Objective To explore the dosimetric effect of using a split of the gross tumor volume (GTV) delineation approach during intensity-modulated radiotherapy (IMRT) treatment planning for advanced T-stage nasopharyngeal carcinoma (NPC) with prevertebral space involvement (PSI).Methods Twenty NPC patients with T3-T4 tumors with prevertebral space involvement were studied.Two kinds of plans were generated based on the same protocol.The first plan was GTV-split consisting of organ at risk (including spine cord and brain stem) overlapping and non-overlapping subsegments.The subsegments were assigned independent dose constraint.The second plan was done based on a standard treatment planning protocol.The two plans were compared with respect to target coverage and organ at risk (OAR) sparing,and target conformity index.Results Two plans both met requirement of dose coverage of target and constraints on normal tissue.Regarding the planning gross target volume (PGTV),the doses of ＜ 93％ volume of plan 1 and plan 2 were [(0.63 ± 0.21)％,and (0.68 ± 0.10)％,P =0.049];the doses of ＞ 110％ volume of plan 1 and plan 2 were [(11.59 ± 7.Ol) ％,and (12.71 ± 6.03) ％,P =0.041];the doses of ＞115％ volume of plan 1 and plan 2 were [(2.05 ± 0.80)％,and (2.76 ± 1.14)％,P =0.049];about OARs,the maximal dose of spine cord for plan 1 and plan 2 were (41.00 ± 4.52) Gy and (45.00 ± 3.25) Gy (P =0.048);and the target coverage and target conformity index of plan 1 were better than those of plan 2,the p-values were 0.063,and 0.135,respectively.The difference between two plans was statistically significant (P ＜ 0.05).Conclusions A split-GTV delineation,independent dose constraint,and multi-course IMRT for advanced T-stage nasopharyngeal carcinoma with prevertebral space involvement optimized IMRT treatment planning,improved target coverage and target conformity index,and decreased the maximal dose for the spine cord and brain stem.It is feasible and has advantage to decrease the dose to OARs.The approach deserves to be further studied.

Objective To develop a mobile application and to investigate the feasibility to support exercising in patients with chronic ob-structive pulmonary disease (COPD) in home. Methods TheCOPDmobile application include 6 function modules including exercising, exercising reminder, ranking, the basic knowledge of disease, exercising statistics and questionnaire collecting. 15 eligible patients with COPD were recruited in the outpatient departments of a tertiary hospital in Beijing by convenience sampling method from August to Decem-ber, 2015. They received Redmi 2a phones and were taught to use COPD application pre-installed in phones. They were asked to useCOPDapplication to support exercising at home for 1 month. Study outcomes included user satisfactions and exercising data. Results 14 (93.3%) patients thoughtCOPDapplications were helpful for exercising, 12 (80%) patients were satisfied withCOPDapplication. Some patients reported difficulty in manipulating smartphones and mobile applications. Some suggestions were put forward, such as, the stability and speed of data transmission should be improved and the sound of metronome should be increased. They exercised (44.6±8.4) minutes ev-ery day for (4.9±1.1) days per week in the latest 1 month. Conclusion Patients with COPD were highly satisfied withCOPDapplication.

ObjectiveTo probe into the clinical application effect of continuity care model in stroke patients. Methods58 patients with stroke in our hospital during June 2008 to June 2011 were selected.According to block randomization method,the selected patients were divided into the study group and the control group with 29 patients in each group.The control group received routine care interventions,while patients in the study group was given routine care interventions plus continuity care model.Activities of daily living,compliance behavior,quality of life,nursing satisfaction degree and other related indicators of patients in two groups were comparatively analyzed. ResultsCompared with the control group,the activities of daily living of the study group at discharge did not show significant differences,while 1 month,3 months,6 months after discharge,the activities of daily living was significantly increased.Regular medication,exercise time,timely return visit,proper diet and other indicators of compliance behaviors were significantly improved.The quality of life score did not show significant differences at discharge,while 3 months after discharge,the quality of life score were significantly higher in the study group than that of the control group.The satisfaction degree of patients was significantly higher in the study group than that of the control group. ConclusionsApplication of continuity care model in stroke patients can improve activities of daily living,compliance behavior,quality of life,satisfaction degree with nurses.It's worthy of further clinical application and promotion.

