Adult ; Aneurysm, Dissecting ; Carotid Artery, Common ; Humans ; Male

Objective To develop stress vulnerability prediction scale for soldiers.Methods 148 items were determined by reviewing items in relating literatures and scales,interview,panel discussion and expert consultation.Then 431 and 351 soldiers in two times were picked out randomly as samples from Army Northwest District.Item analysis,exploratory factor analysis,reliability analysis and confirmatory factor analysis were used to analyse the data.Results Stress vulnerability prediction scale comprised five subscales:traumatic events,positive affect,negative trait,negative coping and interpersonal support.The scale was comprised of 59 items,and the factor loading of the items ranged from 0.503 to 0.839.Cronbach's α coefficient of the five subscales were 0.777,0.903,0.923,0.882,0.908,and the Cronbach's α coefficient of the scale was 0.895.Confirmatory factor analysis showed a higher goodness of fit(RESEA =0.058,NFI =0.89,NNFI =0.93,CFI =0.94,IFI =0.98).Conclusion Stress vulnerability prediction scale in soldiers has good psychometric properties,and can be used as a prediction measurement tool for measuring the stress disorder for soldiers.

Objective To evaluate the effect of repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients. Methods Published articles from the earliest date available to July, 2016 were recalled from PubMed, OVID, Embase, Co-chrane Library, CNKI, VIP and Wanfang Database. Two reviewers selected independently the randomized controlled trials (RCTs) about rT-MS for stroke patients with unilateral spatial neglect, and extracted data independently and analyzed with RevMan 5.3 and GRADE profiler 3.6. Results Twelve trials that represented 353 participants were evaluated. For improving Line Bisection Test, Star Cancellation Test, Albert Test, rTMS groups were significantly more effective than the controls. rTMS groups with different frequencies all showed significantly effec-tive:for low frequency rTMS, SMD=-1.21, 95%CI=-2.17 to-0.25;for high frequency rTMS, SMD=-2.56, 95%CI=-3.54 to-1.58;for continuous theta burst stimulation (cTBS), SMD=-2.51, 95%CI=-3.66 to-1.36. Conclusion rTMS is effective on unilateral spatial neglec-tin in stroke patients.

Objective The aim of this study was to investigate the radiation dose caused by 18 F-fluorodeoxyglucose (FDG) in PET/CT examination and to optimize the concerned radiation protection. Methods Thirty patients from our conventional PET/CT examination were simple randomly selected, and they all underwent whole body PET/CT imaging. The radioactive dose of injected 18F-FDG was recorded. The internal radiation dose was calculated and the external radiation dose from patients was measured with the 451P-DE-SI ion chamber survey meter. The staff's dose was recorded with thermoluminescent detector (TLD). All dosimetry data were processed and analyzed statistically with Excel 2003. Results The injected radioactive dose of 18F-FDG was (432.9±51.8) MBq, and effective dose equivalent received per patient was (8.23±0.99) roSy. The correlation coefficient (r) of the dose equivalent rate and distance was-0.994 by power function curve fitting, and that of dose equivalent rate and time was - 0.988 by exponential curve fitting. The staff's dose was lower than the annual dose limit. Conclusions The patient's internal radiation dose caused by 18F-FDG in PET/CT examination is low, nonetheless, the clinician should always consider optimizing and minimizing the necessary radiation received by the patients. The patients having been injected with 18F-FDG should stay in one place to decrease their radiation to the public. From the medical point of view in optimizing radiation exposure, there may still be a potential to lower the injected 18F-FDG activity.

Objective To measure the normal cerebrospinal fluid of the midbrain aqueduct peak velocity of different age groups by using magnetic resonance imaging (MRI) time‐spatial labeling inversion pulse (time‐SLIP) ,and to discuss the flow law of CSF . Methods Forty‐one cases of healthy volunteers ,including 23 cases of male ,18 cases of female ,aged 7 -73 .Patients were divided into 4 groups:7- <15 age group (n=11) ,15- <35 age group (n=10) ,35- <45 age group (n=9) ,≥45 age group (n=11) .We used the application of Toshiba 1 .5 T MRI head coil ,MRI sequence of time‐SLIP marked CSF to calculated the peak velocity of CSF in the midbrain aqueduct and measure the diameter and length of the midbrain aqueduct .Results The peak flow velocity be‐tween the 7- <15 age group and 15 - <35 age group ,35 - <45 age group ,≥45 age group were statistically significant (P<0 .05);inner diameter and length were no statistically significant difference (P>0 .05) between age .Conclusion In the midbrain aqueduct ,CSF is two‐way flow and supports the CSF of the pulsatile flow theory ;MRI sequence of time‐SLIP could measure CSF velocity and display the turbulence fluiding .

Objective To investigate the effect of hypoxia-inducible factor-1α expression (HIF-1α) on toll-like receptor 4 (TLR4) signaling pathway-mediated rat lung ischemia-reperfusion injury (LIRI).Method Forty-five S-D rats were randomly divided into Sham group,LIRI group,LIRI+ TLR4-activated group,LIRI+ TLR4-inhibited group,LIRI + ASK1-inhibited group,LIRI + p38-inhibited group,and LIRI + HIF-1α-inhibited group.The interaction between TLR4 signaling pathway [including TLR4,myeloid differentiation factor 88 (MyD88),TIR-domain-containing adapter-inducing interferon-βTIR-domain-containing adapter-inducing interferon-β (TRIF),Apoptosis signal-regulating kinase 1 (ASK1) and p38] and HIF-1α and the role of TLR4-dependent HIF-1α in LIRI in vivo were analyzed.Result In LIRI,HIF-1α accumulation was induced in a TLR4-dependent fashion,and MyD88,but not TRIF,and activation of ASK1 and P38 were found to be critical for TLR4-mediated HIF-1α accumulation.HIF-1α protein played a critical role in TLR4-mediated lung injury of LIRI.HIF-1α up-regulated TLR4 expression in LIRI in a positive feedback manner.Conclusion We identify that HIF-1α has a damaging effect on TLR4 signaling pathway-mediated LIRI and TLR4-HIF-1 may synergistically involved in the development of LIRI.Therefore we suggest that the interaction between them may represent a novel therapeutic target for the development of novel target-based therapies of LIRI.

