Objective To observe the interaction between the extreme stress and mild traumatic brain injury in the patients surviving Wenchuan earthquake.Methods Forty survivors in Wenchuan earthquake were selected for the psychological status survey 2-30 days after the disaster,among them 20 survivors were suffering from mild traumatic brain injury,and the remainders were in normal physical conditions.The Symptom Checklist-90(SCL-90),which consisted of 90 items with 5 grades for each item(0-4 grade,grade zero as none and grade 4 as severe),including 9 symptom factors,was adopted to perform the evaluation for all the subjects in both groups,and the subscales were compared.Results Five subscales of SCL-90,including somatization,depression,anxiety,hostility and fear,which averaged 2.12?0.50,1.83?0.60,1.99?0.40,1.80?0.70 and 2.20?0.8,respectively,were significantly increased in mild traumatic brain injury group than that in control group(P0.05).Conclusions Mild traumatic brain injury occurred among survivors of severe earthquakes is strongly associated with psychological problems.A higher incidence of psychological disorder in survivors of earthquake with mild traumatic brain injury indicates that one must be cautious when attributing a health problem to mild traumatic brain injury,since the post-traumatic stress disorder and depression may be the primary problem.The high-risk population with psychological obstacle consists of the survivors with mild traumatic brain injury,and the interactions of both psychological stress and traumatic brain injury may lead to more complex clinical symptoms,so psychotherapy should be emphasized in the treatment of patients with mild traumatic brain injury.

ObjectiveTo investigate the impact of health education and psychological intervention on quality of life of patients with asthma.MethodsNinety-six patients with bronchial asthma were assigned to the treatment group and the control group. The participants in the treatment group were treated with routine therapy and health education and psychological intervention.Results The awareness of bronchial asthma,self monitoring of health condition,and simple strategies to treat acute or serious asthma were improved in the treatment group. The overall effective rate of the treatment group was significantly higher than that of the control group (93.75％ vs 62.5％,P ＜0.01 ),and forced expiratory volume in one second (FEV1),peak expiratory flow (PEF) and ACT score were significantly improved (all P ＜ 0.01 ).Moreover,episode of bronchial asthma was significantly reduced after the combined intervention (P ＜0.01 ).ConclusionHealth education and psychological intervention may contribute to effective prevention and treatment of asthma,improved quality of life of patients,and reduced family and social economic burden.

Colon capsule endoscopy( CCE)is a new technique for the diagnosis of colonic lesions,it has many advantages such as high safety,good tolerance,etc. . Bowel preparation is an important procedure in CCE. The quality of bowel preparation is closely related with the accuracy of CCE. This article reviewed the progress in research on bowel preparation for CCE.

Objective To evaluate the peripheral dose (PD) from megavoltage cone-beam CT (MVCBCT) imaging for head-and-neck region image-guided radiation therapy,to determine the correlation of PD with monitor unit (MU),and to investigate the impact of imaging field size on the PD.Methods Measurements of PD from MVCBCT were made with a 0.65 cm3 ionization chamber placed in a specially designed phantom at various depths and distances from the field edges.The PD at reference point inside the phantom was measured with the same ionization chamber to investigate the linearity between MU used for MVCBCT and the PD.The homogeneity of PD in the axial plane of the phantom were measured.Results PD from MVCBCT increased with increasing number of MU used for imaging and with increasing the field size.The measured PD in the phantom decreased exponentially as distance from the field edges increased.PD also decreased as the depth from the phantom surface increased.There was a strong linear relationship between PD and MUs used for MVCBCT.The PD was heterogeneous,with higher dose at the anterior than the posterior.Conclusions The PD from MVCBCT depend much on the MVCBCT delivery MU and the scan field size.In clinic,using the smallest number of MU allowable and reducing MVCBCT scanning field size without compromising acquired image quality is an effective method of reducing the PD.

Objective To investigate toil-like receptor 4 (TLR4) expression and activity in peripheral blood mononuclear cells(PBMCs) of obese patients.Methods PBMCs from 16 obese patients and 16 normal control subjects were collected.TLR4 and IκBα protein concentrations were measured in PBMCs by western blotting.TLR4 and interleukin-6 (IL-6) mRNA expression levels in PBMCs were measured by quantitative realtime PCR.The blood levels of glucose,insulin,free fatty acids (FFA),IL-6 and tmnor necrosis factor-α (TNF-α) were measured after an overnight fast.Results The levels of FFA,IL-6,TNF-α and homeostasis model assessment of insulin resistance index (HOMA-IR) in obese patients were higher than that of control group (FFA:(879 ± 64) μmol/L vs.(458 ± 48) μmol/L; IL-6:(2.20 ± 0.35) ng/L vs.(1.26 ± 0.25) ng/L; TNF-α:(1.96±0.32) ng/Lvs.(1.38 ±0.24) ng/L;HOMA-IR:(1.8±0.2) vs.(0.4±0.1) ;t=24.613,P=0.000;t =14.993,P =0.000;t =9.128,P =0.000;t =32.254,P =0.000).Increased TLR4 gene and protein expression were observed in PBMCs of obese patients compared with control group(TLR4 mRNA:(3.13±0.21) vs.(0.99 ± 0.03),t =54.758,P ＜ 0.05; TLR4 protein:(7.04 ± 0.42) vs.(2.53 ± 0.17),t =77.450,P ＜0.05).IκBα protein concentration in PBMCs of obese patients (2.52 ±0.16) was lower than in control group (4.00 ± 0.30,t =23.284,P ＜ 0.05),indicating elevated IKKβ/NF-κB signaling.The increase in TLR4 and NF-κB signaling was accompanied by elevated expression of the NFκB-regulated gene IL-6 ((2.55 ±0.15) vs.(1.03 ±0.11),t =53.981,P ＜0.05).Conclusion TLR4 expression and activity are increased in the PBMCs of patients with obesity and might involve in the development and progress of insulin resistance.

