Objective:To explore the influence of psychological and to identify determinants for patients using position immobility by thermoplastic sheet in the course of radiotherapy. Methods:55 patients who received radiotherapy using position immobility by thermoplastic sheet were investigated with questionnaires. Results:There are 34.5%(19/55) patients admit under psychological stress during the treatment, which were affected by the tension from doctors’ consultation and the chemotherapy experience. Conclusion:Some patients were under psychological stress caused by the position immobility with thermoplastic sheet. Nursing intervention is necessary to improve, especially to the patients who show stress when consultation with doctors and who had chemotherapy experience.

Objective To analyze the fetal chromosomal karyotypes in prenatal diagnosis and the relationship between abnormal karyotypes and the indications of prenatal diagnosis. Methods Fetal chromosomal karyotypes were examined in 247 pregnant women (16 to 28 weeks' gestation) by amniocentesis. Results 14 abnormal chromosomal karyotypes were detected, the abnormal rate was 5.67%. Trisomy was the major abnormality, it was 7out of 14(50%), including 4 trisomy 21(42.86%)?2 trisomy 18(28.57%)?1 trisomy 13(14.28%).Balanced translocation was found in 6 fetuses, the frequency was 42.86%. In 18 pregnant women aged over 35 years,1 (5.56%) with trisomy 21 was detected, and 3 of trisomy 21 were in 229 pregnant women aged under 35 years (1.31%,P=0.235). 3 Trisomy were detected in 15 fetuses with ultrasonographic suspected abnormalities. Conclusions During the second trimester, in the pregnant women who had different indications for prenatal diagnosis, the rate of chromosomal abnormality was 5.67%. Trisomy was the most common abnormal karyotype. As one method of prenatal screening, ultrasound in the second trimester could increase the antenatal detection rate of fetal chromosomal abnormality.

4 ng/ml and/or with prostate nodule found on DRE or TRUS . Methods 197 patients suspected of prostate carcinoma underwent ultrasound guided sextant biopsy and 2～4 more cores in the nodule. Four patients whose initial biopsy was negative but subsequent PSA levels were continuously abnormal underwent repeated biopsies. Results Of the 107 cases with prostate nodules,in 34(31.8%) of them prostate cancer was detected,while in 90 cases without a prostate nodule, only 11(12.2%) were positive. Stratified analysis on PSA found that the higher the PSA, the higher the positive biopsy rate of prostate carcinoma. In the 4 cases with repeated biopsies, 1 prostate cancer was detected. Conclusions For patients with prostate nodule and/or PSA over 4 ng/ml,systematic biopsy should be taken, with 2 or more cores toward the nodule.In the patients with continuous high PSA levels,if the first biopsy is negative, rebiopsy should be taken.

Objective To analyze the cause for complications of the long bone fractures treated with the interlocking nail and indicate the prevention and treatment measures. Methods From January 1998 to May 2000,168 patients with long bone fractures were treated with the interlocking nail. Of them, there were 77 cases of femoral fractures, 67 tibial fractures and 24 humeral fractures. Results All patients were followed up for 5-24 months. Complications occurred in 14 cases (8.33%) including 4 cases of infections, 1 lower limb necrosis, 2 internal fixation failure due to incorrect indication, 2 re-fractures during the operation, 2 distal screw misinserted,1 nail into the ankle joint, 1 distal screw broken and 1 distal screw loosening. Conclusions We should attach great importance to the following points during treatment of long bone fractures with interlocking nail:(1) The indications must be correctly handled. (2) The technique for interlocking nail must be performed strictly during operation; close inserting nail is proposed.(3) As for the comminuted fractures, bone continuity should be reconstructed and the time to start weight bearing properly delayed. (4) C-Arm X-ray supervision is necessary during operation.

