Seven patients with nasopharyngeal carcinoma treated with ART were recruited . All patients were treated with SIB-IMRT regimen( named IMRT) . All patients had a second computed tomography scan after 10 fractions and a new plan based on this was initiated from fraction 11 ( ART1 ) . And a third CT scan after 21 fractions and a new plan based on this was initiated from fraction 22(ART2). When the treatment was finished,a fourth CT scan was made. Results revealed that the volumes of primary tumors and parotid glands regressed significantly after the teat-ment. The position of the parotid glands shifted medially an average of 4.5(1.6~9.2)mm during the plans. ART1 reduced mean dose to left parotid by 0. 42 Gy(1. 68%)(P=0.019) and right parotid by 0. 79 Gy (3.04%) (P=0. 013) over the IMRT alone. ART2 further reduced the mean left parotid dose by 0. 86 Gy or 3.5% ( P =0.001 ) and right parotid by 1 . 04 Gy or 4 . 13% ( P=0.035 ) .

Objective To discuss the clinical application of preoperative transcatheter arterial chemoembolization (TACE) in treating squamous cell carcinoma of tongue. Methods A total of 26 patients with pathologically proved squamous cell carcinoma of tongue were enrolled in this study. Using Seldinger technique, lingual artery angiography and TACE were carried out in all patients. Radical resection of tongue cancer was performed in 2-3 weeks after TACE. Results Super-selective catheterization and TACE was successfully accomplished in all patients. After TACE the tumor size was significantly decreased in all patients. During the operation, clear lesion's border was observed, and the amount of blood loss was less than usual. Conclusion For the treatment of squamous cell carcinoma of tongue, preoperative superselective TACE is safe and effective;it can increase the opportunity of surgical resection, reduce the surgical damage, and improve the quality of life as well as the survival rate.

Objective To discuss the nursing countermeasures of common problems in patients with spinal fracture. Methods All patients received evidence- based nursing in on:ler to tackle problems such as pain, paralysis, pulmonary infection, pressure ulcer, urinary tract infection and deep vein thrombosis. Results No one complicated with pulmonary infection, pressure ulcer and deep vein thrombosis, 2 with lower limb swelling and 3 with urinary tract infection. Conclusions Evidence- based nursing is the base of clinic nursing. It can not only improve the quality of nursing and benefit patients,but also can expand the nurses' knowledge.

Objective To compare the effect oropivacaine combined with fentanyl or sufentanil in labor anal-gesia.Methods 116 cases of maternal birth in obstetrics and gynecology were selected.According to the random number table method,116 cases of parturients were randomly divided into observation group (58 cases,received ropiv-acaine and sufentanil analgesia)and control group (received ropivacaine and fentanyl).In two groups of maternal anesthesia before induction (T0 ),used the drug after 30min(T1 ),60min(T2 ),180min(T3 )detection of the mean arterial pressure (MAP)and heart rate (HR),and digital evaluation table Rating Scale (NRS).The complications of maternal and infant in the two groups were recorded,the change of the mode of delivery and the Apgar score of neo-nates in the two groups were analyzed.Results There were no significant differences in the levels of MAP and HR between the two groups in T0-T3 (tMAP =0.123,1.078,0.212,0.047;P =0.903,0.283,0.832,0.963;tHR =0.033, 0.289,0.288,0.036;P =0.974,0.773,0.774,0.972).The NRS scores in T1 -T3 of the two groups were significantly lower than those in the T0;the T1 -T3 scores of the observation group were (2.21 ±0.36 )points,(1.78 ± 0.24)points,(1.83 ±0.25)points,which were significantly lower than (3.61 ±0.75)points,(3.22 ±0.12)points, (2.84 ±0.26)points of the control group(t =12.816,40.871,21.325,P =0.000,0.000,0.000).In the observation group,there was 0 case (0.00%)had cardiac arrhythmia,the control group had 4 cases (6.90%),and the differ-ence was statistically significant(χ2 =4.143,P =0.042).Two groups of labor analgesia,the way of delivery and birth of the newborn after birth,1min,5min of Apgar score were compared,the differences were not statistically significant (χ2 =0.703,t =0.631,1.149,P =0.402,0.530,0.253).Conclusion Ropivacaine combined with sufentanil or fentanyl in analgesia have no effect in childbirth and maternal vital signs and neonatal,and have good analgesic effect, but ropivacaine combined with sufentanil has stronger analgesic effect,higher safety.

ObjectiveTo evaluate the usefulness of an ultrasonography-based method to examine quadriceps femoris contracting. MethodsThe thickness of bilateral rectus femoris (RF) and vastus intermedius (VI) and the cross-sectional area (CSA) of RF was measured in 10 healthy subjects （n=20） in a relaxed position and 3 isometric contraction states using ultrasonography by two examiners. The date was compared with paired t test. Half of these subjects （n=10） were also measured with MRI at rest. The date was also compared with paired t test. ResultsThere was no significant difference between MRI and static compound ultrasonography, nor between two examiners. There was a significant difference (P<0.05) in thickness of RF and VI between relaxed and isometric contraction conditions. There was no significant difference among isometric contraction conditions. There was no significant difference among measurements of RF-CSA. Conclusionultrasonography shows good validity and reliability in measuring quadriceps shape.

