Cervical cancer is one of the leading causes of death in women with malignancies worldwide.Brachytherapy plays an essential role in the radiation therapy for cervical cancer, and its combination with external beam radiation is indicated for previously untreated or recurrent cervical cancer at various stages without distant metastasis.Magnetic resonance imaging (MRI) has superior resolution of soft tissue, which allows for accurate delineation of target volume, protects organs at risk (OARs), and thus improves treatment outcomes.In recent years, many studies have demonstrated the feasibility and superiority of three-dimensional MRI-guided brachytherapy for cervical cancer.This article aims to elaborate on relevant MRI techniques, selection of applicators, delineation of target volume and OARs, evaluation of treatment plans, and the clinical effect of three-dimensional MRI-guided brachytherapy.

?AlM:To observe the clinical effects of thelacrimal fistula excision combined with double silicone intubation in the treatment of chronic dacryocystitis with lacrimal fistula.? METHODS: Totally 25 cases ( 25 eyes ) of chronic dacryocystitis with lacrimal fistula were allocated into two groups:the double silicone intubation group of 13 cases (13 eyes) received lacrimal fistula excision combined with double silicone intubation, and the routine group of 12 cases (12 eyes) received routine dacryocystorhinotomy, we analyzed the curative effect.?RESULTS: The double silicone intubation group had a cure rate of 92. 3% (12 eyes), a effective rate of 100%, compared with the routine group had a cure rate of 91. 7%( 11 eyes ) , a effective rate of 100%, there were no statistically significant difference between the two groups (P>0. 05).?CONCLUSlON:Lacrimal fistula excision combined with double silicone intubation has a same effect with routine dacryocystorhinotomy in the treatment of chronic dacryocystitis with lacrimal fistula, but less invasive, no scar, less pain, and meet the patients' esthetic needs.

Objective:To explore the application and effect of team-based learning (TBL) combined with flipped classroom in the teaching of physiology.Methods:A total of 70 medical students were selected and randomly divided into two groups, experimental group ( n=34) and control group ( n=36). Both groups studied digestion physiology by different method. In the experimental group, the students were taught by TBL combined with flipped classroom. The control group was given traditional teaching. The students studied and discussed problems in a team, and shared the answers in the flipped classroom. The effects of teaching were evaluated by the final test scores and the self-made questionnaire. SPSS 17.0 was used for t test on data comparison between the two groups. Results:The test scores of digestion physiology in the experimental group were (5.47±1.02) points, which were significantly higher than those of the control group (4.42±1.63) points, with significant differences ( P=0.020). A total of 34 questionnaires were issued and 34 valid questionnaires were collected, with an effective rate of 100%. The questionnaire results showed that TBL combined with flipped classroom was accepted and approved by about 82% of students in the experimental group who agreed that the teaching model helps enhance students' initiative and interest in learning, develop their sense of cooperation and comprehensive application ability. Conclusion:TBL combined with flipped classroom is feasible and effective in the physiological teaching, and it can be popularized in medical courses.

Objective As important transcription factors, SOX2, TWIST and SNAIL are closely related to breast cancer me?tastasis. The aim of this study was to explore the expressions of SOX2, TWIST and SNAIL in breast cancer and the relationship between the three factors. Methods We collected 74 specimens of breast cancer and another 74 from paired normal tissue from January 2012 to January 2013. Using immunohistochemistry, we determined and compared the expression of SOX2 in the breast cancer and normal tissues. We also detected the expressions of TWIST and SNAIL proteins and analyzed the relationship of SOX2, TWIST and SNAIL ex?pressions with the clinicopathological characteristics of breast cancer as well as the correlation between the three proteins. Results The expression of SOX2 was significantly higher in the breast cancer than in the normal tissues (25.7% vs 8.1%, P=0.004) and corre?lated with the grade, lymph node metastasis, and TNM stage of breast cancer ( P<0.05) , while the expressions of TWIST and SNAIL were significantly correlated with lymph node metastasis and clinical TNM stages of the malignancy ( P<0.05) . The protein expression of TWIST was correlated positively with those of SOX2 ( Cc=0. 325, P<0.005) and SNAIL (Cc=0.308, P<0.008), and so was that of SNAIL with that of SOX2 (Cc=0.275, P<0.018). Conclusion The SOX2 protein is highly expressed in breast cancer. The expres?sions of SOX2, TWIST and SNAIL are closely related to lymph node metastasis of the malignancy and the three factors are interacted coor?dinatively in the metastasis of breast cancer.

Objective To evaluate the CT and MRI characteristics of Primary Central Nervous System Lymphoma(PCNSL)in immunocompetent patients,and enhance its diagnosis level.Methods CT and MRI data of 20 patients with PCNSL confirmed by histo-pathology were analyzed retrospectively.MRI scans were performed with and without Gadolinium contrast.Two of them had contrast-enhanced CT scan;six had CT scan without contrast administration;1 had CT scan with both non-contrast and contrast enhancement.Re- suits Totally,38 lesions were found in all patients:14 lesions of them were single and 24 lesions were found in 6 patients.Generally,the lesions were located in the surface and/or midline of the brain.The signal features and density were similar to meningioma,and strongly enhancing after contrast administration.Thirty-six of the 38 lesions had spicular sign peripheral to the lesion.Conclusion Although the manifestations of the PCNSL are variety,there are still many characteristics in the medical imaging,especially in the locations,the signal features,and spicular sign in the edge of the lesions after contrast material injection.

