Objective To evaluate the clinical value of stereotactic radiotherapy for the treatment of metastatic hepatic carcino-ma .Methods 42 patients with metastatic hepatic carcinoma (metastases≤3 ,maximum tumor diameter≤5 cm)were treated with Co60 stereotactic radiotherapy alone .The prescription isodose of PTV was 3 .5-4 .5 Gy ,total 10 times ,the median survival time ,lo-cal control ,complication and RILD(radiation-induced liver disease) of the patients were assessed .Results The median survival date was 7 .9 months ,2 cases were complete remission ,the local control rates was 69% ,27 cases were partial remission ,and there was no serious adverse side effect ,such as severe radiation-induced hepatic injury .Conclusion The stereotactic radiotherqpy was a good choice for inoperable metastatic hepatic carcinoma .

Medical psychology master's degree graduate student course mainly includes basic cour-ses, professional courses and psychological skills training, professional practice skills learning and scientific research quality training. Due to the constraints of discipline development starting late, teachers being rela-tively weak and other objective factors, in curriculum setting, there exist problems of unclear objectives, confusing the primary with secondary, unclear standard, lacking principles, and in particular, there are obvious deficiencies in the training and cultivation of students' ! professional skills . Based on the above objective problems, we made preliminary discussion on the training objectives, the main problems, curricu-lum setting, assessment standards and principles to follow, in order to achieve the purpose of cultivating high-level application-oriented talents through curriculum design and teaching practice.

Objective To investigate the effect of super-aged multilevel cervical spondylosis different surgical treatment op tions Abstract Objective.Methods Selected July 2010 Ultra old multilevel cervical spondylosis March 2015 in our hospital 80 ca ses,the anterior cervical corpectomy and fusion (ACCF) and by anterior discectomy and fusion (ACDF) included anterior group,the posterior laminoplasty (PCL) included in the posterior group,the clinical efficacy of two groups were compared,and postoperative conditions and cervical spinal cord injury rates before and after treatment (JOA score),cervical Disability index (NDI index),lordosis and cervical spine.Results Anterior group of 43 cases,including 28 cases of excellent(65.12％),5 cases of good (11.63％),7 cases of moderate(16.28％),3 cases of poor(6.98％),the good rate was 76.74％;posterior group 37 cases,including 24 cases of excellent(64.86％),3 cases of good(8.l1％),6 cases of moderate(16.22％),4 cases of poor(10.81％),the good rate was 72.97 ％.The difference has no statistically significant (P＞0.05) in good rate.Anterior operative time was significantly higher than the posterior group (P＜0.05),blood loss,hospital stay was significantly lower than the posterior group (P＜0.05),the time of symptoms disappeared has no significant difference in two groups(P＞0.05).After treatment,patients in posterior group,the JOA score,cervical activity significantly were higher than the anterior group,lordosis anterior group were significantly higher than the posterior group,the difference was statistically significant (P＜0.05).Conclusion Anterior super aged multilevel cervical disease,posterior approach has achieved good clinical efficacy but greater advantage posterior surgery in patients with long term im provement in the cervical spine function.

Objective Knowledge?based radiotherapy ( KBRT ) can reduce the plan quality variability induced by different experiences between physicians and improve the quality of treatment plans. Methods The Varian Rapid Plan system was used to train a dose?volume histogram ( DVH) prediction model. The obtained model was preliminarily applied to semi?automatic design of the preoperative treatment plans for rectal cancer. Eighty high?quality volumetric modulated arc therapy plans were imported into the model training set of the Rapid Plan system. The structures of the plans were matched to the corresponding labels and codes as listed in the library. The training started after the verification of prescription. The residual plots,regression curves,geometric plots for organ at risk ( OAR) ,in?field DVH plots,and model training logs were examined. After removal of the mismatch, the original plans were assessed to rule out outliers and influential data points. More similar plans may be added for another round of training. Ten KBRT plans were designed using the final model and compared with the clinical plans. Results For the two major OARs,the femoral head and bladder,the average goodness of fit of the principal component were 0?999 415/1.0 and 0?999 963/1.0 for the DVH model,and 0?999 651/1.0 and 0?999 945/1.0 for geometry?based expected dose model,respectively. In all the plans, 11 had Cook ’ s distance values exceeding the tolerance and 4 had studentized residual values exceeding the tolerance. The outliers were all kept in the training set to generalize the scope of the model. The 10 KBRT plans had significantly improved homogeneity indices for PGTV and PTV than the original plans (P=0?00,0?04).The 10 KBRT plans also had significantly reduced D50% to the femoral head and bladder as well as significantly reduced mean doses to the bladder than the original plans (P=0?042,0?000,0?005). Conclusions In this study,the Rapid Plan system is used to train a KBRT model for design of preoperative radiotherapy plans for rectal cancer. The results of preliminary application meet the clinical requirements.

Objective:To study the antibacterial activity of sanguisorba tannin extract in vitro and its mechanism in the antibacterial effect on staphylococcus aureus. Methods:The antibacterial effect of sanguisorba tannin extract was studied by an Oxford-cup method and a tube double dilution method. With staphylococcus aureus as the tested bacteria, extracellular alkaline phosphatase (AKP), potassium ion, soluble protein and T-ATPase were determined. The changes in protein bands and the cell ultrastructure were respectively observed by SDS-PAGE and TEM to illustrate the antibacterial mechanism. Results:The results showed that sanguisorba tannin extract was effec-tive against the gram-positive bacteria, while the effect against the gram-negative bacteria was weak. After staphylococcus aureus was trea-ted with sanguisorba tannin extract, the contents of alkaline phosphatase (AKP), potassium ion, soluble protein, DNA, RNA and the other large molecules were increased obviously when compared with those in the control group. The concentrations of intracellular and ex-tracellular ATP were significant changed. DS-PAGE showed that staphylococcus aureus treated with sanguisorba tannin extract had no pro-tein band formation. TEM showed that the cell integrity was damaged. Conclusion:Sanguisorba tannin extract shows strong antibacterial activity, which can change the cell membrane permeability and damage the cell integrity.

