Target volume definition is one of the important factors in precise radiotherapy of esophageal carcinoma.However,there is considerable controversy about delineation of esophageal carcinoma clinical target volume (CTV),and no consistent standard.Recent researches show that pathological characteristics,imaging methods and lymph node metastasis pattern may have guiding functions for CTV delineation.Novel delineation technique such as individual design has been a research hotspot.

ObjectiveTo investigate the influencing factors for persevering in pelvic floor muscle exercise in puerperal women and nursing countenneasures.MethodsThe influencing factors for persevering in pelvic floor muscle exercise in 120 puerperal women before June 2010 were analyzed,and they were set as the control group.According to the analysis results,targeted nursing countermeasures were developed,comprehensive care approach that combined nursing intervention with health education were applied in 116 cases of puerperal women from June 2010 to June 2011,who were set as the observation group.The situation of recovery for maternal pelvic floor muscle tension was observed.ResultsThere were four main factors that affected maternal pelvic floor muscle exercise:pelvic floor muscle exercise is not inspected as post-natal visits items,obstetric nurses did not carry out necessary propaganda,did not understand the importance of pelvic floor muscle exercise and lack of knowledge among the puerperal women.The test results for pelvic floor muscle tension were as followed:in the observation group Ⅰ degree was in 9 cases,accounting for 7.76％; Ⅱ degree was in 31 cases,accounting for 26.72％; Ⅲ degree was in 76 cases,accounting for 65.52％.In the control group,I degree was in 35 cases,accounting for 29.17 ％; Ⅱ degree was in 44 cases,accounting for 36.67％; Ⅲ degree was in 41 cases,accounting for 34.17％.The recovery effect of pelvic floor muscle tension in the observation group was obviously better than the control group,the difference was significant.ConclusionsFactors influencing the puerperal women in persevering in pelvic floor muscle exercise was various,personalized care and intervention according to the influencing factors can improve compliance of pelvic floor muscle exercise for puerperal women,contribute to the recovery of pelvic floor muscle tension.

A total of 122 patients with acute left ventricular failure from January 2011 to December 2013 at our hospital were recruited and divided randomly into control group (n =62) and observation group (n =60).Control group received conventional therapy and Bi-level positive airway pressure (Bi-PAP) was added along with conventional therapy for observation group.And 12 and 8 patients died in control and observation groups respectively within 24 h after treatment and there was no statistical difference.The BNP levels of the control group pre-treatment and at 1 h and 24 h post-treatment were (1 040 ± 315),(995 ± 245) and (570 ± 164) ng/L.The BNP levels of observation group pre-treatment and at 1 h and 24 h posttreatment were (1 080 ±209),(995 ±245) and (490 ± 138) ng/L.BNP of observation group at 1 h and 24 h post-treatment decreased significantly compared with that pre-treatment and control group (P ＜0.01).Only at 24 h post-treatment,the BNP level of control group decreased significantly compared with that pretreatment (P ＜ 0.01).

An adjustable pillow with inflatable cushion and soft polyurethane sponge is introduced.It is not easily deformed and the height is adjustable.In addition,it is easy to carry and can be cleaned and disinfected thoroughly.Though the design is quite simple,this kind of pillow can improve the patients' sleep quality and prevent pollution of pillow as a result of iatrogenic infection.

Objective To explore the joint toxic effect of formaldehyde and benzene on testicles of the mice. Methods 78 Kunming male mice were divided into groups, in the formaldehyde treatment groups were exposed at dosage of 0.2 mg/kg,2 mg/kg,20 mg/kg, in the benzene treatment groups were exposed at dosage of 100.0 mg/kg,200.0 mg/kg,400.0 mg/kg and the in formaldehyde and benzene combined treatment groups were exposed at dosage of 0.1+50.0 mg/kg,1+100.0 mg/kg,10+200.0 mg/kg respectively. The treatments were conducted by peritoneal injection for five consecutive days,once a day,then killed on 6th day. The activity of superoxide dismutase(SOD),the contents of maleic dialdehyde(MDA),the contents of copper(Cu),zinc(Zn) in testicles of the mice were determined. Results Compared with those in the negative control groups,the activity of SOD and the contents of Cu, Zn in the testicles of the mice in each treatment group significantly decreased, while the contents of MDA significantly increased (P

12-O-tetradecanoylphorbol-13-acetate (TPA) is an activator of protein kinase C (PKC)extracted from the croton oil, it is one of the most powerful inducers of differentiation as well as a powerful tumor promoter. It is used by the study of induction and differentiation generally, because of it can induce the differentiation of tumor cell and promote the lymphocyte transformation and secrete of lymphokine, meanwhile,it is able to induce many kinds of cell of leukemic cell strain like HL-60, HEL and so on, Some literature reported that TPA had the function of differentiation of primary leukemic cell. The article mainly explains the induction and differentiation of leukemic cell by phorbol ester as well as its mechanisms, which to provide the theory evidence for prevention and cure of leukemia.

