Objective To investigate and analyze the resources of radiotherapy in Beijing,in order to provide reference for the subject development,resources allocation and professional training of radiotherapy.Methods A questionnaire survey was conducted by on-site inspection,supplemented by telephone or e-mail investigation among the 33 hospitals with radiotherapy facilities to know the current status of distribution of radiotherapy institutions,radiotherapy facilities,human resources and number of patients treated.Results There were 52 linear accelerators,1 spiral CT machine,and 2 intraoperative radiotherapy machines in these 33 hospitals up to June 2010.Three-dimensional conformal or stereotaetic radiotherapy was carried out in 31 hospitals,intensity modulated radiation therapy(IMRT)in 19,image guided radiation therapy(IGRT)in 6,and volumetric modulated arc therapy(VMRT)in 2.The number of professional personnel(except nurses)was 495,including 214 radiation oncologists,78 radiotherapy physicists,and 203 radiotherapy technologists,and those with senior professional titles accounted for 52.3%,17.9%,and 1.5%,respectively.Conclusions Compared to the national level,the radiotherapy resources level is higher in Beijing,but the distribution of resources is imbalanced.The resource allocation should be optimized and training of the personnel should be strengthened so as to meet the growing needs of patients.

Objective To explore the feasibility of laparoscopic common bile duct exploration without T-tube drainage.Methods A to-tal of 37 patients who were addmitted into our hospital from May 2014 to August 2015 with common bile duct stones were analyzed.Among these patients,22 cases were given T-tube drainage while the other 15 cases were not.The operation time,hospitalization expenses,anal ex-haust time,postoperative hospitalization time,bile leakage rate and the satisfaction of patients after surgery in the two groups were observed. Results In the non-T-tube group,the anal exhaust time was (1.41 ±0.82)d and the hospitalization time was(4.82 ±1.61)d,which were lower than(3.81 ±1.09 )d and (11.17 ±1.19 )d respectively in the T-tube group,and the differences were statistically significant (P <0.05).The number of bile leakage (0%)in the non-T-tube group was also significantly lower than 31.82% in the T-tube group (P <0.05).The satisfaction rate of patients in the non-T-tube group(100%)was significantly higher than that in T-tube group (50%),and the difference was statistically significant(P <0.05).Conclusion The laparoscopic common bile duct exploration without T-tube drainage is feasible and it can be popularized in clinic.

Objective To investigate the effect and safety of alprostadil in the treatment of diabetes complicating chronic kid‐ney disease to provide reference for clinical treatment .Methods 84 cases of diabetes complicating chronic kidney disease in this hospital from September 2013 to January 2015 were selected and divided into the observation group(44 cases) and the control group (40 cases) according to the voluntary principle .The control group used the epalrestat treatment ,while the observation group was combined with using alprostadil on the basis of control group .The effective rate ,serum creatinine ,blood urea nitrogen(BUN) ,uri‐nary albumin excretion rate ,C‐reactive protein(CRP) ,IL‐6 levels and adverse reactions were compared between the two groups .Re‐sults The effective rate of the observation group was 93 .18% ,which was significantly higher than 80 .00% in the control group , the difference was statistically significant (χ2 =4 .251 ,P=0 .005);the CRP and IL‐6 levels after treatment in the observation group were improved ,the difference was statistically significant (P<0 .05);the CRP and IL‐6 levels after treatment in the observation group[(0 .45 ± 0 .05)mg/L ,[(0 .72 ± 0 .11)μg/L] were significantly superior than[(1 .05 ± 0 .14)mg/L ,(1 .25 ± 0 .24)μg/L] in the control group ,the differences were statistically significant(P<0 .05);BUN ,urinary albumin excretion rate ,TNF‐αand endogenous creatinine clearance rate after treatment in the observation group were (6 .41 ± 1 .12)mmol/L ,(41 .12 ± 4 .46)μg/min ,(75 .54 ± 6 .64)ng/L and (92 .94 ± 8 .24)% ,which in the control group were (7 .39 ± 1 .05)mmol/L ,(91 .48 ± 7 .31)mmol/L ,(111 .42 ± 7 .69)ng/L and (81 .55 ± 9 .54)% respectively ,the improvement in the observation group was better than the control group ,the difference was statistically significant (P<0 .05);the occurrence rate of adverse reactions was 18 .18% in the observation group and 17 .50% in the control group ,showing the difference was not statistically significant (P>0 .05) .Conclusion Alprostadil in treating diabetes complicating chronic kidney disease has better effect ,conduces to improve the level of urinary albumin and inflammatory with high safety ,and is worthy of clinical promotion and application .

Objective To investigate the relationship between the expression of DNA methyltransferases(DNMT)and clinical prognosis in children with acute leukemia(AL).Methods The mRNA expressions of DNMT1,DNMT3A,DNMT3B,p15,mdrl were measured in 56 AL children and 20 normal controls by semi-quantitative reverse transcriptionpolymerse chain reaction.Results In 56 cases of children with AL,the positive rate of DNMT1 was 73.2%(41/56);the positive rate of DNMT3A was 67.9%(38 /56);the positive rate of DNMT3B was 64.3%(36/56).Thirty-one cases showed positive expressions of the 3 DNMT simultaneously,4 cases with negative expressionss imultaneously,21 cases with at least 1 positive expression of the DNMT,positive rate of p15 was 19.6%(11/56);positive rate of mdrl was 28.6%(16/56),all 3 simultaneous expressions of the 3 DNMT in AL children were significantly higher than those in normal controls(P

ObjectiveTo study a standardization to establish data element in medical data resource share.MethodsThe library of data element's structural glossary items was established frist, then whole data element was established by selecting structural glossary items, finally, the input of data element's character was executed.ResultsA standardization method to establish data element was desigened based on definition, structure and national standard of data element.ConclusionIt's a important work to share medical data resource that establish data element by standardization, and it must be followed correlative standard and select logical method.

