Objective To evaluate the efficacy and safety of mNGF to peripheral neuropathy induced by n-bexane. Methods 54 cases were treated with mNGF (18 μg i. m qd.) and the period of treatment is 56 days. 15 severe cases treated with two periods of treatment. Subjects received symptoms and signs of nerve system and activi-ties of daily living (ADL) scale were examined before and every 14 days after treated, The efficacy of mNGF was as-sessed by score increase of each index before and after treatment himself. To evaluate the safety, subjects received Is-boratory examinations before and every 28 days after treated, recorded adverse events everyday. Results During the trial, The indexes had improved remarkably in two weeks after the treatment , There were highly significant differ-ences in score increase after 4 ～ 8 weeks of treatment(P < 0. 01). It indicated that treatmented with mNGF was effec-tive. There were no severe adverse events (SAE) found among 54 trial subjects. There were no evident abnormalities in laboratory examinations before and after treatment. Pains of the injected sites are the main ADR, the incidence was 68.5% (37/54). Conclusion The results of the research indicated that mNGF clinical application could be consid-ered as safe and effective.

BACKGROUND: Anterior and lateral columns of the femoral head integrity and stability have been reported to present a positive correlation with the prognosis of the osteonecrosis of the femoral head (ONFH) and efficacy of hip preserving. China-Japan Friendship Hospital Classification stressed that the retention of the anterior and lateral columns of the femoral head was of great importance to avoid the femoral head collapse, but there is little reported on its three-dimensional (3D) digital model.OBJECTIVE: To explore the method of establishing highly-simulated 3D model of China-Japan Friendship Hospital Classification for ONFH.METHODS: 3D reconstruction of normal and necrotic femoral head was established according to the CT and MRI of individuals with normal femoral head. A healthy adult male volunteer was selected and his CT image was collected; three adult male patients with types L1, L2 and L3 ONFH were selected, whose MRI images were obtained, respectively. 3D solid models were established based on CT and MRI data on Mimics 15.0, Geomagic Studio 13, Geomagic Design X, Solidworks2014 and Abauqus6.14 software. RESULTS AND CONCLUSION: A highly-simulated 3D model of L type ONFH was established, including the corticaland cancellous bones of ilium and proximal femur, articular cartilage, necrotic articular cartilage, muscles, joint capsuleand ligaments. It clearly showed the spatial structures of L type ONFH, by which different surgical programs could be compared in a virtual environment for selecting an appropriate treatment strategy to improve the success rate of hip preserving. The highly-simulated 3D model paves ways for surgical simulation and biomechanical analysis.

Objective To investigate the effect of Ningdong granule on 5-hydroxytryptamine metabolism and 5-HT2AR of Tourette’s Syndrome(TS) rat models. Methods 32 SD rats were divided into 4 groups randomly, the control group, the model (Apo) group, the low dosage NDG (NGL) group, and the high dosage (NGH) group. TS rat models were induced by intraperitoneal injection (i.p.) with Apo (2 mg/kg) in the experimental groups last 4 weeks. Rats in the control group were injected with normal saline (0.9%) (3 ml/kg, i.p.). Then, the rats were treated by intragastric administration (i.g.) with ND granular at 1.8g/(kg?d)in NGL group, with ND granular at 3.6 g/(kg?d)in NGH group, with distilled water at equal Volume in Control group and Apo group respectively for 12 successive weeks. Analysis the striatum 5-HT2AR protein expression by Immunohistochemical method;Determination of the content of 5-HT and 5-HIAA in striatum by Enzyme linked immunosorbent assay (ELISA). Results The level of 5-HT and 5-HT2AR protein expression in the model group [(1.98±0.14)ng/ml and(143.10±8.01)], compared with the control group[(1.78±0.10)ng/ml and(127.43±6.72)], was up-regulated (P<0.01 or 0.05). The levels of 5-HT and 5-HT2AR protein expression in NGH group[(2.20±0.14)ng/ml and(166.33±9.21)ng/ml] were further up-regulated, and the levels of 5-HIAA in NDH group [(0.58±0.08) ng/ml] became lower, compared with the control group(P<0.01 or 0.05). Conclusion Activity of 5-HT system enhanced in Apo-induced TS rat model. However, the enhanced activity may still be relatively insufficient. The mechanism of ND granulear treating TS was associated with depression of the 5-HT metabolism, up-regulation expression of 5-HT2AR, and improving the activity insufficient of 5-HT system.

