Objective To investigate the set-up errors of super and middle part of esophageal cancer patients using cone-beam CT (CBCT) during intensity modulated radiotherapy (IMRT),hence determine various margins from CTV to PTV.The corresponding influence on the normal tissues (lung and spinal cord) was also discussed.Methods From December 2012 to December 2013,12 patients with upper and middle segment of esophageal cancer were chosen.Using their 60 sets of weekly acquired CBCT images prior to the treatment,the lateral,longitudinal,and vertical set-up errors of each patient were obtained.Based on these measured errors and the target motions,we adopted new margins to create new PTV.Then IMRT plans were created for the original PTV (5 mm margin in all directions on CTV) and new PTV respectively.On condition of the same target coverage (V95 ≥ 95％),the doses to lungs (V5,V20,V30,D) and spinal cord (D1 cm3) were compared statistically between the original and new plans.Results According to the 60 CBCT scans,the average left-right (RL),superior-inferior (SI),anterior-posterior (AP) set-up errors were (2.02 ± 1.74),(2.03 ± 1.93),and (2.02 ± 1.89) mm respectively.The margins were 5.6 mm (RL),8.5 mm (SI),and 4.7 mm (AP) for the upper esophagus and 6.2 mm (RL),11 mm (SI),and 5.0 mm (AP) for the middle esophagus.Comparison of both lungs and spinal cord suggested significant differences between the two plans (t =-8.23,-5.55,-4.66,-6.87,-4.67,P ＜0.05).Conclusions The margins from CTV to PTV should be created via CBCT-measured set-up errors and previous reports,which can be helpful for clinical treatment.

Objective To explore the association between C reactive protein (CRP)with prostatic cancer (PCa)and benign prostatic hyperplasia (BPH).Methods Retrospective analysis the 110 patients of the First Affiliated Hospital of Zhejiang University In January 2010 to August 2012 whose TPSA>4 ng/ml,postoperative pathology confirmed the diagnosis of 54 cases of prostate cancer,5 6 cases of benign prostatic hyperplasia.Detected serum CRP levels by using transmission turbidim-etry and TPSA levels by using chemiluminescence immunoassay of 54 PCa and 56 BPH patients.According to the Gleason score,PCa patients were divided into high-risk and low-risk PCa two groups,the differences among high-risk PCa,low-risk PCa and BPH groups were analyzed by nonparametric statistics analysis.Results The CRP level of high-risk PCa was 4.20~2.12 mg/L,the CRP level of low-risk PCa was 1.90~0.91 mg/L and the CRP levels in BNP patients was 1.49±0.87 mg/L,the high-risk and low-risk PCa serum CRP level obviously higher than that of patients with BPH,the differences were statistically significant (P<0.05).Conclusion Serum CRP levels of PCa patients were increased significantly,espe-cially in high-risk PCa patients.

Objective To study the pathogenesis of pathogens of sexually transmitted disease (STD) in acute pelvic inflammatory disease (PID) Methods Neisseria gonorrhoeae, chlamydia trchomatis, ureaplasma urealyticum were cutured respectively in 130 patients with acute PID Results The pathogens of STD had been found in 55 patients The detective rate of Neisseria gonorrhoeae was 6 9% (9/130), about half of them were mixed infection; the detective rate of chlamydia trachomatis was 4 6% (6/130), all of them were mixed infection; the positive percentage of ureaplasma urealyticum was 37 7% (49/130), one third of them were mixed infection Conclusion The pathogens of STD might cause acute PID or only play a synergetic role in it

Objective To observe the in vitro damage to hairs by Trichophyton mentagrophytes and Microsporum canis using light microscopy and scanning electron microscopy ( SEM ), and to compare the differences in the duration needed for the two fungi to damage hairs in different age groups. Methods We collected healthy hairs from different age groups, and performed hair perforation test in vitro. The damage to the hairs was observed by SEM and light microscopy. Results Both T. mentagrophytes and M. canis could damage the hairs. The duration needed for T. mentagrophytes to damage the hairs was significantly shorter than that for M. canis in all age groups ( P

