Objective To invesigate the influence of breathing motion on intensity-modulated radiotherapy (IMRT) of chest wall after radical mastectomy,and explore clinical value of accurately determined target volume.Methods A total of 17 radical mastectomy patients underwent 3DCT simulation scans sequentially followed by 4DCT simulation scans during free breathing.The targets and normal organs was determined based on CT images respectively.Three sets of radiotherapy plan were designed for each patient:plan 3D,plan 4D and plan 3D-A.The Plan 3D and plan 4D was designed based on 3D and 4D targets respectively.Plan 3D was copied to 4D target with the same isocenter coordinates.The dose distribution was calculated separately to evaluate the dose-volume histograms parameters for PTV,ipsilateral lung and heart,respectively.Two planning parameters was compared with paired t-test or Wilcoxon sign-rank test.Results The average volume of PTV4D was (10.35 ± 4.80) ％ larger than PTV3D (P =0.000).Compared with plan 3D,the V100,V95,V90,D95,D90,Dmin of plan 3D-A were reduced,that were (0.78 -18.0)％ (P=0.000),(0.01-3.90)％ (P=0.000),(0-2.12)％ (P=0.000),(13-222) cGy (P=0.000),(1-118) cGy (P=0.000),(6-1 910) cGy (P=0.000).However,the V20,V10,V5,Dmean of the ipsilateral lung and V30 of heart were same between 3D plan and 4D plan (P =0.288,0.407,0.435,0.758,0.575).Conclusions The respiratory motion may reduce the target dose and its coverage in chest wall treatments,so 4DCT plan could accurately define target volume without increasing the exposure dose of normal tissues.

Objective To investigate the effect of bibliotherapy in soothing the postoperative pain in children and relieving the perioperative anxiety of children and their care givers. Methods Hospitalized children and their care givers from August 2007 to March 2009 were studied. 153 cases from August 2007 to May 2008 were assigned to the control group and the other 153 cases to the intervention group. Routine surgical nursing were applicated in the control group by introduction of perioperative nursing procedures.Bibliotherapy were applicated in the intervention group on the basis of the control group-using "bibliotherapy materials for hospitalized children" which was designed by ourselves and correspond with the theory of bibliotherapy to interfere in the 153 cases in the intervention group. The variance of preoperative anxiety of care givers and perceptions of postoperative pain of children between the two groups were compared with scales of mYPAS, STAI and FLACC and Wong- Baker Facial Scale. Results The scores of mYPAS in children of the intervention group and the control group was (35.875+4.441)and(46.796+8.606 )respectively and the variance was significant. The scores of STAI in care givers of the two groups was(38.125+4.371 )and (49.901 +7.420) respectively and revealed significant variance. The scores of Wong-Baker and FLACC in children of both groups 1 hour after operation were compared and revealed no statistical significance. The scores of Wong-Baker and FLACC in children at 6 hours and 24 hours postoperative were compared subjectively and objectively and revealed statistic significance. Conclusions Bibliotherapy can ameliorate the anxiety level of both children and their care givers, relieve the perception of postoperative pain in children and improve their comforts. Bibliotherapy thus conduces to the recovery of postoperative children.

Objective To investigate effects of new nursing experimental teaching mode on professional ability of nursing students. Methods Traditional experimental teaching mode was used in control group (402 nursing students of 2006 grade) and experimental teaching model was used in experimental group (564 nursing students of 2007 grade). Questionnaires survey was conducted among clinical teachers to evaluate 8 abilities (service consciousness, knowledge application, practical abil-ity, communication ability. etc) of nursing students after 3 months' clinical practice. Satisfaction de-gree of experimental teaching and the first time employment rate of nursing students were recorded. All data were sorted out and analyzed by Epidata 3.1 and SPSS 13.0. Total score of students' profes-sional capacity was compared by independent t test. Score of the scale item was compared by rank sum test. Satisfaction rating for experimental teaching, passing rate of nurse practicing qualification examination and the first time employment rate were compared by chi-square test. All statistical tests were two-sided and P<0.05 was considered statistically significant different. Results Students' scores of communication ability, innovation capacity, capability to identify problems, practical ability, knowl-edge application, ability of organization and independent learning ability were 2.86±0.23, 2.86±0.17, 2.85±0.19, 2.84±0.24, 2.79±0.20, 2.78±0.19, 2.65±0.19 in experimental group, higher than those in control group. Satisfaction degree of experimental teaching and the first employment rate of students in experimental group were 94.5%(536/567) and 84.5%(479/567), higher than those in con-trol group with statistically significant differences(P<0.05). Conclusion New teaching mode of nurs-ing experiment can improve the professional ability of nursing students.

