Objective : To explore the effects of“radiotherapy assistant”application on lung cancer patients who receive radiotherapy. Methods : A total of 120 patients with lung cancer who received radiotherapy in Hangzhou Cancer Hospital from March to September 2017 were recruited and randomly divided into a control group and an experimental group. The patients in the control group received the routine health education,while the ones in the experimental group performed the“radiotherapy assistant”application focused on interactive guidance. Before and after the intervention,the scores of treatment-nursing compliance and self-management efficacy between the two groups were compared. Results : After the intervention,the compliance scores of radiotherapy treatment,health behaviors,regular review,moderate exercise,medication and diets in the experimental group were 2.77±0.43,2.67±0.51,2.68±0.50,2.45±0.75,2.77±0.43 and 2.65±0.55;the ones in the control group were 2.62±0.49,2.42±0.59,2.55±0.50,2.37±0.64,2.67±0.48 and 2.37±0.69. The scores of the six items of compliance in the two groups were all improved compared to the ones before the intervention,but the interaction between the groups and intervention time was not statistically significant（P>0.05）. The scores of positive attitude,self-decompression,self-decision and total self- management efficacy in the experimental group were 52.48±7.69,10.51±3.31,36.88±6.15 and 97.62±12.87,respectively;the ones in the control group were 37.38±10.44,5.70±1.51,27.58±9.41,and 92.17±11.19. The scores of the two groups were all improved compared to the ones before the intervention,and the ranges of the scores improved in the experimental group were wider than those in the control group. Conclusion The“radiotherapy assistant”application can significantly improve the self-management efficacy of patients who receive the lung cancer radiotherapy,but its effect on the improvement of treatment compliance requires long-term intervention to verify.

Objective to investigate the clinical efficacy of decompression and pedicle screw fixation through posterior approach for complete thoracic spine fracture dislocation.Methods The clinical data of six patients with complete thoracic spine fracture and dislocation treated from September 2002 to June 2016 were analyzed retrospectively by case series study.There were five males and one female,aged 21-67 years old (mean,47.2 years).The injury segments were T3～4 dislocation in one case,T5～6 dislocation in two cases,T6 ～7 dislocation in two cases and T8 ～9 dislocation in one case.There was one case of ASIA grade E and five cases of Grade A,and all of six cases were associated with multiple rib fractures and hemopneumothorax.The companied status was one case of sternal fracture,one case of atlantoaxial complex fractures and three cases of pulmonary contusion.The posterior median incision decompression and pedicle screw system fixation were performed,and the intervertebral bone grafting was conducted after restoration.The surgery time,bleeding volume during surgery,fracture restoration,bone grafting fusion,failure of internal fixation and other complications were recorded.The Visual Analogue Scale (VAS) and American Spinal Injury Association (ASIA) classification were used to assess the pain and neurological function improvement between the preoperative visit and final follow-up visit.Results The surgery time was 150-240 minutes (mean,205 minutes).The bleeding volume during the surgery was 700-2 100 ml (mean,1167 ml).One case was died of pulmonary infection at one week after surgery,the others were followed up for 3-14 months (mean,7.4 months).After operation,five patients were satisfied with the reduction,and the lateral displacement was partially restored in one cases.Five cases of intervertebral bone grafting all had bone fusion.There was no fixation failure.The VAS was (7.4 ± 0.6) points before surgery,(4.5 ± 1.6) points at one week after surgery and (1.8 ± 0.3) points at final visit of follow-up,which had significant difference from the preoperative status (P ＜ 0.05).One case of ASIA grade E had no postoperative aggravation and four cases of grade A had no improvement.Conclusion Posterior decompression and pedicle screw fixation system is optimal choice of treatment for complete thoracic fractures and dislocations for it can attain reduction of fracture and dislocation as well as bone fusion,provide stability for spine and relieve pain.

Objective T o explore the effectiveness of direct am plification for the ST R analysis of carti-lage, and to accelerate the effectiveness of disaster victim identification. Methods E ighty-eight cartilage sam ples w ere directly am plified by Pow erPlex誖21 kit, and the results of genotyping w ere com pared w ith that obtained by the m agnetic beads m ethod. Results In 88 cartilage sam ples, the ST R genotypes w ere successfully detected from 84 sam ples by direct am plification and m agnetic beads m ethod, and both the results of genotyping by tw o m ethod w ere consistent. Conclusion D irect am plification w ith Pow er-Plex誖21 kit can be used for ST R genotyping of cartilages. T his m ethod is operated easily and prom ptly, w hich has a potential application in the individual identification of m ass disasters.

Objective To investigate the results and complications of hemispherotomy for drug resistant hemispheric epilepsy.Methods The authors reviewed 5 patients who were diagnosed as drug resistant hemispheric epilepsy and operated in the neurosurgery department of Peking Union Medical College Hospital from 2011 to 2013.All the 5 patients were underwent hemispherotomy after carefully multidisciplinary pre-operation evaluation.Results All patients tolerated the procedure well and the postoperative course was smooth.All the 5 patients didn`t have seizure in the period of following up of 46 to 69 months.Conclusions According to literatures and the authors` experience, hemispherotomy is as safe and efficient for hemispheric epilepsy as hemispherectomy.It is most important advance for hemispherectomy.The procedure of hemispherotomy is complex but not very difficult, illustrating a good prospect of application and extension.

