Objective To explore the risk factors for the development of delayed neuropsychologic sequelae (DNS)and to characterize the clinical course following the development of DNS in acute CO poisoning cases. Methods This study included 79 cases of acute CO poisoning,and they were divided into two groups consisting of 13 cases who developed DNS and 66 cases who did not.The generally conditions of the two groups [including age, gender,exposure environment,the time of coma,whether through referral,the severity of disturbance of consciousness, computed tomography(CT)abnormal,first time to see a doctor if hyperbaric oxygen therapy]and laboratory index [carbon oxygen hemoglobin(COHb),WBC,creatine kinase (CK),creatine kinase isoenzyme (CK -MB),lactate dehydrogenase(LDH),hospitalization time,HBO]were analyzed by single factor variance analysis,Chi -square test and Mann Whitney U test.Results Compared with the non DNS group,in the DNS group,JCS score was significantly higher[(200.4 ±107.24)points vs.(94.55 ±52.71 )points,U =8.373,P <0.01 ],CT abnormal skull increased (76.9% vs.6.2%,χ2 =9.548,P <0.01),CK[(5976.33 ±4 371.92)IU /L vs.(2 384.67 ±650.86)IU /L,F =6.877],CK -MB[(51.22 ±33.28)IU /L vs.(23.47 ±15.66)IU /L,F =4.329],LDH[(395.80 ±270.04)IU /L vs.(221.87 ±101.95)IU /L,F =1.012]increased,there were statistically significant differences between the two groups by single factor analysis(all P <0.01 ).The patients with DNS had longer hospitalized time [(283.27 ± 251.08)d vs.(37.93 ±37.18)d,F =2.283]and HBO time[(51.62 ±16.69)d vs.(7.70 ±5.38)d,F =6.428], there were statistically significant differences between the two groups by single factor analysis (all P <0.01 ). Conclusion In patients with the characteristics identified in this study,administration of HBO therapy should be proactively considered after informing their family at initial stage,thus to decrease the risk of developing DNS.

Objective To evaluate the clinical value of fibrinogen and D-dimer(D-D)in the diagnosis of patients with acute pulmonary embolism.Methods A retrospective study was conducted.74 patients with acute pulmonary embolism were retrospectively analyzed.The general clinical data were gathered,and the patients were divided into high-risk group(n=20),moderate-risk group(n=32),and low-risk group(n=22)according to the 2008 ESC Guidelines on the diagnosis and management of acute pulmonary embolism.25 patients with physical examination were randomly recruited as control group.The plasma levels of fibrinogen and D-D were detected and compared between these groups.Receiver operating characteristic curve(ROC)was used to evaluate diagnostic biomarker performance.Results In acute pulmonary embolism patients,with the risk degree increased,the level of fibrinogen decreased[(4.20±0.82)g/L,(4.16±0.83)g/L,(3.62±0.74)g/L,(2.83±0.62)g/L](compared with control group,P=0.183,moderate-risk group,P=0.046,high-risk group,P=0.033;compared with low-risk group,moderate-risk group,P=0.041,high-risk group,P=0.037;compared with moderate-risk group,P=0.044),and the level of D-D increased[(1 845.20±3 939.56)μg/L,(4 405.27±2 356.68)μg/L,(4 360.63±2 675.40)μg/L,(16 817.00±6 878.66)μg/L](compared with the control group,low-risk group,P=0.392,moderate-risk group,P=0.042,high-risk group,P=0.027;compared with low-risk group,P=0.136,P=0.016;compared with moderate-risk group,P=0.035).The ROC curve showed that the AUC of D-D in each group were 0.865,0.834 and 0.974,respectively.AUC of FIB were 0.459,0.253 and 0.277,respectively,which were below or even significantly lower than predicted line area.Conclusion The performance of fibrinogen in the diagnosis of acute pulmonary embolism and the classification of the risk degree is very low.

Objective To measure and calculate the dose distribution (tissue absorbed dose) of mouth floor area while using 125I to treat sublingual gland carcinoma.Methods Phantom of head and neck was used to place the 125I radioactive seeds to simulate the sublingual gland carcinoma treatment.125I radioactive seeds of 29.6 and 25.9 MBq per seed were used as two groups,with 31 seeds in each group,and prescribed dose (peripheral matched dose) was 120 Gy.Thermoluminescence dosimetry (TLD) was used to measure the absorbed dose value in the simulated target and adjacent area.Gafchromic Eriochrome Black T (EBT) film was used to draw the dose distribution curve.Results Dose absorbed in the target area,target area center and the adjacent area one centimeter away from target reached 160 Gy,390-500 Gy,and 90-170 Gy,respectively.Dose of the skin ranged from 25 to 81 Gy,dose of mandible ranged from 7.9 to 67 Gy.No radiation cold spot was found.Conclusions 125I seeds could achieve an effective therapeutic dose distribution of the target area for sublingual gland carcinoma.Dose absorbed in the adjacent tissue is under safety limit.The radiation dose at mandible is lower,reducing the possibility of radiation damage to the bone.

In the present study, the efficacy of Naoxintong capsule (NXT), a compound Chinese herbal medicine, combined with dual antiplatelet therapy (DA) in a rat model of coronary microembolization (CME) was evaluated.