Objective To investigate the efficacy and safety of immediate intravesical instillation combined with short-term maintained intravesical instillat.ion chemotherapy of pirarubicin (THP) after operation for preventing postoperative recurrence of superficial bladder tumor.Methods One hundred and seven patients with superficial bladder tumor were divided by random digits table method into two groups:group A (50 cases ) was treated with immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy after operation,and group B (57 cases) was treated with conventional intravesical instillation chemotherapy.Patients in group A underwent intravesical instillation of THP within 24 hours,maintained intravesical instillation once a week for 8 weeks.Patients in group B underwent intravesical instillation of THP in one or two weeks after operation,once a week for 8 weeks.And then once a month for 10 months.All patients were followed up with regular cystoscopy examination.Results Patients were followed up for 13-84 months,the incidence of partial vesical toxic reaction in group A was 26.00 ％ (13/50),general symptom rate was 4.00％ ( 2/50 ),the rate of recurrency was 16.00％ ( 8/50 ).The incidence of partial vesical toxic reaction in group B was 22.81％( 13/57 ),general symptom rate was 1.75％( 1/57 ),the rate of recurrency was 19.30％ (11/57).There was no significant differences between two groups (P ＞ 0.05 ).Conclusions Immediate intravesical instillation of THP after operation is safe and effective,but it is not suitable for patients with obvious bladder perforation and large wound surface of bladder mucosa after transurethral rescection.Immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy of THP after operation for preventing postoperative recurrence of superficial bladder tumor is effective and well tolerated.

Objective To explore the prognostic value for cardiovascular events of elevated NT-proBNP in coronary heart disease(CHD) patients with metabolic syndrome(MS).Methods The level of NT-proBNP was measured in 165 CHD patients with MS diagnosed by coronary angiography.After 2 years follow-up,we recorded the corresponding cardiovascular events in those patients.Results The NT-proBNP level was much higher in ACS group than that in SCHD group( P ＜ 0.01 ).There were totally 45 events after 2 years.After adjustment of traditional risk factors including hypertension,diabetes,smoking history and high sensitivity C reactive protein( hs-CRP),Cox proportional hazard analysis indicated that high NT-proBNP level( ＞ 111.58ng/L)was an independent risk factor for future events (relative risk 2.67,P ＜0.01 ).Conclusion Elevated NT-proBNP level might be one of the independent risk factor for cardiovascular events in CHD patiens with MS.

Objective To improve the effects of health education(HE)and satisfaction degree on HE of inpatients by executing hierarchical full-responsibility nursing. Methods Fourteen wards were randomly chosen form the hospital and divided into the control group and the experimental group, each group having 7 wards. The control group carried out routine holistic nursing model, and the experimental group carried out a new hierarchical full-responsibility nursing system. Reforming nursing scheduling and diminishing the nursing unit to assure that the patients acquired the continous and stable nursing service when they were in hospital. The effect and the degree of satisfaction of HE were compared between two groups after 6 months. Results The effects of HE in the experimental group were significantly better than those in the control group, and the degree of satisfaction on HE in the experimental group was much higher than in the control group. Conclusions The hierarchical full-responsibility nursing system can give patients systematic and normalized HE. It can significantly improve the effects and the degree of satisfaction on HE.

Recent studies reported that thymoquinone (TQ), a component derived from the medicinal spice Nigella sativa (also called black cumin), exhibited inhibitory effects on cell proliferation of many cancer cell lines. This study was performed to investigate the anti-metastatic effect of thymoquinone on the pancreatic cancer in vitro and in vivo. The results showed that thymoquinone suppressed the migration and invasion of Panc-1 cells in a does-dependent manner. To investigate the possible mechanisms involved in these events, Western blotting analysis was performed, and found that thymoquinone significantly down-regulates NF-kappaB and MMP-9 in Panc-1 cells. In addition, metastatic model simulating human pancreatic cancer was established by orthotropic implantation of histologically intact pancreatic tumor tissue into the pancreatic wall of nude mice. And administration of thymoquinone significantly reduced tumor metastasis compared to untreated control. Furthermore, the expression of NF-kappaB and MMP-9 in tumor tissues was also suppressed after treatment with thymoquinone. Taken together, the results indicate that thymoquinone exerts anti-metastatic activity on pancreatic cancer both in vitro and in vivo, which may be related to down-regulation of NF-kappaB and its regulated molecules such as MMP-9 protein. Consequently, these results provide important insights into thymoquinone as an antimetastatic agent for the treatment of human pancreatic cancer.

OBJECTIVE: To observe the changes of endothelium-dependent dilation (EDD) of patients with congestive heart failure (CHF) before and after Kanli Decoction treatment. METHODS: Thirty-five CHF patients were treated with Kanli Decoction. We used color Doppler ultrasound to monitor the flow-mediated dilation (FMD), pulsatile index (PI), resistance index (RI), baseline blood flow (BF), ejection fraction (EF) before and after the treatment. RESULTS: FMD after treatment (9.26+/-3.19) were obviously higher than that before the treatment (7.06+/-2.58) (P<0.05), but BF, PI and RI were not improved. CONCLUSION: Applying color Doppler ultrasound into observation on EDD of patients suffering from CHF and treated by the Kanli Decoction shows that the CHF could be treated by traditional Chinese medicine.