Objective To evaluate method of CT simulation (CT sim) in the treatment planning setup of esophageal carcinoma. Methods From Dec.1999 to Jun.2002, 49 patients with pathologically proved esophageal carcinoma were analyzed. All patients underwent CT sim and treatment planning was configured with three symmetrical fields in the isocenter mode. A few comparisons have been made between CT sim and conventional simulation (Con sim) in the treatment planning setup. Results The difference in isocenter position were observed between CT sim and Con sim with 3～18 mm.When the esophageal lumen was taken as portal center, the 90% isodose curve in 42.8%(21/49) of patients were able to cover the whole lesion. When taking the tumor as the portal center, the whole lesion of all patients was totally covered by the 90% isodose curve. Conclusion The CT sim has an advantage in the delineation of lateral extension of esophageal tumor than the Con sim .Selection of irradiation portal should be done according to the size the silhouette of the tumor.

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ObjectiveTo summarize the clinical features of adult patients with abdominal type Henoch Scholein Purpura(HSP) to improve the early diagnosis and therapeutic outcome of HSP.Methods The clinical features of 31 adult patients with abdominal type HSP from the Hematology department of Handan First Hospital between March 2007 to June 2010 were retrospectively reviewed and compared with that of 30 adult patients with non-abdominal type HSP.Results All the 31 patients had abdominal pain.Of those patients,48.4％ had periumbilical colicky pain, 38.7％ had whole abdominal pain and 12.9％ had lower abdominal pain.The other clinical manifestations included nausea/vomiting(19.4％),positive feces occult blood test(45.1％) .EGD and Colonoscopy of 13 patients showed mucosal congestion, red macda, erosion and ulceration mainly in the descending duodenum, distal ileum and rectosigmoid.There was no difference in age, gender, allergic history and predisposing infection between those with abdominal pain and without.The patients with abdominal pain had more cases of mixed-type HSP than those without and the difference was significant (P ＜ 0.01) .Conclusion Patients with abdominal-type of HSP are mainly young adults.So we must be more alert to abdominal-type of HSP when facing young patients with abdominal emergency.Abdominal-pain-manifesting HSP patients are mostly mixed-type cases.Gastrointestinal endoscopy is specific and might provide valuable clues for early diagnosis.

Objective To explore the contents and modes of community nursing training and improve community care quality.Methods The training course and assessment standard were worked out according to practical work in community health service centers,including basic nursing skills,community first aid skills,hospital infection control skills,preventive health care skills and community document management skills.Toally 58 nurses from 11 community health service centers were trained for 36 hours from January to June,2016 and tested before and after training to assess the effect of training.Result After training,the scores on all skills were significantly higher than those before training (all P＜0.01).Conclusion Regular and practical training and management are the guarantee for the improvement of the community care quality.

This article gives insights into a series of research on the purpose, significance, system, execution and as-sessment of Medical Humanities Curriculums, based on the problems of the existing medical education. The MedicalHumanities Curriculums are divided into three major groups: the fundamental, the comprehensive and the practical,detailedly reasoned by their contents and functions.[

Objective To investigate the distribution and antibiotic resistance patterns of uropathogens in children with complicated urinary tract infection to guide the empirical antimicrobial treatment.Methods Retrospective analysis of isolated bacteria from 141 children hospitalized with complicated urinary tract infection was performed from January 2011 to January 2013.Results Gram-negative bacillus were the main pathogens [56.6％(81/143)],and Escherichia coli was the leading cause (41.3％,59/143).Gram-positive bacillus accounted for 38.5％ (55/143),including Enterococcus faecium (17.5％,25/143) and Enterococcus faecalis (14.7％,21/143).Fungi caused 4.9％ (7/143) of the infections.The resistance of Escherichia coli to amoxicillin was the highest [92.0％ (23/25)] and resistance to imipenem (4.3％,2/47),amikacin (6.8％,4/59) and nitrofurantoin (6.8％,4/59) was lower.It was observed resistance of Enterococcus faecium to linezolid,quinupristin,vancomycin and nitrofurantoin was significantly lower than other common antibiotics.The resistance of Enterococcus faecalis to quinupristin,tetracycline,erythromycin,rifampicin was significantly higher than other common antibiotics.Concluusions Escherichia coli,Enterococcus faecium and Enterococcus faecalis are the common uropathogens.These pathogens have a high antibiotic resistance to many common antibiotics.The selection of empirical treatment of children with complicated urinary tract infection should be adjusted by antimicrobial susceptibility test.

