Thermotherapy is one of the combined therapies of malignant tumor. It can enhance the sen-sitivity to radiotherapy by inhibiting cell DNA repair,changing cell signaling, modulating cell cycle checkpoint and inhibiting tumor cell metastasis. Many clinical trials have also confirmed that the combination of thermother-apy and radiotherapy can enhance the curative effect of head and neck,ventrum and pelvic malignant tumor. In this article,the synergistic effects and mechanism of tumor thermoradiotherapy are reviewed.

Objective To study the method and ability of multi-slice CT isotropic scan and post-processing in displaying the anatomy of cervical vertebrae.Methods The normal cervical spines in 53 cases were scanned with isotropic parameters using 16-slice-helical CT.All the images were post-processed with the methods of MPR,MIP,SSD and VRT and each other were compared between them,then the best one was selected to compare with axial CT images and plain films.The abilities in displaying inter-vertebrae disc,spinal canal longtitude,vertebrae body,vertebral arch,zygapophyseal joint and inter-vertebrae foramen were compared among the 3D reconstruction,direct CT scan and X-ray plain film including post-anterior,lateral,left-anterior oblique and right-anterior position project.Results The quality of isotropic post-processing images had no remarkable differences with that of direct CT scan in showing inter-vertebrae disc,but it was better than X-ray plain film and conventional CT scan mode in showing other structures.Conclusion The multi-slice helical isotropic CT scan and post-processing images are of great value in the study of cervical spine.

Fifty percent TBSA third degree burns was inflicted to 24 dogs and they were treated with immediate fluid infusion (8 dogs),delayed conventional infusion (n=8),and delayed fast infusion (n=8),It was found that in the immediate and delayed fast infusiong groups,strike volume,strike index, left ventricular strike work index,right ventricular strike index and femoral arterial pressure were maintained at a level more than 50% of the normal and were gradually restored.Their pulmonary artery wedge pressure was larger than 1.3 kPa.ALT and LDH were increased but never exceeded the preburn level.DB,TB,UN,Cr,PaO2,P(A-a)O2 were maintained in the normal range.MDA RCR,ADP/O,ATP,positive blood culture rate,mortality rate and morbility of multiple organ failure were all lower than those of the delayed conventional infusion group.It is believed that in the early stage of burn injury,the development of multiple organ failure can prevented effectively with immediate infusion and partially with delayed fast infusion while delayed conventional infusion exerts no protection at all.

In order to improve the teaching competence of clinical teachers in standardized nursing training and ensure the teaching quality of the training, since 2014, Chongqing Municipal Health and Family Planning Commission has held a unified training course for teachers in a standardized training base for new nurses in the city annually, and formulated a teacher training system; on the basis of fully considering the study needs of clinical teachers, the course of "taking teaching competence as the direction and improving clinical teaching ability as the core" has been set up, and the training teachers are evaluated by various ways. At the end of the training, the satisfaction survey on the training effect has been carried out, and the participants are satisfied with the contents and methods of the teaching. Higher satisfaction can improve the teaching competence of teachers.

With the internationalization of nursing education,one major project facing higher nursing education is to foster lots of high quality nursing specialists,with properties of international vision,development prospect,and adaptation to international nursing positions.Chongqing Medical University engaged in reforming and implementation of talents culturing and yielded significant effect along with the main competency ideology of humanistic caring,critical thinking,evidence-based nursing,practicing and international competition.

