Six patients with lung cancer treated with therapy were included. They were retrieved the image and re-planned by fraction 10. The volume of GTV was reduced (65. 59 ± 17. 09)% after three-stage treatments. The doses of target tumor were the same in three-stage treatments. Compared with IMRT, ART1 reduced V20 , V30 , MLD of whole lung by 2. 01%,2. 66%,241. 78 cGy(P=0. 005,0. 039,0. 026). Compared with ART1,ART2 further re-duced the indexes by 3. 21%,2. 97%,288. 64 cGy(P=0. 005,0. 013,0. 046). The doses of ipsilateral lung were reduced significantly (P<0. 05). But this was not for opposite lung. The dose V50,Dmean of heart and V55 of esopha-gus were similar to each plan. Dmean of esophagus with ART1 was smaller than with IMRT(261. 98 cGy,P=0. 002) and Dmean of esophagus with ART2 was smaller than with ART1(300. 43 cGy,P=0. 008). D2% and Dmean of spinal cord were reduced in turn significantly(P<0. 05).

Adaptive radiotherapy (ART) is the product of excellence technology.It reschedules,registers according to tumor's size,shape and alteration of relative position with the surrounding tissue during the treatment.Thereby it raises the accuracy of the conformal radiotherapy.The technology is gradually being chosen by more and more patients.The technology can increase the rate of local control significantly,while reducing the occurrence of radiation-related adverse reactions.

Objective To explore osculating value method combined with rank sum ratio method in evaluation of nursing quality in the hospital nursing management application, to provide a scientific basis for decision making. Methods By reference, from the working efficiency, the quality of nursing, 3 dimensions of nursing skill training, the choice of 11 commonly used in the evaluation of nursing quality indicators, the raw data of each index was normalized, the school of nursing quality with 2004-2013 years of osculating value method analysis was assessed, the development of nursing quality combined with rank and file classified score method. Results The nursing quality of the overall upward trend, according to the grading each year osculating value and ranking in 2011, nursing quality best, osculating value was 0.000, the worst quality of nursing in 2004, osculating value was 3.248;the annual nursing quality grading was reasonable, 2011, 2012 and 2013 were in good quality grade, 2004, 2005 and 2006 were of poor quality grades, the rest of the year at a medium level, with statistically significant difference of the file, P<0.05. Conclusion Osculating value method combined with rank sum ratio method in comprehensive evaluation of nursing quality in the hospital has the objectivity and practicability.

AIM: To study the inhibitive effects of valsartan and spironolactone on expression of insulin like growth factor 1 in cardiacmyocytes of spontaneously hypertensive rats. METHODS: 18 SHRs were randomly divided into 3 groups (n=6 in each): valsartan group treated with 30 mg?kg -1 ?d -1 valsartan, spironolactone group treated with 20 mg?kg -1 ?d -1 spironolactone, and control group treated with placebo. All were administrated by gastric perfusion. 6 WKY rats were served as control. After 13 weeks administration, the expressions of IGF 1 in cardiacmycytes were measured by immunohistochemistry and the IGF 1 concentrations in myocardium were measured by radiommunoassay. RESULTS: The expression of IGF 1 was higher in SHR group than that in the WKY group (P