Objective To find out whether conversation analysis helps to differentiate psychogenic nonepileptic seizure (PNES) from epileptic seizure in Chinese patients.Methods Twelve unselected patients from Peking Union Medical College Hospital during 2014 to 2016 with diagnostic uncertainty were included.Interactions following standard protocol were carried out.A linguist blinded to all medical data and a neurologist studied videos and transcripts of the interactions.Using a diagnostic scoring aid which includes 17 conversation features summarized from previous researches, they attempted to predict the medical diagnosis of those patients independently.Results Accurate diagnosis was predicted in 10/12 patients by both raters.Average scores of patients with epileptic seizures were 8.00 (linguist) and 6.75 (neurologist), while average scores of paitents with PNES were-5.75 (linguist) and-7.88 (neurologist).Both raters agreed on most individual items (81.86%, 167/204).To demonstrate different features between these two groups, a case comparison was made between one patient with frontal lobe epilepsy and one patient with PNES.Conclusion In Chinese patients, conversation analysis can help differentiate between epileptic seizure and PNES.

Objective To explore the clinical features and treatment of skin ulcers.Methods A total of 185 skin ulcer patients with clinical data was analyzed retrospectively in our hospital from October 2014-October 2016.Results Of the 185 patients with skin ulcers,84(45.4％) were 51-70 years old,diabetic ulcers were most common,and most occurred in ankle (44.3％) and limbs (35.7％).After further statistical analysis,the healing rate of patients treated by surgery was significantly higher than non-surgical patients.Surgical procedures of local flap transfer after ulcer resection were most commonly used and of the highest healing rate.The number of ulcers,the largest diameter of ulcers,scar ulcers and blood barrier ulcers were four factors that were independent of the outcome of skin ulcers.Conclusions Skin ulcers hospitalized patients are more common in patients over 50 years of age,occur most in the lower limbs.Surgical therapy is the preferred treatment for most ulcers,of which local flap transfer after ulcer resection has the best effect.Ulcer patients should actively treat the primary disease,strengthen the care,early diagnosis,and early treatment.

Adult ; Child ; Child, Preschool ; Electroencephalography ; Epilepsy, Absence ; physiopathology ; Humans

Objective To summarize the clinical characteristics of Foix-Chavany-Marie syndrome.Methods The clinical,electroencephalography and imaging characteristics,as well as etiology,treatment and prognosis of 4 cases of Foix-Chavany-Marie syndrome were retrospectively evaluated,and relevant literature was reviewed to investigate its pathogenesis.Results All the 4 cases presented with hypersalivation,facial diplegia,dysarthria and dysphagia with autonomic-voluntary dissociation.Brain MRI showed bilateral cortical or subcortical lesions in the opercula and perisylvian areas.Three cases were secondary to encephalitis,and 1 case was related to perinatal hypoxic-ischemic encephalopathy.After administration of antiepileptic drugs,they were free of seizures.But all the other symptoms remained.Conclusions Autonomic-voluntary dissociation is a feature of Foix-Chavany-Marie syndrome.Most patients are due to bilateral structural or functional lesions between motor cortices and brain-stem cranial motor nuclei.The prognosis depends on the heterogeneous etiologies,such as encephalitis and cerebrovascular disease.

Objective This research summarized the nursing experience of critically ill patients infected by H7N9 avian influenza who were treated with extracorporeal membrane oxygenation (ECMO) and artificial liver device.Methods 10 critically ill patients infected by H7N9 avian influenza were selected,during treatment of ECMO combined with artificial liver device,nursing care such as careful observation of the changes of symptoms,strict disinfection and protection,contact isolation,symptomatic treatment to fever,correct management of airway and ventilator circle,pipeline nursing of ECMO and artificial liver device,mental nursing,symptomatic and support therapy which included antivirus,anti-hypoxia and anti multiple organ failure,anti-shock,anti-infection,microecological balance maintenance and water-electrolyte balance maintenance.Results 4 critically ill patients infected by H7N9 avian influenza improved and removed ECMO and artificial liver device,among whom one patient rehabilitated and was discharged.Another 6 patients were in a steady state.Conclusions For critically ill patients infected by H7N9 avian influenza,comprehensive and elaborate care can facilitate early recovery of patients.

Objective To investigate the clinical characteristics,treatment and prognosis of senile epilepsy. Methods The clinical characteristics of 180 elderly patients with epilepsy were retrospectively studied. Results The common causes of senile epilepsy were cerebrovascular disease (8 cases,4.4％),brain tumor(24 cases,13.3％),brain trauma and operation (18 cases,10.0％),brain atrophy (6 cases,3.3 ％ ),The most type of seizures were focal seizures (106 cases,58.9 ％) or focal seizures preceding a generalized (62 cases,34.4％). Electroencephalogram (EEG) usually showed focal slow wave activity or rhythm.Most of seizures were responsive well to single antiepilepsy drug. Conclusions The causes of elderly epilepsy are cerebrovascular disease,brain tumor,brain trauma, brain operation, brain atrophy. Senile epilepsy is more likely to have symptomatic and focal seizures,and can be controlled by anti-epilepsy drugs.