with the model group， Yunkang oral liquid shortened the estrous cycle， increased the voluntary activity， dorsal temperature， grip strength， and bone strength， and alleviated the whitening of tongue coating. Moreover， it elevated the E₂ and P levels and lowered the FSH and LH levels in the serum， decreased ovarian follicular atresia rate， promoted uterine repair， and down-regulated the expression of TGF-β and Smad2/3 in the ovarian and uterine tissues. ConclusionYunkang oral liquid can ameliorate postpartum kidney deficiency in mice by regulating the TGF-β/Smads signaling pathway.

Objective To study the effect of β-aescine sodium on tumor necrosis factor α (TNF-α) in patient with severe traumatic brain injury and the clinical significance. Methods 60 patients with severe traumatic brain injury were divided equally into control group (n=30) and treatment group (n=30), who accepted routine therapy and further β-aescine sodium respectively. The serum TNF-α was determined before and 1 d, 2 d, 3 d, 5 d and 7 d after treatment. The patients were assessed with Glasgow Outcome Scale (GOS) 3 months after treatment.Results There was significant difference of serum TNF-α between treatment group and control group since 3 d after treatment (P<0.05). The score of GOS was better in the treatment group than in the control group 3 months after treatment (P<0.05). Conclusion β-aescine sodium is effective on severe traumatic brain injury. Level of TNF-α may be related with the outcome of patients with severe traumatic brain injury.