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.

The evaluation of biomaterial biocompatibility is a key step before the clinical application.With the rapid development of molecular biology,scientists have begun to evaluate biomaterial biocompatibility at molecular level and proposed the concept of molecular biocompatibility.Researchers'main tasks at present are to identify more molecular markers using molecular biology technology and to establish standards for evaluating molecular biocompatibility of biomaterial,which will provide the guidance for the design of better biomaterials.

β-catenin is an important signaling transduetion and adhesion molecules.Mutation of the betacatenin gene,CTNNB1,is a common case in pediatric tumors,which may induce development and metastasis.In hepatoblastoma,48%have CTNNB1 mutation.In Wilms tumor,mutation only occurs in cases with WT1 gene mutation.In neuroblastoma,mutation is also found.

Objective To observe the therapeutic effect of irradiation of the lumbar sympathetic ganglia by linear polarized light for the lower-limb neuropathie pain.Methods The lumbar sympathetic ganglia was irradiated by super liar therapeutic equipment focused on L_2 as the center,once a day,20 min each time for 30 days.Skin temperature on the lower limb,VAS score and pain threshold were evaluated.Results Compared to before,the skin temperature increased (P<0.01),VAS decreased (P<0.01),and pain threshold incresed(P<0.01).Conclusion The super lizer irradiation has a good therapeutic effect on lower extremity neuropathic pain

Objective To evaluate the ventricular systolic and diastolic synchronicity in elderly patients with the complete right bundle branch block (CRBBB) by Doppler tissue velocity imaging (TVI) technology. Methods The 35 elderly CRBBB patients were selected as CRBBB group, while 31 healthy people were chosen as control group to evaluate myocardial function. The time to peak velocity at systolic and early diastolic phase (Ts and Te) in the base and interlude 14 segments of left and right ventricles was measured. The average time of Ts in right ventricular 2 segments(Ts-2-RV), Ts and Te in left ventricular 12 segments (Ts-12-LV and Te-12-LV), and the standard deviation in left ventricular 12 segments (Ts-12 SD and Te-12-SD), the maximum Ts and Te difference (Ts-diff and To-dill) were calculated. The left ventricular end-systolic and end-diastolic diameter (LVEDs and LVEDd) and volume (LVEVs and LVEVd) were measured. Results (1)The time to peak velocity at systolic phase in 14 segments of left and right ventricles was longer in CRBBB group than that in control group(P<0.05 or P<0.01). Compared with the control group, the Ts-12-LV,Ts-12-SD and Ts-diff showed significant prolongation (P<0.01). The Ts-2-RV was longer than Ts-12-LV in CRBBB group[(226.3±37.4 ) ms vs. (195.5±69.5) ms, P < 0.05]. (2) There was no significant difference in the time to peak velocity at early diastolic phase in 14 segments between CRBBB group and control group(P>0.05), but the Te-12-SD and Te-diff was longer in CRBBB group than that in control group (P< 0.01). (3) The LVEDs and LVEDd were obviously increased in CRBBB group compared with controls (P<0.05 and P<0.01), but no significant difference was showed in LVEVs and LVEVd(P>0.05). Conclusions Compared with normal people, the Ts at systolic phase is longer, especially in the right ventricle, the LVEDs and LVEDd are significantly increased, and the ventricular systolic and diastolic synchronicity is not well in CRBBB patients.

Three ASA Ⅱ patients, aged 24-32 yr, weighing 56-74 kg, undergoing caesarean section with nitroglycerine for uterine smooth muscle relaxation, from May 2005 to April 2007 in our hospital, were studied. Among the 3 cases, 2 cases (39 or 40 weeks of gestation) were singleton pregnancy and 1 case (34 weeks of gestation) was twin pregnancy.Combined spinal-epidural block with an injection was used in the 3 patients and the block level was at T4-6-S3-5. The excess contraction of uterine occurred in the patient at 40 week gestation about 140 s after uterus incision and it was difficult in delivery of the fetus, trananasal administration was then performed with nitroglycerine 0.5 nag, but it was inefficient after 60 s observation. Nitroglycerine 0.2 nag was injected intravenously, 32 s later the uterine smooth muscle relaxation was good and the fetus was delivered smoothly. In the patients at 39 and 34 week gestation, nitroglycerine 0.2 mg was injected intravenously when the excess contraction of uterine occurred about 140 s after uterus incision and the 2rid fetus started to be. delivered respectively. The uterine smooth muscle relaxation was good 45 or 35 s after injection and the fetuses were delivered smoothly. Apgar score was 6-8 and 10 at 1 and 5 min after delivery in the 3 patients. The duration from hysterotomy to delivery was 195-240 s. Intravenous drip of oxytocin 20 U was given immediately after delivery, and then uterus contracted. No obvious adverse reactions were found.

