Objective: To study the effect of gamma irradiation on the permeability of the blood brain barrier(BBB) in rat brains. Methods:The right caudate nucleuses of Sprague Dawley rats were irradiated by OUR XGD gamma units.Maximum dosages of 20,50,75 and 160 Gy were given using a 4 mm collimator.Immunohistochemistry with antibody of serum albumin was used for detecting the extravasation of endogenous serum components.Ultrastructural changes of BBB were observed through injection of lanthanum nitrate into blood vessels. Results: Extravasation of albumin and BBB opening in the right caudate nucleuses were detected as early as 12 h after irradiation at 50,75 and 160 Gy,and were detected 1 d after irradiation at 20 Gy.Immunoreactivity and emematous water reached their maximum after 3 d, gradually decreased during the following few days,and disappeared by day 7(20,50 Gy) or day 14(75 Gy).Irradiation at 160 Gy elicited persistent extravasation of albumin and BBB opening for 14 d. Conclusion: These are transient impairments to BBB after irradiation at 20,50,75 Gy,and persistent impairments after irradiaton at 160 Gy.

Objective To investigate the the clinical effect and immune regulatory mechanism of red-blue light combined with Niuhuang Shangqing capsules for the moderate-severe acne.Methods A total of 180 patients with moderate to severe acne treated in People's Hospital of Nanhai District in Foshan City from June 2014 to June 2016 were randomly divided into 2 groups with each group 90 patients. The control group was treated with red and blue light, and observation group was treated with the combination of red and blue light andNiuhuang-Shangqingcapsules. The levels of SP(Substance P), IL-1 and IL-6 in peripheral blood were observed and analyzed. The recurrence rates and adverse events were observed.Results After treatment, the SP (657.4 ± 36.6 pg/mlvs.799.9 ± 60.2 pg/ml,t=19.188), IL-1(61.8 ± 24.7pg/L vs.92.1 ± 23.5 pg/L,t=8.431), IL-6 (38.7 ± 10.3pg/mlvs.66.7 ± 14.1pg/ml, t=12.421) of the observation group were significantly better than those of the control group (allPs<0.01). The total effect rate of the observation group were 91.11% (82/90), which were significantly higher than 70.00% (63/90) of control group (χ2=12.804,P<0.01). Conclusions The Red-blue light combined withNiuhuang-Shangqing capsules for treating moderate-severe acne, has significant effect and can reduce the serum levels of SP, IL-1 and IL-6, with fewer adverse events and lower recurrence rates. They can be used as a safe and effective treatment of acne.

Objective To investigate the clinical efficacy of photodynamic therapy with red and blue light in the treatment of facial acne. Methods Ninety-two cases of facial acne in dermatology outpatient hospital were randomly divided into the test group and the control group, with 46 cases in each group. Patients in the test group received the photodynamic therapy, and patients in the control group received red plus blue light treatment for eight weeks, respectively. Results Before treatment, patients in the test group and the control group had no significant differences in acne, papules, pustules, nodules, cysts and gags score. After 8-week treatment, the comedones, papules, pustules, nodules cyst number, gags score of patients in the test group were significantly less than or lower than those of patients in the control group (P < 0.05, respectively). The healing rate was 84.78% in the test group, which was higher than that of 65.22%in the control group of (P<0.05). The total efficiency was 97.83%in the test group and 93.48% in the control group, with no significant difference. The adverse reaction rate was 10.87% in the test group and was 23.91% in the control group, with no significant difference. Conclusion The effect of photodynamic therapy for facial acne is better than red plus blue light treatment ,with a less incidence of adverse reactions.

Objective To explore the efficacy of endovascular treatment for closed articular artery injuries.Methods The clinical data of 13 patients from Jan 2010 to Dec 2014 treated for closed articular artery injuries were analyzed retrospectively.The location,severity and extent of arterial injury were confirmed by intraoperative arteriography.The diameter and length of the injured arteries were measured.The guidewire was sent to the lesion site and working wire pathway was established.When the guidewire was difficult to pass through the lesion site,femoral and posterior tibial or radial artery may be used to establish working wire pathway.The stent or stent-graft was implanted through the contralateral femoral artery or distal end of ipsilateral artery.Results Intraoperative angiography confirmed intimal injury (n =2),partial transection (n =5),complete transection (n =5) and arteriovenous fistula (n =1).Eighteen stents or stent-grafts were implanted.Treatment was successful in all patients without peiropeartive death and procedure-related complications.All were followed up for 15 to 48 months and the mean follow-up was (30 ± 11) months.Three patients with stent lumen stenosis less than 50％ as showed by angiography.There was no stent fracture,displacement,or deformation.Conclusions Endovascular treatment for closed articular artery injuries is of less invasion,shorter operative time and quick postoperative recovery.

