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.

Objective To investigate the methods to repair the defection of finger tip.Methods During Feb.2004 to July 2008,in 98 cases,23 fingers were reconstructed with 2nd toe transfer which was reformed with digital flap or trilobed flap from 2nd toe,33 fingers were coverd with wrap around flap or half wrap around flap from great toe,or combined wrap around flap from great with pulp flap from 2nd toe,28fingers were repaired with fabular flap from great toe combined with tibial flap from 2nd flap,and 27 fingers were repaired with nail flap or enlarged nail flap from great toe. Results Vessel articulo took place in 5 cases,and all cases recovered with wonderful outward appearance Conclusion Microsurgical technic is an ideal method to repair the finger-tip defection.

This article introduces the definition of quality of Life.How do the quality of life questionnaires apply in the clinical situations.This paper provides an overview of the factors that influence cancer patients quality of life.These research will give inspirations to our nurses and provide some reference for nursing interfere measurement.In order to improve quality of life of cancer patients,the clinical nurses should pay attention to these influencing factors.

Objective To analyze the clinical characteristics and treatment outcome of citrin deficiengc in infants. Methods The clinical data of 15 patients with citrin deficiengcy were analyzed retrospectively and the diagnoses were confirmed by gas chromatography-mass spectrometry(GC/MS). Results The patients consisted of 9 male and 6 female infants,whose age of onset ranged from 2 to 10 days excepted 1 case later than one month. The main clinical manifestations were jaundice and swelling liver,laboratory data showed increased total and direct bilirubin,bile acid,alanine aminotransferase,γ-glutamyltransferase,blood ammonia,lactic acid and α-fetoprotein;7 paitients had prolongation of prothrombin time and 9 had dyslipidaemia;G C/MS analysis of urine samples showed elevated galactose ,galactitol and 4 - hydroxyl phenyllactic acid;citrin gene were positive in 6 cases ,cytomegalovirus infections were found in 13 cases. After the therapy of fat-soluble vitamins(A,D and K)and lactose free formula,the jaundice relieved rapidly and dispeared within 2 weeks in all cases. The 6-month follow-up data showed no symptoms in 6 cases. Conclusions The clinical manifestations of citrin deficiengcy are nonspecific,GC/MS and lactose free formula treatment can be used to confirm the diagnosis.

Objective To compare the diagnostic value of conventional MR imaging with MR arthrography for acetabular labral tears at 3.0 T MR imaging Methods Forty-four patients suspected of acetabular labral pathology were prospectively scanned with conventional MR imaging and MR arthrography of the affected hip joints. All MR data were retrospectively studied. Each acetabular labrum was divided into three regions of anterior, superior, and posterior, and the acetabular tear and its classification were recorded. Five patients underwent subsequent hip arthroscopy. Wilcoxon signed ranks test was used to compare the difference between MR imaging and MR arthrography, and Kappa value was adopted for the evaluation of agreement of these two techniques. Results One hundred and sixteen regions of acetabular labrum were evaluated to be concordant at MR imaging and MR arthrography. Only 16 regions had different results at MR imaging and MR arthrography, in which 9 were diagnosed to have tears at MR arthrography but non-tear at MR imaging, and 6 had tears at MR imaging but non-tear at MR arthrography, and the other one had tears at both exams but of different classifications. In 5 patients confirmed by hip arthroscopy, both the evaluations of MR imaging and MR arthrography were accordant with that of arthroscopy. There were no statistical difference between MR imaging and MR arthrography ( Z = 0. 347, P ＞ 0. 05 ) for diagnosing the acetabular labral tears, and good agreements (Kappa = 0. 781 ,P ＜ 0. 01 ) were found between these two methods. Conclusion Conventional MR imaging of hip joints at 3.0 T shows similar diagnostic value with MR arthrography in evaluating the acetabular labral tears.

Biliary atresia(BA) is a destructive inflammatory obliterative cholangiopathy of neonates affecting both intrahepatic and extrahepatic bile ducts.BA is more common in east Asia.Genetic susceptibility,viral infections,and immune dysregulation may be related to BA,but immune dysregulation may play a key hole in the pathogenesis of BA.A current view of the pathogenesis of BA is that it may involve both a primary perinatal hepatobiliary viral infection and a secondary generation of an autoimmune-mediated bile duct epithelial injury.The etiology of BA is unknown,but there is evidence for the involvement of immunologic dysregulation mechanisms,which will be discussed in this review.