The importance of course arrangement and standardization construction for the course of hyperbaric oxygenation medicine was expounded in this review.In addition,the measures and experiences on textbook choosing,teaching content assignment,teaching methods designing,assessment means innovation and teaching personnel training were also discussed.The teaching system of the course of hyperbaric oxygenation medicine can be improved and references for thc dcvelopment of clinical hyperbaric oxygenation medicine courses can be provided through these measures.

Objective To investigate the effect of positive end expiratory pressure (PEEP) on thermo-regulatory function during general anesthesia in patients addicted to smoking. Methods Twenty adult male ASA Ⅰ or Ⅱ patients who had been smoking more than or equal to 10 cigarettes per day for more than or equal to 6 years were studied. The patients underwent intra-abdominal surgery under general anesthesia and were randomly divided into 2 groups ( n = 10 each): control group (group C) and PEEP group (group P). Anesthesia was induced with propofol, fentanyl and vecuronium and maintained with inhalation of 1%-2% isoflurane and continuous iv infusion of remifentanil and vecuronium. The patients were mechanically ventilated after tracheal intubation. In group P PEEP of 10 cm H2O was added. Temperature probe was inserted into the lower segment of esophagus and placed on the anterior chest wall, medial surface of thigh anterior surface of forearm and palmar surface of the tip of index finger. Mean skin temperature (TMSK) was calculated according to Roberts. MAP, HR, TES, TMSK and the difference between TES and TMSK (TES-MSK) were recorded before induction of anesthesia (T0 ,baseline) and every 30 min after tracheal intubation. Esophageal temperature was taken as threshold of thermo-regulatory peripheral vasoconstriction when the difference between forearm and finger tip temperature = 0 ℃. The gain in the threshold was calculated according to Sessler. Results TES and TES-MSK significantly decreased,while TMsK increased after tracheal intubation in both groups ( P ＜ 0.05). There was no signifieant difference in TES, TMSK, TES-MSK, MAP, HR, the threshold of vasoconstriction and gain between the 2 gronps ( P ＞ 0.05). Conclusion PEEP cannot improve thermo-regulatory function during general anesthesia in smoking-addicted patients.

In the recent years,the earthquake occured frequently in the whole world which caused the increased incidence of crush syndrome (CS). The four limbs and torso will be bleeding and swelling when they are prounded and crushed from the heavy objects. The necrosis of muscular tissue causes massive production of toxin which leads to a series of symptoms including hypotension ,kidney dysfunction and so on. The serious acute kidney injury (AKI) will be vital. When CS-AKI ,the ascending velocity of urea nitrogen and K+ levels in the blood is quicker than those of general AKI;many kinds of immune cells are activated to engender a great deal of inflammatory mediators;the blood dynamics is often unstable. Therefore, it is advocated that the blood purification treatment should be carried early to eliminate excessive metabolic produces in vivo,to reduce the cardiovascular complication occurrence, and to avoid the irreversible change of the kidney function.

Objective To analyze the clinical characteristics and treatment outcome of citrin deficiengc in infants. Methods The clinical data of 15 patients with citrin deficiengcy were analyzed retrospectively and the diagnoses were confirmed by gas chromatography-mass spectrometry(GC/MS). Results The patients consisted of 9 male and 6 female infants,whose age of onset ranged from 2 to 10 days excepted 1 case later than one month. The main clinical manifestations were jaundice and swelling liver,laboratory data showed increased total and direct bilirubin,bile acid,alanine aminotransferase,γ-glutamyltransferase,blood ammonia,lactic acid and α-fetoprotein;7 paitients had prolongation of prothrombin time and 9 had dyslipidaemia;G C/MS analysis of urine samples showed elevated galactose ,galactitol and 4 - hydroxyl phenyllactic acid;citrin gene were positive in 6 cases ,cytomegalovirus infections were found in 13 cases. After the therapy of fat-soluble vitamins(A,D and K)and lactose free formula,the jaundice relieved rapidly and dispeared within 2 weeks in all cases. The 6-month follow-up data showed no symptoms in 6 cases. Conclusions The clinical manifestations of citrin deficiengcy are nonspecific,GC/MS and lactose free formula treatment can be used to confirm the diagnosis.