Objectives To detect the clinical significance of high sensitive C-reactive protein (hs-CRP) and immune function in children with Mycoplasma pneumoniae pneumonia (MPP). Methods 103 children with MPP, 47 cases of systemic inflammatory response syndrome (SIRS group), 56 cases of non-systemic inflammatory response syndrome (non-SIRS group) were recruited. 26 healthy children served as the control group. ELISA was used to detect the level of serum hs-CRP, immune in-dexes, IgG, IgA, and IgM, Cellular immune CD3+, CD4+, CD8+, CD4+/CD8+. Results The level of serum hs-CRP、IgG、IgM and CD8+in control group were significantly lower than those in non-SIRS group and SIRS group (P<0.05). The level of IgA、CD3+, CD4+, CD4+/CD8+in control group were significantly higher than those in non-SIRS group and SIRS group (P<0.05). The level of serum hs-CRP、IgG in SIRS group were significantly higher than those in non-SIRS group (P<0.05). The level of IgA、CD3+、CD4+、CD4+/CD8+in SIRS group were significantly lower than those in non-SIRS group. There was no significant difference in non-SIRS group and SIRS group of IgM and CD8+(P>0.05). The level change of serum hs-CRP were positively related with IgG (r=0.66,P=0.001) and were negatively related with IgA、CD4+、CD4+/CD8+(r=0.79, 0.67, 0.82, P all were<0.05) in chil-dren with MPP. Conclusion Children with MPP have Immunity function( including humoral immunity and cellular immunity) disorder which is related to the disease status. The level of hs-CRP could be an anpation index for the severity and immune func-tion of the children with MPP.

Objective To investigate the clinical features and therapy of fournier's gangrene.Methods The clinical data of 12 patients with fournier's gangrene who were treated at the Third Affiliated Hospital of Nanjing University of Chinese Medicine from January 2010 to February 2012 were retrospectively analyzed.Eleven patients had perianal abscess and 1 patient had perianal foreign body,most of the patients were presented with perianal pain,fever (＞ 38.5 ℃) and tachycardia.The mean interval between the onset of symptoms and admission to the hospital was 8 days (range,3-20 dyas).Seven patients were complicated with diabetes.Only 2 patients were administered hypoglycemic agents,but the effects were poor.Six patients were complicated with hypertension.One patient had the history of resection of sigmoid colon cancer 2 months before operation.Debridement and drainage were applied to all the patients after examination.Antimicrobial therapy applied to all the patients according to the results of drug sensitivity test.The incisions were washed by hydrogen peroxide solution postoperatively.Redebridement was applied if the disease was progressed.All patients were followed up via out-patient examination and phone call till June 2012.Results Results of clinical features:Perianal tissues necrotized,with the color of black.The scrotum or labia majora of 8 patients were invaded by the necrotic tissues.Results of laboratory test:the white blood cell count was (3.8-27.6) × 109/L,the white blood cell count of 6 patients was above 10 × 109/L,3 was above 20 × 109/L.The ratio of neutrophil granulocytes was 0.61-0.93.Four patients received single debridement,5 received redebridement,and 3 patients received debridement for more than 2 times.Two patients had sapremia and infectious shock,and they received treatment for 3 days and 4 days at the intensive care unit.Results of bacterial culture:6 patients were infected by the escherichia coli,4 by klebsiella pnenmoniae,and 1 by pseudomonas aeruginosa.The mean duration of hospital stay was (25± 14)days (range,1-49 days).All patients were followed up for 4-29 months,1 patient was discharged at postoperative day 2,and the prognosis of the 11 patients was good,no mortality was observed.Conclusions The clinical features of fournier's gangrene include severe pain and rapid spread of infections caused by necrosis of perianal subcutaneous tissues.Diabetes might be the risk factor of fournier's gangrene.Early diagnosis and prompt and aggressive surgical debridement are critical for improving survival.

Objective To retrieve and analyze domestic and international literatures about antibody-drug conjugates, and understand the recent progress and current situation.Methods PubMed, Web of Science and CNKI were searched to collect all the literatures connected with ADCs from the beginning to January, 2016.Endnote X7 was used to sort out and summarize.The type of literature, published year, first author, research institution, published journal, cited frequency, research contents and patent situation were analyzed with bibliometric methods.Results A total of 645 literatures were included, among which 495 were foreign articles and 150 were Chinese articles.The literatures greatly increased after the 21st century.The top one nation and journal which published the most articles were America and Clinical Cancer Research, respectively.Krop IE and Younes A published the most articles.Among them, the most frequently cited paper was cited up to 686 times.Selection of the targets, site-specific drug conjugation to antibodies and cytotoxic agents were frequently involved.Conclusion ADCs, which have made breakthrough progress, are the focus in the field of cancer research.However, there is still room for improvement, and we still need further exploration.