Objective To investigate the efficacy and safety of Ningdong granule on Obsessive-compulsive disorder (OCD) associated with Tourette's syndrome (TS).Methods Thirty-six patients with OCD associated with TS were randomly divided into 2 groups.18 patients in the treatment group were treated with ND granule,and 18 patients in the control group were treated with fluoxetine,the initial dose of fluoxetine was 10 mg/d,and maximum dose was 60 mg/d.All of the participants with history of medication had to be medication-free for≥ 1 weeks prior to the study.The severity of tics and OCD were evaluated at baseline and at end point (8 w),with Yale Global Tic Severity Scale (YGTSS)and Yale-Brown Obsessive Compulsive Scale (Y-BOCS),the contents of 5-HT in serum were measured by ELISA.Side-effects were evaluated according to an adverse event chart produced by this study team.Results The effective rate of treating tics in treatment group was 88.89％ (16/18),and in control group was 77.78％ (14/18).The effective rate of treating OCD in treatment group was 83.33％ (15/18),and in control group was 88.89％ (16/18).The differences in the aspects between treatment group and control group were not significant (P＞0.05).Compared with YGTSS scores [the treatment group was (27.28 ± 8.10),the control group was (29.17 ± 7.53)] and Y-BOCS scores [the treatment group was (22.72 ± 6.75),the control group was (23.17 ± 6.12)] at baseline,the scores YGTSS scores [the treatment group was (12.72±5.20),the control group was (15.50±5.39)] and Y-BOCS scores [the treatment group was (1250± 4.38),the control group was (12.22±4.31)] of both two groups at end point reduced significantly (P＜0.01),but the difference between the two groups was not significant (P＞0.05).The contents of serum 5-HT in the two groups were significantly raised after treatment [the treatment group was (86.05±24.26 vs 66.00±19.63) ng/ml,P=0.01),the control group was (91.16±26.07 vs 67.52±21.18) ng/ml,P＜0.01].Only one subject reported adverse reactions in the treatment group,while 6 subjects experienced adverse reactions in the control group,but no difference was shown in comparison of the aspect between the treatment group and the control group (P＞0.05).Conclusion ND granule with tiapride could improve the syndrome of tics and OCD associated with TS.ND granule with tiapride and fluoxetine with tiapride showed similar efficacy and safety for OCD with TS.

This thesis introduce the Multi-Leaf Collimator of Varian Linac,analyse the regular faults and show how to troubleshoot by every part.At the same time it introduce the daily maintenance of MLC and specific methods.

Objective To formulate a prevention and control guideline for deep venous thrombosis (DVT) in lower extremities in bedridden elderly patients and to explore its effects. Methods The problems existing in prevention and control of DVT in bedridden elderly patients were analyzed by search for literature, interviewing medical and nursing staff in the ward and reviewing DVT cases in bedridden elderly patients. The prevention and control guideline was formulated based on the evidence-based practice guideline. Relevant health videos were made and quality control measures were formulated by building DVT prevention and control teams and processes for bedridden elderly patients and adopting Caprini's and Padua's risk assessment tools. The prevention and control guideline was put into clinical use since February 2017. The incidence of DVT and blood stasis in bedridden elderly patients before (from May 2016 to January 2017, n=112) and after (between February and November 2017, n=99) the implementation of the guideline. Results After the prevention and control guideline was implemented, the positive rate of blood stasis in the bedridden elderly patients rose from 6.3% (7/112) to 15.2%(15/99), while the incidence rate of DVT dropped from 8.9% (10/112)to 2.0%(2/99) (χ2=4.458, 4.676;P＜ 0.05). Conclusions The prevention and control guideline based on the DVT prevention and management guideline can reduce the risks of DVT in bedridden elderly inpatients.

Objective:To investigate the current status of knowledge, attitude and behavior of primary caregivers about aspiration prevention in high-risk aspiration patients and to analyze its influencing factors so as to provide a basis for formulating the health education and continuous nursing intervention in high-risk aspiration patients.Methods:From July 2018 to December 2018, we selected 232 primary caregivers of high-risk aspiration patients at a ClassⅢ Grade A hospital in Ningbo City, Zhejiang Province, by convenience sampling. All care givers were investigated with the Aspiration Prevention Knowledge, Attitude and Practice Questionnaire for the Inpatient Caregiver. We also analyzed the influencing factors of aspiration prevention knowledge, attitude and behavior.Results:Finally, a total of 220 valid questionnaires were collected with 94.83% for the valid recovery rate. Among 220 primary caregivers, scores of aspiration prevention knowledge, attitude and behavior were (31.41±9.99) , (45.83±5.19) and (40.57±8.92) respectively. Correlation analysis showed that the aspiration prevention knowledge of caregivers had positive correlations with the attitude ( r=0.425, P<0.01) and the behavior ( r=0.554, P<0.01) , the attitude also had a positive correlation with the behavior ( r=0.472, P<0.01) . Single factor analysis showed that there were statistical differences in the scores of aspiration prevention knowledge and behavior among caregivers with different ages, genders, relationships with patients, care experience, care years and whether caregivers had been trained ( P<0.05) ; there were also statistical differences in the score of aspiration prevention attitude among caregivers with different ages, relationships with patients, care years and whether caregivers had been trained ( P<0.05) . Multiple linear regression analysis indicated that the influencing factors of aspiration prevention knowledge of caregivers included the ages, care experience and whether caregivers had been trained with statistical differences (Standardized regression coefficients were -0.173, -0.181, -0.337; P<0.05) ; the influencing factor of aspiration prevention attitude of caregivers was the ages with a statistical difference (The standardized regression coefficient was -0.179, P<0.01) . Conclusions:Primary caregivers of high-risk aspiration patients have a good aspiration prevention attitude, a medium level of behavior their knowledge needs to be improves. Nurses should pay more attention to the aspiration prevention care of caregivers with no care experience, untrained and non-middle age.