Objective To identify the suitable echocardiographic predictor,the standard 2-demensional echocardiography and speckle tracking imaging (STI) techniques were applied for the late referred children with transposition of great arteries with intact ventricular septum (TGA-IVS) after neonatal period.Methods 22 children with TGA-IVS after neonatal period were enrolled.According to the intraoperative left ventricular (LV)/right ventricular systolic pressure ratio,they received pulmonary artery banding (PAB group,n =10) or arterial switch operation (ASO group,n =12).15 body surface area matched healthy children were served as control group,Echocardiography was performed before the operation.The dynamic images in basal and apical short axis view were collected respectively.Meanwhile,using the STI technique,the rotation curves at apex and base was analyzed.Results All the patients discharged eventually.A right to left bulging of the ventricular septum was observed in all the patients by the 2D short-axis view.There were no differences in wall thickness and ejection fraction between control,PAB and ASO group.Compared with the control group,the end diastolic diameter,end diastolic volume and indexed LV mass in PAB and ASO group were significantly reduced,however,no difference in the end diastolic diameter and volume and LV mass was observed between the PAB and ASO group.The hypoplasia of LV in PAB and ASO group was associated with an extended time to peak basal rotation and reduced basal rotation and global torsion.Furthermore,the shorter time to peak apical rotation and reduced apical rotation and global torsion were only observed in PAB group.Conclusions The standard echocardiography could be useful for the initial evaluation for regressed LV of the children with TGA-IVS.However,STI allows a much more precious approach to the assessment of LV regressing after neonatal period.The apical rotation and global torsion might be the better predictor to identify the borderline or regressed LV for the surgical management for the children with TGA-IVS.

Objective To investigate the influence of BK virus (BKV) activation in renal transplant recipients on the renal allograft function.Method Recipients receiving renal transplantation during 2010.3-2011.4 were sdected as objectives,the urine and peripheral blood samples of them were taken and real-time PCR assays were performed to detect BKV DNA at 0.5,1,3,6,9,and 12 months post-transplantation.Results Among 88 recipients,BKV viruria occurred in 27 (30.68％) patients,and sustained viruria occurred in 17 patients.37.0％ (10/27) of patients with BKV viruria developed inot BKV viremia,and sustained viremia occurred in 5 patients.The viral load in plasma was higher in patients with sustained viremia than in those with transient viremia (P＜0.05),and serum creatinine concentrations were higher when BK viremia occurred (P＜0.05).Conclusion Graft function was impaired among patients with BK viremia,and regularly monitoring BK virus in renal transplant recipients and clinical imervention based on plasma PCR results can prevent transplant kidney damage effectively.

Objective To screen differentially expressed microRNAs at different stages of hair cycle in a murine model.Methods This study included 30 inbred female C57BL/6 mice (age,6-8 weeks; body weight,15-18 grams).Hair growth cycle was induced in the back skin of C57BL/6 mice by application of wax/rosin followed by depilation under anesthesia witl 1％ chloral hydrate.Three mice were sacrificed by cervical dislocation on day 0,8 and 20 after the induction,and skin tissue was achieved from the same depilated areas parallel to the spine.Total RNAs were extracted from the murine skin and subjected to microarray analysis of microRNA expression.Results Compared with telogen skin,the murine anagen skin showed a higher expression of miR-690,obselote-49 and miR-1308,but a lower expression of miR-291a-5p and miR-212.The expressions of miR-690,obselote-49 and miR-31 were significantly up-regulated,while those of miR-127-3p and miR-212 were downregulated in the catagen skin in comparison with the telogen skin.Conclusion Seven microRNAs are identified in this study to be differentially expressed in murine skin between different stages of hair cycle,which may provide a direction for future research.

Objective To compare the applied value of BK virus DNA load detection in urine and plasma for diagnosis BK virus nephropathy (BKVN) in renal transplantation recipients.Method In 88 renal transplantation recipients receiving renal allograft from February 2011 to January 2012 in our institute,BK virus DNA load in urine and plasma was detected by using real-time PCR,and renal biopsy was performed on the recipients with gradual deterioration of the graft function or the loads of BKV replication being very high.The diagnosis of BKVN was confirmed by using immunohistochemistry.Results Of 88 recipients,there were 35 cases (39.8％) of viruria,18 cases (20.5％) of viremia and 5 cases (5.7％) of BKVN.The median BKV DNA load in both urine and plasma in BKVN recipients was significantly higher than in non-BKVN recipients (P＜0.05).The viruria sensitivity and specificity for BKVN were 100％ and 57.3％ (P =0.03),and the viremia sensitivity and specificity for BKVN was 100％ and 82.9％ (P =0.0002),respectively.We regraded viral load ≧ 105 copies/mL in plasma or ≥107 copies/mL in urine as the best discriminant cut-off value to predict the disease and to identify patients at risk of developing BKVAN.The positive cut-off value of urine's positive predictive value (PPV+) was 26.3％ and negative predictive vaule (PPV-) was 95.7％,and the positive cut-off value of plasma's positive predictive value (PPV +) was 83.3％ and negative predictive vaule (PPV-) was 98.8％.Conclusion The viral load ≥105 copies/mL in plasma can be used as the best discriminant cut-off value to predict the disease and to identify patients at risk of developing BKVAN,but the cut-off value of urine should be only used for screening BKV infection.