Objective To establish a method for content determination of swertiamarin in Lomatogoniopsis alpina. Methods HPLC method for determination was used. Chromatographic column: Alltimal C18 (250 mm?4.6 mm, 5 ?m). Mobile phase: methanol-water (including 0.05% H3PO4), and gradient elution. Flow rate:1 mL/min. Wavelength:234 nm. Column temperture:30 ℃. Results The calibration curve of swertiamarin was in good linearity over the range of 3.10～30.98 (r =0.999 1). The average recoveries were 98.0%, with RSD=2.66% (n =6). Conclusion It is a simple and sensitive method in controlling the quality of Lomatogoniopsis alpina.

Aim Toresearchthemolecularmecha-nisms of adriamycin-induced cardiomyocyte apoptosis based on β-adrenoceptor signaling pathway during de-velopmentofheartfailure.Methods SeventymaleSD rats were assigned randomly into two groups:the con-trol group(CON,n=30)and the ADR-induced cardio-toxicity group (ADR,n =40 ).ADR was administered intraperitoneally in five equal injections (each contai-ning 3 mg·kg-1 )over a period of two weeks,with a total cumulative dose of 15 mg · kg-1 body weight. Age-matched rats injected with saline were used as controls.The general condition of all rats was observed, and transthoracic echocardiography was performed im-mediately following the final ADR injection,and then every other week.Serum and myocardial tissue were harvested at W2,W4 and W6 separately.The serum contents of brain natriuretic peptide(BNP)and cardiac troponin-T(cTn-T)were analyzed by euzymelinked im-munosorbent assay (ELISA ).The pathological change and apoptosis were determined by HE,Masson and ter-minal deoxyribonucleotide transferase-mediated dUTP nick end labeling (TUNEL).The protein expressions ofβ1-AR,β2-AR,PKA and CaMK Ⅱ were detectedbyWesternblot.Results FollowingthefinalADRin-jection,cardiac systolic function and SV declined, which was accompanied by marked atrophy of the heart,low levels of cardiomyocyte fibrosis and apopto-sis,significantly increased serum BNP and cTn-T and decreased β1-AR,PKA and CaMK Ⅱ protein expres-sion.However,cardiac systolic function was improved with the extension of time but remained depressed as compared to CON group.The serum BNP and cTn-T concentration kept on rising.The gradual aggravation apoptosis and concomitant fibrosis in the ADR group heart were observed following ADR withdrawal.β1-AR protein expression was continuously down-regulated,β2-AR protein expression unchanged.Expression of PKA and CaMKⅡ proteins in hearts from ADR-injec-ted rats gradually increased.Conclusion β-AR/PKA/CaMKⅡ signaling pathway mediates cardiomyo-cyte apoptosis during the progress of ADR-induced car-diac dysfunction and pathological remodeling and apop-tosis.

Objective To observe the therapeutic effect of beehive extract for the treatment of allergic rhinitis. Methods Sixty qualified subjects were evenly randomized into large dose group and small dose group, 30 in each group. The large dose group was given oral use of beehive extract 15 g per time, and the small dose group was given 5 g per time, three times per day. One week constituted a treatment period, and the treatment lasted 4 courses. After treatment, the therapeutic effect was evaluated in both groups. Follow-up was carried out one month after suspension of medicine. Results ( 1) The total effective rate was 90.00% in the large dose group, and was 93.00% in the small dose group, and the rank sum test results showed the difference was insignificant between the two groups (P>0.05) . (2) After treatment and during follow-up, the scores of general symptom Visual Analog Scale ( Uni-VAS) and the scores of Rhinoconjunctivitis Quality of Life Questionnaire ( RQLQ) were decreased in both groups ( P<0.01) , and the scores of symptoms in the small dose group were increased during the follow-up ( P<0.05) . The results of intergroup comparison showed that the differences of the decrease of Uni-VAS scores, symptom scores, non-nose/eye symptom scores, practical issue scores, nasal symptom scores, eye symptom scores and emotional reaction scores were insignificant between the two groups after treatment and during the follow-up ( P>0.05) . Conclusion Oral use of large or small dose of beehive extract shows certain therapeutic effect for allergic rhinitis by obviously relieving the symptoms of patients. The effect of large dose is similar to small dose, but the long-term effect of large dose is better.

