Objective To determine the effects of dose reduction on multi-slice spiral CT(MSCT) of neonatal head and assess the lowest possible radiation for acceptable clinical images.Methods Fifty-seven newborns suspected intracranial hemorrhage were entered into the study and underwent MSCT scans.Original images at three anatomic levels (posterior fossa, basal ganglia, centrum semiovale) were collected and synthetic noise was added so as to simulate dose reductions of 25%, 40%, 50% and 70%, respectively by using the noise addition tool.A total of 855 image data sets were obtained for the 57 patients.Original and simulated dose-reduction scan images were analyzed.Image noise and image quality were assessed by two independent experienced pediatric radiologists using diagnostic acceptability score, subjective image noise score on a 5-peint scale and objective noise index.Image noise was measured by respectively placing region of interest (ROI) at cerebellum, thalamus and corona radiata of 3 different slices.And the noise index and mean value was calculated.The degree of inter-observer concordance was determined by Kappa statistical analysis.The Spearman statistical correlations between the noise index and diagnostic acceptability score were performed.Results On the images of original dose and simulated dose reductions of 25%, 40%, 50% and 70%, the diagnostic acceptability was 4.47±0.51, 3.96±0.33, 3.21±0.45, 2.92±0.32, and 1.85±0.57, respectively,the subjective image scores were 1.62±0.48, 1.99±0.48, 2.76±0.81, 3.19±0.67, and 4.27±0.54, respectively, the noise index were 1.90±0.19, 2.17±0.20.2.44± 0.25, 2.68±0.28, and 3.37±0.39, respectively.The two radiologists had good intembserver agreement for diagnostic acceptability (K=0.860, P=0.017) and for image noise scoff ng (K=0.630, P=0.022).There was significant statistical correlation between image noise index and diagnostic acceptability (r= 0.826,P=0.001).At 40% dose reduction to the standard protocol, the noise index was 2.44 and the image quality score was 3.21 which were considered clinically acceptable.Conclusion The study revealed that acceptable imagos could be obtained with mean noise index of 2.44 and 40% dose reduction.

To review the scientific evidence of system management for lung cancer patients with cancer- related fatigue by the method of literature review and evaluate researchers on authenticity, importance and applicability, in order to improve the nursing quality and the quality of life of them. Interventions of lung cancer patients with cancer- related fatigue mainly includes: non- drug intervention, drug intervention and self- management. The use of intervention measures should be combined with the situation of the patients. however, many of the effectiveness of the intervention measures not sure, need large sample randomized controlled trial verifies the results .

Objective To systematically evaluate the effectiveness of intermittent nasogastric feeding on enteral nutrition of critical patients. Methods The relevant randomized controlled trials were searched in the Cochrane Library, PubMed, EMbase, Web of Science, JBI Library and the databases of China National Knowledge Infrastructure (CNKI), China Scientific Journal Database by VIP (VIP), Wanfang Database. The studies were selected according to the inclusion and exclusion criteria by two reviewers. Meta- analysis was conducted by using RevMan 5.2. Results Nine RCTs were included involving 558 patients. The results of meta- analysis showed that intermittent nasogastric feeding was greater than continuous pump feeding in the incidence of constipation, OR=0.32, 95%CI 0.14~0.71, P<0.05, the difference was significant. However, they were alike in the incidences of diarrhea, aspiration pneumonia, gastric residuals, vomiting, abdominal distension and effects of nutrition, there was no statistical difference (P>0.05). Conclusions Intermittent nasogastric feeding and continuous pump feeding did not affect the incidence of diarrhea, aspiration pneumonia, gastric residuals, vomiting, abdominal distension and the effects of nutrition. However, the incidence of constipation was significantly less in patients receiving intermittent nasogastric feeding.

Objective To investigate any anti-inflammatory and curative effect of hyperbaric oxygen (HBO) therapy on mice with acute lung injury (ALI) induced by lipopolysaccaride endotoxin. Methods Fortysix Sprague-Dawley rats, half male and half female, were randomly divided into a normal saline group with 10 rats,an LPS group with 12 rats, and an HBO group with 24 rats. LPS was injected via the tail vein at 5 mg/kg weight to establish the ALI model. The HBO group rats were treated with HBO. Then leucocyte counts, arterial blood gas analysis, interleukin-8 (IL-8) in the blood and lung wet/dry weight (W/D) were compared among the 3 groups at the 3rd and 6th hours. Pathological changes were examined under a light microscope. Results Compared with the LPS group, blood oxygen and W/D were higher in the HBO group, the white blood cell, neutrophil and IL-8 all were lower, and inflammatory cell infiltration was less in lung slides from the HBO group. Conclusions HBO therapy can improve oxygen deficiency and has an anti-inflammatory effect. As a result it might have protective effect against ALI.

