Objective:A dose verification system of two-dimensional semiconductor matrix(SRS MapCHECK)was used to verify the dose of the clinical treatment plan of patients who underwent CyberKnife(CK),which realized rapid verification for individualization of radiotherapy plans of patients through analyzed the γ-passing rates of them.Methods:A total of 253 patients with tumor who received CK clinical treatment in the First Medical Center of Chinese PLA General Hospital from March 2021 to May 2023 were selected.Among of them,121 cases received CK treatment on head,and 30 cases received that on lung,and 102 cases received CK treatment on abdomen and other metastatic tumor.In the MultiPlan treatment plan system,the plan of patient was mapped to the integrated model composed of StereoPHAN model and SRS MapCHECK matrix dose verification system by the means of the plan image center overlap.The dose verification was conducted on the plan of each patient on the basis of ensuring the consistency of the number of beam,direction of beam and the monitor unit.The different γ analysis standards(1%/1 mm,2%/1 mm,3%/1 mm,1%/2 mm,2%/2 mm,3%/2 mm,1%/3 mm,2%/3 mm and 3%/3 mm)were adopted to conduct global analysis of absolute dose for each verification plan,and the threshold(TH)of low dose was set as 10%.Results:The γ passing rates of phantom verification plans of 253 patients were respectively(88.64±5.91)%,(95.43±3.40)%,(97.90±2.06)%,(96.51±2.35)%,(98.15±1.68)%,(99.06±1.12)%,(98.30±1.39)%,(99.09±0.97)%and(99.52±0.63)%under different analysis standards.The γ passing rates of other standards of patients with tumor on different parts were larger than 95%except the analysis result of 1%1 mm standard.The overall analysis result of the deviation of central point dose was(-1.30±2.17)%,among of which the tumor of head,abdominal tumors and other metastatic tumor were about approximately-2%,while that of lung tumors were approximately-3%.The deviation of abdominal and other metastatic tumor was the minimum.The correlation analysis showed that the target volume and the size of the minimum collimator were respectively correlated to the dose deviation of the center.Conclusion:SRS MapCHECK dose verification system can conveniently and quickly realize the individualized verification for the plan of patients who receive CK treatment.

Objective To analyze the quality of 19 batches of Ginseng Formula Granules from 11 different manufacturers by using Ginseng water Extract reference substance(GWERS)as references.Methods Thin layer chromatography(TLC)identification and feature map detection were carried out according to the identification items and characteristic maps of Ginseng Formula Granules standard(YBZ-PFKL-2021186)issued by the National Medical Products Administration.Results The results of TLC analysis showed that the 19 batches of Ginseng Formula Granules-labeled samples could be divided into three categories.The overall pattern of the first type of samples was consistent with that of GWERS,and the similarity was high.Pseudoginsenoside F11,a unique component of American ginseng,was detected in the second type of samples.Four blue fluorescent spots were observed in the third type of samples compared to GWERS.HPLC results indicated that all 19 batches of Ginseng Formula Granules showed eight characteristic peaks at the same retention time as that of GWERS chromatogram.Two more chromatographic peaks were found in the chromatogram of three batches of samples from one manufacturer compared to the chromatogram of other samples,whose similarity to the GWERS chromatogram was less than 0.65.The similarity between the chromatogram of the remaining 16 sample and GWERS chromatogram was higher than 0.94.Conclusion At present,the quality of Ginseng Formula Granules on the market varies greatly.It was suspected that American ginseng might appear among them.The application of GWERS for quality analysis of Ginseng Formula Granules has better applicability to the control medicinal materials.

Objective To analyze the effects of different supplements on anemia related indexes in rural children. Methods A stratified method was adopted, and six villages (towns) in and around Qinghai Province were selected as intervention sits for the present study. A total of 304 children from 2 to 6 years old at each intervention site meeting the inclusion criteria were screened and divided into three groups (A, B, and C), who were intervened for 3 months. Serum vitamin A, vitamin D and hemoglobin levels were measured before and after the intervention. Results The hemoglobin level of 304 children before intervention was (118.65±16.07) g /L, and the prevalence of anemia was 9.54%. The vitamin A value, vitamin D value and hemoglobin value were increased after three months of the intervention. The changes of vitamin A value, vitamin D value and hemoglobin value in rural children in group C were significantly higher than those in groups A and B. The increase in vitamin A value in rural children aged 3 years was significantly higher than that in other age groups, and the increase in hemoglobin in rural children of 1 year old was significantly higher than that in other age groups. The increase in vitamin A value of rural children of other ethnic groups (mainly Tibetans) was significantly higher than that of Han and Hui nationalities, and the increase of hemoglobin value in Hui rural children was significantly higher than that in Han and other ethnic groups. Conclusion Vitamin A combined with iron dextran tablets was effective in preventing anemia in rural children.

