Objective To investigate the emotional memory impairment in patients with lesions located in prefrontal cortex(PFC), and to test the hypothesis that prefrontal cortex is involved in the emotional memory network. Methods The 40 patients with lesions in PFC and forty age-education-level matched healthy adults were given emotional memory tasks using positive, neutral and negative valence images. Results Compared with the healthy adults(positively(11.68 ± 2. 18)and negatively(12. 93 ±1.33)), the patients had significant loss in positively(8. 20 ± 2.02)and negatively(8. 68 ± 1.14)valence image memorizing(t = 7.41, - 2. 75, both P ＜ 0. 05). There was no insignificant impairment in neutral stimuli. Performance difference between left PFC and right PFC in positively(8. 90 ±2. 01 vs 7.50 ± 1.79)and negatively(7.30 ± 1.10 vs 9. 05 ± 1. 00)valence image recognition was significant(Z = -2. 15,-2. 07,both P ＜ 0. 05). Conclusion The results suggest that emotional memory is impaired in the patients with lesions in PFC. The impairment difference between left PFC and right PFC indicates that they may have different neuromechanisms.

Objective To observe the correlation between the gene ploymorphisms of CYP2C19 and the curative effects of clopidogrel in patients with acute cerebral infarction.Methods The gene polymorphisms of CYP2C19 were tested in 171 acute cerebral infarction patients by PCR-restriction fragment length polymorphism method. All participants were treated with clopidogrel for 2 weeks.The platelet aggregation rates before treatment and 1 d, 5 d after treatment were detected.NIHSS and activities of daily living ( ADL) were detected before treatment and 1 week, 2 weeks after treatment.The inhibition rate of platelet aggregation ( IPA) was calculated and analyzed.Results In the 171 patients, homozygous wild CYP2C19 genotype was found in 79 cases (A group), with CYP2C19 *1/*1;heterozygous wild and mutant CYP2C19 genotype was found in 71 cases ( B group ) , including 55 cases with CYP2C19 *1/*2 and 16 cases with CYP2C19 *1/*3; homozygous or heterozygous mutant CYP2C19 genotype was found in 21 cases (C group), including 11 cases with CYP2C19*2/*2, 9 cases with CYP2C19*3/*3 and 1 cases with CYP2C19 *2/*3.The differences of IPA among the 3 groups were statistically significant at 1 d, 5 d after treatment (all P<0.05).Compared with before treatment, the NIHSS scores of the 3 groups at 1 week, 2 weeks after treatment were significantly decreased, and the ADL scores were significantly increased ( all P<0.05 ) . Compared with the A group, the NIHSS scores of B group and C group at 1 week, 2 weeks after treatment were significantly increased, and the ADL scores were significantly decreased (all P<0.05).Multiple Logistic regression analysis showed that smoking (OR=1.584,95%CI:1.079-2.136,P=0.004) and CYP2C19 gene polymorphisms (OR=1.837,95%CI:1.106 -2.540,P=0.002) were independently correlated with IPA in patients with acute cerebral infarction.Conclusion CYP2C19 gene ploymorphisms have influence on the curative effects of clopidogrel in patients with acute cerebral infarction.

Objective To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive function and safety in patients with lesions in prefrontal cortex (PFC).Methods Twenty-one patients with lesions in PFC hospitalized in the Department of Neurosurgery and Department of Neurology,Anqing Hospital Affiliated to Anhui Medical University between January 2012 and October 2014 were enrolled and given regular drug treatment as a background.Event-related potential (ERP) P300 latency and amplitude,Montreal Cognitive Assessment (MoCA) scores were recorded and compared before and after 4-week rTMS treatment.Results Compared with those before rTMS treatment,P300 latency ((367.38 ± 9.79) ms vs (345.43 ± 11.31) ms;t =5.33,P ＜ 0.05) was significantly shortened,while amplitude ((4.79 ± 1.02) μV vs (7.84 ± 1.40) μV;t =-8.08,P ＜ 0.05),MoCA scores (19.57 ±2.06 vs 23.91 ± 1.30;t =-8.14,P ＜ 0.05),memory test scores (2.19 ± 0.81 vs 4.10 ± 0.89;t =-7.24,P ＜ 0.05) and executive function test scores (2.52 ± 1.08 vs 3.57 ± 0.93;t =-3.38,P ＜0.05) were obviously increased.MoCA scores (18.22 ± 1.56 vs 20.58 ± 1.83;t =-3.11,P ＜ 0.05),memory test scores (1.89 ± 0.78 vs 2.42 ± 0.79;t =-2.26,P ＜ 0.05) and executive function test scores (1.56 ± 0.53 vs 3.25 ± 0.75;t =-5.76,P ＜ 0.05) showed statistically significant difference before rTMS treatment in patients with lesions in either right or left front lobe.Conclusions rTMS which is thought to be a safe procedure can improve cognitive function in patients with lesions in prefrontal cortex.

