Target volume definition is one of the important factors in precise radiotherapy of esophageal carcinoma.However,there is considerable controversy about delineation of esophageal carcinoma clinical target volume (CTV),and no consistent standard.Recent researches show that pathological characteristics,imaging methods and lymph node metastasis pattern may have guiding functions for CTV delineation.Novel delineation technique such as individual design has been a research hotspot.

The health care alliance in county was the vertical integration of medical service system,which was conductive to improve the overall efficiency of the county medical service,achieve tiered health care system,optimize regional health resources and enhance the capacity of primary health care services.It took Tianchang County,Anhui as a case study.It investigated and analyzed how the local took measures to carry out the health care alliance reform in organization structure,interest distribution,health human resources construction,information construction,division and coordination mechanism,medical service pattern,etc.,so as to provide references for implementing county medical alliance reform in other regions.

Objective To analyse the clinical characteristics,gene mutation and enzymatic activity of αgalactosidase A(α-GalA)in a 15-year-old male patient with typical Fabry disease,whose mother was without any clinical manifestations.Methods Clinical features and laboratory data were collected from the patient and his mother.Genomie DNA was extracted from peripheral blood of the patient.his mother,and a healthy control subject.Seven exons of the GLA gene were amplified by PCR.PCR products were purified.cloned into T vector,and then sequenced.The enzymatic activity of α-GalA Was measured by fluorimetrie substrate assay. Results DNA sequencing results showed that a missense mutation of 10036-10038delAAG in exon 7 WaS identified in the patient,resulting in the replacement of 374 lysine and 375 glyeine by arginine,which Was not previously reported.The patient Was a hemizygote with gene mutation,his mother WaS a heterozygote carrying gene mutation,and the healthy control without mutation.α-GalA enzymatic activity assay showed that the enzymatic activity of the patient with GLA gene mutation was only 50%of the healthy control subject,while the enzymatic activity of the patient's mother Was about 70%of the heahhy control SObject.Conclusiolls Detecting GLA gene mutation and α-GalA enzymatic activity in patients with Fabry disease who have been clinically diagnosed seelns to be helpful in finding other patients in the family and in further understanding the molecular pathogenesis of that disease.

Objective To explore the relationship between self-control ability and physical and mental health of the elderly people in nursing home.Methods 183 elderly people from three nursing homes were investigated using self control measurement method of dual system scale and World Health Survey.The individuals were divided into high control low impulsiveness group(n=51),high control high impulsiveness group(n=36),low control low impulsiveness group(n=27) and low control impulse group(n=69).Results The total score of physical and mental health for elderly people in nursing homes was.(1.76±0.46),while the scores of body health,mental health and overall self evaluation were (1.84± 0.56),(1.66± 0.42) and (2.93±0.72).The scores of physical health and mental health for elderly people in nursing homes of impulse and control system for elderly people in nursing homes were (2.98 ± 0.63) and (3.35 ± 0.59).The scores of physical health (r=0.15),mental health (r=0.29) and overall self evaluation (r=0.31) were positively correlated with impulse system,and negatively correlated with control system (r=-0.26,-0.33,-0.34,P＜0.05).The scores of physical health,mental health and overall self evaluation in four groups were significantly different (F=12.39,33.82,21.50,P＜0.01).Conclusion The physical and mental health of the elderly people in nursing home is correlated with self-control ability.

BACKGROUND: Disease pathogenic factors are complicated. There is not an effective method to analyze large sample data mining, and application ability of information technology of clinical doctors needs to be improved. OBJECTIVE: Using BP algorithm of artificial neural network to analyze large sample clinical cases, in order to explore inner relations between disease pathogenic factors and diseases.METHODS: Take hypertension for example, medical data of patients with hypertension in a traditional Chinese medical hospital served as experimental data, and the influence factors of the disease were simulated with Microsoft SQL Server 2005 Analysis Services, the mining data was analyzed, and a single query was used as prediction and decision support.RESULTS AND CONCLUSION: Analysis of effect of disease pathogenic factors on disease itself based on artificial neural network with BP algorithm has good predictive effect in clinical diagnosis, which is of benefit to enhance the diagnostic efficiency of medical personnel using information technology.

Objective To prepare metformin hydrochloride pellets with centrifugal granulator by powder layering technique. Methods Metformin hydrochloride and MCC pellets were prepared by means of powder layering with the centrifugal granulation equipment and evaluated by yield percentage,angle of repose,bulk density,and friability. Results The preparation process parameters were optimized as follows: the ratio of metformin hydrochloride and lactose and MCC was 100∶5∶3,150 r/min rotating speed of the centrifugal granulation,20 r/min spraying serosity speed,25 r/min purveying powder speed,and the time of spheronization was 6 min.Metformin hydrochlorid pellets were prepared under the condition. Conclution The metformin hydrochloride pellets had good appearance,uniform granulation diameter,standard rigidity,good fluidity and did not have the structure of cage by means of detecting dissolubility.

