Objective To understand the current situation of smoking and the influencing factors among female students of a medical college in Chongqing .Methods By applying the stratified cluster random sampling method ,992 female students were sam-pled from 5 faculties 3 grades in this college for conducting the smoking questionnaire investigation .Results The smoking rate a-mong female students was 3 .51% and the attempting smoking rate was 9 .18% .Among them ,the higher smoking rate mainly fo-cused on the students from urban area ,which was 9 .30% .The female students without opposite attitude to college student′s smok-ing had the smoking rate of 12 .11% and the female students with peripheral friends smoking had the smoking rate of 28 .22% .The influencing factors of smoking among female students included the place where the students came from ,student′s attitudes to smok-ing ,the smoking status of their peripheral friends ,etc .Conclusion The smoking rate among female students in the medical college is basically consistent to that of the national level of female smoking ,but the total cigarette contact rate is higher .It is necessary to strengthen the frequent smoking control education and intervention on the female students in the medical colleges for effectively re-ducing the smoking rate and decreasing the smoking harm to the female health .

Objective To understand the current situation of smoking among students of a medical college in Chongqing and its influencing factors .Methods By applying the stratified cluster random sampling method ,1 437 students were sampled from 5 facul-ties 3 grades in this college for conducting the smoking questionnaire investigation .Results The smoking rate was 12 .69% ,which in males and females were 32 .59% and 3 .51% ,respectively .Among them ,the nursing faculty and the grade 1 had the lowest smok-ing rates ,which were 4 .02% and 8 .84% respectively ;the smoking rate in the students from different origins had no statistical difference(P>0 .05) .The influencing factors of smoking included male ,faculty ,fresh students ,parents with smoking habit ,drink-ing and the knowledge acquistion frequency of smoking harmful to health ,etc .Conclusion It is imperative to strengthen the fre-quent smoking control education and intervention among the students in the medical colleges ,especially to males and the fresh students ,for effectively reduce the smoking rate .

Objective:To investigate the clinicopathologic features and diagnostic methods of intraductal papillary(IP)lesions of the breast.Methods:The clinical data of 1 679 patients who had been pathologically diagnosed as having IP were analyzed retrospectively.Results:Nipple discharge is the most common clinical symptom of IP. According to the postoperative pathological results, IP patients were divided into solitary IP group and multiple IP group . Nipple discharge was more common in solitary IP group ( P<0.05). Bloody discharge and duct nipple discharge and discharge in unilateral breast were the most common clinical symptom of IP, though the difference was not significant ( P>0.05). The accuracy of diagnosing IP by fiberoptic ductoscopy(FDS) was 88.66% which was significantly higher than that of breast ultrasound and mammography. Solitary IP patients with nipple discharge undergoing FDS before surgery and lesions were more often detected located in general or level Ⅰ-Ⅱ duct system ( P<0.05). Postoperative follow-up did not show malignant transformation in solitary IP group, while there were 4 cases in the multiple IP group of malignant transformation and higher recurrence rate of IP ( P<0.05). Conclusions:Bloody discharge, single duct nipple discharge and unilateral breast involving 1esion and 1esions located in the general or level Ⅰ-Ⅱ duct system are common clinical features of IP. FDS has advantages in the diagnosis of IP with nipple discharge. For fear of recurrence , and malignant transformation in multiple IP, active postoperative follow-up should be carried out.

Objective To understand the smoking intention in future 3-5 years among the students of a medical college in Chongqing .Methods According to the stratified cluster random sampling ,1 457 students from 3 grades in 5 faculties were sampled and performed the questionnaire investigation on the smoking behavior and smoking intention .Results The smoking rate was 12 .69% and the attempting smoking rate was 14 .95% .Among them ,the smoking rate and the attempting smoking rate in males were 32 .59% and 27 .46% ,and which in females were 3 .51% and 9 .18% ,respectively .The proportions of the students with hesi-tation and affirmation for answering the smoking intention in future 3-5 years and the current smoking students were 49 .44% and 23 .89% respectively ;which were 34 .82% and 14 .29% in males and 10 .52% and 1 .65% in females respectively ;which were 10 .24% and 3 .01% in grade 1 ,24 .73% and 7 .44% in grade 2 and 20 .30% and 6 .70% in grade 3 .Conclusion Partial medical students still insist on smoking in future ,and especially the students with the hesitating attitude of smoking in the future occupy a higher proportion .So it is necessary to strengthen the smoking control work in medical college and the antismoking attitude educa-tion .

