Upon the previous studies on the effect of spinal cord repair kinetics, we report the effect of extending the irradiation schedules to 3 treatment day per week. The animals in the experimental group received a pair of 2Gy fraction every other day separated by intervals (day/overnight) of 6h/42h and 8h/40h, respectively. There was significant shift by increasing interfraction intervals from 6/18h and 8/16h to6h/42h and 8h/40h, respectively. It is suggested that the tolerance of spinal cord is reduced while the overnight intervals are shortened from 42h and 40h to 18h and 16h, respectively and the repair of sublethal damage of spinal cord following multifraction treatment per day used in the clinic is not completed. With biexponential model, the ?/? ratio derived from these pooled data was 2.2Gy. T 1/2 values from spinal cord were obtained as 1.3h and 5.5h. It showed that the repair kinetics parameters are in well agreement with the results from the previous work. The repair processes are not influenced by interruption during radiotherapy.

The biology rationale for radiotherapy in the treatment of malignant disease is based on repair, repopulation,reoxygenation and cell cycle redistribution. Various aspects of the roles of the 4R' are discussed, including in determining the sensitivity of tumors and normal tissue tolerances. An improvement in therapeutic ratio may derive from reducing the dose per fraction and minimizing the overall treatmemt duration. Some methods have developed to predict the response of normal and tumor tissues before radiotherapy. The parameters of cell survival at 2Gy(SF2) was correlated with clinical outcome. There is reasons to suppose that the pretreatment tumor LI and Tpot mat be good predictors for tumor repopulation kinetics. This review also discussed the rationale for the use of LQ model in fractionated radiotherapy.

Objective To correctly apply the Capability Maturity Model Integration(CMMI) model to the development process of medical device software,thus optimizing and improving the development process and enhancing the software process capability.Methods The matching between CMMI and IEC62304 was analyzed.The compatibility on application was investigated by taking risk management(the core process) as an example.Results The interface between CMMI and IEC62304 was discovered as well as their optimized process in risk management.Conclusion The process of medical device software development not only can be improved by CMMI model,but also should be.

Pancreatic abscess(PA)is the most serious complication of severe acute pancreatitis(SAP),which can lead to systemic and/ or local complications,and even death. PA cannot be resolved automatically after the formation. Once diagnosed,early drainage,anti-infection and nutrition support should be undertaken,the most important is early drainage. In the past,the treatment of PA was mainly based on surgical treatment. With the development of minimally invasive techniques,endoscopic ultrasound(EUS)guided drainage and percutaneous catheter drainage(PCD)offer a new way for the treatment of PA. Preventing and early diagnosis of PA become a challenge in the treatment of SAP. This article reviewed the progress in diagnosis and treatment of SAP complicated with PA.

ObjectiveTo discuss the feasibility and effect of clinical application of the single-bag and double-chamber anus tube.MethodsPatients who needed retention enema and non-retention enema(80 cases) were divided into 2 groups with 40 cases in each group.The test group was given enema by single-bag and double-chamber anus tube.The control group was given enema by traditional rubber anus tube.The reaction and clinical effect were compared between the two groups.ResultsIn the test group,pain and malaise lessened,intestinal cleaning was good,enema liquid reservation prolonged,the satisfaction degree of patients improved,compared with that of the control group (P<0.01).ConclusionsClinical application of self-made single-bag and double-chamber anus tube can give lesser pain and better effect of patients,and it improved satisfaction degree of patients and efficiency of nursing work greatly.

The paper reviewed basic concepts of corporate governance.Based on these concepts,the authors proposed the general strategy and practices for introducing corporate governance structure at the hospital,and stated key characteristics of such a structural reform,thus making worthwhile attempts to this direction.

