Objective The objective of this study was to study the dosimetric characteristics and advantages of Non-coplanar IMRT techniques stereotactic body radiation therapy(SBRT)in the early stage of NSCLC.Methods Ten patients were selected with early stage of NSCLC.Treatment planning designed 9 fields coplanar IMRT and 9 fields Non-coplanar IMRT,respectively.Non-coplanar plans include five coplanar fields and four non-coplanar fields.Two group patients' plans compared V2.5,V5,V20,V25 of the whole lung,the average exposure doses of the whole lung,and the average exposure doses of the contralateral lung.The comparison of the other OARs include:spinal cord Dmax,heart Dmax,esophagus Dmax,trachea Dmax,chest wall Dmax and V30 of chest wall.At the meantime,we compared the conformal index of PTV(CI)and the homogenization index of PTV(HI).Results Non-coplanar plans reduced V20 of the whole lung(P=0.001),the average exposure dose of the contralateral lung(P=0.001),but V5 of the whole lung non-coplanar plans were increased than that in coplanar plans(P=0.002).Non-coplanar technology reduce max dose of spinal cord,esophagus,trachea,chest wall and V30 of chest wall(P=0.026,0.001,0.026,0.008,0.016).Heart Dmax of the non-coplanar plans was high in coplanar plans with no statistical significance difference(P=0.296).The conformal index of PTV of the non-coplanar plans was better(P=0.036),there was no difference in the homogenization index of PTV(P=0.254).Conclusion The stereotactic body radiation therapy of the early stage of NSCLC,the non-coplanar technology can effectively reduce exposure doses of the lung tissue and the other most OARs,also improve the conformal index of the PTV.The non-coplanar technology have possibility in reducing complications when compared with the coplanar technology and therefore has certain dosimetry advantage.

Objective: To study the relationship between blood pressure (BP) rhythm and cognitive function in elder hypertension patients. Methods: Our research included in 2 groups: Hypertension group:n=74 patients≥80 years and Control group, n=36 elder subjects without hypertension. 24-hour ambulatory blood pressure monitoring (ABPM) was conducted in both groups. According to nocturnal BP reduction rate, Hypertension group was further divided into 4 subgroups as Dipper type BP subgroup, Non-dipper type BP subgroup, Anti-dipper type BP subgroup and Super-dipper type BP subgroup. Cognition function was evaluated by Mini-menta state examination (MMSE) form, MMSE score was compared among different groups and subgroups. Results: By MMSE score, the abilities of orientation, memory, attention, calculation and recall were different between Hypertension group and Control group,P<0.05. By MMSE score, the abilities of orientation and memory were different between Anti-dipper type BP subgroup and Dipper type BP subgroup,P<0.05; the abilities of orientation, memory, attention, calculation and recall were different between Non-dipper type BP subgroup and Dipper type BP subgroup,P<0.05; the memory was different between Super-dipper type BP subgroup and Dipper type BP subgroup,P<0.05. Conclusion: In elderly hypertension patients, compared to those with normal BP rhythm, the abnormal BP rhythm patients had the higher probability to suffer from cognitive dysfunction which was mainly as decreased abilities of orientation, memory, attention, calculation and recall.

Objective To design a new procedure for outpatient safe infusion.Methods Aiming at the errors possibly occur in current management of hospital outpatient infusion process,modern wireless and intelligent recognition technology are applied to research and design a new infusion procedure.Results Based on its program difference from the LAN technology of fixed-point check transfusion management style,this solution truly met the needs of actual medical infusion process and achieve the dynamic information check,exchange and matching between the hospital staffs and patients.Conclusion It ensures the safety of transfusion patients,and creates a harmonious environment for treatment.

