Objective To study the accuracy of SentinelTM system for patient setup using rigid-body phantom.Methods A 002LFC IMRT phantom was placed on Elekta HexaPODTM 6-degree couch using tattoo and the laser in the treatment room.When a well-know shift (3 directions) and rotation (3 positions) was moved,CBCT and SentinelTM system were scanned respectively,and the measuring errors of six dimensions were recorded.The absolute differences between applied and measured errors were compared and paired t-test.Results Total 15 well-know shifts were investigated.The SentinelTM system was very good stability and the largest absolute difference only 0.9 mm (z direction) and 0.2° (arbitrary direction).At the same time,a good conformance between SentinelTM system and CBCT was displayed because the largest absolute difference between applied and measuring error was less than 0.9 mm (z direction) and 0.2° (arbitrary direction).Conclusions SentinelTM system is fast,simple,non-invasive and seems to be reliable in detecting patient setup errors.It maybe hold potential to ensure precise patient positioning with reduced CBCT frequency in tumor locations with fixed relation to surface structures.

OBJECTIVE:To provide reference for the further implementation of national essential medicine system of township hospitals. METHODS:5% township hospitals in a province were collected as sample by using random cluster sampling method, and statistics,comparison and evaluation was made by issuing questionnaires to get health resources distribution status,health ser-vice status and income and expenditure status before(in 2009 and 2010)and after(from 2011 to 2013)the implementation of na-tional essential medicine system of township hospitals. RESULTS:Totally 46 township hospitals were surveyed and totally 46 ques-tionnaires of township hospitals were recycled. Average number of beds in township hospitals increased from 15.1 beds in 2009 to 19.4 beds in 2013. Average annual outpatients increased from 11 200 in 2009 to 16 100 in 2013,and average number of hospital discharge increased from 644 in 2009 to 924 in 2013. The proportion of government financing to total income increased from 25.9% in 2009 to 47.1% in 2013,proportion of drug income to the total income decreased from 54.9% to 29.7%,drug profit rate decreased from 25.5% to 3.7%,and proportion of township hospital under deficit decreased from 17.4% to 4.3%. Average time that residents see a doctor in township health center increased from 0.47 in 2009 to 0.74 in 2013,and cost of average hospitaliza-tion and outpatient drugs decreased from 805 to 718 and 28.1 to 24.1,respectively. CONCLUSIONS:The implementation of nation-al essential medicine system has no negative effect on outpatient service,but first inhibits then promotes the inpatient services. Na-tional essential medicine system has effectively cut down the financial burden of drugs,but it has no effect on total health burden. It is difficult to realize the excessive rapid rise of health ex-pense by the single implementation of essential medicine sys-tem,and it needs comprehensive reform,collaboration and in-teraction of medicine and health to effectively relieve the prob-lem of“expensive ill”.

ObjectiveTo investigate the effects of extracts ofLiaoxuan Kaxifu Powders (LE) on proliferation and transcription of IL-8 and ICAM-1 in HaCaT induced by TNF-α; To discuss its mechanism of action.Methods Cultured HaCaT was assigned into normal group, TNF-α group and low-, medium- and high-dose of LE group. Every group was induced by 40 ng/mL TNF-α except for normal group, and then LE groups were treated by different concentrations (8, 40, 200μg/mL) of LE for 48 h. The proliferation of HaCaT was evaluated by MTT and the apoptosis was detected by inverted fluorescence microscope. Levels of IL-8 and ICAM-1 in HaCaT were assessed by ELISA, and their mRNA expressions was detected by semi-quantitative RT-PCR.Results Compared with normal group, the absorbency of HaCaT and the contents and mRNA expressions of IL-8 and ICAM-1 increased in TNF-α group (P<0.05,P<0.01); compared with TNF-α group, LE of all dose groups could significantly inhibit the absorbency, decrease the contents and mRNA expressions of IL-8 and ICAM-1 (P<0.05,P<0.01).Conclusion LE is able to inhibit the proliferation of HaCaT induced by TNF-α, and the mechanism is probably related to promoting apoptosis and down-regulating the gene expressions of IL-8 and ICAM-1, and then maintaining the normal level of HaCaT.

Objective To provide the effective references for reasonable arrangement of nursing post by comparison on the core competence level and characteristics between the upgraded and the fulltime bachelor nurses.Methods Questionnaire survey based on the basic demographic data and the Competency Inventory for Chinese Registered Nurse for 391 clinical nurses from 13 three level of firstclass hospitals.Results The core competence score of the upgraded and the full-time bachelor nurses showed a moderate degree of satisfaction; the full-time bachelor nurses' total scores were higher than those of the upgraded nurses,and there were statistically significant differences among 6 dimensions included critical thinking and scientific research ability; there was no significant difference in clinical nursing dimension.Conclusions The full-time bachelor nurses' core competence is higher than that of the upgraded nurses in general,but no significant difference exists in clinical nursing dimension.

