ObjectiveThis study was to explore the feasibility of using the orthogonal plane dose formed by the coronal and sagittal plane to verify the volumetric modulated arc therapy (VMAT) plan.MethodsThe VMAT plans of 12 patients were included in this study.The orthogonal plane dose formed by the coronal and sagittal plane were measured based on the combination of 2D ionization chamber array and multicube phantom,and the point dose were measured based on a multiple hole cylindrical phantom attached with two 0.125 cm3 ionization chamber probes.ResultsIn the measurement of the point dose,the average error was 1.5％ in high dose area ( more than 80％ of maximum),and 1.7％ in low dose area ( less than 80％ of maximum),respectively.The discrepancy of point dose measurement was 1.3％ between the 2D ionization chamber array and the VMAT planning system.In the measurement of the orthogonal plane dose,the pass rate of γ were 93.7％ for 2％/2 mm and 97.2％ for 3％/3 mm.ConclusionIt is reliable for using the orthogonal plane dose formed by the coronal and sagittal plane to verify the VMAT plan.

Objective To determine the optimal injection dose of ozone for the treatment of lumbar intervertebral disc protrusion.Methods A total of 240 patients with lumbar intervertebral disc protrusion were randomly and equally divided into four groups,with 60 patients in each group.Under CT guidance intervertebral injection of ozone was performed.The injection dose of ozone(50 ug/ml)used for patients in group A,B,C and D was 10 ml,20 ml,30 ml and 40 ml respectively.Immediately after the procedure CT scanning was made to check the result. A follow-up lasting 6-12 months was carried out.Clinical observation,including the ablation degree of the nucleus puiposus,the therapeutic results and the adverse reactions,was conducted.The results were statistically analyzed and compared among the four groups.Results A significant difference in the therapeutic effect existed between group A(10 ml)and other three groups(P＜0.05),while no significant difference in the therapeutic effect existed among group B(20 ml),group C(30 ml)and group D(40 ml),with P＞0.05.The occurrence of complications was increasing with the injection dose used.Conclusion The optimal injection dose of ozone for the treatment of lumbar intervertebral disc protrusion is 20 ml.

Objective To develop an HPLC method for simultaneous determination of contents of asiaticoside, tetrahydropulmatine and saikosaponin d in Shenji Huwei Granules. Methods The analysis was performed on a R&C C18 column (250 mm × 4.6 mm, 5 μm) by using the mobile phase of acetonitrile (A) - phosphate buffer (which used potassium dihydrogen phosphate 8.34 g, potassium phosphate 0.87 g dissolved by 1000 mL water) with gradient elution (0–15 min, 20％A; 15–30 min, 20％→40％A; 30–42 min, 40％A; 42–45 min, 40％→48％A; 45–50 min, 48％A; 50–70 min, 48％→50％A). The flow rate was 1.0 mL/min; the detection wavelength was set at 210 nm; the column temperature was maintained at 30 ℃. Results Asiaticoside, tetrahydropulmatine and saikosaponin d were in the linear ranges among 0.173–2.770 μg (r=0.9999), 0.021–1.320 μg (r=0.9992), 0.151–9.660 μg (r=0.9993), respectively. The average recovery rates of asiaticoside, tetrahydropulmatine, saikosaponin d were 96.25％, 97.02％, and 97.84％, respectively, and RSD were 2.31％, 4.51％, 1.87％, respectively. Conclusion This method is simple, with good separation effect and strong specificity, and can be used for simultaneous determination of contents of asiaticoside, tetrahydropulmatine and saikosaponin d in Shenji Huwei Granules, which provides references for perfection of quality control of Shenji Huwei Granules.

Objective To explore the methods and the nursing points during the course of using methotrexate to cure moderate and severe psoriasis.Methods 41 moderate and severe patients with psoriasis have been adopted in this study.The procedure of nursing care included medical education,clinical care and psychological nursing in order to increase the compliance of patients.Results All the patients have accepted the therapy of using methotrexate to cure psoriasis,the effective rate was 80.5%,only one case have withdrawed from the study because of leucopenia.The compliance of patients have increased significantly.Conclusion Using methotrexate to cure psoriasis is effective and safe,which can increase the compliance and the confidence of patients.

