Objective:Application of interventional radiology equipment, through the introduction and materials in clinic,to better grasp the method of interventional radiotherapy and interventional radiology treatment,reduce adverse events in clinical application. Methods: Various imaging devices such as DSA, CT, MRI etc, imaging within the body structure, the size of the lesion and its relationship with the surrounding tissue by these devices can be very good;and the development of medical devices that need not operation, can accurately reach the lesion site for treatment. Results:At present, the interventional radiology doctors has to catheters or devicesinterventionalvascular branches, the digestive tract and other specific parts, used in the treatment of disease. Conclusion:Interventional radiology is an emerging treatment method as the development of modern science and technology. Interventional also has some adverse events radiotherapy applications, will damage the doctor and the patient's health and the impact of clinical diagnosis and other accidents, so do the crime prevention work is very important, so as to carry out the interventional radiology treatment.

Objective To investigate demographic factors implicated in the functional maturation of autologous arteriovenous fistula in a population of patients with end-stage renal disease. Methods The data of 335 consecutive patients with end-stage renal disease who were performed autologous arteriovenous fistula from January 2010 to December 2015 were analyzed retrospectively. The parameters affecting autologous arteriovenous fistula functional maturation were screened. Results Overall arteriovenous fistula functional maturation rate was 78.14%(218/279). The arteriovenous fistula functional maturation rate was 68.33%(82/120) in diabetes and 85.54%(136/159) in non-diabetes, and there was significant difference (χ2=11.844, P<0.01). The arteriovenous fistula functional maturation rate was 62.26%(33/53) in hypoproteinemia and 81.86%(185/226) in non-hypoproteinemia, and there was significant difference (χ2=9.648, P<0.01). Diabetes and hypoproteinemia were the risk factors to promote functional maturation (OR=6.003, 8.476). The arteriovenous fistula functional maturation rate was 87.10%(81/93) in calcium channel blockers using and 73.66%(137/186) in non-calcium channel blockers using, and there was significant difference (χ2=6.556, P<0.05). Calcium channel blockers was the protective factor for promoting functional maturation (OR=0.086). Conclusions Diabetes and hypoproteinemia are found to be associated with functional non-maturation, while calcium channel-blocker agents are associated with better functional maturation.

BACKGROUND:The relationship between the occurrence time and clinical symptoms of bone marrow edema in nontraumatic femoral head necrosis is stil controversial. OBJECTIVE:To evaluate the relationship of bone marrow edema in nontraumatic femoral head necrosis with Association Research Circulation Osseous (ARCO) staging and pain grading. METHODS: Forty-eight patients with nontraumatic femoral head necrosis (58 hips) were confirmed to have bone marrow edema on MRI T1 weighted images and T2 fat suppression images. Then, the patients were graded according to the MRI Classification Method reported by Zhao Pei-rong, the ARCO Staging System and Harris hip score for pain grading. We analyzed the correlation of bone marrow edema with ARCO staging and pain grading. RESULTS AND CONCLUSION:The incidence rate of bone marrow edema in ARCO I-III was increased in sequence, and the difference was statisticaly significant (χ2=27.69,P=0.001); the average rank of bone marrow edema in ARCO I-III was increased significantly (χ2=19.947,P=0.000). The incidence rate of bone marrow edema also increased among different pain grading, and the difference was statisticaly significant (χ2=57.0, P=0.000); the average rank of bone marrow edema among different pain grading was increased significantly (χ2=174.0,P=0.000). The presence and aggravation of bone marrow edema indicate the enlargement of necrosis area and the aggravation of symptoms in patients with nontraumatic femoral head necrosis, which can be used as an auxiliary index for the appraisal of disease progression.

Objective To learn the species distribution characteristics and proportion occurrence of methicillin-resistant strains about Staphylococcus detected in the First People′s Hospital of Kunming.Methods The species distribution characteristics and proportion occurrence of methicillin-resistant strains were analyzed retrospectively from January 2005 to December 2013.Results A total of 3 561 Staphylococcus strains were detected in 9 years,included 21 species and subspecies,and another 12 strains were not i-dentified to species.2005-2013 species composition showed an increasing trend,there were five kinds of Staphylococcus in 2005, until 2013 reach to 13 kinds.Each year the main bacterial were Staphylococcus aureus,Staphylococcus epidermidis,Staphylococcus haemolyticus and staphylococcal hominis.Methicillin resistant Staphylococcus aureus incidence decreased significantly since 201 1, decrease from 76.3% in 2010 to 25.6% in 2013.Staphylococcus epidermidis,Staphylococcus haemolyticus,Staphylococcal hominis and coagulase-negative Staphylococci resistant to high incidence of methicillin-resistant strains of the average,remained stable at a-round 70.0%.Conclusion The distribution characteristic of Staphylococcus in this hospital was increasingly complex year by year, the opportunity of infection caused by Staphylococcus was also increased,the detection rate of methicillin-resistant strains was high, it should be noted to use clinical drug rationally.

