Objective To investigate the characteristics of acoustic parameters and spectrograph of organic and functional voice disorder and evaluate the value of acoustic analysis technique by computer in the differential diagnosis of voice disorder. MethodsThe voice signals of sustained vowel "a" were measured with a microcomputer (Dr.Speech Software) in 70 healthy adults, 60 patients with varying organic diseases of vocal cords and 50 cases with functional voice disorder. The acoustic parame ters (jitter, shimmer, NNE) and spectrographic characteristics were analyzed and compared. ResultsIn 60 patients with organic diseases of vocal cords, all the acoustic parameters were significantly increased and the spectrograph showed irregularity,breakage or lack of harmonic waves and formants, and increase of noise. In 50 cases with functional voice disorder, the shimmer and NNE were significantly increased but the jitter was usually normal. The spectrograph showed pathologic changes of harmonic waves and formants in middle and high frequencies. The normal acoustic characteristics could be found in 94% (47/50) of the patients with functional voice disorder. ConcluisionThe acoustic analysis by computer technique is of value in the differential diagnosis of or ganic and functional voice disorder.

Cystic neoplasms of the pancreas are rare lesions,usually without typical clinical manifestations.This article summarizes the clin-icopathological features and surgical treatment of common cystic neoplasms of the pancreas,including serous cystic neoplasm (SCN),mu-cinous cystic neoplasm (MCN),intraductal papillary mucinous neoplasm (IPMN),and solid pseudopapillary neoplasm (SPN).The clini-copathological features are independent prognostic factors for patients.More attention should be paid to correct diagnosis and appropriate sur-gical strategy for each cystic neoplasm of the pancreas.

Objective To analyze the clinical efficacy of daily online cone-beam computed tomography (CBCT)-guided stereotactic body radiation therapy (SBRT) for primary and metastatic lung cancer and its related factors.Methods From May 2009 to May 2013,36 patients with lung cancer were treated with SBRT,including 24 patients with primary lung cancer and 12 patients with metastatic lung cancer.The biologically effective dose at 10 Gy was ≥ 100 Gy in 85.7％ of 42 lesions.Before each delivery,CBCT was acquired,and online automatic or manual registration was performed to make the tumors on CBCT within the planning target volume/primary gross tumor volume;the setup threshold was not set,and the couch was moved for correction.Results The 1-,2-,and 3-year sample sizes were 36,29,and 26,respectively.The 1-,2-,and 3-year local control (LC) rates were 96％,89％,and 72％,respectively.The 1-,2-,and 3-year cancer-specific survival (CCS) rates were 82％,74％,and 64％,respectively.The 1-,2-,and 3-year overall survival (OS) rates were 78％,64％,and 53％,respectively.Univariate analysis found no factors associated with LC.Multivariate analysis revealed no factors associated with OS.Both univariate and multivariate analyses showed that only tumor location (central type or peripheral type) was associated with CCS;the mean values (95％ confidence intervals) of CCS in patients with central-type and peripheral-type lesions were 21.4 months (13.2-29.6 months) and 42.3 months (35.7-49.0months),respectively (P=0.024).Conclusions Daily online image-guided SBRT for primary or metastatic lung cancer can lead to a satisfactory LC.

This paper summarized nursing care in intra-hospital transfer of 13 critically ill patients with extracorporeal membrane oxygenation. The key points to guarantee safety of critically ill patients were establishing a well-trained professional team and developing standardized procedures,and applying checklist for ECMO Transfer. The key points in nursing were assessment and pretreatment,homogenized nursing during transfer and effective handover after transfer. As a result,six cases of avian influenza patients successfully completed CT ex-amination,five cases of lung re-transplant patients and two cases of lung transplant patients were successfully trans-ferred to the operating room.

Objective To explore a method of using a computer system for multi-media cases study in radiation oncology clinical work,in order to replace the traditional use of film images and paper.Methods We use a dedicated networked computer's Windows XP's Remote Desktop feature to remote access an Eclipse TPS and the radiation therapy information management system.Then we can online read the patient' s information of CT images,target volumes,treatment plans,plan application forms and electronic medical records,and use a projector to project it on the screen.Results There has been half a year since we successfully set up a radiation therapy case study multi-media system in the department.It's convenient and effective to achieve the department conducted a collective case discussion.Conclusions The equipment required is simple,and it's a safe and reliable technology,greatly improving the clinical efficiency and quality of medical care.

