There is a huge gap in the quality of assistive technology (AT) service between China and the USA. In the USA, the certification of Assistive Technology Professional （ATP） has been used to supervise the development of AT service, while China is at the beginning of AT service. The current situation and the effects about the certification of ATP, how to get the ATP, the requirements someone must have were discussed in the paper.

Objective To discuss and analyze clinical pathological characteristics of senile recurrent ovarian cancer and its influences on prognosis.Methods 140 senile ovarian cancer patients who have been admitted in ourhospital were selected as study subjects.103 cases with recurrent ovarian cancer were selected as observation group (group A),and the rest 37 cases who did not suffer from recurrent ovarian cancer were selected as control group(group B).Pathological characteristics of carcinoma tissues after their first admission in our hospital were compared between the two groups.And pathological characteristics of carcinoma tissues of group A after their second admissionin our hospital were analyzed,comprehensively analyzed prognosis situations and clinical pathological characteristics of patients in these two groups.Results In group A,the number of poorly differentiated carcinoma tissues was obviouslymore than group B,and the number of patients whose neoplasm staging was M stage was more than that in group B,the differences between the two groups were significant (x2 =13.48,15.87,all P ＜ 0.05).The incidence rate of adverse reactions between the two groups also had statistical significance(x2 =13.8,11.6,14.5,13.9,14.9,13.4,all P ＜0.05).Conclusion The clinical pathological characteristics of senile recurrent ovarian cancer can reflect patients'prognosis situations in some degree,and has certain clinical value in evaluation of patients' disease recurrence and prognosis.

Objective:To explore the clinical characteristics and diagnosis and treatment of occult poisoning caused by long-acting anticoagulant rodenticides.Method:Records of 12 patients from July 2008 to April 2011 diagnosed as anticoagulant rodenticide occult poisoning,who had been misdiagnosed initially at other hospitals were analyzed retrospectively.Elements from the records included clinical symptoms and signs,laboratory findings for prothrombin time (PT) and activated partial prothrombin time (APTT),and initial misdiagnosis and treatment outcome at our hospital.Results:The clinical presentations of patients were insidious and serious,often presented as skin ecchymose,hematuria,menorrhagia and gastrointestine bleeding.Laboratory examinations showed prolonged PT and APTT; bleeding was controlled effectively by administoring vitamin K1 daily.There were statistical difference between PT and APTT before and after the treatment (P＜0.01).Conclusion:Coagulation disorders might be caused by the reduced acquisition in vitamin K dependent coagulation factors,which tends to be neglected due to a hidden medical history,delayed signs of poisoning,and various organs involved.A detailed patient history and systematic review may improve the diagnostic accuracy.Once diagnosed is made,vitamin K1 should be given as soon as possible.

0.05). However, the 5-year local control rate appeared significantly different in three groups (?~2=7.239, P0.05). The 1-,3-,and 5-year disease-free survival rate among three groups were significantly different in the three groups (79.1%, 41.9% and 35.6% for CFR group, 85.7%, 57.1% and 38.1% for FHR group, and 95.4%, 62.8% and 58.1% for LAHR group) (?~2=6.60,P0.05). The incidence of loss of hearing, the radiation-induced temporomandibular joint lesion, and the radiation-induced brain injury was 31.3%, 41.9% and 9.3% in CFR group, and 25.0%, 35.7% and 7.1% in FRH group, and 22.7%, 35.7% and 7.0% in LAHR group, respectively. Conclusion A better 5-year local control rate and disease-free survival rate were achieved in patients in LAHR and FHR groups than those in CFR group. There are no differences in the incidence of late complications and overall survival rate among three groups.