Aiming at molybdate and boron deficient acid purple soil from main peanut cultivated areas in Sichuan,and Mo and B requirement of peanut growth,the feasibility of Co-inoculum of peanut Bradyrhizobium and molybdate and boron was studied.The tolerance to molybdate and boron of the tested strains Spr2-9,Spr4-5 was inspected.The result indicated that the two tested strains could tolerate higher concentration of molybdate than that of boron.The compound inoculum of Bradyrhizobial strain and trace element Mo was developed.The optimum concentration of Mo was 0.4%.

Objective To develop a network system for radiotherapy.Methods Delphi 6.0 lan- guage was used to program the system based on PACS through the model of client-server machine and local network.Data of different facilities were transferred among each other through Dicom 3.0 and Dicom RT pro- tocol.Results The main function of this system was a management software for radiotherapy,a PACS sys- tem,a TPS system and a therapeutic machine system.Conclusion The network system operates steadily with data safe and reliable,and is an important part of the information construction in the department of radio- therapy

Objective To introduce the clinical types of perforator branches of anterosuperior malleolus flap and explore its application.Methods Anterosuperior malleolus flap coupling with dorsal pedal flap was used for repairing the soft tissue defect of hands in 18 patients,in which anterosuperior malleolus flap-dorsal pedal single flap in 12 cases,anterosuperior malleolus flap-dorsal pedal bilobate flap in 4 cases,anterosuperior malleolus flap-dorsal pedal trilobate flap in 2 cases;Anterosuperior malleolus retrograde island (bone) flap was used in recovering pedal soft tissue in 22 patients,the flap pedicled from stem of anterior tibial artery in 16 cases,dorsal pedal flap-anterosuperior malleolus flap in 2 cases,the flap from perforate vessels without injuring the anterior main tibial artery in 2 cases,the bone flap combined with the distal of tibia in 2 cases.Results In the 18 cases of hands,17 cases survived,and 1 case of flap mild necrosis at the distal site took a second-phase skin-grafting to repair.Twenty cases of anterosuperior malleolus retrograde island (bone) flap survived,and the other 2 cases needed secondary skin-grafting to repair the necrosis edge of flaps because of venous limited.After a follow-up from 3 to 6 months,30 cases showed the satisfied postoperative outlook,with the good healing of the donor sites.Typing the 40 cases according to the location of perforator branches of the anterosuperior malleolus flap,20 cases locate in the medial of anterior tibial muscle,16 cases locate between the anterior tibial muscle and extensor hallucis longus,4 cases locate between extensor hallucis longus and extensor digitorum longus.Conclusion Knowing the clinical types of the perforator branches of anterosuperior malleolus flap is not only helpful for the accurate processes of operations、preventing cutaneous branches,but also improving the success rate of surgery.

Objective To explore the expressions of Survivin and VEGF and relationship between them in hepatocellular carcinoma(HCC).Methods The expressions of Survivin protein and VEGF protein in 50 HCC.30 cirrhosis and 10 normal tissues were assessed by immunohistochemical method.The expressions of Survivin mRNA and VEGF mRNA in 50 HCC,30 cirrhosis and 10 normal tissues were assessed by in situ hybridization.Results The expressions of Survivin and VEGF in cancer tissues,cirrhosis tissues,normal tissues weresignificantly different. The expression of Survivin in HCC tissues was stronger than that in cirrhosis,but the expreesion of VEGF in cirrho- sis was stronger than that in HCC tissues.Conclusion The expression of survivin.is closely associated with the ex- pression of VEGF in HCC and they take positive correlation.The abnormal expressions of Survivin and VEGF are closely associated with the development of HCC.They may play important roles in the development of HCC.

Abstract: Objective　To explore the clinical characteristics of nucleic acid negative newborns delivered by pregnant women infected with SARS-CoV-2 (Omicron variant BA. 5.1.3) in Sanya area, and to provide evidence for understanding its clinical characteristics. Methods　A retrospective analysis was performed on 14 neonates with negative nucleic acid delivered by pregnant women who tested positive for SARS-CoV-2 (Omicron variant BA.5.1.3) in Sanya Central Hospital (the Third People's Hospital of Hainan Province) from June 2022 to September 2022 (observation group, n=14). The corresponding nucleic acid-negative newborns delivered by pregnant women detected negative with SARS-CoV-2 (Omicronon variant strain BA.5.1.3) were set as the control group (n=56), and the general data and clinical characteristics of neonates in the two groups were compared. Results　There was no significant difference between the observation group and the control group in pregnancy diabetes, pregnancy induced hypertension, gestational pre-eclampsia, fetal intrauterine distress, premature rupture of membranes (P>0.05); there was no significant difference between the observation group and the control group in terms of sex, gestational age, birth weight, age, mode of delivery, birth Apgar score, heart screening, pulmonary disease, glucose 6-phosphate dehydrogenase (G6PD) deficiency, thalassemia, breast milk jaundice, hemolytic jaundice (P>0.05). The bilirubin level, blue light irradiation cases and the duration of blue light irradiation of the newborns in the observation group at 7 days after birth were higher than those in the control group (P<0.05); the ratio of blood oxygen saturation ≥ 90% in the observation group was lower than that in the control group (21.43% vs 89.29%, P<0.05), and the ratio of blood oxygen saturation occasionally<90% was higher than that in the control group (57.14% vs 10.71%, P<0.05). The ratio of blood oxygen saturation<90% had no significant difference compared with that in the control group (7.14% vs 0, P>0.05), and the ratio of blood oxygen saturation reduced to the required oxygen uptake was higher than that in the control group (14.29% vs 0, P<0.05). Conclusions　The jaundice manifestation of the nucleic acid-negative newborns delivered by pregnant women infected with SARS-CoV-2 (Omicronon variant strain BA.5.1.3) in Sanya area is relatively obvious, with blood oxygen saturation easily lower than 90% and even requiring oxygen inhalation in severe cases.