OBJECTIVE: To analyze the relationship between female resting energy expenditure and obesity-related indicators, and to compare the differences of resting energy expenditure and resting energy expenditure per kilogrem between obese women and normal weight women.METHODS: A total of 565 healthy women who did medical examination or visited Department of Endocrinology in Beijing Obstetrics and Gynecology Hospital between 2004 and 2008 were recruited, their height and weight were measured. Human metabolic apparatus was used to measure resting energy expenditure, then body surface area, body mass index, resting energy expenditure per kilogram were calculated. According to the diagnostic cdtada of obesity by body mass index, the 565 cases were divided into two groups: obese group (n=179) and normal body weight group (n=240), and all the measurement results were calculated and did the tests of normality, correlation analysis and two independent samples rank sum test or t test. RESULTS: The resting energy expenditure of 565 healthy women were normality, the result was (5.793±0.940) k J/d, and resting energy expenditure showed a positive correlation with body weight, height, body mass index and body surface area (P < 0.05), while showed no significant correlation with age (P > 0.05), there was no significant difference of age end height between obese group and normal body weight group (P > 0.05), while a statistical significant difference was found in resting energy expenditure and resting energy expenditure per kilogram between obese group and normal body weight group (P > 0.05).CONCLUSION: There is a positive correlation that female resting energy expenditure with their height, weight, body mass index and body surface area, and the resting energy expenditure of obese women is higher than that of normal body weight women, while resting energy expenditure per kilogram of obese women is lower than that of normal body weight women.

BACKGROUND:Many present studies have reported the early clinical therapeutic effects of short-segment non-fusion fixation for the repair of thoracolumbar burst fracture. The results are satisfactory. However, the mid-and long-term fol ow-up results of this scheme for treating thoracolumbar burst fracture are seldom reported. ＜br> OBJECTIVE:To evaluate the mid-term results of short segment pedicle screw fixation without bone fusion for unstable thoracolumbar burst fracture. ＜br> METHODS:Data of 12 patients with unstable thoracolumbar burst fractures undergoing short segment pedicle screw fixation without bone fusion were retrospectively analyzed. Al patients experienced severe intraspinal occupying and neurological dysfunction, and al of them affected single segment thoracolumbar injuries. The surgical procedure included postural reduction for 2 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants at 12 months after the initial operation. Imaging and clinical findings, including canal encroachment, percentage of vertebral body height loss, Cobb angle, American Spinal Injury Association motor score, Frankel grade and adjacent segment degenemtion, were evaluated. ＜br> RESULTS AND CONCLUSION:Al patients were fol owed up for at least 5 years. Significant differences in canal encroachment, percentage of vertebral body height loss and Cobb angle were detectable between post-fixation and pre-fixation (P＜0.05). Evaluation results were significantly better after fixation than that before fixation, but no significant difference in evaluation results after fixation was detected (P>0.05). After implantation and removal of fixator, none cases affected aggravated symptoms of neurological impairment. American Spinal Injury Association motor score was 34.2±6.3 before fixation, and 47.7±9.5 during the final fol ow-up, showing significant differences (t=-4.103, P=0.000). During the final fol ow-up, adjacent segments in damage levels did not suffer from degeneration in al patients. Neurological function showed the recovery of Frankel grades 1 or 2. These data indicated that a good mid-term result of short segment pedicle screw fixation without bone fusion for unstable thoracolumbar burst fracture with neurological deficit can be achieved. The improved saggital alignment was effectively constructed and maintained. Adjacent segment degeneration was not found at the injury level.

Objective To investigate the set-up errors of super and middle part of esophageal cancer patients using cone-beam CT (CBCT) during intensity modulated radiotherapy (IMRT),hence determine various margins from CTV to PTV.The corresponding influence on the normal tissues (lung and spinal cord) was also discussed.Methods From December 2012 to December 2013,12 patients with upper and middle segment of esophageal cancer were chosen.Using their 60 sets of weekly acquired CBCT images prior to the treatment,the lateral,longitudinal,and vertical set-up errors of each patient were obtained.Based on these measured errors and the target motions,we adopted new margins to create new PTV.Then IMRT plans were created for the original PTV (5 mm margin in all directions on CTV) and new PTV respectively.On condition of the same target coverage (V95 ≥ 95％),the doses to lungs (V5,V20,V30,D) and spinal cord (D1 cm3) were compared statistically between the original and new plans.Results According to the 60 CBCT scans,the average left-right (RL),superior-inferior (SI),anterior-posterior (AP) set-up errors were (2.02 ± 1.74),(2.03 ± 1.93),and (2.02 ± 1.89) mm respectively.The margins were 5.6 mm (RL),8.5 mm (SI),and 4.7 mm (AP) for the upper esophagus and 6.2 mm (RL),11 mm (SI),and 5.0 mm (AP) for the middle esophagus.Comparison of both lungs and spinal cord suggested significant differences between the two plans (t =-8.23,-5.55,-4.66,-6.87,-4.67,P ＜0.05).Conclusions The margins from CTV to PTV should be created via CBCT-measured set-up errors and previous reports,which can be helpful for clinical treatment.