Objective To investigate the application value of virtual touch tissue image technology (VTI) and virtual touch tissue quantification technique (VTQ) in the differential diagnosis of benign and malignant superficial lymph nodes. Methods Fifty superficial lymph nodes were obtained, including 23 for nonspecific inflammatory, 2 for tuberculosis, 5 for lymphoma and 20 for metastasis. All lymph nodes were confirmed by biopsy pathology or follow-up after anti-inflammatory treatments and scanned by traditional ultrasound, VTI and VTQ before resections or treatments. Receiver operating characteristic curve of traditional ultrasound, VTI and VTQ was made to determine the optional cut-off point in the differential diagnosis of benign and malignant superficial lymph nodes and calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Final diagnosis was defined as the golden standard. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated by the combined application of traditional ultrasound with VTI and VTQ technology. Results Nine (evaluation value) was taken as the critical value which was scanned by both two-dimensional ultrasound and color Doppler. The ROC curve indicated that the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of conventional two-dimensional ultrasound of benign and malignant lymph nodes were 76.0%, 84.0%, 80.0%, 82.6%, and 77.8%. Taking three (critical value) as the cut-off point, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of VTI in the diagnosis of benign and malignant lymph nodes were 88.0%, 64.0%, 76.0%, 71.0%and 84.2%. Taking 2.755 m/s (shear wave velocity) as the cut-off value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of VTQ in the differentiation of benign and malignant superficial lymph nodes were 80%, 92.0%, 86.0%, 90.9%and 82.1%. Defined“traditional ultrasound +VTI+VTQ series method” as using conventional ultrasound, VTI, VTQ simultaneously, superficial lymph nodes could be diagnosed with malignant or benign if each method confirmed the same diagnosis. Defined“traditional ultrasound+VTI+VTQ parallel method”as using conventional ultrasound, VTI, VTQ simultaneously, superficial lymph nodes could be diagnosed with malignant if any one method indicated malignancy, otherwise benign. Specificity of‘traditional ultrasound+VTI+VTQ series method’ was consistent with VTQ, which was 92.0%, while the sensitivity and accuracy decreased significantly, which was 64.0%and 78.0%, respectively;the sensitivity and negative predictive value increased significantly by using “traditional ultrasound +VTI+VTQ parallel method” when compared with traditional ultrasound, VTI or VTQ, almost near 100%, but declined significantly in specificity and accuracy, which was 64.0%and 82.0%, respectively. Conclusions Traditional ultrasound, VTI and VTQ have certain clinical value for differential diagnosis of benign and malignant superficial lymph nodes. Combined application of traditional ultrasound, VTI and VTQ can improve the accuracy in the diagnosis of benign and malignant lymph nodes effectively.

Objective To decrease radiation induced toxicities especially mucostis in patients with locally advanced nasopharyngeal carcinoma( NPC ) who underwent concurrent radiochemotherapy, the maximum tolerated dose and dose limited toxicities of capecitabine combination with cisplatin were observed. Methods From Aug 2006 to Oct 2007, 24 patients with intensity modulated radiotherapy(IMRT) and concurrent chemotherapy with capecitabine and cisplatin for nasopharyngeal carcinoma(stages Ⅲ-Ⅳ) were enrolled in this study. There were four dose-level groups of Capecitabine[625-1250 mg/(m2 ·d) , d1-14]and fixed cisplatin dose[20 mg/(m ·d) ,d1-5) ]MRI and CT scan were used for evaluation of tumor shrinkage. Treatment related toxicities were evaluated according to the common toxicity criteria( NCI-CTC Version 3.0). Results The acute side-effects include Grade 3 or Grade 4 mucosal toxicity(lasting for at least 5 d) and Grade 3 or Grade 4 non-mucosal toxicity were evaluated. Group 625 mg/m2 and Group 825 mg/m2 had none, Group 1000 mg/m2 had 6 patients and Group 1250 mg/m2 had 3 patients for mucosal toxicity, which were the main dose-limited toxicity and relevant to the dose of capecitabine apparently( P < 0. 05 ). There was also a trend of increase by the dose level of capecitabine for other toxicities. The median follow-up time for all patients was 28. 5 months. The locoregional recurrence occurred in 2 patients and distant metastasis in 2 patients. Two-year overall survival rate and locoregional control rate were 100% and 91.7%, respectively.Complete response and partialresponse were found on MRI or CT scan in patients of 29. 2% at the end of treatment and 83. 3% after three months, respectively. Conclusions The combination regimen of capecitabine and cisplatin is safe and effective according to the preliminary result. Toxicities related to radiochemotherapy for NPC were significantly associated with the dose level of chemotherapy.

Objectives:To investigate the impact of doctor-attacking on medical students’ occupation atti-tude. Methods: We conducted a sample survey towards different major of Wenzhou Medical University by using self - made questionnaire. Reults: The occupation attitude of interviewee is not so bad, the confidence about the occupation is really deep down and the occupational sense of mission worries a lot of people. Doctor-attacking cases damage the honorable sense of occupation, even threatens basic personal security. The spread passive emotion by Network media , as well as the varied choices of occupations, expand the influence of hospital violence. Conclusions: The fre-quent occurrences of doctor-attacking cases weaken the occupational attitude of medical students and became the obstruc-tion to be a doctor,countermeasures should be taken from multiaspect of society,media,schools and teachers through a va-riety of ways.