Objective To study the cardioprotective function of Zhurihen dripping pills in experimental animals.Methods By hypoxia tolerance model and isoproterenol hydrochloride induced acute hypoxia model, measuring the time of death in mice.For rat serum LDH, CK, SOD and MDA were measured to observe protective effect of Zhurihen dripping pills on vasopressin-induced acute myocardial ischemia model.The effect of Zhurihen dripping pills on latency and durations were observed in acute arrhythmia induced by inhaled chloroform – epinephrine rabbits model.Results The hypoxia tolerance in mice and myocardial hypoxia tolerance significantly improved by Zhurihen dripping pill, and prolonged the survival time in mice.The serum level of LDH, CK, SOD and MDA significantly improved, and protected the impaired myocardial cell in rats.The latent period of arrhythmia was significantly prolonged and duration of arrhythmia was shortened in rabbits.Conclusion Zhurihen dropping pills an improve myocardial oxygen deficiency, anti-arrhythmia effect and protect myocardial cells.

Objective To establish experimental autoimmune cerebral spinal cord inflammation ( EAE) model rats, and observe the pathological changes and effect of oxymatrine on EAE model.Methods 30 rats were randomly divided into control group,EAE ( model group) group and oxymatrine group.The EAE symptom score was used to evaluate the rats after the model, and to observe the changes of its behavior.By HE staining and Kluver &Barrera myelin dyeing to observe the inflammation of the brain and spinal cord demyelinating changes.Results The animals in control group had no change in behavior and pathological.In model group, all animals occured behavioral changes, accompanied by varying degrees of demyelination and inflammatory infiltration of the brain and spinal cord.In oxymatrine group,6 rats did not appear EAE clinical manifestations and behavioral change, and the myelin structure was intact.Conclusion Oxymatrine can extend the incubation period experimental autoimmune encephalomyelitis in rats of the disease, relieve symptoms and protect nerve.

To study the effects of Roudoukou-8 San against hydrogen peroxide-induced cardiomyocyte in neonatal rats and to explore its mechanism. Cardiomyocytes were isolated and cultivated by neonatal rats and the injure models were established by H2O2. Methyl thiazolyl tetrazolium(MTT)assay was used to detect the protective effects of Roudoukou-8 San on H2O2-induced cardiomyocyte. The effects of Roudoukou-8 San on myocardium morphology were observed under inverted microscope. The contents of lactate dehydrogenase(LDH), creatine kinase(CK)and aspartate aminotransferase(AST)in cell culture medium were determined by Automatic biochemical instrument; The levels of malonydialdehyde(MDA), superoxide dismutase(SOD)and NO in the cells were detected by kit method. The apoptotic morphology of cardiomyocytes was observed by Hoechst fluorescence staining. Cell apoptosis were measured by Annexin V and PI double staining and flow cytomety. 100μmol/L H2O2 for 2 h could cause about 50% of myocardial injury. In the inverted optical microscope, H2O2 model group showed increased cell gap, decreased cell count, cell cytoplasmic vacuoles and other obvious damage. Roudoukou-8 San protected cell from H2O2-induced morphlogical improved in different degrees, reduced the release of LDH, CK and AST content, reduced the content of MDA, NO in myocardial cells significantly and increased the activity of SOD. Roudoukou-8 San energy significantly inhibited H2O2 damage myocardial cell apoptosis. Our study suggested that Roudoukou-8 San can protect cardiomyocyte from H2O2-induced injury by improving the cell viability, reducing oxidative stress injury, inhibiting inflammatory reaction and inhibiting cell apoptosis.

Objective To investigate the continuous ambulatory peritoneal dialysis ( CAPD) and daytime ambulatory perito-neal dialysis ( DAPD) on sleep quality. Methods This is a multi-center cross-sectional survey, we used the Pittsburgh Sleep Index Scale ( PSQI) ,the unified investigating time, the organized trained peritoneal dialysis nurses qualified to conduct research full-time. Survey content includes general information, sleep index, laboratory tests, dialysis adequacy and other indicators, and the results were pooled analysis. Results A total of eight hospitals of 325 patients undergoing peritoneal dialysis were included in this study,which CAPD patients and DAPD Pittsburgh Sleep Quality Index Scale scores were 6.88 ±2.43,6.71 ±2.69, the difference was not statisti-cally significant (P>0.01).DAPD patients had a lower sleep efficiency than CAPD patients, but it had no difference between subjec-tive feeling, CAPD patients were more likely to have more nocturnal cough, snoring and other symptoms and lower quality of life in mental status scores than DAPD patients(P<0.01). Conclusion Sleep quality of peritoneal dialysis patients scored lower than the norm.Dialysis modes have an impact on sleep quality of patients, health care workers should fully assess the physical and mental state of the patients in order to select the appropriate mode of dialysis.

