Radiation pneumonitis (RP) is one of the most common toxicities in patients with lung cancer treated by radiotherapy,which limits the delivered dose and may thus hampers tumor control,then lowers the patients,life quality.Based on the progress of molecular biology,RP may be regarded as a continuous progression of events induced by various cytokines involving numerous cells.Researches on gene polymorphisms indicate different mechanisms in the pathogenesis of RP among different races.Besides,more studies focus on the predictive value of dosimetric parameters such as V20、mean lung dose(MLD) and biological markers such as transforming growth factor-β ( TGF-β1 ).Decreasing use of drugs which may exacerbate RP and increasing use of modern treatments may be beneficial in the prevention.Meanwhile as the respect of drug prevention,more and more emphases are being placed on the target molecule of radiation-induced injury.

Objective To study the association between metastatic ratio of lymph node and clinical pathological features and its prognosis in elderly patients with gastric cancer.Methods The first postoperative pathological data of 219 patients with gastric cancer aged ≥ 60 years were retrospectively analyzed.The relationships of metastatic ratio of lymph node with gender,differentiation degree,depth of tumor invasion,vascular invasion,perineural invasion were analyzed.We used Kaplan-Meier survival analysis and Cox regression model to analyze this relationship.Results The metastasis rate of lymph node was higher in gastric cancer patients with higher degree of differentiation,deeper tumor-infiltration,vascular invasion or neural invasion,and the metastasis rate of lymph node was increased in females than in males (all P＜0.05).Kaplan-Meier survival analysis and Cox regression model analysis suggested that the metastasis rate of lymph node was an independent factor for postoperative survival rate in the elderly with gastric cancer.Conclusions The metastatic ratio of lymph node could be used to estimate the clinical prognosis of elderly gastric cancer.

Objective To design and realize hospital special information system and solve the information management questions of special diagnosis, such as emergency observation, radiation therapy, hemodialysis, assisted reproductive of bear and rear better children. Methods The main problems of hospital special medical in China were analyzed and defined the basic concept of hospital special medical. The main flow and system of hospital special medical from 13 aspects were introduced. Results The work mode and management methods about special medical were changed and solved the limitations of traditional management. Conclusion The design and realization of hospital special medical information systems can be improved work efficiency, medical quality effectively and the informationization level of the hospital.

Objective To develop a set of hospital material management information system with the mature technique of barcode so as to realize the whole flow management of material.Methods By analyzing the main problems in present hospital material management,we put forward ways and procedures of material management,and gave an overall introduction to the composition of the system from three aspects: warehouse management on material and drugs,the second level storehouse management,such as material management in department,inspect reagent consumptive material management,no stock for high-cost medical consumables management,etc and the cost accounting and collecting system.The key technologies and implementation methods adopted in the designing process of this system were also introduced.Results The achievement of whole flow tracking management from material purchase to material consumption not only ensures a real whole flow management of materials,but effectively reduces the consumption of hospital materials.Conclusion With the mature and advanced technique of barcode and wireless network,the management of material can be better achieved.

Objective To retrospectively analyze the prognostic factors of advanced esophageal carcinoma (EPC) with concurrent chemoradiotherapy.Methods A total of 200 advanced EPC patients between January 2008 and December 2011 were reviewed,and all of them received concurrent chemoradiotherapy,either IMRT or CRT.Among them,there were 92 and 108 patients in the IMRT and CRT group,respectively.The chemotherapy scheme was paclitaxel combined with different platinum drugs (cisplatin,nedaplatin,oxaliplatin or lobaplatin).The number of chemotherapy cycles was 2-4.Results Patients who received IMRT had a significant higher 3-year overall survival (OS) than that who received CRT (63.6 ％ vs 38.9 ％,x2 =12.102,P =0.001).Three-year OS differed no significantly between different chemotherapy regimens.There were 44.6 ％,57.5 ％,52.5 ％ and 52.5 ％ for those who received cisplatin,nedaplatin,oxaliplatin and lobaplatin,respectively (x2 =2.756,P =0.431).Patients received different cycles of chemotherapy had comparable treatment outcome,and the overall survival were 44.1％,51.6 ％ and 57.4 ％ for those who underwent 2,3 and 4 chemotherapy cycles at 3 years,without any statistical significance (x2 =2.497,P =0.287).Univariate analysis indicated that lesion length on X-ray,M stage,6th edition UICC staging and radiotherapy methods were the potential predictive factors.Multivariate analysis shown that gender,lesion length on X-ray and radiotherapy methods were the significant prognostic factors.Conclusion The significant prognostic factors for advanced EPC with concurrent chemoradiotherapy are mainly lesion length on X-ray and radiotherapy methods.

