Chaihu Guizhi Ganjiang Decocotion is a famouse prescription recorded in Treatise on Febrile Diseases. In this article,the application of Chaihu Guizhi Ganjiang Decoction is discussed in treating gynaecological diseases through the cases of dysmenorrhea, climacteric syndrome, hypogalactia and hysteria. The mechanism is also expounded.

Objective To analyze the advantage of altered fractionation radiotherapy by calculating the accumulative effects of daily biologically effective dose (BED) to find out the difference between conventional fractionated radiotherapy and altered fractionation radiotherapy.Methods The data in the report of hyperfractionated or accelerated radiotherapy for head and neck cancer published by Cochrane Collaboration in 2010 was analyzed.Based on the radiotherapy processes mentioned in this report,the accumulative effects of daily BED were calculated and compared in different radiotherapy processes by using linear-quadratic mode.The variation of BED in different radiotherapy processes was find out.Results In total dose of unity as the premise of 70 Gy,altered fractionation especially the hyperfractionated accelerated radiotherapy could give a higher BED to the tumor during a shorter period,hyperfractionated radiotherapy could give a lower BED to normal tissues,and hyperfractionated radiotherapy with split course could give higher BED to the tumor while lower BED to normal tissues.Conclusions The variation of BED in different radiotherapy processes can be shown clearly by linear-quadratic mode.It can be simple and shortcut through mathematical models for the evaluation of different radiotherapy plan,on clinical symptomatic selection play a guiding role in tumor therapy.

Objective To study the difference in the measurement of the absorbed dose in water between the dosimetry protocols of IAEA TRS-398 and TRS-277 for high-energy electron beams.Methods The differences were compare in absorbed doses from 6 kinds of electron beams among the three methods of using cylindrical chamber,plane-parallel chamber and cross-calibrated plane-parallel chamber which was calibrated in user' s high-energy electron beam according to IAEA TRS-398 and IAEA TRS-277.Results The difference in absorbed doses measured,following the two protocols,was 0.4％-2.3％ for planeparallel chamber,0.6％-2.2％ for cylindrical chamber,and 0.5％-2.0％ for cross-calibrated chamber.The differences in measured absorbed doses between the two dosimetry protocols were slight.Conclusions The methods used to determine absorbed dose to water recommanded by IAEA TRS-398 for high-energy beams are more accurate and more suitable for clinical users to measure compared to the TRS-277.

Objective To explore the MatriXX measurements the dose distributions for each beam in intensity-modulated radiotherapy (IMRT) plans were measured with 0 degree gantry angle and actual gantry position respectively.To discuss whether the two multi-angle synthetic pass rate from the two methods has statistics differences.Methods The dose distributions for each beam in IMRT plans were measured with 0 degree gantry angle and actual gantry position for twelve patients with head and neck tumor respectively.The γ pass rates (according to 3％/3 mm) for each beam under each angle condition was obtained by the comparison between the measured and the calculated dose distributions from the treatment planning system which was treated as the reference distribution.Use the t-test to analyse the actual gantry angle method and use the one factor analysis of variance to analyze the two multi-angle synthetic pass rate from the two methods.Results The γ pass rates of actual gantry angle was found generally declined seemingly compared with 0 degree gantry angle,but differentγ pass rates showed only in 80 °,120°and 240° with98.71％,93.59％(t=2.10,P=0.000),98.15％,93.17％ (t=2.10,P=0.000) and 98.94％,92.85％ (t =2.10,P =0.000) respectively.The γpass rate of multi-angle synthetic was seemingly between methods (98.27％,94.63 ％,F =0.50,P =0.134).Conclusions Two kinds of IMRT verification mode are from two position to validated the IMRT plans dose accuracy,comparatively analysing the conclusions drawn from the two methods can protect accuracy of IMRT plans more comprehensively.

Urine provides an alternative to blood plasma as a potential source of disease biomarkers. Exosomes was separated by ultracentrifuge at 200000 g in normal persons and non-small cell lung cancer (NSCLC) patients′ urine. For proteomic analysis of urinary exosome, 1D sodium dodecylsulfonate-polyacrylate gel electrophoresis(SDS-PAGE) was carries out and cut the gel 31 kDa-20 kDa bands in normal group and disease group′s. These gel blocks were subjected to in-gel trypsinization, and the extracted peptides were analyzed HPLC-CHIP-MS/MS. Approximately 24 unique proteins were identified in the UniProtKB/SWISS-PORT. The difference expression proteins were found in urinary exosome from NSCLC patients, including three fragment of the immunoglobulin kappa, two kinds of Ras related proteins, glutathione S-transferase A2, serum amyloid P-component precursor and phosphatidylethanolamine-binding protein 1.

