This article analyses and summarizes the clinical maintenance work of Elekta Precise Linac in five years.Afer the further research on its performances and errors,a better way is found to solve the main problem of clinical electronic linac,i.e.the way to reduce the Stop Rate of Linac in Radiotherapy.

Objective:To analyze correlation between thrombelastograph (TEG) indexes and serological indexes in patients with acute cerebral infarction (ACI) .Methods :A total of 116 ACI patients treated in our hospital were se‐lected as ACI group ,another 98 cases without ACI , who underwent routine physical examination were regarded as healthy control group .According to severity of neurological function defect during acute phase ,ACI group was fur‐ther divided into mild ACI group (n=51) ,moderate ACI group (n=32) and severe ACI group (n=33) .TEG inde‐xes and serum indexes of platelet activation were measured and compared among above group ,and the correlation a‐mong TEG indexes and serum levels of platelet activation indexes were analyzed .Results:Compared with healthy control group ,there were significant reductions in R value [ (6.17 ± 1.38) min vs .(5.26 ± 0.77) min] and K value [ (2.39 ± 0.53) min vs .(1.71 ± 0.58) min] ,significant rise in α angle [ (63.27 ± 9.23) deg vs .(77.45 ± 12.08) deg] ,MA value [ (55.09 ± 6.38) mm vs .(77.13 ± 13.25) mm] of TEG ;clot index [CI ,(1.68 ± 0.53) vs .(2.56 ± 0.87)] ,D-dimer level [(0.24 ± 0.07) mg/L vs .(0.38 ± 0.09) mg/L] and platelet aggregation rate [PAR ,(56.12 ± 6.75)% vs .(69.17 ± 9.33)% ] in ACI group after treatment ,P<0.05 all .Among ACI subgroups with different severity ,the more severe neurological function defect was ,the lower R and K values were ,the higherαangle ,MA value ,CI ,D-dimer level and PAR were ,there were significant difference in pairwise comparisons ( P<0.05 or <0.01) .Linear regression analysis indicated that PAR was significant inversely correlated with R (B= -2.254) and K values (B= -2.286) ,and significant positively correlated with αangle (B=2.536) ,MA (B=2.537) and CI (B=2.352) ,P<0.05 or <0.01 ;D-dimer level was significant inversely correlated with R (B= -2.276) and K val‐ues (B= -2.259) ,and significant positively correlated with α angle (B=2.621) ,MA (B= 2.462) and CI (B=2.647) , P<0.05 or <0.01. Conclusion:TEG indexes are significantly correlated with platelet activity in ACI pa‐tients .TEG possesses good practical value in diagnosis ,severity judgment and therapeutic guidance for these pa‐tients .

Objective To observe the effects of Lipopolysaccharide (LPS) in different concentrations on expression of Robo4 in human umbilical vein endothelial cells (HUVECs). Methods HUVECs were cultured in vitro and randomly divided into 3 groups: control group, low dose LPS group (10 μg/mL) and high dose LPS group (100 μg/mL). Robo4 protein level was detected by immunofluorescence staining and western blot , and Robo4 mRNA level was measured by real-time PCR. Results Robo4 protein and Robo4 mRNA in high dose LPS group were 0.49 ± 0.08 and 0.23 ± 0.08 respectively , which were significantly decreased than those (1.35 ± 0.15 and 0.97 ± 0.17) in control group(P < 0.05). However, there were no significant difference between the low dose (1.23 ± 0.13 and 0.94 ± 0.14) group and the control group (P > 0.05). Conclusion High dose LPS (100 μg/mL) could down-regulate expression of Robo4 in HUVECs.

An innovative approach,named associating liver partition and portal vein ligation for staged hepatectomy (ALPPS),has made possible a marked increase in future liver remnant (FLR) over a short period of time,and has challenged the concept of unresectability.To date,ALPPS has been employed for a variety of primary and metastatic liver tumors from many centers across the world.Many technical variations of ALPPS have been described.However,much controversy has surrounded this procedure,and many problems remain to be solved,such as the reasons for rapid hypertrophy,the technical feasibility,safety and long-term oncologic outcomes,and the result compared with the conventional two-stage hepatectomy.These aspects are needed to be evaluated further in large-scale studies.We believe that the ALPPS procedure will has much room for further development.