Objective To evaluate the agreement between dynamic transperineal ultrasound (DTP-US)and dynamic magnetic resonance imaging defecography (DMRD) in the diagnosis of rectocele,and to compare the correlation and difference between the depth of rectocele measured by DTP-US and DMRD.Methods The clinical data of 18 female patients with rectocele who were admitted to the Third Affiliated Hospital of Nanjing University of Chinese Medicine from September 2011 to May 2012 were retrospectively analyzed.All patients received examination via DTP-US and DMRD,and the agreement of the 2 diagnosing methods was analysed.The accurate rates of the detection of other pelvic floor abnormalities by the 2 methods were calculated.The agreement of DTP-US and DMRD in diagnosing rectocele was analysed by Cohen's kappa test.The difference of the depth of rectocele measured by DTP-US and DMRD was compared by paired samplet test,and the correlation of the depth of rectocele measured by DTP-US and DMRD was analyzed by using the Pearson correlation coefficient.Results Of the 14 patients diagnosed by DTP-US,there were 7 patients with bladder prolapse,5 with unrelaxed pelvic floor,2 with uterine prolapse,2 with rectal internal mucous intussusception and 1 with enterocele; of the 18 patients diagnosed by DMRD,there were 12 patients with bladder prolapse,8 with unrelaxed pelvic floor,8 with uterine prolapse,6 with rectal internal mucous intussusception and 1 with enterocele.The agreement coefficient between DTP-US and DMRD in diagnosing rectocele was obvious (κ =0.737,P ＜ 0.05).The depth of the rectocele detected by DTP-US and DMRD were (15 ±6)mm (range,7-24 mm) and (27 ±7)mm (range,20-41 mm),with significant difference between the 2 groups (t =-16.124,P ＜0.05).There was a high coefficient between DTP-US and DMRD in detecting the depth of rectocele (| r | =0.874,P ＜ 0.05).The depth of rectocele detected by DMRD increased as the increase of depth of rectocele detected by DTP-US (| r | =1.000,P ＜ 0.05).Conclusions The agreement between DTP-US and DMRD in diagnosing rectocele is high.The depth of rectocele measured by the 2 methods not only has statistically significance,but also exists a high degree of correlation.While DTP-US is superior to DMRD in terms of quick diagnosis and better telerance of patients.

Objective To investigate the optimal time of termination of pregnancy for patients with hemolysis elevated liver enzymes and low platelet (HELLP) syndrome Methods 57 patients with HELLP syndrome admitted from October 1992 to September 2001 were enrolled According to the length from the time diagnoses confirmed to the time of delivery,patients were divided into 3 groups; group Ⅰ,within 24 hours, group Ⅱ,24 to 48 hours and group Ⅲ,over 48 hours Complications,maternal and perinatal mortality were analyzed retrospectively between different groups Results Maternal and perinatal mortality were 7% and 11% in group Ⅰ, 16% and 21% in group Ⅱ, 64% and 73% in group Ⅲ with significant differences between group Ⅲ and group Ⅰ or group Ⅲ and group Ⅱ ( P

One hundred and fifty femoral head necrosis patients with intramedullary decompression received autologous stem cell transplantation. The blood was taken from unilateral or bilateral iliac, in each group the volumes of blood taken were 200, 300 or 400 ml respectively. The number of mononuclear cells was counted before and after centrifugation. The mononuclear cell count in subgroup of 200 ml,300 ml and 400 ml taken from unilateral iliac after centrifugation was (3. 11 ±1. 42) × 1010/L, (2. 62 ±1. 31 ) × 1010/L and(2. 13 ±. 91) × 1010/L. The concentration was significantly lower in subgroup of 400 ml than that of 200 ml (t=5. 118, P<0. 01). The mononuclear cells count in subgroup of 200 ml,300 ml and 400 ml taken from bilateral iliac was(4. 51 ±. 21) × 1010/L, (3. 89 ±. 06) × 1010/L and (2. 98 ±1. 39) × 1010/L, the concentration was significantly lower in subgroup of 400 ml than that of subgroup of 200 ml (t = 6. 446, P < 0. 01). Whether 200 ml or 300 ml or 400 ml blood were taken, the mononuclear cell count in blood taken from bilateral iliac after centrifugation was significantly higher than that from unilateral iliac(t = 3. 119,P < 0. 01; t = 5. 544, P < 0. 01 ;t = 2. 207 ,P < 0. 05). The results indicate that the concentration of isolated bone marrow mononuclear cells is higher from bilateral iliac than unilateral iliac. The concentration of isolated monocytes is reduced gradually with the increased blood volume.