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 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.

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.

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

Objective To investigate the clinical effects of different doses of propranolol in treatment of infantile mixed and deep hemangioma,and to provid theoretical and experimental evidence for the treatment of hemangioma. Methods The selected 62 patients with mixed and deep hemangioma were divided randomly into low dose (1.5mg·kg-1 ·d-1 )and high dose (3.0 mg·kg-1 ·d-1 )of propranolol groups,3 times a day,6 months as a course,the changes in hemangioma size and the incidence of adverse reactions were recorded.Results The efficacy was evaluated using Achauer system.The total effective rate was 80.65% in low dose of propranolol group and 93.55% in high dose of propranolol group,including 6 cases of class Ⅰ (poor),9 cases of class Ⅱ (moderate), 11 cases of classⅢ (good),and 5 cases of class Ⅳ (excellent)in low dose propranolol group;while 2 cases of class Ⅰ (poor),4 cases of class Ⅱ (moderate),10 cases of class Ⅲ (good)and 15 cases of Ⅳ (excellent)in high dose of propranolol group.The efficacy in high dose of proprandol group was significantly better than that in low dose of proprandol group (P<0.05),there were no significant differences in the efficacies between different sites and different types (P>0.05)and there was no significant difference in the incidence of adverse reaction between two groups (P>0.05).Conclusion The efficacy of oral 3.0 mg·kg-1 ·d-1 propranolol in treatment of infantile mixed and deep hemangioma is increased significantly, and there is no significant adverse reactions after increasing doses.Therefore,high dose of propranolol should be recommended in order to improve the therapeutic effect.

Objective To investigate the effects of improved end-to-end invagination pancreaticojejunostomy on the occurrence of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 396 patients who received pancreaticoduodenectomy at the Cancer Hospital of Shandong Province from January 2001 to January 2011 were retrospectively analyzed.All patients were divided into the improved group(235 patients)and traditional group(161 patients)according to different anastomotic methods.All the operations were done by the same surgical group,and the digestive tract was reconstructed by the Child method.Patients in the improved group received improved end-to-end invagination pancreaticojejunostomy,and patients in the traditional group received traditional end-to-end anastomosis.The volume of operative bleeding,operation time,incidence of pancreatic fistula and duration of hospital stay of the 2 groups were compared.All data were analyzed using the t test,chisquare test or Fisher exact probability.Results The operative blood loss,operation time and duration of hospital stay were(383 ±56)ml,(7.2 ± 1.0)hours,(21 ±3)days in the improved group,and(381 ±39)ml,(7.0 ± 0.5)hours,(22 ± 5)days in the traditional group,with no significant difference between the 2 groups(t =0.388,1.680,-1.835,P ＞ 0.05).No operative death was detected in the 2 groups,and the overall incidence of pancreatic fistula was 7.6％(30/396).The incidence of pancreatic fistula of the improved group was 0(0/235),which was significantly lower than 18.6％(30/161)of the traditional group(P ＜ 0.05).Patients complicated with pancreatic fistula in the traditional group were cured by drainage,somatostatin administration and parenteral nutrition.Conclusion Improved end-to-end invagination pancreaticojejunostomy can significantly reduce the incidence of pancreatic fistula after pancreaticoduodenectomy.

Objective:To study the relationship between telomerase activity and the expression of proliferating cell nuclear antigen(PCNA) in oral squamous cell carcinoma (OSCC). Methods:Telomerase activity and expression of PCNA in 68 cases of OSCC,34 cases of epithelium immediately adjacent to carcinomas and 12 cases of normal oral mucosa were detected by TRAP-PCR-ELISA and immunohistochemical SP method. Results:The positive rate of telomerase in OSCC, the epithelium immediately adjacent to carcinomas and the normal oral mucosa was 67.65%(46/68), 8.82%(3/34) and 0(0/12) respectively. Telomerase activity in OSCC was related to the grade of the clinicopathology(P

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 analyze the risk factors of subclavian venous catheter-related infections in patients with traumatic hemorrhagic shock (THS) and provide a basis for prevention and control of the infection. Methods A retrospective study was conducted. 357 patients with THS and indwelling of subclavian vein catheter admitted in the Department of Emergency of Affiliated Hospital of Sichuan Provincial Luzhou Medical College were enrolled, and according to the infection state, they were divided into infection group (56 cases) and non-infection group (301 cases). The patients' data of gender, age, history of underlying disease, catheter position, catheter indwelling time, time staying in hospital, situation of antimicrobial drug used, application of tracheotomy or not, white blood cell count (WBC) levels, etc were collected for univariate analysis. The resulting indexes with statistical significance were applied for carrying out the multivariate logistic regression analysis, and then the independent risk factors involved in the development of subclavian venous catheter-related infections in the shock patients could be screened out.Results In 357 patients with THS, 56 were infected (15.7%). Univariate analysis showed: age ≥ 60 years (χ2 = 19.839,P < 0.001), with diabetes mellitus in past history (χ2 = 6.252,P = 0.012), catheter indwelling time ≥ 7 days (χ2 = 19.261,P < 0.001), time staying in hospital ≥ 7 days (χ2 = 4.315,P = 0.038), time for use of antimicrobial drug≥ 7 days (χ2 = 16.161,P < 0.001), tracheotomy (χ2 = 40.969,P < 0.001), WBC < 4×109/L (χ2 = 39.451,P < 0.001) and the disease severity grade 4 - 5 (χ2 = 8.345,P = 0.004) were the risk factors of subclavian venous catheter-related infections in patients with THS. Multivariate analysis showed: catheter indwelling time ≥ 7 day [odds ratio (OR) = 16.713, 95% confidence interval (95%CI) 3.651 - 76.624), tracheotomy (OR = 6.861, 95%CI 2.377 - 18.246), WBC < 4×109/L (OR = 4.903, 95%CI 1.887 - 12.643) were the independent risk factors of subclavian venous catheter-related infections in THS patients.Conclusion The strict implementation of aseptic catheterization, shortening the time of catheter indwelling as much as possible and the rational use of antibiotics can effectively reduce and prevent the incidence of venous catheter-related infection in THS patients.