Objective To compare the results of three different registration methods in the kilovolt CBCT guided IMRT for nasopharyngeal cancer (NPC).Methods Total 560 CBCT images of 24 NPC patients who received kilovolt CBCT guided IMRT were analyzed off line.Three registration methods were used for alignment between CBCT and planning CT,including translational and rotational errors for bone and grey (BoneT + R,GreyT+ R),only translational errors for grey (GreyT).The registration results were analyzed by mean paired t-test respectively.Results With method BoneT+R,the translational errors on x,y and z axes were (-0.11 ± 1.35) mm,(0.40 ± 2.09) mm and (0.95 ± 1.56) mm and the rotational errors were 1.06° ±0.67°,0.01° ± 1.28° and 0.92° ± 1.00° respectively.With GreyT+R,the translational errors on x,y and z axes were (-0.02 ± 1.06) mm,(0.68 ± 1.92) mm and (0.81 ± 1.46) mm and the rotational errors were 0.85° ±0.61°,-0.05° ± 1.32° and 0.91° ±0.72° respectively.With GreyT,the translational errors on x,y and z axes were (0.58 ± 1.02),(0.52 ± 1.89) and (0.44 ± 1.43) mm.The results of compared mean t-test for different registration methods groups have significant difference (P =0.00-0.01) except for the rotational errors on y and z axes between BoneT+R and GreyT+R (P =0.05,0.62).Conclusions There have different alignment errors when different registration methods used for NPC kilovolt CBCT guided radiotherapy.If there have correct methods for rotation errors,GreyT+R registration method may be a better choice.In opposite,GreyT+R registration method would be used firstly to verify whether the rotational error ＞ 2°or 3°.If the rotational error ＞ 2°or 3°,the patient should be re-setup.If not,according to these alignment results,the GreyT method,manual method would be used to compensate the translational errors.

Objective To explore the nursing method during bedside fibrobronehoseope to patients with inhalation injury and ensure the safety of the procedures. Methods 58 patients with inhalation injury with bed-side flbrobronehoseope treatment from 2005 to 2008 were retrospectively analyzed. Results 3 eases showed a-cute respiratory distress syndrome, 3 cases died of respiratory failure, 2 patients died of multiple organ failure,dyspnea, cough symptoms improved in others after sputum aspiration. Conclusions To master the preoperative,intraoperative, postoperative nursing methods during fibmbronehoscope can improve clinical efficacy.

Objective: To understand the effects of remuneration incentive and their influences on job satis-faction in county public hospital. Methods: Stratified random sampling was adopted. Six county public hospitals in county level in Heilongjiang province were selected as the sample. Exploratory factor analysis was used to ana-lyze the remuneration incentives, descriptive statistical analysis and logistic regression analysis were used to ana-lyze the effects and their influences on work satisfaction. Results: remuneration incentives are divided into four dimensions that comprised a total of 16 items, which including direct material rewards, indirect material re-wards, occupational rewards and social rewards. The surgeon’s job satisfaction is higher than the physician, and is lower than the obstetrics and gynecology and pediatrics. Technician and nurses’ satisfaction is lower than the general practitioner. The medical staff who worked less than5 years has the lowest satisfaction. Authorized staff’s satisfaction is lower than off-staff. Direct material rewards and occupational rewards are related to job satisfac-tion. Conclusions:Material rewards were in low level, and non-economic incentive was insufficient. The salary incentive for highly educated talents should be strengthened.

Adult ; Female ; Humans ; Rheumatic Heart Disease ; therapy ; Treatment Failure

Objective Inquire into the relationship between diabetic peripheral neuropathy(DPN)pathogenic factor and Antigangliosides antibody(Anti-GS-Ab)in type 2 diabetes mellitus. Methods It was examined by enzyme-linked immunosorbent assays(ELISA)to the levels of serum Anti-gangliosides(Anti-GS)in 2 DM and DPN as well as healthy.Results The positive rate of Anti-GS-IgM,IgG in DPN group were 46.7% and 20.0%.repectivily it was obviously higher than normal group and 2 DM group.Conclusion The relationship between the DPN and Anti-GS-Ab is a close.It show that Anti-GS-Ab play an important role in DPN pathological process.