Objective To provide a framework for understanding the need for a structured assessment of altered mental status (AMS) to better understand underlying causes of the mental status changes in adults and therefore potentially improve diagnostic skills and eventually management.Methods This is a prospective cohort observational study.We recruited consecutive adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24 months.Demographical,clinical presentations,assessment approaches,cause factors,emergency treatments and outcomes were collected prospectively.Results One thousand nine hundred and thirty-four patients with AMS were recruited,this number of patients represented 5％ of the total ED census.Out of 1934 patients,1026 (53.1％) were male,908 (46.9％) were female.Mean age was (51.95 ± 15.71) years.Etiologic factors included neurological (n =641,35.0％),pharmacologic & toxicologic (n =421,23.0％),systemic and organic (n =266,14.5％),infectious (n =167; 9.1％),endocrine/metabolic (n =145,7.9％),psychiatric (n =71,3.9％),traumatic (n =38,2.1％),gynecologic and obstetric (n =35,1.9％).Total mortality rate was 8.1％ (n =156).The death rate was higher in elderly patients (≥ 60) than that in younger patients (10.8％ vs.6.9％,P =0.003).Conclusions The patient with AMS poses a challenge to physicians in ED.The most frequently encountered diagnostic category causing AMS were primary CNS disorders,intoxication,organ system dysfunction and endocrine/metabolic diseases.Fatality rate is very high.Prompt evaluation and treatment are essential to decrease the morbidity and mortality associated with this condition.

Objective To investigate the epidemiology and features of severe poisoning.Methods A retrospective analysis of patients with severe poisoning admitted into the emergency intensive care unit of Peking Union Medical College Hospital from February 2008 to March 2010 was made.Results A total of 138 patients consisting of 45 males and 93 females were enrolled.The average age was 39.2 years.Committed suicide with toxic agents was the major cause of poisoning (76.8％ ),followed by alcoholism (8.7％ ) and misuse of medicine (5.8％).Of them,96.4％ patients were poisoned by swallowing poison agents,and 45.7％ patients were treated with gastric lavage and 15.2％ of patients with hemofiltration.Mortality was 3.62％.Conclusions Our study presents the current status of acute severe poisoning in the large general hospital.

Objective To investigate the perioperative complications and therapeutic effects of balloon-assisted coiling (BAC) and stent-assisted coiling (SAC) in patients with ruptured intracranial aneurysms in the acute phase. Methods Totally 91 patients with 91 intracranial ruptured aneurysms were treated with BAC or SAC in our hospital between January 2014 and December 2016. Among them, 37 patients were treated with BAC and 54 patients with SAC respectively. Of the two groups, the position distribution and shape of aneurysms, and the complications after procedures and the therapeutic effects were summarized and evaluated retrospectively using chi-square test. Results The width of the aneurysm neck was narrower in the BAC-treated group compared to the SAC-treated group (3.31±1.63 mm vs. 4.35±2.10 mm, P=0.01). The aneurysm body/neck ratio (B/N) was lower in the BAC-treated group than in the SAC-treated group (1.64 ± 0.46 vs. 1.35±0.66, P=0.025). The recurrence rate was higher in the BAC-treated group than that in the SAC-treated group (18.9％ vs. 0.9％, P=0.005). There was no statistical difference in perioperative complication in both the BAC-treated group and SAC-treated group. However, 2 patients died due to the relative postoperative intracranial bleeding in the SAC-treated group. Better outcomes (Modified Rankin Score, mRS, 0-2) were achieved in the BAC-treated group compared to the SAC-treated group (94.6％ vs. 88.9％, P=0.028) at the follow-up visit. Conclusions These findings suggested that there is no difference between the BAC-treated group and the SAC-treated group in the risk of complication. BAC can achieve a better prognosis,but it is more prone to relapse. The SAC method was more appropriate for wider neck aneurysms. It was also an option to coiling the aneurysm in BAC in acute phase firstly, followed by additional treatment in SAC during the follow-up period.