ObjectiveTo compare the clinical effect of posterior circumferential fusion with versus without intertransverse process fusion on lumbar instability in aged patients. MethodsThe elderly with lumbar instability were treated with the posterior instrumented circumferential fusion technique in 80 cases. Among 58 patients followed up for at least 2 years, 28 cases (group A)underwent posterior circumferential fusion with intertransverse process, while 30 cases (group B)without intertransverse process. X-ray examination was used before and 1, 3, 6, 12 and 24 months after operation to evaluate the fusion condition of the bone graft, and visul analogue scale (VAS) and Oswestry disability index (ODI) questionnaire were applied to assess the pain of center back and leg,and the conventional activity.ResultsThe operation time and blood loss were more in group A[(185.3±56.6) min and (376.3±92.9) m1] than in group B [(146.4±46.3) min and (234.3±64.5)ml (t=12.37, 37.49, P＜0.01)]. All the 58 cases were followed for at least 2 years. The 27 cases (96.4％) of group A and 28 cases (93.3％) of group B got bone fusion (x2 =0.004, P＞0.05).There were marked differences in the VAS of center back at 1 and 3 months after operation between the 2 groups (t=3.178, 2.158, both P＜0.05), while no difference at the other 3 time point. VAS about the leg pain and the ODI showed no differences between group A and B after operation (all P＞0.05). ConclusionsFor the lumbar instability in the elderly, the posterior circumferential fusion with or without intertransverse process fusion can achieve a similar high rate of fusion and satisfactory clinical results,andtheposteriorcircumferentialfusionwithoutintertranaverseprocess is recommended for less trauma.

Objective: To detect varicella-zoster virus ( VZV ) antibody levels among children aged 1 to 12 years in Lu'an City, Anhui Province, so as to provide insights into perfection of the varicella immunization strategy. Methods: Children aged 1 to 12 years were recruited from Lu'an City using the stratified random sampling method from July 2018 to February 2019, and subjects' demographics were collected using questionnaires. The inoculation of varicella vaccines was retrieved through the Anhui Immunization Information Management System or review of preventive immunization certificates, and the serum VZV IgG antibody was detected using enzyme-linked immunosorbent assay ( ELISA ). The seroprevalence and geometric mean concentration of the VZV-IgG antibody were estimated, and the changes of serum the VZV-IgG antibody levels were analyzed at different time intervals following varicella vaccination. Results: Totally 734 children were surveyed, with a mean age of ( 6.94±2.95 ) years, and the subjects included 412 boys ( 56.13% ) and 322 girls ( 43.87% ). There were 514 children ( 70.03% ) with a history of varicella vaccination, including 501 children ( 68.26% ) with one dose of varicella vaccine and 13 children ( 1.77% ) with two doses. There were 297 children ( 40.46% ) positive for VZV-IgG antibody, with seroprevalence of 40.46%, and the GMC of VZV-IgG antibody was 74.97 ( 95%CI: 65.55-85.75 ) mIU/mL. The seroprevalence of the VZV-IgG antibody were 34.55%, 42.91%, and 46.15% among the unvaccinated children and children receiving one dose and two doses of varicella vaccine, with the GMCs of 53.04, 86.31 and 114.46 mIU/mL, respectively. The mean time interval between inoculation of the last dose of varicella vaccine and blood sample collection was ( 5.21±2.79 ) years, and the lowest seroprevalene (31.48%) and GMC of the VZV-IgG antibody (49.96 mIU/mL) were found 4 years after inoculation of varicella vaccine. Conclusions The serum VZV-IgG antibody level is low among children aged 1 to 12 years in Lu'an City, and the seroprevalence of the VZV-IgG antibody is affected by age and doses of varicella vaccine. A 2-dose schedule of varicella vaccine is recommended for children.

BACKGROUND: Posterior lumbar non-fusion devices have been developed to control vertebral column movement, change load pattern of instability segment, restrict abnormal action, as well as avoid adjacent segment degeneration.OBJECTIVE: To investigate the efficiency of Wallis dynamic stabilization system in the treatment of lumbar vertebrae instability.METHODS: Ten cases suffering from lumbar instability were selected, including 3 males and 7 females, aged 43-65 years. One patient sustained L_(1/2) and L_(4/5) segmental instability, one was L_(2/3) and another was L_(3/4), and the others were L_(4/5). Two patients complicated with lumbar disc herniation and 7 patients combined with lumbar spinal stenosis at the same affected segment, and 3 patients associated with lumbar spinal stenosis at adjacent segment. All unstable segments were treated with decompression, posterior implantation of Wallis dynamic stabilization system. Visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) scores for low back pain and Oswestry disability index (ODI) were used to evaluate clinical outcomes. In addition, therange of motion (ROM) at the instrumented segment and adjacent segments and posterior disc height (PDH) in standing and extension position at L_(4/5) segment were also measured.RESULTS AND CONCLUSION: All the patients were followed-up for 2-13 months, mean 9.2 months. The mean operation duration was 128 minutes (90-185 minutes), with bleeding volume of 264 Ml (50-600 Ml). Sings and symptoms of all patients were improved significantly after operation, except one patient with recurrence of L_(4/5) lumbar spinal stenosis at 3 month after surgery, whose symptoms relieved by revision with fenestration and decompression. The postoperative VAS was dramatically decreased than that of preoperation (P=0.003); the JOA score was obviously increased (P=0.002), and the ODI score was decreased (p=0.008). The postoperative range of motion decreased significantly (P<0.05). However, there was no obviously difference between preoperative and postoperative L_(3/4), L_5/S_1 and posterior disc height (P>0.05). Good clinical results can be achieved by surgical intervention with Wallis dynamic stabilization system in treating lumbar vertebrae instability.