OBJECTIVE:To evaluate the economics of Yindan xintai dropping pills in the treatment of angina pectoris caused by coronary heart disease from societal perspectives. METHODS:Therapy regimens related to Yindan xintai dropping pills and con-trol regimens were selected from published literatures included in database,and the cost of therapy regimens and clinical effect data were extracted from literatures. Contingent evaluation method was used to measure people's willingness-to-pay for angina pectoris treatments. An econometric model was conducted to transfer the effectiveness data to benefit data. The economics of treatment was evaluated depending upon net benefit or incremental net benefit indicator. RESULTS & CONCLUSIONS:When Yindan xintai drop-ping pills is used alone,its net benefit is >0,indicating economical advantage;56 d therapy regimen is better than 28 d therapy. When Yindan xintai dropping pills were combined with glyceryl trinitrate tablet,Isosorbide mononitrate sustained-release tablet, Simvastatin dispersible tablet and other drugs,its incremental net benefit is better than control regimens and has good economics.

Objective To investigate the effects of continuous venovenous hemodiafiltration (CVVHDF) on plasma lipopolysaccharide (LPS),interleukin(IL) 1β,IL-4,high mobility group box 1 (HMGB-1) in multiple organ dysfunction syndrome (MODS) dogs,to explore the therapeutic mechnism of CVVHDF.Methods Dogs were subjected to hemorrhagic shock plus resuscitation and endotoxemia to establish MODS model,then they were randomly divided into 2 groups:CVVHDF group (n=6) and MODS group (n=6).After endotoxin injection completed,the CVVHDF group received CVVHDF treatment for 24 h; MODS group did not receive CVVHDF treatment.The LPS,IL-1β,IL-4,HMGB-1 levels in plasma and ultrafiltrate were measured at different time points(before operation,before intravenous infusion of endotoxin,0 h,3 h,6 h,9 h,12 h,18 h,24 h after intravenous infusion completion of endotoxin),then the sieving coefficient (SC) was calculated.Results Compared with MODS group,the LPS,IL-1β,IL-4,HMGB-1 levels in plasma were significantly decreased in the CVVHDF group at 9 h,12 h,18 h,24 h (P ＜ 0.05).Some concentration of IL-1β,IL-4 and HMGB-1 was detected in the ultrafiltrate,the SC for IL-1β,IL-4 and HMGB-1 was 0.60±0.12,0.83±0.11,0.70±0.09 respectively,and LPS could not be detected in the ultrafiltrate,its SC was 0.After treatment,the damage level of lung and renal had been significantly reduced in CVVHDF group.Conclusion CVVHDF can effectively reduce the levels of pro-inflammatory mediator and anti-inflammatory cytokine related to MODS,cut off the vicious circle of cytokine network and reduce the damage level of organism in the treatment of MODS.

Objective To measure the setup errors in thoracic esophageal carcinoma treated with intensity modulated radiotherapy (IMRT) using kilo-voltage cone-beam CT (kV-CBCT),and to evaluate the impact of the setup errors on the dose distributions in tumor target volume and the peripheral normal tissues.Methods Twenty-one patients with thoracic esophageal carcinoma undergoing image guided IMRT (IG-IMRT) were included in this study. Using kV-CBCT,173 setup errors of these patients were acquired before treatment.By shifting the isocenters,these setup errors were simulated in the 3-dimentional treatment planning system and the corresponding impact of the dose distribution in tumor target volume and peripheral organs were evaluated.Results The translational deviations of lateral,longitudinal and vertical directions were ( 2.73 ± 1.85 ),( 3.19 ± 2.71 ),and ( 2.35 ± 1.71 ) mm,respectively.The dose of gross tumor volume (GTV) was not impacted significantly by the setup errors. However,comparing with the standard plan without setup errors,the setup errors in the simulated plan reduced the dose of 95％ planning target volume (PTV) by 3.38 Gy.The dose to PTV Dmin and PTV Dmean were also reduced by 9.83 Gy and 0.65 Gy respectively. The correction of setup errors improved the conformity index (CI) and the homogeneity index (HI) for PTV.The C1 and HI for the standard plan were 0.74 ± 0.10 and 1.07 ±0.02, respectively. The C1 and H1 for the simulated plan were 0.69 ± 0.08 and 1.13 ± 0.07,respectively.Statistically significance was observed in these differences ( t =3.43 and -3.91 respectively,P ＜ 0.05 ). No statistical significance was observed in the dose differences in lungs,spinal cord and heart between the two plans ( P ＞ 0.05).The mean maximum dose of the spinal cord was (42.20 ± 4.97 ) Gy in the simulation plan,which was (41.37 ± 2.75 ) Gy in the standard plan.For some patients,the maximum dose of the spinal cord exceeded the tolerance level of 45 Gy in the simulation plan,and one case even reached 52.8 Gy.Conclusions Using the image guidance of kV-CBCT,the setup errors can be reduced significantly for patients with esophageal carcinoma receiving IG-IMRT.The correction of setup errors can increase the treatment precision and enhance the dose in PTV.No significant dose changes were observed in the lung,spinal cord and heart as a result of setup error correctio.

