Objective To explore the key points of graded nursing care to rectal cancer patients with radioactive proctitis induced by preoperative neoadjuvant chemoradiotherapy.Methods The clinical data of 162 rectal cancer patients undergoing neoadjuvant chemoradiotherapy were analyzed retrospectively. The experience of grading nursing care for patients with radioactive proctitis induced by neoadjuvant chemoradiotherapy was summarized.Results Of 162 patients,radioactive proctitis occurred in 110 patients(67.9%).Among the 110 patients with proctitis,62(38.3%)were grade I radioactive proctitis,29(17.9%)gradeⅡand 19(11.7%)gradeⅢ.The graded nursing was done to the patients with radioactive proctitis and achieved good effect.Conclusions Radioactive proctitis has a high incidence in rectal cancer patients with preoperative neoadjuvant chemoradiotherapy and graded nursing care can reduce the distress of patients with radioactive proctitis effectively and promote wound healing,thus to improve their quality of life.

Objective To observe the efficacy of intense pulsed light(IPL)incorporated with optimal pulse technology (OPT)in the treatment of rosacea.Methods Thiris-two patients with erythematotelangiectatic rosacea and 53 patients with papulopustular rosacea were treated with IPL-OPT for 4 sessions with an interval of 3 weeks.Patients were assessed clinically and photographically by physicians before each treatment.Skin melanin index,erythema index,sebum secretion level and water content in stratum corneum were tested at the baseline,3 weeks after each treatment,and 6 months after the last treatment.Results Three weeks after the last treatment,the effective(more than 60%improvement)rate WaS 81.18%in total,75%in erythematotelangiectatic rosacea,and 84.91%in papulopustular rosacea;there WaS no significant difference between erythematotelangiectatic rosacea and papulopustular rosacea (x2=1.28,P＞0.05).Six months after the last treatment,the total effective rate still remained at 78.82%with no significant difierence from that observed at 3 weeks after the treatment(x2=1.62,P＞0.05).The value of melanin index,erythema index and sebum secretion level decreased significantly after the final treatment,however,water content in stratum corneum remained at the salne level as that before treatment.After 6-month follow-up,no significant change was noticed in the above 4 parameters compared with those obtained at 3 weeks after the treatment.Neither hyperpigmentation nor hypopigmentation was observed during the treatment and follow-up.Conclusion This study demonstrates that IPL-OPT is an effective treatment for rosacea with relatively few side effects.

Objective To compare the efficacy and safety of the non-invasive high frequency ventilation (NHFV) and non-invasive intermittent positive pressure ventilation (NIPPV)in neonates with respiratory distress syndrome (RDS) after extubation.Method Neonates with RDS from January 2015 to January 2016,who required high frequency ventilation after birth and were extubated after treatment were retrospectively studied.The enrolled patients were divided into NHFV group and NIPPV group to compare the rate of successful extubation within 7 days,non-invasive respiratory ventilation support time and complication incidence.Result In total 42 neonates were included,NHFV group were 21 cases and NIPPV group were 21 cases.The rates of successful extubation were not statistically different (71.4％ vs.80.9％,P ＞ 0.05);Compared with NIPPV group,NHFV group had shorter ventilation time [3.5 (2.2,4.1) d vs.4.6 (2.8,5.3)];the incidence of bronchopulmonary dysplasia,pneumothorax,intraventricular hemorrhage,periventricular leukomalacia,retinopathy of premature and necrotizing enterocolitis between groups were not statistically different (P ＞ 0.05).Conclusion NHFV is a new safe and efficient ventilation support method for extubated neonates,and needs further research.

Objective To evaluate the impact of three to four cycles of neoadjuvant chemotherapy (NACT) on the survival of patients with N2-N3 nasopharyngeal carcinoma (NPC).Methods The clinical data of 915 patients with T1-4N2-3M0 NPC from 2007 to 2010 were retrospectively analyzed.A total of 179 patients treated with 3-4 cycles of NACT (NACT≥3 group) were matched with 358 patients treated with 2 cycles of NACT (NACT=2 group) and 179 patients treated without NACT (NACT =0 group,concurrent chemoradiotherapy group) for age,N stage,pathological subtype,and NACT regimen.The Kaplan-Meier method was used to calculate overall survival (OS),disease-free survival (DFS),recurrence-free survival (RFS),and distant metastasis-free survival (DMFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox proportional hazards model was used for multivariate prognostic analysis.Results For the NACT≥ 3,NACT =2,and NACT =0 groups,the 5-year OS rates were 89.4％,81.6％,and 73.7％,respectively (P=O.000),the 5-year DFS rates were 83.2％,69.8％,and 64.2％,respectively (P=O.000),the 5-year RFS rates were 86.0％,76.0％,and 69.3％,respectively (P=0.001),and the 5-year DMFS rates were 86.6％,76.0％,and 68.3％,respectively (P=0.000).Three to four cycles of NACT was an independent protective factor for OS,DFS,RFS,and DMFS in patients with N2-N3 NPC.Conclusion Three to four cycles of NACT can significantly improve the survival of patients with N2-N3 NPC.