Objective To identify age-related changes in emotional memory.Methods A neuropsychological battery was set to measure the education-matched 48 younger, 48 middle-aged and 48 normally aging adults who were given picture tasks.Results Compared with the younger [positive (67.02 ±9.70)%,neutral (60.83 ±9.18)%, negative(75.38 ±12.80)%] and middle-aged controls [positive (68.25 ±10.89),neutral (61.63 ±7.46)%, negative (72.19 ±11.34)%], the differences of the affective images recognition accuracy in the elderly [positive (61.10 ±10.06)%, neutral (49.77 ±8.35)%, negative (55.65 ±11.17)%] were statistically significant (F=6.70,F=30.17,F=38.72,P<0.05-0.01), older adults remembering positive image better than negative image (F=15.67,P<0.05).However, there was no significant difference in their rating of valence of the images. Conclusion Emotional memory is impaired in the healthy elderly people, and indicates that age-related changes in emotional memory indicates may have different neuromechanisms.

Objective To evaluate the detection competence of HbA2 and HbF in Guangxi medical laboratories.Methods The external quality assessment(EQA) of HbA2 and HbF was conducted twice a year and five samples was detected each time during 2012 to 2016.The laboratories participated in EQA completed the samples' detection and submitted the detection results at specified time according to the requirements of EQA.The distribution of each detection system,the qualification rate of each laboratory,the variation degrees of each detection system and each detection method,and the variations of results for different levels of quality control(QC) materials during 5 years were analyzed based on the returned results.Results The application of high performance liquid chromatography (HPLC) and capillary electrophoresis(CE) increased year by year and their usage rates in 2016 reached up to 46.1％ (82/178) and 18.0％ (32/178),respectively.The qualification rates of HbA2 and HbF increased from 51.5％ (34/66) and 60.6％ (40/66) in 2012 to 93.3％ (166/178) and 92.1％ (164/178) in 2016,respectively.The average coefficient of variation(CV) of each detection system decreased year by year.There were good CVs for the results of high,medium and low levels of HbA2 QC materials detected by the Bio-Rad Variant Ⅱ and Sebia CAPILLARYS 2 systems,and they were less than 6.0％.HPLC and CE could quantitatively detect the HbA2 and HbF levels,and their total detection competence was superior to that of agarose gel electrophoresis.Conclusion EQA can assess the abihty of one laboratory detecting HbA2 and HbF,and quantitatively analyze the levels of HbA2 and HbF,which may provide the quality assurance and data support for the screening and prevention of thalassemia.

The development of higher education and economy are closely linked.In order to make the medical institutions of higher learning have their own unique core competence in many similar institutions in the country,it is necessary to precisely position,run schools with our own characteristics,make rational analysis of market demand,have a correct view of the medical degree,guarantee the quality of personnel training and strive to cultivate local talent and innovative features.