Objective? To explore the mental state of laryngeal carcinoma patients after total laryngectomy and to analyze its correlations with coping style and social support. Methods? From January 2017 to October 2017, we selected 36 laryngeal carcinoma patients with total laryngectomy in otolaryngology dead and neck surgery at Beijing Tongren Hospital, Capital Medical University as subjects by convenience sampling. All of the patients were investigated with the Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Medical Coping Modes Questionnaire (MCMQ) and Social Support Rating Scale (SSRS). A total of 36 questionnaires were sent out and 34 of them were collected. Results? Among 34 patients, the total scores of SAS and SDS were (45.38±10.27) and (50.32±11.82) respectively. The score of "avoidance" coping style of patients after total laryngectomy was higher than that of norm with a statistical difference (P＜ 0.05). Pearson correlation analysis showed that SAS and SDS were negatively correlated with the total score of social support (P＜0.05);SAS and SDS were positively correlated with the confrontation dimension of coping style (P＜0.05), and were negatively correlated with the avoidance dimension (P＜ 0.05). Conclusions? After total laryngectomy, patients are with high levela of anxiety and depression. Medical staff should guide patients to take correct coping styles after surgery to face diseases, and improve patients' social support to relieve patients' negative emotions and total laryngectomy,and to promote the rehabilitation of diseases.

Objective To explore the effect of improving clinical practice ability of nursing undergraduates via double evaluation.Methods From September 2015 to May 2016, 61 nursing undergraduates enrolled in 2012 to Guangzhou University of Chinese Medicine were selected by convenience sampling method and divided randomly according to their student number into experimental group (30 cases) and control group (31 cases). According to the double evaluation method adopted in the experimental group, clinical teaching scheme was modified dynamically. In the control group, clinical teaching was conducted according to clinical teaching scheme made by the university, with OSCE and evaluation form of clinical practice ability as tools for observer and self evaluation.Results Within the experimental group, both scores of observer evaluation in OSCE and scores of self evaluation in clinical practice behavior showed a trend of going up in phases (P<0.05). In comparison of observer evaluation in OSCE at the 9th month, scores of the experimental group were all higher than those in the control group in all dimensions except writing of nursing documents (P<0.05). In comparison of self evaluation in clinical practice behavior at the 9th month, scores of the experimental group were all higher than those in the control group in all dimensions except communication ability, slightly lower (P<0.05).Conclusions With the double evaluation method adopted, dynamically modified clinical teaching scheme according to phases can obviously improve clinical practice ability of nursing students.

Objective To explore clinical value of serum carcinoembryonic antigen (CEA) rate in early evaluation of imaging tumor efficacy and prognosis of disease control for advanced non-small cell lung cancer (NSCLC) before and after the second course of chemotherapy, and provide the basis for clinical adjustment chemotherapy regimens.Methods Patients in the Third Affiliated Hospital of Sun Yat-sen University were randomly collected in January 2007-September 2014 during the pathological diagnosis of 130 cases for advanced NSCLC, who had an elevated serum CEA level, including pre-chemotherapy and prochemotherapy, were collected.Receiver operating characteristic (ROC) was used to evaluate efficacy of CEA change in evaluation of early disease control (DC).SPSS 18.0 was used to analyze the relationship between CEA change and prognosis.Results After two chemotherapy cycles, the area under the ROC curve was 70.6％.When the cut-point of the change rates of CEA levels was 2.05％ , the Youden index reaches the maximum.Adenocarcinoma group and squamous cell carcinoma patients after 2 courses of CEA change rate evaluation, which area under the ROC curve was 72.0％ (95％ CI :61.4％ ～ 82.5％), and 70.1％ (95％ CI:45.8％ ～94.5％).Survival was analyzed with the Kaplan-Meier method, which showed the change rates of CEA levels were all the influencing factors of progression-free survival (PFS) in patients with advanced NSCLC(P ＜ 0.05).While the change rates of CEA levels were not predictive overall survival (OS) (P =0.715).Conclusions It prompts effective chemotherapy, and patients have the extended PFS, when CEA levels before and after chemotherapy dropped to a certain degree.

