This article analyses and summarizes the clinical maintenance work of Elekta Precise Linac in five years.Afer the further research on its performances and errors,a better way is found to solve the main problem of clinical electronic linac,i.e.the way to reduce the Stop Rate of Linac in Radiotherapy.

Objective]To clarify the meaning of the phase“without high fever”in ShangHan Lun. [Method]To sort out the explanation of “without high fever”of interpreters from past to nowadays,then to analyse the scriptures of ShangHanLun and Sypnosis of Golden Chamber that involve“without high fever”,to re-define the exact meaning of the phase. [Result] Two main opinions are found about the explanation of“without high fever”in the past literature:one is “heat is in interior not exterior”,while the other is“exterior syndrome is passed”,Both are not accorded with Zhong Jing’s word expression and the real clinical situation. If “high fever”is explained as“the fever characteristics of Yang-ming disease”,the scripture involved and the meaning of“without high fever”can be thoroughly understood.[Conclusion] “Without high fever”is the phase Zhang-zhong-jing used to differentiate the disease in scripture from Yang-ming visceral substantial syndrome .Clarifying the phase“without high fever”helps us to better understand the meaning of related scriptures.

Objective To investigate the clinical effects of fast track surgery ( FTS ) in perioperative nursing care of laparoscopic cholecystectomy . Methods A total of 200 cases of laparoscopic cholecystectomy between January and December 2012 were randomly divided into two groups , with 100 cases of each group , receiving either FTS or conventional treatment .Comparison of the two groups in patients rehabilitation and complications were observed . Results The postoperative anal flatus time was significantly shorter in the FTS group (12.0 ±4.4) h than that in the control group (24.9 ±5.4) h (t=-18.519, P=0.000).The postoperative hospital stay was significantly shorter in the FTS group (3.2 ±1.3) d than that in the control group (4.2 ±2.1) d (t=-4.049, P=0.000).The patients’ weight loss at the 5 postoperative day was significantly less in the FTS group (3.2 ±0.3) kg than that in the control group (5.2 ±0.6) kg (t=-29.814, P=0.000). Conclusion FTS measures applied in laparoscopic cholecystectomy can significantly accelerate postoperative rehabilitation .

Objective]To summarize the principle of usage of Chenqi Decoction Family, and compare with the similarities and differences of those in ShangHan Lun. [Method]To classify and analyse the scriptures related to Chenqi Decoction Family, and make a comparison with those in Chapter of Yangming Disease in ShangHan Lun. [Result]Besides the method of purgation and urgent purgation to preserve Yin, Wu Jutong inhertied and developed the purgation method of Zhang Zhongjing’s ShangHan Lun, such as Fluid-increasing Decoction, The New Yellow Dragon Decotion, The Lung-ventilating Chenqi Decotion, The Heart-fire Conduction Chenqi Decotion, The Calculi bovis Chenqi Decotion and The Fluid-increasing Chenqi Decotion, which enriched the syndrome differentiation system of ferbile disease. A deeper comparison of WenBingTiaoBian and ShangHanLun is worth researching.

Objective To compare the treatment effects of catheter directed thrombolysis and thrombetomy for acute ar?terial ischemia of the lower extremity. Methods Patients who visited Tianjin Medical University General Hospital from 2011 to 2013 and were attacked by acute ischemic disease of lower extremities within 3 days (n=66) were investigated. Thrombetomy and thrombolysis treatment had been performed to 32 cases and 34 cases respectively according to patients’ own willingness. Postoperative symptom remission rate, limb salvage rate, fatality rate, reperfusion injury rate (including re?nal inadequacy, heart failure, muscle fascia compartment syndrome), bleeding rate and limb dysfunction rate were compared between these two groups. Results There was no statistical difference on the rate of symptom remission (93.8% vs 94.1%), limb salvage(96.9%vs 100%), case fatality rate(3.1%vs 0), bleeding rate(0 vs 8.8%)and limb dysfunction rate (0 vs 5.9%)between these two groups. However, the incidence of reperfusion injury was higher in the group of thrombectomy (37.5%vs 2.9%, P<0.05)compared to that of the other group. Conclusion Similar effect of treatment and less reperfusion injury, especially renal injury, had been achieved by CDT compared with thrombetomy.

