Protons and heavy ion radiation therapy have proven highly effective against a wide range of cancers and in recent decades there have been rapid advances.Due to the physical characteristics of the Bragg-peak and superior biological properties,proton and heavy ion radiation is able to focus its energy on the tumor while minimizing exposure to surrounding normal tissues and organs,which is expected help enhance the tumor dose and reduce normal tissue damage.In recent years,many studies have explored the efficacy and safety of proton and heavy ion radiotherapy on various malignancies,such as head and neck cancer,lung cancer,esophageal cancer,and liver cancer.The results of these studies enable a better understanding of the characteristics and advantages of proton and heavy ion therapy.

Breast ; surgery ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Female ; Humans ; Lymph Node Excision ; Mastectomy, Segmental ; Neoplasm Recurrence, Local ; Treatment Outcome

We have conducted a tireless practice and exploration in order to establish a solid,long-term and appropriate social practice basement for medical students,which is the platform for them carrying on social practice activities.Practice has proved that early preparation for basement construction is the basis,support from local government is the key,leaders' attention 、abundant fund and multi-sectional coordination are the guarantee,and that diverse forms as well as effective social practice activities is the fundamental way to promote basement construction.

Objective To evaluate MRI in diagnosis and follow-up of Achilles tendon rupture. Methods From April 2003 to May 2005, 24 cases of closed Achilles tendon rupture were examined in our department with MRI. It was performed through sagittal T1WI, T2WI, GE-STIR and axial TME imaging. Four cases were followed up with MRI after 4 to 8 weeks. Results MRI could determinate the severity and exact location of Achilles tendon rupture by demonstrating signal changes of Achilles tendon. In this series, complete rupture of Achilles tendon mostly occurred at the median part, with augmentation and high signal on T2WI. MRI demonstrated high signal on T2WI in partial rupture of Achilles tendon. The signal intensity in the four cases followed up by MRI was shown to decrease. Conclusion MRI is a valuable tool for clinical diagnosis and follow-up of Achilles tendon, because it provides enough information through signal changes at the tendon.

Proximal humerus fractures are clinically common upper limb injury,accounting for about 4％ to 5％ of all human fractures.At present,displaced proximal humerus fractures are often treated by locking plate fixation,but complications may follow.Of them,a locking screw piercing the humeral head has the highest incidence and is thus the most common reason for surgery.Such a screw tends to cause claws of the glenoid cavity,leading to severe pain.Therefore,it is an unavoidable challenge how to effectively prevent postoperative screw piercing for orthopedic surgeons who use locking plating to treat proximal humerus fractures.In this paper,the progress in research will be reviewed on the causes and management of screw perforation after locking plate fixation of proximal humerus fracture.

Objective To evaluate the effect and safety of low or medium heparinization in porcine model for coronary artery restenosis and investigate the rational dose of unfractionated heparin.Methods According to the doses of unfractionated heparin given to the animal models 24 porcines were randomized into low heparinization group(100 U/kg) and medium heparinization group(150 U/kg).We took blood samples from each porcine and measured the ACT value before intravenous injection of unfractionated heparin and 5 minutes,20 minutes,30 minutes and 60 minutes after heparinization.We compared the effects of anticoagulation,compression hemostasis and the occurance of adverse events.Results Both low and medium heparinization groups achieved the ACT peak value(245.3?93.64 s vs.241.0?37.29 s,P=0.824) 5 minute after intravenous injection of heparin and maintained high ACT value(191.8?53.06 s vs.184.6?42.82 s,P=0.707) within 20 minutes.The ACT value of medium heparinization group was higher than low heparinization group 30 minute later(193.9?58.95 s vs.154.0?28.20 s,P=0.005).The compression time for hemostasis in medium heparinization group was longer than low heparinization group(17.7?2.96 mins vs.14.3?4.44 mins,P=0.042).No peri-operation adverse events were found in both groups.Conclusion Low heparinization can provide adequate anticongulation for a 20-minute-operation and at the same time reduce the compression time for hemostasis in the porcine model for coronary artery restenosis.

