Objective To investigate the effect of xenon intervention on delayed neuropsychologic sequelae (DNS)in acute carbon monoxide(CO)poisoning.Method Adult Wistar rats were randomly divided into sustained group,early intervention group,and control group.CO(150 ml/kg)was infused by intraperitoneal injection to produce DNS model.In sustained intervention group(S-group),xenon(150 ml/kg/d)was infilsed by intraperitoneal injection for 2 weeks;in control group(C-group),xenon was replaced by equal volume air;and in early intervention group(E-tvoup),xenon(150 ml/kg/d)was,employed in the first 3 days and air(150 ml/kg/d)was substituted for xenon in the following days until 2 weeks after CO poisoning.Morris maze test was used to evaluate the intelligence of rats.The long-term potentiation(LTP)of hippocampus Was detected by neuroelectricity recording.The apoptosis rates in brain was detected by TUNEL staining.The data were expressed as(x±s)and analyzed with student's test and analysis of variance.A P value less than 0.05 indicated statisfical significance.Results After exposure to CO,poisoned rats showed intelligence decline,demyeliation ofwater matler and cell apoptosis increased,which were consistent with DNS.In S-group and E-group,the rates of DNS and apoptosis were significantly lower than those in C-group,whereas the rote of LTP in S-group and E-group Was significantly higher than those in C-group.Conclusions Early xenon intervention can effectively decrease the rates of DNS occurred after acute CO poisoning.

Objective To compare the efficacy of self-made bone cement spacers containing vancomycin(vancomycin spacer)and Link infection-treating spacers(Link type spacer)for chronic infection after total hip arthroplasty(HTA)and investigate the choice of spacers for the two-stage revision of infection.Methods The study included 26 patients with infection combined with HTA,aged 32-82 years(mean 69.5 years).In the first stage,after complete debridement and removal of infected prostheses,the vancomycin spacers were implanted in 14 patients,while the Link type spacers were implanted in the rest 12 patients.Two weeks of intravenous administration of antibiotics and then six weeks of oral administration of antibiotics were done postoperatively.White blood cells(WBCs),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were measured periodically after operation.THA revision was performed in the second stage.Clinical outcomes were evaluated according to the pre-and post-operative Harris hip score.Results All patients obtained primary healing of incision after complete debridement,removal of prostheses and implant of the vancomycin spacers or the Link type spacers.Two-stage revision surgery was performed at 3-11.5 months after the one-stage surgery(mean 5.2 months).The follow-up ranging from 12 to 33 months(mean 20.8 months)manifested no signs of reinfection.The mean Harris hip score was increased from 27.9 points before one-stage operation to 52.9 points before two-stage operation,and 83.6 points at the latest follow-up(P＜0.05)One of 12 vancomycin spacers was broken before the revision surgery,as was free from the Link spacers.Conclusions(Ⅰ)Two-stage revision is an effective method in the treatment of infection after HTA because of high eradication rate of infection,effective pain relief and good postoperative functional result.(2)The vancomycin spacers and the Link type spacers can both effectively control infection and restore part of limb function.(3)The Link type spacers take advantages of simple in operation and the function improvement of the limbs during the intermittent period of treatment,but disadvantages of the catheters being prone to block,limited slow release of antibiotics and high cost of treatment.Thereby,the Link type spacer is suitable for the patients with relatively strong constitution,little serious infection,or high requirement of limb functions at the interval of two operations.

Objective To explore the influencing factors on short -term efficacy of intravenous thrombolysis with rt -PA.Methods The clinical data of the 95 acute ischemic stroke(AIS)patients who received thrombolytic therapy were analyze.Multivariate logistic regression analysis was used to determine the possible influencing factors. Results Fifty -six(58.95%)patients had favourable outcomes after thrombolytic therapy for 24 hours.Multivariate logistic regression analysis indicated that diabetes(OR =3.933,95% CI 1.199 ~12.897)and TOAST classification (OR =1.448,95% CI 1.032 ~2.032 )were the independent predictors of short -term outcome.Conclusion Diabetes and TOAST classification are the major influencing factors of short -term efficacy after intravenous thrombolysis with rt -PA.It should pay attention screening patients for intravenous thrombolysis therapy and predicting the efficacy of thrombolysis.

OBJECTIVETo develop a non-pharmacotherapy program for patients with hyperlipidemia and assess its effectiveness.

METHODSA cluster control trial was used. The experimental group was given non-pharmacotherapy for hyperlipidemia once a week for 6 weeks; the content of non-pharmacotherapy included the basic knowledge about hyperlipidemia, a guide of changing unhealthy diet and life-style. Patients were followed for once every two weeks in the department of out-patient. The control group received general care conducted by university clinicians, without the non-pharmacotherapy program. A self-completion questionnaire on hyperlipidemia-related knowledge level, questionnaires on diet and exercise, body weight, body height and the serum TG, TC were measured at entry point and at the end of 6 month.

