Objective To observe the therapeutic effects and toxicities of bone marrow-sparing intensity-modulated radiation therapy (BMS-IMRT) for postoperative cervical cancer.Methods From January 2011 to June 2012,totally 70 postoperative patients with cervical cancer were divided into BMS-IMRT group with 34 cases and IMRT group with 36 cases randomly.External whole pelvic intensitymodulated irradiation combined with chemotherapy was carried out for all patients.The planning target volume received a dose of 45 Gy/25 fractions in all patients.Delineation of the pelvis and limitation dose were carried out in BMS-IMRT group:the pelvis V30 ≤ 50％.All cases received chemotherapy with cisplatin (40 mg/m2) once a week concurrently with radiotherapy.Results Treatment was completed in 67 patients,as the other 3 patients stopped chemotherapy because of myelosuppression.There was no statistically significant differences between two groups for the 2-year local control survival(LCS)and overall survival(OS),alimentary tract toxicity and urinary toxicity.IMRT group had more serious hematologic toxicity than BMS-IMRT group,with statistically significant difference (x2 =14.355,P ＜ 0.05).Conclusions The postoperative cervical cancer patients with poor prognostic factors who undergo concurrent chemoradiotherapy,IMRT group has more serious hematologic toxicity than BMS-IMRT group.The short-term effect and other toxicities reaction are similar between two groups.

Objective To evaluate the imaging features,pathologic characteristics and diagnostic methods of gastrointestinal stromal tumor(GIST).Methods A retrospective study was performed to analyze the clinical pathological and imaging data of 14 GIST patients diagnosed by surgery and pathology.Results 14 cases of GIST were all solitary.10 cases were located in stomach and 4 cases in small intestine.Tumors were mostly round or oval,and a few of them were irregular lobulated.Immunohistochemistry analysis:12 cases were CDll7 positive and 9 cases were CD34 positive.Conclusion The imaging examination was important to the diagnosis and localization of GIST,but the final diagnosis of GIST depended on histopathological and immunohistochemical examination.

Objective To express human inducible eostimulator (ICOS) extracellular region and IgG Fc fusion protein, and analyze their function in allogenie lymphocyte proliferation in vitro and in vivo. Methods Human ICOS extraeellular region and IgG Fc fragment were cloned into a soluble expression vector. ICOS-Ig fusion protein was expressed and purified in CHO cells. To monitor primary MLR, Balb/c spleen T cells were isolated as responder cells, and irradiated C57BL/6 spleen cells as stimulator cells. 50 μg/ml ICOS-Ig or IgG was added to primary MLR cultures. The cells responsive rates were detected by 3 H-TdR methods. ELISA tested supernatants for eytokines (IL-2,IL-4, IL-10 and IFN-γ). T cells of each group in primary MLR were cultured as responder cells for secondary MLR, and irradiated C57BL/6 (donor) or C3H (third party) spleen cells as stimulator cells. Similar indexes were detected in secondary MLR. Then vital dye CFSE was used to study alloreactive T cell proliferation in vivo. CFSE-labeled C57BL/6 spleen cells were transferred to irradiated Balb/c mice. Mice were then intraperitoneally injected with 0. 2 mg IgG, ICOS-Ig or CsA each day.At the 3rd day after transfection, the spleen cells of the mice were harvested to detect CD4+ CFSE+ and CD8+ CFSE+ by FACS. Results In primary MLR, ICOS-Ig inhibited allogenic T-cell proliferation with inhibition rate being (58 ± 8)% in 50 μg/ml, and increased IFN-γ secretion. In secondary MLR, ICOS-Ig specifically inhibited the proliferation of donor spleen cells with inhibition rate being (42±8)%, and in ICOS-Ig group the levels of IL-4 and IL-10 were lower and the level of IFN-γ higher than in IgG group. However, ICOS-Ig didn't inhibit the proliferation of third-party spleen cells. In the CFSE dye assay, CFSE intensity of CD4+ and CD8+ T cells in ICOS-Ig and CsA groups was stronger than that in control group (P < 0. 05), while CFSE intensity in combined treatment group were even stronger than that in ICOS-Ig and CsA groups (P<0. 05). Conclusion ICOS-Ig could inhibit allo-reactive T cell proliferation in vitro and in vivo, and induce donor-specific T cell hyporesponsiveness specifically.

