Objective To compare the dosimetric difference of RapidArc and fixed gantry angle dynamic IMRT (dIMRT) for loco-regionally advanced nasopharyngeal carcinoma.Methods Ten previously treated patients with loco-regionally advanced nasopharyngeal carcinoma were replanned with RapidArc and dIMRT, respectively.The prescription dose was GTV 70 Gy/33 f and PTV 60 Gy/33 f.All plans met the requirement:95% of PTV was covered by 60 Gy.Dose-volume histogram data, isodose distribution, monitor units,and treatment time were compared.Results Dose distribution has no significant difference between the two techniques.RapidArc reduced the dose of the brainstem, mandible, and other normal tissues compared with dIMRT.Mean monitor units were 589.5 and 1381.0 for RapidArc and dIMRT (reduced by 57% relatively).Mean treatment time was 2.33 min and 7.82 min for RapidArc and dIMRT (reduced by 70% relatively).Conclusions Compared with dIMRT, RapidArc achieves equal target coverage and OAR sparing while using fewer monitor units and less time during radiotherapy for patient with loco-regionally advanced nasopharyngeal carcinoma.

Objective To investigate and analyze the application and effect of the course of Labo-ratory diagnostics in general medical training from the Navy physicians. Methods 37 students attending the general medical training in our university in September 2015 were selected as the subject. At the end of the course, the “Questionnaire Survey on Teaching Feedback” was designed and conducted among them to understand the students'!opinions on the arrangement, teaching content and teaching methods of the experi-mental diagnostics. A total of 37 questionnaires were issued and retrieved effectively and the survey data were collected and summarized. Results Among 37 questionnaires, 100%of trainees (n=37) thought it was necessary to set up the Laboratory diagnostics course in the general medical training, 72.9%(n=27) suggested 3 to 4 teaching hours, and on the demand side of teaching content settings, 91.9%(n=34) chose analyses of blood, urine, stool routine tests and then tests of liver and kidney function. The proportions of students to recommend theory teaching, case discussion and practice operation were 24.3% (n=9), 51.4% (n=19) and 48.6% (n=18) respectively. Conclusions The setup of the Laboratory diagnostics course plays an active role in the general medical training from navy physicians. In the future, according to the demand of the general medical training, teachers should optimize the teaching contents and learning hours, improve the teaching methods and enhance the training quality.

Cardiac arrhythmia is one of the most common cardiovascular diseases,with high morbidity and mortality,which threatens human health and lives. With the development of medicine, natural products are revealing ever-greater anti-arrhythmic benefits and potential. However,their targets have not been fully clarified. In the recent ten years ,scientists have been studying the molecular mechanisms of natural products that have been found to inhibit INa,ICa-L,Ito,IK1,IKr,IKM3,HERG channel current and steady state K+ current,promote IKs and IKATP,inhibit microRNA-1 expression and change cardiac microRNA expression profile,affect Na+-K+-ATPase and superoxide dismutase activity,inhibitβ receptor and angiotensinⅡ receptor,and regulate lipid metabolism,thus affecting cardiac rhythm and exerting anti-arrhythmic effect. This paper revies the research advances in the antiarrhythmic tar?gets of natural products.

Objective To study the effect of lipopolysaccharide(LPS)on the endo-pulmonary natrium channel(ENaC)expression in the lung of rats with acute lung injured.Method Sixteen rats were randomly divided into normal control group and LPS-group.Rats of normal control group and LPS-group were killed at 6 hours after intravenous injection of normal saline(8 ml/kg)or LPS(8 mg/kg).The extent of lung injury was assessed by arterial blood gas analysis and histological examination.At the same time,?-ENaC protein and???- ENaC mRNA expression in the lung tissue were analyzed by immunohistochemistry and RT-PCR.Results PaO_2 in LPS-group was noticeably lower than in normal control group(P