Objective To establish and evaluate 3 kinds of minimally-invasive valve implantation model in vivo.Methods A novel tissue engineered heart valve(TEHV) manufactured by branched polyethylene glycol cross-linked acellular porcine valve and a minimally-invasive valve implantation system according to the design of Corevalve revalving system were adopted.After anesthesia,18 adult male goats were randomly divided into 3 groups: the ulrasound-directed orthotropic group (group A,n =6),angiography-directed orthotropic group (group B,n =6) and direct-released heterotopic group (group C,n =6),and all received minimally-invasive valve implantation orthotropically or heterotopically.4 weeks later,the valvular function was evaluated by CTA and/or echocardiography.Results All 3 kinds of caprine model were successfully constructed.The operation success rate of each group was A: 66.7％,B: 50.0％ and C: 100.0％,respectively(multiple x2 analysis,group A and B P ＞0.05; group A and C,group B and C,P ＜0.05).The operation-time of each group was A: (79 ± 18) min,B:(61 ±23) min,C: (45 ± 15) min(one-way ANOVA,P ＜0.05).The survival rate at4 weeks was A: 100％,B: 100％ and C: 83.3％ (multiple x2 analysis,P ＞ 0.05).Echocardiography and CTA proved the short-term function of implanted TEHV was satisfactory.Conclusion All 3 kinds of caprine valve implantation model can be established without cardiopulmonary bypass and blood transfusion.The devices and equipments required in group A is relatively simple,but the procedure cost longer time for it is hard to determine the right position by ultrasound.The application of angiography made the positioning much easier in group B while the procedure had to be performed in specific operation room with angiographic apparatus.Group C did rely on neither special equipments nor complex operation,but the valve leaflets cannot work normally,so this model was only suitable for testing in vivo characteristics such as biocompatiblities.

Objective To evaluate the clinical effect of the chest orthosis on patients with multiple rib or(and) sternal fracture in early period of closed chest trauma.Methods Patients with multiple fractured of ribs or (and) sternal fracture were divided into control group (n =16)treated with the traditional fixation methods ( thoracic girdle added with folding towels) and experimental group ( n =30 ) treated with chest orthosis between January 2009 and December 2011.Correlated parameters of these patients in the two groups,including pain,indexes of blood gas analysis,pulmonary complications and hospitalization time were evaluated.Results There were significant differences on visual analogue scale(VAS) [ (4.45 ±2.23) vs (8.15 ±2.02),t =2.921,P ＜0.01 ],blood gas analysis including PaO2 [ 88.16 ± 9.12) mm Hg vs (77.22 ± 6.24 ) mm Hg,t =2.413,P ＜0.05] andPaCO2[ (40.91 ±3.40)mm Hg vs (46.06 ±5.40)mm Hg,t =2.335,P＜0.05] between experimental group and control group.The incidence rate of pulmonary complications in experimental group was significantly lower than that in control group [ 17％ ( 5/30 ) vs 44％ ( 7/16 ),x2 =23.478,P ＜ 0.05 ].And hospitalization time in experimental group was significantly shorter compared with control group[ (7.26 ± 4.17) d vs ( 14.26 ±3.53)d,t =2.430,P ＜0.05].Conclusion The chest orthosis in early treatment of chest trauma can reduce the pain and improve the condition of patients,and it is a simple,effective and cheap method with significant clinical effect.

Objective To estimate the prevalence of sexually transmitted diseases(STDs) among men who have sex with men (MSM) in some cities of Jiangsu province.Methods A cross-sectional questionnaire survey was carried out among MSM attending gay bars in some cities of Jiangsu province.Participants underwent screening for STDs in accordance with their personal wishes.Urethral swabs,first void urine and blood samples were collected at these survey sites and delivered to the STD research laboratory for testing.Univariate analysis and multivariate logistic regression analysis were performed to assess factors associated with STDs.Results A total of 388 subjects completed the questionnaire and underwent physical examination and STD screening.Of these subjects,45.6％ had only homosexual behavior.Examination of urine or urethral swab specimens showed that the prevalence rate was 1.3％ (5/388),9.4％ (36/385),17.2％ (66/384) and 28.1％ (109/388) for Neisseda gonorrhoeae,Chlamydia trachomatis,Mycoplasma genitalium and Ureaplasma urealyticum infection respectively.Serological tests revealed that the positivity rate was 1.0％ (4/388) for anti-human immunodeficiency virus (HIV)antibody,18.8％(73/388) for Treponema pallidum particle agglutination assay (TPPA),12.1％(47/388) for rapid plasma reagin (RPR) test,9.8％ (38/388) for human herpes simplex virus (HSV)-2-IgG,9.8％ (38/388) for hepatitis B surface antigen,1.0％ (4/388) for anti-hepatitis C virus antibody and 2.1％ (8/388) for anti-hepatitis E virus antibody.Multivariate analysis indicated that Chlamydia trachomatis infection was independently and significantly associated with polymorphonuclear leucocyte (PMNL) counts in urethral swab smears (adjusted odds ratio (AOR):5.30,95％ CI:2.04-13.77,P ＜ 0.01),Mycoplasma genitalium infection was significantly associated with age (AOR:2.84,95％ CI:1.17-6.87,P＜ 0.05),PMNL counts in urethral swab smears (AOR:2.37,95％ CI:1.01-557,P＜ 0.05) and urethral discomfort in the past three months (AOR:2.43,95％ CI.1.18-5.02,P＜ 0.05),and syphilis (defined as a positive TPPA and RPR test) was associated with age (AOR:2.46,95％ CI:1.05-5.75,P ＜ 0.05) and seropositivity for anti-HSV-2 antibodies (AOR:3.70,95％ CI:1.62-8.44,P ＜ 0.01).Conclusions There is a high prevalence of STDs among MSM attending gay bars in some cities of Jiangsu province,with Chlamydia trachomatis and Mycoplasma genitalium as the most common pathogens of urethritis.