Objective To analyze thyroid papillary carcinoma (PTMC) neck lymph node metastasis (LNM) related factors,and further to explore the diagnostic value of ultrasonography in LNM.Methods A retrospective analysis of 384 cases of patients with PTMC confirmed by pathology and ultrasonic data were performed,according to the presence of cervical lymph node metastasis,they were divided into transfer group (116 cases) and nontransfer group (268 cases).Analysis was made to summarize the clinical and sonographic features of the two groups.Chi-square test and the multi-factor Logistic regression analysis were used to study the risk factors.Results ①The single factor analysis of sonographic features showed that the factors of gender (X 2 = 3.893,P = 0.048),age (P = 0.001),tumor diameter (P = 0.008), boundary(X 2 =6.327,P =0.012),acoustic halo (X2 = 15.562,P =0.001),and place (X 2 =9.441 ,P =0.024) were statistical different between the two groups;②Multiariable Logistic regression analysis showed that:patient age,tumor diameter,and acoustic halo were independent risk factors for PTMC neck lymph node metastasis,if Logistic model was used to predict the probability P =0.50 as a threshold,its accuracy was 74.2%,and the area under the ROC curve was 0.744.Conclusions Patients with age ≤ 45 years, tumor diameter ≥ 0.7 cm,located in the lower pole,boundary with uneven acoustic halo,were prone to LNM,and easy to Ⅵ area,suggest preventive cleaning lymph node in central region.

OBJECTIVE:To observe clinical efficacy and safety of Modified xiaohuang paste in the treatment of paralytic ileus after thoraeolumbar fractures.METHODS:One hundred and thirty-eight patients with paralytic ileus after thoracolumbar fractures were divided into control group (group A,43 cases),Xiaohuang paste group (group B,47 cases) and Modified xiaohuang paste group (group C,48 cases).Group A was given routine treatment as fasting,gastrointestinal decompression,fluid replacement,nutritional support;group B was additionally given Xiaohuang paste on the basis of group A;group C was additionally given Modified xiaohuang paste on the basis of group A.Group B and C were given relevant paste every 12 h until intestinal peristalsis was recovered and gas exhausted from anus,at the most for 5 days.The improvement time of clinical symptom improvement,VAS score and CRP level were compared among 3 groups as well as the occurrence of ADR.RESULTS:After treatment,the time of gastrointestinal decompression,bowel sound recovery and passage of gas by anus in group B and C were significantly shorter than group A,and group C was significantly shorter than group B,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in VAS score and CRP level among 3 groups (P＞0.05).After treatment,VAS score of abdominal pain and distension,CRP level of 3 groups were decreased significantly compared to before treatment;those of group C were significantly lower than group A and B,and CRP level of group B was significantly lower than that of group A,with statistical significance (P＜0.05).There was no statistical significance in VAS score between group A and B (P＞0.05).No significant ADR was found in 3 groups.CONCLUSIONS:For paralytic ileus after thoracolumbar fracture,Modified xiaohuang paste can significantly shorten treatment duration,relieve abdominal distension and pain,inflammation with good safety.

Objective To investigate paclitaxel cross resistance and provide information for clinical therapy by establishing a paclitaxel resistant human lung adenocarcinoma cell line.Method A paclitaxel resistant human lung adenocarcinoma cell line named with SPC-A1/Taxol was developed by intermittent exposure to gradually increasing concentration of taxol.Resistant index was calculated from median inhibitory concentration(IC50)which was evaluated by MTT assay.Results SPC-A1/Taxol cell line displayed high resistance to taxotere,vinorelbine,vincristine and doxorubicin.It also displayed median or low resistance to camptothecins and podophyllotoxins.No cross resistance was observed to antitumor platinum and antimetabolite drugs and elemene emusion.Conclusion SPC-A1/Taxol cell line is a typical multidrug-resistant cell line in vitro.It could be useful for studing the cross resistance and direct clinical medication.

Grid management plays an important role in improving the efficiency of social service management. The authors explored the establishment of a nosocomial infection grid management model and implemented it at a tertiary general hospital in Shanghai. χ2 test results showed that since the hospital fully implemented the grid management model in early 2016, the number of hospital infections, surgical site infections, type I surgical incision infections, and ventilator-related pneumonia had shown a downward trend year by year. The number of inspections before the use of antibacterial drugs, the number of blood cultures submitted for fever patients, and the timing of hand hygiene compliance showed an increasing trend year by year( P<0.05), and the management of nosocomial infection was more effective than the previous period. The application of grid management model required establishment of grid organization structure, control of key links, implementation of the special personnel responsibility, formulation of a performance evaluation system, and implementation of incentive measures. The grid management model can significantly reduce the risk of hospital infection, improve the efficiency of hospital infection management, and was valuable to be applicated and promoted in medical institutions.

