OBJECTIVE: To analyze the relationship between female resting energy expenditure and obesity-related indicators, and to compare the differences of resting energy expenditure and resting energy expenditure per kilogrem between obese women and normal weight women.METHODS: A total of 565 healthy women who did medical examination or visited Department of Endocrinology in Beijing Obstetrics and Gynecology Hospital between 2004 and 2008 were recruited, their height and weight were measured. Human metabolic apparatus was used to measure resting energy expenditure, then body surface area, body mass index, resting energy expenditure per kilogram were calculated. According to the diagnostic cdtada of obesity by body mass index, the 565 cases were divided into two groups: obese group (n=179) and normal body weight group (n=240), and all the measurement results were calculated and did the tests of normality, correlation analysis and two independent samples rank sum test or t test. RESULTS: The resting energy expenditure of 565 healthy women were normality, the result was (5.793±0.940) k J/d, and resting energy expenditure showed a positive correlation with body weight, height, body mass index and body surface area (P < 0.05), while showed no significant correlation with age (P > 0.05), there was no significant difference of age end height between obese group and normal body weight group (P > 0.05), while a statistical significant difference was found in resting energy expenditure and resting energy expenditure per kilogram between obese group and normal body weight group (P > 0.05).CONCLUSION: There is a positive correlation that female resting energy expenditure with their height, weight, body mass index and body surface area, and the resting energy expenditure of obese women is higher than that of normal body weight women, while resting energy expenditure per kilogram of obese women is lower than that of normal body weight women.

By discussing the importance of emotional education, the paper points out the existing problems of emotional education in nursing teaching as followings:the lack of teachers′emotional education awareness, the im-balance of cognitive development of nursing students and the lack of professional ideological education. Aiming at the above problems, this paper puts forward these specific countermeasures: strengthening the teachers′ emotional accomplishment so as to enhance their emotional education awareness and building a relaxed and pleasant diversi-fied educational environment so as to strengthen the professional thinking.

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.

BACKGROUND:Many present studies have reported the early clinical therapeutic effects of short-segment non-fusion fixation for the repair of thoracolumbar burst fracture. The results are satisfactory. However, the mid-and long-term fol ow-up results of this scheme for treating thoracolumbar burst fracture are seldom reported. ＜br> OBJECTIVE:To evaluate the mid-term results of short segment pedicle screw fixation without bone fusion for unstable thoracolumbar burst fracture. ＜br> METHODS:Data of 12 patients with unstable thoracolumbar burst fractures undergoing short segment pedicle screw fixation without bone fusion were retrospectively analyzed. Al patients experienced severe intraspinal occupying and neurological dysfunction, and al of them affected single segment thoracolumbar injuries. The surgical procedure included postural reduction for 2 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants at 12 months after the initial operation. Imaging and clinical findings, including canal encroachment, percentage of vertebral body height loss, Cobb angle, American Spinal Injury Association motor score, Frankel grade and adjacent segment degenemtion, were evaluated. ＜br> RESULTS AND CONCLUSION:Al patients were fol owed up for at least 5 years. Significant differences in canal encroachment, percentage of vertebral body height loss and Cobb angle were detectable between post-fixation and pre-fixation (P＜0.05). Evaluation results were significantly better after fixation than that before fixation, but no significant difference in evaluation results after fixation was detected (P>0.05). After implantation and removal of fixator, none cases affected aggravated symptoms of neurological impairment. American Spinal Injury Association motor score was 34.2±6.3 before fixation, and 47.7±9.5 during the final fol ow-up, showing significant differences (t=-4.103, P=0.000). During the final fol ow-up, adjacent segments in damage levels did not suffer from degeneration in al patients. Neurological function showed the recovery of Frankel grades 1 or 2. These data indicated that a good mid-term result of short segment pedicle screw fixation without bone fusion for unstable thoracolumbar burst fracture with neurological deficit can be achieved. The improved saggital alignment was effectively constructed and maintained. Adjacent segment degeneration was not found at the injury level.

Purpose:To investigate genetically a diagnostic method of occult metastasis of lymph node in patients with squamous cell carcinoma of the esophagus.Methods:Using assays of reverse transcriptase polymerase chain reaction technique (RT PCR), MUC1 gene mRNA in thirty negative and thirty positive control lymph nodes was detected to evaluate diagnostic sensitivity and specificity. Eighty seven negative regional lymph nodes by conventional histologic examination (pN 0 ) from thirty patients with esophageal carcinoma were studied to detect MUC1 gene mRNA to diagnose lymph node occult metastasis.Results:MUC1 mRNA was not identified in any specimen of negative control group (specificity =100%); MUC1 mRNA was identified in twenty five of positive control specimen (sensitivity =83%). MUC1mRNA was identified in nine lymph nodes (10.3%) from eight patients with pN 0 esophageal carcinoma. Conclusions: Nodal occult metastasis could be diagnosed by the detection of expression of MUC1mRNA of lymph node in patients with pN 0 esophageal carcinoma.