Objective To meet the special needs of the department of radiation oncology, a radiation therapy information management system ( RTIMS) has been developed as a secondary database system to supplement the Varian Varis/Aria since 2007. Methods The RTIMS server was used to run a database and web service of Apache + PHP + MySQL. The RTIMS sever's web service could be visited with Internet Explorer (IE) to input, search, count, and print informations from about 30 workstations and 20 personal computers. As some workstations were installed with Windows and IE in English only, some functions had English version. Results In past five years, as the RTIMS was implemented in the department, some further needs were met and more practical functions were developed. And now the RTIMS almost covered the whole workflow of radiation therapy ( RT) . By September 2011 , recorded patients data in the RTIMS is as follows: 3900 patients, 2600 0utpatient RT records, 6800 progress notes, 1900 RT summaries, 6700 charge records, 83000 workload records, 3900 plan application forms, 1600 ICRT records. etc. Conclusions The RTIMS hased on the workflow of RT has been successfully developed and clinically implemented. And it was demonstrated to be user-friendly and was proven to　significantly improve the efficiency of the department. Since it is an in-house developed system, more functions can be added or modified to further enhance its potentials in research and clinical practice.

400 ng/ml and in those the post-LT AFP level failed to decrease to ≤20 ng/ml within 2 months. The dynamic changes of AFP after LT were valuable in predicting post-transplant HCC recurrence.

Objective To investigate the efficacy and safety of citrate anticoagulation for continuous renal placement therapy (CRRT) in patients at high risk of bleeding. Methods Forty-seven patients who needed to CRRT and were admitted into the department of critical care medicine from January 2015 to October 2016 were enrolled in this study. According to the patient′s actual condition, they were divided into citrate groups (24 cases) and saline group (23 cases). Patients in saline group were given saline wash. The efficacy and safety were compared between the two groups. The filter lifetime, after treatment the activated partial thromboplastin time (APTT), hemoglobin (Hb), blood gas indexes were compared between the two groups. Results The citrate group used 76 filters while the 0.9% sodium chloride group used 87 filters. The average filter lifetime in citrate group was (22.4 ± 12.7) h which was longer than (8.6±3.3) h in 0.9%sodium chloride group (t=9.79, P<0.01). The incidence of coagulation in extracorporeal circulation was 3.9%(3/76) which was lower than 16.1%(14/87) in 0.9%sodium chloride group(χ2=5.20, P<0.05). Conclusions Regional citrate anticoagulation is a safe and effective option for CRRT in patients at high risk of bleeding.

This paper retrospectively analyzed nursing care of 20 critically ill patients with human infections of avian influenza A(H7N9) virus treated by oxygen therapy.According to the severity of hypoxia in patients admitted to the hospital,individualized oxygen therapy strategy was selected,such as humidified high flow nasal cannula or mechanical ventilation.Oxygen therapy strategy was adjusted in a timely manner according to patients' condition,such as prone position ventilation and extracorporeal membrane oxygenation.As a resuh,15 cases were transferred to the general ward when the virus associated test was negative,and 5 cases died.

Objective To evaluate the prognosis and side-effects of three-dimensional conformal radiotherapy (3 DCRT) and intensity modulated radiotherapy (IMRT) for prostate carcinoma. Methods From 2001 to 2009, 62 patients with prostate carcinoma treated with radiotherapy were included in the retrospective analysis. Among them, 60 patients received IMRT while the other two received 3DCRT. There were 56 patients receiving androgen deprivation therapy before radiotherapy. The median dose was 78 Gy to 95% planning target volume (PTV) of the prostate and seminal vesicles, and the median dose to 95% PTV of the pelvic lymph nodes was 48 Gy. Results The median follow-up was 15.4 months. The 3-and 5-year overall survival (OS) rates were 92% and 83%, with the corresponding biochemical disease-free survival rates of 87% and 69%, and the distant metastasis-free survival (DMFS) rate of 77% and 55%, respectively. Patients with a PSA nadir ≤ 2 ng/ml had a 3-year OS of 94% and DMFS of 88%, compared with 56% and 11% (χ~2 = 16. 39, P < 0.01 for OS ; χ~2 = 28. 87, P < 0. 01 for DMFS) for those with a PSA nadir > 2 ng/ml. The incidence of grade 1 and 2 urinary toxicity was 32% and 0% for acute damage, 10% and 0% for late damage, respectively. The incidence of grade 1 and 2 intestinal toxicity was 19% and 3%. for acute damage, 5% and 3% for late damage, respectively. Conclusions Radiation therapy for patients with prostate carcinoma shows satisfactory outcomes with a good toleration. Monitor of PSA after radiotherapy has benefit for prognosis evaluation.