Objective To observe the effect of Yishen Paizhuo Decoction(Decoction for reinforcing the kidney and discharging the turbid)on chronic renal failure(CRF)patients.Methods The 82 CRF patients were randomized into observation group(42 cases) and control group(40 cases).In addition to the routine treatment,the observation group was administered modified Yishen Paizbuo Decoction,and the control group was given coated aldehyde oxystarch.The course of treatment was 6 months for both groups. Changes of clinical symptoms,renal functions,blood fat,and hemoglobin were observed,and the linear regression evaluation and renal survival evaluation were employed to evaluate the development of CRF.Results The improvement of observation group in renal func- tions and blood fat was remarkable with the increased renal survival rate,compared with the control group,the difference was signifi- cant(P

Objective To evaluate the effect of dose-rate and leaf position tolerance on the point dose in step-and-shoot intensity-modulated radiotherapy(IMRT). Methods IMRT plans of 2 prostate cancer patients were selected and recalculated for a water phantom.An ionization chamber was used to measure the dose of some points in the phantom at five nominal dose-rates:100 MU/min,200 MU/min,300 MU/min,400 MU/min and 500 MU/min.It was necessary to adiust the position of the water phantom to locate the ionization chamber in region where the dose gradient was very low in order to minimize the effect of dose gradient on the measured results.When measuring the effect of leaf position tolerance on point dose,the dose-rate was kept constant and the values of tolerance were 1 mm,2 mm,3 mm and 4 mm.This work was conducted on a Varian 23EX equipped with a Millennium 120-leaf multi-leat collimator(MLC).The treatment planning system was Varian Eclipse. Results As the dose-rate increased,the error between the measured dose and the calculated dose also enlarged.The difference between the maximum and the minimum was 1.2%.When MLC control system was working normally,tlle effect of leaf position tolerance on the measured point dose was very little and negligible. Conclusions The dose-rate must be selected suitably to ensure that the delivery can be finished in a short time with the radiobiological effect taking into account.It should be noted that the error between the measured dose and the calculated dose increases with the trend of inereasing more rapidly at higher dose rates.The value of leaf position tolerance should not be set too large,in order to minimize the difference between the measured dose and the planned dose in the region of steep gradient and find as early as possible when the multi-leaf collimator control system performs improperly.

Aconitine ; poisoning ; Aconitum ; chemistry ; poisoning ; Cardiopulmonary Resuscitation ; Charcoal ; therapeutic use ; Female ; Hemoperfusion ; Humans ; Male ; Middle Aged ; Poisoning ; drug therapy

Objective To analyze the clinical application of high?throughput gene sequencing technolo?gy and STR in chromosome karyotype analysis of the villus tissues of spontaneous abortion. Methods In 27 ca?ses of spontaneous abortion after pregnancy,classic cell of villus tissues culture and chromosomal karyotype anal?ysis,and high ?throughput gene sequencing technology and STR were performed,and then compared the analysis results of two methods. Results ( 1) The successful rate of cell of villus tissues culture and chromosomal karyo?type analysis was 85%( 23/27) ,of high?throughput gene sequencing technology and STR was 96%( 26/27) ,and the difference was not significant( P>0. 05) ( 2) In the 4 cases that failed in karyotype analysis,there were 3 ca?ses showed abnormal chromosomal number variation( CNV) in high?throughput gene sequencing technology and STR. ( 3) Of the 23 cases,chorionic villus was successfully cultured in 10 cases,abnormal karyotypes were iden?tified in 13 cases,the positive rate was 57%. Of the 26 cases,high?throughput gene sequencing technology and STR was successfully checked in 3 cases,abnormal CNV were identified in 23 cases,the positive rate was 85%, the difference was significant(χ2=6.387,P<0.05). (4)The rates of chromosomal number abnormality were 52%( 12/23) and 50% ( 13/26) of karyotype analysis and chromosome aberration detection,respectively. In 10 cases of normal cell culture karyotype,there were 7 cases in the presence of micro deletion / micro repetition de?tected by high?throughput gene sequencing technology and STR. Conclusion The method of massively parallel sequencing in chromosome analysis,compared with the method of cell of villus tissues culture and chromosome a?nalysis,can be accurate and quick,and has high successful rate in detecting the chromosome of non aneuploid and deletion/duplication abnormality,which can be a good complementary and alternative method of the classic cell of villus tissues culture and chromosome karyotype analysis.

Post-stroke depression(PSD) is one of the most common complications after stroke,and seriously influenced the quality of life of hemiplegic patients.The article would review the associated factors and mechanism of PSD.

Objective Combination of chemotherapy regimens and chemoradiotherapy to the curative effect of locally advanced nasopharyngeal carcinoma is unclear. The carcinoma radiotherapy adverse reaction and curative effect were investigated in nedaplatin plus fluorouracil in the same period radiotherapy(Group NF)compared with cisplatin(DDP)in the same period (Group DDP)in the treatment of locally advanced nasopharyngeal. Method Patients with locally advanced(ⅢandⅣB)nasopharyngeal carcinoma(NPC)in Sun yat?sen university cancer hospital were enrolled and divided into two groups:222 cases in the NF group and 165 cases in the DDP group. The adverse reaction,5?year progression?free survival(PFS)and overall survival(OS)for 5 years were evaluated in two groups. Results The 5?year PFS in the NF and DDP group was 85.13%and 82.42%,respectively, with no significant difference. The 5?year OS in the NF and DDP group was 85.58% and 82.42%,respectively, with no significant difference. The proportion of oral mucositis in the NF group was significantly lower than that in the DDP group. Conclusion Nedaplatin plus fluorouracil radiation therapy has similar curative effect ,adverse reaction with cisplatin plus the same radiation therapy in the treatment of locally advanced nasopharyngeal carcinoma.