Objective To observe the efficacy of combination of pranoprofen and artificial tears in treatment of dry eye syndrome after recovery from acute conjunctivitis. Methods This study involved 206 eyes of 157 consecutive patients who had recovered from acute conjunctivitis after routine treatment between July 2008 and September 2010. All cases were randomly divided into artificial tears group (79cases,104eyes) : artificial tears eye drops alone and combination group(78cases,102eyes) : pranoprofen combined with application of artificial tears eye drops. All patients'symptoms, signs such as tear film break 2 up time (BUT ) ,Schirmer I test (SIT) , corneal fluoresce staining (FL) score at 3,7,14days after treatment Were observed. Results All patients finished the trial at the end of the follow-up duration. There were significant differences in symptoms, BUT and corneal fluoresce staining between the two groups after treatment,combination group was superior to artificial tears group in BUT and FL. Conclusion Pranoprofen combined with artificial tears eye drops is superior to artificial tears eye drops alone

Objective This study intends to evaluate different acoustic windows that can be used to obtain the midsagittal plane of fetal brain during abdominal ultrasound scanning and the application of acoustic windows in practice.Methods The midsagittal planes were obtained respectively through anterior fontanel,posterior fontanel,sagittal suture and forehead seam of 12 aborted fetuses,and feasible acoustic windows were used as standard acoustic windows to obtain midsagittal planes of second trimester screening fetuses,which were divided into two groups according to the position of fetal brain,cephalic presentation group (367 cases) and non-cephalic presentation group (384 cases).The success rates were compared between groups.Results Of the second trimester fetuses,497 midsagittal planes of 751 cases were successfully obtained.The success rate of the cephalic presentation fetuses (32.7％,120/367) was statistically lower than that of the non-cephalic presentation fetuses (98.2％,377/384,P ＜ 0.01).Of the cephalic presentation fetuses,the combined acoustic windows acquisition success rate of the forehead,anterior fontanelle,sagittal suture and posterior fontanel acoustic window was 32.7％ (32.7％,120/367),significantly higher than the single acquisition success rate of the forehead,anterior fontanelle,sagittal suture and posterior fontanel acoustic window (17.2％,25.9％,1.6％ and 7.6％,all P ＜ 0.01).Of the non-cephalic presentation fetuses,the combined acoustic windows acquisition success rate of the forehead,sagittal suture and posterior fontanel acoustic window was 98.2％ (98.2％,377/384),significantly higher than the single acquisition success rate of the forehead,anterior fontanelle,sagittal suture and posterior fontanel acoustic window (31.8％,61.2％,64.8％ and 62.0％,all P ＜ 0.01).Conclusions The midsagittal plane of fetal brain can be obtained through forehead seam,anterior fontanel,posterior fontanel and sagittal suture acoustic windows in transabdominal screening.The combination of four acoustic windows can increase the success rate of obtaining midsagittal planes.

Objective: To explore the clinical effect of two disinfectors on prevention for central line-associated blood stream infection (CLABSI) in hemodialysis. Methods: 168 patients received blood purification through central venous indwelling catheter were divided into control group (82 cases) and observation group (86 cases) as random table. The patients of control group were disinfected by using iodophor disinfectant on central venous catheter and skin around puncture, while the patients of observation group were disinfected by using medical chlorhexidine gluconate (2% chlorhexidine gluconate, 70% isopropanol and 28%injection) on the same positions. In different stages, before and after central venous indwelling catheter and 24 hours after central venous indwelling catheter, the colony count and incidence of CLABSI of patients between two groups were compared. Results: There was no significant difference between the two groups for colony count around puncture before central venous indwelling catheter (t=-1.478, P>0.05). The colony count of observation group was lower than that of control group after 24 hours of disinfection. According to the diagnosis standards of CLABSI, the incidence of CLABSI in observation group was significant lower than that in control group (x2=6.048, P<0.05). Conclusion: The disinfector of chlorhexidine gluconate can decrease the incidence of CLABSI in hemodialysis and its bacteriostatic time is longer than that of iodophor disinfectant. Therefore, this method is worthy for promotion in clinical practice.