Objective To investigate the application effect of service-learning pattern in clinical nursing teaching in Obstetric department. Methods A total of 113 nursing students in Obstetric department were randomly divided into two groups:57 were trained with traditional clinical nursing teaching method as the control group, 56 with service-learning teaching method as the experimental group. All students were examined for comprehensive assessment, including professional theory, professional operation and comprehensive quality after their training. At the same time, the clinical teaching satisfaction of nursing students were surveyed. Results There was no statistical difference in exam results between two groups of nursing students after training(P>0.05). However, the experimental group had higher achievements in professional operation and comprehensive quality after their training than the control group (35.24 points vs. 32.10 points, 16.27 points vs. 14.05 points), as well as, the clinical teaching satisfaction of the experimental group was higher than that of the control group(96.42% vs. 89.60% ), the differences were statistically significant (P<0.05). Conclusions Service-learning pattern can significantly improve the clinical teaching effect of undergraduate nursing students in Obstetric department.

Objective To evaluate the relation between cystatin C and the presence and severity of asymptomatic coronary artery disease in metabolic syndrome(MetS).Methods A total of 201 asymptomatic MetS patients with normal renal function were per-formed the coronary angiograph and the detection of serum Cystatin C level and other risk factors for atherosclerosis.Results Ser-um cystatin C level in the MetS patients with asymptomatic coronary artery disease were significantly higher than those in the pa-tients without coronary artery disease,moreover the more severe of the disease,the higher the cyctatin C,which was independently associated with other risk factors for atherosclerosis.Conclusion Serum cystatin C level can been used as the index for the presence and severity of asymptomatic coronary artery disease in Mets with normal kidney function.

Objective To investigate the anti-proliferation effect of triptolide-eluting stent, as well as its effectiveress, dose-effect relationship and safety. Methods Experimental stents were divided into 4 groups with 10 stents each, namely bare stent group, sirolimus-coated stent group, 5.6 ?g triptolide-coated stent group and 56 ?g triptolide-coated stent group. By morphometric and histopathologic analysis,we compared 5.6 ?g and 56 ?g triptolide-eluting stents with bare metal stents and sirolimus-eluting stents 28 days after stenting in rabbit iliac models of restenosis. Results The neointimal area of 5.6 ?g triptolide-eluting stents was similar to that of bare metal stents, but larger than that of sirolimus-eluting stents. The neointimal area of 56 ?g triptolide-eluting stents was smaller than that of bare metal stents and 5.6 ?g triptolide-eluting stents, but was similar to that of sirolimus-eluting stents. In all the groups, proliferation on both edges of the stents was insignificant. No toxic effect had been found in the experimental animals related to triptolide-eluting stent. Conclusion Triptolide-eluting stents may inhibit neointimal proliferation. The effect of inhibiting neointimal proliferation is dose dependent and with no adverse effect. These results suggest that triptolide-eluting stent can prevent restenosis within four weeks.

Objective To investigate and analyze the relationship of the level of high-sensitivity C-reactive protein (hs-CRP) and carotid artery atherosclerosis with acute cerebral infarction (ACI).Methods Fifty-nine patients with ACI were assigned as experimental group and thirty healthy people as control group. The serum level of hs-CRP was measured, and the carotid plaques and the changes of carotid intimal-medial thickness (IMT) were examined by color Doppler ultrasonography.Then the relationship between the serum level of hs-CRP and the severity of disease was analyzed.Results The serum level of hs-CRP was higher in ACI group than in control group [(5.96± 1.52)mg/L vs. (1.78±1.02) mg/L, t=15.383, P＜0.01]. The detection rates of carotid plaques and the increased carotid IMT were higher in ACI group than in control group [77.97% vs. 36.67%, x2 =12.92, P＜0.01; (1.18±0.17) mm vs. (1.02±0.15) mm, t=4.544, P＜0.05]. The hs-CRP levels were higher in the severe cases [(15.68±1.45) mg/L] than in moderate cases [(4.16±1.39)mg/L] and mild cases [(1.88±0.34) mg/L, t=37. 217, 25. 243, both P＜0.01]. Conclusions The elevated levels of hs-CRP have overt clinical significances for the atherothrombotic cerebral infarction. Early determination of hs-CRP is helpful to evaluate patient's condition and prognosis.