Objective To evaluate the value of transcatheter arterial embolization(TAE) in the treatment of intractable epistaxis.Methods TAE using gelform or polyvinyl alcohol(PVA) particles of forty-one patients with intractable epistaxis were undertaken by the femoral artery approach,through selective catheterization of involved maxillary artery or the bleeding arteries for the stopage of bleeding..Results Of the forty-one patient,39 cases were cured by once TAE and the other 2 with recurrent bleeding on the next day after the TAE,to whom a second interventional treatment fullfilled the requirement.Conclusions Transcatheter arterial embolization is a simple,safe and effective treatment for the intractable epistaxis.

Objective To evaluate the effect of Astragalus on T lymphocyte immune function in peripheral blood and intestinal mucosa of immature rats with obstructive jaundice. Methods Three-week-old Wistar rats were randomly divided into four groups(n=12,in each):control group, sham operation group, obstructive jaundice(OJ)group,OJ+Astragalus (OJ+A)group.The percentage of CD4 and CD8 T lymphocytes, the ratio of CD4 to CD8 in peripheral blood and intestinal mucosa of immature rats was detected by flow cytometry. Result The percentage of CD4+ cell and the ratio of CD4 to CD8 in the OJ group were lower than those in the control group and the sham operation group,with significant difference(P＜0.05).The percentage of CD4 cell and the ratio of CD4 to CD8 in the OJ+A group were higher than those in the OJ group(P＜0.05).Conclusion Astragalus can increase T lymphocyte immune function in OJ immature rats.

Under the condition of information society, we should cultivate students'!ability of infor-mation literacy and innovation. Based on the early investigation of medical students'!information ability and scientific research quality, we carried on a staged and systematic subject-oriented information literacy training for post-graduate students in specialty of anesthesiology through such measures as enriching infor-mation resources, strengthening students'!awareness of information, the implementation of the supervisor group system or double tutor system, and other measures, which strengthened the graduate students' ! independent study ability and scientific research quality. The related practice can provide reference for the development of information literacy education in colleges and universities.

One of the major responsibilities for medical students is to save lives and to popularize emergency medical treatment knowledge for the masses of society.Based on research analysis,systemic training of cardiopulmonary resuscitation program including lectures,simulation education and social practice were performed for medical students.After practice activities,these students could proficiently apply the basic knowledge and skills of cardiopulmonary resuscitation in practical work and spread what they have learned to the public.Furthermore the program could improve students' abilities in social practice and team spirit and it is of great social significance.

Objective To explore the clinical value of the interventional and comprehensive treatment of iliac-femoral venous thrombus(I-FVT).Methods 32 patients with I-FVT were underwent interventional therapy.First the filter was implanted into the inferior vena caval via opposite side of femoral vein,then the catheteres were implanted into the pathologic regions within the vena to process the emboluses,and balloon-directed extend when necessary.Results The procedure of treatment was successful in all patients.The iliac-femoral veins were patent,swollen and pain symptom of lower limb disappeared gradually after operation.The followed-up study the longest period for 30 months showed no severe complications and recurrence.Conclusion The interventional and comprehensive therapy is of ideal effect on treating I-FVT,occuring interventional and comprehensive treatment has ideally effect to cure the patients with I-FVT.

ObjectiveTo analyze the correlation between primary tumor volume (PTV) and prognosis of nasopharyngeal carcinoma ( NPC ) treated by intensity-modulated radiotherapy ( IMRT ).Methods330 NPC patients treated by IMRT were included.Pretreatment computerized tomography image were input into tree-dimensional treatment-planning system,in which the primary tumor volume were calculated automatically.The receiver operating characteristic curve was used to determine the best cut-off point of PTV.Within the framework of UICC 2002 T stage,The PTV was divided into four groups:V1 ＜ 10cm3,V2 10-25 cm3,V3 ＞ 25-50 cm3 and V4 ＞ 50 cm3.Kaplan-Meier and Logrank test was used to analyze the survival,Cox proportion risk regression model were used to analysis the correlation between PTV and prognosis.ResultsThe mean PTV for all NPC patients was ( 34.2 ± 27.1 ) cm3 with the range of 0.4- 153.7 cm3.The 3-year overall survival for V1,V2,V3 and V4 stage were 88.6％,90.0％,91.2％ and 74.2％,respectively (x2 =12.83,P =0.005 ).There was no significant difference among V1,V2 and V3in terms of overall survival ( x2 =1.96,P =0.376).The 3-year distant metastasis-free survival and diseasesfree survival or overall survival were decrease in PTV ＞50 cm3 and PTV≤50 cm3 (77.4％:89.9％,x2 =7.24,P=0.007and 64.5％:85.1％,x2 =13.95,P=0.000 or 74.2％:90.3％,x2 =11.76,P=0.001).Multivariate analysis revealed that PTV was a adverse prognostic factors for overall survival (x2 =0.00,P =2.580).ConclusionOur data showed that the primary tumor volume had significantly impacted on the prognosis of NPC patients treated by intensity modulated radiotherapy.