AIM To study the cancer promoting effects of N nitrosodiethylamine (DEN) and 2 Acetylaminofluorene (2 AAF). METHODS Medium Term Rat Liver Bioassay (MTRLB). Male SD rats were initially given a single dose (200 mg?kg -1 ) of DEN ip and starting 2 weeks later, were treated with 10, 33 and 100 ppm DEN in drinking water, or with 2 2, 6 6 and 22 mg?kg -1 2 AAF by gavage for 6 weeks. All rats were subjected to two thirds partial hepatectomy at week 3 and killed at the end of week 8. Carcinogenic potential was scored by comparing the numbers and areas in induced glutathione S transferase placental form (GST P) positive foci in the liver with those of corresponding control group given DEN alone. RESULTS Both DEN and 2 AAF caused the increases of the numbers and areas of GST P positive foci in the liver, and showed dose response relationship. CONCLUSION Both DEN and 2 AAF shows cancer promoting effects, and MTRLB was a convenient, economical and effective tool to study the cancer promoting effects of test chemicals.

Objective:To investigate the site and characteristic ofp53 gene mutations in familial or early-onset breast cancer patients in part population of southern China.Methods:A total of 150 patients with familial and early-onset breast cancer in parts population of southern China were enrolled.Genomic DNA was isolated from each peripheral blood sample,and the entire coding sequence and exon and intron splicing region of p53 gene were amplificated by PCR in the 150 patients.The mutation analysis were detected by denaturing high performance liquid chromatography (DHPLC) and confirmed by DNA sequence analysis.Results:In the 150 patients with familial and early-onset breast cancer,6 mutations including one novel pathogenic mutation 869_888 ins20 (insert mutation) and 5 previously reported pathogenic mutations (deletion mutation 643_660de118 and 4 missense mutation 91G＞A,215C＞G,537T＞G,743G＞A) were identified in p53 gene encoding region in 9 patients of breast cancer.Moreover,one same sense mutation 141G＞A in exon 4,one 16 bases deletion in intron 3,and 9 single nucleotide polymorphisms in p53 gene introns were also identified.The total mutation frequency ofp53 gene in 150 patients with familial breast cancer and early-onset breast cancer from part population of southern China was 6.00％,and the mutation frequency of familial breast cancer and early-onset breast cancer was 6.81％ and 6.25％,respectively.Conclusion:The total mutation frequency ofp53 gene in 150 patients with familial breast cancer and early-onset breast cancer from partpopulation of southern China is higher than the frequency previously reported.The pathogenicity of the novel mutations (insert mutation) 869_888ins20 will be confirmed by function analysis in the future study.The deletion mutation 643_660de118 enriches the p53 gene mutation database among Chinese population,which is probably the specific mutation of breast cancer in Chinese population.

Objective To explore the risk factors of twin preeclampsia,so as to provide evidence for early identification,early warning and prognosis,and better guide clinical work.Methods The clinical data of 236 cases of twin pregnancy with preeclampsia and 200 cases of preeclampsia in the same period in Beijing Haidian District maternal and child health care hospital were analyzed retrospectively.The clinical epidemiology of patients in two groups was conducted in a cohort study to analyze the risk of disease,and to explore the risk factors for twin pregnancy and preeclampsia.Results The preeclampsia incidence of multipara (OR =2.275,95％ CI:1.404-3.686) increased compared with the primipara.The risk of preeclampsia increased in elderly patients (≥35 years old) (OR =1.412,95％ CI:0.917-2.174).The preeclampsia incidence of double chorionic twins was 1.946 times that of monochorial twins (OR =1.946,95％ CI:1.321-2.868).The preeclampsia incidence of assisted reproductive technology pregnancy was 2.063 times that of natural pregnant women (OR =1.946,95％ CI:1.321-2.868).Overweight and obesity were closely related to preeclampsia (OR =3.482,95％ CI:2.064-5.874;x2 =23.498,P ＜ 0.001) and excessive weight gain during pregnancy increased the risk of preeclampsia.Conclusions Primipara,advanced age,double chorionic twins,assisted reproductive technology pregnancy,overweight or obesity and excessive weight gain during pregnancy were all risk factors of preeclampsia in twin pregnancy women.Age,chorionicity and assisted reproductive technology were independent risk factors for preeclampsia.In order to reduce the incidence of preeclampsia and improve the prognosis in twin pregnant women,high risk factors should be identified as early as possible and more perinatal health care should be taken in clinical work.