Objective To propose a method to improve the efficiency and accuracy of the Pinnacle treatment planning system in searching for a certain patient. Methods The original Pinnacle system was modified by adding a button of"Search Patient" in the window of"Patient Select" to call a self-built window of"Search Patient by MRN or Name". After inputting the patient′s Medical Record Number or Name, a self-built script file was called to quickly find and locate the patient′s record. Results The patient′s MRN or Name was input in the window of"Search Patient by MRN or Name",and then input"Enter" or clicked the button of Search to rapidly identify the patient and enhance the search efficiency. Conclusion The openness and script of the Pinnacle system can be utilized to modify and improve and supplement the existing func-tions.

Objective: To analyze the possible responses of parents of young children to Child sexual assault (CSA) and the potential influencing factors, so as to provide evidence for prevention programs of CSA. Methods: Part of the data from "2016-2020 Child Injury Prevention Project" was used to analyze responses to CSA among parents of children younger than 3rd grade in primary school by chi square test and Logistic regression analysis. Results: A total of 4 072 parents were included in the analysis. Among them, 86.8% of parents chose "to solve problems together", 51.0% of parents taking children to a "psychologist", 4.9% of parents "scolding children for being too careless", 2.9% of parents "letting child not disclose abuse" and 6.5% of parents chose "other" coping methods. Parents with foreign nationality [OR(95%CI)=2.58(1.25-5.15)] and lower education level (OR=0.26-0.64) tend to "blame" their children. Mothers [(OR(95%CI)=0.54(0.33-0.90)], higher parental education level (OR=0.27-0.72) were more reluctant to encourage their children to keep quiet. Mothers [OR(95%CI)=1.73(1.32-2.27)], older children (OR=1.33-1.78) and parents with higher education level (OR=1.65-2.99) tend to "accompany". Parents aged 30 or more, and from high school/technical school/technical secondary school tend to take their children to see a "psychologist" [OR(95%CI)=1.39(1.14-1.71), 1.79(1.26-2.53)]. Conclusion Parents universally pay attention to the physical and mental health of children after CSA, but some parents still take negative coping methods, e.g. "blame" and "not disclose". Parenting educational level, duration of parent-child communication and age of children are primary factors associated with parental responses to child sexual assault. This study suggests that prevention secondary injury following child sexual assault should be farther strengthened, while fully considering the characteristics of the educated objects.

Objective: To explore experience of wound treatment of extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident. Methods: On August 2nd, 2014, 98 extremely severe burn mass patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to 20 hospitals in China. The patients with complete medical record were enrolled in the study and divided into microskin graft group with 56 patients and Meek skin graft group with 42 patients. Split-thickness skin in area of residual skin were resected to repair wounds of patients in microskin graft group and Meek skin graft group by microskin grafting and Meek miniature skin grafting, respectively. The residual wound size on 28 days post injury and wound infection after skin grafting of patients in the two groups, and position of donor site of all patients were retrospectively analyzed. Data were processed with t test and chi-square test. Results: The size of residual wound of patients in Meek skin graft group on 28 days post injury was (59±13)% total body surface area (TBSA), which was obviously smaller than that in microskin graft group [(70±14)%TBSA, t=4.379, P<0.05]. Twenty-nine patients in microskin graft group and 11 patients in Meek skin graft group suffered from obvious wound infection after skin grafting. Wounds of patients in two groups were repaired with residual skin around wound in head, trunk, groin, armpit, and uncommon donor sites of scrotum (4 patients), vola (10 patients), and toe or finger web (8 patients). Conclusions Meek skin graft is the first choice for wound repair of extremely severe burn mass patients, with faster wound healing, less wound infection. Uncommon donor sites of scrotum, vola, and toe or finger web can also be used for wound repair in case of lack of skin.