Upon the previous studies on the effect of spinal cord repair kinetics, we report the effect of extending the irradiation schedules to 3 treatment day per week. The animals in the experimental group received a pair of 2Gy fraction every other day separated by intervals (day/overnight) of 6h/42h and 8h/40h, respectively. There was significant shift by increasing interfraction intervals from 6/18h and 8/16h to6h/42h and 8h/40h, respectively. It is suggested that the tolerance of spinal cord is reduced while the overnight intervals are shortened from 42h and 40h to 18h and 16h, respectively and the repair of sublethal damage of spinal cord following multifraction treatment per day used in the clinic is not completed. With biexponential model, the ?/? ratio derived from these pooled data was 2.2Gy. T 1/2 values from spinal cord were obtained as 1.3h and 5.5h. It showed that the repair kinetics parameters are in well agreement with the results from the previous work. The repair processes are not influenced by interruption during radiotherapy.

The biology rationale for radiotherapy in the treatment of malignant disease is based on repair, repopulation,reoxygenation and cell cycle redistribution. Various aspects of the roles of the 4R' are discussed, including in determining the sensitivity of tumors and normal tissue tolerances. An improvement in therapeutic ratio may derive from reducing the dose per fraction and minimizing the overall treatmemt duration. Some methods have developed to predict the response of normal and tumor tissues before radiotherapy. The parameters of cell survival at 2Gy(SF2) was correlated with clinical outcome. There is reasons to suppose that the pretreatment tumor LI and Tpot mat be good predictors for tumor repopulation kinetics. This review also discussed the rationale for the use of LQ model in fractionated radiotherapy.

Objective To correctly apply the Capability Maturity Model Integration(CMMI) model to the development process of medical device software,thus optimizing and improving the development process and enhancing the software process capability.Methods The matching between CMMI and IEC62304 was analyzed.The compatibility on application was investigated by taking risk management(the core process) as an example.Results The interface between CMMI and IEC62304 was discovered as well as their optimized process in risk management.Conclusion The process of medical device software development not only can be improved by CMMI model,but also should be.

Objective To introduce the development of an adjustable and bed- type table for pleural puncture and observe its clinical effect. Methods 100 patients who were to undergo pleural puncture were divided into the experimental group and the control group with 50 cases in each group.The experimen-tal group adopted the adjustable and bed-type table for pleural puncture, while the control group used the conventional method.The pulse,respiration and artery blood oxygen saturation degree were observed. The ef-feet of puncture was also compared. Results The pulse and respiration increased and the artery blood oxygen saturation degree decreased after puncture,which were significantly different between the two groups. One- time success rate of puncture,comfort degree and satisfaction degree of patients in the experimental group were better than those of the control group. Conclusions Adjustable and bed- type table for pleu-ral puncture can reduce the uncomfort of patients and increase the success rate of puncture and satisfaction degree of patients.

The paper reviewed basic concepts of corporate governance.Based on these concepts,the authors proposed the general strategy and practices for introducing corporate governance structure at the hospital,and stated key characteristics of such a structural reform,thus making worthwhile attempts to this direction.

Objective To examine the differences in the level of sedation and adverse effects produced by equivalent analgesic doses of remifentanil,sufentanil and fentanyl.Methods Eighty ASA Ⅰ female patients aged 18-39 yr with BMI of 18-25 kg/m2 scheduled for laparoscopic surgery under general anesthesia were randomly divided into 4 groups ( n =20 each):group control (group C) ; group remifentanil ( group R) ; group sufentanil (group S) and group fentanyl (group F).Remifentanil 2 μg/kg,sufentanil 0.2 μg/kg and fentanyl 2 μg/kg in normal saline 10 ml were infused iv over 2 min in groups R,S and F respectively.Depth of sedation was assessed and scored using OAA/S scale (5 =alert,1 =no response to prodding) and wavele index (WLI),before (baseline) and at 2,4,6,8 and 10 min after drug administration.Besides RR,pulse oxygen saturation,BP,HR were also monitored.The incidences of apnea,muscle rigidity,nausea and vomiting,pruritus,vertigo,bradycardia,profuse sweating and skin rash were measured and calculated.Results The 4 groups were comparable with respect to age,BMI and height.The lowest values of OAA/S scores,WLI and RR were significantly lower in groups R,S and F than in group C.Sufentanil produced the deepest sedation among the 3 opioids.Remifentanil produced strongest respiratory depression and nausea and vomiting.Conclusion The equivalent analgesic dose of sufentanil produces deeper sedation than that of remifentanil and fentanyl while remifentanil has the greatest impact on RR.