OBJECTIVE: To introduce the efficacy of three surgical options for juvenile nasopharyngeal angiofibroma (JNA) resection, and causes of operative bleeding. METHOD: Retrospective analysis of 36 JNAs,three surgical options were used to resect the tumor. There were 15 cases of Class I tumors , using endoscopic nasal cavity approach. Eighteen cases of class II tumors, via extended Caldwell-Luk incision, using the transantral-infratemporal fosse-nasal cavity combined approach for tumor resection. Three cases of class III tumors, the combined intracranial and extra-cranial approach was used to resect the tumor. Meanwhile, report six typical cases for reference. RESULT: Fifteen (15/36) cases of class I tumors, 14 cases were completely resected for the first time without recurrence, 1 recurrence case was re-resected using the same approach. Eighteen (18/36) cases of class II tumors, 13 cases were completely resected for the first time without recurrence, 5 recurrence cases were re-resected totally. Three (3/36) cases of class III were not completely removed, and underwent about 40 Gy radiotherapy with good effects. CONCLUSION Using these three surgical options can effectively remove different types of JNA. When necessary, the intracranial residue can use radiotherapy. Under direct vision to separate the tumor, and effective hemostasis play crucial roles for complete removal of the tumor.
Adolescent ; Angiofibroma ; surgery ; Blood Loss, Surgical ; Child ; Female ; Humans ; Male ; Nasopharyngeal Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective:To explore the impact of narrative nursing on the meaning and quality of life in chemotherapy patients with advanced lung cancer.Methods:A total of 86 chemotherapy patients with advanced lung cancer hospitalized in the Oncology Department of Shanghai Pulmonary Hospital Affiliated to Tongji University from October 2020 to November 2021 were selected and divided into control group with 42 cases and narrative group with 44 cases by random number table method. The control group was treated with routine nursing of patients with tumor chemotherapy while the narrative group was implemented on narrative nursing intervention as well as routine nursing. A total of 12 to 14 times, each chemotherapy period was 7 times. The effect of the intervention was assessed by Meaning in Life Scale for Advanced Cancer Patients (MiLS)、Chinese Version of the Functional Assessment of Cancer Therapy-Lung(FACT-L 4.0) and Distress Thermometer (DT) before intervention, 1 week, 3 weeks and 2 months after intervention.Results:Forty cases in the control group and 42 cases in the narrative group were involved in the statistical analysis. Two months after intervention, the total score of MiLS, the score of the will to search for meaning, the meaning of life and satisfaction,existential frustration, life control, suffering tolerance and death acceptance in the control group were (98.60 ± 9.17), (14.90 ± 1.91), (13.38 ±2.62), (16.40 ± 2.73), (26.48 ± 3.19), (14.30 ± 1.68), (13.15 ± 3.07) points, which were significantly lower than those in the narrative group (112.02 ± 9.73), (16.45 ± 2.24), (16.31 ± 1.96), (19.40 ± 2.42), (28.76 ±3.48), (16.14 ± 1.82), (14.95 ± 2.39) points, and the difference were statistically significant ( t value were -6.42 --2.98, all P<0.01), and the main effect between groups and time were statistically significant ( F values were 2.76-24.47, all P<0.05). Two months after intervention, the total score of FACT-L, social/family status, emotional status, functional status and lung cancer specific module in control group were (90.75 ± 11.65), (18.58 ± 3.75), (15.65 ± 3.85), (13.48 ± 3.34), (22.00 ± 4.93) points, which were lower than those in the narrative group (102.12 ± 9.32), (20.36 ± 4.29), (18.10 ± 3.25), (16.74 ± 4.05), (24.80 ±3.83) points, the differences were statistically significant ( t values were-4.89--1.99, all P<0.05), and there was intergroup effect ( F values were 5.14-24.47, all P<0.05). Three weeks and 2 months after intervention, the psychological distress score of control group were (3.88 ± 2.73), (3.60 ± 2.19) points, which were significantly higher than the narrative group (2.52 ± 2.18), (1.90 ± 1.78) points, and the differences were statistically significant ( t=2.50, 3.85, both P<0.05), with a time, groups, interaction effect ( F=15.29, 15.86, 2.80, all P<0.05). Conclusions:Narrative nursing can effectively improve the meaning and quality of life and relieve psychological distress in chemotherapy patients with advanced lung cancer. It is worthy of clinical promotion.

Objective In this study,we attempted to investigate whether Electroacupuncture(EA)could promote the autophagy function in macrophages of inflammatory skin tissues by activating CB2 receptor,thus relieving inflammatory pain induced by CFA in mice,and whether activation of CB2 receptor in NR8383 macrophages cell line can simulate the effect of EA on the autophagy function and mitochondrial damage.Methods Inflammatory pain model was induced by CFA injection into the planta the hind paw of wildtype and CB2 knockout mice.EA or sham EA was applied on the left Huantiao(GB30)and Yanglingquan(GB34)sites.Thermal hyperalgesia was determined with the Hargreaves test.Mechanical sensitivity was assessed with von Frey filaments.NR8383 microphage cell line was used to study the effect of CB2 activation on macrophage function induced by CFA.The expression level of autophagy protein LC3 and p62 in wildtype and CB2 knockout mice skin tissue and NR8383 cell line were determined by Western blot.And flow cytometry analysis was applied to detect damaged mitochondria and mitochondrial superoxide.Results CFA significantly reduced the thermal and mechanical pain threshold in both wildtype and CB2 knockout mice,comparing with the vehicle control groups(P<0.01).EA significantly inhibited thermal and mechanical hyperpathia induced by CFA in wildtype mice(P<0.05),but had no effect on CB2 knockout mice with CFA(P>0.05).CFA significantly increased the expression of p62 protein and decreased LC3-II/I ratio,which was inversed by EA in wildtype mice but wasn't affected by EA in CB2 knockout mice.CFA increased the expression of p62 protein and decreased LC3-II/I ratio in NR8383 cell line,which were inversed by CB2 agonist AM1241.CFA increased mitochondria damage,which were then attenuated by CB2 agonist AM1241.Conclusion The analgesic effect of EA on inflammatory pain induced by CFA was mediated by activation of CB2 receptor,which promoted the autophagy function and the clearance of damaged mitochondria in macrophage.

OBJECTIVETo investigate the clinical features, diagnosis and prognosis of sudden sensorineural hearing loss accompanied with inner ear hemorrhage.

