Objective To investigate the influence rule of the atmospheric Rainfall to the γ radiation Kerma rate in surface air in order to revise the resuh of its measurement during rainfall.Methods The influence factors of rainfall to the measurement of the γ radiation Kerma rate in air were analyzed and then the differential equation of the correlation factors was established theoretically,and by resolving the equation,the mathematical model Was obtained.The model was discussed through several practical examples.Results The mathematical model was coincided with the tendency of curve about the measured data on the influence rule of rainfall to the γ radiation Kerma rate in surface air.Conclusion By using the theoretical formula in this article which is established to explain the relationship between the rainfall and the γ radiation Kerma rate in surface air,the influence of rainfall to the γ radiation Kerma rate in surface air could be correctly revised.

The surface-enhanced Raman spectra of bilirubin and biliverdin were obtained.By the bands analysis of the spectra,the orientation of bilirubin and biliverdin on the surface of silver colloid was discussed.In such case,the bilirubin was adsorbed on the silver colloid particle with the two planar pyrromethenone groups intercalated into the globe silver colloid particle,however,the biliverdin might lie flat on the surface of silver colloid with syn-synsyn conformation.

Objective To evaluate outcomes of modified transforaminal lumbar interbody fusion (TLIF) assisted by the minimally invasive expandable access system and spinal channel endoscope for acute and chronic lumbar intervertebral disc injury.Methods From March 2013 to November 2014, 45 patients with lumbar intervertebral disc injury were managed with minimally invasive (Group A) or open TLIF (Group B).Location for disc injury was at L3/4 in 5 patients, L4/5 in 28 patients and L5-S1 in 12 patients.Group A composing 12 males and 10 females showed age of (53.70 ±3.59) years (range, 43 to 67 years).Group B composing 14 males and 9 females showed age of (54.80 ± 4.37) years (range, 42 to 68 years).Between-group comparison was conducted with respect to operation time, blood loss, postoperative drainage loss, ambulation time and postoperative complications.Clinical outcomes were evaluated using the visual analogue scale (VAS), Oswestry dysfunction index (ODI), and bone fusion rate.Results Except for the comparable operation time, group A was associated with better results in the blood loss [(152.1 ± 15.5) ml vs (409.9 ± 28.3) ml], drainage volume [(106.1 ± 14.3)mlvs (223.0 ± 19.4)ml], ambulation time[(4.5 ±1.1)d vs (8.9 ±1.4)d] and 1-week postoperative VAS [(3.0±0.7) points vs (4.7 ±0.4) points] (P ＜0.05).At the final follow-up, VAS and ODI of both groups were significantly improved compared to the preoperative levels (P ＜ 0.05), but the differences between groups were insignificant (P ＞0.05).Bone fusion rate in Group A was 95％ (21/22) versus 96％ (22/23) in Group B 6-month postoperatively (P ＞ 0.05).No nerve root injury, intervertebral space infection or other complications occurred.Conclusion Modified TLIF assisted by the minimally invasive expandable access system offers the benefits of less trauma, less bleeding and a quicker recovery for acute and chronic lumbar intervertebral disc injury and has similar long-term clinical outcomes with open TLIF.

Objective To investigate the treatment of acute obstructive colorectal cancer.Methods The clinical data of 26 cases with acute obstructive colorectal cancer were analysed retrospectively and relevant literatures were reviewed.Results Radical right hemicolectomy was performed in 9 patients with obstructive right colonic cancer.Among 17 patients with obstructive left colorectal cancer,one-stage radical resection was perfomed in 12 cases,including one-stage anastomosis in 4 cases and Hartmann's operation in 8 cases.Palliative colostomy was performed in 3 cases.Right hemicolectomy and sigmoid colon loop colostomy was performed in 1 case of rectum cancer with ascending colon strangulation.One case refused surgery.Two cases died of MODS and 1 case with inflammatory ileus recovering from conservative treatment after operation.In the course of disease,septic shock and MODS happened in 3 cases,lung infection in 5 cases,heart disease in 2 cases and Hypoalbuminemia in 16 cases.Conclusions One-stage radical colectomy and anastomosis should be performed in patients with obstructive right colonic cancer.In order to reduce toxin absorption and prevent the deterioration of disease,Bowel decompression and removal of inflammatory exudate should be performed in patients with obstructive left colorectal cancer according to the damage control theory.Then effective and safe operation should be chosen in accordance with patients' status.Anti-infection and nutrition support treatment must be strengthened after operation.

Objective: To describe the prevalence of depressive and/or anxiety symptom and disorder in patients with coronary heart disease(CHD) in the general hospitals.Methods: A hospital-based cross-sectional study was conducted in four main cities in China in 2004.359 eligible subjects with CHD were recruited from the outpatient or inpatient departments within six months.Face-to-face interviews were used in data collection together with the self-completed HAD scale for depressive and/or anxiety symptom screening.Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with HAMA scales and HAMD scales by the licensed psychologists or psychiatrists.Results: The prevalence of depressive symptoms,anxiety symptoms,depressive and anxiety symptoms,and total depressive and/or anxiety symptoms were 19.8%,16.7%,13.6% and 22.8% respectively in patients with CHD.Less than 4% of the subjects had been diagnosed or treated for the depressive or anxiety disorders prior to the investigation.In inpatients,the diagnosis and treatment rate was low to less than 1% during the current admission.Conclusion: It was noticeable to health care providers and health policy makers that there was high prevalence of depressive and/or anxiety symptoms and depressive and/or anxiety disorders,and low percentages of previous diagnosis and treatment in patients with CHD in general hospitals.

