0.05),but incidence of recurrent angina was higher in NHT group(P

Objective To observe the effect of rehabilitation on ADL scores in patients with type 2 diabetes complicated with cerebral stroke.Methods According to the selected order,three hundred and twenty type 2 diabetes patients complicated with cerebral stroke were numbered in Arabic numbers 1,2,3 and so on,the odd number patients were randomly enrolled into the observation group,the even number patients were assigned into the control group.The control group was only given corresponding clinical treatments.In addition to the same clinical treatments,rehabilitation training was given to the observation group at the same time.The ADL scores,change between the two groups were compared after three months.Results After treatment,the ADL score of the observation group was significantly improved,the difference was statistically significant (t =-24.9,P =0.000,P ＜ 0.05).The ADL score of the control group was also improved,and the difference was statistically significant (t =-15.52,P =0.000,P ＜ 0.05).The ADL score between the observation group and the control group had statistically significant difference (t =24.24,P =0.000,P ＜ 0.05).Conclusion Type 2 diabetes patients complicated with cerebral stroke who are early given rehabilitation training actively,car significantly improve the function of hemiplegia limbs,improve the ADL scores and the quality of life.

0.05), although there were more patients with large area anterior infarction and enlarged left ventricle in the DEF group (P

Objective To evaluate the capability of virtual non-contrast (VNC)of the second-generation dual-source CT (DSCT), and to display the adipose tissue of gastric serosa.Methods 48 patients with gastric cancer undergoing preoperative DSCT and sur-gery were enrolled.The true non-contrast (TNC)values and VNC values of perigastric adipose tissue were measured and compared with conventional non-contrast scanning and VNC of arterial phase and venous phase.The VNC values of perigastric adipose tissue were compared between serosal involvement group and non-serosal involvement group.Results There was statistical difference be-tween TNC values and VNC values of perigastric adipose tissue (P <0.05),the absolute differences were under 13 HU.The differ-ence of VNC values between serosal involvement group and non-serosal involvement group was significant (P <0.05).Conclusion VNC of the second-generation DSCT can clearly display the adipose tissue of gastric serosa.It has certain capability in judging sero-sal involvement.VNC has the proficiency to replace conventional non-contrast scanning.

Objective To investigate the clinical utility of dual-energy virtual non-contrast CT(VNCT)of dual source CT in the di-agnosis and differential diagnosis of solitary pulmonary nodule(SPN).Methods Thirty-six patients with suspected SPN underwent chest plain single energy CT and dual-phase contrast enhanced CT (DECT)(25 and 90 s).The images of dual energy were sent to a commercial workstation for VNC image generation.CT values of SPN on VNC and true non-contrast(TNC),as well as signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were compared.The accuracy of calcification detection was compared according to the diameter and density of the calcification.The TNC images were used as the reference.Results CT values,SNR and CNR of VNC had no statistical difference among TNC and VNC at 25 s and 90 s(P >0.05).DECT VNC(5mm slice)could accurate detected calci-fication(diameter>2 mm,CT value>1 50 HU)in SPN.The 2 mm slice performed significantly better than 5 mm slice VNC images. Conclusion The VNC could provide consistent diagnostic information with TNC.The thin slice DECT VNC images can be used in clinical practice to replace TNC without losing small calcification in SPN,which has potential to reduce the patient radiation dose.

Objective To analyze the clinical efficacy of daily online cone-beam computed tomography (CBCT)-guided stereotactic body radiation therapy (SBRT) for primary and metastatic lung cancer and its related factors.Methods From May 2009 to May 2013,36 patients with lung cancer were treated with SBRT,including 24 patients with primary lung cancer and 12 patients with metastatic lung cancer.The biologically effective dose at 10 Gy was ≥ 100 Gy in 85.7％ of 42 lesions.Before each delivery,CBCT was acquired,and online automatic or manual registration was performed to make the tumors on CBCT within the planning target volume/primary gross tumor volume;the setup threshold was not set,and the couch was moved for correction.Results The 1-,2-,and 3-year sample sizes were 36,29,and 26,respectively.The 1-,2-,and 3-year local control (LC) rates were 96％,89％,and 72％,respectively.The 1-,2-,and 3-year cancer-specific survival (CCS) rates were 82％,74％,and 64％,respectively.The 1-,2-,and 3-year overall survival (OS) rates were 78％,64％,and 53％,respectively.Univariate analysis found no factors associated with LC.Multivariate analysis revealed no factors associated with OS.Both univariate and multivariate analyses showed that only tumor location (central type or peripheral type) was associated with CCS;the mean values (95％ confidence intervals) of CCS in patients with central-type and peripheral-type lesions were 21.4 months (13.2-29.6 months) and 42.3 months (35.7-49.0months),respectively (P=0.024).Conclusions Daily online image-guided SBRT for primary or metastatic lung cancer can lead to a satisfactory LC.

Objective To study a series of tests to the IMRT planning system RayStation,and verify the feasibility of this Standard.Referring to the standard Performance and test methods for intensity modulated radiation therapy (IMRT) treatment planning system (Standard).Methods Referring to the Standard,the tests include:dose goals used for planning,point dose calculation accuracy and dose distribution calculation accuracy.And test phantoms include:AAPM TG119 report's test cases and solid water phantom for verification,and IMRT test cases include:multitarget,mock prostate,head/neck and CTshape (easier version and harder version) and so on.Referring to the Standard,we optimize and calculate doses of interest in RayStation,and use the common measurement equipments and tools,such as an ionization chamber,films,a detector array,and etc,to measure the doses on the accelerator,then calculate and analyze the errors between them.Results The results of dose goals for five different mock plans meet the requirements of the Standard.And the point dose ionization chamber measurements are in line with the requirements of the Standard,and the total error of the mock plans was (0.83 ± 1.65) ％.The γpass rates of per-field measurements using detector array are all greater than 99.0％,and the γpass rates of composite film measurements are all greater than 92.5％.Conclusions The results of three trials to IMRT performance of RayStation are in full compliance with the requirements of the Standard.And also it is an evidence for the feasibility of this Standard.