Aim To optimize the traditional method of right catheterization in rats and establish a rapid , stable and reliable method of the right heart catheter guided intubation to measure pulmonary artery pressure. Methods Nighty male wistar rats were used to optimize the method of detection of pulmonary arte-rial pressure. Three catheter namely PE50, PU I, and PU II were used for choosing the best intubation. The new technology of right catheterization was established and used for the research of pulmonary arterial hypertension. Results The PU I catheter was obviously better than PE50 and PU II catheter in the success rate and measurement time ( P <0. 05 ) . The method of right heart catheter guided intubation was significantly superior to the traditional right heart direct intubation (P<0. 05 or P<0. 01). After improving the right catheterization, the detection of hemo-dynamic indexes in PAH-model rat was successful with regular pressure curve and reliable experimental data. Conclusions The right heart catheter guided intubation method has a high suc-cess rate and it can detect the pulmonary artery pressure quick-ly, easily, and can help other researchers to complete experi-ment as efficiently as possible.

Objective To investigate the effect of interferon-γ(IFN-γ) on the expression of indoleamine 2,3-dioxygenase(IDO),and tryptophanyl-tRNA-synthetase (TTS) in thyrocytes; and to study the relevant immunopathological significance in Graves' disease.Methods The expressions of IDO and TTS genes in IFN-γ stimulated Nthy-ori3-1 cell line and human thyrocytes,as well as in human thyroid tissues were determined by realtime quantitative PCR.Results IDO and TTS genes were expressed slightly in both Nthy-ori3-1 cell line and human thyrocytes,and were significantly up-regulated after IFN-γ stimulation(P＜0.01).Compared to healthy controls,TTS mRNA level was higher in thyroid tissues of patients with Graves' disease (P =0.018 2),while IDO mRNA level showed no difference,but was notably correlated with IFN-γ mRNA level (R2 =0.716,P =0.002).Conclusion In the early stage of Graves' disease,thyrocytes may decompose local tryptophan by enhancing the expression of IDO and TTS under IFN-γstimulation,thus inhibit auto-reactive function of lymphocytes and balance excessive autoimmune reaction.

Objective To explore the dynamic changes in the plasma levels of thrombomodulin(TM)with traumatic hemor-rhagic shock (THS).Methods The model of the THS with gradient decerease in the systolic blood pressure was eatablished in 1 7 rats without specific pathogen.The arterial blood during the different phase of shock,i.e.when the systolic pressures were three forth,one second,two fifth of the basis systolic blood pressure,one fifth of the basic systolic blood pressure and 10mmHg,was collected and TM levels in the plasma were determined by the double antibody sandwich method of enzyme-labeled immunosorbent assay (ELISA)and analyzed.Results There were significant differences in plasma levels of TM be-tween groups,with TM levels in T2~T3 period of time increased with the extension of time,and TM levels in T4~T5 peri-od of time decreased with the extension of time,and TM levels in T5~T6 period of time increased with the extension of time.Conclusion The animal model of THS was related to the systolic pressure during the shock,may be helpful to assess-ment changes in blood loss.The dynamic observation of the plasma levels of TM which is a good index of the damage to the vascular endothelial cells,may be helpful to assessment of the THS is related to the degree of damage to the vascular endo-thelial cells.

In this study ,we analyzed the genetic characterizations and propagation paths of measles viruses prevalent in Ningbo ,China from 2004 to 2013 .Measles viruses were isolated from throat swab specimens from 2004 to 2013 ,and 450 bp fragments of C terminus of nucleoprotein (N) gene were amplified by RT-PCR .Sequence analysis was conducted of all 31 virus strains ,and then compared with other measles virus strains published in GenBank .Results showed that all the 31 measles virus isolates belonged to genotype H1 ,6 strains (one strains in 2004 and 5 ones in 2005) belonged to H1b subtype ,and others be-longed to H1a subtype .Compared the 31 strains to the China 93-4 and China 94-7 ,the homology of 450 bp fragments of C ter-minus of nucleoprotein (N) gene were 97 .1%-100% and 96 .7%-100% ,respectively .The homology of 450 bp fragments of nu-cleotide and nucleotide (amino acids) compared with S191 were 81 .9%-92 .4% and 87 .2%-90 .6% ,respectively .It’s suggested that genotype H1 measles virus circulated in Ningbo from 2004 to 2013 ,and H1a was the predominant epidemic strain ,and H1b strain was existed as well .There are five different transmission chains of H1a subtype caused measles co-circulations in Ning-bo .