Radiotherapy has been an effective non surgical treatment for brain metastases.While the benefit of survival was achieved,the potential cognitive impairment caused by radiotherapy gradually arouse people's attention.To improve patient's prognosis,ensuring tumor control and caring patients' quality of life and neurocognitive functions should be weighed equally.This article reviews the related research on the neurocognitive protection of brain metastasis radiotherapy.

Objective To explore core competency of nursing students during internship in western China,and to provide reference for the nursing education.Methods 380 nursing students during internship were investigated with Competency Inventory for Registered Nurse (CIRN).Results The total score of core competency of nursing students was (136.40±31.99) points,weighted mean scores of eight dimensions was (2.36±0.51)points;the highest mean score was the dimension of legal and ethical practice (2.88±0.57)points,and the lowest mean score was the dimension of critical thinking (1.91±0.52)points.There was significant difference of core competency in students with different education background and with varied firstchoice profession.Conclusions The core competence of nursing students during internship remains at lower middle level.The nursing educators should shift their concept of nursing education to the new mode of professional competence orientation.

Objective To explore the relationship between hepatitis B virus (HBV) S gene variation,genetype and immunoprophylaxis failure to intrauterine infection of HBV.Methods The serum HBV DNA levels of 35 pairs of mother-infants were amplified and quantified by real-time fluorescent quantitative polymerase chain reaction (PCR).Thereafter,the sequences of HBV S gene were determined by sequencing and compared with Genbank standard sequence using DNASTAR software.Results HBV DNA levels of the 35 pairs of mother-infants were all above 1×106 copy/mL.Nucleotide diversity rates were 11.4% in the children and 17.1% in their mothers.The sequence homology between paired mother and infant was beyond 99.3%.The HBV genotype and serotype in 23 pairs of mother-infants was C and adr respectively,while that was B and adw in the other 12 pairs.The HBV genotype and serotype were identical between paired mothers and infants.Conclusions HBV S gene variation may not be a crucial factor for immune failure to HBV intrauterine infection in women with high level viremia.Genotyping could not predict and evaluate the risk of immunoprophylaxis failure to HBV intrauterine infection in neonates.

Objective To explore the risk factors,composition of pathogen and drug sensitivity of pulmonary infection in neurosurgical intensive care unit(NICU) and provide basis forclinical effective prevention and appropriate treatment.Methods Retrospective analysis the detected pathogenic strains,theirdrug resistance and predisposing factors of the cases of pulmonary infection in NICU from January 2010 to September 2011.Results Among the isolated 602 bacteriastrains,363 strains (60.2％ ) were G-bacteria,71 strains ( 11.8％ ) were G + bacteria,168 strains (28 ％ )were molds.In G-bacteria,the main strains are acinetobacter and pseudomonas aeruginosa,and in G+ bacteria,staphylococcus epidermidis based most.Conclusion Acinetobacter has become the dominant flora of pulmonary infection in NICU and it has multidrug resistance to antibiotics in clinical.The Specific pathogen should be indentified through bacteriological examination of sputum as soon as possible,and the antibiotics should be used alternatively based on their drug sensitivity to control lung infection in critically ill patients.

Ischemic stroke is closely associated with carotid atherosclerosis.Detecting carotid plaque components (including fibrous Cap,lipid core,hemorrhage,and calcification) using high-resolution 3.0T magnetic resonance imaging contributes to evaluate the risk of ischemic stroke and guide treatment.This article reviews the research status of magnetic resonance imaging of carotid atherosclerotic plaque components.

Stroke-associated pneumonia (SAP) refers to the stroke patients suffering from infectious lung parenchyma (including the alveolar wall,i.e.the general pulmonary interstitial) inflammation without previous pulmonary infection.It is one of the most common major complications resulting in death and affecting functional recovery in patients with stroke.Dysphagia resulting in aspiration is the main reason of SAP.Therefore,avoiding aspiration and preventing SAP have important significance for patients with stroke through early correct tube feeding.This article reviews the tube feeding methods of preventing SAP.

