As a new way,on-line bid & purchase expands and deepens the bid principle of "Honest,Justice,Public". This paper analyzes the characteristics of on-line bid,puts forward the centralized bidding frame based on Internet,and optimizes the bid procedure. The study not only makes the on-line bid more effective and strict but also makes the bid result more convincing.

Objective To evaluate the optimized conformal and IMRT plans for the upper esophageal carcinoma. Methods Eight patients with upper esophageal carcinoma underwent CT simulation.GTV was contoured on the CT image,referring the esophagogram and endoscopy simuhaneously,then CTV and PTV were also defined using the same criteria.Different conformal radiotherapy plans consisting of 3 fields(F),4F or 6F,IMRT plans consisting of 3F,4F,5F,7F,9F or 11F,and a simplified IMRT(s-IMRT)plan were designed for these patients.The minimum prescription dose that 95%of PTV volume received was 6000 cGy.Dose distributions of the PTV and OARs in different 3 DCRT and IMRT plans were compared and the optimized plans for the upper esophageal carcinoma were then recommended. Resuits Dose and volume parameters of PTV were similar among the 3DCRT plans(P＞0.05).4F 3DCRT plan reduced lung V20 as compared to 6F plan(P＜0.05),and mean lung dose(MLD)of 3F and 6F 3DCRT plans were higher than that of4F plan(P＜0.05).PTV D100 of 3F IMRT plan was lower than that of 9F and 11F plans(P＜0.05).IV of 4F IMRT plan was larger than that of 9F and 11F IMRT plans(P＜0.05).PTV dose and volume parameters of the 9F IMRT and 1 1 F IMRT were similar comparing with 5F.7F and s-IMRT plans,and OARs dose was also similar among IMRT plans(P＞0.05).PTV CI,D100,D95,V100 and V95 of the 4F 3DCRT plan were all lower than those of 5F,7F and s-IMRT plans(P＜0.05).5F,7F and s-IMRT plans reduced lung V20 as compared to 4F 3DCRT plan(P＜0.05).Conclusions For the upper esophageal carcinoma.4F 3DCRT plan is recommended among the 3DCRT plans.5F.7F and s-IMRT plans are recommended among the IMRT plans,which are superior than 4F 3 DCRT plan.

Objective To evaluate the variance and the concordance between the tumor length measured by CT scans and that measured by surgical specimens in esophageal carcinoma. Methods Fiftytwo surgical specimens of the esophageal carcinoma were made into pathological giant section.The shrinkage ratio of tumor was calculated by comparing the length of the specimen fixed by formalin for 24 h and that measured during the operation.One hundred and thirty-seven patients with esophageal carcinoma underwent spiral CT scan before the surgery,and the length of the gross tumor volume was obtained.After the tumor length of the fixed specimen had been measured,the real tumor length in situ was calculated using the shrinkage ratio.Then the variance and the concordance between the tumor length in CT scans and that in situ were compared.Results The mean shrinkage ratio was 90%±10%.The mean tumor length in CT scans was longer than that in situ(5.8 am±2.4 cm vs 4.1 cm±1.8 cm,P=9.68,P=0.000).The concordance of the length measured by the two methods was 40.9%(56/137). Conclusions A certain variance existed between the tumor length in CT images and that computed from surgical specimen in esophageal carcinoma.The results of esophagography and endoscopy should also be referred to delineate the gross tumor volume of esophageal carcinoma.

Objective To explore the relationship and the clinical significance of homeobox gene B1 (HOXB1 )and microRNA-31 75 (miR-31 75)expressions in human glioma.Methods The expression levels of HOXB1 and miR-31 75 in 60 glioma tissues and 1 5 normal brain tissues were analyzed by real-time fluores-cent quantitative PCR (qRT-PCR).Spearman rank correlation analysis was performed to explore the relation-ship between HOXB1 and miR-31 75 in human glioma tissues.The relationship between HOXB1 (or miR-31 75)and clinical pathological characteristics of glioma patients was analyzed.The correlation of HOXB1 (or miR-31 75)and survival rate was calculated by Kaplan-Meier.And COX regression models were used to assess the prognostic factors.Results Compared with normal brain tissues,the expression of HOXB1 was significant-ly decreased in glioma tissues (1 .498 ±0.323 vs.0.946 ±0.588,t =-5.680,P =0.000);and the expre-ssion of miR-31 75 was obviously increased in glioma tissues (1 .008 ±0.355 vs.2.076 ±0.841 ,t =4.274, P =0.000),and HOXB1 expression was negatively correlated with miR-31 75 expression in glioma tissues (r =-0.601 ,P =0.000).HOXB1 expression was related with histologic grade (χ2 =4.848,P =0.028), and miR-31 75 expression was related with histologic grade (χ2 =5.640,P =0.01 8)and Karnofsky score (χ2 =4.785,P =0.029).The results of Kaplan-Meier revealed that there were significant differences in median survival time between HOXB1 (or miR-31 75)high-expression group and HOXB1 (or miR-31 75)low-expression group [HOXB1 :(21 .0 ±4.0)months vs.(7.0 ±0.8)months;χ2 =7.495,P =0.006;miR-31 75:(6.0 ±0.6)months vs.(1 6.0 ±5.8)months;χ2 =9.591 ,P =0.002].COX regression models showed that tumor degree (RR =6.556,95% CI:1 .1 96-35.952,P =0.002),HOXB1 (RR =0.01 8, 95%CI:0.001 -0.31 2,P =0.006)and miR-31 75 (RR =2.098,95%CI:1 .663-7.51 3,P =0.037)were independent prognostic factors for prognosis.Conclusion The HOXB1 expression may be negatively correlated with miR-31 75 in human glioma tissues,and the expression levels of HOXB1 and miR-31 75 are associated with the glioma malignant degree,survival time and prognosis of glioma patients.

