Objective:To compare performances of Wechsler Memory Scale(WMS)and Clinical Memory Scale(CMS),to explore applicability of WMS and CMS in the different degree traumatic brain injured patients.Methods:206 patients were tested with WMS and 300 with CMS,and completed clinical diagnosis for all,to compare the performances.Results: ①There was no significant differences in the MQ between the two groups in the normal、marginal memory impairment, there were significant differences in the mild memory impairment.②There were remarkable variance between the MQ and the clinical diagnosis,WMS was even more variant.Conclusion:①There is similar outcome between WMS and CMS in the patients with normal、marginal memory impairment,CMS shows more applicable in the patients with more severe mem- ory impairment.②It is not correct to diagnose memory defect degree with MQ without more clinical information.

Objective: To evaluate Raven's Standard Progressive Matrices (RSPM) for assessing validity of test performance. Methods: To compare the results of RSPM between head injured patients with and without malingering. Results:①There were significant differences in the performance between the two groups of patients in subtests A,B,C and D of RSPM. There was no significant difference on subtest E. ②Based on p

Objective:To study the validity of Binomial Forced-Choice Digit Memory Test(BFDMT) in detecting dissimulation of intellectual deficit.Methods:64 subjects with compensable head injury were assessed by BFDMT,experiential judgment and Raven's Standard Progressive Matrices (RSPM),and were finally diagnosed on intellectual deficit degrees.Results:(1)The rate of malingering was 78.1% judged by BFDMT,and 43.8% by experiential judgment.(2)All of the 16 uncertain cases by experiential judgment were assessed as malingering by BFDMT.(3)Only one case in 64 was considered as a faulted diagnosis by follow-up.Conclusion:BFDMT is useful for detecting dissimulation of intellectual deficit particularly for the difficul cases in clinical experiential judgment.

Objective:To explore the effects of cognitive impairment on the performance of Binomial Forced-Choice Digit Memory Test (BFDMT). Methods: Subjects were screened by Mini-Mental State Examination (MMSE) and the brief form of WAIS-RC.BFDMT was administered to 38 dementias and 19 controls.Results: (1) There was no significant difference in the scores of two dimensions and total score of BFDMT between dementias and controls. (2) There was significant difference in the difficult item scores and the total score among three groups of subjects with different levels of IQ. The difficult item scores and the total score of the subjects with IQ 70～84 were significantly higher than those with IQ 50～69 and IQ 34～49. There were no significant differences among all groups in the easy item scores. (3) The false positive was 15.8% by the cutoff scores of total scores of BFDMT and increased with the decline of IQ. Conclusion: The performance of BFDMT is somewhat influenced by intellectual defect. A high false positive of BFDMT particularly happens in the patients with severe intellectual decline.

The blood vessels, nerves and the size of the gracilis muscle were studied in 50 adult Chinese cadavers (43 males and 7 females).In average, the length of the gracilis muscles is 325 mm the breadth is 26.18mm the thickness is 6.56mm. The length of its tendon is 112.78 mm.The nutrient arteries of the gracilis muscle may arise from the profund femoral artery, medial circumflex femoral artery, the first perforating artery, femoral artery, popliteal artery, supreme genicular artery or obturator artery. Among them, the profund femoral artery and femoral artery give off constant branches to the gracilis muscle.The dominant nutrient artery of the gracilis muscle arises from the profund femoral artery in 94 cases (94％), from the medial circumflex femoral artery in 5 cases (5％). There is only one case (1％) arising from the first perforating artery.The average length of the dominant nutrient artery is 83.6mm. Its diameter in the origin is 2.24mm. and outside the hilum, 1.44mm. The distance from the vascular hilum to the pubic tubercle is 142.48mm. The surface respresentation of the dominant neuro-vascular hilum is situated at the junction point of the upper and middle thirds of the line joining the pubic tubercle to the adductor tubercle.There are 72.5％ of the dominant nutrient arteries of the gracilis muscle accompanying with two veins and 27.5％, with only one vein.The gracilis muscle is innervated by the anterior branch of the obturator nerve which accompanies the dominant nutrient artery entering the muscle. Its average diameter is 1.78mm.

The satorius muscle,its blood vessels and nerves have been dissected and examinedin 20 Chinese adult cadavers.It was found,on the average,that the length of thesatorius muscle is 529?8.48mm;the breadth,25.30?0.82mm;and the thickness,10.5?0.66mm.The arteries of the satorius muscle may arise from the surperficial circumflex iliacartery (0.66%?0.46),the femoral artery(58.36%?2.82),the deep femoral artery(3.93?1.11),the lateral circumflex femoral artery and its branches(13.44%?1.95),the supreme genicular artery(20.98%?2.33)and the popliteal artery(2.62%?0.91).There may be 5～13 arterial branches,averaging 7.6,in each satorius muscle,distributing roughly and evenly to the whole muscle,with an interval of about 7cmbetween two adjacent arteries and showing segmental distribution.The upper one third of the satorius muscle is mainly supplied by the branchesof the deep femoral artery and the lateral circumflex femoral artery while theinferior one third,by the branches of the supreme genicular artery.Therefore twoisolated flaps may be planned depending on the arteries mentioned above.The satorius muscle is innervated by the femoral nerve.70% of the cases arewith 1～2 branches of nerves,which,before entering the muscle,may give out 1～7twigs.