To evaluate the effect of papaverine administered via different routes following cerebral aneurysm operation, 43 cerebral aneurysm patients were divided randomly into two groups: A and B. Patients of group A were placed with a silicagel tube in cerebral ventricle and lavaged repeatedly with papaverine solution during operation and following 3 days after operation, those of group B were intramuscularly injected with papaverine 30mg, 3 times per day,for one week. By analysis of clinical features and TCD data, both A and B could cure cerebral vasospasm, but group A was obviously superior to group B. Our conclusion is that papaverine solution lavaged locally can effectively prevent cerebral vasospasm after cerebral aneurysm operation .

Objective To investigate the effect of several types of cervical braces used for external immobilization on craniovertebral junction malformation. Methods 48 patients with craniovertebral junction malformation applied several types of cervical braces, including Philadelphia collar, sterno-occipito-mandibular immobilizer (SOMI) and Halo-vest, for the surgical treatment were retrospectively analyzed. Results The primary applications of external cervical brace after posterior internal craniovertebral fixation in this series were 20 cases of Philadelphia collar, 16 cases of SOMI and 12 cases of Halo-vest, with excellent or good results in 80%, 87.5% and 91.7%. The applications of external brace for post-hospital recovery were 16 cases of collar, 15 cases of SOMI and 17 cases of Halo-vest. 35 (72.9%) patients were followed-up for at least 4 months, with satisfying immobilization and duration which fulfilled the requirements for post-operative recovery. Conclusion The applications of the all of 3 kinds of external brace, including collar, SOMI and Halo-vest, have their important clinical value for peri-operational and post-operational recovery in the treatment of patients with craniovertebral junction malformation. To have a reasonable choice of these brace in different patients, the characteristics of pathology as well as the surgical stages should be taken into account.

Tetrahydroisoquinoline alkaloids distributed widely in the nature and some have a broad application in clinic. More attention has been paid in recent years on this type of alkaloid, owing to the diverse range of biological activities exhibited by these alkaloids and the discovery of new functional mechanisms and molecular targets underlying these activities. This article summarized the recent advances in the biological activities and functional mechanism of tetrahydroisoquinoline, which included the activities such as antitumor, antibiotic, antivirus, anti-inflammatory, anticoagulation, bronchodilation, and the action on central nervous system, with the purpose of providing some ideas in the study of biological activity of this type of alkaloid and in the search for lead-compound and rational drug design.
Animals ; Anti-Inflammatory Agents ; pharmacology ; Anticonvulsants ; pharmacology ; Antifungal Agents ; pharmacology ; Antineoplastic Agents ; pharmacology ; Antiviral Agents ; pharmacology ; Bronchodilator Agents ; pharmacology ; Central Nervous System Agents ; pharmacology ; Fibrinolytic Agents ; pharmacology ; Humans ; Neuroprotective Agents ; pharmacology ; Tetrahydroisoquinolines ; chemical synthesis ; chemistry ; pharmacology

Objective To evaluate the clinical effect of noninvasive positive pressure ventilation (NIPPV)on chronic obstructive pulmonary disease (COPD) with type Ⅱ respiratory failure. Methods Seventy-six cases of COPD with type Ⅱ respiratory failure were randomly divided into two groups.All patients were treated with antibiotics and other coventional therapy, 6 hours of intravenous drop infusion coramine was added to the control group (38 cases) and 6 hours of NIPPV was added to the treatment group (38 cases). Vital signs and arterial blood gas analysis were evaluated. Results After 6 hours of treatment, blood pressure, heart rate, respiratory rate and pH were significantly improved in the treatment group than those in the control group (P< 0.05 or < 0.01).Compared with the control group, there was a significant improvement of pH in the treatment group (P < 0.05). PaO2 increased [(81.7 ± 6.3) mm Hg (1 mm Hg = 0.133 kPa) vs (50.6 ± 4.3) mm Hg, (67.6 ± 7.4) mm Hg vs (50.8 ± 5.2) mm Hg] and PaCO2 decreased [(49.6 ± 4.5) mm Hg vs (78.5 ± 10.4) mm Hg, (60.8 ± 6.1)mm Hg vs (76.8 ± 8.3) mm Hg] was found in both groups, the amplitudes of PaO2 and PaCO2 before and after treatment were more singnificant in the treatment group (P < 0.01). Conclusion NIPPV on COPD with type Ⅱ respiratory failure can improve clinical symptom and arterial blood gas analysis more significantly than conventional therapy.

Objective To evaluate the clinical effect of ambroxol, budesonide and obstructive combinedly atomized inhalation on old patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Meth-ods 60 old patients with acute exacerbation of COPD were allocated into two groups in random, the control group(n =30) and the treated group(n =30). The control group was received conventinal theray,but the treated group re-ceived combinedly atomized inhalation on basis of conventional therapy. The two groups were treated in five-seven days, and were recorded the changes of clinical symptom, physicak sign, arterial blood gas analysis and the related side effect (for example, liver and renal function, blood sugar, etc). Results There are significant difference be-twcen the two groups in clinical effect (P < 0.05). Conclusion Ambroxol, budesonida and terbutaline combinedly atomized inhalation in the treatment of old patients with acute exacerbation of COPD was effective, little side effect and very safe.