Objective The purpose of this study is to evaluate the relationship between different types of partial laryngectomy and post-operative voice quality by investigating the preserved voice function and its change after the surgery.Methods The computer multimedia program of Dr.Speech science for Windows was used to obtain the acoustic parameters from 30 normal adults and 55 patients operated 5 years ago with partial laryngectomy: 20 cases of horizontal partial laryngectomy,18 cases of vertical partial laryngectomy,and 17 cases of extended partial laryngectomy.Within 5 years after operation,F0,jitter,shimmer,NNE,F1 and F2 were measured several times and were compared.Results For the patients the fundamental frequency was lower and jitters,shimmer,NNE were higher compared to the control group.The parameters of jitter,shimmer and NNE of patients with supraglottic horizontal laryngectomy were the lowest while for those with vertical partial laryngectomy they were the highest.Compared were the formant frequencies(F1)of vowels /a:/,/i:/,/u:/ in group supraglottic horizontal laryngectomy and the normal gruop.The former was significantly higher.Conclusion Close relationships were noted in the different surgery methods and the voice qualities after partial laryngectomy.The voice functions of horizontal partial laryngectomy were the best while vertical partial laryngectomy the worst.The acoustic analysis can be used to assess the postoperative voice quality,and the data can guide the rehabilitation and training in terms of the improvement of their quality of life(QOL) after surgery.

Objective To introduce the development of an adjustable and bed- type table for pleural puncture and observe its clinical effect. Methods 100 patients who were to undergo pleural puncture were divided into the experimental group and the control group with 50 cases in each group.The experimen-tal group adopted the adjustable and bed-type table for pleural puncture, while the control group used the conventional method.The pulse,respiration and artery blood oxygen saturation degree were observed. The ef-feet of puncture was also compared. Results The pulse and respiration increased and the artery blood oxygen saturation degree decreased after puncture,which were significantly different between the two groups. One- time success rate of puncture,comfort degree and satisfaction degree of patients in the experimental group were better than those of the control group. Conclusions Adjustable and bed- type table for pleu-ral puncture can reduce the uncomfort of patients and increase the success rate of puncture and satisfaction degree of patients.

Background and purpose:Radical cystectomy is viewed as the standard treatment for bladder carcinoma,but organ preservation has been attempted for patients with muscle-invasive bladder carcinoma over the past decades as an alternative to radical cystectomy.The majority of studies included transurethral resection of bladder tumor(TURB),radiotherapy,and chemotherapy,as a feasible and safe organ-sparing approach with the similar outcome to radical cystectomy.The current study evaluated the outcomes and complications of the radiation therapy for the patients with bladder cancer,and prognosis factors had been analyzed.Methods:We retrospectively analyzed 21 patients with bladder cancer.The clinical stages of the patients were 15 with T_2;5 with T_3 and 2 with T_4.2 of them were lymph node-positive,16 of patients were pathologically proved as transitional cell carcinoma,4 as adenocarcinoma and 1 as transitional cell carcinoma plus squamous cell carcinoma.Conventional fractionation radiotherapy was given at a median dose of 54.5Gy(ranged 49.2-69.9 Gy) after surgery.Kaplan-Meier method and Logrank method were used for the statistical analysis.Results:Median follow-up was 32 months.The overall survivals at 1 year,3 years and 5 years were 90.5%,47.1%,and 36.7% respectively.The local disease free rates were 95.0%,62.4%,and 47.5% respectively.15 of 16 patients' deaths were related to the tumor.In univariate analysis,only small field irradiation was found as a prognosis factor in survival(?~(2)=5.36,P=0.02).Conclusions:Combined treatment appears to provide high response rates and can be offered as an alternative option to radical cystectomy for selected patients who refuse or are unsuitable for surgery.A large number of patients,multicenter,prospective randomized trial would be desirable to evaluate the role of radiotherapy in the multi-modality treatment of bladder cancer.

Clinical tutors' personality manifesting during the process of clinical practice and daily communication with medical interns has a series of influences on medical ethics formation of medical interns,including influences of direction,demonstration,contraction,and halo effect.Thus,clinical tutors should pay attention to cultivating a decent moral personality,and hospitals should value the proper combination of moral evaluation and supervision for medical staff in order to achieve the unity of heteronomous morality and self discipline,and effectively promote the formation of decent morality and personality of clinical tutors.