In order to improve the utilization efficiency of nursing human resources, stable nursing troop and enhance the quality of care, at present, the post management experiences for nurses of domestic and international are adopted by many hospitals and certain results are achieved. Study about nurses stratified management is reviewed, the approach, basis, effects, features and the advantages and disadvantages of hierarchical management experiences for nurses in different countries and regions is summarized and some thinking and prospect in studying is proposed in this article, as well as the follow-up research, to explore a constructive policy of further promoting the development of the level management for nurses.

Purpose To explore the clinicopathologic characteristics, pathologic diagnosis and differential diagnosis of extraskeletal myxiod chondrosarcoma. Methods The clinical and pathological features were studied with HE and immunohistochemical staining in 5 cases of extraskeletal myxoid chondrosarcoma, and the related literatures were also reviewed. Results Extraskeletal myxoid chondro-sarcoma was male predominance (4 males: 1 female), and the age ranged from 32 to 62 years with an average of 52 years. Four tumors occurred in thigh and another in chest. Histologically, the neophlasm were composed of round and oval cells. Immunohisto-chemically, the tumor cells were positive for vimentin in five cases, synaptophysin expressed in one case, S-100 showed focal positivity in two cases, but negative for CK, p63, EMA, CD34, SMA in all cases. Molecular genetics detection shows chromosome exchange be-tween number 9 and 22. Conclusion Extraskeletal myxoid chondrosarcoma is a rare tumor which has no special characteristics in clinical and iconography, and its diagnosis mainly depends on the histopathologic features, immunohistochemistry and molecular genet-ics. Extraskeletal myxoid chondrosarcoma grows slowly, but have a high tendency for local recurrence and metastases.

Objective:To investigate the role of planning risk volume (PRV) in estimating the radiation dose for various cardiac substructures (CS). Methods:The CS of 23 patients with left-sided breast cancer who underwent postoperative intensity-modulated ra-diotherapy (IMRT) was delineated. PRV was expanded from CS with an additional margin determined by the mean amplitude of cardi-ac motion. Two IMRT plans were designed. The volume, mean dose, maximal dose (D2%), and standard deviation of CS and its PRV were calculated. Results:In comparison to the volume of CS, the PRV of the heart, specifically the left ventricle, increased by 50%to 80%, whereas the PRV of the main coronary arteries and sub-branches increased by 18.7 times to 42.6 times. In the two IMRT plans, the mean dose to the heart, anterior myocardial territory, anterior descending artery, and their corresponding PRVs ranged from 9.4 Gy to 11.4 Gy, 11.0 Gy to 17.5 Gy, and 22.6 Gy to 27.8 Gy, respectively. The D2%to CS and its PRV was 24.5 Gy to 36.2 Gy, 28.2 Gy to 38.8Gy, and 36 Gy to 45 Gy. The mean dose and D2%to the coronary arteries, including both left and right main coronary arteries, right marginal artery, and left circumflex artery, were 8.6 Gy to 14.9 Gy and 12.5 Gy to 23.7 Gy, respectively. The difference of the mean dose and D2%to CS and its corresponding PRVs was 2.5%to 12.5%and 8.0%to 43.1%, respectively. Compared with the stan-dard deviation of the radiation dose to CS, majority of the standard deviation to PRVs increased significantly. Conclusion:The radia-tion dose difference between CS and its corresponding PRVs is<12%.

Objective To observe the clinical curative effect of drug combined with psychological treatment on patients with sleep disorders after stroke.Methods A total of 180 cases of eligible patients with sleep disorders were included and randomly di-vided into control group and treatment group.Control group were treated with conventional vascular drug(estazolam,2 mg,before sleep);treatment group increased anxiolytic and sedative hypnotic drugs(venlafaxine,dexzopiclone)compared to control group.Af-ter 14 days,sleep quality,NIHSS were compared both within the treatment group and between the two groups.Results The Bar-thel index,NIHSS and PSQI of two groups had significant differences,and those index of treatment group before and after treat-ment had significant differences too(P <0.05).Conclusion Combined conventional cerebrovascular drugs with Venlafaxine,dexzo-piclone as well as psychological treatment significantly improved sleep quality of patients with acute stroke.

Photobiomodulation therapy (PBMT) is the use of red or near-infrared light to heal, restore, and stimulate physiological processes that repair damage caused by trauma or a disease. PBMT is widely used in sports injuries, arthritis, neuropathic pain, and back and neck pain. In recent years, PBMT is a safe and effective tool for toxic reactions associated with cancer treatment, such as oral mucositis in patients undergoing chemo-radiotherapy for head and neck cancer or stem cell transplantation, radiation-associated dry mouth, taste disorders, radiation dermatitis, post-radiotherapy fibrosis, and lymphedema associated with head and neck cancer and breast cancer. However, the equipment and optimal dosimetric parameters for PBMT have not been fully defined and need to be further explored.