Purpose:To investigate the correlation between early postoperative metastasis with occult micrometastasis of mediastinal lymph nodes in patients with stageⅠa non small cell lung carcinoma (NSCLC).Methods:Using RT PCR assay, detection of the expression of MUC1 mRNA was used to diagnose occult micrometastasis in mediastinal lymph nodes. All the patients underwent checked up at least once a year to detect early metastatic lesions after surgery, by means of CT scan of chest and brain, ultrasound examination of liver and adrenal glands, and bone scanning. The patients with and without occult nodal micrometastasis were divided into two different groups. Difference in early metastatic rate between two groups of patients was compared by ? 2 test, and odds ratio (OR) was calculated.Results:Occult nodal micrometastasis was diagnosed in sixteen patients (32.0%). Early metastatic rate (31.25%) in the patients with occult nodal micrometastasis was higher than that (5.88%) in the patients without occult nodal micrometastasis ( P

Objective: To explore the effect of radiotherapy on preventing the recurrence of lymph node metastasis of esophageal cancer after Ivor-Lewis esophagectomy. Methods: Three hundred and sixty-six pa-tients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients un-derwent Ivor-Lewis esophagectomy with two-field lymph node dissection in our hospital between June 1999 and June 2004. All statistical analyses were performed with SPSS 13.0 statistical software. Kaplan-Meier method was performed to calculate the relapse rate. Log-rank test was performed to compare the relapse rate. Cox regression analysis was performed to identify independent prognostic factors for postoperative lymph node metastasis. Results: Of the 366 cases, lymph node metastasis was found in 105 patients (28.5%)within 3 years after surgery, occupying 52.2% (105/201) of total recurrence. Of the 181 patients treated with postoperative radiotherapy, lymph node metastasis was found in 37 patients. The rate of lymph node metasta-sis was 20.4%, significantly lower than that in patients treated with chemotherapy alone and those without sys-temic adjuvant therapy (P<0.05). Chemotherapy was administered in 103 cases and lymph node metastasis was found in 33 patients. The rate of lymph node metastasis was 32.0%, lower than that in patients without systemic adjuvant therapy, but without statistical significance (P=0.17). The results of Cox analysis demon-strated that T stage, lymph node metastasis and postoperative adjuvant radiotherapy were independent prog-nostic factors. Conclusion: Ivor-Lewis esophagectomy for the middle third thoracic esophageal cancer was a safe surgical procedure. Postoperative radiotherapy is helpful for the control of local recurrence. T stage,lymph node metastasis and postoperative adjuvant radiotherapy are independent prognostic factors. Radio-therapy is helpful for preventing the recurrence of lymph node metastasis of esophageal cancer after Ivor-Lew-is esophagectomy.

Objective To investigate the expression of chemokine receptor CCR7 and its correlation with lymph node metastasis and prognosis in esophageal cancer after esophagectomy. Methods One hundred and eighty-four patients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients underwent operation in Provincial Hospital Affiliated to Shandong University between June, 2003 and June, 2005. The expression of CCR7 was detected by immunohistochemistry. All statistic analyses were performed with SPSS 13.0 statistical software. According to the clinico-patho-logic factors, the difference of CCR7 expression was compared by x2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The expression rate of CCR7 in stage Ⅰ , stage Ⅱ and stage Ⅲ patients was 25.0 % , 70.3% and 85.5% , respectively. The difference of CCR7 expression between stage Ⅱ and stageⅢ was statistically significant (x2 =5.0, P =0.02). The CCR7 expression rate in T1, T2 and T3 patients was 33.3% , 64.9% and 80.9% , respectively. The difference of CCR7 expression between T2and T3 was statistically significant (x2 =5.4, P =0.01). The level of expression of CCR7 in patients with lymph node metastasis was significantly higher than those without metastasis (x2 =10.8, P = 0.00). The 5-year survival rate instage Ⅰ , stage Ⅱand stage Ⅲ patients was 100.0% , 38. 3% and 22.4% , respectively. The 5-year survival rate in patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression (x2 = 23.7, P = 0.00). The 5-year survival rate in T2, T3, NO and N1 patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression The result of Cox analysis demonstrated that T , N and CCR7 overexpression were independent prognostic factors. Conclusion CCR7 expression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage,N stage and lymph node metastasis. The patients with CCR7 expression was significantly lower the 5-year survival rate than without CCR7 expression. T stage, lymph node metastasis and CCR7 expression were independent prognostic factors.

Objective To evaluate the penumbra of a new multileaf collimator equipped with Elekta Synergy accelerator. Methods The penumbra were derived from beam profiles measured in air and water using PinPoint ion chamber with PTW MP3 water phantom. Variations of penumbra with X-ray beam energy, depth in water, and leaf position were investigated. Results The penumbra in air for 6 MV X-ray was 2 mm less than that at depth of maximal dose in water. The penumbra of leaf side was 1 mm less than that of the leaf end. The penumbra had close relationship with beam energy, depth in water and leaf position. Penumbra was increased with beam quality and water depth. The leaf position had great influence on the penumbra. Conclusions The penumbra of the multileaf collimator is related to its original design and radiation delivery technique. Special considerations should be taken into during treatment planning.Regular measurement should be performed to guarantee the delivery quality.

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.