Objective To investigate the expression and clinical value of miRNA -22 in esophageal and gastric cancer tissues and cell lines.Methods Realtime -PCR was performed to detect the expression of miRNA -22 in human esophageal cancer cell lines ECA109,TE -1,TE -8,TE -13 and normal esophageal epithelial cells HEEC,48 cases of esophageal cancer tissues and matched adjacent normal tissues,human gastric cancer cell lines SGC -7901,MKN -45,NCI -N87,AGS,NUGC -3,SUN -1,normal human gastric mucosa cell line GES -1 and normal stomach fibroblastic cell NSFC,88 cases of gastric cancer tissues and matched adjacent normal tissues.Results The expression of miRNA -22 was much less in four esophageal cancer cell lines than that of immortalized normal esophageal epithelial cells HEEC,and the expression of miRNA -22 was much less in six gastric cancer cell lines than that of gastric mucosal epithelial cell line GES -1 and normal stomach fibroblastic cell line NSFC.The esophageal cancer tissues showed aberrant down regulation of miRNA -22 compared with the adjacent non -tumor tissues [(3.51 ±1.05)vs.(11.23 ±2.95),t =18.13,P <0.05].The gastric cancer tissues showed aberrant down regula-tion of miRNA -22 compared with the adjacent non -tumor tissues [(2.15 ±1.23)vs.(9.14 ±2.86),t =22.93, P <0.05].Conclusion The expression of miRNA -22 was much lower in esophageal and gastric cancer tissues and cell lines,which provided basement to nosogenesis,early diagnosis and create drug treatment of the cancers.

Objective To assess the efficacy and safety of over-the-scope clip(OTSC) system in treatment of the perforation ,fistula and bleeding of the digestive tract .Methods The data of 33 patients who were treated with OTSC in our department were analyzed retrospective-ly,and the technical success rate ,clinical success rate and complications were statistically analyzed .Among the 33 patients,there were 14 pa-tients with upper gastrointestinal bleeding , 8 patients with postoperative fistula , and 11 patients with endoscopic full-thickness resection (EFTR) of gastric or duodenal bulb.Results The technical success rate and clinical success rate of 33 cases were 96.97% and 93.94%respectively,and there was no complication in all patients .Among them,the clinical success rate of the upper gastrointestinal bleeding was 92.85%,the anastomotic fistula was 75.00%,and the EFTR was 100%.Conclusion As a new type of clinical endoscopic suture system , OTSC is safe and effective in gastrointestinal bleeding ,perforation and fistula .

Objective To observe the clinical efficacy of cerebral palsy children with liver strong spleen weak syndrome treated with integrated traditional Chinese medicine therapy. Methods Eighty cerebral palsy children with liver strong spleen weak syndrome were divided into treatment group (40 cases) and control group (40 cases). Patients in control group were treated with conventional therapy (including exercise therapy, occupational therapy, guidance education, physical factors, and psychological therapy), and patients in treatment group were treated with integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) additionally. Three months were set for a course of treatment, and the whole treatment lasted for a total of four courses. TCM clinical symptoms were scored every six months, muscle tone (MAS), gross motor function (GMFM), and daily life activity ability (MBI) were evaluated every three months for both groups. Results There were significant differences in the total scores of TCM clinical symptom, MAS, GMFM, and MBI at different treatment time points in the two groups, compared with that before treatment (P<0.01). There were significant differences in the total scores of clinical symptom for Chinese medicine, MAS, GMFM, and MBI at different treatment time points for treatment group, compared with that of control group (P<0.05). Conclusion Integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) for cerebral palsy children on the basis of western medicine therapy can more effectively improve function and life quality of children patients.

