4cm) or involved the urethra、 vagina、 clitoris or anus. Pathologic grouping was 25 squamous carcinomas 3 adenocarcinomas and 2 undifferentiated carcinomas. Radiotherapy was given by angled radiation with wedge block. Dose was 65 to 70 Gy/6-7W. RESULTS Thirty patients completed their inductive chemotherapy within 30 days for 86 courses. The response rate was 86. 7% (26/30). CR was 30. 16%. 18 of 30 patients were followed-up for over 5 years. Five years survival rate was 72.2 (13/18). Major acute complications were vuvitis (23%). Late adverse effects were 1 patient with ure-throstenotic uroschesis, 1 patient with pathologic transcervical fracture. None of patients had radiation rectitis and cystitis. CONCLUSION Inductive chemotherapy consisting of modified VBP regimen was active in reducing the vulvar tumor volume. Radiotherapy used angled radiation with wedged block to treat advance vulvar cancer was fa-ciliated. Chemoradiotherapy was found to be an effective treatment for locally advanced vulvar carcinoma, with acceptable morbidity even in an elderly population. The technique allowed maintenance of normal anatomical and physiologic function that would have been compromised by primary surgical approach. It yielded survival rates comparable to those achieved with ultraradical surgery in younger patients. Life quality was improved significant-ly.

Objective To explore the factors that affect the prognosis of extensive small cell lung cancer by analyzing the association between lab-oratory indicators before treatment of extensive small cell lung cancer patients and the initial evaluation results with disease progression and overall survival. Methods This study retrospectively analyzed 96 cases of hospitalized patients in the medical oncology department of The First Hospital of China Medical University from March 2008 to September 2014. Kaplan-Meier method and Cox proportional hazards models were adopted to ana-lyze the relevant factors affecting the prognosis of extensive small cell lung cancer. P<0.05 was considered statistically significant. Results There was no obvious correlation between HB level before treatment with PFS of patients(P=0.179),but there was obvious significant correlation be-tween HB level and OS of patients(P=0.041). Our results showed that the TBIL level of patients before chemotherapy was significantly associated with the PFS(P=0.039)and OS(P=0.026)of patients. Conclusion HB and TBIL levels are the influencing factors that affect the prognosis and survival of patients with extensive small cell lung cancer.

Objective To determine whether neuron?specific enolase(NSE)affects the prognosis of extensive small cell lung cancer by analyz?ing the association between NSE before treatment and disease progression and overall survival of patients. Methods This study retrospectively an?alyzed 83 inpatients in the medical oncology department of the First Affiliated Hospital of China Medical University from March 2008 to September 2014. The Kaplan?Meier method and Cox proportional hazards models were used to analyze relevant factors affecting the prognosis of extensive small cell lung cancer;statistical significance was determined for a P value less than 0.05. Results The lactate dehydrogenase(LDH)level be?fore treatment was significantly associated with the progression?free survival(PFS)(P=0.001)and overall survival(OS)(P=0.036). The NSE level before treatment was also significantly associated with the PFS(P=0.007)and OS(P=0.013). Conclusion LDH and NSE affect progno?sis and survival of patients with extensive small cell lung cancer.

The diagnosis and treatment of invasive fungal infections has been attracting more and more attention along with the increase incidence in the current clinical practice.We hereby work out this paper to elaborate some key issues,coveting the history and methodology of anti-fungal susceptibility testing, the MIC recognition of yeast fungus and mycelial fungus,breakpoint interpretation,and finally the guidance for clinical practice.To better undemtand susceptibility test results and improve the guality of susceptibility tests in this review,we chosed several most-often used anti-fungal drugs and explained their effect activity.

Objective To observe the effect of Ceftazidime on the early and mature Pseudomonas aeruginosa biofilm bacteria. Method The early and mature PA biofilm were formed through the chemostat combined Robbins device. Then 64 ?g/ml Ceftazidime was applied to the early and mature PA biofilm bacteria for 24 hours respectively. Scanning electronic microscope(SEM) was used to observe the effect of Ceftazidime on early and mature biofilm. The difference between the viable bacteria in early and mature biofilm was analyzed by statistical method. Result 24 hours after Ceftazidime was added, Pseudomonas aeruginosa in early biofilm was killed on the whole while there were still numbers of bacteria in mature biofilm. Statistical analysis demonstrates a great variance in viable counts. Conclusion Pseudomonas aeruginosa in mature biofilm is more tolerant to antibiotics than that in early biofilm.