Objective To evaluate the efficacy and safety of HLA identical and haploidentical related allogeneic hematopoietic stem cell trans?plantation in the treatment of acute myeloid leukemia(AML)and myelodysplastic syndrome(MDS). Methods A total of 21 patients with AML and 8 patients with MDS who underwent allogeneic hematopoietic stem cell transplantation in our hospital from April 2011 to April 2016 were ana?lyzed retrospectively,including 16 cases of HLA?identical allogeneic HSCT,10 cases of haploidentical allogeneic HSCT,and 3 cases of syngeneic HSCT. BUCY2 or TBI plus CY ± chemotherapeutic agents was the regular conditioning regimen. No graft versus host disease(GVHD)prophylax?is was required for syngeneic HSCT,but cyclosporine in combination with methotraxate was essential for allogeneic HSCT,cyclosporine,methotrax?ate,antithymocyte globulin,mycophenolate mofetil and glucosteroids for haploidentical HSCT. Results All patients achieved fully donor?originat?ed hematopoiesis. Two patients died of severe acute GVHD within 100 days post HSCT. Acute GVHD with gradeⅡ?Ⅳoccurred in 23.1%(6/26) patients,chronic GVHD in 50%patients,therapy and relapse?relevant mortality was 4/29(13.8%)and 6/29(20.7%)cases within a median follow?up of 23(1?60)months,respectively. Two?year overall survival and leukemia free survival rates are 68.09%( 95%CI:45.77%?82.78%)and 60.22%(95%CI:38.19%?76.55%),respectively. High risk AML is still the main challenge to long?term leukemia free survival. Conclusion HLA identical and haploidentical allogeneic HSCT for AML and MDS is safe ,effective and feasible. Minimal residual disease monitoring and pre?ventative as well as preemptive intervention is necessary for improving prognosis of high risk AML.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Staphylococcal Scalded Skin Syndrome ; diagnosis ; drug therapy ; pathology

Objective To explore the effectiveness of a respiratory function training instrument with stable chronic obstructive pulmonary disease (COPD) patients.Methods Sixty-seven COPD patients in the stable period were randomly divided into a treatment group of 36 and a control group of 31 using a random number table.Both groups were given conventional pulmonary rehabilitation,including half-closed lip respiration,abdominal respiration and upper limb training.The treatment group was additionally provided with 30 minutes of respiratory training using a respiration function training instrument 5 times per week for 6 months.Both groups were assessed for their mobility,life quality and pulmonary function using the 6-minute walk test (6 MWT),a COPD assessment test (CAT),the BODE index,forced vital capacity (FVC),forced expiratory volume in one second (FEV1) and surface electromyography (SEMG) of the respiratory muscles before and after the 6-month intervention.Results Before the treatment there were no significant differences between the two groups in terms of any of the measurements.After the treatment,significant improvement was observed in the average 6 MWT,CAT,BODE index and SEMG results in both groups,but with significantly greater improvement in the treatment group.The average FVC and FEV1 results did not improve significantly,so after the intervention there was still no significant difference between the groups.Conclusions Respiratory training using the pulmonary function training instrument can improve the mobility,life quality and the functioning of the respiratory muscles of COPD patients in the stable period.

Objective:To determine the expression profile and potential roles of CD24 in oral squamous cell carcinoma and explore the values of CD24 function as a potential target of clinical therapy.Me-thods:Semi-quantitative immunohistochemistry was used to construct the expression profile of CD24 in 78 human oral tissues and 59 Hamster buccal pouch tissues.Real-time RT-PCR and Western blot were used to analyze the CD24 expression levels in oral DOK4 cells,oral cancer CAL-27 and WSU-HN6 cells. Then these two cancer cell lines were selected to evaluate the effect of all-trans retinoic acid (ATRA)and CD24 antibody on CD24 expression,and the proliferation and tumorsphere formation capacity of these two cell lines.Results:CD24 expression was found significantly elevated in both human and animal tissues compared with normal and benign tissues (P<0.05),as well as in oral cancer CAL-27 and WSU-HN6 cells compared with DOK cells (P<0.05).CAL-27 and WSU-HN6 cells possess increased proliferative and specific tumorsphere formation capability compared with DOK cells (P<0.05 ).Both ATRA and CD24 antibody were able to effectively inhibit the proliferation and tumorsphere formation of CAL-27 and WSU-HN6 cells (P<0.05).Among them ATRA at least involved partially in the proliferation by down-regulating the CD24 expression (P<0.05 ),while CD24 antibody blocking had no effect on the CD24 expression.Conclusion:CD24 was upregulated in oral cancer and functioned as a potential factor that promoted the proliferation and tumorsphere formation of CAL-27 and WSU-HN6 cells.Both ATRA and CD24 antibody might effectively inhibit the proliferation and tumorsphere formation of CAL-27 and WSU-HN6 cells and function as a potential therapy target.