BACKGROUND: In the field of intervertebral disc tissue engineering, seed cells primarily consist of nucleus pulposus cells (NPCs) and mesenchymal stem cells (MSCs). NPCs have been known to have several shortcomings: limited source, inconvenient collection, poor proliferative capacity, and difficult in vitro culture.OBJECTIVE: To investigate the proliferation of MSCs after co-culture with NPCs in alginate beads-simulated three-dimensional environment.DESIGN, TIME AND SETTING: A cell observation was performed at the Laboratory of Orthopedics, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology between December 2007 and October 2008.MATERIALS: Six healthy New Zealand rabbits of 4 months old were provided by the Laboratory Animal Center, Tongji Medical College of Huazhong University of Science and Technology and were used for the present study.METHODS: Rabbit MSCs were isolated and purified using density gradient centrifugation and adherence methods. Rabbit NPCs were isolated and purified using collagenase Ⅱ digestion and adherence methods. Following liposome-mediated green fluorescent protein tranfection and G418 screening, MSCs of passage 3 were cultured either alone (control group) or with NPCs at a ratio of 1:1 (co-culture group) in alginate beads. After 14 days of culture, alginate beads were dissolved and MSCs were collected by flow cytometry sorting.MAIN OUTCOME MEASURES: The expression of collagen Ⅱ and aggrecan in MSCs was detected by RT-PCR and Western blot techniques.RESULTS: mRNA and protein expression of collagen Ⅱ and aggrecan was observed in the co-culture group, but not in the control group, after 14 days of culture.CONCLUSION: MSC differentiation towards nucleus pulposus-like cells can be induced by co-culture with NPCs in a three-dimensional environment.

Objective To investigate the induced-factors levels of venous thrombosis associated with the placement of peripherally inserted central catheters (PICC) in patients with malignant tumor,and establish intervention model accordingly. Methods 40 patients complicated with venous thrombosis after PICC were set as the thrombosis group, 40 patients without venous thrombosis were selected as the no-thrombosis group, 30 healthy cases were selected as the control group. All cases' serum samples were ob-tained to measure the levels of molecular biomarkers of the coagulation system, platelet parameters and molecular biomarkers of the fibrinolysis system. The results of the three groups were assessed. Results Patients in the thrombosis group were reported significantly higher levels of vWF, GMP140,TAT than those in both two other groups, but lower levels of ATⅢ. Higher levels of MPV and PCT were found in the throm-bosis group than those in both two other groups.Tthe data also showed higher PLG and PAI levels and lower levels of PLM in the thrombosis group. Conclusions From this study it shows that patients with malig-nant tumors during the placement of PICC have evident hypercoagnlahility, high- activated platelet and se-vere pre- thrombosis state caused by PICC. In treatment of malignant tumor patients with PICC, the level of coag-ulation system molecular markers, platelet parameters,fibrinolysis molecular markers shoud be used as a clinical routine and as the index of early intervention and evaluation of the PICC.

Objective:To assess the effect of rosiglitazone on inflammation in peritoneal dialysis patients. Methods:Fifty patients undergoing continuous ambulatory peritoneal dialysis were collected in our hospital. The treatment group was assigned to receive regular peritoneal dialysis and rosiglitazone 4mg once daily while the control group was received regular peritoneal dialysis for 12 weeks. Such serum examinations as fasting blood glucose (FBG), glycosylated hemoglobin A1c, haemoglobin, serum total cholesterol, high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol, triglycerides and high sensitivity C reactive protein (hs-CRP) were measured, tumor necrosis factorα(TNF-α) and interleukin-6 (IL-6) levels were measured by ELISA, and homeostasis model as-sessment of insulin resistance( HOMA-IR) was also evaluated before and after the treatment. Results:After the 12-week treatment by rosiglitazone, the levels of FPG, HOMA-IR, hs-CRP, TNF-αand IL-6 were declined significantly(P<0. 05), and the level of HDL-C was increased significantly(P<0. 05). Conclusion: Rosiglitazone shows significant anti-inflammatory, insulin resistance improve-ment and anti-lipidemic effects in peritoneal dialysis patients.

Objective To determine the efficacy of the double balloon catheter in ripening and dilatation of the unfavorable cervix for induction of labor .Methods A total of 332 full-term women who were underwent induction of labor with the double balloon devices were collected for retrospective analysis .Cervix was assessed before the double balloon insertion and after it was removed 12 hours later, then amniotomy alone or combined with oxytocin was performed .Cord blood gases were analyzed .Results The double balloon catheter increased Bishop score in all subgroups with a mean improvement of 2.5 ±0.7 ( P <0.05 ) .The mean insertion-deliv-ery interval was (19.07 ±4.31)h.Cesarean section was performed in 80/332 (24.1%) patients.Cord arterial pH value was 7.3 ± 0.1 .Conclusions The double balloon catheter induced significant ripening and dilatation of the unfavorable cervix .It was effective and safe.

Objective To study the results of laparotomy and Cool-tip radiofrequency ablation to treat large liver tumors.Methods Laparotomy and Cool-tip radiofrequency ablation were carried out on 64 patients with large hepatic cancer.To destroy the tumor completely,for tumors of 3.0～4.0 cm in diameter,7 ablations were required; for 4.0～5.0 cm in diameter 15 ablations; for 5.0～6.0 cm in diameter 19 ablations; for 6.0～7.0 cm in diameter 40 ablations.Result The complete necrosis rate of laparotomy and radiofrequency ablation was 93.75％ (60/64).The short-term results were good.Conclusions Laparotomy and Cool-tip multipoint overlapping radiofrequency ablation for large liver tumors (tumor diameter＞3 cm) could result in a high complete necrosis rate and a low complication rate.It is a good radical treatment for unresectable and large liver cancer.