BACKGROUND:Medical stuff have significant impacts on the development of organ donation and transplantation, however, medical students present insufficient knowledge and ambivalent attitude towards organ donation and transplantation. OBJECTIVE:To perform a systemic review on the effectiveness of educational program intervention on medical students’ knowledge and attitudes toward organ donation and transplantation. METHODS:PubMed, WILEY ONLINE LIBRARY, ProQuest Health, Medline, EMbase, CNKI, Wanfang and VIP databases were ful y searched for the published literature of medical students receiving an educational program intervention on organ donation and transplantation. According to the inclusion criteria, randomized control ed trials and quasi-experimental study were evaluated with the standard of Joanna Briggs Institute. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework was used to guide the assessment of the methodological quality of the studies. The outcomes were mainly medical students’ knowledge and attitudes toward organ donation and transplantation.
RESULTS AND CONCLUSION:Eight studies from three countries were summarized. The methods were employed in two studies of randomized control ed trials and quasi-experiment received a high quality rating, five studies received middle quality rating and one study received low quality rating. Educational program increased the knowledge in six studies, and changed the attitudes in six studies. Educational program intervention is a significant strategy to increase medical student’s knowledge about organ donation and transplantation. The majority of involved study are
quasi-experiment study, so more high-quality randomized control ed studies are needed.

Objective To summarize the perioperative nursing of undergoing radical cystectomy with ileal neobladder for the treatment of bladder cancer? Method The nursing measures included preoperative psychological care,bowel and body preparation as well as postoperative nursing of drainage tube,ileal bladder irrigation,bladder functional exercise and basic nursing care? Results No patients suffered from postoperative complications such as infections,urinary fistula and anastomotic leakage? Twenty patients recovered autonomous urination within 3-6 months after the operation? One patient got minor urinal incontinence? Conclusions Cystectomy with orthotopic ileal neobladder trauma contributes to more complications due to large surgical trauma? Therefore,good perioperative care is important for the successful operations?

Objective To investigate the damage mechanism of fluetuant high glucose on the INS-1 cells (pancreatic β-cell lines).Methods The cells were divided into five groups:the control groups (A group:5.5 mmol/L of glucose),the continuing high glucose group (B group:16.7 mmoL/L of glucose),the fluctuant glucose group ( C group:16.7 mmol/L of glucose for cultivation for 2 h,then the concentration changed to 5.5 mmol/L for cultivation for 3 h,which was repeated 3 times per day;the ceils were kept in the medium containing 5.5 mmol/L of glucose during night time for 9 h),the continuing high glucose plus NAC ( 1.0 mmo/L) group ( D group),the fluctuant glucose plus NAC group ( E group).The intracellular reactive oxygen species (ROS) was observed by the flow cytometry.The activity of glucose-6-phosphate dehydrogenase (G6PD) was estimated by the tetrazolium linked cytochemical method.Results 72 h after intervention,the levels of ROSwere 37.77±2.31,86.97±7.97,124.27±10.04,60.92±2.61 and 51.47±3.36,respectively,in A～E group;the activities of G6PD were 1.25±0.03,1.09±0.02,1.03±0.01,1.12±0.02 and 1.21±0.01,respectively;the levels of NADPH were (0.123±0.003) mmol/mg prot,(0.112±0.004) mmoL/mg prot,(0.099±0.002 ) mmol/mg prot,( 0.116±0.005 ) mmol/mg prot and ( 0.120±0.002) mmol/mg prot,respectively.The level of ROS in the cells of the fluctuant glucose group were significantly higher than that in the continuing high glucose group ( P ＜ 0.01 ).The G6PD activity and NADPH was significantly lower in fluctuant high glucose group than those in the continuing high glucose group (P ＜0.01 ).NAC co-cultivation decreased the extent of cell's change.Conclusions Exposure of INS-1 to high glucose lead to increased oxidative stress, possible mechanism included decreased G6PD activity and subsequent imbalance between oxidation and reduction.

