Objective To explore the effect of situational health education on self-efficacy of primipara in breast-feeding and child rearing. Methods One hundred and eighty-five pregnant women taking prenatal examinations in our hospital from September 2012 to August 2013 were selected into control group and they received traditional education. Another one hundred and ninety-two pregnant women taking the same prenatal examinations in our hospital from Sep 2013 to Aug 2014 were selected into experiment group and the antenatal situational health education was applied . The self-efficacy in breast-feeding and child rearing of the two groups before and after discharged from hospital (6 weeks after delivery) were compared. Result The self-efficacy in breast-feeding and child rearing of the experiment group were significantly better than those of the control group and before discharged from hospital (P<0.05). Conclusion The situational health education is important for increasing self-efficacy in breast-feeding and child rearing and is beneficial for the growth and development of the neonates.

To characterize the ultra-fine particles of Atractylodes lancea (Thunb.) DC., Phellodendron chinense Schneid and the ERMIAO PILL*, a compounded preparation of the above two drugs, for the purpose to observe a deeper view on their physico-chemical properties. Methods　By comparing their particle size, porosity and specific surface area with light and scanning electron microscope. Results　The size of the ultra-fine particles were more uniform in size, 90% of which were under 20 μm, their specific area were increased by 60% ～ 190% and bulk density were around 0.42 g/cm3, and the great majority of the plant cells were broken as compared with the conventional coarse powder. Conclusion　Both A. lancea and P. chinense together with their combined preparation became smaller in particle size, more uniformly distributed with increased specific surface area and broken cell wall.

Object To characterize the ultra fine particles of Atractylodes lancea (Thunb ) DC., Phellodendron chinense Schneid and the ERMIAO PILL *, a compounded preparation of the above two drugs, for the purpose to observe a deeper view on their physico chemical properties Methods By comparing their particle size, porosity and specific surface area with light and scanning electron microscope Results The size of the ultra fine particles were more uniform in size, 90% of which were under 20 ?m, their specific area were increased by 60% ～ 190% and bulk density were around 0 42 g/cm 3, and the great majority of the plant cells were broken as compared with the conventional coarse powder Conclusion Both A. lancea and P chinense together with their combined preparation became smaller in particle size, more uniformly distributed with increased specific surface area and broken cell wall

Object To investigate the effects of ultra-fine powder technique and granularity of pellets on dissolution rate in vitro. Methods The dissolution rate of ultra-fine ERMIAO PILL with different granule diameters in vitro was measured and compared with the index of berberine by UV spectro-photometry. Results The dissolution parameters T 50 and T d of four kinds of ultra-fine ERMIAO PILL are 61.60, 19.48, 17.84, 8.97 min and 102.3, 33.29, 26.98, 14.77 min, respectively. Those of general powder ERMIAO PILL with granule diameter of 2.4 mm are 89.61 and 155.68 min. Conclusion The dissolution rate of ultra-fine powder is quicker than that of general powder, and the rate increases with the granularity of PILL decreasing.

Objective To investigated the protective ways of intensity modulated radiotherapy (IMRT)for submandibular gland function in patients with nasopharyngeal carcinoma.Methods From March 2010 to November 2012,101 patients with nasopharyngeal carcinoma were enrolled into study.They were treated with IMRT and evaluated by face to face dry mouth questionnaire during the follow-up of 3,6,12,18,24 and more than 24 months,meanwhile,their dose volume histogram of submandibular gland were taken into consideration.Results The average contralateral median dose and that of ipsilateral submandibular gland were (45.69±7.22) Gy and (51.64±8.20) Gy,respectively,and the V35,V40,V45,V50 were 95.82 ％,69.99 ％,46.90 ％,25.50 ％,and 100 ％,96.50 ％,82.24 ％,60.98 ％,respectively.There were positive relationship between the xerostomia grading of 3,6,and 12 months after radiotherapy and the average dose of submandibular gland or the V35,V40,V45,V50.After 6 month,the xerostomia in 77.2 ％ (78/101) was significantly improved,and after 12 months,less than 5 ％ of patient complained about G3 or more grade of xerostomia.Conclusions When using IMRT in nasopharyngeal carcinoma,it' s necessary to reduce the irradiated volume and the dose of submandibular gland.It is confined that the median dose of contralateral submandibular gland should be less than 40-45 Gy,and V40 or V45 ≤66.7 ％ or ≤50 ％,which can effectively protect the function of salivary gland.