METHODSEleven cases of sudden sensorineural hearing loss accompanied with inner ear hemorrhage were retrospectively analyzed, including clinical manifestation, hematological and audiological examinations, as well as characteristics of inner ear three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI).

RESULTSEleven cases of sudden hearing loss with inner ear hemorrhage were accompanied by varying degrees of vertigo, lasting from several minutes to several hours, nine of whom had persistent tinnitus. The audiometry curves of the 11 cases included total deafness or flat descending type. The inner ear 3D-FLAIR MRI studies revealed abnormal high signals at different positions of the inner ear, one case with endolymphatic hydrops. After the treatment, seven cases were invalid, two cases had notable effect, and two cases were effective.

CONCLUSIONSAbnormal high signals in the inner ear were sensitively detected by 3D-FLAIR MRI sequence, which was applied for the diagnosis of the sudden hearing loss accompanied with inner ear hemorrhage. The effect of conventional treatment was not good and the appropriate treatments for this type of sudden hearing loss need further investigation.

Audiometry ; Deafness ; complications ; diagnosis ; Ear, Inner ; physiopathology ; Endolymphatic Hydrops ; complications ; Hearing Loss, Sensorineural ; complications ; diagnosis ; Hearing Loss, Sudden ; complications ; diagnosis ; Hemorrhage ; complications ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Prognosis ; Retrospective Studies ; Tinnitus ; complications ; Vertigo ; complications

Objective To investigate the prevalence and related characteristics of alcohol dependence in the Pumi people of Ninglang area in Yunnan Province.Methods By stratified multistage cluster randomization,542 residents were interviewed by psychiatrists using the structural questionnaire MINI-International Neuropsychiatric Interview.Results The prevalence of drinking in the study were 37.3％,13.6％ and 22.5％ for the male,female and the total sample.There were significant differences of alcohol dependence between males and females (x2 =304.310,P＜0.01) in which males were significantly higher than those in females.The current prevalence of alcohol dependence in Pumi people was 4.8％(95％CI=3.0％-6.6％),and standardized current prevalence was 3.3％.The current prevalence of alcohol dependence in males was 9.3％,which was significantly higher than that (2.1％) in females (x2 =14.613,P＜0.01).The prevalence of alcohol dependence in the Pumi people was 6.1％ in the 21-30 years old,and 8.6％ in the 51-60 years old.There were one case of major depression,one case of panic disorder,and five cases of insomnia.Conclusion The prevalence of alcohol dependence in Pumi people of Ninglang areas is high.Alcohol dependence has become one of the most common mental disorders and the public health problem.It is necessary to carry out prevention research in the future.

Objective To evaluate the regulatory role of azithromycin-induced persistent Chlamydia trachomatis (Ct) infection in the apoptosis of Hela229 cells.Methods Hela229 cells were firstly co-cultured with Ct for 22 hours,and then cultured with Dulbecco's modified Eagle's medium (DMEM) containing 0.08 mg/L azithromycin for 26 hours to establish a cell model of persistent Ct infection (persistent infection group).These infected Hela229 cells cultured with azithromycin-free DMEM served as a cell model of acute Ct infection (acute infection group).After 48-hour infection with Ct,azithromycin was removed,and infected Hela229 cells in the above 2 groups were successively cultured with DMEM for the resurgence of Ct.Immunofluorescence assay and electron microscopy were performed to verify the persistent Ct infection model.The Hela229 cells in the persistent infection group and acute infection group as well as uninfected Hela229 cells (control group) were treated with staurosporine (STS) for 4 hours to induce the apoptosis,and then cell apoptosis was detected by Hoechst 33258 staining,annexin V/propidium iodide staining and flow cytometry.Results After the treatment with azithromycin,atypical inclusions with aberrant reticulate bodies appeared in the Ct-infected cells.After removing azithromycin,cells were cultured until 96 hours after infection,and infectious elementary bodies reappeared in the Ct inclusions.After the treatment with STS,Hoechst staining showed that there was loose chromatin in the persistently infected cells,while chromatin condensation was observed in the uninfected cells.After 24-hour infection with Ct and 4-hour induction with STS,the apoptosis rate was significantly higher in the persistent infection group (45.567％ ± 2.631％) than in the acute infection group (38.567％ ± 1.701％,t =2.686,P =0.028),but significantly lower in the persistent infection group than in the uninfected group (69.800％ ± 2.835％,t =8.187,P ＜ 0.001).After 48-hour infection with Ct and 4-hour induction with STS,there was a significant difference in the apoptosis rate between the persistent infection group (46.700％ ± 5.257％) and acute infection group (61.767％ ± 1.815％,t =5.781,P ＜ 0.001),as well as between the persistent infection group and the uninfected group (68.667％ ± 3.156％,t =7.421,P ＜ 0.001).Conclusion This study showed that azithromycin-induced persistent Ct infection regulated the apoptosis of host cells,and this effect lasted 48 hours.