Objective To investigate the expression of anti-apoptosis gene bag-1 and its relation to the differentiation of intrahepatic cholangiocarcinoma (ICC). Methods Immunohistochemical techniques were adopted to study the expression of bag-1 in ICC tissue ( n=48) and para-hepatocarcinoma bile duct ( control group, n=25). Results Expression of bag-1 in the ICC group was significantly higher than that in the control group. In the ICC group (P

Objective To study the toxicity and efficacy of induction chemotherapy followed by concurrent cisplatin chemotherapy and three dimensional conformal radiotherapy (3DCRT) for inoperable locally advanced non-small cell lung cancer (LA-NSCLC). Methods Totally 76 patients with LA-NSCLC received two cycles induction chemotherapy followed by 3DCRT with a median dose of 68 Gy (64 to 74 Gy).During the 3DCRT, cisplatin (25 mg/m2, weekly) was given intravenously for 6-7 times. Results The CR rate, PR rate and overall response rate of induction chemotherapy were 3% ,42% and 45%. After the concurrent chemoradiation, the corresponding figures were 10%, 62% and 72%. The median survival time (MST) and median progression-free survival (PFS) of all patients were 16.6 months and 10.3 months. The 1-, 2- and 3-year overall survival (OS) and PFS rates were 67% , 35% , 21% and 42% , 15%, 6%. Of patients with stage ⅢA and stage ⅢB disease,the MST were 19.7 months and 15.6 months, the PFS were 10.8 months and 9.4 months. The major treatment-related toxicities included radiation esophagitis, radiation pneumonitis, nausea ( or vomiting) and leukopenia. The major pattern of treatment failure was distant metastasis. Forty-five patients (59%) experienced the local recurrence or/and distant metastasis, including 4 (9%) with in-field failure, 38 (84%) distant metastasis and 3 (7%) malignant pleural effusion. Conclusions Induction chemotherapy followed by concurrent weekly cisplatin and 3DCRT for inoperable locally advanced NSCLC results in encouraging outcomes and acceptable tolerance.

The development process of joint kinematics and kinetics is expatiated from the aspects of technology and method. Firstly, the classical mechanics-based methods are introduced. Secondly, the computer assisted methods are analyzed from the technical aspects of video tracking, fluoroscopy and MR imaging separately. Then the assistance of robotic technique in this field is discussed. Finally the potential trend in the joint kinematics and kinetics is concluded.
Biomechanical Phenomena ; Computer Simulation ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Joints ; physiology ; Magnetic Resonance Imaging ; Movement ; physiology ; Range of Motion, Articular ; physiology

Objective: To investigate the expression of BRCA-associated protein 1 (BAP1) in malignant mesothelioma, non-small cell lung cancer and carcinosarcoma, and its application in the differential diagnosis. Methods: Twenty-two cases of malignant mesothelioma including 17 epithelioid type, 2 sarcomatoid type and 3 biphasic type were collected.As the study control, 80 non-small cell lung cancers infringement pleural membrane(including 40 lung adenocarcinomas and 40 lung squamous cell carcinomas) and 15 carcinosarcomas were included. BAP1 expression was detected using immunohistochemical method. A differential diagnosis antibody panel, including calretinin, WT1, CK5/6, D2-40, CAM5.2, CEA, TTF1, Napsin A, p63 and p40 was tested in all cases. Results: All 80 cases of non-small cell lung cancer and 15 cases of carcinosarcoma were BAP1 positive. In contrast, 64% (14/22) of malignant mesotheliomas lost BAP1 expression (P<0.01). Addition of BAP1 to the mesothelioma marker panel, the diagnostic accuracy of malignant mesothelioma was enhanced to 93%. Focal expression of BAP1 in tumors suggested multiclonal evolution of mesothelioma. Conclusions Loss of BAP1 expression helps to confirm the diagnosis of malignant mesothelioma whereas all non-small cell lung cancer expresses BAP1. It is therefore recommended that BAP1 can be used in conjunction with other immunohistochemical markers to improve the diagnostic accuracy of malignant mesothelioma.

Objective:To analyze survival in patients with advanced oral cancer from prospective clinical trials. Methods:From 2008 to 2010, 256 patients with oral cancer at clinical stage III/IVA were randomly categorized into two groups. Patients in the experi-mental group received neo-adjuvant chemotherapy, surgery, and post-operative radiation, and patients in the control group underwent surgery and post-operative radiation. All patients were routinely followed-up after treatments. Survival was analyzed using Kaplan–Meier method and log-rank test, and differences were considered statistically significant at P value lower than 0.05. Results: Each group was composed of 128 patients. With the median follow-up period of 60 months, the 5-year overall survival rate was 61.7%and the disease-free survival rate was 53.9%. The overall survival rate (P=0.350) and the disease-free survival rate (P=0.160) were not sig-nificantly different between the experimental and control groups. Patients with positive pathological response to neo-adjuvant chemo-therapy exhibited significantly improved overall survival (P＜0.05). Conclusion:Radical surgery should be emphasized to improve the prognosis of oral cancer. Functional reconstruction could also improve the quality of life and survival of patients. Despite that neo-adju-vant chemotherapy could not improve the survival of patients with advanced oral cancer in entirety, it could benefit patients exhibiting positive treatment responses.