It has been realized that the 4Rs (repair,repopulation,redistribution,and reoxygenation) would affect the result of cell irradiation,and thus radiation treatment.The 4Rs each occurs at different dose rates,usually very low dose rates.Depending on the dose rate used for treatment,the corresponding R should be included in the linear-quadratic equation (LQ) and biological effective dose (BED) calculation.For low dose rate brachytherapy(LDR) especially permanent implant,all the 4Rs should be included in LQ for BED calculation.The 4Rs,especially repair and repopulation,play a critical role in dose fractionation.Various dose fractionation schemes such as hyperfractionation and hypofractionation are determined in consideration of the 4Rs.Stereotactic radiation therapy uses hypofractionation with high fractional doses and combine with high accuracy target localization techniques to achieve high local control rates compared to conventional dose fractionation schemes.The 4Rs have been taken into account for LDR and permanent implant.Recently,LQ for permanent implant brachytherapy has been modified to include all the 4Rs for gynecological malignancy 131Cs permanent implants.Including the 4Rs in radiation therapy has significantly improved the effectiveness and efficiency of radiation therapy for cancer treatment.

Bone marrow mesenchyma stem cells are stem cells that occupy self-renewal and multiple differentiations into cells,which have been recognized as the optimal origin for liver cell.With an increasing number of studies addressing marrow mesenchyma stem cells,more attention has been drawn to treating liver disease using the stem cell and organ reconstruction,especially seeks for the appropriate in vitro induction system.This paper comprehensive summarized the differentiation characteristics of marrow mesenchyma stem cell under many kinds of micro environment,and explains the superiority,as well as existence question of each kind of induction condition.

Objective To manufacture the skin suction blister apparatus and observe the curative effect of autologous epidermal grafting in treating vitiligo.Methods According to the theory of local skin suction blister: local skin suction blister is decided by the two facts of the negative pressure and temperature,the skin suction blister apparatus was manufactured based on feedback principle,and was applied to autologous epidermal grafting for treating vitiligo.Results The performance of skin suction blister apparatus was stable,the operation was relative simple,and the total survival grade of autologous epidermal grafting was 98.01%.Conclusion The skin suction blister apparatus is simple to operate and its curative effect is excellent for clinical application.

Objective To design and manufacture the injecting roll booster,by which Dipospan mix liquid is injected for treating keloid.Methods According to the principle that screw roll can save labour when it is circumvolved forward,the injecting roll booster was developed.Dipospan mix liquid(Dipospan1ml,Hyaluronidase1500U,5-Fluorouracil 2~5ml) was injected for treating keloid.Results The treatment effect of the injecting roll booster was apparently better than that of general injector.The Dipospan mix liquid and Dipospan for keloid were injected,and the total efficacies were 94.45% and 85.51% respectively.There was marked difference statistically(p

To discover factors affecting the inpatient’ actual reimbursement rate of urban resident basic medical insurance ( URBMI ) . Methods: Using the method of correlation analysis and multiple stepwise regression modeling to identify the influencing factors. Results: The per capita funding criteria, rate of inpatient out of pocket payment over resident annual per capita disposable income and per capita hospitalization rate have significant effect on the actual reimbursement rate of URBMI. Conclusion: It is needed to establish a sustainable steady financing mechanisms for URBMI, improve the evaluation system of reimbursement policy and gradually raise the level of actual reimbursement.

Objective To evaluate the curative effect in treatment of hepatic metastases tumor with poorly blood supply through superselective transcatheter nutrient arterial full chemoembolization.Methods 75 cases of hepatic metastases tumors with poorly blood supply were treated by full chemoembolization through superselective transcatheter nutrient arterial infusion under DSA guided.Results After treatment 2～3 months,CT scans showed that totally 202 tumors in 75 cases,the tumors were fully filled with lipiodol in 189,large part in 11 and not well in 2.159 tumors were obviously shrunk,41 tumors were shrunk part,2 tumors were not obviously shrunk.The survival rate in 6 months,12 months,24 months,36 months and 3～5 years was 100%(75/75),85.3%(64/75),55%(41/75),42.7%(32/75)and 20%(15/75)respectively.Conclusion The transcatheter superselective nutrient arterial full filling chemoembolization for hepatic metastases tumor with poorly blood supply is a effective therapy.