Objective To investigate the relationship between degree of endometrioma adhesions and clinical feature, surgical treatment and postoperative recurrence. Methods From Jan 2003 to Mar 2008, 662 patients with endometrioma undergoing laparoscopic ovarian endometrioma excision in Peking Union Medical College Hospital were studied retrospectively. All patients were classified into four groups according to the extent of adhesions: 31 cases in none adhesions group, 123 cases in mild adhesions group (filmy thickness, avascular, easily separated adhesions), 310 cases in moderate adhesions group (less than a half of ovary was adjacent to dense thickness adhesions which was difficult to separate, or above a half of ovary were adjacent to filmy thickness adhesions) and 198 cases in severe adhesions group (above a half of ovary was adjacent to dense thickness, well vascularized adhesions which was difficult to separate, and always involved the other pelvic organs, observed angiogenesis). The comparison of degree, characteristics, period of pain, lab test, surgical management and postoperative recurrence was performed among those above groups. In the mean time, risk factors and multinomial logistic regression were analyzed. Results (1)Clinical characteristics: The incidence of patients with dysmenorrhea, dyspareunia, straining feeling in anus, chronic pelvic pain and the level of CA125 (>35 kU/L) was remarkably higher in moderate-to-severe adhesion groups than in none-to-mild adhesions groups (P=0.000, 0.000, 0.001, 0.006 and 0.000, respectively). Infertility rate were significantly higher in severe adhesions group(15.7%,31/198) than none adhesions group(3.2%,1/31), mild adhesions group(11.4%,14/123) and moderate adhesions group(9.7%,30/310, OR=1.728, P<0.05).(2)Operating time and blood loss: Operating time of each groups was as followed: (37±15) min in none adhesions group, (42±19) min in mild adhesions group, (50±20) min in moderate adhesions group and (63±22) min in severe adhesion group. Blood loss was (23±12) ml in none adhesion group, (31±27) ml in mild adhesion group, (40±32) ml in moderate adhesion group and (70±67) ml in severe adhesions group. Thicker adhesions result in longer operation time and more blood loss. (3)Combined with other disease: The ratio of patients who combined with adenomyosis or deeply infiltrating endometriosis in moderate-to-severer adhesion groups was higher than patients in none-to-mild adhesions groups (OR=3.466, P=0.000). (4) Postoperative recurrence: It was categorized into recurrence of pain and cyst. Moderate-to-severe adhesions was related to higher recurrence rate of pain (OR=1.685,P=0.046), but was irrelevant to recurrence of cyst. Conclusion The more extent of endometrioma adhesions was related to severer pelvic pain symptoms, longer operating time and more blood loss. Postoperative pain recurrence rate was observed in moderate-to-severe adhesion group. Extent of adhesions was irrelevant to cyst recurrence.

Objective To understand the condition of anxiety and analyze the influencing factors related to anxiety among nurses working in department of infectious diseases.Methods 206 nurses from 6 third class hospitals in Wenzhou were selected by simple random sampling method.A survey was carried out by using the socio-demo-graphic information questionnaire,working conditions questionnaire,self-rating anxiety scale and social support rating scale.Results The SAS score among nurses ranged from 36 to 72 points,and the average score was (48.32 ± 12.06)points,which was higher than the norm SAS value(t=14.39,P<0.01).The percentage of anxiety was about 55.33%.The percentage of moderate and severe anxiety was 16.51%.The main factors related to the anxiety among nurses were age(t=11.34,P<0.01),working years(t=5.68,P<0.01),moonlit night shift(t=4.42,P<0.05), worrying about making mistakes(t=7.18,P<0.01),worrying about occupational exposure(t=19.93,P<0.01) and nursing management of much criticism(t=5.68,P<0.01).Conclusion The condition of anxiety was serious among nurses working in department of infectious diseases.Interventions should be taken to reduce the anxiety level among nurses.