OBJECTIVETo observe the protective effect on renal function of Chinese drugs combined with benazepril in patients with diabetic nephropathy (DN).

METHODSAdopting stratified randomized and controlled design, 108 patients with DN were assigned to two groups. Besides the same measures of diet regulation, exercise, education, hypoglycemic and symptomatic treatment applied, benazepril was administered to all patients, and Chinese drugs were given to patients in the treated group additionally. The treatment course was 3 months. The changes before and after treatment of symptoms and signs, 24-h urinary protein (24 hUpro), serum creatinine (SCr), serum creatinine clearance rate (CCr), blood urea nitrogen (BUN), plasma glucose (PG) and blood pressure (BP) were observed, and the time of dialysis therapy initiating was recorded.

RESULTSSCr and 24 hUpro decreased and CCr increased in the treated group significantly (P < 0.01), and the improvement were superior to that in the control group (P < 0.05 or P < 0.01), the renal living time in the treated group was longer than that in the control group, but no significant different in BUN, PG and BP was found between the two groups (P > 0.05).

CONCLUSIONThe treatment program of Chinese drugs combined with benazepril could obviously reduce the levels of SCr and 24 hUpro, increase CCr in patients with DN, and its effect in improving renal function is better than that of using benazepril alone.

Aged ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Benzazepines ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome

Objective To learn the information about the parents' knowledge and inquiry to the nursing participating of the consultant. Methods One hundred and twenty cases of parents were investigated with the self-designed questionnaire. The rates of grade data was accomplished with statistical analysis. Results Knowledge of consultant: 82.5 percent eases parents knew their fight of consultant provided by the hospital. 70.32 percent of parents were satisfied with the nursing consultant for them. Parents of different ages had different ideas about the consultant contents and ranges provided by the doctors and nurses (P < 0.01). Styles of consulting: 67.5 percent of parents wanted to be consulted in prior. 53.33 percent wanted to be consulted at the suitable situation and be informed part of the contents. 78.53 percent wanted to be informed by the nurse in charge of the children. Lines of the consulting contents : the former three ones are as followings, staff of the department, environment, rules and discipline;kinds of the diet;function of the medication, purposes of the tests, items to be care about. Conclusions Parents agreed with the nursing consulting in the practice of medical affairs. More sufficient nursing consultants were needed. Consultant was the basic insure of their informed consents.

Objective To compare the planning systems of the simplified manual intensity modulated (SMIM) irradiation and standard tangential (ST) irradiation,in order to explore the application of SMIM technique in clinic.Methods In 64 cases of breast cancers after breast conserving surgery,each underwent both SMIM and ST planning systems.SMIM planning was designed by copying additional fields for shielding the high dose areas from internal or lateral tangential field.The high dose areas were reduced by adjusting the size of the additional field and open tangential field.To optimize the SMIM planning,3 high dose areas (＞ 103% ,＞ 105% and ＞ 107%) were shielded and 3 protocols carried out.The wedges were also optimized in ST plan.The target coverage and dose homogeneity and dose of organ at risk were compared between SMIM and ST planning systems.Results When the dose was normalized to cover the volume of 95% CTV,85% of the shielded areas in optimal SMIM planning were that of ＞ 103% high dose area,and 94% of target area was covered.The study on the volume of breast CTV showed that,in the large breast group,SMIM could not only significantly reduce the high dose areas,and the maximum dose as well as the dose of organ at risk,but also enhance the dose homogeneity index.However,no such effect was not significant in the small breast group.Conclusions The simplified manual intensity modulated technique can improve target dose homogeneity in the large breast cases instead of the standard tangential technique.

Objective To investigate the correction of manual monitor unit calculation for asymmetric fields using the Varian enhanced dynamic wedge.Methods Monitor unit (MU) was calculated when the field sizes ranged from 6 cm × 6 cm to 20 cm × 20 cm at a depth of 5 cm using Varian Eclipse and both 6 MV and 10 MV X-rays data from Varian Clinac 23EX for all seven available EDW angles,including 10°15°,20°,25°,30°,45°and 60° The field size was kept fixed,and the distance between geometry center of field and isocenter was increased in increments of 1 cm,ranging from -9 cm to 4 cm.When the field size was the same,the correction factor was defined as the ratio of MU calculated for asymmetric field to monitor unit calculated for symmetric field.To ensure the correction factors obtained above could be used in routine manual calculation for EDW fields,measurements were made at a depth of 5 cm for 30°and 45°EDW with field size of 10 cm × 10 cm using 6 MV X-rays.Results The correction factor was independent of field dimensions,so the average value was adopted to make practical calculation.Without correction,the maximum error was 18% for 30°,and 30% for 45.After the results of monitor unit calculation were corrected,the largest error was - 1.8% and - 1.7% for 30° and 45°EDW,respectively.The magnitude of errors was within the clinical tolerance limits.Conclusions For asymmetric EDW fields,there is very large difference between the prescribed dose by manual calculation using EDW factors measured for symmetric fields and that delivered during treatment in order to obtain correct dose to reference point.The errors are decreased to be acceptable after correction.The method of correction is simple and independent of machine specific beam parameters.