Objective To evaluate the anatomic changes and dosimetric variations of patients with nasopharyngeal carcinoma (NPC) during the course of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) by comparison of the dosimetric differences with or without replanning.Methods Twelve cases with NPC treated with SIB-IMRT underwent repeated CT scans after 20- 25 fractions of the initiation of therapy.The original treatment plan ( Plan1 ) based on the first CT scan ( CT1 ) and the second IMRT plan (Plan 2) based on the second CT scan (CT2) were calculated with an inverse planning system (Pinnacle3,Philips Medical System).In addition,the hybrid IMRT plan,Planl (CT2),was generated by deformable registration with MIMVISTA software,and the doses in Plan 1 ( CT1 ) and Plan 2 ( CT2 ) were accumulated based on CT2.The dosimetric differences were compared among the Plan 1 ( CT1 ),Plan 1 (CT2) and Plan 1 + 2(CT2).Results Compared with CT1,the mean volumes of the right and left parotid glands in the CT2 were significantly smaller by ( 24.6 ± 11.9 ) ％ and ( 35.1 ± 20.1 ) ％,respectively.Compared with Plan 1 ( CT1 ),the dose received by 95％ of the target ( D9s ) to PGTV,PTV1 and PTV2,and mean dose (D ) to PGTV,and PTV2 were all significantly lower in the Plan 1 (CT2),indicating that the doses to targets decreased without replanning.With repeated CT and replanning after 25 fractions as shown in Plan 1 + 2 (CT2),the doses to targets would be improved.The doses to normal tissue were increased without replanning,although no statistical significance was observed.In 5 of 12 cases,the doses to the spinal cord and brainstem exceeded the constraint without replanning,while the corresponding values decreased with replanning.Conclusions During the course of IMRT for cases with NPC,the volumes of the targets and parotid glands decrease significantly.Mid-treatment CT scanning and replanning should be recommended to ensure adequate doses to the targets and safe doses to the normal tissues.

Objective To investigate the effect of unfractionated heparin (UFH) on the expression of heme oxygenase-1 (HO-1) in intestinal mucosa of mice with sepsis.Methods Thirty-six male C57BL/6J mice were randomly divided into sham group,cecal ligation and puncture (CLP) group and UHF group,n =12 in each group.Model of intestinal injury in sepsis was induced by CLP.In sham group,the mice were exposed without ligation of cecum.In UFH group,the mice were treated intravenously with 8 U of UFH via the tail vein half an hour before the operation and 12 hours after the surgery respectively.Six mice in each group were randomly chosen at 4 hours and 24 hours after operation to collect inferior vena venous blood samples and terminalileum tissues.The serum levels of interleukins (IL-1 β,IL-6),and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA).The serum level of D-lactate was determined by colorimetry.Pathological changes of ileum tissue and Chiu score were observed after hematoxylin eosin (HE) staining.The HO-1 expression was detected immunohistochemically.Results In sham group,no significant changes in the serum levels of IL-1 β,IL-6,TNF-α and D-lactate were observed.Twenty-four hours after the operation,the structure of intestinal mucosa was basically normal without obvious pathology change and no HO-1 positive cells were found.The serum levels of IL-1 β,IL-6,TNF-α,and D-lactate in CLP group were gradually increased,and they were significantly increased as compared with sham group [IL-1 β (ng/L):40.87±2.88 vs.22.60±2.05 at 4 hours,113.73±3.96 vs.22.07±2.74 at 24 hours;IL-6 (ng/L):63.89±3.26 vs.44.89±3.38 at 4 hours,176.56±5.45 vs.45.76±4.02 at 24 hours;TNF-α (ng/L):194.62± 14.13 vs.152.05±6.22 at 4 hours,599.62± 10.20 vs.155.90± 14.18 at 24 hours;D-lactate (mmol/L):0.24± 0.02 vs.0.19 ± 0.01 at 4 hours,0.33 ± 0.04 vs.0.20 ± 0.02 at 24 hours,all P ＜ 0.05].Twenty-four hours after the operation,edema and inflammation in ileal mucosa,intestinal villi structural damage were observed,the Chiu score was significantly higher than those in the sham group [4.5 (3.0-5.0) vs.0 (0-1.0),P ＜ 0.05],and a small amount of HO-1 positive cells were localized in the intestinal mucosa.Compared with CLP group,the serum levels of IL-1 β,IL-6,TNF-α,and D-lactate of UFH group were significantly decreased [IL-1 β (ng/L):31.53 ± 2.90 vs.40.87 ± 2.88 at 4 hours,61.13 ± 2.80 vs.113.73 ± 3.96 at 24 hours;IL-6 (ng/L):51.16 ± 5.68 vs.63.89 ± 3.26 at 4 hours,81.16 ± 4.54 vs.176.56 ± 5.45 at 24 hours;TNF-α (ng/L):171.76± 5.60 vs.194.62± 14.13 at 4 hours,328.48 ± 10.79 vs.599.62± 10.20 at 24 hours;D-lactate (mmol/L):0.21 ±0.01 vs.0.24±0.02 at 4 hours,0.24±0.02 vs.0.33±0.04 at 24 hours,all P ＜ 0.05].Twenty-four hours after the operation,intestinal injury was ameliorated,the Chiu score was significantly lower [1.5 (1.0-5.0) vs.4.5 (3.0-5.0),P ＜ 0.05],and HO-1 positive cells in the intestinal mucosa was remarkably increased.Conclusion UFH can enhance the expression of HO-1 in intestinal mucosa,reduce the release of inflammatory factors,ameliorate the intestinal inflammatory response,and thus play a protective role in intestinal tissue in mice with sepsis.