Objective To discuss the characteristics,diagnosis,mechanism and the prognosis of dilated cardiomyopathy (DCM) induced by accessory pathway (AP).Methods The clinical,electrophysiological and echocardiographic characteristics in four cases,who were diagnosed as AP-induced DCM in the Department of Pediatric Cardiology of Beijing Anzhen Hospital,Capital Medical University from Mar.2011 to Aug.2012,were analyzed before and after ablation.Results The electrocardiograms of the 4 patients all indicated type B ventricular preexcitation.The locations of the APs were the right-sided anteroseptum and the free wall.Dyschronous contractions between posterior wall of left ventricle and interventricular septum were demonstrated by M-Mode echo.The basal segments of the interventricular septum turned thin and moved similar to an aneurysm,with typical bulging during end-systole,which was observed in all cases by two-dimension echo.Dyschronous left ventricular contraction was shown by speckle tracing technique.All patients received successful radio frequency current ablations.Their physical activities and growth improved greatly in the 4 cases.The echocardiographic data demonstrated that their left ventricular contraction recovered to synchrony shortly after the ablation,left ventricular ejection fraction recovered to normal and left ventricular end diastolic diameter decreased to almost normal gradually during the follow-up.Conclusions Overt right-sided APs localized in anteroseptum or free wall may have adverse effects on ventricular wall motion and left ventricular function.They can even result in DCM.Dyssynchronous ventricular contraction induced by right-sided overt accessory pathway may be the vital mechanism.AP-induced DCM is an indication for ablation with good prognosis.

Objective To investigate the influence of treatment table with C-arm and immobilization device in IMRT planning accuracy, and to explore methods to solve this problem.Methods The solid water slabs and the ionization chamber was scanned and images were transmitted to the treatment planning system (TPS).Beam parameters in the TPS were set with 6 MV beam and 100 MU exposures were used.Measurements were performed at two different sizes of 5 cm×5 cm and 10 cm×10 cm.The gantry was rotated through angles from 0° to 180° with measurements taken at 5° increments.The measure point was set at center of the ionization chamber' measure point, which was also the central point of planning.The center axis of Matrix was aligned with the center of couch and was irradiated in accordance with the same conditions.OmniPro-FmRT software was used to compare and analyze the dose distribution of the radiation field of measurement and the treatment planning system output.Using the function of add constant value to find the appropriate coefficient to improve the plan total dose.The dose distributions for each beam in IMRT plans which was increased or unincreased total dose were measured for 6 patients with pelvic tumor respectively.Results In radiation therapy, treatment couch and immobilization device may attenuate radiotherapy dose.The impact of the incident range from 65°-70° and 115°-125° were the largest.Increasing the total dose of the treatment plan by 2％ could compensate the attenuation of the treatment table and immobilization device.Conclusions In radiation therapy, the impact of the incident range from 65°-70°, 115°-125° and another side of 290°-295° and 230°-245° should be avoided.The attenuation should not be neglected in the TPS and dose should be compensated by adjusting beams' MU.

Objective To investigate the effect and mechanism of melatonin on bioactivity of fibroblasts from human hypertrophic scar.Methods Fibroblasts from hypertrophic scar were cultured and incubated with melatonin,melatonin and Luzindole,and Luzindole,respectively,for 24 h,and the media as control.XTT/PMS assay was used to measure the proliferation of fibroblasts,ELISA assay to detect the TGF-β1 production of fibroblasts,and the expression of cell a-SMA,collagen Ⅰ,collagen Ⅲ mRNA were determined with real-time PCR method.Results Compared with the control,melatonin at the concentration of 10-5mmol/L,10-3mmol/L,and 1 mmol/L could inhibit the proliferation of fibroblasts in a does-dependent manner (P＜0.05); melatonin at the concentration of 10-3 mmol/L could significantly decrease the TGF-β1 production and expression of a-SMA mRNA and collagen Ⅰ mRNA in fibroblasts from human hypertrophic scar (P＜0.05) ; the effect of melatonin on fibroblast was significantly blocked by Luzindole (P＜0.05),but melatonin could not inhibit collagen Ⅲ mRNA expression (P＞0.05).Conclusions Melatonin can significantly regulate the biological activity of fibroblasts from human hypertrophic scar through a receptor pathway.