RESULTSOne hundred and fifty-four patients in experimental group and 150 patients in control group completed the study. The non-pharmacotherapy group showed a significant increase of knowledge on hyperlipidemia in the experimental group comparing with the control group: the mean (sd) score of hyperlipidemia-related knowledge were 22.5 (4.8), 17.4 (4.2) (95% CI: 4.1, 6.1). The diet score and the proportion of regular physical activity had increased 27.20%, 21.78% respectively in experimental group. The mean (sd) of serum TG, TC and body mass index (BMI) for experimental group [2.0 (0.9) mmol/L, 5.4 (0.9) mmol/L, 23.4 (1.9)] lowered significantly comparing to those for control group [2.4 (0.9) mmol/L, 5.9 (1.0) mmol/L, 24.2 (3.0)].

CONCLUSIONNon-pharmacotherapy seemed to be an important intervention for the patients with hyperlipidemia. If same patients with hyperlipidemia failed to respond to non-pharmacotherapy, it is necessary to use pharmacotherapy. However, non-pharmacotherapy should be viewed as basic therapy.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Hyperlipidemias ; blood ; therapy ; Life Style ; Lipids ; blood ; Male ; Middle Aged ; Regression Analysis

Multiple sclerosis (MS) is a disease characterized as inflammatory demyelinating of the central nervous system,which is the main cause of non-traumatic neurological disability in young and middle-age adults.The main manifestations of MS are memory and information processing speed,executive function and other cognitive impairments.MS associated with memory impairment (MSMI) is often overlooked because of the occult onset,which seriously affecting patients' life quality.In recent years,with the rapid development of neuro-functional imaging,MRI has become an important method to observe and diagnose MS,providing imaging evidence for diagnosis of MSMI.The clinical and MRI research progresses of MEMI were reviewed in this article.

Objective:To measure and analyze the distribution characteristics of the micro-hardness of the middle-upper thoracic vertebrae (T 1-T 10) in the human body. Methods:T 1-T 10 vertebrae from three fresh cadavers were divided into vertebral body area and attachment area. 3 mm specimens were cut by a high-precision slow saw and 11 regions were selected and measured on each vertebrae by a Vickers microhardness tester (cortical bone: 1-9, cancellous bone: 10-11). The micro-hardness distribution of T 1-T 10 vertebrae was recorded and analyzed. Results:A total of 330 measurement areas from 30 vertebrae were measured, and 1 650 hardness values were collected. The average hardness values of the overall cortical bone of the middle-upper thoracic vertebrae of the 3 cadavers were 30.55±5.44 HV, 29.94±4.86 HV, and 29.55±4.36 HV, respectively. The difference among the groups was statistically significant ( F=4.680, P=0.009). The average hardness values of the overall cancellous bone were 27.93±5.61 HV, 28.21±4.96 HV, 27.98±3.94 HV, respectively. There was no significant difference among the groups ( F=0.091, P=0.913). There were statistically significant differences between the hardness values in the attachment area and vertebral body area of each cadaver ( t=7.467, 4.750, 6.621, P<0.001); the hardness of the cancellous bone in the attachment area of each cadaver was higher than that of the cancellous bone in the vertebral body ( t=1.785, 3.159, 3.103, P=0.077, 0.002, 0.003). The distribution of microhardness in 11 measurement areas of 3 cadavers were similar: the hardness of the cortical bone of pedicle, lamina and inferior endplate cortex (1, 2, 7) were higher; the hardness of the cortical bone of upper endplate and peripheral cortex (6, 8, 9) were lower. The distribution patterns of the microhardness in different vertebral segments of the 3 cadavers were similar: The hardness values gradually increased from T 1 to T 10. The vertebra with the largest hardness of the cortical bone was T 8; and the vertebra with the largest hardness of the cancellous bone were T 7, T 7 and T 6, respectively. Conclusion:The hardness of the upper endplate and peripheral cortex was low, which could disperse the load to protect the fragile cancellous bone. The hardness of the pedicle was the highest. The hardness of the cortical bone was higher than that of the cancellous bone, and the values of different segments gradually increased from top to bottom, which may be related to the physiological and anatomical morphology, and the gradual increase of the load of muscle force and body weight.