BACKGROUND:Hydroxyapatite (HA) artificial bone,as bone grafting substitute,would not cause inflammatory reaction or immunological rejection and possesses good biocompatibility after transplantation into human body.It is a novel implant material with bone conduction ability.OBJECTIVE:To investigate the efficacy of HA artificial bone in bilateral open-door posterior cervical expansive laminoplasty and to make a comparison with autogenous bone.DESIGN,TIME AND SETFING:A retrospective case analysis was performed at the Department of Spine Surgery,Hungpuyuan Branch,the First Affiliated Hospital of Sun Yat-sen University from March 2001 to December 2008.PARTICIPANTS:Seventy patients with cervical spondylosis complicated by compression in 3 or more segments or by cervical stenosis and additional fifteen patients with cervical stenosis complicated by cervical trauma were included in this study.METHODS:A bilateral open-door posterior cervical expansive laminoplasty was performed,in which,23 patients received autogenous bone transplantation (autogenous bone group) and 62 patients underwent HA artificial bone transplantation (HA group).MAIN OUTCOME MEASURES:① Japanese Orthopaedic Association (JOA) score pdor to and after surgery,surgery time,and intraoperative bleeding.② HA artificial bone-host biocompatibility.RESULTS:All eighty-five patients were followed up for more than 3 months.There was no significant difference in JOA scores no matter prior to or after surgery between the autogenous bone and HA groups (P＞0.05).The surgery time averaged 85.2 minutes (range 65-110 minutes) in the HA group and averaged 116.4 minutes (range 75-150 minutes) in the autogenous bone group.The intraoperative bleeding averaged 210 mL (range 130-400 mL) in the HA group and averaged 260 mL (range 170-500 mL) in the autogenous bone group.There were no material-host response and other severe complications found in each group,except HA artificial bone fragmentation in 3 patients from the HA group.CONCLUSION:HA artificial bone yields good efficacy and causes fewer complications in bilateral open-door posterior cervical expansive laminoplasty;in addition,it requires less time for surgery and causes less bleeding.

BACKGROUND:Antedor canulated screw has been considered an ideal method to treat odontoid fracture.OBJECTIVE:To compare the biomechanical properties of different anterior screws.DESIGN,TIME AND SETTING:A randomized contrast study was performed at the Biomechanics Laboratory of Southern Medical University from March to September 2006.MATERIALS:Double-thread canulated screws and single-thread canulated screws were made of titanium alloy and provided by Shuangyang Medical Apparatus Co.,Ltd.,Suzhou.METHODS:A total of head-neck complexes (C0-C3) which were collected from 20 corpses were maintained in formaldehyde for less than 3 months;thereafter,the muscles and ligaments were removed to obtain the axis specimens so as to make type Ⅱ odontoid fracture models.The fracture samples were individually treated with double-thread and single-thread canulated screws,with 10 samples for each group.MAIN OUTCOME MEASURES:The shear stiffness and the maximum resistance of the two kinds of screw were tested in this study.RESULTS:The shear stiffness of the double-thread screw group was significantly higher than the single-thread screw group (P＜0.01 );however,there was no significant different in the maximum resistance between the two groups (P＞0.05).CONCLUSION:Double-thread canulated screws have a strong biomechanical stability for treating odontoid fracture;therefore,the first choice of the internal fixation should be double-thread canuiated screws for patients with osteoporosis or those who are susceptible to expanded screw pathway during surgical procedures.