As a pediatric radiation oncologist, it is necessary to master and evaluate the sedative/anesthesia indications, adverse reactions and solutions and deliver whole-course management of sedation/anesthesia in pediatric radiotherapy under sedation. Although significant progress has been made in sedation/anesthesia, the psychological stress and family burden of sedation/anesthesia still exist. There is still great research potential in the field of investigating effective nonpharmacological interventions to reduce sedation/anesthesia use. In this article, the issues and challenges of sedative management and complications of pediatric radiotherapy and interventions for reducing sedation/anesthesia of radiotherapy were reviewed.

As a pediatric radiation oncologist, it is necessary to master and evaluate the sedative/anesthesia indications, adverse reactions and solutions and deliver whole-course management of sedation/anesthesia in pediatric radiotherapy under sedation. Although significant progress has been made in sedation/anesthesia, the psychological stress and family burden of sedation/anesthesia still exist. There is still great research potential in the field of investigating effective nonpharmacological interventions to reduce sedation/anesthesia use. In this article, the issues and challenges of sedative management and complications of pediatric radiotherapy and interventions for reducing sedation/anesthesia of radiotherapy were reviewed.

OBJECTIVE: To observe the effect of integrated Chinese and Western medicine for the treatment of occupational noise-induced deafness( ONID). METHODS: A total of 80 ONID patients were selected and randomly divided into control group and treatment group by judgment sampling method,with 40 cases in each group. The control group received routine western medicine treatment using mecobalamin tablets,vitamin B complex,nerve growth factor and hyperbaric oxygen. The treatment group received routine western medicine as the control group,plus acupuncture,moxibustion and auricular point pressing. The patients in both groups were treated continuously for 30 days. The questionnaire of conscious,the selfconscious symptoms such as tinnitus,headache,dizziness and insomnia were recorded in these two groups before and after treatment. Pure tone audiometry was performed on the patients at the same time. RESULTS: After treatment,the binaural high frequency threshold average( BHFTA) and threshold of weighted value of the left and right ears in the treatment group were better than that in the same group before treatment( P < 0. 05). The difference of the BHFTA and threshold of weighted value of the right ear in the treatment group before and after treatment was higher than that in the control group( P < 0. 05). After treatment,the symptoms of tinnitus,headache,dizziness and insomnia in the two groups were better than those in the same group before treatment. The total improvement rate of tinnitus and dizziness symptoms in the treatment group was higher than that in the control group( P < 0. 05). CONCLUSION: The treatment with integrated traditional Chinese and Western medicine for ONID can improve the hearing level of patients,effectively alleviate the accompanying self-conscious symptoms,and is suitable for promotion in clinical use.

Objective To explore the effect of hydrogen sulfide (H2S) on corticosterone (CORT) -induced neuronal and synaptic damages in the hippocampus of depression rat models.Methods Adult male SD rats were randomly divided into 4 groups:control group,CORT group,low-concentration NaHS (30 μmol/kg) treatment group and high-concentration NaHS (100 μmol/kg) treatment group (n=10).CORT (40 mg/kg) was subcutaneously injected into the rats from the later three groups for 28 d to establish depression models.After administration of CORT for 14 d,the control rats and CORT rats were treated with normal saline (5 mL/kg,ip) for 14 d,rats in the later two groups were treated with NaHS (30 and 100 μmol/kg/d,ip) for 14 d.The depressive-like behaviors were evaluated by sucrose preference test,the neuronal pathological changes in the hippocampus CA3 area were observed by HE staining,the neuronal apoptosis in the hippocampus was observed under microscope using Tunel staining,the protein expressions of Bcl-2,Bax and synaptophysin in the hippocampus were quantified by Western blotting,and the content of Caspase-3 was analyzed by ELISA.Results After administration of CORT for 28 d,rats from the CORT group exhibited decreased sucrose preference,disordered arrangement and sparse morphology as well as increased amount of apoptotic neuron in hippocampal CA3 area as compared with those in the control group with significant differences (P＜0.05);in addition,as compared with those in the control group,the expressions of Bcl-2 and SYN in the hippocampus were significantly suppressed,while the activity of Caspase-3 and the expression of Bax in hippocampus were significantly up-regulated in the rats firom the CORT group (P＜0.05).As compared with CORT group,low-concentration NaHS treatment group and high-concentration NaHS treatment group had significantly increased sucrose preference,improved arrangement of neurons,decreased amount of apoptotic neurons in CA3 areas of CORT rats,up-regulated Bcl-2 and Syn expressions,down-regulated Bax expression as well as reduced activity of Caspase-3 in the hippocampus,with statistically significant differences (P＜0.05);but there was no significant difference between low and high concentration NaHS treatment groups (P＞0.05).Conclusion H2S can effectively improve the damage of hippocampal neurons and synapses in CORT rats.