Objective To evaluate the absorbed doses of lower-neck and supraclaviclar subclinical target and the normal tissues of nasopharyngeal carcinoma using three different intensity-modulated radiation therapy (IMRT) techniques. Methods Three radiotherapy techniques were single tangential low neck-supraclavicular field technique (tech1), seven portal IMRT in which the gantry angles are 180°, 150°, 120°, 90°, 270°, 210°(tech2) and 240°and eight portal IMRT in which the gantry angles are 180°, 150°, 120°,90°,0°,270°,210°and 240°(tech3). The dose distribution of lower-neck and supraclaviclar subclinical target and normal tissues were analyzed through the dose-volume histograms, high dose volumes were analyzed using V60 (volume of accepted > 60 Gy/all volume × 100%). The delivery efficiencies were evaluated by means of the total number of segments and MUs. Results The V60 of PTV2 were 65%, 10% and 3% in tech1, tech2 and teeh3 respectively. The maximum doses of spinal cord were 42.0, 48.9 and 45.1 Gy in techl, tech2 and tech3 respectively. The average doses of trachea were 32.92, 52.17 and 36.56 Gy in techl, tech2 and tech3 respectively. Conclusions Tech1 is simple method, but the dose distribution is very nonuniform. Tech2 is better than the Tech1, but the spinal cord and trachea receive the highest doses in three strategies. Tech3 uses less number of segments and MUs than Tech2, and has the best dose distribution.

In order to investigate whether defense genes PAL, LOX, PBZ1, PR 1 a and Cht 1 participate in APR(adult plant resistance)to rice bacterial blight, their expression were analyzed using RT-PCR. Enzymatic activities of PAL and LOX were also measured. Results indicated that PAL was induced by pathogen and wounding in adult plants while it only induced by pathogen at the seedlings, and the expression of PAL was stronger in adult plants than that in seedlings. Expression of LOX was induced by pathogen both in seedlings and adult plants and it was stronger in adult plants than that in seedlings. Expression PBZ1 was induced by both pathogen and wounding in both seedlings and adult plants and it is earlier and stronger in adult plants than that in seedlings. No expected fragments were obtained for PR 1 a and Cht 1. Enzymatic activities of PAL and LOX were consistent with their mRNA accumulations, respectively. It is probable that activation of PAL,LOX, and PBZ1 play crucial roles in APR to rice bacterial blight.

Objective The aim of this study is to evaluate word recognition abilities in 4-talker babble noise (BN) in children with normal hearing (NH), and to explore the lexical effects, age on speech recognition ability in children.Methods Children of 3~6 years old with normal hearing (N=212)were participated in this study.One hundred and twenty-four children were performed under the quiet conditions,while 88 were performed in 4-talker babble noise.The standard-Chinese version of the lexical neighborhood test was used to assess spoken word recognition performance.The speech level was 70 dB SPL, and signal to noise ratio (SNR) was chosen 4 dB in BN.Results The correct scores of the NH children in quiet for the DE, DH, ME, and MH words were 96.45%±5.17%, 88.87%±7.73%, 91.90%±7.31% and 82.38%±7.95%, while the scores in BN were 85.34%±11.23%, 66.42%±11.08%, 68.81%±15.99% and 48.58%±12.81%, respectively.The word-recognition performance in BN was significantly poorer than that in quiet.The word recognition scores showed that the lexical effects were significant in the BN (P<0.05).Children scored higher with dissyllabic words than with monosyllabic words;easy words scored higher than hard words in both quiet and noisy environments.The word-recognition performance also increased with age in each lexical category in the 3-to 6-year-old NH children.Conclusion Age and lexical characteristics of words had significant influences on the performance of Mandarin-Chinese word recognition in BN.The lexical effects were more noticeable under noise listening conditions than in quiet.The word-recognition performance in noise increased with age in NH children of 3-to 6-years old in noise and had not reached adult-like performance at 6 years of age.