Use of the existing data to analyse the situation for Military progress prizes in science and technology,medical achievement prizes,Army logistics major science and technology achievement award of Nanjing Military Commands health system from the eighth five-year plan period to the eleventh five-year plan.It shows that the medical research is overall increase during the ninth five-year plan period and downturn during the tenth five-year plan period,then the lever picks up again during the eleventh five-year plan period.This suggests that the improve the quality and quantity of the achievement in science and technology is effected by subject scale and scientific research innovation factors.Then put forward some countermeasures and suggestions for guiding the project direction of subject research,expanding the scale of subject,introducing high quality talents actively,using the incentive mechanism to strengthen the innovation of science and technology and expressing the special advantage to speed up the transformation of scientific and technological achievements.

Objective To explore the clinical head nurses'effective competence through interviewing nursing supervisors by in depth interview method and to provide reference for constructing training content for clinical head nurses in Macau and Guangzhou.Methods In depth interview was carried out among 8 nursing supervisors from 2 hospitals in Macau and 9 nursing supervisors from 2 tertiary hospitals in Guangzhou.Content analysis was utilized through organizing records and then forming written documentations.Results The themes were drawn after the interview,which were good moral character accomplishment,good communication skill,prospective and creative thinking,favorable executive ability.Forwardlooking and innovative were significantly different in Macau and Guangzhou.Conclusions The effective clinical head nurses' competence is multi-faceted,the results can provide reference for selection,evaluation and training for head nurses.

Objective:To study the effect of endoscope on the treatment of Hepatocellular Carcinoma (HCC) combined with biliary tract obstrucition (BTO).Methods:We have analyzed retrospectively the results of twelve patients suffering from HCC combined with BTO from 5,1990 to 5,2000.Among these cases,various reasons were found.5 of them were intrabilitary cancer embolus,7 were billary calculus.7 of them were treated with endoscope and following surgical resection,1 was treated with endoscope、TAE and resection,the 3 rest of them were solely treated with endoscope.Results:Of all the 12 cases,1 died of resection,2 failed to follow the survey,these 3 cases above took 25%;among the rest of 9 cases,2 of them survived for 3 to 6 months,3 for half to 1 year,3 for 1 to 2 year,1 for at least 2 years.Those cases suviving for more than 1 year were received surgical resection.Conclusions:We should have no fixed way but to deal with each patient of HCC combined with BTO on his/her merits.As our recognition towards them began accumulating,we found that,in the early stage of obstruction,active endoscopic treatment would prove to be preferable.If combined with other therapy such as surgical resection and TAE,Endoscopy would improve the curative effect of HCC combined with BTO substantially.

Pancreatic cancer is a commonly malignant gastrointestinal tumor with an significantly increasing incidence.Those patients without nonspecific symptoms at early stage had mostly lost the opportunity of surgical therapy when pancreatic cancer was detected at advanced stage,and its prognosis is poor.Therefore,it is rather important to improve the early diagnosis of pancreatic cancer.In recent years,proteomics is developing rapidly.Proteomics technologies have been widely used in clinical research.Using proteomics technology screening pancreatic cancer tumor markers becomes the research focus,thus we try to find a kind of or a group of pancreatic tumor markers,so as to improve the diagnosis of pancreatic cancer.