Objective To evaluate the effect of transtheoretical model(TTM)-based health education on the self-care behaviors of patients with heart failure.Methods One hundred and fifty heart failure patients from January 2012 to June 2013 were randomly assigned to two groups,75 cases in each group.The patients in the experimental group received TTM-based health education;the patients in the control group received conventional health education.All patients were investigated with the Self-Care of Heart Failure Index (SCHFI) at baseline,1 month and 3 months after intervention.Results After intervention,the scores of self-care maintaining,self care management and self care confidence in the experimental group were significantly higher than those in the control group.Conclusions TTM-based health education can effectively improve the self-care behaviors of patients with heart failure.

Objective To investigate the effects of batroxobin on blood coagulation and fibrinolytic function of patients with sud-den deafness .Methods 87 patients with sudden deafness were enrolled .Their prothrombin time(PT ) ,activated partial thrombo-plastin time(APTT) ,thrombin time(TT) ,fibrinogen(Fib) ,D-dimer and fibrin/fibrinogen degradation products(FDP) were detec-ted before batroxobin treatment and 3 ,6 days after treatment .Results Compared with pre-treatment ,patients after treatment expe-rienced prolonged PT and TT (P<0 .05) ,decreased Fib(P<0 .01) ,increased FDP (P<0 .01) ,and the difference of APTT ,D-di-mer between treatment before and after showed no statistically significant (P>0 .05) .Conclusion PT ,TT ,Fib ,FDP can be applied to monitor the coagulation and fibrinolytic function of patients with sudden deafness treated with batroxobin .

Objective To explore the effects of vecuronium bromide within 24 hours in severe bronchial asthma with acute attack with breathing machine in conventional sedatio.Methods Prospective study,double-blind randomized standard control,where 46 cases of patients of severe bronchial asthma with acute attack transferred to ICU using breathing machine in this year were randomly divided into the vecuronium bromide group (muscle relaxant group) and conventional sedation group (normal group) according to medical record number; Two groups of sample compositions were compared by x test,using two independent samples of t test to compare the effects the treatment and prognosis.Results After mechanical ventilation for 15min and 1-3h in muscle relaxant group,patients' vital signs were statistically analyzed,including respiration; Blood gas analysis parameters were as follows:pH,PaO2,PaCO2,SpO2 of these were improved compared with those in the conventional group (P ＜ 0.05) with statistically significant differences;Compared with the conventional group,in the muscle relaxant group,the retention time in ICU (146.20 ± 17.92) hours,(214.15 ± 22.21) hours,the using time of breathing machine (125.93 ± 16.23) hours,(192.89 ± 22.60) hours,and the dosage of glucocorticoid (2.61 ± 0.17) mg · kg-1 · d-1,(3.55 ± 0.26) mg · kg-1 · d-1,anticholinergic agent(6.25 ±0.51) μg · kg-1 · d-1,(10.64 ±0.75) μg · kg-1 · d-1 and β2 adrenergic receptor agonist (0.06 ±0.01)mg · kg-1 · d-1,(0.15 ±0.04)mg · kg-1 · d-1 were all reduced (all P ＜0.05) with statistically significant differences;The patients were smoothly transferred out of ICU,without the adverse events of mechanical ventilation and cardiovascular diseases.Conclusion The use of vecuronium bromide made the patients with severe bronchial asthma in routine sedation use of breathing machine rapidly correct the clinical symptoms and improve the off-period prognosis.

Objective To study the expression of CXCL12 and E-cadherin in condyloma acuminatum (CA) lesions caused by low-risk type (HPV6 and HPV11) humanpapilloma viruses. Methods The expressions of CXCL12 and E-cadherin mRNA in the lesions of CA caused by HPV6 and HPV11 and in the foreskins from normal males as controls were detected by real-time fluorescent quantitative PCR. Results The expressions of CXCL12 in the lesions of CA were down-regulated (fold change = 20.23,P = 0.001), and the expressions of E-cadherin were up-regulated (fold change = 3.129,P > 0.05). Conclusions The expression of CXCL12 is lower and the expression of E-cadherin is higher in the lesions of CA caused by low-risk HPV. It suggests that HPV may suppress local immune response and change the adhesion between langerhans cells and keratinocytes , which may contribute greatly to the persistent infection of HPV and relapse of CA.