AIM: To investigate whether Janus kinase/signal transducer and activator of transcription ( JAK/STAT) signaling pathway mediates high glucose-induced damage in human umbilical vein endothelial cells ( HUVECs ) . METHODS:The cell viability was examined by CCK-8 assay.The expression levels of JAK2, STAT3, caspase-9 and en-dothelial nitric oxide synthase ( eNOS) were detected by Western blot .The intracellular levels of reactive oxygen species ( ROS) were tested by DCFH-DA staining followed by photofluorography .Mitochondrial membrane potential ( MMP) was measured by rhodamine 123 staining followed by photofluorography .RESULTS:Treatment of HUVECs with high glucose (40 mmol/L glucose) for 6~12 h enhanced the protein level of phosphorylated JAK 2, peaking at 9 h.Treatment of the cells with high glucose for 6~12 h also increased the protein level of p-STAT3 with the peak value at 12 h.Pretreatment with the inhibitor of JAK/STAT pathway AG490 for 1 h before exposure of the HUVECs to high glucose significantly inhibi-ted the high glucose -induced injury , as evidenced by an increase in the cell viability , decreases in the expression of caspase-9 and the intracellular ROS production , and increases in MMP and the expression of eNOS .CONCLUSION:JAK/STAT signaling pathway is involved in the high glucose-induced damage in HUVECs .

Objective To discuss the feasibility of percutaneous nephrolithotomy (PCNL) for treating upper urinary calculi under local anesthesia.Methods One thousand three hundred and sixty-three patients who suffered with upper urinary calculi were treated with PCNL, the puncture and tracts were created using local anesthesia and guided through ultrasound.Of the 1363 patients, 475 patients had complicated renal caluli, 520 patients had kidney pelvic calculi and 368 had upper uretere calculi.Results All of the patients successfully received PCNL under the local anesthesia.Of the 1363 patients five tracts were used in two patients, four tracts were used in four patients, three tracts were used in nine patients, double tracts were used in 25 patents and one tract was used in the remaining patients.The stone-free rate was 96.0% in the kidney pelvic calculi patients, 100.0% in the upper uretere calculi patients, and 90.1% in the complicated renal caluli patients.90.0% patients were find well throught the operation, 10.0% patients find a little pain and solved by another more 5 - 10 ml lidocaine local injection or 50 - 75 mg pethidine hydrochloride intramuscular injection.No case stop operation because of pain or position changed.All without any severe complications such as damaged of liver, spleen, thorax and intestine.Conclusion The PCNL handled under local anesthesia was simple safe and effective, deserved clinical popularizing use.

Objective To evaluate therapeutic ERCP in the treatment and preventing the recurrence of acute biliary pancreatitis(ABP).Methods One hundred and seventeen patients of ABP were randomly divided into two groups,ERCP treatment group(n=49)and non-ERCP control group(n=68).Changes of clinical symptoms and laboratory indexes were recorded accordingly.Follow-up study was for all the patients. Results Of the 117 with ABP,99 cases were mild(MABP)and 18 ones were severe(SABP).The days of relief of abdominal pains,normalization of hepatic function indexes and hospitalization were significantly shorter in ERCP treatment group than that in control group.The complications related to endoscopic therapy were not found.All patients had got followed-up visits for average 20(range 5-37)months(94.0%).The re- currence rate in the ERCP group 0(0/46)were significantly lower than that in the control group 46.8%(29/ 62)(P

Objective To discuss the technique and value of preoperative reformatting with three-dimensional computed tomography technique for C_2 pedicle screw track.Methods GE Light Speed 16 Pro spinal CT scans of 15 adult dry vertebrae were loaded into an imaging station (software ADW4.2).Two methods of C_2 pedicle screw techniques were analyzed through virtual screw trajectory by VR (volume rendering) and MPR (multiple planar reformatting) techniques,in method A,screw entry point was the intersection between the media-vertical and the cranial line of C_2 inferior facet joint,in method B,the screw track was from the cranial and medial quadrant of the dorsal part of C_2 inferior facet joint.Results The screw track could be observed dynamically from any plane.Two vertebrae were ob- served with smaller height in isthmus and the medial edge of the transverse foramen since no space was a- vailable for the screw.The screw trajectories data were compared between method A and method B,which showed that the angles towards the cephalad (in sagittal plane) and midline (in transverse plane) were bigger in method A than in method B (P＜0.05,0.01),but the safe screw diameter was smaller in method A than in method B (P＜0.05),and there was no difference of the screw length between the two methods(P＜0.05 ).Conclusion In this research,the individual C_2 pedicle screw entry points, screw diameter and security screw angle can be simulated,and the screw track can be observed dynami- cally to make sure if it transits the bone structure completely.Preoperative three-dimensional computed tomography reformatting for pedicle screw track is of great value in clinical and basic researches.

Clinical medicine is a comprehensive discipline integrating natural science and hu-manities and social science. Lemology is closely related with basic medicine and medical microbiology and medical immunology are the basis of lemology. Therefore, in the process of cultivating postgradu-ates of lemology, we should not only should attach importance to the cultivation of basic medical knowl-edge and clinical professional quality, but also pay more attention to the development of the intelligence factors and non-intelligence factors. Meanwhile education on humanity, social sciences and relevant laws and regulations should be enhanced to cultivate doctors' professional quality. Reverse thinking and lateral thinking in the clinical diagnosis should be strengthened to achieve the training objectives of cultivating international medical talents.