Objective To observe the clinical efficacy of narrow-band ultraviolet B (NB-UVB) in the treatment of the patients with atopic dermatitis (AD) and the effects of NB-UVB on the expression of the CC subfamily of chemokines in AD patients. Methods Fifty-five AD patients were treated with NB-UVB with a starting dose of 50％ of the minimal erythma dose.ELISA was used to measure the serum levels of thymus and activation-regulated chemokine ( TARC),cutaneous T cell-attracting chemokine ( CTACK),macrophage-derived chemokine (MDC) and eotaxin in all of the patients before and after treatment,and the clinical efficacy was evaluated.The scores on an atopic dermatitis index (SCORAD) and a visual analogue scale were used for the clinical evaluation.Thirty healthy persons were recruited and served as normal controls. Results The serum levels of TARC,CTACK and MDC were significantly higher in patients with AD than in the normal controls.There was no significant difference between the patients and controls with regard to the average serum level of eotaxin.After treatment with NB-UVB,the serum levels of TARC,CTACK and MDC,but not eotaxin,significantly decreased in the patients.The total clinical effectiveness rate was 76.36％,and the accumulated SCORAD points and VAS scores decreased significantly. Conclusions NB-UVB is able to down-regulate significantly the serum levels of TARC,CTACK and MDC.It can affect immune function and regulate any imbalance of Th1/Th2 cells.This might be one of the mechanisms of NB-UVB treatment for AD.The clinical data demonstrate that NB-UVB is a safe and effective treatment for AD.

Objective To analyze and compare the mutations in two different regions of the katG gene and study the relevance of Mycobacterium tuberculosis isoniazid-resistance and mutations in two different regions of the katG gene. Methods Fifty-three INH-resistant Mycobacterium tuberculosis strains isolated in cultures of sputum samples obtained from Zhejiang province were analyzed. PCR was used to amplify two regions of the katG gene (GenBank accession no. U06258) region 1 (from codon 1 to codon 150) and region 2 ( from codon 227 to codon 470) which were then sequenced in order to identify mutations. Results Three strains resistant to INH did not contain mutations in either region. Fourteen strains carried mutations in region 1. Among them 5 strains barbered deletions, and showed high-level resistance to isoniazid. Five strains had mutations only in region 1. Region 2 carried multiple point mutations, especially at codon 315, and there were S315 N ( AGC→AAC ) substitution in 18 of those cases. The frequency of mutations in the katG S315 of high-level INH-resistance isolates ( 84. 4%, 27/32) was significantly higher than those of low-level INH-resistance isolates( 15.6%, 5/32 ), there was statistically significant difference (x2 = 30. 25, P ＜ 0. 01 ).katG S315 mutations in high-level INH-resistance frequency (84. 4%, 27/32) was significantly higher than the other mutations of katG gene of high-level INH-resistance frequency (27. 7%, 5/18 ), there was significant difference (x2 = 16.02, P ＜ 0. 01 ). The analysis of region 2 allowed INH resistance to be diagnosed in 84. 9% of the strains. Five strains had mutations only in region 1 ,which allowed the proportion of INH-resistant strains identified to be increased to 94. 3%. Conclusions The number of mutations at codon 315 was high. Mutation type and location closely related with drug resistance and the analysis of region 1 resulted in a 9. 4% increase in the rate at which mutations were identified.

Objective To study the feasibility of dose calculation using kilovoltage X-ray cone-beam CT (KVCBCT) imaging for head-and-neck radiation therapy.Methods 11 patients with nasopharyngeal carcinoma were scanned with KVCBCT to adjust position before treatment, and rescanning images with KVCBCT after correction were input a treatment-planning system.The dose was recalculated by applying the patients′ treatment plans based on planning CT to the KVCBCT images.The dose distributions and dose volume histograms (DVH) of the tumor and critical structures were compared with the original treatment plan.Results The DVH and dose distribution of the plan based on the KVCBCT are compared with that of the planning CT, and they shows a good consistency for the 11 cases.The doses calculated from the planning CT and KVCBCT were compared on the isocenter planes.Using γ analysis with a criterion of 3%/3 mm, 98.0%±1.33% of the points on the isocenter planes in the planning CT and KVCBCT.The difference of the dose to target volume was<1% and to normal structure was<2%.Conclusions This study indicated that CBCT images can be used to make a treatment plan with its individual hounsfield unit-electron density calibration curve.

Purpose To quantitatively evaluate the severity of brain damage in the acute phase of CO poisoning using intravoxel incoherent motion imaging.Materials and Methods MRI scans were performed in 26 patients with CO intoxication of acute stage and 18 healthy controls with matched age and gender.The difference of D value,D* value and f value in different ROIs between the poisoning and the control groups were compared,and the best cut-off values were determined.The correlation between the consciousness state and the D value as well as f value in the vulnerable area of the brain (globus pallidus) was analyzed.Results Compared with control group,the D and F value of the poisoning group were decreased in multiple ROIs,of which statistical significance was observed in the f values in the centrum semiovale,globus pallidus and thalamus,and the D values in the centrum semiovale,lateral ventricle,globus pallidus and corpus callosum splenium (P＜0.05).The best cut-off value,sensitivity and specificity were as follows:fcs=51％,77％,73％;fga=61％,77％,83％;ft=80％,85％,64％;D,=0.69×10-3 mm2/s,85％,83％;Dlv=0.65× 10-3 mm2/s,73％,89％;Dga=0.68× 10-3 mm2/s,62％,83％;Dccs=0.70× 10-3mm2/s,81％,89％.The disturbance of consciousness was positively correlated with decrease of D value and f value (rD=0.828,rf=0.745,P＜0.05).Conclusion The D and f values of intravoxel incoherent motion imaging can quantitatively evaluate the brain damage severity in acute CO poisoning.