Objective To observe the clinical efficacy of ZHU Lian's acupuncture activating method with type 1 manipulations in treating hypotonic cerebral palsy.Method Sixty patients with hypotonic cerebral palsy, aged 9-59 months, were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by ZHU Lian's acupuncture activating method with type 1 manipulations, while the control group was intervened by acupoint injection of vitamin B1 and B12. The two groups were treated once a day, 5 sessions as a treatment course. The Gross Motor Function Measure-88 (GMFM-88) was evaluated before the treatment and after 10 treatment courses.Result The GMFM-88 score was significantly changed after the treatment in both groups (P<0.05). After the intervention, the GMFM-88 score in the treatment group was significantly different from that in the control group (P<0.05).Conclusion ZHU Lian's acupuncture activating method is an effective approach in treating hypotonic cerebral palsy.

Objective To explore the expression of ErbB3 in osteosarcoma cell lines Saos-2 and its significance.Methods Real-time quantitative PCR was used to detected ErbB3 mRNA expression in osteosarcoma cell lines Saos-2 and normal human osteoblasts cell lines N704,and Western blotting was used to detected ErbB3 protein expression.Short hairpin RNA was used to construct ErbB3 knockdown cells and the cell count in 0-3 d was detected.The 48 h survival rates of ErbB3 knockdown cells and normal Saos-2 cells were detected in the presence of 0-100 μmol/L paclitaxel.Results Real-time quantitative PCR showed significant enhanced ErbB3 mRNA expression in Saos-2 cells compared with N704 [(4.15 ± 0.04) times,t =7.31,P ＜0.05],and Western blotting showed significant enhanced ErbB3 expression in Saos-2 cells compared with N704.As compared with normal Saos-2 cells,ErbB3 knockdown could reduce the Saos-2 cells proliferation,at the first three days in culture,the Saos-2 cell number of ErbB3 silent was (22.2 ± 2.9) thousand,and the control was (45.8 ± 4.1) thousand,with statistical significance (t =8.23,P ＜ 0.05).Moreover,ErbB3 knockdown could reduce the Saos-2 cells tolerance to paclitaxel,when treated with 20 μmol/L paclitaxel,surviving cells in ErbB3 silent group was (43.2 ± 4.7) ％,and the control was (61.4 ± 5.9) ％,with statistical significance (t =6.74,P ＜ 0.05).Conclusion ErbB3 highly expresses in Saos-2 cells,ErbB3 expression can enhance the proliferation of Saos-2 cells and the tolerance of Saos-2 cells to paclitaxel.

Objective To explore the enhancement effects and mechanisms of IL-32β on human cervical carcinoma cells C33A to hypoxic/hypoglycemic condition.Methods After cultured in hypoxia/hypoglycemic circumstance and normal circumstance for 20 hours respectively, the mRNA and protein expression of IL-32β in C33A cells were detected by real time-polymerase chain reaction (RT-PCR) and Western blotting respectively.Trypan blue stain was used to detect C33A cells viability in hypoxia/hypoglycemic circumstance and adding 10, 100,500 ng/ml IL-32β circumstance.The xenografted tumor of nude mice was established by intraperitoneal injection, and their volumes were tested for a given time after injecting 0, 1.0 mg/kg IL-32β.siRNA was used to construct IL-32β knockdown cells and detect the expression of VEGF.Results Under the hypoxia/hypoglycemic circumstance, the expressions of IL-32β mRNA were (6.12 ± 0.03) times of the normal circumstance (F =43.16, P ＜ 0.05), the expressions of IL-32β protein were (2.23 ± 0.04) times of the normal circumstance (F =22.32, P ＜ 0.05).The C33A cells viability in hypoxia/hypoglycemic circumstance was (51.92 ± 3.41) ％, whereas, viability in 10 ng/ml IL-32β group was (55.23 ± 3.92) ％ (F =14.25, P ＜ 0.05), viability in 100 ng/ml IL-32β group was (62.52 ± 4.14) ％ (F =35.53, P ＜ 0.01), viability in 500 ng/ml IL-32β group was (69.14 ± 2.45) ％ (F =56.28, P ＜ 0.01).After 28 days, the volume of xenografted tumor of 0 mg/kg IL-32β group was (578 ± 64)mm3, and 1.0 mg/kg IL-32β group up to (1 402 ± 142) mm3 (F =27.84, P ＜ 0.01).In addition, compared with control group, the expression of VEGF in IL-32β knockdown C33A cells was significantly decreased (F =36.85, P ＜ 0.05).Conclusion IL-32β can enhance the resistance to hypoxic/hypoglycemic condition of C33A cells, which is associated with the increase of VEGF.