Objective To discuss the application effect of brain natriuretic peptide (BNP)and QRS wave in nursing intervention of postmenopausal women with heart failure.Methods 85 postmenopausal women with heart failure in our department were chosen.43 patients in the control group were given routine nursing,42 patients in the observation group were given pertinent nursing according to BNP concentration and QRS wave.The alleviation rate of symptoms,reoccurrence rate of heart failure,mortality rate,NP concentration and QRS wave time limit and hospitalization days were compared between two groups.Results The reoccurrence rate of heart failure,mortality rate,NP concentration and QRS wave time limit and hospitalization days in the observation group were lower than those of the control group,but the alleviation rate of symptoms was higher than that of the observation group.Conclusions To give pertinent nursing according to BNP concentration and QRS wave for postmenopausal women with heart failure can alleviate symptoms,decrease attack of heart failure,shorten hospitalization days,improve cardiac function and prognosis,which is worthy of clinical application.

Objective To explore the effect of horizontal beam on IMRT plan for lung cancer.Methods Totally 18 patients were enrolled,including 10 cases of left lung cancer and 8 cases of right lung cancer.Two intensity modulated radiation therapy (IMRT) plans were generated:one was the normal IMRT plan and another was the IMRT plan including a horizontal beam (H-IMRT).MUs,sub-field and the dose distribution of target and organs at risk (OARs) were compared.Results There were no statistically significant differences between two plans in D Dminand D of PTV,the V30 and D of the ipsilateral lung,V20 and V30 of the contralateral lung,and V30 of the total lung.When the horizontal beam was added,the PTV heterogeneity index (HI) and conformity index (CI) were significantly increased (t=-9.33,10.88,P＜0.05),the other dose index in lung was inferior (t =-1.55--7.58,P＜ 0.05),whleheart sparing were clearly better (t =1.84-3.99,P＜0.05),the number of MUs and segments were less(t =12.57,3.19,P ＜ 0.05).Conclusions IMRT in the treatment of lung cancer can further improve the PTV coverage when the horizontal beam is added.However,the increasing lung volume of low dose irradiation is not conducive to lung protection.

Objective:To study on effect of Jiantai Liquid on progesterone receptor(PR)in the uterus at the nidation stage in the mouse with disturbance of blastocyst nidation.Methods:The gestational mice were randomly divided into a normal group,a model group and a Chinese drug group.Mifepristone was used for inducing disturbance of blastocyst nidation in the mice,which were interfered with Jiantai Liquid.At the eighth week of pregnancy,the mice were killed and morphological changes of the endometrium were observed,and PR expression in the uterus was detected with immunohistochemical method and PR and PRmRNA expressions were detected with Western blot and PT-PCR methods.Results:The endometrium showed maldevelopment in the model group and normal development in the Chinese drug group,similar to the normal group;the gland,the PR expression range and intensity of PR expression in the interstitial substance in the Chinese drug group increased as compared with the model group(P0.05);expressions of PR protein and gene in the Chinese drug group were significantly higher than those in the model group(P0.05).Conclusion:Jiantai Liquid can promote development of the endometrium and improves blastocyst nidation via regulating expressions of PR and PRmRNA in the uterus in the mice with disturbance of blastocyst nidation.

Objective To investigate the effect of manual operation on occupational therapy teaching. Methods 83 students were randomly divided into 2 groups: 41 students of general teaching group and the other 42 of manual operation teaching group, who received the ordinary classroom teaching and manual operation teaching respectively. After 4 h of study, they were measured with Canadian Model of Occupational Performance (CMOP). Results There were 37 and 41 questionnaires recalled from the general teaching group and the manual operation teaching group, and 2 and 3 questionnaires excluded as incomplete respectively. The scores of the classroom atmosphere, interesting stimulation, explanation of curriculum connotation, obtaining professional ideology, ability cultivated to solve practical problems, good relationship between doctors and patients developing, and thinking of discussion stimulating were more in the manual operation teaching group than in the general teaching group (P<0.01). Conclusion Manual operation is a new, effective, convenient, and low-cost mode of teaching for occupational therapy.

BACKGROUND: Fibular fixation and tantalum rod implantation are two commonly used methods for the treatment of early osteonecrosis of the femoral head (ONFH), both of which can effectively delay or even reverse the progress of ONFH. However, further comparative evaluation on their mechanical properties and therapeutic efficacy is required.OBJECTIVE: To compare the clinical efficacy of fibular fixation and tantalum rod implantation on ONFH at early stage.METHODS: Fifty-eight patients (81 hips) suffered from ONFH with ARCO stage 1 and stage 2, and underwent fibular fixation (30 cases, 41 hips) or tantalum rod implantation (28 cases, 40 hips). Postoperatively, both groups were followed up for over 2 years. The Harris scores of the hip were compared between two groups before and after treatment. With femoral head collapse and the collapse distance > 4 mm as observation points, the survival rate of the femoral head was compared between two groups.RESULTS AND CONCLUSION: The postoperative Harris scores of the two groups were significantly improved than before (P < 0.05). With the appearance of femoral head collapse as the observation point, the Kaplan-Meier survival curve showed that the overall survival rate of the hip was 83% in the fibular fixation group and 65% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0431). With > 4 mm collapse as the observation point, the Kaplan-Meier survival curve showed that overall survival rate of the hip was 95% in the fibular fixation group and 83% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0418). To conclude, both fibular fixation and tantalum rods implantation applied to ONFH at early stage can effectively improve the hip function, and the survival rate of the hip at ARCO Stage IIC is better in patients undergoing fibular fixation than tantalum rod implantation.