Postoperative cognitive dysfunction (POCD) is a common complication of the central nervous system after major surgery with anesthesia,which severely impairs patients' quality of life.Near infrared spectroscopy (NIRS) is advantageous for its convenience,inexpensiveness,noninvasiveness,continuous operation and bedside monitoring.Routine monitoring of regional cerebral oxygen saturation has the potential of optimizing the anesthesia plan and reducing the incidence of POCD.The aim of this review is to describe the NIRS technology and its clinical application.

Objective: To set up a multi-components by single maker (QAMS) method for determination of four diterpene lactones in Lianzhi Xiaoyan capsules.
Methods: Shimadzu Shim-pack C₁₈ column（250 mm×4.6 mm,5 μm）was adopted with 35 ℃. Acetonitrile-0.1% phosphoric acid aqueous solution as the mobile phase in gradient mode was used at flow rate of 1.0 mL·min^-1. The detection wavelength was set at 203 nm. Andrographolide was used as reference to calculate the relative correction factors of the other three components.
Results: The linear relationships of four components were good （r≥0.999 9） within their ranges, and their average recoveries were 100.0%-102.8% with RSDs 1.1%-2.2%. The results obtained by QAMS were close to those obtained by external standard method.
Conclusion: This rapid, precise and reproducible method can be used for the quality control of Lianzhi Xiaoyan capsules.

Objective To observe the effect of small interfering RNA(siRNA)expression plasmids targeting transforming growth factor p receptor(TαR)Ⅰ gene on the collagen synthesis of hepatic stellate cells(HSCs).Methods Three siRNA expression plasmids were designed and constructed according to TBR Ⅰ sequence.Then the plasmids were transfected into HSC-T6 using 1ipofectamine2000 reagent. The mRNA and protein expressions of TβR Ⅰ were analyzed by reverse transcription polymerase chain reaction(RT-PCR)and Western blot technique, respectively. The cell proliferation was detected using methylthiazo-lyldiphenyl-tetrazolium bromide(MTT)methods. Concentrations of haluronic acid and type Ⅲ pro-collagen in the supernatants were determined by radioimmunoassay. The data were analyzed using least significant difference(LSD).Results Three recombinant plasmids expressing siRNAs were successfully constructed and confirmed by restriction enzyme assay. Compared with the blank control,all the three recombinant plasmids could inhibit the expressions of TβR Ⅰ mRNA,of which plasmid expressing siRNA2 exhibited the strongest inhibitory effect(psiRNA1 group:t=7.354,P＜0.01;psiRNA2 group:t=9.214,P＜0.01;psiRNA3 group:t=5.967,P＜0.01).The expressions of TβR Ⅰ protein were also reduced by all the three recombinant plasmids,of which the plasmid expressing siRNA2 showed the strongest inhibitory effect(psiRNA1 group: t=6.324,P＜0.01;psiRNA2 group:t=8.741,P＜0.01;psiRNA3 group:t=4.128,P＜0.01).The proliferation activity and collagen synthesis of HSCs also decreased in all three HSC groups treated with recombinant plasmids, of which, again, plasmid expressing siRNA2 exhibited the strongest inhibitory effect. However, no significant change was observed in HSCs transfected with non-related siRNA. Conclusion Recombinant plasmids targeting TβR I can inhibit collagen synthesis, which suggests a novel target for gene therapy of liver fibrosis.

Objective To evaluate the significance of coronary calcification and stenosis in elderly hypertensive patients by 16-row multi-sliced computed tomography (MSCT) and its association with peripheral arterial atherosclerosis and other target organ damages. Methods Sixty-four patients with hypertension (n=50) 76.1?6.5 years and normotensions (n=14) 73.4?6.8 years were enrolled. All patients underwent coronary calcification scan by MSCT and the coronary calcification score(CCS) was calculated as AJ130 and Volume. Fourty-four patients in the hypertensive group were subjected to MSCT enhanced scan for evaluation of coronary stenosis. Intima media thickness (IMT), atherosclerotic and calcified plaques in carotid and femoral arteries and ankle-brachial index (ABI) carotid and femoral arteries were measured by echosonography and echocardiography; Fasting plasma blood glucose, blood lipid series, insulin, HOMA-IR, hsCRP and morning urine albumin were determined. Results (1) Both AJ130 and Volume of left anterior descending artery(LAD), left circumflex artery(LCX) and the total calcification score were higher in the hypertensive group than those in the control group (P

