Objective To analyze the curative effects,late phase reactions and their prognostic factors of nasopharyngeal carcinoma (NPC) treated with radiotherapy.Methods Retrospective analysis was made for 246 cases of NPC which were confirmed by pathological diagnosis and with complete follow-up data in the first affiliated hospital of Soochow university.Kaplan-Meier method was used for analysis of survival rate and the log rank method was used to compare the survival between groups.Cox regression was used for analysing the prognostic factors.Logistic regression was used for analysing the factors which affect the late phase reactions.Results The follow-up rate was 94.6％.The 1-year,3-year,5-year overall survival (OS) were 97.97％,81.82％,67.85％.The 1-year,3-year,5-year progression-free survival (PFS) were 83.33％,70.00％,39.29％ respectively.Age (x2=6.604,P=0.010),T stage (x2 =3.670,P=0.050),N stage (x2=19.658,P =0.001) and the clinical stage (x2 =4.626,P =0.031) were the prognostic factors for the OS.Cox multi-variate analysis showed that the independent prognostic factors for the OS were clinical stage and age.Logistic regression analysis showed that the independent prognostic factors for the late phase reactions were age and rehabilitation time.Conclusion The main factors for the long term survival of NPC patients after radiotherapy are early TNM stage and young age.Patients with younger age and longer rehabilitation time have lower incidence of late phase reactions.

Objective To assess the prevalence of hand hygiene compliance rates of health care workers (HCWs) at general hospitals in China in 2010-2012. Methods Literatures about hand hygiene compliance of HCWs from 2010 to 2012 were retrieved from China Biology Medicine disc (CBM),China National Knowledge Infrastructure (CNKI),Wan Fang database,VIP ,and PubMed database ,Comprehensive Meta Analysis V2 software and Stata 1 2 .0 software were adopted to conduct statistical analysis . Results Ninety literatures were selected with heterogeneity (Q= 48 118.32,P<0.01),random effect model was used. The overall hand hygiene compliance rate of HCWs was 47.83% (95% CI:43.27% -52.42% );When stratified by occupation group,the overall compliance rate of doctors,nur-ses,and unclassified HCWs was 40.36% (95% CI:35.42% -45.49% ),46.70% (95% CI:41.81% -51.65% ),and 40.72% (95% CI:27.75% -55.13% )respectively. According to subgroup analysis,there was no statistical difference in compliance rate between doctors and nurses(Q= 3.12,P>0.05);the compliance rate after patient contact was higher than before patient contact (54.33% [95% CI :44.76% -63.59% ]vs 20.21% [95% CI:14.12% -28.06% ])(Q= 32.59, P<0.01 );hand compliance rate from field observation was higher than from covert observation (70.91% [95% CI :70.71% - 71.10% ]vs 41.20% [95% CI:37.55% -44.94% ])(Q= 247.66,P<0.01).Conclusion The overall hand hygiene compliance rate of HCWs in 2010-2012 was low,in order to reduce the risk of healthcare-associated infec-tion,hand hygiene compliance of HCWs need to be increased .

Objective To investigate the probabilities of brain-derived stem cells from fetal rats differentiating into neurons and astrocytes by velvet antler polypeptide(VAP) in vitro. Methods Neural stem cells from E12-14d rats were cultured for 7 days until neural stem cells (NSCs) aggregations were formed into neurospheres. The neurospheres were cultured at different concentrations of VAP, and immunocytochemistry was used to detect the differentiation of neural stem cells. Results The differentiated cells in 50?g/L VAP group are more than that in control group; the number of NSE positive cells in 50?g/L,100?g/L and 200?g/L groups is more than that in control group.Conclusion Neural stem cells can be successfully induced into neurons by VAP in vitro, which could provide a basis for regeneration of nerve system.;

Objective To investigate the causes and treatment measures of an outbreak of Norwegian scabies oc-curred in a hospital.Methods In May 2013,an outbreak of Norwegian scabies among health care workers(HCWs) occurred because of the misdiagnosis of a patient with Norwegian scabies,epidemiological investigation was carried out by healthcare-associated infection(HAI)control department,medical intervention and disinfection and isolation measures were performed.Results A total of 27 HCWs and patients’relatives developed Norwegian scabies.After active medical treatment,patients’condition improved;all appliances used by patients were cleaned and disinfected after being wrapped and sealed with plastic bags for one week.Epidemic trend of infection was under control and no new case was found.Conclusion With highly contagious,Norwegian scabies can be spread in local area,it is neces-sary to improve HCWs’diagnostic ability to this disease and take effective measures to prevent the epidemic once HAI occur.