2 years, no involvement of regional lymph nodes and the recurrence presented as a single nodule.

Mitochondria ATP synthase is a key enzyme in cellular energy interconversion. It is generally believed that ATP synthase is strictly confined to mitochondria. However, it has been demonstrated that ATP synthase also occurs on the extracellular surface of vascular endothelial cells, tumor cells and adipocytes, instead of normal cells. Based on this characteristic, many functional researches have been conducted on the angiogenesis, tumor inhibition and lipid metabolism, and the mechanism on which this enzyme works has been preliminarily elucidated. The research advances in cell-surface ATP synthase are reviewed in this paper.

Objective The objective of this study was to determine the effect of curative chemotherapy regimen on breast cancer cells and its mechanism.Methods A tumor-bearing mouse model was established and routine dose of capecitabine was given as a conventional chemotherapy group.Continuous low-dose capecitabine chemotherapy was used as a radiotherapy group and no chemotherapy was used as a control group.The expression of microvessel density(MVD),vascular endothelial growth factor(VEGF)and thrombospondin 1(TSP-1)were measured by flow cytometry.The percentage of myeloid-derived suppressor cells(MDSCs),NK cells and macrophages in the program was observed.The tumor size and blood leukocyte count were measured after chemotherapy.Results MVD and VEGF in the radiotherapy group were significantly decreased and TSP-1 was significantly increased in comparison with the conventional chemotherapy group(P<0.05).The proportion of MDSCs in the radiotherapy group was significantly decreased,the proportion of NK cells and macrophages were significantly increased when compared to the conventional chemotherapy group(P<0.05).The tumor volume was no difference between the control and chemotherapy groups(P>0.05).However,the white blood cell count in the radiotherapy group was significantly higher than that in the conventional chemotherapy group(P<0.05).Conclusion Capecitabine chemotherapy at continuous low-dose inhibits neovascularization and adjusts the proportion of immune cells to suppress tumor formation.Thus,this chemotherapy could reduce side effects caused by chemotherapy and improve the quality of life.

Objective To assess the cost-effectiveness of different modes of the cataract operation. Methods Firstly, 291 cases of cataract inpatient were divided four groups according to operation modes (PHACO and ECCE) and the prices of intraocular lens (IOL) (high and low). Then the comparisons of inpatient cost, operation cost, postoperative VA, postoperative VF and QOL were made among four groups respectively. Finally, the cost-effectiveness of different cataract operation modes was analyzed by comparing the differences of their costs with the VA, VF and QOL improvement. Results There were significant differences in the above indicators among four groups in general (P 0.01). The VA improvement amount of PHACO was higher than that of ECCE whereas the VF and QOL improvement lower than those of ECCE. The price of IOL had no effect on the improvement quantity of VA, VF and QOL. When one unit amount of VA improvement wanted, the cost-effectiveness ratio of inpatient with PHACO and low-price IOL was the lowest. When one unit amount of VF and QOL improvement wanted, the cost-effectiveness ratio of patients with ECCE and high-price IOL was the lowest. When one unit amount of VA and QOL improvement wanted, the operation cost-effectiveness ratio of ECCE with low-price IOL was the lowest. And when one unit amount of VF improvement wanted, the operation cost-effectiveness ratio of ECCE with high-price IOL was the lowest. Conclusions There were cost differences among different cataract operation modes. The cost of PHACO was higher than that of ECCE. The ECCE mode and price of IOL were the main determinants of cost. The effects of improving VA and QOL by ECCE were better and the effect of improving VA by PHACO was better than by ECCE. The homemade or low price IOL had no influence on the cataractous operative effectiveness, but could decrease the operation cost. ECCE with low-price IOL was the optimal cost-effectiveness strategy and operation mode, especially for poor rural and remote areas.