BACKGROUND: Aseptic loosening occurs after long-term total hip replacement, which directly affects the service life and prospective efficacy of artificial joints. The particles produced by artificial joint wear lead to the surrounding bone dissolved, further cause loosening, among which, polyethylene particles because of acetabular liner wear stand out. OBJECTIVE: To systematically assess the acetabular liner wear, loosening and osteolysis caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty. METHODS: A computer-based research of Medline, EMbase, CBM, CNKI, CqVip, WanFang databases before December 2015 and Cochrane (3rd issue, 2011) was performed in accordance with the retrieval strategy made by Cochrane collaboration. A manual retrieval of related bone journals and conference papers was conducted. Eleven randomized controlled trials about the wear caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty were enrolled based on inclusion criteria, followed by a Meta-analysis using RevMan 5.0 software. RESULTS AND CONCLUSION: (1) Eleven randomized controlled trials involving 952 patients were included. (2) Meta-analysis showed that the acetabular liner wear rate of cross-linked polyethylene was significantly lower than that of conventional polyethylene at 5 years postoperatively [MD=-0.07, CI(-0.09, -0.05), I2=93%, P < 0.00001]; the large heterogeneity was decreased [MD=-0.06, 95%CI (-0.07, -0.04), I2=39%, P < 0.00001] after three research removed through sensitivity analysis. (3) The osteolysis rate in the cross-linked polyethylene group was significantly lower than that in the conventional polyethylene group [RR=0.39, 95%CI (0.27, 0.57), I2=0%, P < 0.00001]. (4) These results suggest that the cross-linked polyethylene liners exhibit reduced radiological wear and osteolysis, but the mean follow-up of 5 years (1.8 to 8.0) cannot meet the long-term requirements. Therefore, multi-central, large sample size and high-quality randomized controlled trials are needed to testify the efficacy and safety of cross-linked polyethylene.BACKGROUND: Aseptic loosening occurs after long-term total hip replacement, which directly affects the service life and prospective efficacy of artificial joints. The particles produced by artificial joint wear lead to the surrounding bone dissolved, further cause loosening, among which, polyethylene particles because of acetabular liner wear stand out. OBJECTIVE: To systematically assess the acetabular liner wear, loosening and osteolysis caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty. METHODS: A computer-based research of Medline, EMbase, CBM, CNKI, CqVip, WanFang databases before December 2015 and Cochrane (3rd issue, 2011) was performed in accordance with the retrieval strategy made by Cochrane collaboration. A manual retrieval of related bone journals and conference papers was conducted. Eleven randomized controlled trials about the wear caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty were enrolled based on inclusion criteria, followed by a Meta-analysis using RevMan 5.0 software. RESULTS AND CONCLUSION: (1) Eleven randomized controlled trials involving 952 patients were included. (2) Meta-analysis showed that the acetabular liner wear rate of cross-linked polyethylene was significantly lower than that of conventional polyethylene at 5 years postoperatively [MD=-0.07, CI(-0.09, -0.05), I2=93%, P < 0.00001]; the large heterogeneity was decreased [MD=-0.06, 95%CI (-0.07, -0.04), I2=39%, P < 0.00001] after three research removed through sensitivity analysis. (3) The osteolysis rate in the cross-linked polyethylene group was significantly lower than that in the conventional polyethylene group [RR=0.39, 95%CI (0.27, 0.57), I2=0%, P < 0.00001]. (4) These results suggest that the cross-linked polyethylene liners exhibit reduced radiological wear and osteolysis, but the mean follow-up of 5 years (1.8 to 8.0) cannot meet the long-term requirements. Therefore, multi-central, large sample size and high-quality randomized controlled trials are needed to testify the efficacy and safety of cross-linked polyethylene.

Objective To evaluate the differences of α-fetoprotein (AFP), ffeeβ-human chorionic gnnadotropin (HCG) indexes in 3 foreign median databases for antepartum risk screening, and establish the median databases of normal pregnant women in Wenzhou for antepartum screening of AFP, free-β-HCG indexes through the suitable median computational models. Methods The levels of AFP and free β-HCG of 20054 normal pregnant women in Wenzhou were detected by time-resolved fluorometry. The data in this paper were compared with the data of 2T-risk ( 2T), Lifecycle-2. 2 (LC2.2 ) and Lifecycle -3.0 (LC3.0) by double-factor ANOVA. The differences between the data in the paper and the data from Shenyang and Ningbo were analyzed. The median database of Wenzhou pregnant women was established by the suitable regression model, with the stability of nonlinear regression models of the 3 software assessed by model correcting fitting, distribution mean of model fitting logarithmic and standard deviation. Results The levels of AFP and freeβ- hCG reported here were 10% and 16% higher than the data of 2T-risk, 15% and 20% higher than that of LC 2. 2, 6% and 17% higher than that of LC 3.0 respectively. The differences were statistically significant. ( FAFP = 161. 757 ,P < 0. 01 ; Ffree-β-HCG = 58. 261, P < 0.01 ). The levels of AFP and free β- hCG in Wenzhou were 2% higher and 3% lower than that of Shenyang, 1% and 2% higher than that of Ningbo. There was no statistical difference of AFP levels among Wenzhou , Shenyang and Ningbo( FAFP = 0. 174 ,P =0. 840) while the differences of free-β-hCG were statistically significant( F<,free-β-HCG> = 13.303 ,P < 0. 01 ). The differences of quadratic equation regression model, exponent quadratic function regression model and exponent quadru-function regression model of 2T, LC-2. 2 and LC-3.0 were not remarkable. The exponent quadru-function regression model was the best. Conclusions There are significant differences between the data from Wenzhou, Shenyang and Ningbo and the data of T-2 risk, LC-2. 2, LC -3.0. The discrepancy is due to the ethnic and different parameters of regression models. So the model parameters and the median databases are urgently required in China. The differences of large sample size of AFP from Wenzhow, Shengyang and Ningbo are not significant, while the differences of free-β- hCG from Wenzhow, Shengyang and Ningbo is remained because of its instability. The levels from Wenzhow and Ningbo are near. It is suggested that the laboratories with small sample size can establish their own laboratory parameters using the reference obtained from large sample size under the same experimental conditions. There are no significant differences of stability among regression computational models in the 3 software. The exponent quadru-function regression model can be used to establish the median databases for the screening with the similar data distribution in the paper.

