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.

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 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.

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.

Objective To analyze the pregnancy outcome of laparoscopy cervical cerclage before pregnancy in treatment of uterine cervical insufficiency. Methods The clinical data of 78 uterine cervical incompetence patients having underwent cervical cerclage before pregnancy were retrospectively analyzed. Among them 40 cases underwent laparoscopy cervical cerclage (laparoscopy group), and 38 cases underwent transvaginal cervical cerclage (transvaginal group). The operation time, complications, length of cervix in pregnancy, lengthen time of gestational weeks, gestational weeks, perinatal infant weight, survival rate of perinatal infants and infection rate of uterine cavity were compared between 2 groups. Results The length of cervix in pregnancy, lengthened time of gestational weeks, perinatal infant weight, term labor rate and survival rate of perinatal infants in laparoscopy group were significantly higher than those in transvaginal group: (4.35 ± 0.52) cm vs. (3.51 ± 0.66) cm, (116.7 ± 9.8) d vs. (90.2 ± 5.2) d, (3 050 ± 759) g vs. (2 500 ± 431) g, 60.0%(24/40) vs. 31.6%(12/38) and 95.0%(38/40) vs. 78.9%(30/38), and the infection rate of uterine cavity was significantly lower than that in transvaginal group: 2.5% (1/40) vs. 18.4% (7/38), and there were statistical differences (P<0.05). There were no statistical differences in operation time and incidence of complications (P > 0.05). Conclusions Laparoscopy cervical cerclage before pregnancy in treatment of uterine cervical incompetence can effectively maintain the cervical length period of pregnancy, improve the success rate of surgery, prolong gestational weeks, and improve perinatal outcome.

Objective To study the pre- pregnancy cervical cerclage method in the different cervical length of uterine cervical incompetence patients. Methods The clinical data of 128 uterine cervical incompetence patients having underwent pre-pregnancy cervical cerclage were retrospectively analyzed. The preoperative cervical length was measured by transvaginal ultrasound. Cervical length >2.5 cm was in 60 cases, of which 34 cases underwent laparoscopic cervical cerclage, and 26 cases underwent transvaginal cervical cerclage; cervical length ≤ 2.5 cm was in 68 cases, of which 32 cases underwent laparoscopic cervical cerclage, and 36 cases underwent transvaginal cervical cerclage. Results For the patients with preoperative cervical length > 2.5 cm, there were no statistical differences in the postoperative pregnancy cervical length, gestational weeks time, perinatal birth weight, perinatal survival rate, gestational age of delivery and intrauterine infection rate between 2 methods (P>0.05). For the patients with preoperative cervical length ≤ 2.5 cm, the postoperative pregnancy cervical length, gestational weeks time, perinatal birth weight, perinatal survival rate and gestational age of delivery in laparoscopic cervical cerclage patients were significantly higher than those in transvaginal cervical cerclage patients: (3.85 ± 0.37) cm vs. (3.16 ± 0.49) cm, (101.75 ± 4.71) d vs. (80.62 ± 3.53) d, (2850 ± 323) g vs. (2330 ± 585) g, 90.6% (29/32) vs. 69.4% (25/36) and 50.0% (16/32) vs. 22.2%(8/36), but the intrauterine infection rate was significantly lower than that in transvaginal cervical cerclage patients:0 vs. 16.7%( 6/36), and there were statistical differences (P<0.05). All patients had no obvious complications. Conclusions For cervical length > 2.5 cm patients with uterine cervical incompetence, pre- pregnancy cervical cerclage can choose transvaginal or laparoscopic. But for patients with the cervical length≤2.5 cm or previous cervical cerclage failure, laparoscopic cervical cerclage is better than transvaginal cervical cerclage.

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.

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.