Objective To investigate the application efficacy objective structured clinical exam-ination (OSCE) in assessment of interns of traditional Chinese medicine in anesthesiology department. Methods Totally 62 interns were examed by OSCE formulated by anesthesiology department before de-partmental rotation. Contents of the exam included preoperative evaluation,endotracheal intubation tech-nique,deep venipuncture,lumbar puncture,case analysis,medical documents writing,etc. Assessment was made by exam results and questionnaire survey. Quantitative data were analyzed by ANOVA and results of questionnaire were analyzed by calculating percentage of each option and describing directly. Results Test results showed that the score of medical document writing was the highest(18.25 ± 1.53),while that of case analysis was the lowest(13.49±1.46)and there was no significant difference in scores of three clinical skills. Questionnaire survey showed the OSCE method is superior to traditional method since it is more scientific,objective and fair. Conclusions OSCE method can scientifically as-sess the clinical practice effect of interns of traditional Chinese medicine in anesthesiology department. Meanwhile, it can find the shortcomings in the teaching, which is helpful in promoting the assessment and improvement of clinical teaching.

Objective To observe the analgesic effects of dexmedetomidine combined with dif-ferent-doses of sufentanil in patients undergoing spine surgery.Methods Sixty patients(ASA grade Ⅰor Ⅱ degree,age 18-70 years)undergoing spine surgery were randomly assigned into three groups ac-cording to PCA formulation(n =20):3 μg/kg sufentanil group (group S1),1.5 μg/kg dexmedetomi-dine+ 2 μg/kg sufentanil group (group S2 )and 1.5 μg/kg dexmedetomidine + 1 μg/kg sufentanil group (group S3).The same anesthesia method was applied among three groups.Patient-controlled intravenous analgesia pump was applied before 30 minutes prior to the end of surgery.The drugs in each group were diluted to 1 50 ml and infused by a pump at a rate of 3 ml/h with a patient-controlled analgesia (PCA)bolus of 0.5 ml and lock time of 30 minutes.VAS and Ramsay scores at 2 h(T0 ),4 h (T1 ),8 h(T2 ),12 h(T3 ),24 h(T4 )and 48 h(T5 )after surgery were estimated.Postoperative nausea and vomiting,bradyrhythmia and hypersomnia were also recorded.Results Compared with group S1, VAS of groups S2 and S3 was significantly decreased at T1-T5 (P <0.05).There were also no signifi-cant difference in the incidence of postoperative nausea and vomiting,bradyrhythmia and hypersomnia among three groups.Conclusion Dexmedetomidine of 1.5 μg/kg can significantly reduce the dosage of sufentanil on postoperative analgesia in patients undergoing spine surgery,and decrease the rate of postoperative nausea and vomiting without any bradyrhythmia and hypersomnia.

Objective To restrospectively investigate clinical outcomes and prognositic factors in localized prostate cancer treated with neoadjuvant endocrine therapy followed by intensity modulated radiotherapy (IMRT). Methods Between March 2003 and October 2008, 54 localized prostate cancer treated by IMRT were recruited. All patients had received endocrine therapy before IMRT. The endocrine therapy included surgical castration or medical castration in combination with antiandrogens. The target of IMRT was the prostate and seminal vesicles with or without pelvis. The biochemical failure was defined according to the phoenix definition. By using the risk grouping standard proposed by D'Amico, patients were divided into three groups: low-risk group (n = 5), intermediate-risk group (n = 12), and high-risk group (n = 37). Kaplan-Meier method was used to calculate the overall survival rate. Prognostic factors were analyzed by univariate and multiple Cox regression analysis. Results The follow-up rate was 98%. The number of patients under follow-up was 39 at 3 years and 25 at 5 years. Potential prognostic factors, including risk groups, mode of endocrine therapy, time of endocrine therapy, phoenix grouping before IMRT, the prostate specific antigen doubling time (PSADT) before radiotherapy, PSA value before IMRT, interval of endocrine therapy and IMRT, irradiation region, and irradiation dose were analyzed by survival analysis. In univariate analysis, time of endocrine therapy (75 % vs 95 %, χ~2= 6. 45, P = 0. 011), phoenix grouping before IMRT (87% vs 96%, χ~2 = 4. 36, P = 0. 037), interval of endocrine therapy and IMRT (80% vs 95% ,χ~2= 11.60,P= 0. 001) ,irradiationdose(75% vs 91% ,χ~2=5.92,P= 0. 015) were statisticallysignificant prognostic factors for3 - year overall survival , and risk groups (85 vs 53 vs 29 , χ~2= 6. 40,P =0. 041) and PSADT before IMRT (62 vs 120, U =24. 50,P =0. 003) were significant factors for the median survival time. In the multiple Cox regression model, only time of endocrine therapy and phoenix grouping before IMRT were significantly related to the overall survival. The 3-year overall survival rates in patients with endocrine therapy less than 3 months versus more than 3 months were 75% versus 95% (χ~2= 5.45, P= 0.020). The 5-year overall survival rates in patients with biochemical failure versus nobiochemieal failure was 71% versus 92% (χ~2= 8.83 , P= 0.003) Conclusions Neoadjuvant endocrine therapy should last at least three months. Intensity modulate radiotherapy should start before biochemical failure after the endocrine therapy.