Transient ischemic attack (TIA) traditionally refers to temporary brain dysfunction lasting no longer than 24 hours due to a shortage of blood and oxygen, without any residual neurological deficit. In recent years, the development of imaging technology enables us to have a new awareness about TIA. This article reviews the effects of MRI, especially diffusion-weighted imaging, in the diagnosis and prognostic prediction of TIA.

Objective To study the effect of exogenous 3-deoxyglucosone (3-DG) on blood glucose of normal mice. Methods Kunming male mice were divided into two groups: 3-DG (5mg/kg) treatment and control group.At day 1,week 1 and week 2 after treatment, we compared fasting blood glucose,and did the glucose tolerance test in 3-DG group after 2 weeks' 3-DG administration. Results Blood glucose was increased obviously 2h after administration with 3-DG once versus pre-administration and control (7.78±0.694 vs 6.41±0.408,and 6.43±0.43,all higher than control,but no statistical significance (P＞0.05). There were no differences in 6 hour fasting blood glucose after once administration with 3-DG and in 12 hours fasting blood glucose two weeks after administration with 3-DG between 3-DG and Con groups. After 3-DG administration for two weeks,as compared with Con, the 30 minute blood glucose of 3-DG administration mice during OGTT was obviously increased (19.47±1.541 vs 17.22±1.911,P＜0.05), but glucose levels at 60 minute and 120 minute had no changes (P＞0.05). Conclusions Exogenous 3-DG increases the normal mice's blood glucose immediately after once administration with 3-DG and results in up-moving of glucose physiological curve and leads to a light impairment of glucose tolerance when mice were continuously fed with 3-DG for 2 weeks.

Objective To investigate the incidence and occurrence time of PICC-related upper extremity asymptomatic and symptomatic venous thrombosis in cancer patients;to explore the risk of asymptomatic venous thrombosis' developing into symptomatic venous thrombosis.Methods A total of 246 cancer patients who were scheduled to receive PICC between April and October 2014 were prospectively studied and divided into 2 groups by random digits table method.The time-phased follow-up observation on PICC cathertering cancer patients was conducted by Doppler ultrasound.The follow-up visiting inspection on the cathering upper limb vein by Doppler ultrasound at the 2nd,7th,14th,21st,28th,35th,42nd day were arranged after insertion of the catheter in experimental group (127 cases) to understand the incidence and occurrence time of asymptomatic venous thrombosis,while the control group (119 cases) were investigated for inspecting whether there were venous thrombosis through clinical symptoms or not.Once the clinical symptoms occurred,the incidence and time of occurrence of symptomatic venous thrombosis would be diagnosed by Doppler ultrasound and recorded.Results The incidence rate of asymptomatic thrombosis in the experimental group was 48.82％(62/127),the median time was 3 days,and there was no symptomatic thrombosis.Among them,85.48％(53/62) of the asymptomatic thrombosis occurred within 1 week,11.29％ (7/62) occurred in 2-3 weeks,and 3.23％ (2/62) occurred in 4-6 weeks after catheter insertion.Meanwhile,the incidence and median time of symptomatic thrombosis was 23.53％(28/119) and 12 days respectively in the control group.And 32.14％ (9/28) of these cases occurred within 1 week,50.00％ (14/28) occurred in 2-3 weeks,and 17.86％ (5/28) occurred in 4-6 weeks after catheter insertion.Conclusions The incidence of PICC-related upper extremity venous thrombosis in cancer patients is relatively high,and most cases have no symptoms and occur in an early time.Cancer patients are high-risk patients of venous thrombus.We should take early preventive intervention and treatment to reduce the incidence of venous thrombosis after catheter insertion.

Glucose-6-phosphatase (G6Pase) activity in the skeletal muscle cells was observed with electron microscope in rats.It was found that the reaction product of G6Pase activity was localized in the sarcoplasmic reticulum (SR) and nuclear envelope and a heterogenous distribution of G6Pase activity in the SR was shown.On the basis of the position relationship between SR and sarcolemmal system,the skeletal couplings can be classified as follows.1.The coupling between the terminal cisternae and the transverse tubules such as a triad.2.The peripheral coupling between the peripheral SR and the surface sarcolemma.3.The coupling between the subsarcolemmal SR and the subsarcolemmaltransverse tubules.The significance of the findings was discussed.