Objective To investigate the effect of exercise on the recovery of locomotor and neurological function in rats after incomplete spinal cord injury (SCI). Methods Ninety-five male Sprague Dawley rats were randomly divided into a control group, a training group (including subgroups which received training for 1 week, 2 weeks, 3 weeks and 4 weeks) and a sham operation group. The control and training groups were administered an SCI model at the T_(10) level by extradural compression using a modified Allen's stall with a damage energy of 40 g-cm. These rats were loosely restrained and given partial weight-bearing treadmill training 5min/time, twice a day for 1-4 weeks. Locomotor and neurological function were evaluated with inclined plane tests, modified Tarlov scores, the Basso-Beattie-Bresnahan scale and spinal cord somatosensory evoked potential (SCSEP) before injury and at different time points thereafter. Results Locomotor function improved significantly at different time points during the train-ing, and significantly better than in the control group. In the rats trained for 2-4 weeks, SCSEP latency shortened sig-nificantly compared to the control group. The latency shortened gradually with longer exercise. Conclusions Exer-cise with partial weight support may improve locomotor and neurological function. The improvements are correlated closely with the duration of the training.

Objective:To investigate the clinical effect of botulinumtoxin type A (Botox-A) combined with electromyographic biofeedback therapy on the upper limb muscle spasm after stroke.Methods:86 cases of patients with upper limb muscle spasm after stroke in our hospital from January 2016 to January 2017 were selected and divided into the observation group and the control group,with 43 cases in each group.Patients in the control group were treated with electromyographic biofeedback therapy,and the observation group was treated with Botox-A based on the basis of control group.The improvement of upper limb muscle spasm,Upper limb movement function,the active range of wrist joint and life skills before and after treatment were compared between two groups.Results:After treatment,the total effective rate of improvement of upper limb muscle spasm of observation group were significantly higher than that of the control group (P＜0.05);At 2 weeks and 4 weeks after treatment,the Fugl-Meyer scores,Wrist joint activities,modified Barthel index (MBI) of two groups were significantly higher than those before treatment (P＜0.05),which were significantly higher in the observation group than those of the control group (P＜0.05).Conclusion:Botox-Acombined with electromyographic biofeedback therapy had remarkable clinical effect on the upper limb muscle spasm after stroke,which could effectively reduce the upper limb spasticity,improve the arm and wrist movement ability and the ability of daily life.

Objective To evaluate the value of MRI performance for the differential diagnosis of atypical solitary metastatic malignant melanoma from spinal hemangioma.Methods Thirteen patients of atypical solitary metastatic malignant melanoma and 40 patients of spinal solitary hemangioma were retrospectively analyzed.Conventional MR imaging (T1WI,T2WI,and fat suppressed T2WI) and enhanced imaging were performed at 1.5T MRI.The signal intensities (SIs) of spinal lesions were qualitatively evaluated on conventional imaging and were described as hypointense,isointense,or hyperintense.The spinal lesions were qualitatively categorized into minimal enhancement,iso-enhancement,slightly hyper-enhancement,or strong enhancement on contrast-enhanced imaging.The lesions' maximum diameter was also measured and the mean value was obtained.Results The qualitative assessment of SIs on T1WI showed that 76.92％ (10/13),15.38％ (2/13) and 7.69 ％ (1/13) of atypical solitary metastatic malignant melanoma were hypointensity,isointensity and hyperintensity respectively.The qualitative evaluation of SIs on T2WI were found that 61.54％ (8/13) of atypical solitary metastatic malignant melanoma with hypointense,30.77％ (4/13) with isointensity and 7.69％ (1/13) with hyperintensity,respectively.About 92.31％ (12/13) of atypical solitary metastatic malignant melanoma displayed strong enhancement on contrast-enhanced imaging.There were significant differences in SIs on T1WI,T2WI and contrast-enhanced imaging between atypical solitary metastatic malignant melanoma and hemangioma (all P＜0.05).The maximum diameter of atypical solitary metastatic malignant melanoma was significantly higher than that of spinal hemangioma (P＜0.001).Conclusion MR imaging would be practicable for differentiation between atypical solitary metastatic malignant melanoma and hemangioma in spine.