Objective To compare the dosimetric difference between volumetric are modulation with RapidArc and fixed field dynamic IMRT for breast cancer radiotherapy after breast-conserving surgery.Methods Twenty patients with early left-sided breast cancer received radiotherapy after breast-conserving surgery.After target definition,treatment planning was performed by RapidAre and two fixed fields dynamic IMRT respectively on the same CT scan.The target dose distribution,homogeneity of the breast,and the irradiation dose and volume for the lungs,heart,and eontralateral breast were read in the dosevolume histogram (DVH) and compared between RapidAre and IMRT.The treatment delivery time and monitor units were also compared.Results In comparison with the IMRT planning,the homogeneity of clinical target volume (CTV) ,the volume proportion of 95% prescribed dose (V95%) was significantly higher by 0.65% in RapidAre (t =5.16,P = 0.001) ,and the V105% and V110% were lower by 10.96% and 1.48 % respectively,however,without statistical significance (t =-2.05 ,P =0.055 and t =-1.33 ,P =0.197).The conformal index of planning target volume (PTV) by the Rap~dAre planning was (0.88±0.02),significantly higher than that by the IMRT planning [(0.74±0.03),t = 18.54,P < 0.001].The homogeneity index (HI) of PTV by the RapidArc planning was 1.11±0.01,significantly lower than that by the IMRT planning (1.12±0.02,t =-2.44,P =0.02).There were no significant differences in the maximum dose (Dmax) and V20 for the ipsilateral lung between the RapidArc and IMRT planning,but the values of V10,V5 ,Dmin and Dmean by RapidArc planning were all significantly higher than those by the IMRT planning (all P < 0.01).The values of max dose and V30 for the heart were similar by both techniques,but the values of V10 and V5 by the RapidArc planning were significantly higher (by 18% and 50% ,respectively).The V5 of the contralateral breast and lung by the RapidArc planning were increased by 9.33% and 3.04% respectively compared to the IMRT planning.The mean MU of the RapidArc was 608 MU,significantly higher than that by the IMRT planning (437 MU,t = 10.86,P < 0.001).The treatment time by the RapidArc planning was 111.3 s,significantly longer than that by IMRT planning (103.6 s,t = 3.57,P = 0.002).Conclusions The RapidArc planning improves the dose distribution of CTV and homogeneity of PTV for breast cancer radiotherapy after breast-conserving surgery.However,it significantly enlarges the volume of normal tissues irradiated in low dose areas,prolongs the treatment delivery time,and increases the MU value in comparison with IMRT.

ObjectiveTo investigate the role of CD4+ CD25+ regulatory T cells(Treg) in peripheral blood and intestinal endotoxin (ET) in liver injury of rat severe acute pancreatitis (SAP).MethodsSixty male Wistar rats were randomly allocated into sham operation group(SO group) and severe acute pancreatitis group(SAP group).The rats in SAP group recevied the injection of Sodium Taurocholate(NaTc) into their far-end of bile-pancreatic duct and were sacrificed in 3-,6-and 12-hour,serum amylase(AMY) and alanine aminotransferase(ALT) determined by full-automatic biochemistry instrument,limulus reagent method is used to determine ET content in plasma,the proportion of Treg among peripheral lymphocytes was determined by Flow Cytometry(FCM),HE stain is used to observe pathological changes in liver and pancreas,the protein of Foxp3 activity was evaluated by immunohistochemistry staining,and the relationships between these indicators were analyzed using Pearson correlation analysis test.ResultsHistopathologic examination and the level of ALT revealed the occurrence of pancreatic inflammation and pathological changes of liver in SAP group.The percentage of Treg in SAP groups significantly increased at 3 h(2.26％ ±0.32％),6 h(2.36 ％ ±0.48％)and 12 h(2.80％ ±0.35％) comparing to the SO groups(P＜0.01) ; plasma ET levels compared with the SO group was statistically significant (P＜ 0,01 ),and 12 h (0.85 ± 0.11) compared to,3 h (0.74±0.11) and 6 h (0.78-±-0.07) was no significant difference (P＞0.05).The expression of Foxp3 protein on the livers were upregulated markedly.Pearson correlation analysis teat showed that quantities of Treg were positively proportional to the levels of ET(r=0.89,P＜0.01) after liver injury of SAP.ConclusionsSAP may lead to liver injury and the high plasma levels of ET and Treg in peripheral blood may play an important role in liver injury of SAP.

BACKGROUND:Patients with elder hip fracture has more complications, poor affordability and high perioperative risk, so the preoperative ful preparation and evaluation are needed.
OBJECTIVE:To predict the accuracy of the prognosis of elderly patients with hip fracture through comparing the difference between American Society of Anesthesiologists score and Daping orthopedics operation risk scoring system for senile patients.
METHODS:A retrospective study was performed on 300 cases with elderly hip fracture selected from January 2011 to December 2012 from Department of Orthopedics, Gongli Hospital of Pudong. American Society of Anesthesiology score and Daping orthopedics operation risk scoring system for senile patients were conducted before treatment, and the predictive values of two scoring systems on the incidence of complications and mortality were compared.
RESULTS AND CONCLUSION:According to the American Society of Anesthesiology score and Daping orthopedics operation risk scoring system for senile patients, 148 cases and 97 cases had complications respectively. On the contrary, the actual number of complications was 89. The former predicted value was significantly higher than the actual value, and there was no significant difference between the latter forecast value and the actual value. The numbers of death predicted by American Society of Anesthesiology score and Daping orthopedics operation risk scoring system for senile patients were 27 cases and six cases, but the actual number of death was three cases, indicating that former predicted value was significantly higher than the actual value, and there was no significant difference between the latter predicted value and the actual value. The American Society of Anesthesiology score has a certain errors in predicting the postoperative complications and mortality of patients with elderly hip fractures, but it is simple and useful in clinic. The Daping orthopedics operation risk scoring system for senile patients can accurately evaluate elderly hip fracture operation risk, and can predict the postoperative complications and mortality more objective when compared with the American Society of Anesthesiology score.