Objective To explore the survival/proliferation,apoptotic and death effects of keratinocyte growth factor (KGF) in alveolar epithelial type Ⅱ cells (AT Ⅱ Cs) exposed to hyperoxia.Methods Primary culture of AT Ⅱ Cs from the Sprague-Dawley rat fetuses was studied under room air condition (210 mL/L O2) and hyperoxic condition (950 mL/L O2) for 0.5-12.0 h.Various concentrations of KGF (15 μg/L,25 μg/L,50 μg/L,75 μg/L,100 μg/L)were added into the cell cultures.Cells were randomly divided into room-air group,room-air-KGF group,hyperoxic-exposure group and hyperoxic-exposure-KGF group.The levels of intracellular reactive oxygen species (ROS),cleaved cysteinyl aspartate specific proteinase-3 (Caspase-3),cell death and proliferation of AT Ⅱ Cs were measured by flow cytometer,Western Blot,release of lactate dehydrogenase assays (LDH assays) and 3-(4,5-Dimethyhhiazol-2-yl)-2,5-diphenyhetrazolium bromide assays (MTT assays),respectively.Results Under room air condition,KGF could significantly increase AT Ⅱ Cs proliferation with 15-100 μg/L in a dose-dependent manner and significantly decrease LDH production at concentrations of 25-100 μg/L.Exposure to hyperoxia resulted in a significant increase in intracellular ROS production in AT Ⅱ Cs in a time-dependent manner compared with that of the room air group.Cell viability decreased and LDH release increased significantly in a time-dependent manner when AT Ⅱ Cs were exposed to 950 mL/L O2 for more than 4 h.After exposure to hyperoxia for 0.5 h and 1 h,KGF could significantly increase AT Ⅱ Cs proliferation in 15-75 μ g/L and significantly decrease LDH production at concentrations of 25-75 μg/L.After exposure to hyperoxia up to 4 h,higher viability was observed in 15 μg/L and 25 μg/L KGF group,and lower death rate presented in 25-100 μg/L KGF group.Further,prolnged hyperoxic exposure for 8 h,high viabilitv was shown only in 50 μg/L KGF group,and less death rate was observed only in 75 μg/L KGF group.In addition,no significant difference in viability and mortality was found between hyperoxic group and hyperoxic-KGF group after hyperoxic exposure for 12 h.Expression of cleaved Caspase-3 was significant higher after 4 h and 8 h hyperoxic exposure than that in room-air group ;at the same time,by adding 25 μg/L and 75.μg/L KGF led to decreased expression of Caspase-3 was detected,compared to hyperoxic group.Conclusions KGF may promote survival/proliferation,inhibited apoptosis and death of rat fetal AT Ⅱ Cs in room air condition or under temporary exposure to hyperoxia in vitro.However,prolonged exposure to hyperoxia may decrease the sensitivity of AEC Ⅱ Cs to KGF and limit its protective effects on lung injury.

Objective:To analyze the effects of essential medicine system on revenue structures at primary med-ical institutions. Methods:Data on revenue status and structures from 58 township health centers in Shanxi Province was collected to analyze changes and trends. Results:Along with growing government investments in primary medical institutions, the essential medicine system has fundamentally realized full coverage. The percentage of essential medi-cine revenue to pharmaceutical revenue rose from 20 . 45% in 2009 to 97 . 03% in 2013 , though the percentage of pharmaceutical revenue to total revenue dropped by 18 . 43%. The percentage of fiscal subsidy revenue in total reve-nue rose from 25 . 77% in 2009 to 54 . 16% in 2013 , though the percentage of business revenue to total revenue dropped in general. Conclusions:The essential medicine system requires the government’s financial support. Essen-tial medicine lists and primary financial aid policies should be further improved;doctor reimbursement and incentive mechanisms should be improved as well and unreasonable doctor service pricing and reimbursement mechanisms should be reformed.