By discussing the importance of emotional education, the paper points out the existing problems of emotional education in nursing teaching as followings:the lack of teachers′emotional education awareness, the im-balance of cognitive development of nursing students and the lack of professional ideological education. Aiming at the above problems, this paper puts forward these specific countermeasures: strengthening the teachers′ emotional accomplishment so as to enhance their emotional education awareness and building a relaxed and pleasant diversi-fied educational environment so as to strengthen the professional thinking.

Purpose:To investigate genetically a diagnostic method of occult metastasis of lymph node in patients with squamous cell carcinoma of the esophagus.Methods:Using assays of reverse transcriptase polymerase chain reaction technique (RT PCR), MUC1 gene mRNA in thirty negative and thirty positive control lymph nodes was detected to evaluate diagnostic sensitivity and specificity. Eighty seven negative regional lymph nodes by conventional histologic examination (pN 0 ) from thirty patients with esophageal carcinoma were studied to detect MUC1 gene mRNA to diagnose lymph node occult metastasis.Results:MUC1 mRNA was not identified in any specimen of negative control group (specificity =100%); MUC1 mRNA was identified in twenty five of positive control specimen (sensitivity =83%). MUC1mRNA was identified in nine lymph nodes (10.3%) from eight patients with pN 0 esophageal carcinoma. Conclusions: Nodal occult metastasis could be diagnosed by the detection of expression of MUC1mRNA of lymph node in patients with pN 0 esophageal carcinoma.

Purpose:To investigate the correlation between early postoperative metastasis with occult micrometastasis of mediastinal lymph nodes in patients with stageⅠa non small cell lung carcinoma (NSCLC).Methods:Using RT PCR assay, detection of the expression of MUC1 mRNA was used to diagnose occult micrometastasis in mediastinal lymph nodes. All the patients underwent checked up at least once a year to detect early metastatic lesions after surgery, by means of CT scan of chest and brain, ultrasound examination of liver and adrenal glands, and bone scanning. The patients with and without occult nodal micrometastasis were divided into two different groups. Difference in early metastatic rate between two groups of patients was compared by ? 2 test, and odds ratio (OR) was calculated.Results:Occult nodal micrometastasis was diagnosed in sixteen patients (32.0%). Early metastatic rate (31.25%) in the patients with occult nodal micrometastasis was higher than that (5.88%) in the patients without occult nodal micrometastasis ( P

Objective To investigate the expression of chemokine receptor CCR7 and its correlation with lymph node metastasis and prognosis in esophageal cancer after esophagectomy. Methods One hundred and eighty-four patients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients underwent operation in Provincial Hospital Affiliated to Shandong University between June, 2003 and June, 2005. The expression of CCR7 was detected by immunohistochemistry. All statistic analyses were performed with SPSS 13.0 statistical software. According to the clinico-patho-logic factors, the difference of CCR7 expression was compared by x2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The expression rate of CCR7 in stage Ⅰ , stage Ⅱ and stage Ⅲ patients was 25.0 % , 70.3% and 85.5% , respectively. The difference of CCR7 expression between stage Ⅱ and stageⅢ was statistically significant (x2 =5.0, P =0.02). The CCR7 expression rate in T1, T2 and T3 patients was 33.3% , 64.9% and 80.9% , respectively. The difference of CCR7 expression between T2and T3 was statistically significant (x2 =5.4, P =0.01). The level of expression of CCR7 in patients with lymph node metastasis was significantly higher than those without metastasis (x2 =10.8, P = 0.00). The 5-year survival rate instage Ⅰ , stage Ⅱand stage Ⅲ patients was 100.0% , 38. 3% and 22.4% , respectively. The 5-year survival rate in patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression (x2 = 23.7, P = 0.00). The 5-year survival rate in T2, T3, NO and N1 patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression The result of Cox analysis demonstrated that T , N and CCR7 overexpression were independent prognostic factors. Conclusion CCR7 expression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage,N stage and lymph node metastasis. The patients with CCR7 expression was significantly lower the 5-year survival rate than without CCR7 expression. T stage, lymph node metastasis and CCR7 expression were independent prognostic factors.