Objective To analyze the family burden of the caregivers of the psychosis patients in community, and the psychosocial factors which influence the family burden.Methods Conducted some questionnaires to survey the requirement and attitude on mental health knowledge,social support,family burden and coping style of the caregivers of the psychosis patients from the twelve communities which served as the stations for the psychosis of the twelve prefectures organized uniformly by Guangdong provincial disabled federation.Results 360 questionnaire was provided,and 308 replied to our questionnaire effectively.The mean score of each single item of the family burden questionnaire was beyond the moderate.The factor score of the economy burden was the highest among the factots of the economy burden(2.33±0.52),the daily activity of the family(2.17±0.53),the recreation activity of the family(2.00±0.58),the family relationship(2.10±0.54),the body health of the family members (2.03±0.65),and the mental health of the family members(2.09±0.68).The bad emotion and experience with the patients aggravated some factors of the family burden(P<0.05～0.01).According to correlation analysis and regression analysis,there were significant relation and impact between family burden with the requirement and attitude on mental health knowledge,subject support,coping style,age,economy,culture and so on(P<0.05～0.01). Conclusion Negative assumption to mental health will aggravate the family burden,transfering the positive message and changing passive coping style will help to reduce the family burden.

ObjectiveTo investigate the negative emoion and the relative factors in the caregivers of the schizophrenia patients in community. Methods212 caregivers from 12 communities psychotic service stations in 12 prefectures in Guangdong were investigated with the Zung Self-rate of Depression, the experience and attitude of the psychosis, the requirement and attitude on mental health knowledge, the social support scale, the family burden scale and the simply coping style questionaire. ResultsThere were 112 caregivers with no depression (52.8%), 57 with mild depression (26.9%), 30 with middle depression (14.2%), 13 with severe depression (6.1%). More than 50% caregivers worry about unsafty, getting into trouble, worse reputation, genetics, felt scare, strained relationship with the patients. There were significant differences in the hopelessness, the strained relaionship, treatment in other cities, superstition, hospitalization longer between the depression and no depression group, as well as in the economy burden, the interference in the family living, the amusement of family, the family relaionship, the body health and the mental health of the other family members, but no significant in the factors of the requirement and attitude on mental healh knowledge. The caregivers with depression reported less social support than the caregivers with no depression, but there was no difference between these groups in utilization of support. ConclusionThe caregivers of the schizophrenia patients experience negative emotion in community, who need mental and material assistance and the education of the knowledge about diseases.

Objective To investigate the requirement and the attitude of the mental health knowledge and some psychological factors indifferent developed regions. Methods The mental patients, their caregivers and normal people in total of 534 were surveyed with the Zung'sSelf-rating Depression Scale, the Questionnaire of Experience and Attitude of the Psychosis (self-edited), the Questionnaire of Requirementand Attitude on Mental Health Knowledge (self-edited), the Social Support Rating Scale and the Simplified Coping Style Questionnaire. Theresults were compared between the developed and the developing regions. Results Compared with those from developing, the requirementwas more and the attitude was more positive on mental health knowledge in all the people from the developed regions; the patients obtainedand applied more support, and took more positive coping style, less depressive emotion; the caregivers took more positive and negative copingstyles, and more depressive emotion; the healthy people applied more support, and took more positive coping style; the caregivers feltmore un-safety and wished the patients stay in hospital longer. Conclusion Development of the region plays a role in the mental health. Thecaregivers need more support and care.

ObjectiveTo analyse the requirement and attitude to mental health knowledge and the influence factors among the psychosis patients, the caregivers and the healthy pepople.MethodsThe questionnaire survey conducted among the psychosis patients, the caregivers and the healthy pepople from 12 communities which served as the stations for the psychosis where 12 prefectures were organized uniformly by Guangdong Provincial Federation of Disabled Persons.Results1080 sheets of questionnaire were provided, and 986 replied to meet the requirements. The caregivers showed significant difference in requirment and attitude to mental health knowledge compared to the psychosis patients and the healthy pepople(P＜0.05-0.001). The main influence factors were cultural education, regional economic, the frequency of inpatient, the anxiety emotion of the caregivers, which were statistical significance(P＜0.05-0.001).ConclusionIt is lack in the requirement and cognition to mental health knowledge among the psychosis patients, the caregivers and the healthy pepople. Cultural education and economic development are the effective measures to improve the level of the mental health knowledge.