Objective To investigate the role of mesenchymal stem cells in the repair of radiation induced liver injury.Methods 12 female SD rats were irradiated with 20 Gy 6 MV X-rays on the right lobe of the liver,to establish the model of radiation induced liver injury.The rats were divided randomly into two groups as invention group and control group,and transplanted with 1 ml male mesenchymal suspension or 1 ml normal saline in 4 hours after radiotherapy.The morphological changes of liver were observed.The existence of sex determining gene Y(SRY)and the level of alpha-smooth muscle actin (a-SMA) were detected.Results Some injury of right lobe liver in two groups were observed,and the injury degree of right lobe liver in intervention group were lower than that of control group.The amount of SRY positive cells in the right lobe liver of intervention group was higher than that in the left lobe liver(t ＝ 3.77,P ＜0.05).The positive expression rate of a-SMA in right lobe liver of intervention group was lower than that of control group.Conclusions Acute radiation induced liver injury could lead BMSCs＇ homing in order to decrease the degree of liver fibrosis.

Objective To investigate whether the bilateral nipple discharge with the background of hypothyroidism and pituitary tumor causes intraductal neoplasm. Methods Clinical data of 222 bilateral nipple discharge patients with hypothyroidism or pituitary tumor undergoing mammary ductoseopy (MDS) examination were analyzed. Those diagnosed as intraductal papilloma received surgery and pathological exam. 158 cases with inflammatory comedomastitis diagnosed by MDS received milk duct washing with gentamycin, dexamethasone and corresponding medical treatment. Results Among the 222 cases, 158 cases(71.17%) were diagnosed as inflammatory comedomastitis by MDS, 64 cases (28.83%) were diagnosed as intraduetal papilloma (64/222) by MDS and received operation,59 cases were pathologically diagnosed as intraductal papilloma,the other 5 cases were pathologically diagnosed as mammary duct ectasia. The pathological coincidence was 92.2% and no breast cancer was observed. 68.10% of inflammatory comedomastitis cases suffered from breast pain. There were no significant difference in the disease distribution of the ethnic groups. During pre-menopause period, the incidence of period neoplasia is higher in pituitary tumor than hypothyroidism; However, during the post-menopause the situation was vice versa. The color of niplle discharge is mostly milk-like in patients with pituitary tumor, while serous in patients with hypothyroidism. 71.19% of duct papilloma locate at the branch of the main duct. Conclusion The bilateral nipple discharge with hypothyroidism or pituitary are usually concomitant with intraduetal lesions. Mammary ductosopy is helpful to discover intraduetal neoplasia.

Objective To explore the gender difference in Chinese version of autism spectrum rating scale (ASRS)-in terms of parents and teacher rating.Methods A total of 701 children (380 boys,321 girls;6 -11 years old)were recruited from one Primary School in Minhang District of Shanghai.The parents and teachers of the children completed the ASRS.While the data were imput into the database,the software automatically calculated T -standard score according to the formula for the raw score of screening scale,treatment scale,and Diagnostic and Statistical Manual of Mental Disorders -Ⅳ -Turning Reversion scale.In the end,the gender differences in Chinese version of ASRS for both parents and teacher ratings were analyzed.Results A total of 671 parents rating scale were retrieved (response rate was 95.7%),involving 368 boys (54.8%);685 for teacher rating scale (response rate was 97.7%), involving 381 boys (55.6%).No significant difference was observed in the distribution of gender(P >0.05).Minor influence of age was found among ASRS sub -scales for both parents and teacher ratings in boys and girls (parent rating scale r =-0.219 1 to -0.124 4,teacher rating scale r =-0.328 0 to -0.120 0).In parent and teacher ver-sion of ASRS,boys had higher T -standard scores in all subscales by 1 -3 and 2 -4 points than those in girls,respec-tively,and apart from abnormal behavior,adult socialization,behavioral rigidity,and sensory sensitivity there was no sig-nificant difference(all P >0.05)in parents rating scale while others had significant differences(all P <0.05),and all sub -scales had significant difference in teacher rating scale(all P <0.01).Conclusions The T -standard scores of both ASRS questionnaire has the gender differences in ASRS subscales,so it is necessary for researchers to understand the Chinese version of ASRS questionnaire from different angles.