OBJECTIVE: To establish a method for analysis of proteome of human peripheral leukocytes and to explore the difference between the healthy volunteers and patients with acute lymphocyte leukemia(ALL) in leukocyte proteomics and to study the ALL-related abnormal proteins.METHODS: Peripheral blood samples taken from 10 healthy volunteers and 10 ALL patients were separated for the extraction of leukocyte proteins.The leukocyte proteins were separated by two-dimensional electrophoresis(2-DE).2-DE patterns were analyzed by PDQuest 2D software and the differentially expressed proteins were identified by matrix assisted laser desorption ionization-time of flight-mass spectrometer(MALDITOF-MS) and bioinformatics.RESULTS: The 2-DE patterns of peripheral blood leucocytes from patients with ALL versus those from healthy volunteers were analyzed by PDQuest 2D software and the differentially expressed proteins identified by matrix assisted laser desorption ionization-time of flight-mass spectrometer(MALDI-TOF-MS) were confirmed to beALL-related proteins: AnnexinA5 and cytoskeleton 14 etc.CONCLUSION: Using MALDI-TOF-MS and bioinformatics,the AnnexinA5 and cytoskeleton 14 proteins had been proved to be of close relationship with ALL.The results provided a satisfactory basis for the searching for treatment targets and the molecular targets for the early diagnosis of ALL.

Objective To study the expression of STK15 in the young patients with esophageal carcinoma and gastric cardia adenocarcinoma in Henan Province, Northern China and to further understand the mechanism of esophageal and gastric cardia carcinogenesis. Methods STK15 expression was detected by immunohistochemical method (ABC) in 54 SCC and 43 GCA patients. Results The positive rate of STK15 in SCC (39% , 21/54) was lower than that in GCA (63 % , 27/43 ), and the difference was significant (P

ObjectivesTo explore the clinical significance of tyrosine kinase receptor RON mRNA expression and it's splicing variant in bladder tumors. Methods Sixty-three cases of transitional cell carcinoma of the bladder (TCCB), including 30 cases of pathological grade I , 15 cases of pathological grade Ⅱ and 18 cases of pathological grade Ⅲ (44 cases of clinical stage Tis + T1, 15 cases of T2 + T3 +T4), 7 inverted papilloma of the bladder ( IPB), 9 cases of papillary urothelial neoplasm of low malignant potential (PUNLMP) and 12 cases of normalbladder mucosa RT-PCR was employed with the internal standard (GAPDHmRNA) to detect the expression of RON mRNA. PCR and direct sequencing was then utilized to identify the potential RON mRNA splicing variants. Finally, the variants' positive rates of expression were analyzed among the different tissues, diverse TCCB pathological grades and clinical stages. ResultsThe expression levels of RON mRNA/GAPDH mRNA among TCCB, IPB, PUNLMP and normal control were 4. 9 × 10-3 ( 1. 8 × 10-3-1.0 × 10-2 ), 3. 8 × 10-3 (2. 4 × 10-3-1.7 × 10-2 ), 4. 9 ×10 -3 ( 1.7 × 10 -3-1.1 × 10 -2 ) and 1.0 × 10-3 (4. 5 × 10-4-2. 8 × 10-3 ) respectively. The difference had a statistical significance (x2K-W = 17. 278 ,P ＜0. 05 ). The expression levels among pathological grade I, Ⅱ andⅢ were 3.7 × 10-3( 1.3 × 10-3-7.5 × 10-3) , 4. 9 × 10-3(1.9 × 10-3-1.1 × 10-2) and 8.9 × 10-3(2. 7 ×10 -3-8.0 × 10 -2 ) respectively. The erpression levels among the clinical stage Tis + T1 and T2 + T3 + T4were 3.5 × 10-3 ( 1.2 × 10 -3-7. 7 × 10-3 ) and 9. 7 × 10 -3 ( 2. 9 × 10-3-5. 3 × 10-2 ). The differences between expression levels were of statistical significance among the different pathological grades ( x2k-W =7. 341, P ＜0. 05 ) and clinical stages ( Z = - 2. 306, P ＜ 0. 05 ). The positive rates of exon 11deletion(E11△) in TCCB, IPB and PUNLMP were 71％ (45/63), 57％ (4/7) and 67％ (6/9) respectively, andthe total positive rate in bladder tumor tissues was 70％. Meanwhile, expression of the novel RON variant wesnot detected in the normalbladder mucosa. The positive expression rate of E1 1△ has no significant correlationamong the different clinical pathological tissues (x2 = 0. 620, P ＞ 0. 05 ). There was no statistical significancein expression positive rate between different pathological grades ( Z =0. 221, P ＞0. 05 ) and clinical stages( Z = 0. 538, P ＞ 0. 05) as well. A novel RON splice variant, deletion of RON exon 11 3 476 - 3 539 ( E3476 -3539△) was fond in the pathological tissue. The positive expression rates of E3 476 -3 539 in TCCB,IPB and PUNLMP were 57％ (36/63), 43％ (3/7) and 56％ (5/9) respectively, and the total positive expression rate was 56％ (44/79). The positive rates of E3 476 -3 539△ in pathological grade I , Ⅱ and Ⅲ were 40％ ( 12/30), 67％ (10/15) and 78％ (14/18), and it's positive rates in clinical stage Tis +T1and T2 +T3 + T4 were 48％ (21/44) and 80％ (12/15). The differences in each group had significantly statistical significance ( Z = 7. 285, 5. 041, P ＜ 0. 05 ) . However, the positive rates amongdifferent pathological tissues had no significance (x2 = 0. 517, P ＞ 0. 05 ). Conclusions The expression level of RON mRNA is significantly associated with histological grading and clinical stage. RON may play an important role in the progression ofTCCB. Compared with the normal control, the increased RON variant expression may contribute to the carcinogenesis of the bladder tumor.