Objective To study the effect of 125Iodine seed on the rabbit ischiadic nerve at different time point after implantation. Methods Thirty healthy New-Zealand rabbits were randomly assigned into 3 groups( 2-week group, 2-month group and 4-month group) using envelope method. During operation, 10 radioactive 125I seeds were implanted randomly near one of the ischiadic nerve, while 10 non-radioactive seeds were implanted into the contralateral ischiadie nerve. According to treatment plan system(TPS),90% of the prescription dose (PD)was centered in the specific place, where the nerves were chosen to be studied. After 2 weeks, 2 months and 4 months respectively, nerve electro-physiolngy experiment was used to evaluate the bilateral ischiadic nerves, at the same time the morphology of the ischiadic nerve was examined by general observation, light microscope and electron microscope. The electron microscope photo with the same ×4000 amplification was divided into 100( 10 × 10) cages and non-specific changes in one cage account for 1%. The t test and sum rank test were used for statistics. Results Potential leaking point of experimental ischiadic nerves near heart in 2-week group ,2-month group and 4-month group were (0.52± 0.26), (0.60±0.19), (0.48±0.17)V, while that of the control sides were (0.59±0.19), (0.60± 0.15), (0.53±0.13 ) V, there was no statistical significance in the same group respectively (t=0.91, 0.03,0.67,P>0.05). Potential leak point of experimental ischiadic nerves far from heart in 2-week group, 2-month group and 4-month group were (0.51±0.15), (0.52 s0. 11 ), (0. 53±0.15) V,the control sides were (0.52±0.10), (0.56±0.12), (0.54±0.10)V, there was no statistical significance in the same group respectively (t= 0.25,0.74,0.17, P > 0.05 ). Action potential amplitude of experimental ischiadic nerves near heart in 2-week group,2-menth group and 4-month group were (13.18±4.09), (12.78± 4.42), (12.09±1.20) mV, while that of the control sides were (10.55± 4.21 ), ( 10.31±4.22), (12.88±3.54) mV, there was no statistical significance in the same group respectively (t=1.57,1.36, 0.50,P>0.05). Action potential amplitude of experimental ischiadic nerves far from heart in 2-week group,2-month group and 4-month group were (11.18±3.38), (11.68±3.21), ( 12.52±3.09) mV, while that of the control sides were (11.56±4.80), (10.71±3.40), (11.67±2.48) mV ,there was no statistical significance in the same group respectively(t=0.29,1.01,0.55, P>0.05 ). Nerve conduction velocity of experimental ischiadic nerves in 2-week group,2-month group and 4-month group were (40.56± 9.46), (38.79±5.78), (39.44±8.64) m/V, the control sides were (42.56±6.59), (44.64±7.53), (43.33±6.05)m/V, there was no statistical significance in the same group respectively( t = 0.57,1.94, 0.01,P>0.05). There were some changes in general observation and light microscope, in electron microscope, many non-specificity changes were observed. All of these changes included delamination, collapse, disaggregation of the myelinated nerve, mitochondria swelling and vacuolization of neurilemma cell and axon. The ratio of degenerative alterations in nerves was 60% --70% in 2-week group, 50% in 2-month group and 30% in 4-month group, and there was statistical significance among three groups (P<0.05). Conclusion 125I permanent plantation in our test dose has little effect on ischiadic nerve, all these non-specificity changes were observed in electron microscope, and it has no evident impacts on physiological functions.

Objective To evaluate the effect of combination treatment by psychological intervention and a new atypical antipsychotic Paliperidone extended-release tablets(paliperidone ER)on first-episode schizophrenic out-patients.Methods All 62 patients diagnosed as first-episode schizophrenia by DSM-Ⅳ were randomly allocated into,combination treatment group and control group,for a 12-month treatment study.The combination treatment group was treated by paliperidone ER once a day and psychological counseling once a month,while the control group was treated only by paliperidone ER.The efficacy and social function were assessed by Positive and Negative Syndrome Scale(PANSS)and Personal and Social Performance Scale(PSP)individually at baseline,and following 1,3,6,9,12 months.The remission rate was calculated at the end of the 3rd,6th,9th month.The safety and tolerability were assessed using Barnes Akathisia Scale(BARS),extrapyramidal side effects scale(SAS)and involuntary movement scale(AIMS).Results Twenty-seven patients of combination treatment group and seventeen patients of the control group completed the trial with the discontinuation rate 12.9% and 45.2%,respectively.The difference between the above two groups was statistically significant(P＜0.05).The mean total score of PANSS and the PSP of the both groups were significantly improved(P＜0.05)after treatment.PANSS total score reduced more than 30% compared with baseline,and PSP total score increased more than 7.The remission rate of combination treatment group was 74.2%,51.6% and 67.7% at the end of 3rd,6th,and 9th month,which was better than the control group(45.2%,38.7% and 38.7%)(P＜0.05).Both incidence and types of adverse events were almost same between the two groups.The major adverse events were extrapyramidal symptoms,tachycardia,gastrointestinal discomfort and akathisia.Conclusion Paliperidone ER treatment combined with psychological intervention on first-episode schizophrenia out-patients can improve their treatment compliance by reducing the discontinuation rate.And this combination treatment can increase the remission rate and improve social functioning of the patients.