ObjectiveTo evaluate the mid-term clinical effect of nano-hydroxyapatite and polyamide 66 (n-HA/PA66) intervertebral fusion cage in treatment of thoracolumbar burst fractures.Methods A total of 87 patients with thoracolumbar burst fractures were managed by thoracolumbar body resection combined with n-HA/PA66 intervertebral fusion cage from December 2007 to September 2008.The clinical effect, safety and radiographic outcomes were evaluated.Results No nerve damage was deteriorated in all the patients.The neural function was improved for 1-2 grade except for four patients at Frankel grade A.The patients were followed up for mean 21.3 months (17-24 months).The kyphosis was (14.4 ± 12.6)° preoperatively, (3.7 ± 8.7) ° immediately after surgery and (4.0 ± 8.3)° at final follow-up.The distance between the upper and lower vertebral bodies was (96.9 ± 17.2) mm preoperatively, (109.5 ± 17.1) mm immediately after surgery and (108.3 ± 16.4) mm at final follow-up.No cage replacement, internal fixation breakage or neurologic impairment were observed during follow-up period.There were 58 patients with grade E fusion, 22 with grade D fusion and 7 with grade C fusion.ConclusionsAnterior decompression combined with n-HA/PA66 intervertebral fusion cage is an effective method for treatment of thoracolumbar burst fracture.The kyphosis is rectified and the intervertebral distance is corrected, with a high rate of fusion.

Objective To investigate the effect of pelvic autonomic nerve preservation (PANP) for urinary function and sexual dysfunction after total mesorectal excision (TME) of rectal cancer in male patients. Methods A total of 147 patients, hospitalized from March 2009 to March 2010,were enrolled into this study and received TME plus PANP combination treatment. The clinical data of these cases were analyzed retrospectively. Results There were no operative deaths. The 0. 5 - 1.0 years follow-up data showed that 9 cases (6. 12% ) had voiding dysfunction, 11 cases (7.48%) had sexual dysfunction, 12 cases ( 8.16% ) had local recurrence. Conclusion TME plus PANP combination treatment can improve the urinary and sexual function,without increasing the postoperative local recurrence rate.

Objective To optimize the preparation process of Tangzu Granula. Methods With the paste-forming rate and total content of paeoniflorin as the indexes, the optimal water-extraction condition was screened by orthogonal design. With hydroscopicity, fluidity and formability as the indexes, the appropriate ratio of the excipient and the formula were selected. Results The optimum water-extraction condition was as follows: 10-fold water, decoction for 2 times and 1.5 hour for each time. The optimal ratio of the excipient and the formula for preparation of Tangzu granules were two proportions of the extract and three proportions of the excipient which consisted of lactose and dextrin(2 : 1, w/ w). Conclusion The technology is effec-tive, scientific, reasonable, and practical.

By using the software CiteSpace Ⅱ,the paper makes a quantitative analysis and interpretation of research literatures on telemedicine in SCIE of Web of Science from three perspectives,namely the research hotspots,knowledge base and research fronts.The research hotspots of telemedicine mainly include tele-diagnosis,tele-monitoring and evaluation of the application effects of telemedicine.It sets forth key literatures representing the knowledge base one by one and reveals that most of them focus on clinical applications.The analysis of burst terms indicates that more attention has been paid to tele-monitoring and distance education of chronic diseases in recent years and mobile technology is one of the greatest driving forces for the development of telemedicine at the present stage.

Objective To investigate the method of the separation gel vacuum tube combined with matrix‐assisted laser desorp‐tion/ionization time of flight mass spectrometry system (VITEK‐MS) for fasting identifying positive blood culture bacteria .Methods Fifty cases of positive blood culture by the BacT/ALERT3D blood culture system and Gram‐negative bacteria by direct staining in the First Affiliated Hospital of Guangzhou University from March to October 2015 were collected .The bacteria were directly ex‐tracted from the blood culture bottle by the separation gel tube and performed the fast identification by adopting the VITEK‐MS system .At the same time the bacteria were performed the subcultivation and identification .then the coincidence of this method was compared .Results Among 50 cases of Gram‐negative bacteria by positive blood culture ,21 cases of bacteria were not identified ,29 cases of bacteria were identified ,the positive rate was 58 .0% .the coincidence rate with the conventional identification results was 96 .6% ;the method of separation gel combined with VITEK‐MS was nearly 24 h in advance compared with the traditional method . Conclusion Adopting the separation gel vacuum tube combined with VITEK‐MS for identifying bacteria has the higher coincidence rate of positive blood culture Gram negative bacteria ,can greatly shorten the identification time ,this method is rapid and simple .