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 investigate the correlation between thyroid antibody level and carotid atherosclerotic plaque in patients with acute ischemic stroke.Methods Consecutive patients with acute ischemic stroke were enrolled retrospectively.They were divided into a non-plaque group and a plaque group according to the findings of carotid artery color-Doppler ultrasonography.The plaque group was redivided into a stable plaque subgroup and a non-stable plaque subgroup.Chemiluminescence method was used to measure the serum thyroperoxidase antibodies (TPOAb) and thyroglobulin antibodies (TGAb) levels and they were compared.Results A total of 383 patients were enrolled in the study,including 116 (30.3％) did not have plaque and 267 (69.7％) had plaque,68 of them had unstable plaque,and 199 had stable plaque.The level of TGAb in the plaque group was significantly higher than that in the non-plaque group (Z =-4.826,P ＜0.001).Multivariate logistic regression analysis showed that the level of TGAb might be an independent risk factors for carotid plaque (odds ratio 1.007,95％ confidence interval 1.001-1.012;P =0.016).The serum level of TPOAb in the stable plaque group was significantly higher than that in the unstable plaque group (Z =-2.114,P=0.035),but multivariate logistic regression analysis showed that it was not the independent risk factor for unstable plaque (odds ratio 1.001,95％ confidence interval 0.996-1.006;P =0.786).Conclusions The level of serum thyroid antibodies increased in patients with acute ischemic stroke,especially the increased level of TGAb might be associated with the occurrence and development of carotid atherosclerotic plaque,however,it was not associated with the plaque stability.

This paper focus on conductive education approach during exercise therapy of cerbral palsy childrens, which emphasis the children active participation in the exercises and their phsycological reactions. Its main feature is using the rythmicl intention, task analysis and task series as the tools to perform the goal - directed activities in group setting and carry it out in the children' s daily life. The current studies on the motor control and motor learning are reviwed in this paper as well.

Objective To study the clinical and imaging characteristics of cerebral venous sinus thrombosis(CVST).Methods Clinical data of 9 cases with CVST were retrospectively analyzed.Results All patients had headache,nausea and vomiting; 5 patients had epilepsy; 3 patients had focal neurological deficits; 3 patients had fever; 3 patients had palilledema; 3 patients had disturbance of consciousness. CSF examination showed prominent high intracranial pressure, but conventional and biochemical examinations were normal. 8 patients did CT scan, but the diagnosis was not clear. All patients first MRI showed venous sinus and related brain areas long T1 and T2 signal; MRV showed that the involved venoussinus had non-visualized signal. MRI in chronic phase showed slightly higher T1 and T2 signal; MRV showed sinus enhancement.The outline of uncomplete reconalzation was unclear. Conclusions The common high intracranial pressure is unspecific sign and symptom of patients with CVST. CSF examination show that the intracranial pressure is prominent high, but conventional and biochemical examination are normal. MRI can show that the normal flow void of the dural sinus is disappeared, instead of abnormal high or equality intensities. The characters of CVST in MRV are those the blood flow signal of involved venous sinus be disappeared or showed anormalism.

Objective To investigate the clinical characteristics, treatment, and factors of recurrence of abdominal wall endometrioms ( AWE). Methods 19 cases of AWE diagnosed at Shaoxing People' s Hospital from January 2005 to April 2009 were reviewed retrospectively. Results All patients had a history of cesarean section. Eleven patients (57.9%) had the typical complaint of an enlarging mass and pain during menstruation. All patients received surgical excision and postoperative adjuvant therapy of gonadotropin releasing hormone agonist (GnRHa) or Mifepristone treatment for 6 months. The diagnosis was confirmed by histological examination in all patients. At follow- up, ranging from 1 month to 3 years, there was 1 case of recurrence of endometrioms during a follow -up of 2 years. Conclusion AWE could be diagnosed easily by its typical clinical manifestations preoperatively. Sonography or MRI may be helpful in identifying the exact anatomical location of the lesion and in excluding other surgical conditions, however it lacks specificness. Surgical excision is the only effective treatment, and complete and wide local excision is the key point to prevent recurrence. Combination surgical excision with postoperative adjuvant therapy might reduce the recurrence, although its effectiveness need being testified in the future.

OBJECTIVE:To provide a method for a scientific and rational formation of hospital drug purchase plan.METHODS:Based on the major factors influencing the drug purchase plans,a moving-average method(mathematical principle)was used to establish computational formula for hospital drug purchase plan model,which was then put into practice.RESULTS:The predicted amount calculated using the computation model could be used to track the actual consumption quantity rapidly;this model could auto-adjust the inventory and dynamically forecast the drug purchase amount.CONCLUSION:The computation model contributes to the scientific and reasonable formation of hospital drug purchase plan thus meeting the needs of majority clinical drugs.