Objective]To clarify the meaning of the phase“without high fever”in ShangHan Lun. [Method]To sort out the explanation of “without high fever”of interpreters from past to nowadays,then to analyse the scriptures of ShangHanLun and Sypnosis of Golden Chamber that involve“without high fever”,to re-define the exact meaning of the phase. [Result] Two main opinions are found about the explanation of“without high fever”in the past literature:one is “heat is in interior not exterior”,while the other is“exterior syndrome is passed”,Both are not accorded with Zhong Jing’s word expression and the real clinical situation. If “high fever”is explained as“the fever characteristics of Yang-ming disease”,the scripture involved and the meaning of“without high fever”can be thoroughly understood.[Conclusion] “Without high fever”is the phase Zhang-zhong-jing used to differentiate the disease in scripture from Yang-ming visceral substantial syndrome .Clarifying the phase“without high fever”helps us to better understand the meaning of related scriptures.

Patent ductus arteriosus( PDA) has high morbidity in new-borns. This disease tends to occur in premature,especially in the low-birth-weight infants. It can lead to severe complications including intracranial hemorrhage,respiratory distress syndrome,and chronic lung disease without treatment. Treatment for PDA usual-ly involves medications,operations,interventions and symptomatic treatment. This paper summarizes the progres-ses of the therapy of PDA in low-birth-weight premature infants.

Objective To explore the effect of repetitive transcranial magnetic stimulation (rTMS) on motor function in cerebral palsy children with epilepsy. Methods 270 cerebral palsy children with epilepsy hospitalized from February, 2011 to September, 2014 were ran-domized to control group (n=130) and treatment group (n=140). The control group received comprehensive rehabilitation, including mas-sage, exercise, occupational therapy, physiotherapy, speech training, cognitive function training and medication, and the treatment group re-ceived rTMS in addition. They were assessed with Gross Motor Function Measure-88 (GMFM-88) and Peabody Developmental Measure Scale-Gross Motor (PDMS-GM) before, and 1 and 2 months after treatment. Results The total scores of GMFM-88 and PDMS-GM in-creased more in the treatment group than in the control group (F>93.9, P<0.001). Conclusion rTMS can further improve the motor function in cerebral palsy children with epilepsy.

Biliary atresia(BA) is a destructive inflammatory obliterative cholangiopathy of neonates affecting both intrahepatic and extrahepatic bile ducts.BA is more common in east Asia.Genetic susceptibility,viral infections,and immune dysregulation may be related to BA,but immune dysregulation may play a key hole in the pathogenesis of BA.A current view of the pathogenesis of BA is that it may involve both a primary perinatal hepatobiliary viral infection and a secondary generation of an autoimmune-mediated bile duct epithelial injury.The etiology of BA is unknown,but there is evidence for the involvement of immunologic dysregulation mechanisms,which will be discussed in this review.

Objective To investigate the clinical effects of fast track surgery ( FTS ) in perioperative nursing care of laparoscopic cholecystectomy . Methods A total of 200 cases of laparoscopic cholecystectomy between January and December 2012 were randomly divided into two groups , with 100 cases of each group , receiving either FTS or conventional treatment .Comparison of the two groups in patients rehabilitation and complications were observed . Results The postoperative anal flatus time was significantly shorter in the FTS group (12.0 ±4.4) h than that in the control group (24.9 ±5.4) h (t=-18.519, P=0.000).The postoperative hospital stay was significantly shorter in the FTS group (3.2 ±1.3) d than that in the control group (4.2 ±2.1) d (t=-4.049, P=0.000).The patients’ weight loss at the 5 postoperative day was significantly less in the FTS group (3.2 ±0.3) kg than that in the control group (5.2 ±0.6) kg (t=-29.814, P=0.000). Conclusion FTS measures applied in laparoscopic cholecystectomy can significantly accelerate postoperative rehabilitation .

Objective]To summarize the principle of usage of Chenqi Decoction Family, and compare with the similarities and differences of those in ShangHan Lun. [Method]To classify and analyse the scriptures related to Chenqi Decoction Family, and make a comparison with those in Chapter of Yangming Disease in ShangHan Lun. [Result]Besides the method of purgation and urgent purgation to preserve Yin, Wu Jutong inhertied and developed the purgation method of Zhang Zhongjing’s ShangHan Lun, such as Fluid-increasing Decoction, The New Yellow Dragon Decotion, The Lung-ventilating Chenqi Decotion, The Heart-fire Conduction Chenqi Decotion, The Calculi bovis Chenqi Decotion and The Fluid-increasing Chenqi Decotion, which enriched the syndrome differentiation system of ferbile disease. A deeper comparison of WenBingTiaoBian and ShangHanLun is worth researching.