Objective To investigate the ability of theory of mind use in elders,and determine the role of inhibitory control in the use of theory of mind. Methods The participants included 30 young-old people ,30 oldold people and 30 young people. Their ability of theory of mind use and inhibitory control were examined with The Referential Communication Task and Hayling Sentence Completion Test,respectively. Results The correct rate of referential communication task was significantly lower in old-old people (0.43 ± 0.32) than those of young-old people (0.69 ±0.24, P=0. 001 ) and young people (0. 77 ±0. 25, P＜0. 001 ). Partial correlation analysis showed that the total errors in Hayling Test-B was negatively correlated with the correct rate of Referential Communication Task ( r= -0.442, P＜0.001 ). Hiberarchy regression analysis showed that the total errors in Hayling Test-B entered the equation ( β = -0.451, P＜0. 001 ) and could independently explained 16.8% of the variance (△R2 = 0. 168, △F = 19.359, P ＜ 0.001 ) after controlling for age. Conclusion Old-old people show worse performance in the use of theory of mind. The impairment of inhibitory control can partly explain the decline of theory of mind use in old-old people.

Objective To study the influence of postnatal high protein feeding on learning and memory abilities of preterm rats.Methods After weaning,the SD offspring were divided into 6 groups randomly according random digits table:preterm standard protein group (group A),term standard protein group (group B),preterm low protein group (group C),term low protein group (group D),preterm high protein group (group E),and term high protein group (group F),with 34 rats in each group.Starting from 22 days of age,the standard protein group,low-protein group and the high-protein group were respectively fed with a standard protein diet (containing 18％ protein),low-protein diet (containing 8％ protein) and a high-protein diet (containing 30％ protein) until the end of experiment.Within each group,the rats were respectively tested in 6 weeks and 8 weeks.Morris water maze task was performed to assess the learning and memory abilities of the premature rats.Results 1.Directional navigation experiments:(1) At the age of 6 weeks,the escape latencies to find the platform were shortened with increased training times for full-term rats.The escape latencies of the premature rats did not change significantly on the third and fourth day of the experiment.(2) At the age of 8 weeks,the escape latencies to find the platform were shortened with increased training time for all of the rats.2.Probe trial test:(1)At the age of 6 weeks,premature rats spent significantly less time in target quadrant than full-time rats.And the percent age of traveled distance in target quadrant of premature rats was significantly less than full term rats (P ＜ 0.05).(2) At the age of 8 weeks,group E [(68.48 ± 20.65) s] spent significantly greater time in target quadrant than group A and group C [group A(52.41 ± 11.24) s,group C (49.54 ± 11.04) s].And the percent age of traveled distance in target quadrant of group E [(36.56 ± 10.44) ％] were significantly higher than group A and group C [group A (29.83 ± 8.33) ％,group C (26.97 ± 5.41) ％] (P ＜ 0.05).(3) At the age of 8 weeks,group E spent time in target quadrant and the percent of traveled distance in target quadrant [(68.48 ± 20.65) s,(36.56 ±10.44)％] were higher than group F [(61.29 ± 16.27) s,(35.71 ±6.61)％],but there was no significant difference (P ＞ 0.05).Conclusions In the early growth and development process of the brain,premature birth may seriously affect early brain functions in rats,and the learning and cognitive abilities of the premature rats are worse than full-term rats.In the subsequent process of growth and development,after a long time of high protein nutritional intake,the learning and cognitive abilities of the premature rats can be restored and they can catch up with full-term rats.

