AIM: To establish a method of determining eucalyptol, camphor, menthol and borneol in Ganmaokang Spray. METHODS: GC was conducted on a EC-WAX column(30 m?0.53 mm?1.2 ?m) and naphthalene was adopted as internal standard. RESULTS: Eucalyptol, camphor, menthol and borneol respectively showed a good linear relationship in the following ranges of concentration:0.384 48-0.987 12 mg/mL,0.240 6～(0.561 4 mg/mL,)0.367 56-0.857 6 mg/mL and 0.135 6-0.316 4 mg/mL. The average recoveries were obtained as 98.4%, 98.2%, 98.5% and 98.2%(n=5). CONCLUSION: The method is simple, sensitive, accurate and suitable for the determination of four constituents in Ganmaokang Spray.

Objective To analyze the surveillance data from 2003 to 2007 for Hubei province,investigate the epidemic characteristics of human rabies in these years,so as to provide scientific basis for its control and prevention.Methods Rabies data collected from the National Disease Surveillance Reporting System from 2003 to 2007 in Hubei province and 134 Rabies cases investigated in 2007 were analyzed in detail.Results The results showed that the trend of the number of rabies reported cases in Hubei province was obviously increased from 2003 to 2007.The involved counties and districts of the epidemic situation were widely expanded accordingly.Each month had Rabies case,but a lot of cases were dominated in August to November for every year.Most of the cases were farmers and students.The sex ratio of male to female was 2.38∶1.The age of the cases were mainly ranged from 5 to 15 and from 40 to 70 years old.Investigation of 134 cases indicated that the median of the incubative period was 66 days;94.78% of cases were injured by the dog;only 15.67% of injured cases were treated by the medical institution;the vaccinate ratio was 14.93%;the proportion of patients who received wound treatment,vaccinate and passive immunization were 5.80% of all the grade-Ⅲ-exposed patients.Conclusions The epidemic situation of Rabies was serious from 2003 to 2007 for Hubei province.The main reasons of the increase of rabies cases in Hubei province are absence of the effective management of the dog,the lack knowledge of rabies prevention,low rate of vaccine and passive immunization after exposure,and the lack of the standardized management for some of the low level medical institutions.

OBJECTIVE To study the constituent ratio of the pathogentic bacteria of the newborn omphlitis and their resistance.METHODS The bacteria were identified by ATB-Expression system and antibiotic susceptibility tests.RESULTS Of the specimens in 153 cases,there were 136 positive strains(88.9%).From high to low,Staphylococcus aureus occupied 26.5%,S.epidermidis occupied 16.2%,S.haemolyticus occupied 13.2%,Klebsiella pneumoniae occupied 13.2%,and Escherichia coli occupied 9.6%.Piperacillin/tazobactam,vancomycin,meropenem and imipenem had low drug resistance(2.0%) that doctors could choose the drugs according to pathogenic bacteria.MRSA occupied 13.9%,MRCNS occupied 73.2%.E.coli and K.penumoniae of ESBLs accounted for 21.4% and 44.4%.CONCLUSIONS The main pathogentic bacteria of the newborn omphlitis are S.aureus,S.epidermidis,S.haemolyticus,and K.pneumoniae.Doctors select the antibiotics according to the results of susceptibility test.It is necessary to advise how attend to the newborn in order to decrease the newborn omphlitis.

Objective To investigate the clinical appliance value of plantar pressure measurement in hemiplegic patients with acute cerebral infarction(ACI).Methods Plantar pressure was measurered and recorded by the means of Germany-made Zebris in 21 hemiplegic patients with ACI before and 30 d after treatment.Results Although plantar pressure on foot of the paralysed side was found remarkably decreased compared to that of the contralateral side before treatment(all P

Objective:To explore the clinical features and risk factors of systemic inflammatory responses syndrome (SIRS) after flexible ureteroscopic lithotripsy (FURL) with upper urinary tract stones.Methods:A retrospective of 157 patients with upper urinary calculi treated by FURL who were admitted to Suzhou First People′s Hospital from January 2018 to October 2020 were selected to analyze the treatment results and complications of the patients. Patients were divided into SIRS group ( n=31) and non-SIRS group ( n=126) according to whether they were complicated by SIRS. The clinical data between the two groups were analyzed by a single factor, and the factors with statistical significance were included in the LASSO-Logistic regression analysis. Visualize the model through the Nomogram, and verify and evaluate the discrimination and accuracy of the model. Results:The results of univariate analysis showed that gender( P=0.010), average stone size ( P<0.05), preoperative urine white blood cell count ( P<0.05), operation time ( P<0.05) and postoperative stone bacterial culture ( P<0.05) were different between the two groups and the differences were statistically significant. The LASSO-Logistic regression analysis results show that the above factors were all independent risk factors for patients with SIRS. The Nomogram complicated SIRS risk prediction model constructed based on the above risk factors has good discrimination and high consistency with actual observations. Conclusion:Females, large stones, high preoperative white blood cell counts, longer operation time, and positive bacterial culture of postoperative stones are independent risk factors for SIRS after FURL in patients with upper urinary calculi.