Objective To evaluate the absorbed doses of lower-neck and supraclaviclar subclinical target and the normal tissues of nasopharyngeal carcinoma using three different intensity-modulated radiation therapy (IMRT) techniques. Methods Three radiotherapy techniques were single tangential low neck-supraclavicular field technique (tech1), seven portal IMRT in which the gantry angles are 180°, 150°, 120°, 90°, 270°, 210°(tech2) and 240°and eight portal IMRT in which the gantry angles are 180°, 150°, 120°,90°,0°,270°,210°and 240°(tech3). The dose distribution of lower-neck and supraclaviclar subclinical target and normal tissues were analyzed through the dose-volume histograms, high dose volumes were analyzed using V60 (volume of accepted > 60 Gy/all volume × 100%). The delivery efficiencies were evaluated by means of the total number of segments and MUs. Results The V60 of PTV2 were 65%, 10% and 3% in tech1, tech2 and teeh3 respectively. The maximum doses of spinal cord were 42.0, 48.9 and 45.1 Gy in techl, tech2 and tech3 respectively. The average doses of trachea were 32.92, 52.17 and 36.56 Gy in techl, tech2 and tech3 respectively. Conclusions Tech1 is simple method, but the dose distribution is very nonuniform. Tech2 is better than the Tech1, but the spinal cord and trachea receive the highest doses in three strategies. Tech3 uses less number of segments and MUs than Tech2, and has the best dose distribution.

Objective To investigate the risk factors with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy. Methods The subjects were 82 patients with pN0 esophageal cancer who underwent Ivor-Lewis esophagectomy from January 2001 to January 2005. By using RT-PCR, VEGF-C mRNA was detected in tumor issues, and Mucin l( MUC1 )mRNA was detected in lymph nodes. The Kaplan-Meier method was used to calculate the survival rate and lymph nodal metastatic rate. Log-rank test was performed to compare the recurrence rate, and Cox regression multivariate analysis was performed to determine independent prognostic factors. Results VEGF-C mRNA was identified in 42 patients (51.22%), and MUC1 mRNA was identified in 23 patients(28.05% )from at least 1 lymph node station . The diagnosis of lymph node micrometastasis (LNMM) was based on the detection of MUC1 mRNA. The first recurrence exhibiting lymph node metastasis was recognized in 37 patients (45.1%) at the first 3 years after operation and this was significantly associated with T status ( P ＜ 0. 05 ). Lymph node metastatic rate for patients with VEGF-C mRNA expression in tumor issues was significantly higher than that for patients without VEGF-C mRNA expression( P ＜0. 01 ). And lymph node metastatic rate for patients with LNMM was significantly higher than that for patients without LNMM ( P ＜0. 01 ). The results of multivariate analysis confirmed that T status, VEGF-C mRNA expression in tumor issues and LNMM were independent relevant factors. Conclusion Status,VEGF-C mRNA expression in tumor issues and LNMM in patients with N0 esophageal cancer were independent risk factors for 3-year lymph node metastatic recurrence after Ivor-Lewis Esophagectomy.

Objective To investigate the expression of MTA1 protein and its relationship to the prognosis in esophageal cancer after esophagectomy. Methods One hundred and sixty-five patients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients underwent operation in Provincial Hospital Affiliated to Shandong University between January 2002 and January 2004. The expression of MTA1 protein was detected by immunohistochemistry. All statistic analyses were performed with SPSS 10.0 statistical software. According to the clinicopathologic factors, the difference of MTA1 protein expression was compared by x2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The 5-year survival rate in Ⅰ stage,Ⅱ stage and Ⅲstage was separately 100.0% 、38.3% and 22.4%, and the MTA1 protein expression rate in Ⅰ stage, Ⅱ stage and Ⅲ stage was separately 25.0% 、30.9% and 57.9%, the difference of MTA1 protein expression between Ⅱ stage and Ⅲ stage was statistically significant ( x2 = 11.6, P = 0. 00). The MTA1 protein expression rate in T1 stage, T2 stage and T3 stage was separately 42.9% 、13.3% and 50%. MTA1 protein expression rate in T2 stage patients and T3 stage patients was separately 13.3% and 50%, the difference of MTA1 protein expression between them was statistically significant (x2 = 13.2, P =0.00). The positive expression of MTA1 protein in patients with lymph node metastasis was significantly higher than those without metastasis ( x2 = 8.2, P = 0.04). The 5-year survival rate in patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression (P =0.00 ), and the 5-year survival rate in T3 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression ( P =0.01 ), and the 5-year survival rate in N0 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression (P = 0.03 ), and the 5-year survival rate in N1 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression ( P =0.04). However, the 5-year survival rate in T2 stage patients with MTA1 protein positive expression was not significantly lower than those without MTA1 protein positive expression (P =0.20). The result of Cox analysis demonstrated that N stage and MTA1 protein positive expression were independent prognostic factors. Conclusion MTA1 protein overexpression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage and lymph node metastasis. The patients with MTA1 protein overexpression was significantly lower the 5-year survival rate than without MTA1 protein expression. Lymph node metastasis and MTA1 protein overexpression were independent prognostic factors.