Objective To investigate feasibility and clinical application value of improved percutaneous transhepatic biliary internal-external drainage (PTBIED).Methods Consecutive patients from April 2007 to April 2010 with malignant obstructive jaundice were diagnosed by medical imaging or pathological confirmation whenever possible.The patients with proximal malignant biliary obstruction and intact inferior common bile ducts ＞ 3 cm in length,and a bilirubin of 70 μmol/L or higher,were included in the experimental group.The control group included patients with low malignant biliary obstruction,and those who met the criteria for the experimental group but refused to receive the altered method of PTBIED.The patients underwent traditional PTBIED in control group.The patients in the experimental group received the procedure as following:according to percutaneous transhepatic cholangiography,a biliary external drainage catheter was modified by adding side-holes.Then under fluoroscopic guidance,the loop tip of the modified biliary drainage catheter was positioned in the inferior common hepatic duct/common bile duct,while the additional side-holes were located in the expanded hepatic duct.Technical success rate,complications,hepatic function and white cell count (WBC) were recorded pre- and post-procedure.All patients were followed-up until death.A t-test was used to compare continuous variable data changes,the Chi-square test was used to compare categorical variable data in two groups,and survival time was assessed using the Kaplan-Meier method.Results Forty-six patients were included in the study,with 21 in the experimental group and 25 in the control group.The procedures were successfully performed in all patients in the two groups.There was no procedure-related death in the two groups.Symptoms were improved similarly after procedures in the two groups.The mean quantity of drained bile per day [experimental group (521 +136) ml/d,control group (606 + 159 ) ml/d,t =1.930,P ＞ 0.05],decrease of the serum total bilirubin after the procedures [ experimental group (87 ± 51 ) μmol/L,control group( 105 ± 66 ) μmol/L ( t =1.061,P ＞ 0.05 ) ] and the median survival time ( experimental group 7.7 months,control group 6.9 months,x2 =0.610,P ＞0.05 ) of the patients showed no statistically significant difference between two groups.The mean WBC amount of patients was higher after the traditional procedure [ ( 10.9 ±5.2) × 109/L] than before the procedure [ (7.8 ±2.9) × 109/L] in the control group ( t =3.606,P ＜ 0.05 ),but the converse change occurred in the experimental group [ pre-procedure (8.2 ± 3.4) × 109/L ],post-procedure [ (7.4 ± 2.6) × 109/L] ( t =2.649,P ＜ 0.05 ).No reflux of duodenal juice was observed in all patients of the experimental group,and 1 patient had infection of biliary tract.The reflux was observed in 11 patients of the control group after conventional PTBIED.Of them,8 patients had infection of biliary tract.Incidence rate of infection of biliary tract in the control group was higher than that in the experimental group( x2 =5.381,P ＜ 0.05 ).Conclusions Improved PTBIED is convenient and feasible,and compared with traditional PTBIED,it can reduce the complications of infection of biliary tract.

PURPOSE: This study aims to investigate the feasibility of contouring target volume according to residual tumor and decreasing the dose to the tumor regression field after induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: From August 2009 to August 2013, patients with stage III–IVB NPC were treated with IC and concurrent chemoradiotherapy. Gross tumor volume of nasopharynx (GTVnx)–residual and gross tumor volume of cervical lymph node (GTVnd)–residual were contoured according to post-IC residual primary tumor and any N+ disease, respectively. The tumor regression field was included in CTVnx1/CTVnd1 and prescribed a dose of 60 Gy. Outcomes and toxicities of all patients were evaluated. RESULTS: A total of 57 patients were enrolled. At a median follow-up of 68 months, three cases displayed locoregional recurrence and one case showed both distant metastasis and locoregional recurrence. All locoregional recurrences were in the GTVnx-residual/GTVnd-residual and in-field. The 5-year overall, locoregional relapse-free, distant metastasis-free, and progression-free survival rates were 82.2%, 87.7%, 85.8% and 80.3%, respectively. CONCLUSION: After IC, contouring of GTVnx-residual/GTVnd-residual as residual tumor volume and distribution 60 Gy ofradiation dose to the tumorregression field may be feasible and need further investigation.
Chemoradiotherapy ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Lymph Nodes ; Nasopharynx ; Neoplasm Metastasis ; Neoplasm, Residual ; Radiotherapy, Intensity-Modulated ; Recurrence ; Tumor Burden