Objective To investigate the effect of docosahexaenoic acid (DHA) on the body weight growth and lipid metabolism of neonatal rats during lactation.Methods The specific pathogen free Sprague-Dawley neonatal rats were randomly assigned into 4 groups (high-dose group,medium-dose group,low-dose group and control group) by random number table method.The rats in 3 experiment groups received intragastric administration with DHA 600 mg/kg,300 mg/kg and 100 mg/kg,respectively,while the control group were given 9 g/L saline,totally for 21 days.Body weight was monitored and compared among groups on postnatal day 1,7,14 and 21.And body weight growth rates at each time point were calculated.The serum concentrations of high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride (TG) and total cholesterol were measured and compared at 6-week and 8-week ages.The pathological and histological changes in the heart,the large vessel and the liver were observed at same time.Results The mean body weight of the neonatal rats were significantly different among 4 groups on postnatal day 7,14 and 21 (F =17.334,4.159,6.485,all P ＜ 0.01).Comparisons were made between every 2 groups,the low-dose group was higher than the control group on postnatal day 7 [(21.60 ±0.89) g vs.(18.57 ± 0.76) g] and day 21 [(58.52 ±6.62) g vs.(53.01 ± 11.75) g];the medium-dose group was lower than the control group on postnatal day 7 [(14.23 ±0.49) g vs.(18.57 ±0.76) g] and lower than the low-dose group on postnatal day 21 [(52.47 ±8.18) g vs.(58.52 ±6.62) g];the high-dose group was lower than the low-dose group on postnatal day 7[(16.13 ± 1.02) g vs.(21.6 ±0.89) g],and it was lower than the control group and the low-dose group on postnatal day 14[(31.69 ± 1.77) g vs.(37.60 ± 1.32) g and (36.24 ±0.84) g],and lower than all the other 3 groups on postnatal day 21 [(45.9 ± 13.17) g vs.(53.01 ± 11.75) g,(58.52 ±6.62) g and (52.47 ±8.18) g];all the differences above were statistically significant (all P ＜ 0.05).During the first and the second week after birth,there were significant differences in the mean body weight growth rate among 4 groups (F =8.369,8.331,all P ＜ 0.01),but there was no significant difference during the third week (F =0.603,P ＞ 0.05).Compared with 2 groups,the mean body weight growth rate of the low-dose group was higher than that of the control group in the first week [(184.96 ± 63.16) ％ vs.(141.02 ± 72.07) ％],but which was lower than that of the control group in the second week [(72.60 ± 35.37) ％ vs.(103.20 ± 40.11) ％];the medium-dose group was lower than the low-dose group at the first week [(116.78 ± 51.59) ％ vs.(184.96 ± 63.16)％],but higher than the low-dose group and lower than the control group at the second week[(139.93 ± 67.4) ％ vs.(72.60 ± 35.37) ％ and (103.20 ± 40.11) ％];the high-dose group was lower than the low-dose group in the first week [(137.33 ± 34.42) ％ vs.(184.96 ± 63.16) ％] and lower than that of the medium-dose group in the second week [(98.22 ± 65.86) ％ vs.(139.93 ± 67.4) ％];all these differences were statistically significant (all P ＜ 0.05).At 6 weeks of age,the mean serum concentrations of total cholesterol,TG and LDL-C were not significandy different (F =1.899,1.450,2.581,all P ＞ 0.05) among 4 groups,but the mean concentration of HDL-C was statistically different (F =7.801,P ＜ 0.01).In detail,the mean concentration of HDL-C in medium-dose group was higher than that of the control group,the low-dose group and the high dose group [(1.66 ± 0.08) mmol/L vs.(0.97 ± 0.16) mmol/L,(1.20 ± 0.09) mmol/L and (0.82 ± 0.09) mmol/L,all P ＜ 0.05],and which in the high-dose group was lower than that in the low-dose group (P ＜ 0.05).At 8-week age,the mean serum concentrations of HDL-C,LDL-C and total cholesterol were not significantly different among 4 groups (F =0.935,0.300,1.299,all P ＞ 0.05),but the mean concentration of TG was significantly different (F =2.875,P ＜ 0.05).The mean concentration of TG in the medium-dose group was lower than that in the control group [(0.98 ± 0.11) mmol/L vs.(1.36 ± 0.09) mmol/L,P ＜ 0.05].There were 5 (15.62％) neonatal rats in the high-dose group which were found to have adipose tissue accumulation around the large vessel walls and the heart and were confirmed by histological examination.The liver cells in these rats were found to have mild fatty changes.No similar changes were found in the other groups.Conclusions Neonatal rats supplemented with DHA during lactation can affect their body weight growth and lipid metabolism.Supplemented with high dose may bring risks,while moderate dose may bring benefits.

Objective:To investigate the reason for the adhesion of vocal cord after CO_2 Laser laryngeal surgery.Method:One hundred and nineteen patients who were untaken CO_2 Laser laryngeal microsurgery.Result: Among 119 cases,9 cases of bilateral vocal cord paralysis, 42 cases of vocal cord polyps and 3 cases of precancerous laryngeal lesions did not show vocal cord adhesion after CO_2 Laser laryngeal microsurgery.Contrarily, one of 5 cases with laryngeal stenosis, 5 of 41 cases with laryngeal papilloma and 6 of 19 cases with laryngeal carcinoma shew the adhesion of vocal cord after CO_2 Laser laryngeal microsurgery.Conclusion:Through selecting the appropriate patient and surgery spot, processing correctly during and after surgery, using the suitable dosage of laser and reducing the heat radiation, the adhesion of vocal cord can be avoided after CO_2 Laser laryngeal surgery.