Objective To evaluate the validity and reliability of the Chinese version of Alcohol Withdrawal Scale (AWS). Methods Totally 175 patients diagnosed as alcohol dependence according to the criteria of ICD-10 were studied. Intraclass correlation coefficient (ICC) analysis was applied for examining interrater consistency and Cronbach' s α for internal consistency. Factor analysis was used to examine the construct validity. Correlation analysis between AWS and CGI,Revised Clinic Institute Alcohol Withdrawal Syndrome Scale(CIWA-Ar) were conducted to evaluate the criterion validity. Based on clinical criteria,ROC curve was calculated so as to test the discriminative ability and establish the cut-off point of the scale. Results ( 1 ) Reliability: ICC value was 0.93,and Cronbach's α was 0.83,which indicated good interrater and internal consistency. (2) Validity:the correlation coefficients of the two subscale with the total scale score were 0.78,0.83 respectively. The correlation coefficients between the subscale were 0. 81 and factor analysis revealed that each item of the scale had relatively high load on the primary factor (0.409 ～0.926). At the time of admission,the total score of the AWS was positively correlated with that of CGI ( r = 0.71, P < 0.05 ). The total score of the AWS also was positively correlated with that of CIWA-Ar ( r = 0. 86, P<0. 05). As treatment went on,total score of the AWS showed a downward trend,at the end of the first week,the total score of the AWS was positively correlated with that of CGI ( r = 0.62, P<0.05). (3)The cut-off point of AWS for mild alcohol withdrawal state was determined as ≥3. With this cut-off point,AWS had both high sensitivity (92.1% ) and specificity (73.5% ) ,and the area under curve (AUC) was 0. 91. The cut-off point of AWS for moderate withdrawal state was determined as ≥7, and the sensitivity and specificity of AWS were 94.3 % and 89.7 % respectively, with the AUC of 0.94. The cut-off point of AWS for severe withdrawal state was determined as ≥ 10. With this cut-off point AWS had both high sensitivity (94. 9% ) and high specificity (92.6% ) .with the AUC of 0.93. Conclusion AWS has good reliability and validity and can reflect the change of the disease and the efficacy of treatment.

Objective To investigate the effect of terlipressin on hepatic and renal function in cirrhotic patients undergoing hepatectomy.Methods Aanlyze the clinical data of 57 patients following irregular hepatectomy for hepatocellular carcinoma with cirrhosis,according to whether use terlipressin or not after operation,which were divided into terlipressin group (A group,n =27) and control group (B group,n =30).Liver function parameters (ALT,AST,TB),ascites,urine volume and renal function parameters (Cr,BUN) preoperatively and on postoperative day(POD) 1,3,5 and 7 were compared between the two gruops.Results Compared with those of POD 1,the levels of ALT,AST and ascites on POD 3,5,7 were significantly lower in two groups (P ＜ 0.05),urine volume was significantly increased (P ＜ 0.05),Cr of POD 7 was significantly lower (P ＜0.05),but it is more remarkable in group A than group B.The levels of ALT in terlipressin group on POD 5,7 were (144.9 ±76.3) U/L,(100.5 ±61.5) U/L,which were lower than those of (267.2±91.2) U/L,(199.3 ±70.5) U/L in control group.On POD 3,5,7,the levels of AST,BUN,Cr and peritoneal fluid in terlipressin group,which were respectively(211.1 ±99.8) U/L,(80.4 ±54.6) U/L,(50.6 ±46.5) U/L,(6.6 ± 1.9) mmol/L,(6.5 ± 1.7) mmol/L,(6.3 ± 2.1) mmol/L,(74.3 ± 10.9) μmol/L,(71.5 ± 8.9) μmol/L,(58.7 ±4.1) μmol/L,(247.6±60.3) ml,(58.8±54.3) ml,(40.2±31.8) ml,were significantly lower than those in control group which were (298.7 ±131.2) U/L,(201.1 ±93.4) U/L,(114.7 ±70.3) U/L,(7.3 ± 1.9) mmol/L,(7.2±1.8) mmol/L,(7.1±1.7) mmol/L,(79.5±15.1) μmol/L,(76.9±16.2) μmol/L,(69.4±11.4) μmol/L,(275.2±88.1) ml,(191.7±71.6) ml,(93.2±50.2) ml.while urine volume of (2232.3±409.8) ml,(2270.5 ±395.8) ml,(2179.0±301.4) ml was much more than that of (1921 ± 510.4) ml,(2019.1 ±411.2) ml,(1978.7±323.7) ml in the control group,the differences in the two groups were statistically significant (P ＜ 0.05).There were 11 (36.7％) patients with hepatic and renal dysfunction and hepatorenal syndrome after operation in group B,while only 2 (7.4％) patients in group A.Conclusions The use of terlipressin after partial liver resection has a protective effect on hepatic and renal function in patients with cirrhosis,and can reduce postoperative ascites and prevent hepatorenal syndrome.