With the widely development of psychiatric clinical researches,the ethical issue has been concerned gradually.Although the ethical review has strict rules on informed consent,there are many problems and challenges on informed consent implementation because of the special mental illness population.According to the relevant laws and regulations,combined with the characteristics of clinical psychiatric researches,this paper discussed the protection of subjects' fights and interests during the implementation of informed consent in psychiatric clinical researches,from the following aspects:providing a quiet,comfortable,and relatively independent environment for the participants to ensure informed consent,guaranteeing full informed consent time,choosing qualified researchers for informed consent,ensuring the effective process of informed consent,and guiding the subjects to correctly sign their names and the date.

Objective To explore the risk factors for early interhepatic recurrence and metastasis of hepatocellular carcinoma (HCC)on CT imaging before treatment.Methods 1 1 5 patients suffered from HCC from July 2003 to January 2009 were retrospec-tively enrolled for reviewing their clinical characteristics and CT signs.The status of metastasis and/or recurrence was followed reg-ularly.Signs on pre-treatment enhanced CT images were measured and analyzed.Analysis of variance and independent sampler t test were applied for Univariate survival analysis.Then multivariate analysis was carried out by the Logistic regression,Lon rank meth-od,and p-value < 0.05 was defined to be statistically significant.Results The early interhepatic recurrence and metastasis rate of the study group was 58.26%.With univariate analysis,tumor size,location,extent,capsule,satellite nodule,vascular invasion, AVM and necrosis were the risk factors for early recurrence and metastasis of HCC on pre-treatment enhanced CT imaging (P<0.05).Multi-variable Logistic regression analysis showed that tumor size,satellite nodule,vascular invasion capsule and were independently sig-nificant CT signs for early interhepatic recurrence and metastasis of HCC (P =0.031,0.005、0.037、0.048).Conclusion Pre-treat-ment enhanced CT imaging with HCC was closely related to early interhepatic recurrence and metastasis of the tumor.A tumor of larger size,with satellite nodules,without complete capsule and vascular invasion on CT may predict a tendency to early interhepatic recurrence and metastasis of HCC.

Objective To study the early diagnostic value of high-sensitivity cardiac troponin Ⅰ(hs-cTnI) and soluble growth stimulating gene 2 protein (soluble suppression of tumorigenicity 2,sST2) in myocardial injury of acute organophosphorus pesticide poisoning (AOPP).Methods Totally 168 AOPP patients hospitalized from March 2014 to October 2018 were divided into the mild group (n=45),moderate group (n=55) and severe group (n=68).Another 30 healthy persons were served as the control group.The levels of cTnI,hs-cTnI,N-terminal B-type natriuretic peptide(NT-proBNP) and sST2 were detected at 4 h and 12 h after admission.SPSS 21.0 was used for statistical analysis.The measurement data were expressed by mean±standard deviation,two groups were compared by LSD-t test,and the multigroup comparison was made by single factor analysis of variance (ANOVA).The correlation analysis by Spearman correlation test (P＜0.05).Results At 1 h after admission,the hs-cTnI of AOPP patients with different degrees of poisoning was higher than that of control group,and that of severe group was higher than that of mild to moderate group.Comparison between groups was statistically significant (P＜0.05).However,there was no significant difference in the cTnI level (P＞0.05).At 4 h and 12 h after admission,the levels of cTnI and hs-cTnI increased with the increase of poisoning degree and the extension of time,and their level at 12 h after admission were significantly higher than those at 4 h after admission,with statistically significant difference between the two groups (P＜0.05).At 1 h after admission,the level of sST2 in the poisoned patients was higher than that in the control group,and the level in the severe group was higher than that in the mild to moderate groups.At 4 h and 12 h after admission,the level of sST2 was increased significantly,especially in the severe group.The level of sST2 at 12 h after admission was significantly higher than that at 4 h after admission (P＜0.05).The concentration of NT-proBNP was in normal range 1 h after admission,increased gradually at 12 h after admission,and the level of NT-proBNP in the severe group was significantly higher than that in the other groups (P＜0.05),and comparison between the groups was significantly different (P＜0.05).The correlation analysis showed that there was a positive correlation between hs-TnI and sST2 in AOPP patients (r=0.776,P＜0.01).hs-TnI and sST2 was positively correlated with the severity of AOPP (r=0.958,P＜0.01;r=0.844,P＜0.01).That is,the more severe the patient,the higher the concentration of hs-TnI and sST2,and the more serious myocardial injury.Conclusions Early detection ofhs-cTnI and sST2 levels in AOPP patients can identify early myocardial damage and objectively evaluate the extent of myocardial damage.