OBJECTIVE: To investigate the reason for the adhesion of vocal cord after CO2 Laser laryngeal surgery. METHOD: One hundred and nineteen patients who were untaken CO2 Laser laryngeal microsurgery. RESULT: Among 119 cases, 9 cases of bilateral vocal cord paralysis, 42 cases of vocal cord polyps and 3 cases of precancerous laryngeal lesions did not show vocal cord adhesion after CO2 Laser laryngeal microsurgery. Contrarily, one of 5 cases with laryngeal stenosis, 5 of 41 cases with laryngeal papilloma and 6 of 19 cases with laryngeal carcinoma shew the adhesion of vocal cord after CO2 Laser laryngeal microsurgery. CONCLUSION Through selecting the appropriate patient and surgery spot, processing correctly during and after surgery, using the suitable dosage of laser and reducing the heat radiation, the adhesion of vocal cord can be avoided after CO2 Laser laryngeal surgery.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Laryngeal Diseases ; etiology ; pathology ; Laryngeal Neoplasms ; surgery ; Lasers, Gas ; adverse effects ; Male ; Middle Aged ; Precancerous Conditions ; etiology ; Tissue Adhesions ; Treatment Outcome ; Vocal Cords ; pathology ; Young Adult

Objective To study the influence of protein intake in learning and memory capabilities and mammalian target of rapamycin (mTOR) expression in premature rats.Methods Premature rars were randomly divided into three groups after weaning:preterm standard protein group,preterm low protein group and preterm high protein group.After weaning,three groups were respectively fed with standard protein diets (18％ protein),low protein diets (8％ protein) and high protein diets (30％ protein) until the end of experiment.When rats were at the 6th and 8th weeks,they were performed Morris water maze test to assess the learning and memory abilities,and irnmunohistochemistry and Westem blotting were used to observe the mTOR distribution and mTOR protein expression in the hippocampus.Results At the age of 6 weeks,the escape latencies of the premature rats did not change significantly on the 3rd and 4th day of the experiment; the frequency of crossing the platform and the mTOR-positive cells in hippocampal CA1 and CA3 regions of each group showed no significant differences (P＞0.05).At the age of 8 weeks,the escape latencies in finding the platform were shortened with increased training times for premature rats; the frequency of crossing the platform of high-protein premature rats was significantly higher than that in the other two groups (P＜0.05); and the mTOR expression in the hippocampal CA1 and CA3 regions of high-protein premature rats was also significantly increased as compared with the other two groups (P＜0.05).High-protein premature rats at the age of 8 weeks had significantly higher frequency of crossing the platform and increased mTOR-positive cells in the hippocampal CA1 and CA3 regions than those at the age of 6 weeks (P＜0.05).Western blotting also indicated that the hippocampal mTOR protein expression was not significantly different in each group at 6 week-old; the mTOR expression of high-protein premature rats was significantly higher than that in the other two groups at the age of 8 weeks.Conclusions In the early growth and development process of the brain,mTOR activity might be inhibited in the premature birth rats,which can lead to impaired learning and memory abilities.After a long time of high protein nutritional intake,impaired learning and cognitive abilities of premature rats can get recovery,which may be associated with up-regulation ofmTOR expression.

Acute postoperative pain and postoperative sleep disturbances are both major challenges in perioperative management,and they interact with each other.Acute pain can interfere with postoperative sleep,and sleep disturbances can lead to hyperalgesia and aggravate postoperative pain.At present,the in-teraction mechanism between the two is not clear,and there is also a lack of unified standards for prevention and control strategies.Therefore,this article reviews the research status of the definition,harmful effect,in-teraction mechanism,prevention,and management strategies of acute postoperative pain and postoperative sleep disturbances.We hope to provide valuable reference for the prevention and treatment of perioperative complications.