Objective Set up a new performance management system with JCI standard that designed for improvement of nursing research.Methods Based on JCI standard,the new system was designed to be performed separately.Re-design a performance appraisal plan that will take account into nursing workload,care quality,nursing risk,nursing research,personal comprehensive quality etc.Results The average performance of the nurses in 42 wards had increased by 24.64％.In this system,research project application,and paper publishing was significantly improved.Projects Standardization was also improved.Enthusiasm of continuing education increased.Conclusions The system is helpful to improve the quality of nursing research.It can also help to assure the occupational stability of the clinical nurses and enthusiasm of nursing research.

Objective To investigate global cerebral blood flow perfusion in fetuses with congenital heart disease (CHD)by three-dimensional power Doppler ultrasound (3D PD).Methods The vascular index (VI),flow index (FI)and vascular/flow index (VFI)in the global cerebral were prospectively compared in 1 12 fetuses with CHD and 1 12 normal fetuses using 3D PD.Correlations between the 3D PD indices and neurodevelopment scores were assessed.Results Compared with the controls,the VI,FI and VFI of the global brain were significantly increased in fetuses with hypoplastic left heart syndrome (HLHS) and left sided obstructive lesions (LSOLs)(P <0.001).The mean psychomotor development index (PDI) and mental development index (MDI)scores were significantly lower than normal (P < 0.001 ).FI was positively correlated with PDI (r =0.342,P =0.029)and MDI (r =0.339,P =0.030).Conclusions Global cerebral blood flow perfusion was significantly increased in most fetuses with CHD and had association with neurodevelopment scores.3D PD ultrasound might help to identify cases of brain vasodilatation earlier and inform parental counseling.

BACKGROUND:The ankle is one of the most important joints of human body. Medial maleolar fractures are very common, and there are lots of surgical methods to treat it. A traditional approach is open reduction and internal fixation. As views changed, percutaneous cannulated screw internal fixation become increasingly popular, but various clinical studies are stil needed to analyze the efficacy of these two methods. OBJECTIVE:To compare the recovery of joint function after medial maleolus fracture repaired by open reduction and internal fixation and percutaneous cannulated screw fixation. METHODS:A total of 63 cases of medial maleolus fracture, who were treated in the Department of Orthopedics, People’s Hospital of Xinyi City from March 2009 to March 2013, were enroled. According to repair plan, they were divided into two groups: open reduction and internal fixation group (n=29) and percutaneous cannulated screw fixation group (n=34). Ankle function was assessed in accordance with Kofoed ankle score standard on admission and at 3 months after repair. RESULTS AND CONCLUSION:The patients were folowed up for 3 to 12 months. Among 29 cases in the open reduction and internal fixation group, the wound was healed at grade A in 27 cases and at grade B in 2 cases; 29 cases were reset, and no poor reduction was found. In the percutaneous cannulated screw fixation group, 34 cases had healing at grade A, with the presence of good reduction. Al patients experienced bone union, and no infection appeared. In accordance with Kofoed score, at 3 months of folow-up, the satisfaction rate was 97% in the open reduction and internal fixation group, and 100% in the percutaneous cannulated screw fixation group. These data suggest that both open reduction and internal fixation and percutaneous cannulated screw fixation for medial maleolus fracture obtained positive effects, but percutaneous cannulated screw fixation showed smal surgical trauma, which could reduce the rate of infection and contributed to early functional recovery of ankle joint.

Objective To explore the characteristics of clinical symptoms and serum brain-derived neurotrophic factor(BDNF)level between depressive patients with and without attempted suicide behavior.Methods Serum BDNF level in depressive patients with(n=36)and without(n=55)attempted suicide behavior were assayed by ELISA,the severity of depression was measured by Hamilton rating scale for depression(HAMD).Results HAMD24 total scores(t=3.632,P=0.000),cognitive disturbance(t=-2.339,P=0.019)and hopelessness factor scores(t=-2.812,P=0.005)in depressive patients with attempted suicide behavior were significantly higher than those in depressive patients without attempted suicide behavior.There were no significant differences of anxiety/somatization,body weight,diurnal variation,psychomotric inhibition and sleeping disturbance fator scores between two groups(P＞0.05).The serum BDNF level in depressive patients with attempted suicide behavior was significantly lower than that in depressive patients without attempted suicide behavior(t=-2.122,P=0.037).There was no significant difference of serum BDNF level between male and female patients(P＞0.05).Conclusion There were certain characteristics on clinical symptoms of depressive patients with attempted suicide behavior.The low serum BDNF level might play an important role in the risk of suicide in depressive patients.

Objective To explore the serum levels of brain-derived neurotrophic factor in patients with depression and their correlation with age,gender,age of onset,illness course,depressive severity.Methods Serum BDNF levels in 91 depressive patients and 36 healthy controls were assayed by the ELISA method .The clinical char-acteristics were assessed by the Hamilton Rating Scale for Depression ( HAMD) .Results The serum BDNF levels in depressive patients were (24.38 ±6.27)μg/L,which was significantly lower than (31.44 ±10.72)μg/L in controls (t=3.708,P <0.01) and were unrelated to age,gender,age of onset,illness course,depressive severity (r =-0.034,t=0.068,r =-0.025,0.026, -0.076,P >0.05).Conclusion Serum BDNF levels in depressive patients was decreased and low levels of BDNF in serum may be a state characteristic for depression .