Two new compounds Ⅰ and Ⅱ were isolated from Sparganium stoloniferum Buch. -Ham.. On the basis of chemical evidences and spectral analysis (UV,IR, 1H and 13CNMR,FAB-MS),the structure of l was elucidated as 5-ene-methyl-cholate-3-O-?-D-glucuronopyranosyl- (1→4 )-?-L-rhamnopyranoside,Ⅱ was 5-enemethyl-cholate- 3-O-?-D-glucopyranoside

Objective To explore the optimal time and sequence for getting the best magnetic resonance (MR) imaging when MR image of synovium macrophages was used for the diagnosis of collageninduced arthritis (CIA) in a rat model,and whether it can be used to monitor the efficacy of drug treatment.Methods CIA was induced by subcutaneous injection of chicken type Ⅱ collagen and complete Freund's adjuvant (CFA).Arthritis rats were randomly divided into the model group,the leflunomide group and the control group.Knees of the model group rats were imaged before and 24 h,48 h,72 h after USPIO intravenous administration (300 μmol Fe/kg) on day 28,29,30,31,respectively.From day 28,the leflunomide group was given a gauge of drug at a dose of 8 mg/kg.Then they were imaged before and 24 hours after USPIO administration on day 42,43 respectively.MR sequences included SE T1WI,SE T2WI,GRE T2 * WI.After the completion of MR imaging,rats were sacrificed to obtain histopathologic samples of synovial membrane.LSD-t test and one-way analysis of variance (ANOVA) were used for statistical analysis.Results No distinct signal enhancements were observed on the 24 h,48 h,72 h post-contrast enhancement on T1WI.On T2WI,signal intensity ratio of synovium (SNR) pre-contrast and 24 h,48 h post-contrast were 24.13±1.96,17.09± 1.23,19.14±0.91,respectively.On T2 * WI,SNR pre-contrast and 24 h,48 h post-contrast were 22.28±0.92,11.40±0.53,17.18±0.63,respectively.Distinct signal changes were observed on 24 h,48 h post-contrast on T2WI and T2 * WI (P＜0.05).The changes between SNR at 24 h,48 h,72 h post-contrast and pre-contrast were-29.09±2.42,-20.83±2.90,-6.2±2.9 respectively on T2WI,which were-48.4±1.3,-22.9±0.8,-8.2±1.6 respectively on T2 * WI.Changes were more obvious at 24 h post-contrast than 48 h post-contrast on both T2WI and T2 * WI (P＜0.05).The quantitative analyses were coinci-dent with the visual differences in signal changes between pre-contrast and post-contrast images.Difference between △SNR of leflunomide group and the control group on T1WI was not significant,while that on T2WI and T2 * WI were significantly different (P＜ 0.01).Histological examination confirmed the uptake of iron in the macrophages of arthritic knees.Signal intensity changed more on GRE T2 * WI than SE T2WI in all arthritis rats.Conclusion GRE T2 * WI is more sensitive for the diagnose of rat CIA,and 24 h post-contrast is better than 48 h and 72h post-contrast to get better images.We successfully observed the effects of leflunomide through signal changes of synovium,and the technique maybe contribute to diagnosis and therapeutic monito-ring of rheumatoid arthritis.

Objective To study medicine storage scale model for disaster relief.Methods The medicine storage scale for disaster relief was dynamically simulated by using DAMANO programming language of System Dynamics (SD) and was calculated with discrete algorithm using FORTRAN programming language.Results The established model could be used for dynamic tracing of the inventory of the warehouse.Conclusion Medicine storage scale for disaster relief can be determined through the model established by dynamic simulation or discrete calculation.

By reviewing the practice of informed consent,the authors analyzed the elements,forms of informing and consent,main parts,contents,informing process,signing,and saving of the informed consent and put forward some suggestions which are useful for the medical scientific resesxchers and management personnel.