食管癌术后纵隔转移的放射治疗

目的：评价食管癌术后出现纵隔转移致上腔静脉综合症及呼吸道梗阻的放射治疗的价值。材料与方法：１９９８年１月至１９９９年７月共收治了３２例食管癌要治术后出现纵隔转移行放射治疗而缓解，剂量４０￣６０Ｇｙ。结果：全部患者症状获得了暂时缓解。结论：（１）食管癌术后纵隔转移放疗是主要的、有效的治疗手段之一。经治疗仍可缓解症状，提高生存质量、延长生存期。（２）较早期食管癌根治术后，应常规行“预防性”放射治疗。     

Teaching tools for the Marker Model for standards development and the Umbrella Model for quality assurance

The learning process benefits adults more when the material is presented in the presence of "positive conditions." Teaching standards developed and QA provides ample opportunity to provide positive conditions. The Marker Model is easily adapted to all practice settings and can often be taught by using unit-specific or patient population-specific examples; however, developing these specific examples can be time-consuming. Instruction is often given to groups of nurses from different clinical areas, so unit- or patient population-specific examples are therefore inappropriate. Development of the "universal" example has also provided humor for the presentation. The Head of Household Standards model and the Quality Assurance Plan for Head of Household are applicable to almost all adults and are easily understood (see boxes). They supply further humor in their "audit" formats (Figures 3 and 4).