Objective To assess the effect of acute hypervolemic hemodilution (AHH) with different hemodiluents on activation of platelets. Method Twenty ASA I-II patients undergoing total hip replacement under general anesthesia were enrolled in this study. They averaged 54 ~ 76 years and 50 ~ 74 kg. The patients were premedicated with intramuscular phenobarbital 2 mg.kg-1 and atropine 0.01 mg. kg-1 . Anesthesia was induced with fentanyl 2ug. kg-1 , dropendol 50 ug. kg-1 , midazolam 40 ug. kg-1 and propofol 1 mg.kg-1. Tracheal intubation was facilitated with vecuronium 0. 1 mg.kg-1 . Anesthesia was maintained with infusion of propofol (2-4mg.kg-1. h-1) and vecuronium (0.06-0.2 mg. kg.h-1) and isoflurane inhalation. Radial artery and right suhelavian vein were eannulated for BP and CVP monitoring. The patients were randomly divided into 2 groups with 10 patients in each group : (A) HES group received hydroxyethyl starch (HES) 25 ml.kg-1 and (B) LR group received Ringer's lactate solution 25 ml.kg-1. In both groups HES or RL solution was infused at a rate of 30 ml-kg-1.h-1 after induetion oi anesthesia. Venous blood samples were taken before induction of anesthesia (T1 ), before AHH (T1 ), 15 min ( T3 ) , 30 min ( T4 ) and 45 min ( T5 ) after the beginning of AHH for determination of the percentage of CD62P and CD63 positive platelet using flow eytometry. ECG, HR, MAP, CVP and urine output were continuously monitored. Small doses of nitroglyeerin were given according to CVP monitoring. Results CD62P expression at T3 , T4 and T5 was significantly higher than that at T, ( P

This paper introduces the implementation of an electronic medical records system and the integration of clinical data in our hospital. The electronic medical records system is grounded on XML based electronic inpatient records and focused on information of patient treatment, which has integrated information of prescriptions , outpatient visits, PACS, medical examination technologies, laboratories, nursing records, reports of infectious diseases and hospital infections, licenses for antibiotics and pharmaceutical repositories, and the clinical data with electronic medical records as the carrier. This system has provided physicians with effective tools for diverse paperless medical records and favorable conditions for diagnosis and treatment, it has improved the work efficiency of physicians, optimized hospital process, minimized errors and improved quality of medical treatment. With the development of real-time quality control of medical records, we have improved efficiency and quality of hospital management.

Objective To investigate the effect of hypobaric hypoxia postconditioning( HHP) on neurological func-tion prognosis in traumatic brain injury( TBI) rats. Methods 48 adult male Wistar rats were randomly divided into sham group(n=12),fpi group(n=18) and HHP group(n=18). The rat model of TBI was made by the method of fluid percussion injury( FPI) and rats in HHP group were submitted to HHP(360 Torr,2 h,3 trails spaced at 24 h) starting 3 h after FPI. The learning and memory abilitiy,motor coordination,anxiety and depression-like behaviors and surviving neurons of ipsilateral hippocampus were evaluated by Morris water maze( MWM) ,rotatord test,open-field test and hippocampus nissl stain respectly. Results Morris water maze:compared with sham and HHP group, learning and memory abilitiy of rats in fpi group were significantly decreased(F=4. 257 6,P<0. 05),whereas no difference was observed between sham and HHP group(P>0. 05);Rotatord test:compared with sham group,motor coordination of rats in HHP group were significantly decreased ( F=4. 335 , P<0. 05 ) , whereas no difference was observed between sham and fpi group ( P >0. 05 );Open-field test:compared with sham group, rats of fpi group showed significant anxiety and depression-like behavioral changes, whereas no difference was observed between sham and HHP group;Nissl stain:No difference of surviving neurons of ipsilateral hippocampus CA1 and CA3 re-gion was observed among three gourps at 3 d after FPI(P>0. 05). There were significantly fewer surviving neurons of ipsilateral hippocampus CA1 and CA3 region in fpi group than sham and HHP group at 24 d after FPI ( F =46. 758,5. 486,P<0. 05). Conclusion TBI induces learning and memory impairment,anxiety and depression-like behaviors and neurons death in hippocampus. HHP was first discovered having double effects on neurological func-tion prognosis in TBI rats. On the one hand,HHP can remove the impairment of learning and memory,anxiety and depression-like behaviors and neurons death in hippocampus;on the other hand,HHP impairs motor coordination at the same time.

Objective To establish evaluation methods for compliance of patients taking Chinese medicine decoctions, according to the score of degree and weight for the unreasonable behaviors. Methods The patients taking TCM decoctions during July to December in 2010 were interviewed. Self-made scale was used for questionnaire and interview. The score of degree and weight for the unreasonable behavior were employed as evaluation indexes for compliance (0:complete compliance;0