Objective To investigate the status of uncertainty in illness and social support among patients with post-traumatic brain syndrome (PTBS) and analyze their correlation.Methods One hundred and fourteen patients with PTBS were selected by convenience sampling and assessment.They were evaluated by Chinese disease Mishel Uncertainty in Illness Scale (MUIS) and Social Support Assessment Scale (SSAS) and the correlation of two scales was analyzed.Results MUIS total score was(135.23±19.29) scores with a median of 128.74 scores and SSAS total score was (43.14±5.54) scores with a median of 42.00 scores in patients with PTBS.Among 114 patients with PTBS,regarding ambiguity score was negatively correlated with objective support,subjective support,utilization degree of support and SSAS total score,r=-0.301,-0.374,-0.521,-0.509,complexity score was negatively correlated with objective support,sub-jective support,SSAS total score and utilization degree of support,r=-0.367,-0.326,-0.355,-0.533,both lack of information and regarding unpredictability score were negatively correlated with utilization degree of support,r=-0.376,-0.330,MUIS total score was negatively correlated with objective support,utilization degree of support and SSAS total score,r=-0.284,-0.424,-0.305.Conclusion There is high uncertainty of PTBS patients;increase of patients' social support will be good for decreasing the ambiguity and com-plexity among patients' uncertainty;promotion of patients' utilization degree of support will help to reduce patients' lack of information and unpredictability.

Objective To investigate the effect of continuous hemofiltration in patients with acute renal injury induced by rhabdomyolysis and summarize the nursing experience.Methods Ten patients with acute kidney injury induced by rhabdomyolysis were managed with continuous hemofiltration,corresponding nursing care performed.Results After treatment,the renal function of 7 patients resumed normal,the function of 2 were improved,and only 1 needed long-term hemodialysis.After treatment,the levels of serum creatine phosphokinase(CPK),myoglobin(Mb),blood urea nitrogen(BUN),creatinine(Scr),aspartate aminotransferase(AST) were gradually decreased,K+resumed normal and urine volume increased to normal level,with significant difference as compared to those before treatment(P<0.05).Conclusions Continuous hemofiltration together with pertinent nursing measures can ensure the curative effect.It is of great significance for improving the prognosis of rhabdomyolysis.

BACKGROUND: Vogt-Koyanagi-Harada (VKH) disease is characterized by bilateral granulomatous uveitis with neurologic, auditory, and dermatologic manifestations. However, acute myelitis complicating VKH disease has rarely been reported. CASE REPORT: A 50-year-old Chinese Han woman presented with difficulty walking, numbness on the left side of the body, and difficulty with urination. The patient was diagnosed with incomplete VKH disease and received corticosteroid treatment prior to the neurological presentation. Acute myelitis was diagnosed based on both clinical and spinal-cord MRI findings. CONCLUSIONS: Clinicians should consider acute myelitis as a rare possible neurological manifestation in VKH disease patients, and early systemic administration of corticosteroids will suppress the acute inflammatory process and prevent recurrences. This report raises the possibility that VKH disease and acute myelitis share common pathogenic pathways.
Adrenal Cortex Hormones ; Asian Continental Ancestry Group ; Female ; Humans ; Hypesthesia ; Mobility Limitation ; Myelitis ; Neurologic Manifestations ; Recurrence ; Urination ; Uveitis ; Uveomeningoencephalitic Syndrome

Objective To investigate radiation dose to the patients undergoing interventional radiology and make radiation risk assessment.Methods Data was collected on 198 instances of 10 interventional radiology procedures by using Philips Allura Xper FD20 DSA, which was equipped with the transparent ionization chamber system in compliance with IEC 60601-2.Patient peak skin dose and effective dose were estimated.Results Cumulative fluoroscopy time was 2.1 - 80.9 min, and number of images monitored for PSD were above 1 Gy and 79 cases monitored for E were above 20 mSv.Conclusions Substantial number of cases exceeded the dose threshold for erythema.Due attention should be paid to radiation protection of patients.