Objective To quantify the setup errors for the different anatomical sites of patients who received intensity-modulated radiotherapy (IMRT) with linear accelerator on-board kilovolt fan beam CT(kV-FBCT) as non-isocenter IGRT and megavolt cone beam CT (MV-CBCT) as isocenter IGRT. Methods A retrospective analysis was performedon 70 patients who underwent radiotherapy, kV-FBCT, and/or MV-CBCT scans after each routine setup prior to IMRT. The average displacement (M), systematic error (Σ), and random error (б) at different treatment sites in the left-right, anterior-posterior, and cranial-caudal directions were calculated according to the individual displacements. The formula 2.5Σ+0.7б was used to estimate the PTV margin in respective direction. For each single patient, the root mean square in three directions was used as 3D displacement. Results A total of 1130 displacements were recorded in the 70 patients. The PTV margin was estimated to be 1.9-3.1 mm in head and neck cancer, 2.8-5.1 mm in thoracic cancer, 4.6-5.1 mm in breast cancer, 3.0-5.5 mm in upper abdominal cancer, and 3.5-6.8 mm in pelvic tumor. For the 3D mean displacements, the head and neck, thoracic, breast, upper abdominal, and pelvic cancer were 2.4±1.0, 4.0±1.6, 4.1±2.0, 4.6±2.1, and 4.6±2.1 mm, respectively. The average 3D displacement obtained by kV-FBCT and MV-CBCT were 4.1 and 3.4 mm, respectively (P=0.212). Conclusion The quantitative setup-error data can be obtained using linear accelerator on-board FBCT, and the non-isocenter IGRT induced set-up error cannot be negligible.

Objective:To investigate the standardized training needs of new nurses in Yunnan province and provide scientific basis for the formulation of standardized training programs for new nurses.Methods:From December 2019 to September 2020, nurses from all 5 provincial tertiary Class A hospitals in Yunnan Province were selected as the research objects. A questionnaire survey was conducted among 712 nurses selected by the convenience sampling method, among which 456 were new nurses and 256 were senior nurses. The questionnaire was designed by the research team based on the Training Outline for Newly Recruited Nurses, which mainly included three dimensions of knowledge, skills and attitude.Results:The total score of new nurses and senior nurses on standardized training requirements for new nurses were (575.32 ± 85.76) points and (583.16 ± 86.32) points, which were above the average level. There was no statistically significant difference between the scores of training theme needs of new nurses and those of senior nurses ( t value was -1.168, P>0.05). Conclusions:The total score of standardized training needs of new nurses is above the average level, and the demand for knowledge dimension in standardized training of new nurses is the strongest. It is suggested to develop a systematic and scientific standardized training plan for new nurses according to the training needs and training methods.

Objective:To investigate the situation of wearing protective equipment in the process of X-ray radiation examination (including DR and CT) in a 3A general hospital, so as to provide technical basis and solutions for better reducing the radiation dose of accompanying patients.Methods:From November 1, 2018 to June 30, 2019, the accompanying examinee 6 who had to stay in the examination room during the radiology examination (X-ray and CT examination) of a 3A general hospital from June 1, 2018 to June 30, 2019 was selected 535 people were divided into three groups according to whether they were reminded and instructed to wear protective equipment: group A was not reminded (group A) , group B was reminded to wear protective equipment, and group C was reminded and instructed to wear protective equipment (Group C) .Results:The wearing rates of protective equipment of the three groups were 35.0% (744/2126) , 85.2% (1858/2181) and 91.0% (2028/228) , and the complete wearing rates were 15.0% (319/2126) , 54.8% (1195/2181) and 88.0% (1960/228) , respectively. 4% (1450/3060) , 28.6% (876/3060) , 24.0% (734/3060) , respectively. 523 patients refused to wear protective equipment. The main reasons were emotion (33.8%, 177/523) and time (32.5%, 170/523) .Conclusion:The intervention of radiation workers can effectively improve the correct wearing rate of protective equipment and reduce the radiation exposure of accompanying people.