Objective:To study the effects of gender on clinical outcomes of extremely low birth weight infants (ELBWI) and to analyze the risk factors of mortality.Methods:From January 2011 to December 2020, ELBWI (birth weight <1 000 g) admitted to the Neonatology Department of our hospital were retrospectively studied. The infants were assigned into the male group and the female group. Incidences of major complications, survival rate and mortality rate were compared between the two groups. The infants were also assigned into survival group and death group according to their clinical outcomes. Binary multivariate unconditional Logistic regression was used to analyze the risk factors of mortality in ELBWI.Results:A total of 637 ELBWI cases were included. 311 cases were in the male group with a survival rate of 57.9% (180/311) and 326 cases were in the female group with a survival rate of 57.4% (187/326). The incidences of neonatal respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), pulmonary hemorrhage and severe intraventricular hemorrhage (IVH) in the male group were significantly higher than the female group ( P<0.05). Significant increases of survival rate existed for both groups year by year ( P<0.01).No significant differences existed in survival rate, mortality rate of infants receiving proactive treatment and mortality rate of infants withdrawing treatment between the two groups ( P>0.05). Multivariate unconditional Logistic regression analysis showed that withdrawing treatment ( P<0.01) and pulmonary hemorrhage ( P<0.05) were associated with increased risks of mortality. Conclusions:Male ELBWI have higher risks of RDS, BPD and severe IVH than female ELBWI. Withdrawing treatment and pulmonary hemorrhage are common risk factors of mortality for both male and female ELBWI.

Objective To carry out quality assessment and content analysis on guidelines on arteriovenous fistula (AVF) dysfunction monitoring in hemodialysis patients so as to provide a reference for building the localized clinical practice plan. MethodsDocuments were retrieved in guideline websites, professional society websites and electronic databases at home and abroad by computer. Quality assessment was carried out with the appraisal of guidelines for research and AGREEⅡ and JBI quality assessment tool on consensuses, and the recommendations of included guidelines were summarized. ResultsTotals of 4 evidence-based guidelines and one consensus were included with three of them in the level A and one in the level B of overall quality evaluation. A total of 12 items in 7 aspects were extracted including policy-making, team building, monitoring technology, training of personnel, continuous quality improvement, risk assessment and health education. Intraclass correlation coefficients of 4 evidence-based guidelines ranged from 0.866 to 0.935. Conclusions The guidelines have high levels of overall quality, but applicability needs to be improved. The recommendations are in general accord with each other, which can provide a basis for building the localized clinical practice plan.

Objective To investigate the impact of four different collimator angle optimization techniques on the planning target volume (PTV) and organ at risk (OAR) during intensity-modulated radiotherapy (IMRT) for gastric cancer.Methods Ten patients with gastric cancer undergoing IMRT in Zhongnan Hospital of Wuhan University from 2015 to 2016 years were recruited in this study.All IMRT plans were designed by conventional five fields (330°,10°,45°,90°and 180°).In the Eclipse treatment planning system,four different collimator angle optimization techniques with consistent planning optimization parameters were employed to design the IMRT plan.Collimator angle optimization techniques included the following aspects.The collimator angle was set at 0 degree (CL0),collimator angle was set at 90 degree (CL90),Eclipse automatic collimator angle optimization (CLA) was adopted and collimator angle was set as the angle when the distance between X-Jaws and PTV (CLx) was the shortest.The dosimetric parameters mainly included the conformal index (CI) of PTV,the homogeneity index (HI),the mean dose (Mean),and the dosage of OAR.The treatment time (Time),monitor unit (MU),control point (CP),split field (SF) and conformal distance (Fx) were also considered.Results Regarding CL0 as the control,the CI,HI and Mean did not significantly differ among four collimator angle optimization techniques (all P＞0.05),whereas CLx could significantly increase the average dose of PTV in the target area (P＜0.05);CLx optimization reduced the liver (V30 reduction by 1.54％),left kidney (V12 decrease by 1.46％),right kidney and other OARs,whereas it slightly increased the maximum dose of the small intestine and spinal cord (＜1％).CLgo and CLA optimization elevated the dose of OAR in gastric cancer.Among four different collimator angle optimization techniques,CLx optimization reduced the MU (25.02％),CP (26.03％),Fx (20.27％) and SF (by 1.3separate fields on average) and treatment time (10.03％).CLgo and CLA optimization could decrease the MU,CP,Fx and SF.CL90 optimization had certain advantages in shortening the treatment time,whereas CLA optimization could prolong the treatment time by 5.04％.Conclusions During IMRT for gastric cancer,CL90,CLA and CLx collimator angle optimization techniques can obtain comparable dosimetry distribution to CL0 optimization technique,which can reduce the MU,decrease the radiation leakage,shorten the treatment time and improve treatment efficiency.