Objective To investigate the dosimetric difference of organ at risk (OAR) for planning and actual estimated during intensity-modulated radiotherapy (IMRT) for patients with nasopharyngeal carcinoma.Methods Thirteen patients were enrolled to accept full course of IMRT.CT scans were acquired in the 10th,20th,and 30th fractions during radiotherapy,respectively.OAR,including brain stem,spinal cord,parotid gland and submandibular gland,were delineated on repeated CT scans.The volume change of OAR were investigated.After that,the plans were copied to the new CT image to calculate the escalated average dose of OAR during radiotherapy (Actual estimated receiving dose minus planning dose).Results The change trend of volume was decreasing gradually for parotid gland and submandibular gland during the 10th,20th,and 30th times radiotherapy (all P =0.000).The maximum dose (Dmax) of brain stem and spinal cord and the 50％ volume receiving dose (D50) of parotid gland increased significantly in the 10th,20th,and 30th times during radiotherapy,respectively.The escalated average dose were 3.76 and 3.68 Gy for Dmax of brain stem and spinal cord (P =0.000,0.000),5.11 and 3.54 Gy for D50 of left and right parotid (P =0.001,0.023),and 0.49 and 0.75 Gy for D50 of left and right submandibular gland (P =0.220,0.230),respectively.Conclusions The volume of parotid gland and submandibular gland significantly decreased after radiotherapy The actual receiving dose of brain stem,spinal cord,and parotid gland increased significantly during radiotherapy.However,there was no significant change for the actual receiving dose of submandibular gland.

Objective To assess the differences in delineation of organs at risk (OAR) and dosimetry between junior and senior physicians during intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) and to evaluate the role of specific training in reducing the differences.Methods Sixteen patients newly diagnosed with NPC were selected in the study.The OAR was delineated separately by three junior physicians and three senior physicians,and the geometric and dosimetric differences were assessed relative to the reference OAR.Delineation was performed again for the two OARs with the biggest difference after specific training in the two groups of physicians,and the differences were evaluated again.The difference was determined by paired t test.Results The maximum dose differences (Dmax) of OAR in the junior and senior physicians were (2.33 ± 12.06) ％ (-48.06％-137.82％) and (0.09 ± 4.72) ％ (-49.54％-42.96％),respectively (P =0.039),and the difference in the optic chiasm was the greatest ((5.85 ± 19.63) ％ ∶ (1.36 ± 4.64) ％,P =0.042).The mean dose differences (Dmean) of OAR in the junior and senior physicians were (3.10 ± 8.07)％ (-46.76％-59.76％) and (-0.93 ± 2.03) ％ (-45.54％-35.69％),respectively (P =0.021),and the difference in the parotid gland was the greatest ((13.23 ± 13.39) ％ ∶ (3.20 ± 6.71) ％,P =0.002).In the secondary delineation after training,the Dmax of the optic chiasm in the junior and senior physicians was (1.68 ± 3.34)％ and (1.50 ± 1.87) ％,respectively (P =0.841),and the difference in junior physicians was reduced significantly compared with before training ((1.68 ± 3.34) ％ ∶ (5.85 ± 19.63) ％,P =0.048) ; the Dmean of the parotid gland in the junior and senior physicians was (2.46 ± 3.06) ％ and (1.35 ± 3.00) ％,respectively (P =0.2 7 4),significantly reduced compared with before training ((2.46 ± 3.0 6) ％ ∶ (13.23 ± 13.39)％,P=0.002; (1.35 ± 3.00)％ ∶ (3.20 ± 6.71) ％,P =0.033).Conclusions The differences in delineation of OAR lead to dose uncertainties during IMRT for NPC,and specific training can improve the accuracy of delineation.

