This article analyses and summarizes the clinical maintenance work of Elekta Precise Linac in five years.Afer the further research on its performances and errors,a better way is found to solve the main problem of clinical electronic linac,i.e.the way to reduce the Stop Rate of Linac in Radiotherapy.

The flavin-containing monooxygenase 3 (FMO3) is an important hepatic microsomal enzyme. Numerous mutations of FMO3 gene have been reported, and polymorphic varients of the gene have been identified. Several studies indicated that variability in the expression of FMO3 involved in some nitrogen, or sulfur-containing durg metabolism. This review summarizes the genetic polymorphism of FMO3 and its role in drug metabolism and toxicity.
Drug-Related Side Effects and Adverse Reactions ; Humans ; Oxygenases ; genetics ; Polymorphism, Genetic

Objective:To analyze correlation between thrombelastograph (TEG) indexes and serological indexes in patients with acute cerebral infarction (ACI) .Methods :A total of 116 ACI patients treated in our hospital were se‐lected as ACI group ,another 98 cases without ACI , who underwent routine physical examination were regarded as healthy control group .According to severity of neurological function defect during acute phase ,ACI group was fur‐ther divided into mild ACI group (n=51) ,moderate ACI group (n=32) and severe ACI group (n=33) .TEG inde‐xes and serum indexes of platelet activation were measured and compared among above group ,and the correlation a‐mong TEG indexes and serum levels of platelet activation indexes were analyzed .Results:Compared with healthy control group ,there were significant reductions in R value [ (6.17 ± 1.38) min vs .(5.26 ± 0.77) min] and K value [ (2.39 ± 0.53) min vs .(1.71 ± 0.58) min] ,significant rise in α angle [ (63.27 ± 9.23) deg vs .(77.45 ± 12.08) deg] ,MA value [ (55.09 ± 6.38) mm vs .(77.13 ± 13.25) mm] of TEG ;clot index [CI ,(1.68 ± 0.53) vs .(2.56 ± 0.87)] ,D-dimer level [(0.24 ± 0.07) mg/L vs .(0.38 ± 0.09) mg/L] and platelet aggregation rate [PAR ,(56.12 ± 6.75)% vs .(69.17 ± 9.33)% ] in ACI group after treatment ,P<0.05 all .Among ACI subgroups with different severity ,the more severe neurological function defect was ,the lower R and K values were ,the higherαangle ,MA value ,CI ,D-dimer level and PAR were ,there were significant difference in pairwise comparisons ( P<0.05 or <0.01) .Linear regression analysis indicated that PAR was significant inversely correlated with R (B= -2.254) and K values (B= -2.286) ,and significant positively correlated with αangle (B=2.536) ,MA (B=2.537) and CI (B=2.352) ,P<0.05 or <0.01 ;D-dimer level was significant inversely correlated with R (B= -2.276) and K val‐ues (B= -2.259) ,and significant positively correlated with α angle (B=2.621) ,MA (B= 2.462) and CI (B=2.647) , P<0.05 or <0.01. Conclusion:TEG indexes are significantly correlated with platelet activity in ACI pa‐tients .TEG possesses good practical value in diagnosis ,severity judgment and therapeutic guidance for these pa‐tients .

Objective To observe the effects of Lipopolysaccharide (LPS) in different concentrations on expression of Robo4 in human umbilical vein endothelial cells (HUVECs). Methods HUVECs were cultured in vitro and randomly divided into 3 groups: control group, low dose LPS group (10 μg/mL) and high dose LPS group (100 μg/mL). Robo4 protein level was detected by immunofluorescence staining and western blot , and Robo4 mRNA level was measured by real-time PCR. Results Robo4 protein and Robo4 mRNA in high dose LPS group were 0.49 ± 0.08 and 0.23 ± 0.08 respectively , which were significantly decreased than those (1.35 ± 0.15 and 0.97 ± 0.17) in control group(P < 0.05). However, there were no significant difference between the low dose (1.23 ± 0.13 and 0.94 ± 0.14) group and the control group (P > 0.05). Conclusion High dose LPS (100 μg/mL) could down-regulate expression of Robo4 in HUVECs.

An innovative approach,named associating liver partition and portal vein ligation for staged hepatectomy (ALPPS),has made possible a marked increase in future liver remnant (FLR) over a short period of time,and has challenged the concept of unresectability.To date,ALPPS has been employed for a variety of primary and metastatic liver tumors from many centers across the world.Many technical variations of ALPPS have been described.However,much controversy has surrounded this procedure,and many problems remain to be solved,such as the reasons for rapid hypertrophy,the technical feasibility,safety and long-term oncologic outcomes,and the result compared with the conventional two-stage hepatectomy.These aspects are needed to be evaluated further in large-scale studies.We believe that the ALPPS procedure will has much room for further development.

Schwannomas of the vagus nerve (SVN) and schwannomas of the cervical sympathetic nerve (SSN) are the two most common schwannomas in the carotid space. Because schwannomas are asymptomatic, moreover, the vagus nerve and the cervical sympathetic nerve have adjacent anatomical location, it is diffcult to differentiate SVN or SSN. In addition, the current surgical treatment of schwannomas still remains controversial. This article summarized the studies on SVN and SSN, and meanwhile discussed the advances in the diagnosis and management of the disease.