BACKGROUND:The effect of dimethyl sulfoxide cryoprotectants has been got a lot of verification in the low-temperature medical applications. But there is no literature addressing microdialysis detection of dimethyl sulfoxide cryoprotectants. OBJECTIVE:To investigate the microdialysis relative recovery of different concentrations of dimethyl sulfoxide cryoprotectants used for limb reattachment. METHODS:In vitro linear probe relative recovery of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) was detected by retrodialysis gain and loss method. The correction in vivo experiment was done to estimate dimethyl sulfoxide relative recovery in rabbit amputated limbs. RESULTS AND CONCLUSION:The relative recoveries of different concentrations of dimethyl sulfoxide (2%, 5%, 8%) were (49.49±3.56)%, (46.30±1.48)%, (52.66±2.54)%using retrodialysis gain method and (50.99±6.89)%, (43.86±1.35)%, (50.67±0.75)%using retrodialysis loss method. The average recoveries were (49.48±3.18)%and (48.51±4.03)%, respectively. There was no difference in the relative recovery of dimethyl sulfoxide detected using two methods. The change of dimethyl sulfoxide concentration could not influence the retrodialysis gain and loss method calibration results. The recovery was (15.45±4.8)%in vivo. These findings indicate that the microdialysis technology is suitable for dimethyl sulfoxide sampling in vivo that has no obvious influence on the relative recovery.

OBJECTIVE:To study the plasma total homocysteine(tHcy)level in the uremia patients and to study the therapeutic effects of folic acid combined with methylcobalamin in the intervention treatment of uremia patients with homo-cysteinemia.METHODS:Levels of plasma tHcy of60uremia patients(treatment group)and40normal subjects(control group)were determined both before treatment and8weeks after intervention treatment with folic acid combined with methylcobal-amin.RESULTS:The plasma level of tHcy in uremia patients were significantly higher than that in the normal subjects(P

Objective To evaluate the effect of computer-aided design of composite materials with epoxide acrylate maleic (E) and hydroxyapatite (H) in cranioplasty. Methods A total of 45 patients with cranium defects were treated with cranioplasty by using skull bone flaps made of composite materials including epoxide acrylate maleic (E) and hydroxyapatite (H) ,which was designed with computer aid according to individual requirements. The patients were followed up for 6-36 months. Results After cranioplasty with composite EH, there occurred subcutaneous fluid in one patient and mild bone collapse in one. The composite EH showed good histocompatibility, with no infection or rejection. Conclusion During cranioplasty, use of computer-aided design of composite EH takes advantages of good accuracy, short operation time, good biocompatibility and good clinical efficiency.

Objective To explore efficacy and safety of simulated artificial pancreas in modulating stress hyperglycemia in critically ill patients. Methods A prospective randomized controlled study was performed. Seventy-two critically ill patients with stress hyperglycemia, aged 18-85 years, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score over 15, two consecutive random blood glucose 11.1 mmol/L or higher, glycated hemoglobin (HbA1C) below 0.065, unable to eat food for 3 days after inclusion, or only accepting parenteral nutrition, admitted to intensive care unit (ICU) in Shanghai Punan Hospital of Pudong New District from January 1st, 2015 to June 30th, 2017 were enrolled. The patients were divided into three groups according to the random number table method, high-intensity group and low-intensity group were injected Novolin R (high-intensity group 2/3 dosage, low-intensity group 1/3 dosage) to modulate stress hyperglycemia by simulated artificial pancreas. Simulated artificial pancreas consisted of Guardian real time glucose monitoring system (GRT system), close-circle control algorithm and micro-pump;subcutaneous injection of Humulin 70/30 was applied to modulate stress hyperglycemia in humulin group. Real-time glucose levels of interstitial fluid in abdominal wall, equivalent to blood glucose levels, 10 minutes each time, were monitored by using of GRT system for all patients in three groups. Fasting serum levels of stress hormones including epinephrine and cortisol and insulin resistance index (IRI) were recorded within 24 hours after inclusion. Mean blood glucose, blood glucose variation coefficient, blood glucose target-reaching rate, blood glucose target-reaching time, hypoglycemia rate and 6-month mortality were measured. Twenty healthy adults from health administration department of the hospital were recruited as healthy control group. Results A total of 60 eligible critically ill patients were included in this study, each group with 20 patients. There was no significant difference in gender, age, APACHE Ⅱ scores among three groups. The levels of serum epinephrine, cortisol and IRI within 24 hours after inclusion in the three groups were significantly higher than those in healthy control group. The mean blood glucose levels of humulin group, low-intensity group, high-intensity group were decreased (mmol/L: 10.2±3.2, 8.4±2.6, 8.1±2.2), the blood glucose target-reaching rate were increased [40.2% (3 295/8 196), 71.1% (5 393/7 585), 80.4% (6 286/7 818)], the blood glucose target-reaching time were shortened (hours: 49.1±5.8, 24.6±4.6, 17.5±4.2), the hypoglycemia rates were increased respectively [1.3% (108/8 196), 2.8% (211/7 585), 4.0% (313/7 818)], with statistically significant differences (all 1 = 0.000). There was no significant difference in blood glucose variation coefficient and 6-month mortality among three groups [blood glucose variation coefficient: (29.4±3.7)%, (28.5±5.3)%, (26.1±4.6)%, 6-month mortality: 55.0%, 45.0%, 40.0%, all 1 > 0.05]. Conclusions Simulated artificial pancreas could effectively and safely modulate stress hyperglycemia in critically ill patients, high-intensity modulation could bring about better efficacy in the regulation of hyperglycemia. High-frequency blood glucose monitoring by using GRT system could promptly identify hypoglycemia and help it to be corrected.