Objective To investigate the continuous ambulatory peritoneal dialysis (CAPD) and daytime ambulatory peritoneal dialysis (DAPD) on sleep and quality of life. Methods In this is a multi-center cross-sectional survey, we used the Pittsburgh Sleep Index Scale (PSQI) and the Chinese version of peritoneal dialysis patient quality of life scale, the unified investigating time, the organized trained peritoneal dialysis nurses qualified to conduct research full-time. Survey content includes general information, sleep and quality of life, laboratory tests, dialysis adequacy and other indicators, and the results were pooled analysis. Results A total of 325 hospitalized peritoneal dialysis patients were included in the study, including 177 patients in CAPD, 148 patients in DAPD. The total scores of QOL, physical function, physical factors, psychological status, social function and life satisfaction were (72.61± 10.94), (19.44±3.65), (59.69±7.31), (32.65±5.65), (24.82±6.03), (15.42±5.47)and (74.06±13.59), (20.16± 2.95), (58.99 ± 5.86), (34.58 ± 6.17), (25.10 ± 5.01), (15.36 ± 4.28). The score of CAPD in the mental state dimension was significantly lower than that in DAPD patients (t=-3.715, P<0.01). Else, there was no significant difference between the two groups (P> 0.05). Conclusions Sleep and quality of life in peritoneal dialysis patients are lower than normal adults. Dialysis modes have an impact on sleep andquality of life of patients, health care workers should fully assess the physical and mental state of the patients in order to select the appropriate mode of dialysis.

Subarachnoid hemorrhage (SAH) is a devastating cerebrovascular event that often is followed by permanent brain impairments. It is necessary to explore the pathogenesis of secondary pathological damages in order to find effective interventions for improving the prognosis of SAH. Blockage of brain lymphatic drainage has been shown to worsen cerebral ischemia and edema after acute SAH. However, whether or not there is persistent dysfunction of cerebral lymphatic drainage following SAH remains unclear. In this study, autologous blood was injected into the cisterna magna of mice to establish SAH model. One week after surgery, SAH mice showed decreases in fluorescent tracer drainage to the deep cervical lymph nodes (dcLNs) and influx into the brain parenchyma after injection into the cisterna magna. Moreover, SAH impaired polarization of astrocyte aquaporin-4 (AQP4) that is a functional marker of glymphatic clearance and resulted in accumulations of Tau proteins as well as CD3⁺, CD4⁺, and CD8⁺ cells in the brain. In addition, pathological changes, including microvascular spasm, activation of glial cells, neuroinflammation, and neuronal apoptosis were observed in the hippocampus of SAH mice. Present results demonstrate persistent malfunction of glymphatic and meningeal lymphatic drainage and related neuropathological damages after SAH. Targeting improvement of brain lymphatic clearance potentially serves as a new strategy for the treatment of SAH.
Animals ; Apoptosis ; Aquaporin 4 ; Astrocytes ; Brain ; Brain Ischemia ; Cisterna Magna ; Drainage ; Edema ; Hippocampus ; Lymph Nodes ; Mice ; Neuroglia ; Neurons ; Prognosis ; Spasm ; Subarachnoid Hemorrhage ; tau Proteins

Objective:To evaluate the clinical efficacy of the Kechuansan acupoint plaster combined with acupoint injection of Chuankezhi in treating bronchial asthma. Methods:A total of 65 patients with bronchial asthma, who met the inclusion criteria in Shanghai Municipal Hospital of TCM from June 2018 to September 2018, were selected anddivided into control group and observation group by random number table method, 32 in the control group and 33 in the observation group. The control group was treated with acupoint injection of Chuankezhi, while the observation group was treated with acupoint plaster of Kechuansan combined with acupoint injection of Chuankezhi. Both groups were treated for 6 weeks. TCM syndromes and frequency of acute attackin one year before and after the treatment was scored and recorded. The patients' quality of life was assessed by Asthma Control Test (ACT) and the fractional exhaled nitric oxide (FeNO) level was measured by Sunvou-p100 nakurun breath analyzer to evaluate the clinical efficacy. Results:Through out the treatment, there were 3 dropouts in the observation group and 2 dropouts in the control group. 30 cases were completed in each group. The total effective rate in the observation group was 93.3% (28/30), and the control group was 73.3% (22/30). The difference was statistically significant ( χ2=4.320, P=0.038). After the treatment, the scores of TCM syndromes and ACT in the observation groups were significantly higher than those of the control group ( t values were 4.834 and 5.642, respectively, all Ps<0.01). The FeNO in the observation group were significantly lower than those in the control group ( t=3.180, P=0.020). The frequency of acute attack in one year in the observation group was less than that ofthe control group ( t=5.466, P<0.01). Conclusions:Acupoint plaster Kechuansan combined with acupoint injection of Chuankezhi can relieve the clinical symptoms of asthma, reduce the frequency of asthma attack, improve the control ability of asthma, reduce airway inflammation, which is more effective than using acupoint injection therapy alone.