AIM:To evaluate the effects of treatment with HP 1188-immunoglobulin yolk ( HP1188-IgY) on Helicobacter pylori ( H.pylori)-infected gastritis in BALB/c mice.METHODS:BALB/c mice were used to establish an animal model of H.pylori-infected gastritis, and the mice were divided into 8 groups (10 mice per group).Oral antibiotics were used in group 1, 1 mg HP1188-IgY in group 2, 1 mg HP1188-IgY plus 30%sucralfate in group 3, 5 mg HP1188-IgY in group 4, 5 mg HP1188-IgY plus 30%sucralfate in group 5, PBS in group 6, and 30% sucralfate in group 7 with the treatment once per day for 10 d;and 2.5 mg HP1188-IgY was injected hypodermically twice with a 48-h interval in group 8.Another 10 mice were used as normal control in group 9.The planting of bacteria in the stomach was assayed by bacteri-al culture, rapid urease test, PCR and pathological sectioning .RESULTS:Intragastric administration with 1 mg HP1188-IgY plus 30%sucralfate per day effectively cured the injury of gastric mucosa caused by H.pylori infection, and the effect has no significant difference compared with antibiotics (P>0.05).CONCLUSION:We establish a BALB/c mouse mod-el infected with H.pylori successfully.Sucralfate (30%) is an ideal protectant for HP1188-IgY, which might decrease H. pylori infection in the stomach of BALB/c mice by oral inoculation .

Objective To report the clinical results and the advantages/disadvantages of anterolateral thigh flap (ALT) and forearm flap (FAF) in reconstruction of head and neck defect after cancer ablation. Methods 20 FAFs and 12 ALTs were performed to repair the head and neck tumor ablation defects. Of the 20 FAFs, 7 were used for repair of the through and through buccal defects, 4 for circumferential bypopharyngeal defects, 2 for plate defects, 1 for parotid area skin defect, 4 for floor of the mouth defects, and 2 for defect, of the base of the tongue, while of the 12 ALTs, 3 were used for repair of the defects of the base of the tongue, 4 for plate defects, and 5 for the floor of the mouth and/or lower gum defects. Survival of the flaps, function of the recipient site, and impact to the donor site were compared between these two groups to analyze the advantages/disadvantsges and key technique details of these two flaps. Results 19 FAFs totally survived. Vascular crisis occurred in 2 cases of FAF, of which 1 flap survived after conservative treatment, while the other 1 developed partial necrosis. All the 12 ALTs survived, without vascular crisis. 2 of the 14 planed ALTs were abandoned and replaced by FAFs, of which 1 because of absence of the perforating branch and the other 1 because of injury of the perforating branch. Secondary defects of the ALTs could be closed primarily, while secondary defects of the FAFs should be closed with skin grafts. Conlusion Both ALT and FAF can be performed with high survival rate. Each has its own advantages. Selection of the donor site deponds on situation of the defect and purpose of the reconstruction.

[ABSTRACT]OBJECTIVEThis study was designed to compare the quality of life between patients who
underwent a tongue reconstruction with radial forearm flap (RFF) and infrahyoid myocutaneous flap (IHMCF) after hemiglossectomy for their tongue cancers, and to figure out an optimal reconstructive method for the defects resulted from hemiglossectomy.METHODSA non-randomized case-control study was performed on 24 patients with tongue squamous cell carcinoma who underwent a standard hemiglossectomy combined with perfectly tongue reconstruction from June 2005 to June 2012. All of the cases were without tongue base invasion. Of the 24 cases, 19 had T2 disease, 5 had T3 disease, and they were divided into RFF group (n=10) and IHMCF group (n=14). The quality of life were evaluated one year after operation using EORTC-QLQ30 and FACT-H&N35 and compared between the two groups.RESULTSThe scores were comparable between the two group with regard to all domains of EORTC-QLQ30,with all P values>0.05.The scores of swallowing(P=0.005), speech (P=0.008), teeth (P=0.014), and cough (P=0.009) domains were significantly higher in IHMCF group than in RFF group, with P value of 0.005, 0.008, 0.014 and 0.009 respectively, while the other domains of FACT-H&N35 were comparable between the two groups, with allP values>0.05.CONCLUSIONOverall quality of life was similar in the two groups. Oral function domains were better in IHMCF group than in RFF group. When guarantee of flap survival is available, IHMCF could be used as a good alternative flap to RFF in tongue reconstruction after hemiglossectomy.