Objective To investigate the safety and efficiency of radiofrequency ablation (RFA) in the treatment of complicated multifetal gestations.Methods There were 6 multifetal pregnant women (gestational age ranged from 14+6 to 27 +2 weeks) diagnosed in the Department of Obstetrics,Provincial Hospital Affiliated to Shandong University:two with twin-twin transfusion syndrome (TTTS) stage Ⅳ,one with reversed arterial perfusion sequence,one with dichorionic triamniotic triplets,one with absence of a lower limb,one with severe intrauterine growth restriction.All of them accepted ultrasound-guided selective fetocide by RFA.Results (1) Blood flow of three reduced fetuses stopped completely after one RFA circulation,whereas the other three stopped after two circulations.One reduced fetus stopped heartbeating in 10 minutes after RFA; three reduced fetuses' heartbeats slowed down and stopped completely in 35 minutes after RFA ; and the heartbeats of the other two cases stopped completely within 3 to 7 minutes after RFA.The heartbeats of the reserved fetuses were normal.All of the operations succeeded.(2) The reserved fetuses received a series of ultrasound examinations after the operations.In Case 1,the ascites of the reserved fetus,which was 4.0 cm× 2.3 cm before RFA,disappeared two weeks later; and the umbilical artery systolic/diastolic (S/D) ratio,which was 3.35 before the operation,decreased to 2.70 six weeks later.Amniotic fluid depth decreased from 44.6 cm to normal two weeks after RFA.The reserved fetus received brain MRI three weeks after RFA and no abnormality was detected.In Case 2,the increased heart size (cardiothoracic ratio ＞ 0.35) of the reserved fetus recovered to normal size ten days after the operation ; and the umbilical artery S/D decreased from 4.69 to 3.39 seven days after the operation.Reserved fetuses of the other three cases were normal on ultrasound and MRI after the operations.In Case 6,the ascites of the reserved fetus,which was 2.3 cm × 1.5 cm before RFA,disappeared sixteen days after the operation.The brain MRI suggested normal three weeks after the procedure.Amniotic fluid depth reduced from 11.0 cm to normal two weeks after the operation.(3) Three women delivered normal premature babies,and the other three got healthy mature infants.At present,all children are still in follow-up,and their physical examinations suggest normal.Conclusions RFA is a safe,efficient,minimal invasive treatment,which provides a new choice for fetocide,especially for complicated monochorionic multifetal gestations.Fetocide by RFA can effectively improve the life quality of the reserved fetuses.

Objective To investigate the risk factors for sensorineural hearing loss (SNHL) in patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT).Methods From January 2012 to January 2013,29 patients with histopathologically confirmed NPC who received radiotherapy alone or concurrent chemoradiotherapy were included in this study.All patients underwent hearing tests,including pure tone audiometry and acoustic immittance measurement,before and after the IMRT.The cochlear doses for each ear were also collected for analysis.A prospective analysis was performed to investigate the relationship between cochlear dose and SNHL in patients with NPC,and the effects of other factors,including time after radiotherapy,chemotherapy,T stage,and age,were also analyzed.Results Of the 58 ears studied,6(10％) had low-frequency SNHL,and 17 (29％) had highfrequency SNHL.There were significant differences in mean cochlear doses between the patients who developed SNHL after radiotherapy and those who did not (left ears:46.1 Gy vs.35.5 Gy,P =0.006;right ears:45.0 Gy vs.35.8 Gy,P =0.009).When the mean cochlear dose was less than 44 Gy,only 15％ (6/38) of ears had high-frequency SNHL.The invasion of skull base bone was also a significant risk factor for SNHL(P =0.047),but age,chemotherapy,and time after IMRT were not significant risk factors.Conclusions The mean cochlear dose and invasion of skull base bone are significant risk factors for SNHL in patients with NPC after radiotherapy.It is recommended that the mean cochlear dose should be limited to 44 Gy to minimize the incidence of SNHL after IMRT.

Objective To explore the feasibility and safety of primary suture in laparoscopic common bile duct exploration(LCBDE) for treating choledocholithiasis.Methods The clinical data in 185 cases of choledocholithiasis underwent LCBDE in Sun Yat-sen Memorial Hospital from March 2010 to October 2015 were retrospectively analyzed.The patients were divided into 1aparoscopic common bile duct exploration and primary suture(LBEPS) group(117 cases) and T tube drainage group(68 cases) according to different processing modes of common bile duct incision.The operative time,intra-operative blood loss amount and postoperative complications were observed in the two groups.Results All operations were successfully performed in both two groups without converting to laparotomy.The operative time,intra-operative blood loss amounts and postoperative complications had no statistically significant differences between the LBEPS group and T tube drainage group(P>0.05).The postoperative hospital stay of the LBEPS group was significantly shorter than that of the T tube drainage group(P<0.01).There was no bile duct stricture or stone recurrence during the follow up period in the two groups.Conclusion Under strictly grasping the operation indication,selecting correct suture material and possessing practiced operating skills,primary suture of laparoscopic choledocholithiasis is safe and feasible,can avoid the risk of T tube placing related complications,has short postoperative hospitalization duration and increases postoperative living quality.