Objective To evaluate the effect of transtheoretical model(TTM)-based health education on the self-care behaviors of patients with heart failure.Methods One hundred and fifty heart failure patients from January 2012 to June 2013 were randomly assigned to two groups,75 cases in each group.The patients in the experimental group received TTM-based health education;the patients in the control group received conventional health education.All patients were investigated with the Self-Care of Heart Failure Index (SCHFI) at baseline,1 month and 3 months after intervention.Results After intervention,the scores of self-care maintaining,self care management and self care confidence in the experimental group were significantly higher than those in the control group.Conclusions TTM-based health education can effectively improve the self-care behaviors of patients with heart failure.

Objective To investigate the effects of batroxobin on blood coagulation and fibrinolytic function of patients with sud-den deafness .Methods 87 patients with sudden deafness were enrolled .Their prothrombin time(PT ) ,activated partial thrombo-plastin time(APTT) ,thrombin time(TT) ,fibrinogen(Fib) ,D-dimer and fibrin/fibrinogen degradation products(FDP) were detec-ted before batroxobin treatment and 3 ,6 days after treatment .Results Compared with pre-treatment ,patients after treatment expe-rienced prolonged PT and TT (P<0 .05) ,decreased Fib(P<0 .01) ,increased FDP (P<0 .01) ,and the difference of APTT ,D-di-mer between treatment before and after showed no statistically significant (P>0 .05) .Conclusion PT ,TT ,Fib ,FDP can be applied to monitor the coagulation and fibrinolytic function of patients with sudden deafness treated with batroxobin .

Objective To explore the effects of vecuronium bromide within 24 hours in severe bronchial asthma with acute attack with breathing machine in conventional sedatio.Methods Prospective study,double-blind randomized standard control,where 46 cases of patients of severe bronchial asthma with acute attack transferred to ICU using breathing machine in this year were randomly divided into the vecuronium bromide group (muscle relaxant group) and conventional sedation group (normal group) according to medical record number; Two groups of sample compositions were compared by x test,using two independent samples of t test to compare the effects the treatment and prognosis.Results After mechanical ventilation for 15min and 1-3h in muscle relaxant group,patients' vital signs were statistically analyzed,including respiration; Blood gas analysis parameters were as follows:pH,PaO2,PaCO2,SpO2 of these were improved compared with those in the conventional group (P ＜ 0.05) with statistically significant differences;Compared with the conventional group,in the muscle relaxant group,the retention time in ICU (146.20 ± 17.92) hours,(214.15 ± 22.21) hours,the using time of breathing machine (125.93 ± 16.23) hours,(192.89 ± 22.60) hours,and the dosage of glucocorticoid (2.61 ± 0.17) mg · kg-1 · d-1,(3.55 ± 0.26) mg · kg-1 · d-1,anticholinergic agent(6.25 ±0.51) μg · kg-1 · d-1,(10.64 ±0.75) μg · kg-1 · d-1 and β2 adrenergic receptor agonist (0.06 ±0.01)mg · kg-1 · d-1,(0.15 ±0.04)mg · kg-1 · d-1 were all reduced (all P ＜0.05) with statistically significant differences;The patients were smoothly transferred out of ICU,without the adverse events of mechanical ventilation and cardiovascular diseases.Conclusion The use of vecuronium bromide made the patients with severe bronchial asthma in routine sedation use of breathing machine rapidly correct the clinical symptoms and improve the off-period prognosis.

Objective To study the expression of CXCL12 and E-cadherin in condyloma acuminatum (CA) lesions caused by low-risk type (HPV6 and HPV11) humanpapilloma viruses. Methods The expressions of CXCL12 and E-cadherin mRNA in the lesions of CA caused by HPV6 and HPV11 and in the foreskins from normal males as controls were detected by real-time fluorescent quantitative PCR. Results The expressions of CXCL12 in the lesions of CA were down-regulated (fold change = 20.23,P = 0.001), and the expressions of E-cadherin were up-regulated (fold change = 3.129,P > 0.05). Conclusions The expression of CXCL12 is lower and the expression of E-cadherin is higher in the lesions of CA caused by low-risk HPV. It suggests that HPV may suppress local immune response and change the adhesion between langerhans cells and keratinocytes , which may contribute greatly to the persistent infection of HPV and relapse of CA.

Metabolic surgery for obesity and type 2 diabetes mellitus has been received more and more attention in the world.After the development for more than 10 years,metabolic surgery has been widely carried out in China.With the development and progress of the new field of surgery,many related problems have emerged.Besides absorbing foreign experiences,our own practical experience should be also gradually formed according to the patients,condition and the situation of the development of the discipline in China.Therefore,related questions were explored in this article,in order to promote the healthy development of metabolic surgery in China.