[Objective] To develop biomimicking chitosan scaffolds with longitudinally oriented micro-channels,and investigate their efficacy in bridging 15 mm sciatic nerve gap in rats.[Methods]Chitosan scaffolds with longitudinally oriented micro-channels were fabricated using unidirectional freezing-dry methods.The chitosan scaffolds were used to bridge 15 mm nerve defect in rats,and their efficacy in bridging nerve gap was evaluated by morphometric analysis,retrograde labeling,electrophysiological studies and behavioral analysis.[Results]The chitosan scaffolds developed in the present study showed longitudinally oriented micro-channels,which resembled the dimensions of basal lamina channels in normal nerves.Implantation of chitosan scaffold achieved axonal regeneration and functional recovery similar to autograft implantation in vivo.[Conclusion]The chitosan scaffolds have inner microstructures which resemble the basal lamina channels in normal nerves.The chitosan scaffold may be used as an alternative to autograft in bridging nerve gaps.

Objective To study the MRI manifestations of hemangioblastomas.Methods MRI data of 27 cases of hemangioblastomasproved by surgery and pathology were analyzed retrospectively.Results Hemangioblastomas were often located in hemispherium of cerebellum.All cases could be divided into three types : cyst-nodule type cyst-solid type and purely solid mass type.The large cyst and small nodule sign were characteristic manifestations of the cyst-nodule type,the signals of the fluid of the cyst were higher than that ofcerebrospinal fluid on MRI.The nodules or solid potions of the mass were showed as equal or slight long T_1 and slight long T_2 signalintensity,and were obviously enhanced.The blood vessel flow-void-sign around and inside the solid parts of the masses could be seen,and had a close relation with surrounding meninges.Conclusion MRI is a effective method in diagnosing hemangioblastomas,but the atypical cases should be differentiated from cystic astrocytoma,meningioma and metastesis.

High intensity focused ultrasound (HIFU)is a new technology of focal therapy for patients with hepatic carcinoma.Comparing with operation and other focal therapeutic methods (such as radiofrequency and transcatheter arterial chemoembolization) of liver cancer,HIFU is non-invasive,accurate,and definite in killing the tumor tissue with fewer complications.Thus,it is widely accepted in clinical settings and has a promising prospect.In this article,we review the mechanism and present situation of hepatic carcinoma therapy with HIFU and dicuss some clinical application and development in the future.

Objective To evaluate clinical value of tumor biomarkers in ascitic fluid and serum in differentiating benign from malignant ascites and their correlation. Methods From July 2006 to July 2009,67 patients with ascites undergone abdominal paracentesis in Renmin Hospital of Wuhan University were enrolled in the study and divided into malignant and benign groups according to their etiology. Levels of tumor biomarkers in ascitic fluid and serum were determined and their correlation were analyzed. Diagnostic sensitivity and specificity of tumor markers were evaluated. Results There was statistically significant difference in levels of cancer antigen 199 (CA199) in serum and ascitic fluid between the malignant group and the benign one ( P ＜ 0. 01 ), and level of cancer embryonic antigen (CEA) significantly increased in ascitic fluid (P ＜ 0.05 ). Levels of CA199 and CEA in serum were significantly higher than those in ascetic fluid in the benign group (P ＜ 0. 01 and P ＜ 0. 05 ), and level of CA125 was significantly lower in serum than that in ascitic fluid (P ＜ 0. 01 ). Level of alpha-fetal protein (AFP) in serum significantly correlated with that in ascitic fluid in the benign group (r =-0. 992, P ＜0. 01 ). In the malignant group, levels of CA199, CEA and CA125 were significantly higher in ascitic fluid than those in serum (P ＜0.05 or P ＜0. 01 ). Levels of CA199 and CEA in serum significantly correlated with those in ascetic fluid in the malignant group (r =0. 746 and 0. 572, respectively, P ＜0. 01 ), and level of AFP in serum also correlated with that in ascetic fluid (r=0. 384, P ＜0. 05). Ratios of levels of CA199 and CEA in ascetic fluid to those in serum (F/S) were significantly higher in the malignant group than those in the benign group (P ＜0.05 or P ＜0.01). Use of combination of CA199, CEA and CA125 determinations showed a higher sensitivity and specificity in differential diagnosis for benign and malignant ascites (P ＜0.05). Conclusions Determinations of CA199 and CEA are beneficial for differentiating benign ascites from malignant one. Determinations of tumor biomarkers in serum can not fully replace those in ascetic fluid. Combined determinations of CA199, CEA and CA125 can increase their sensitivity and specificity in diagnosis for malignant ascites.