Objective:To investigate the situation of wearing protective equipment in the process of X-ray radiation examination (including DR and CT) in a 3A general hospital, so as to provide technical basis and solutions for better reducing the radiation dose of accompanying patients.Methods:From November 1, 2018 to June 30, 2019, the accompanying examinee 6 who had to stay in the examination room during the radiology examination (X-ray and CT examination) of a 3A general hospital from June 1, 2018 to June 30, 2019 was selected 535 people were divided into three groups according to whether they were reminded and instructed to wear protective equipment: group A was not reminded (group A) , group B was reminded to wear protective equipment, and group C was reminded and instructed to wear protective equipment (Group C) .Results:The wearing rates of protective equipment of the three groups were 35.0% (744/2126) , 85.2% (1858/2181) and 91.0% (2028/228) , and the complete wearing rates were 15.0% (319/2126) , 54.8% (1195/2181) and 88.0% (1960/228) , respectively. 4% (1450/3060) , 28.6% (876/3060) , 24.0% (734/3060) , respectively. 523 patients refused to wear protective equipment. The main reasons were emotion (33.8%, 177/523) and time (32.5%, 170/523) .Conclusion:The intervention of radiation workers can effectively improve the correct wearing rate of protective equipment and reduce the radiation exposure of accompanying people.

Excess activation of cardiac fibroblasts inevitably induces cardiac fibrosis. Emodin has been used as a natural medicine against several chronic diseases. The objective of this study is to determine the effects of emodin on cardiac fibrosis and the underlying molecular mechanisms. Intragastric administration of emodin markedly decreased left ventricular wall thickness in a mouse model of pathological cardiac hypertrophy with excess fibrosis induced by transaortic constriction (TAC) and suppressed activation of cardiac fibroblasts induced by angiotensin II (AngII). Emodin upregulated expression of metastasis associated protein 3 (MTA3) and restored the MTA3 expression in the setting of cardiac fibrosis. Moreover, overexpression of MTA3 promoted cardiac fibrosis; in contrast, silence of MTA3 abrogated the inhibitory effect of emodin on fibroblast activation. Our findings unraveled the potential of emodin to alleviate cardiac fibrosis upregulating MTA3 and highlight the regulatory role of MTA3 in the development of cardiac fibrosis.

Objective To study epidemic of schistosomiasis in the Qiandao Lake reservoir area,and to provide a reference for prevention and control of schistosomiasis in the construction of large water conservancy projects in the epidemic area of schistosomiasis.Methods The data over the years of snail condition and monitoring of schistosomiasis before and after building the dam,and water conservancy project reconstruction related information were collected.Based on the survey results of the river channel,the lake beach and the dissipation zone in the reservoir area,the influence of Xin'an River water conservancy project on epidemic of schistosomiasis in the Qiandao Lake reservoir area was analyzed,and the epidemic factors of the schistosomiasis in the Three Gorges reservoir were compared and analyzed.Results Before the dam was built,an area of 38 144 000 m2 was examined but Oncomelania was undetected.The Qiandao Lake reservoir area belonged to a non epidemic area of schistosomiasis.After the dam was built,557 cases of schistosomiasis were found in 6 232 immigrants during 1962-1965,resulting in an imported epidemic.In 1970-1980,an area of 379 654 m2 in which Oncomelania was found was examined and snails were mainly distributed in some rice fields and ditches in the end of the reservoir.949 cases of local schistosomiasis were found in the snails.The condition and condition of the snail are gradually controlled through several decades of comprehensive prevention and control.Compared with the epidemic factors of schistosomiasis in Qiandao Lake and the Three Gorges reservoir,the environment of elevation beach and ecologically fragile fluctuation zone coexist in the two reservoir areas.Conclusion From the long-term longitudinal monitoring data of the Qiandao Lake reservoir area and the epidemic regularity of schistosomiasis and the comparison with the ecology of the Three Gorges reservoir,it is concluded that the two reservoir areas will not cause a large range of schistosomiasis epidemic in general,but it does not exclude the possibility of the breeding of the inputting Oncomelania.