Objectives To study two airway humidification methods on airway humidification of tracheotomy patients. Methods Sixty patients with traeheotomy were evenly randomized into experiment group and control group:in the former,the method of continuous oxygen atomization was used and in the latter,that of intermittent intratracheal instillation was used.The effects were compared in terms of stimulating cough,sputum clot formation,frequency of suction phlegm,time spent on the airway humidification and incidence of pulmonary infection between the groups.Results The effects in the experiment group were significantly better than in the control group in terms of stimulating cough,sputum clot formation,frequency of suction phlegm,time spent on the airway humidification and incidence of pulmonary infection(all P<0.05).Conclusion Continuous oxygen atomization can improve the effects of airway humidification,reduce the incidence of pulmonary infection and improve the efficiency of nursing work.

Objective To investigate the clinical and pathological features of anorectal malignant melanoma ( AMM) .Methods The clinical pathological and follow-up data of 7 cases of anorectal malignant melanoma were collected.The clinical and histopathological features and immunophenotype were analyzed .Results Among the 7 cases, 5 cases were female, 2 cases were male, aged 50-68 years, the average was 61 years.The tumors located in the lower rectum in 1 cases, 2 cases of teeth near the line , 4 cases of anal anus .The structure and morphology of the cancer cells were diverse .The organizational structures were mainly diffuse , focal and acinar .The cellular morphologies were mainly epithelioid , spindle and lymphocyte like .And the results of IHC showed the expression of the following three markers, vimentin, S-100 and HMB45, were strongly positive in cancer cells.However, the expression of CK , EMA and LCA were negative .And 2 cases of CEA expression were positive , LI Ki-67 was 20%-50%.Conclusions Anorectal malignant melanoma is one kind of rare malignant tumor and its characteristic morphology , immunophenotype could be helpful for diagnosis and differential diagnosis .

Objective To explore the effect of ultrasound in the diagnosis and treatment of rheumatoid arthritis .Methods though early diagnose of RA by ultrasound ,DAS28 and MRI′s result to measure the accuracy of ultrasound test .then though the ul‐trasound index at different time point in the treatment of RA patients ,we knew the changes of the joint ,and provide treatment plan and prognosis .Results ultrasound had high accuracy rate in the diagnoses of RA(P< 0 .05) ,and there were correlation among ul‐trasound diagnoses accuracy and DAS28 and MRI score(r= 0 .859 ,P< 0 .05) ;at the same time ,it provided accurate changes of the joint during the treatment ,and provided basis for treatment .Conclusion Ultrasound has manifest advantageous in diagnose RA .It could be used as a method in early diagnose RA and evaluate the effect on RA′s treatment .

AimThe aim of this study was to establish a rodent model with similar characters of human metabolic syndrome(MS).Methods Three species mice and Wistar rats were fed with high energy chows(HEC)for 6 to 23 weeks.Animals were weighted every week.Fasting blood glucose(FBG)together with total cholesterol(TC)and low density lipoprotein-cholesterol(LDL-C)were investigated by oxidase test every two week.And fasting blood insulin(FINS)was determined by radioimmunoassay.Homeostasis model assessment of insulin resistance(HOMA-IR)was calculated as FBG×FINS/22.5.At the end of the experiment,oral glucose tolerance test(OGTT)was performed.Then animals were decapitated,and coel-fat and orchio-fat were collected and weighted to calculate the visceral fat coefficient(VFC).Results FBG,serum TC and LDL-C significantly increased(P<0.01)after 6 weeks feed of HEC in KM mice.The mice also formed abdominal obesity and insulin resistant together with impairment of glucose tolerance(P<0.05 or P<0.01).Though similar to the KM mice,C57BL/6 and BALB/c mice couldn't form abdominal obesity while the latter had increased body weight(P<0.05 or P<0.01).Wistar rats formed hyperlipidemia from 1 to 10 week and hyperglycemia from 10 to 23 week together with insulin resistance and impaired glucose tolerance(P<0.05 or P<0.01).Conclusion KM mice feed with HEC for 6 weeks could successfully establish metabolic syndrome mice model which might be suitable for drug-screening,the major characters includes the formation of abdominal obesity(increase of VFC),the increase of serum TC,LDL-C,FBG and HOMA-IR,and the decrease of OGTT.