Objective To explore a rapid,simple and effective therapy for serious pneumothorax which could be used in pre-hospital and in-hospital first-aid.Methods Sixty-seven patients were randomly divided into the observation group and control group .Patients in the observation group were treated using laparoscopic trocar for rapidly closed thoracic drainage,and patients in the control group were treated by using the traditional large caliber drainage tube and the intercostal incision method of conventional closed thoracic drainage.The operation time,remaining time of drainage,length of stay,effective rate,and complications,including of postoperative pain,hemorrhage,subcutaneous emphysema and infection were observed in both groups. Results The total effective rate was 94.1%(32/34) in the observation group,which was significantly higher than that in the control group(90.9%,30/33)(x2=1.876,P＞0.05).No significant difference was found on the remaining time of drainage and length of stay between the two groups(remaining time of drainage:[4.56±1.65]d vs.[6.26±3.45]d;length of stay:(6.0±2.6)d vs.(6.7±2.2)d ,t=1.335 and 0.779,respectively,Ps＞0.05).The operation time of using laparoscopic trocar was significantly lower than that of the control group((5.00±1.28)min vs.(15.00±4.03)min,t=3.031,P＜0.05).The incision length was(0.95±0.11)cm in the observational group,which was significantly lower than that in the control group((2.41±0.52)cm ,t=2.585,P＜0.05).Postoperative pain occurred in 14.7%(5/34) of patients in the observational group,which was significantly lower than that in the control group(87.9%(29/33))(t=2.983,P＜0.05).In the observational group no hemorrhage and infection occurred,whereas in the control group the hemorrhage and infection rate was 36%(12/33) and 33%(11/33),respectively(x2=5.880 and 3.687,respectively,Ps＜0.05). Conclusion The use of laparoscopic trocar for rapidly closed thoracic drainage in the treatment of serious pneu-mothorax is simple,easy,convenient,effective and reliable,with few complications.This therapy is suitable for using in pre-hospital and in-hospital first-aid.

Objective To investigate clinical characteristics, diagnosis, treatment and prognosis of thyroid carcinoma in childhood. Methods Sixty patients under 14 years of age with thyroid carcinoma were retrospectively reviewed. Results Forty-nine suffered from papillary carcinoma, eight were with follicular carcinoma and three with medullary carcinoma. Cervical lymph node metastasis was found in 36 cases (60%). Operations included unilateral total thyroidectomy and isthmectomy in 20 cases (33.3%), unilateral total thyroidectomy and contralateral subtotal thyroidectomy in 36 cases (60%) and total thyroidectomy in 4 cases (6.7%). The follow-up period was 1 to 20 years (mean 10.5 years), and the survival rate of 5 and 10 years were 93% and 87.1% respectively. Conclusions Most thyroid carcinoma in children is well differentiated and the prognosis is good. A proper surgical procedure and postoperative comprehensive therapy are important for good outcome.

Objective To compare the effect of nursing students acting as social volunteers to participate in gerontological nursing practice teaching with traditional practice teaching mode, and promote the reform of teaching mode in nursing practice. Methods Students of two classes from department of nursing, medical college of Wuhan University of Science and Technology were selected as research objects. In class one nursing students acted as social volunteers to participate in gerontological nursing practice teaching (the experimental group), In class two nursing students took practice in geriatric wards according to traditional practice mode(the control group). The practice effect was compared between two groups. Results The average final grade of the experimental group was 86.50, and 78.51 in the control group. Ridit analysis revealed that, setting class one as the experimental group, R=0.796 8,95% confidence interval was 0.715 1-0.878 4, in the control group, R =0.500 0. The investigation showed that the experimental group and the control group were different in moral elevation aspect, teaching level, capability improving aspect and employment promotion aspect, the difference was significant (P<0.01). Conclusions The mode of nursing students acting as social volunteers to participate in gerontological nursing practice teaching has advantage over traditional practice teaching, and it can gain satisfying teaching effect.