Objective To compare the dosimetric differences between two plans of RapidArc and 5F-IMRT for breast cancer radiotherapy after breast-conserving surgery.Methods Eight female patients with left-sided breast cancer after breast-conserving surgery were selected.A dose of 50 Gy in 25 fractions was prescribed for plans of RapidArc and 5F-IMRT.Target conformity index (CI),homogeneity index (HI),target coverage,exposure dose volume delivered to organ at risk were compared between two plans.At the same time,treatment delivery time and monitor units (MU) were also compared.Results The target conformity index (CI) in RapidArc plan (·0.88 ±0.03) was higher than that in 5F-IMRT plan (0.79 ±0.02,t =8.28,P ＜ 0.05).The homogeneity index (HI) in RapidArc plan 9.01 ± 0.73 was significantly lower than that in 5F-IMRT plan10.44 ± 1.08 (t =-2.73,P ＜0.05).For the dose volume delivered to the ipsilateral lung in two plans,the values of V10,V20,V30,and Dmean in RapidArc plan were lower than those in 5F-IMRT plan(t =-7.53,-7.20,-8.39,-7.80,P ＜ 0.05).However,the value of V5 in RapidArc plan was higher than that in 5F-IMRT plan (t =5.67,P ＜0.05).For the heart,the values of V5,V10 and Dmean in RapidArc plan were higher than those in IMRT plan(t =10.46,28.76,5.40,P ＜ 0.05),while the value of V30 in RapidArc plan was lower than that in 5F-IMRT plan(t =-6.12,P ＜0.05).The values of V5 in contralateral lung and breast were higher in RapidArc plan than those in 5F-IMRT plan(lung:t =21.50,P ＜0.05;breast:t =5.44,P ＜0.05).The MU in RapidArc plan was decreased by 25％,and the average treatment delivery time was saved by 60％,compared with that of 5F-IMRT plan.Conclusions During breast cancer radiotherapy after breast-conserving surgery,compared with 5F-IMRT plan,the RapidArc plan could improve the target HI,and reduce both the irradiated dose in high-dose volume and MU,and shorten the treatment time,but increased the exposed volume in low-dose volume of normal tissues.

Objective To know the correlation of anxiety and pains of out-patients who had accept-ed operation and the effect of nursing intervention. Methods Divided 173 out-patients with operation in-to the intervention group(83 cases) and the control group(90 cases) randomly. Routine nursing cares was used in the control group, preoperative health education was used in the intervention group in addition. Us-ing the Me-Gill and SF-MPQ to evaluate pains between the 2 groups. Using the S-AI and the T-AI to evaluate the emotional condition between the 2 groups. Results The indexes which can indicated the pains and emotional condition in the intervention group after the health education were significant better than those of in the control group and themselves before the nursing intervention. Conclusions Preoperative pains and emotional condition should be evaluated among out-patients, and then carry out certain counter nursing measures to release patients' pain and negative emotion.

Aim To find the material foundation of treatment for diabetes in Coptidis Rhizoma ( RC ) . Methods The antihyperglycemic effect of RC alka-loids ( berberine, coptisine, palmatine, epiberberine, and jatrorrhizine) was evaluated in spontaneity diabe-tes KK-Ay mice. Results After 40 days′ oral admin-istration ( 225 mg · kg-1 · d-1 , ig ) , berberine and coptisine significantly suppressed the elevated fasting blood glucose level and ameliorated the glucose toler-ance . Body weight gain of KK-Ay mice was significant-ly decreased in the epiberberine-treated group. Berber-ine improved insulin resistance and jatrorrhizine in-creased the SOD activity, decreased the MDA level. Conclusions These results indicate that the main an-tihypoglycemic effect constituents are berberine and coptisine, while they show different mechanisms. Pal-matine, epiberberine and jatrorrhizine display different potential roles in the treatment of diabetes. The meth-ylene-dioxy groups at the C-2 , C-3 , C-9 and C-10 po-sitions are indispensable for antihyperglycemic effect of RC alkaloids.

Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoemblization (TACE) using raltitrexed and lobaplatin in treating advanced hepatocellular carcinoma (HCC).Methods From March 2009 to November 2014,95 cases were treated by raltitrexed combined with lobaplatin (raltitrexed group) through TACE and 124 cases by fluorouracil combined with oxaliplatin (fluorouracil group) through TACE.Disease control rate (DCR),median progression-free survival (mPFS) time and median overall survival (mOS) time were compared between the two groups.Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis in SPSS 16.0.Results The disease control rate of raltitrexed group was 91.6％ (87/95),compared with fluorouracil group of 84.6％ (105/124) in fluorouracil group (x2 =2.505,P =0.474).The mPFS of raltitrexed group was 6.8 months and that of fluorouracil group was 5.9 months (x2 =5.542,P =0.019);mOS of raltitrexed group was 13.6 months and fluorouracil group was 11.4 months (x2 =5.953,P =0.015).The main adverse reactions in the two groups were not statistically significant (P ＞ 0.05).Conclusions TACE using rahitrexed and oxaliplatin prolongs the progression free survival and overall survival time of patients with advanced hepatic carcinoma.

Objective To investigate the current popularity of ERCP training in China.Methods A questionnaire-based survey was performed on a professional survey website.A total of 48 questions were designed,including personal information,training information,current status of ERCP performance and sug-gestions to ERCP training.The questionnaire was completed anonymously by physicians who fulfilled full-time ERCP training in any Chinese endoscopy center for at least 1 year before.Results A total of 464 phy-sicians,from all the regions of mainland China,among which 362 people completed all the questions.More than two thirds trainees thought that they had got fruitful training and 27.4% trainees had their ERCP vol-umes greatly increased and 64.3% trainees increased practice.According to related index,the physicians who were competent in routine ERCP performance were 84.5%,with outstanding operators of 12.2%.Con-clusion China has made great progress in the training program of ERCP technique in recent decades,but problems still remain such as various admission standard,insufficient training duration,incomprehensive program,as well as lack of evaluation and follow-up system.

Objective The incidence of traumatic brain injury (TBI) has been on the rise year by year around the globe.According to the latest Guidelines for the Management of Severe Traumatic Brain Injury (Fourth Edition) released by the Brain Trauma Foundation (BTF),there is no sufficient evidence that related medicine can promote the repairment of neural injury in the treatment of central nerve damage.The clinical treatment of TBI is facing multiple difficulties.In recent years,brain computer interface (BCI) technology has developed rapidly and shown enormous potential in TBI repairment,especially in visual and auditory restoration,neural function recovery,and cognitive restoration.BCI provides a new approach to improve the quality of life for patients.This paper reviews the application and prospect of BCI in sense,motion,and cognitive function repairment after TBI,so as to provide new insights for the treatment of TBI nerve function.

Dermatology ; history ; History, 15th Century ; History, 16th Century ; History, 17th Century ; History, Medieval ; Humans ; Medicine, Chinese Traditional ; history

【Objective】 To explore the effects of insulin on the QT interval and induced arrhythmias of cardiomyocytes derived from human induced pluripotent stem cells （hiPSC-CMs）. 【Methods】 Immunofluorescence staining and flow cytometry were used to analyze the purity of hiPSC-CMs. Microelectrode array （MEA） was utilized to detect the electrophysiological changes including heart rate （HR）， field potential duration （FPD， which is similar to QT interval in ECG）， FPDc （FPD corrected by HR）， conduction velocity （CV）， and spike amplitude before and after insulin treatment. The effects of E4031 on QT interval prolongation and induced arrhythmias of hiPSC-CMs were evaluated before and after treatment with insulin. 【Results】 hiPSC-CMs highly expressed myocardial specific marker cTnT. The purity of hiPSC-CMs was 97.1%. After 5-day insulin treatment of hiPSC-CMs， HR increased by （11.9±3.3）%， FPD shortened by （22.7±2.8）%， FPDc shortened by （15.6±1.6）%， and spike amplitude increased by （39.1±7.9）% when compared with untreated group， but CV remained unchanged. 10 nmol/L of E4031 could prolong the FPDc of hiPSC-CMs by （37.8±9.0）%， and 30 nmol/L of E4031 could induce arrhythmias. After insulin treatment， 10 nmol/L of E4031 prolonged the FPDc of hiPSC-CMs by （21.8±3.1）% （compared with the untreated group， insulin decreased FPDc prolongation by E4031， 37.8%±9.0% vs. 21.8%±3.1%， P<0.05）， while 30 nmol/L of E4031 did not induce arrhythmias. 【Conclusion】 Insulin can shorten the QT interval of hiPSC-CMs and significantly reduce the QT interval prolongation and the risk of arrhythmias induced by drugs.