Objective To study the expression and significance of cyclin A1 in the skin of wild-type mice at RNA level.Methods Thirty 6-12-week old wild-type Kunming mice(15 male and 15 female)were included in this study.In situ hybridization was used to detect the expression of cyclin A1 mRNA in the skin of head and neck of the mice.The skin treated without probe was regarded as negative control and the testis of male mice was taken as positive contr01.Results The expression of cyclin A1 mRNA was found in sebaceous glands of 25 mice and in epidermis of 12 mice.Strong positive staining of sebaceous glands was seen in 50% and positive staining in 33.3% of sections,whereas strong positive and positive staining of epidermis was seen in 13.3% and 20% of sections.respectively.The positive rate of sebaceous glands was 83.3%,much higher than that of epidermis(33.3%).Conclusions There is a quite high expression of eyelin A1 mRNA in the skin sebaceous gland and epidermis of head and neck of wild-type mice.Especially a strong expression is in the sebaceous glands.It indicates that cyclin A1 mRNA may play a certain role in the physiological function of sebaceous glands and epidermis of the skin.

Objective To assess the effectiveness of the combined treatment model for Wilms'tumor and to improve treatment results.Methods Fifty-five patients diagnosed with Wilms' tumor between July 1981 to June 2010 were analyzed retrospectively.Eighteen patients were diagnosed by preoperative ultrasound-guided fine needle biopsy,and 53 patients were confirmed by postoperative pathology results.Seven cases were in clinical stage Ⅰ,19 cases in clinical stage Ⅱ,21 cases in stage Ⅲ,six cases in stage Ⅳ and two cases in stage Ⅴ.Thirty-five cases had histopathological subtype,30 cases had the favorable type,and five cases had the unfavorable type.Among the 55 patients,kidney tumor resection was performed on 48 cases,wide edge partial nephrectomy was performed on two cases,tumor enucleation was performed on one bilateral renal tumor case,kidney tumor resection with pulmonary metastasectomy was performed on two cases,and two cases had no surgical procedures.Eighteen cases received preoperative chemotherapy,40 cases received postoperative chemotherapy,and 12 cases received postoperative radiotherapy.Patients were grouped according to age,stage,histological type,treatment model,treatment course and whether or not they had radiotherapy.The Kaplan-Meier method was used in the evaluation and comparison of over survival (OS),disease free survival (DFS) and relapse free survival (RFS) of the different groups to reveal the relationship between different grouping factors with the prognosis of Wilms' tumor. ResultsThe median of follow-up was 34 mon ( ranging from 3 to 355 mon).The 3-year OS,5-year OS and 2-year DFS were 77.6％,69.0％ and 52.4％,respectively.The differences of OS in different stages ( P =0.006 ),DFS between pure operation group and combined therapy group ( P =0.004 ) and RFS between radiotherapy group and no radiotherapy group ( P =0.03 ) were significant,P ＜ 0.05.ConclusionsThe normative multi-disciplinary treatment model for patients with Wilms' tumor can achieve good results and is well tolerated.

Objective To investigate the protective effect of green tea-based cream at different con- centrations on photoaging and photo-immunosuppression. Methods Twenty healthy female volunteers were enrolled into this study with informed consent. Green tea-based cream with a mass fraction of 2%-5% (pre- pared by adding green tea extracts to an emollient formulation), excipient or green tea extracts alone were applied to six unexposed sites on the back of these volunteers. Thirty minutes later, these treated sites were subjected to solar-simulated ultraviolet irradiation (ssUVR) with a 1.5-fold minimal erythema dose once a day for 4 days. At 6, 24 and 48 hours after the last irradiation, green tea-based cream were applied repeatedly to the corresponding sites. Biopsy specimens were obtained from the seven sites 72 hours following the last irradiation, and immunohistochemical staining was performed to detect cytokeratin 5/6 and 16 expression, as well as the densities of CDla- or HLA-DR-positive cells. Resttlts Green tea-based cream at a mass fraction of 2% to 3% could effectively prevent ssUVR-induced obvious erythema and hyperpigmentation. The posi- tivity (+) rates plus strong positivity (++) rates reached 50% and 25% for CK5/6 in the sites treated with ssUVR only and those irradiated and protected with green tea cream at a mass fraction of 3%, respectively, 69% and 31% in the sites treated with ssUVR only and those irradiated and protected with green tea-based cream at a mass fraction of 2%, respectively. Compared with the control site without irradiation or protec- tion, a decrease over 75% was noticed in the density of epidermal CD1a- or HLA-DR- positive Langerhans cells in the irradiated sites without protection, and green tea-based cream, especially those at a mass fraction of 3%, could effectively inhibit the density decrease. Conclusion Green tea extracts could effectively pro- tect skin from photoaging and photo-immunosuppression with the optimal mass fraction at 2% or 3%.

