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.

Carcinoma, Hepatocellular ; surgery ; Hepatectomy ; Humans ; Liver Neoplasms ; surgery

The risk factors of traffic crash include drinking/drunk drive, accident proneness, fatigue driving, speeding, and poor vehicle quality. This article introduces the protection, emergency treatment, and basic scientific research of road traffic injury (RTI). As a public health issue, RTI is preventable, and personal factor is a key problem. It is important to establish an accurate and comprehensive RTI database, which may provide necessary information for the epidemiological research and crash prevention. The author also gives some suggestions on road traffic safety development in our country.
Accidents, Traffic ; prevention & control ; Databases, Factual ; Epidemiologic Research Design ; Humans ; Wounds and Injuries ; prevention & control ; therapy

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.

Pancreatic cancer has a strong ability of invasive and metastasis,and the mechanism is still not completely clear.It has been demonstrated that aberrant expression of microRNAs(miRNA) is closely associated with the occurrence,development and metastasis of pancreatic cancer.The reveal of miRNA mechanism related to the metastasis of pancreatic cancer would provide a new approach to the treatment of pancreatic cancer.

The importance of course arrangement and standardization construction for the course of hyperbaric oxygenation medicine was expounded in this review.In addition,the measures and experiences on textbook choosing,teaching content assignment,teaching methods designing,assessment means innovation and teaching personnel training were also discussed.The teaching system of the course of hyperbaric oxygenation medicine can be improved and references for thc dcvelopment of clinical hyperbaric oxygenation medicine courses can be provided through these measures.

Objective To investigate the effect of positive end expiratory pressure (PEEP) on thermo-regulatory function during general anesthesia in patients addicted to smoking. Methods Twenty adult male ASA Ⅰ or Ⅱ patients who had been smoking more than or equal to 10 cigarettes per day for more than or equal to 6 years were studied. The patients underwent intra-abdominal surgery under general anesthesia and were randomly divided into 2 groups ( n = 10 each): control group (group C) and PEEP group (group P). Anesthesia was induced with propofol, fentanyl and vecuronium and maintained with inhalation of 1%-2% isoflurane and continuous iv infusion of remifentanil and vecuronium. The patients were mechanically ventilated after tracheal intubation. In group P PEEP of 10 cm H2O was added. Temperature probe was inserted into the lower segment of esophagus and placed on the anterior chest wall, medial surface of thigh anterior surface of forearm and palmar surface of the tip of index finger. Mean skin temperature (TMSK) was calculated according to Roberts. MAP, HR, TES, TMSK and the difference between TES and TMSK (TES-MSK) were recorded before induction of anesthesia (T0 ,baseline) and every 30 min after tracheal intubation. Esophageal temperature was taken as threshold of thermo-regulatory peripheral vasoconstriction when the difference between forearm and finger tip temperature = 0 ℃. The gain in the threshold was calculated according to Sessler. Results TES and TES-MSK significantly decreased,while TMsK increased after tracheal intubation in both groups ( P ＜ 0.05). There was no signifieant difference in TES, TMSK, TES-MSK, MAP, HR, the threshold of vasoconstriction and gain between the 2 gronps ( P ＞ 0.05). Conclusion PEEP cannot improve thermo-regulatory function during general anesthesia in smoking-addicted patients.

In the recent years,the earthquake occured frequently in the whole world which caused the increased incidence of crush syndrome (CS). The four limbs and torso will be bleeding and swelling when they are prounded and crushed from the heavy objects. The necrosis of muscular tissue causes massive production of toxin which leads to a series of symptoms including hypotension ,kidney dysfunction and so on. The serious acute kidney injury (AKI) will be vital. When CS-AKI ,the ascending velocity of urea nitrogen and K+ levels in the blood is quicker than those of general AKI;many kinds of immune cells are activated to engender a great deal of inflammatory mediators;the blood dynamics is often unstable. Therefore, it is advocated that the blood purification treatment should be carried early to eliminate excessive metabolic produces in vivo,to reduce the cardiovascular complication occurrence, and to avoid the irreversible change of the kidney function.

Objectives To assess whether prodromal transient ischemic attack (TIA) has beneficial effects on type 2 diabetic patients and those had acute fasting hyperglycemia with the first-ever acute anterior circulation infarction.Methods One hundred and seventy patients with first-ever ischemic acute anterior circulation infarction were involved.According to whether they had type 2 diabetes mellitus,patients were divided into group A (non-diabetic patients) and group B (diabetic patients).Mean infarct volume was also compared between patients with pro-TIA and without pro-TIA in group A and B,and each group with acute hyperglycemia too.Results In group A,prodromal TIA was associated with a smaller infarct volume (M: 2.61 cm3 vs 5.99 cm33 Z=-2.69,P=0.007).On the contrary,in group B,there was no significant difference in infarct volume (M: 3.25 cm3 vs 11.0 cm3,Z=-1.699,P=0.08) between patients with and without prodromal TIA.In group A patients absent with acute fasting hyperglycemia,infarct volume significantly smaller in patients with prodromal TIA than in those without (M: 2.69 cm3 vs 6.46 cm3,Z=-2.34,P=0.019) ; In patients with acute fasting hyperglycemia,there was no a significant difference in infarct volume (M: 2.61 cm3 vs 5.69 cm3 ,Z=-1.218,P=0.27).However,among group B patients present or absent with acute impaired fasting glucose,there was no significant difference in infarct volume in patients with or without prodromal TIA.Conclusion Diabetes mellitus and the acute fasting hyperglycemia might prevent the ischemic preconditioning.

Objective To evaluate the ventricular systolic and diastolic synchronicity in elderly patients with the complete right bundle branch block (CRBBB) by Doppler tissue velocity imaging (TVI) technology. Methods The 35 elderly CRBBB patients were selected as CRBBB group, while 31 healthy people were chosen as control group to evaluate myocardial function. The time to peak velocity at systolic and early diastolic phase (Ts and Te) in the base and interlude 14 segments of left and right ventricles was measured. The average time of Ts in right ventricular 2 segments(Ts-2-RV), Ts and Te in left ventricular 12 segments (Ts-12-LV and Te-12-LV), and the standard deviation in left ventricular 12 segments (Ts-12 SD and Te-12-SD), the maximum Ts and Te difference (Ts-diff and To-dill) were calculated. The left ventricular end-systolic and end-diastolic diameter (LVEDs and LVEDd) and volume (LVEVs and LVEVd) were measured. Results (1)The time to peak velocity at systolic phase in 14 segments of left and right ventricles was longer in CRBBB group than that in control group(P<0.05 or P<0.01). Compared with the control group, the Ts-12-LV,Ts-12-SD and Ts-diff showed significant prolongation (P<0.01). The Ts-2-RV was longer than Ts-12-LV in CRBBB group[(226.3±37.4 ) ms vs. (195.5±69.5) ms, P < 0.05]. (2) There was no significant difference in the time to peak velocity at early diastolic phase in 14 segments between CRBBB group and control group(P>0.05), but the Te-12-SD and Te-diff was longer in CRBBB group than that in control group (P< 0.01). (3) The LVEDs and LVEDd were obviously increased in CRBBB group compared with controls (P<0.05 and P<0.01), but no significant difference was showed in LVEVs and LVEVd(P>0.05). Conclusions Compared with normal people, the Ts at systolic phase is longer, especially in the right ventricle, the LVEDs and LVEDd are significantly increased, and the ventricular systolic and diastolic synchronicity is not well in CRBBB patients.