Objective To develop a mathematical model for clinical calculation of and to verify its practical accuracy in tissue phantom ratios (TPRS). Methods An exponential attenuation algorithm was designed to express the TPRS through a function of any depth and field size of the primary beam with a beam hardening correction coefficient. In our model,the variation of attenuation coefficient with the field size was described by an attenuation factor and the hardening coefficient was replaced by a correction factor. Results From fitting in with the published TPR data of 6, 18 and 24?MV X-rays at the normalization depth sufficient for electron equilibrium, it was found that the attenuation factor can be described by a second-order function of field sizes. And the correction factor exhibited a linear relation to the attenuation factor. In order to determine the five parameters needed to calculate the above attenuation factor and correction factor, only eight TPR values at four extreme and mode rate field sizes were measured. A linear fit to the quality index(QI) showed that these parameters were strongly energy-dependent with R2 ranging from 0.844 to 1.000. The attenuation coefficient and hardening coefficient of the primary beam were calculated directly from two parameters. The derived initial attenuation coefficients from QI fitted well to published experimental data and the hardening coefficients were also consistent with measured data. Compared with practical measured results,the error rate of derived functional TPRS,presented within 1.5% at 6?MV, 1.2% at 18?MV and 1.1% at 24?MV X-ray.The principal attenuation and havdening coefficients were also obtained from our developed model.Conclusions The derived model is able to accurately describe the central axis dose distribution of the primary photon beam and be used to calculate the clinical TPR table from limited TPR values.

The lung cancer outbreak takes the first place in the global malignant tumor outbreak,becoming mainly reason to make death.Non-small cell lung cancer accounts for 80% of lung cancer around,70%～80% has already belonged to a later period while diagnosing(Ⅲ～Ⅳ period),It is the recommendation mode for later period NSCLC that the chemotherapy and radio treatment to put.The solution of using DDP/CBP with taxanens/gemcitabine/vinorelbine can raise curative effect further.It is a new way to treat later period NSCLC that is to use targeted treatment drug.

Objectives To analyze the influence factors for promoting appropriate health technologies to rural health workers in Zhejiang province. Methods 1957 health workers from county and township levels were surveyed by questionnaires, regarding their use of appropriate technologies. Results The influence factors for rural health workers to employ such technologies include their medical competency, training approach and technical categories. Those medical workers of higher education are

After a descrption of the background of patron-driven acquisition ( PDA) or demand-driven acquision (DDA) and its short-term loan model, purchase model, auto-purchase model, librain-purchase model, and evi-dence-based acquisition model, the total amount of resources in common PDA platform, PDA models and their users were analyzed.The key problems in PDA implementation were pointed out, such as formulation of criteria for the development of resources, control of funds, mangement of MARC data, and assessment of PDA project, and sug-gestions were put forward for their solution .

Objective The aim of this study is to observe the clinical characteristics and surgical effects of macular hole retinal detachment in high myopia patients with pars plana vitrectomy (PPV)and secondary internal limiting membrane (ILM)peeling.Methods This was a retrospective study.The clinical data of 1 5 patients (1 5 eyes)with macular hole retinal detachment and high myopia,who underwent primary PPV and secondary ILM peeling,were analyzed,including disease history,refraction diopter,ocular axis length,posterior scleral staphyloma,BCVA,macular reattachment and macular hole heeling.There were 3 males (3 eyes)and 12 female (12 eyes),the average age was (60.80 ± 5.85 )years.All patients were examined by best corrected visual acuity (BCVA ), slit lamp microscopy with 90D pre-lens, indirect ophthalmoscopy,A scan and optical coherence tomography (OCT).After the first PPV and silicone oil tamponade,a shallow retinal detachment around the macular hole,especially around the scleral staphyloma was detected by OCT.During the 2nd surgery to remove the silicone oil,ILM peeling and C3 F8 tamponade were performed.Results The average refraction diopter was (- 12.6 ± 1.86)D,the average ocular axial length (29.82±0.993)mm and the average disease duration was (5.20±1.24)months.All eyes had total retinal detachment of all four quadrants,choroid detachment and macular choroidal atrophy,and type ⅡCurtin posterior scleral staphyloma. After the second surgery, all had retina attached by fundus examination.OCT examination indicated that macular hole closure in 7 eye,macular hole attached and retinal attached in 8 eyes.Their BCVA improved after both the first and second surgery (P =0.000),the BCVA after second surgery was better than that after first surgery (P =0.038).Conclusions The clinical characteristic of our series of patients were as follows:long history,with choroidal detachment and type ⅡCurtin posterior scleral staphyloma.All 1 5 eyes showed retinal attached after secondary ILM peeling.The secondary ILM peeling and C3 F8 tamponade may improve the visual outcome and retinal reattachment rate.

It is the trend to integrate the curriculum contents and strengthen the ability training in reform of edu-cation model at present .After the abilities to develop and maintain medical informatics-related information sys-tems, to process medical information and to provide medical information service were analyzed, certain suggestions were put forward for the practical teaching reform of medical informatics according to the requirements of ability training and the characteristics of subject knowledge structure .

Medicine, Chinese Traditional ; Translations

Objective To explore a surgical therapy on close depressed fracture of the skull.Methods Ni-Ti form memory-alloy cramps were fixed on between the depressed bone and the normal surrounding skull in 16 patients with close depressed fracture of the skull.Results The follow up was 5～54 months(average 26 months).It indicated that there was no displacement and depressing of the fixed bone, no subcutaneous collection of fluid, no reject reaction and inflammation, and no erosion. The fixed bone and skull density showed normal by X ray and the fixed cramp did not disturb CT and MR scaning. All patients declared no mental burden and felt safe.Conclusion The Ni-Ti form memory-alloy cramp has a good mechanical restoration force and a good plastic effect,but no complication,it can increase the ability to resist external force in fracture region, and the surgical procedure is very simple, therefore it is ideal to treat the depressed fracture of skull.

Post-traumatic stress disorder (PTSD) is a kind of mental disorder that usually occurs after life-threatening and strong mental traumas .Clinical studies showed that the PTSD patients are 3 times more likely to have can-nabis as compared with the healthy people .The use of cannabinoids has a close relationship with the occurrence and clini-cal manifestations of PTSD .Experimental studies revealed that endocannabinoid ( eCB) signal alterations in animal models of PTSD influenced fear memory of the animals , suggesting a close correlation between the eCB system and the pathogenesis of PTSD.Given that the eCB system was reported to regulate affective states and participate in memory consolidation , re-trieval and extinction , targeting the eCB system may improve the emotional and cognitive features of PTSD , thereby holding out great promise for the development of novel approaches for clinical treatment of PTSD .

0.05),but significantly between VEGF levels before(261?135 pg/ml) and after(679?175 pg/ml) treatment in control group(P