Objective To compare the dosimetry between inversely optimised intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy using the field-in-field technique (FIF) for whole-breast radiotherapy with a boost to the tumor bed after breast-conserving surgery.Methods IMRT and FIF treatment plans were respectively performed and optimised for 9 patients with early stage leftbreast cancer after breast-concerving surgery.The prescribed dose of breast was 50.4 Gy in 28 fractions,1.8 Gy per fraction and that of tumor bed was 61.6 Gy in 28 fractions,2.2 Gy per fraction.The conformity index,the dose and volume for OAR( organs at risks),time of planning and treatment for the two plans were compared.Results The conformity index(CI) for IMRT was improved compared with the FIF in breast [(1.82±0.16) vs.(2.21±0.15)] and tumor bed [(1.19±0.04) vs.(1.59±0.11),t=2.08,3.97,P ＜ 0.05 ].There was no difference for V20 of ipsilateral lung and V30 of heart between two plans.The Dmax and Dmean of the contralateral lung of FIF were (5.41 ±2.76) and (0.51 ±0.10) Gy,lower than those of IMRT [ (25.72 ± 2.61 ) and (7.46 ± 0.39) Gy,t =-22.44,- 21.14,P ＜ 0.05 ].The Dmax and Dmean of the contralateral breast of FIF were (8.50 ± 5.61 ) and (0.47 ± 0.11 ) Gy,lower than those of IMRT [(27.73±4.30) and (6.38±0.48) Gy,t=-5.66,-14.83,P＜0.05].ForFIF,theV5of the contralateral lung and breast were (0.09 ± 0.09) ％ and (0.45 ± 0.45 ) ％,respectively,lower than those of IMRT,which were (84.66 ±3.06) ％ and (60.79 ±4.94)％ (t =-28.19,- 12.80,P＜0.05).The time of optimised plan was (61.57 ± 0.89) min for FIF and(241.28 ± 1.06) min for IMRT (t=-32.35,P＜0.05),and that of treatment were (16.14±1.42) min for FIF and (29.85 ±0.59) min for IMRT (t =- 8.82,P ＜ 0.05).Conclusions For patients with early stage breast cancer after breast-concerving surgery,IMRT could improve the conformity index of target but increase the dose of eontralateral lung and breast.However,FIF has advantage on the time of optimising plan and treatment.

Objective To study three contouring approaches of the bowel and evaluate the bowel dose volume with cervical cancer patient.Methods Twelve patients were selected,prescribed dose 45 Gy/ 25f.For each patient we contoured the bowel according to three different definitions:bowel loops,bowel bag and peritoneal space.Then we generated three rival plans each considering a different bowel definition and to evaluate dose differences of the HI,CI of PTV and D D V5-V45 of bowel loops with paired t-test.Results Comparison between BL and BB plan,Dmax,HI and CI of PTV,V5-V45 of bowel loops were not significantly different (P =0.171,0.076,0.192,P =0.315-0.855),D of PTV and Dmax of bowel loops had difference (P=0.017,0.038).Comparison between BL and PS plan,Dmax,D HI and CI of PTV and Dmax of bowel loops had differences (P=0.033,0.044,0.046,0.041,0.013),V5-V45 of bowel loops were not significantly different (P=0.416-0.977).If the bowel loops V40 ≤ 15％,and bowel bag and peritoneal space V40≤20％.Conclusions All definitions provided a very similar dose volume of bowel loops.Taking into account HI and CI of PTV and max dose of bowel loops,BB seems better than PS.

Objective To evaluate the uncertainty of the small bowel dose?volume and the normal tissue complication probability (NTCP) during intensity?modulated radiotherapy (IMRT) for rectal cancer, and to provide a reference for the dose limit and protection of the small bowel during IMRT for rectal cancer. Methods A total of 20 patients with rectal cancer who received postoperative adjuvant radiotherapy from March 2014 to August 2015 were enrolled in this study, including 10 patients receiving CT scan in the supine position and 10 patients in the prone position. All patients received computed tomography ( CT) scan before the treatment and at weeks 1, 2, 3, and 4 of treatment, and they were defined as Plan, 1W, 2W, 3W, and 4W CT groups, respectively. The small bowel loop ( BL ) and peritoneal space ( PS ) were delineated on the images. The IMRT plan based on the Plan CT was copied to the 1W, 2W, 3W, and 4W CT groups, and then the small bowel dose?volume and NTCP were assessed for all CT groups. The paired t?test was used for comparison between groups. The Pearson method was used to analyze the correlation between NTCPC(chronic NTCP) and dose?volume. Results A total of 89 CT images of 20 patients were obtained. In all the patients, the volumes of BL and PS were 25121 cm3 and 132416 cm3 , respectively, and the shift% was 2315% and 1134%, respectively. The V15 of BL and PS was 18486 cm3 and 79245 cm3 , respectively, and the shift% was 3169% and 370%, respectively. The V30 of BL and PS was 8801 cm3 and 64573 cm3 , respectively, and the shift% was 3766% and 1049%, respectively. The V15 of BL in 35% of patients and V15 of PS in 20% of patients, the Dmax of BL in 50% of patients, and the NTCP of 15% of patients in the course of treatment exceeded the safety limits. The 1?4W CT groups had a significantly higher NTCPC than the Plan CT group (402% vs. 320%, P=0104), and their SD% was 4168%. There was a significant correlation between NTCPC and V30?V50 of BL (R>0400, P=0000). The NTCPA ( acute NTCP ) and NTCP C in the supine position were significantly higher than those in the prone position ( 6230% vs. 5674%, P=0061;488% vs. 322%, P=0145 ) . Conclusions Small bowel motility leads to an uncertainty of the adverse event assessment during IMRT for rectal cancer. The change in BL is significantly larger than that in PS and the change in BL and PS in the supine position is significantly larger than that in the prone position. Using the prone position and minimizing V15 and V30 when designing the treatment plan can reduce the NTCP A and NTCP C in the small bowel.