Objective:To provide the solution based on electronic authentication service and electronic signature for doctor and nurse in order to guarantee the integrity and authenticity of electronic medical records system(EMRS) in building, writing and storage.Methods: To establish integrated electronic signature platform based on the installation and debugging for the digital signature sever device; and to improve some parts of the database, such as the digital certificate, certificate logging and the integration process of digital signature etc.Results: The integrated electronic signature of EMRS can guarantee the authenticity and reliability of identity when doctor logged system or finished the normal medical work; and it can reduce manual signature process and contribute to finish the automatic signature after doctor or nurse finished EMRS and nursing recorder sheet.Conclusion: The implementation of the electronic signature can ensure the reliability of electronic medical records, achieve the complete electronic file storage for patient medical records, and greatly save manpower and material resources.

Purpose [WT5”BZ]To estabalish a quantifying model of retinal neovascularization suitable for the study of pathogenesis and therapeutic intervention for the retinal neovascularization. [WT5”HZ]Methods [WT5”BZ]Sixteen one week old C 57 BL/6 mice were exposed to 75% oxygen for 5 days and then to room air and 16 mice of the same age kept in room air as controls.Ink perfused retinal flatmount was examined to assess the oxygen induced changes of retinal vessels.The proliferated neovascular response was quantitated by counting the nuclei of endothelial cells of new vessels extending from the retina into the vitreous in 6 ?m sagittal cross sections. VEGF and bFGF were determined on the cross sections after immunohistochemcal stain. [WT5”HZ]Results [WT5”BZ]Constriction and closure of the blood vessels were found under the hyperoxia condition,and dilation and proliferation were found under the relatively hypoxia status.There was a mean of 24 neovascular nuclei per cross section in the oxygen treated retina and less than 1 nucleus in the control group ([WT5”BX]P

The paper gives an account of the four systems that are currently used for evaluating hospital quality in America, viz. America's Best Hospitals, Solucient 100 Top Hospitals, International Quality Indicator Project, and the Joint Commission on Accreditation of Healthcare Organizations. The "America's Best Hospitals" methodology takes into account three factors, infrastructure, process and outcome. Hospitals are first ranked in specialties, then the index of hospital quality is calculated by means of weighted indexes, and after that the best hospitals are selected according to the specialty rankings and the number of the hospitals. The "Solucient 100 Top Hospitals" methodology selects 100 top hospitals among hospitals of the same size on the basis of hospital quality and safety indexes. The evaluation indexes include eight items, such as index of risk-adjusted mortality rates, index of complications, and disease severity-adjusted average length of hospital stay. The methodologies of "International Quality Indicator Project" and "the Joint Commission on Accreditation of Healthcare Organizations" are used in many countries to evaluate clinical efficiency and enjoy high reputation in monitoring and promoting medical quality.

OBJECTIVE:To develop a HPLC method for the assaying of the principal agent in oxiracetam sodium chloride injection.METHODS:The separation was performed on Intersil CN-3column;the mobile phase was a mixture of acetonitri_ le-water(6∶94)with detection wavelength at214nm,flow rate at0.6ml/min and sample size at5?l under room temperature. RESULTS:The linear correlation of oxiracetam was observed over the concentrations of0.5625to288?g/ml(r=0.9999).The average recovery was99.95%(RSD=1.36%).CONCLUSION:The method is accurate,convenient specific and repro-ducible,and suitable for the determination and quality control of Oxiracetam.