The education of rehabilitation therapy is important in the modern rehabilitation medicine education. The course of rehabilitation therapy specialty cannot meet the needs of the education. Hubei University of Medicine reformed the course arrangement, textbook construction, method and content of teaching from 2008 to develop the rehabilitation therapists with modern ideas

Objective:To compare 5-year overall survival (OS) and disease free survival (DFS) between preoperative three dimensional conformal radiotherapy (3DCRT) and volumetric medulated arc therapy (VMAT) concurrently combined with chemotherapy for locally advanced rectum cancer (LARC), and analyze the value of induction and/or consolidation chemotherapy in these circumstances.Methods:334 patients with LARC treated with preoperative 3DCRT (172 cases) and VMAT (162 cases) concurrently combined with chemotherapy, main protocol XELOX (capecitabine plus oxaplatin), and subsequent surgery in Sun Yat-sen University from May 2007 to April 2013 were retrospectively analyzed. The radiation prescription dose for VMAT group was 50 Gy 25 fractions for planning target volume1(PTV 1), and 46 Gy 25 fractions for PTV 2. The radiation prescription dose for 3DCRT group was 46 Gy 23 fractions for PTV 2. One hundred and eighty-five cases of all received preoperative concurrent chemoradiotherapy (namely, CCRT group), 149 cases received preoperative concurrent chemoradiotherapy plus median 2 courses (1-7 courses) induction and/or consolidation chemotherapy (namely, CCRT±induction chemotherapy±consolidation chemotherapy group), whose main chemotherapy protocol was XELOX. Difference of 5-year OS and DFS between 3DCRT and VMAT group was compared. The rate differences of acute toxicity during chemoradiotherapy, postoperative complications, ypCR, and survival between CCRT group and CCRT±induction chemotherapy±consolidation chemotherapy group were analyzed. Results:After a median follow-up of 62.3 months (2.4-119months) for the 334 patients, no any significant difference for 5-year OS (79.0% vs. 83.2%, P=0.442) and 5-year DFS (77.0% vs. 82.1%, P=0.231) between 3DCRT and VMAT group was observed. There was no any significant difference for the Grade 3 hematological toxicity (7.0% vs. 12.1%, P=0.114) and non-hematological toxicity (14.1% vs. 16.8%, P=0.491) during chemoradiotherapy, postoperative complications (17.3% vs. 17.4%, P=0.971), ypCR rate (25.4% vs. 30.2%, P=0.329), 5-year OS (80.5% vs. 82.0%, P=0.714) and 5-year DFS (78.8% vs. 81%, P=0.479) between CCRT group and CCRT±induction chemotherapy±consolidation chemotherapy group. Conclusions:Compared with 3DCRT, the physics advantage of VMAT technique does not significantly convert into clinical benefits and improve 5-year OS and DFS, even further boosting radiation dose to the gross tumor volume. It is safe for median 2 courses of induction and/or consolidation chemotherapy before and or after preoperative concurrent chemoradiotherapy in the treatment of LARC, though it does not significantly improve ypCR rate and survival.

Objective To analyze the possible association of psoriasis vulgaris with herpes simplex virus type 1 (HSV-1). Methods Polymerase chain reaction was used to detect HSV-1 DNA in lesional skin biopsies, periphery blood mononuclear cells (PBMCs)and throat swabs from patients with psoriasis vulgaris, and ELISA was used to detect IgM and IgG antibodies against HSV-1 in sera from these patients. Results The positive detection rates of HSV 1 DNA in lesional skin biopsies, PBMCs and throat swabs were 37.5%, 18.6%and 18.8%, respectively. Anti HSV 1 IgM and IgG antibodies were positive in 37.2%and 53.5%of serum specimens, respectively. The detection rates of HSV 1 DNA in lesional skin biopsies and PBMCs, and IgM antibody in sera were significantly higher than those in normal controls. In psoriatic patients of guttate type the positive detection rates of HSV 1 DNA and IgM antibody were significantly higher than those in the plaque type. Conclusions There is strong association of psoriasis vulgaris, especially the guttate type, with HSV 1, and there may be recent infection of HSV 1 in these patients.