Objective To explore the value of post processing technique of dual source CT in diagnosing peripheral PE.Methods One hundred and fifty patients with suspected PE were underwent dual source CT scan,and 20 of the all patients met the criterion. The raw CT data were reconstructed by the pulmonary embolism detection (PED)software,double energy perfusion imaging (DEPI)and CT pulmonary artery angiography (CTPA).The PED,DEPI and CTPA map were analyzed by 2 senior doctors in cardiovascular diagnosis profession.According to the diagnosis standard of PE,the location,number of the emboli in segmental and sub-segmental pulmonary arteries were respectively recorded on the PED and DEPI map.We calculated the detection rate,evaluated the significant difference and evaluated the diagnosis consistency between the DEPI and CTPA map.Results Emboli were found in 30 segmental and 40 sub-segmental arteries on the CTPA map with the detection rate of 7.50% and 5.00%,respectively.Emboli were found in 48 segmental and 62 sub-segmental arteries on PED map with the detection rate of 12.00% and 7.75%,respectively.There was significant difference between the CTPA and PED map (χ2 =4.60,5.06,P<0.05).The DEPI and PED map had higher consistency in diagnosing PE.The Kappa coefficient was 0.94 if the PED map was regarded as the reference standard,Among 48 cases with segmental PE detected by the PED map,there were 13 cases of complete filling defects and 35 cases of partial filling defects.Among 13 cases of complete filling defects,there were perfusion defect in 10, and perfusion thin in 3 on the DEPI map.Among 35 cases of partial filling defects,there were perfusion defect in 2,perfusion thin in 29,and perfusion normal in 4 on the DEPI map.Conclusion The PED map combined the DEPI map of dual source CT can significantly improve the diagnosis rate of peripheral PE and has a high clinical value.

Objectives:To investigate the impact of doctor-attacking on medical students’ occupation atti-tude. Methods: We conducted a sample survey towards different major of Wenzhou Medical University by using self - made questionnaire. Reults: The occupation attitude of interviewee is not so bad, the confidence about the occupation is really deep down and the occupational sense of mission worries a lot of people. Doctor-attacking cases damage the honorable sense of occupation, even threatens basic personal security. The spread passive emotion by Network media , as well as the varied choices of occupations, expand the influence of hospital violence. Conclusions: The fre-quent occurrences of doctor-attacking cases weaken the occupational attitude of medical students and became the obstruc-tion to be a doctor,countermeasures should be taken from multiaspect of society,media,schools and teachers through a va-riety of ways.

Tissue plasminogen activator(tPA) had been used clinically as a choice drug for the therapy of ischemic shock.Evidence in animal experiments suggests that tPA may play a neurotoxic role in central nervous system(CNS) via the induction of microglial activation,degradation of laminin matrix and enhancement of the N-methyl-D-aspartate(NMDA) receptor-mediated signaling in neurons,other reports imply tPA could protect rat neuronal cells from zinc-induced toxicity.

Objective To understand the health of the electronic waste (e-waste) treatment workers and the adverse effects of e-waste on the workers engaged in e-waste dismantlement.Methods Health states were assessed by questionnaire investigation on 226 e-waste dismantlement workers and 172 non e-waste dismantlement workers (control group).Results The prevalence rates of headache/vertigo(47.7%),tetter /itch (15.0%),nausea(11.1%),insomnia(9.7%),hypomnesia (5.3%),nasal obstruction(5.3%),and conjunctiva congestion(4.8%) in e-waste dismantlement workers were significantly higher than that in the control group,and it seemed that the severity of the symptoms was strongly related to the type of work.Furthermore,there was a tendency that rate of insomnia raised with the length of service in the circuit boards dismantlement group.Conclusion E-waste dismantlement will produce adverse effects on health of the employed workers.