Objective Comprehensive evaluated the characteristics and differences of prevalence of hypertension in cold and non-cold areas,to provide evidence-based prevention strategies for establishment and perfection hypertension prevention and control suitable for China's national conditions in cold area.Methods Northeast China (Heilongjiang,Jilin,Liaoning),Inner Mongolia,Ningxia,Gansu,Qinghai,Tibet and Xinjiang were classified as cold area,and the rest were non-cold area.Use hypertension as a search term,literatures on the prevalence of hypertension were retrieved in WanFang Data,CqVip,CNKI,SinoMed and Pubmed database from January 1 1995 to May 1 2017,then the relevant data were screened and extracted.Heterogeneity was estimated and corresponding effect model was selected.Publication bias was evaluated by funnel plot,Egger test and Begg test.Comprehensive meta-analysis V2 was used for Meta analysis,stratified analysis of age,gender,province and region was did.Results In China,the pooled prevalence of hypertension was 27.00％.The pooled awareness rate of hypertension was 50.80％,the pooled treatment rate of hypertension was 40.40％,and the pooled control rate was 6.80％.The pooled prevalence in cold area was 29.70％ and 26.30％ in non-cold area,respectively,the difference of prevalence between cold and non-cold areas was significant (P ＜ 0.05).After the stratified analysis of age and gender,the pooled prevalence in men and women in cold area had a increased trend than that in non-cold area;the pooled prevalence in ＜ 30,40-,50-,and 60-＜ 70 years old groups in cold area was higher than that in non-cold area.The pooled prevalence was the highest in Tibet (40.70％) and north and northeast China area (30.40％,29.20％),and the lowest in Hainan (16.70％) and southern China area (20.70％).Conclusions In China,the pooled prevalence of hypertension is 27.00％,which is higher in cold area than non-cold area.The pooled prevalence is the highest in Tibet and north and northeast China,and the lowest in Hainan and Southern China.

Objective To evaluate the effect of parecoxib combined with ropivacaine for incision infiltration on agitation during recovery from anesthesia in patients undergoing abdominal hepatectomy. Methods Forty patients of both sexes, aged 35-64 yr, with body mass index of 18-24 kg∕m2 , of Ameri-can Society of Anesthesiologists physical statusⅠ or Ⅱ, undergoing elective partial hepatectomy, were di-vided into parecoxib sodium group ( group P ) and parecoxib sodium plus ropivacaine group ( group RP ) with 20 cases in each group. Parecoxib sodium 40 mg was intravenously injected at 30 min before operation in group P. Parecoxib sodium 40 mg was intravenously injected at 30 min before operation, and incision in-filtration was performed with 0. 5％ ropivacaine 20 ml at the end of surgery in group RP. Patient-controlled intravenous analgesia was performed at the end of surgery in both groups. The development of agitation, re-spiratory depression and nausea and vomiting was recorded within 30 min after operation. Blood samples were collected from the radial artery immediately before induction ( T0 ) , at the end of surgery ( T1 ) and at removal of extubation ( T2 ) for determination of plasma cortisone ( Cor) concentrations ( by radio-immunity method), plasma epinephrine (E) and norepinephrine (NE) concentrations (by enzyme-linked immu-nosorbent assay) and blood glucose ( using a blood gas analyzer) . Results Compared with the baseline at T0 , the plasma concentrations of Cor, Glu, E and NE were significantly increased at T1,2 in two groups ( P>0. 05) . The incidence of agitation and plasma concentrations of Cor, Glu, E and NE were significantly low-er at T1,2 in group RP than in group P ( P<0. 05) . No patients developed nausea and vomiting and respira-tory depression in two groups. Conclusion Parecoxib combined with ropivacaine for incision infiltration can decrease the occurrence of agitation during recovery from anesthesia, which is related to inhibiting stress responses of patients undergoing abdominal hepatectomy.