Objective: To explore relationship among bullying victimization, psychological traits and suicide ideation of middle school students, and to provide suggestions for school bullying and suicide prevention for adolescents. Methods: A total of 3 635 students of 7-9th grade from 5 junior middle schools were enrolled and investigated with the Olweus Bully/Victim Questionnaire (OBVQ), psychological traits questionnaire for middle school students and suicide ideation questionnaire. Results: Prevalence of bullying victimization was 28.34% of middle school students, while the prevalence of verbal, relational and physical bullying were 22.59%, 12.05% and 7.54%, respectively. Boys had significantly higher rates of bullying victimization than girls (χ2=88.92，94.29，7.69，P<0.01). Bullying victimization was positively associated with suicidal ideation (r=0.21, P<0.01), while associated with psychological traits (r=-0.17, -0.22, P<0.01). Psychological traits had a moderating effect on the relationship between bullying victimization and suicidal ideation (β=-0.04, P<0.05). Conclusion Psychological traits can buffer the adverse effects of bullying victimization on suicidal ideation, and the critical role of psychological traits in the maintenance and development of adolescent mental health should be emphasized.

Objective To investigate antimicrobial resistance among gram-positive cocci in China in 2009. Methods From June to December 2009, 1169 consecutive and non-repetitive gram-positive cocci were collected from 12 teaching hospitals at 9 cities. The minimal inhibitory concentration (MIC) of antibacterial agents was determined by agar dilution method. Results The prevalences of methicillinresistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRCoNS) were 45.3% (211/466) and 89. 5% (214/239), respectively. The isolation rate of MRSA was 33. 3%-68. 1% from different samples. All Staphylococci isolates were susceptible to vacomycin, teicoplanin and linezolid. Five point five percent (7/128) E. faecium strains were resistant to vacomycin. All E.faecalis strains were susceptible to vacomycin. About 99. 1% (108/109) of E. faecalis and E. faecium were susceptible to linezoild. The prevalence of penicillin-intermediate Streptococcus pneumoniae (PISP) was 21.6% (48/222). Only 1 (0. 5%, 1/222) Streptococcus pneumoniae strain was resistant to penicillin.Teicoplanin, vancomycin, linezolid and tigecycline were the most active agents against Streptococcus pneumoniae (susceptible rate 100% ). Conclusions The high prevalence of methicillin-resistance is among Staphylococcus strains. Different samples show a different MRSA prevalence. Teicoplanin, vancomycin and linezolid show very high activity to Staphylococci,E. faecalis, E. faecium and Streptococcus pneumoniae.

Objective To improve hand hygiene (HH)compliance of health care workers (HCWs)in neonatal in-tensive care units(NICUs)in China through a series of intervention measures.Methods A multicenter study was conducted,17 tertiary first class hospitals in 9 provinces and cities were selected,HH compliance of HCWs in these hospitals were investigated every month according to HH investigation method of World Health Organization.From October 1 ,2013 to March 31 ,2014 was pre-intervention stage;from April 1 ,2014 to September 30,2014 was post-intervention stage,timely feedback and intensified training were conducted at post-intervention stage.Results HH compliance rates of HCWs before and after intervention were 80.29% and 80.85% respectively,there was no sig-nificant difference (P >0.05).HH compliance rates of HCWs in different sizes of ICUs were significantly different before and after intervention (all P <0.05),in NICUs with<20 beds and 20-30 beds after the intervention were both significantly higher than before intervention (both P <0.05 ),while >30 beds were significantly lower than before intervention(P <0.001 );HH compliance rate of cleaners increased from 58.82% before intervention to 68.09% after intervention (P <0.05 );Of different hand hygiene indications,except before clean/aseptic task, compliance to the other HH indications were significantly different between before and after intervention(all P <0.05).Conclusion HH compliance is high among HCWs in NICUs in China,intervention measures,such as inten-sified training and timely feedback have certain influence in compliance to HH among HCWs at different sizes of ICUs,of different occupations,and at different HH indications.