Objective:To analyze the indicators and resistance rate of antibacterial drugs for special use in our hospital before and after the implementation of network online approval process to provide reference for the management and rational use of antibacterial drugs for special use. Methods:A retrospective analysis was performed, and the consumption amount, sales amount, utilization ratio, AUD, submission rate of microbial specimen and resistance rates for the main pathogenic bacteria of antibacterial drugs and ones for special use were investigated during 2012 and 2015 in our hospital. Results:The approval process of antibacterial drugs for special use developed from handwork to network online. The consumption amount of antibacterial drugs increased slightly year by year from 2012 to 2015 in our hospital, the mean expense of antibacterial drugs for the inpatients increased from 1602. 85 yuan to 1888. 63 yuan,and AUD increased from 54. 50 DDDs/(100 persons × d) to 65. 47 DDDs/(100 persons × d). The sales amount proportion of antibacterial drugs for special use (13. 90%) was the lowest in 2013, and the highest (17. 34%) in 2015, and AUD increased from 4. 85 DDDs/(100 person × d)to 6. 37 DDDs/(100 person × d), and the submission rate of microbial specimen before the treatment increased from 85. 5% to 90. 0%. The main pathogenic bacteria were Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa and Acinetobacter baumannii,and their ratio had slight change. Except Staphylococcus aureus, the resistance rate of the other four pathogenic bacteria kept increasing, and the resistance rates of Acinetobacter baumannii to cefepime and carbapenems were over 50%. Conclusion:The approval process management of antibacterial drugs for special use must be strengthened in order to truly a-chieve reasonable use of antibacterial drugs for special use.

Objective To establish a rabbit model of hypoglycemia and evaluate the accuracy and timeliness of hypoglycemia monitoring by continuous glucose monitoring system (CGMS).Methods Sixteen female New Zealand white rabbits were randomly divided into 4 groups, with 4 rabbits in each group.The rabbits in the control group were given intravenous infusion of saline.The animals in the experimental group were infused with insulin continuously, which were divided into 0.1 U/kg/h insulin group (RI=0.1 U group), 0.2 U/kg/h insulin (RI=0.2 U group) group and 0.4 U/kg/h insulin group (RI=0.4 U group) accordingly.During the experiment, CGMS was monitored for 240 min.Blood samples were collected at a 30-minute interval and the blood glucose level was measured by a hand glucose meter.Results A total of 1296 CGMS monitoring data were obtained during the study period, and 136 BG monitoring data matched with CGMS time were obtained.After the insulin administration, BG and CGMS were significantly decreased.The reduction rates of BG and CGMS were 0.016 and 0.017 mmol/L/min in the RI=0.1 U insulin group, 0.04 and 0.027 mmol/L/min in the RI=0.2U insulin group, and 0.049 and 0.032 mmol/L/min in the RI=0.4 U group.According to whether BG monitoring value was lower than 4.4 mmol/L, the BG-CGMS paring data were divided into hypoglycemia and normoglycemia.In hypoglycemia, the average deviation of BG-CGMS was 0.55 mmol/L (the upper and lower limits were-0.98 and 2.08 mmol/L, respectively) and the absolute difference percentage (RAD) was 40.2% ± 45.2%.The mean deviation of BG-CGMS in normal blood glucose was-0.19 mmol/L (upper and lower limits were-1.38 and 1.00 mmol/L, respectively) and 5.8% ± 5.3% in RAD.The error grid analysis (EGA) showed that the proportion of zone A was 93.4%, 0.7% in zone B, and 5.9% in zone D, and the zone D was distributed in area of low BG and high CGMS.Conclusions The results of this study indicate that CGMS has a significant hysteresis phenomenon when blood glucose is reduced rapidly.When the blood glucose levels fall below 4.4 mmol/L, CGMS may have a risk of overestimating blood glucose.Such risk should be fully considered during CGMS clinical application.

Objective To explore the relationship between self- management and DOSE index for patients with chronic obstructive pulmonary disease (COPD). Methods The convenient sampling and Pearson correlation analysis was used in the study,a total of 81 patients was investigated with Self- Management Scale (SMS) for COPD patients and DOSE index. Results The relationship of symptom management and DOSE index for COPD patients was a positive correlation (r=0.259, P<0.05);with self- efficacy was a negative correlation(r=-0.288, P<0.05).But self- management, daily life management, emotion management and information management with DOSE index were no correlation (P>0.05). Conclusions Through health education, nurses should strengthen to effectively help patients manage symptoms, enhance self- efficacy, improve the patients′quality of life.

Objectives:The objective of this study is to make suggestions for the internet medical development. Methods:Based on the field survey, this paper analyzes three kinds of internet medical mode in China, and sums up the pros and cons. Results:The internet medical has the ability of technically providing healthcare by internet, and meeting the patients’ essential health care requirements. The problems mainly include health insurance, regional dis-tribution, electronic prescription audit, electronic medical record and safekeeping the record files, operation supervi-sion etc. The corresponding countermeasures include elaborating laws, gradually completing the internet medical and health insurance cooperation, the government’s regional division handling, setting up a special supervision department in the hospitals etc. Conclusion:It is important to clear the internet medical related problems and develop a model which is suitable for healthcare institutions.