Objective To evaluate the effects of OPRM1All8G and CYP3A4*18B genetic polymorphism and the interaction on postoperative analgesia with fentanyl in the patients undergoing radical resection of lung cancer.Methods One hundred and thirty-nine patients (native of Henan province),aged 40-64 yr,weighing 40-70 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical resection of lung cancer under general anesthesia,were enrolled in this study.The polymorphic sites of the OPRM1All8G and CYP3A4*18B allele were analyzed by using polymerase chain reaction technique and ABI 3130 Genetic Analyzer.The patients were divided into wild homozygote group (group AA,group *1/*1),heterozygote group (group AG,group * 1/*18B) and mutation homozygote group (group GG,group *18B/*1SB) according to their genotypes.The patients were divided into 7 groups according to the interaction between the two genes:AA plus *1/*1 group (group Ⅰ),AA plus *1/*18B group (group Ⅱ),AG plus *1/*1 group (group Ⅲ),AG plus *1/*18B group (group Ⅳ),GG plus * 1/*1 group (group Ⅴ),GG plus *1/*18B group (group Ⅵ) and *18B/*18B group (group Ⅶ).Patientcontrolled intravenous analgesia with fentanyl was started at the end of surgery to maintain the visual analogue scale ≤ 3 points.The amount of fentanyl used within 24 and 48 h after surgery was recorded,and the occurrence of adverse reactions within 48 h after surgery was observed.Results The amount of fentanyl used within 24 and 48 h after surgery was significantly higher in group GG than in group AA (P＜0.05).The amount of fentanyl used within 48 h after surgery was significantly lower in group *18B/*18B than in group *1/*1 (P＜0.05).The amount of fentanyl used within 48 h after surgery was significantly higher in Ⅱ and Ⅳ groups than in group Ⅰ,in group Ⅲ than in group Ⅱ,in group Ⅴ than in Ⅰ-Ⅳ groups,and in group Ⅵ than in Ⅱ and Ⅳ groups,and was significantly lower in group Ⅶ than in Ⅰ-Ⅵ groups (P＜ 0.05).There was no significant difference in the incidence of adverse reactions within 48 h after surgery between groups (P＞0.05).Conclusion OPRM1A1l8G and CYP3A4*18B genetic polymorphism and the interaction are the genetic factors contributing to individual variation in fentanyl pharmacodynamics in the patients undergoing radical resection of lung cancer.

Objective To evaluate the effect of OPRM1A118G genetic polymorphism on postoperative analgesia with fentanyl in the patients undergoing radical resection of lung cancer.Methods One hundred and seventy-four patients(native of He′nan province), aged 40-64 yr, weighing 40-70 kg, with American Society of Anesthesiologists physical status Ⅰor Ⅱ, undergoing elective radical resection of lung cancer under general anesthesia, were enrolled in this study.OPRM1A118G genetic polymorphic sites were analyzed by using polymerase chain reaction technique and ABI 3130 Genetic Analyzer.The patients were divided into wild homozygote group,heterozygote group and mutation homozygote group according to their genotypes.The analgesia pump was connected at the end of operation.Patient-controlled intravenous analgesia solution contained fentanyl 30 μg/kg and ondansetron 8 mg in 200 ml of normal saline.The analgesia pump was programmed to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at a rate of 2 ml/h, maintaining the visual analogue scale score ≤3 points.The amount of fentanyl consumed within 24 and 48 h after operation was recorded, and the occurrence of adverse reactions was recorded within 48 h after operation.Results Compared with wild homozygote group, the amount of fentanyl consumed within 24 and 48 h after operation was significantly increased in mutation homozygote group(P<0.05), and no significant change was found in the amount of fentanyl consumed within 24 and 48 h after operation in heterozygote group(P>0.05).There was no significant difference in the incidence of postoperative adverse reactions between the three groups(P>0.05).Conclusion OPRM1A118G genetic polymorphism is one of the genetic factors contributing to individual variation in fentanyl pharmacodynamics in the patients undergoing radical resection of lung cancer.