Objective To investigate the application value of magnetic resonance enterography (MRE) with multiple sequences in detection of children bowel intestinal diseases .Methods Retrospective analysis of 35 patients with bowel diseases confirmed by clini‐cal results ,surgery and pathology was performed .The patients underwent MRE with multiple sequences including T 1WI ,fat‐suppressed T2 WI ,diffusion weighted imaging (DWI) ,single‐shot fast spin‐echo (SSh‐TSE) sequence ,rapid balance fast field echo (B‐FFE) ,and unenhanced and enhanced fat‐suppressed (FFE‐IP‐SPAIR) scans .Results SSh‐TSE showed the whole intestinal distribution in 34 patients (34/35);DWI showed the lesions with high signal in 29 (29/35);T1WI and fat‐suppressed T2 WI showed hyperintensity on T2WI in 3 ,slight hypointensity on T1WI and T2WI in 2 ,and hyperintensity on T1WI and hypointensity on T2WI in 1 .Enhancement of lesion was found in 28 ,and unenhancement was in 2 .Conclusion MRE with multiple sequences with more information ,sensitivity and non‐ionizing radiation ,can be used as an important method in diagnosis of children intestinal diseases .

Objective To explore the digital tomosynthesis(DTS)technology application value in children with atlanto-axial joint subluxation inspection.Methods 30 children with torticollis after injury,head and neck activities obstacles or local pain were selected.The consent of patient and family was obtained.At the same time the atlanto-axial joint open mouth,cervical lateral radiographies and DTS scanning were performed,two imaging quality and the diagnosis were compared.Results In all 30 cases,excellent imaging rate was 90% (27/30)on DTS and 53% (1 6/30)on DR respectively.On DTS atlanto-axial sublution were found in 22 cases but on DR atlanto-axial sublution were diagnosed in only 12 cases,suspicious subluxation in 4 cases,and misdiagnosis in 6 cases.Conclusion For diagnosis of atlanto-axial joint subluxation in children,DTS can obtain high quality images,clearly display anatomic structures and pathological morphology of atlanto-axial joint.

Objective To investigate the value of flexi-rigid thoracoscopy in pleural effusion of unknown causes and the correlation with CEA, TK1 and ADA. Methods The clinical data and results of CEA, TK1 and ADA of 25 patients were retrospective analyzed in our department from 2015 January to November 2015. These patients accepted the examination of flexi-rigid thoracoscopy with pleural effusion of unknown causes. Results In the 25 patients with pleural effusion of unknown causes, definite diagnosis was made in 22 cases (88.00 %), of which 9 cases were malignant pleural effusion (36.00 %), 11 cases were tuberculous pleural effusion (44.00 %), 2 cases were inflammatory pleural effusion (8.00 %), 3 cases were undetermined (12.00 %). The positive rate of TK1 and CEA in malignant group was significantly higher than that in the tuberculosis group and inflammatory group, the positive rate of ADA in the tuberculosis group was significantly higher than that in the malignant group and inflammatory group. Conclusion Flexi-rigid medical thoracoscopy examination is an effective and safe method for diagnosis of unexplained pleural effusion with high exact diagnosis rate, less trauma and less complication. Combination with CEA, TK1 and ADA are helpful to improve diagnostic rate of pleural effusion of unknown causes.

Upper urinary tract calculi combined with dual infections is rare, and the antimicrobial therapy is complicated. This retrospective study analyzed the clinical data of 3 patients with upper urinary tract calculi combined with dual infection who were admitted to our hospital. Three patients were treated with piperacillin sulbactam combined with fluconazole for 1 week, according to the preoperative urine culture and drug sensitivity results. Endoscopic surgery was performed after the efficacy was determined by routine urine examination. After surgery, fluconazole was administered until the removal of the double-J tube for 2 weeks, and fluconazole was discontinued when no white blood cells or fungus were found. No recurrence of stones or infection was observed at a follow-up of 11 months to 2 years. The rational choice of antimicrobial drugs to treat upper urinary tract calculi combined with dual infection could create good conditions for endoscopic surgical intervention, thus achieving satisfactory clinical outcomes.

Objective To explore the effect of early pressure therapy during sensory training on functional recovery after island skin flap repairing vitia of thumb ventral. Methods From January, 2016 to July, 2017, 63 patients accepted island skin flap repairing vitia of thumb ventral were divided into control group (n=31) and observation group (n=32) according to the order of hosptalization. The control group accepted routine sensory training, while the observation group accepted early pressure therapy in addition. Their swelling, scars and sensory function were observed after treatment. Results The swelling and scars were milder, and the sensory function was better in the observation group than in the control group (P<0.05).Conclusion Combination with early pressure therapy during sensory training may promote the recovery of sensory function and fadeaway of swelling, and alleviate the formation of scar.