Objective To study the value of transcranial Doppler (TCD) combined with digital subtraction angiography (DSA) in the evaluation of intracranial vessels in patients with cerebral watershed infarction.Methods The clinical and imaging data of 97 patients with cerebral watershed infarction,admitted to our hospital from June 2008 to June 2011,were retrospectively analyzed.All patients underwent TCD and DSA examination.Comparative analysis of TCD and DSA for intracranial stenosis diagnosis and compensatory collateral circulation in these patients was performed,and the advantages and disadvantages of TCD and DSA in these cases were compared.Results Eight hundred and seventy-three intracranial vessels of the 97 patients were analyzed.TCD and DSA showed no significant differences in evaluation of vascular stenosis or occlusion (P=0.503).As to the collateral circulation,no significant differences between TCD and DSA were shown in the evaluation of anterior communicating artery compensatory (P=0.754),while TCD was more sensitive than DSA in the evaluation of ophthalmic artery compensatory (P=0.039),and DSA was more sensitive in evaluating the posterior communicating artery and pial artery compensatory (P=0.035 and P=0.000).The internal watershed infarction and cortical watershed infarction had significant differences in intracranial vascular stenosis or occlusion and collateral circulation (x2=9.762,P=0.002; x2=24.708,P=0.000).Conclusion Combining TCD and DSA can contribute to judge the intracranial vascular lesions and collateral circulation correctly.

Objective To assess the factors associated with occurrence of stroke in Xuzhou region on the basis of stroke registry database using data mining methods Relief F algorithm.Methods Five hundred and forty-six patients with acute cerebral infarction from June 2013 to June 2014 in Stroke Registry database and 546 healthy people at the same period in the region were chosen;their clinical data were collected and retrospectively analyzed.And the related data were collected,arranged and put into epidata database.Firstly,the data were normalized and converted to the number between 1 and 10.Relief F algorithm was used to analyze the weight of past histories and hematology index between healthy control group and stroke group.Matlab software was used to program and calculate,and the main program runs for 20 times.And then,the obtained results for each weighted average were summarized.Finally,the weight of past medical history and blood parameters in healthy control group and stroke group were obtained.Results Relief F algorithm was applied for data analysis:as compared with healthy controls,stoke group had higher weight of infarction (0.0353125) and history of drinking (0.01175),while not higher weight of history of hypertension,diabetes mellitus or transient ischemic attack;as compared with healthy controls,stoke group had higher weight of uric acid nitrogen level (0.0072),blood uric acid level (0.0071),cholesterol level (0.0067) and homocysteine level (0.0064),followed by high-density lipoprotein (0.0062),low density lipoprotein (0.0041) and triglyceride (0.0039).Conclusion Application of Relief F algorithm can excavate the closely related potential risk factors for stroke in stroke registration database.

Compared with the previous automatic segmentation neural network for the target area which considered the target area as an independent area, a stacked neural network which uses the position and shape information of the organs around the target area to regulate the shape and position of the target area through the superposition of multiple networks and fusion of spatial position information to improve the segmentation accuracy on medical images was proposed in this paper. Taking the Graves' ophthalmopathy disease as an example, the left and right radiotherapy target areas were segmented by the stacked neural network based on the fully convolutional neural network. The volume Dice similarity coefficient (DSC) and bidirectional Hausdorff distance (HD) were calculated based on the target area manually drawn by the doctor. Compared with the full convolutional neural network, the stacked neural network segmentation results can increase the volume DSC on the left and right sides by 1.7% and 3.4% respectively, while the two-way HD on the left and right sides decrease by 0.6. The results show that the stacked neural network improves the degree of coincidence between the automatic segmentation result and the doctor's delineation of the target area, while reducing the segmentation error of small areas. The stacked neural network can effectively improve the accuracy of the automatic delineation of the radiotherapy target area of Graves' ophthalmopathy.
Algorithms ; Image Processing, Computer-Assisted ; Neural Networks, Computer ; Tomography, X-Ray Computed

Although high-efficiency targeted delivery is investigated for years, the efficiency of tumor targeting seems still a hard core to smash. To overcome this problem, we design a three-step delivery strategy based on streptavidin-biotin interaction with the help of c(RGDfK), magnetic fields and lasers. The ultrasmall superparamagnetic iron oxide nanoparticles (USIONPs) modified with c(RGDfK) and biotin are delivered at step 1, followed by streptavidin and the doxorubicin (Dox) loaded nanosystems conjugated with biotin at steps 2 and 3, respectively. The delivery systems were proved to be efficient on A549 cells. The co-localization of signal for each step revealed the targeting mechanism. The external magnetic field could further amplify the endocytosis of USPIONs based on c(RGDfK), and magnify the uptake distinctions among different test groups. Based on photoacoustic imaging, laser-heating treatment could enhance the permeability of tumor venous blood vessels and change the insufficient blood flow in cancer. Then, it was noticed that only three-step delivery with laser-heating and magnetic fields realized the highest tumor distribution of nanosystem. Finally, the magnetism/laser-auxiliary cascaded delivery exhibited the best antitumor efficacy. Generally, this study demonstrated the necessity of combining physical, biological and chemical means of targeting.