Objective To investigate the effect-site concentration for 50% of maximal effect (EC50 )of propofol required for loss of consciousness and onset of burst suppression and to assess the effect of target-control infusion(TCI)of remifentanil on these EC50 of propofol.Methods Sixty patients undergoning general anesthesia for scheduled surgery were randomly divided into 2 groups (n=30):group R received TCI of remifentanil with a target concentraton of 4 ng/ml 10 minutes before TCI of propofol,which started at a target plasma concentration of 1μg/ml and then increased by 1μg/ml step every 1 minute until the burst suppression ratio reach to 15%.Group N received a mock TCI of saline instead of remifentanil and the other procedures were as same as group R.During this,all patients were assessed by modified Observ-er’s Assessment of Alertness/Sedation (OAA/S)scale,the loss of consciousness was definited by modified OAA/S values less than 2,the onset of burst suppression was definited by 15% of burst suppression ratio. Results The EC50 of effect-site concentration of propofol required for loss of consciousness and onset of burst suppression were 2.35 (95%CI 2.29-2.41)and 6.31 (95%CI 6.13-6.47)μg/ml respectively.The EC50 of propofol required for loss of consciousness was decreased to 1.73μg/ml by TCI of remifentanil,but the EC50 of propofol required for onset of burst suppression did not changed by TCI of remifentanil. Conclusion TCI of remifentanil could decrease the EC50 of propofol effect-site concentration required for loss of consciousness but has no effect on the EC50 of propofol required for onset of burst suppression.

BACKGROUND:Regulatory T cels (Treg) are classified into two subsets, nature Treg (nTreg) and induced Treg (iTreg). Although there is consensus that CD4+CD25+FoxP3+CD127-is the widely accepted phenotype of Treg, it remains unclear what is the difference in phenotypes including cytokine patterns of nTreg and iTreg. OBJECTIVE:To understand and compare the plasticity of nTreg and iTreg and to search the exact mechanism of cytokine secretion in Tregs. METHODS: We investigated the frequency and cytokine pattern of CD4+CD25+FoxP3+CD127-nTreg in freshly separated peripheral blood mononuclear cels of five healthy individuals using 8-color fluorescence flow cytometry (FACSCanto II). Subsequently, after 9 days of alostimulation in mixed lymphocytes, the frequency and cytokine pattern of CD4+CD25+FoxP3+CD127-iTreg were determined and analyzed. RESULTS AND CONCLUSION:In fresh cels, (1.5±0.70)% of CD4+ T cels were CD4+CD25+FoxP3+CD127- nTregs. Almost al these cels expressed interferon (IFN)-γ-, interleukin (IL)-2- or transforming growth factor-β+, and partial cels expressed IL-10+ or IL-10-. After 9-day alostimulation, the number of CD4+CD25+FoxP3+CD127- iTreg expressing IFN-γ+, IL-2-, IL-2+, IL-10+ or TGF-β+increased strongly. The main subsets of human nTregs were CD4+CD25+FoxP3+CD127-IFN-γ-IL-2-IL-10+TGF-β+and CD4+CD25+FoxP3+CD127-IFN-γ-IL-2-IL-10-TGF-β+ T cels. The proportion of each subset in CD4+ T cels was (1.1±0.59)% and (0.39±0.16)%, respectively. Whereas the main subsets of human iTregs were CD4+CD25+FoxP3+CD127-IFN-γ+IL-2-IL-10+TGF-β+ and CD4+CD25+FoxP3+CD127-IFN-γ+IL-2+IL-10+TGF-β+. Human nTregs were characterized as IFN-γ-IL-2- double negative, producing IL-10 and TGF-β or only TGF-β without IL-10, and not proliferatingin vitro. During the alostimulation in mixed lymphocytes, IFN-γ+ iTregs proliferated remarkably. One-third of IFN-γ+ iTreg expressed IL-2+, and two-thirds of IFN-γ+ iTregs expressed IL-2, both of which produce IL-2 and TGF-β. Our results imply that CD4+CD25+FoxP3+CD127- Treg are potentialy immunosuppressive probably because of their mandatory TGF-β and optional IL-10 production.

Objective To explore the relationship among psychological flexibility,anxiety and depression in postoperative thyroid carcinoma patients.Methods A total of 184 postoperative thyroid carcinoma patients selected randomly were measured with Acceptance and Action Questionnaire-Second Edition (AAQ-Ⅱ),Cognitive Fusion Questionnaire (CFQ),Self-Rating Anxiety Scale (SAS),Self-rating depression scale (SDS),and the Meaning in Life Questionnaire-the presence of meaning(MLQ-P).Variance analysis,pearson correlation analysis and stepwise multiple regression analysis were conducted in 157 questionnaires which were effective.Results The scores of AAQ-Ⅱ,CFQ,SAS,SDS,MLQ-P were(17.62±7.63),(27.37± 11.00),(32.38±6.99),(34.73±7.87),(28.55±5.09) respectively.The MLQ-P scores were negatively correlated with other scales(r=-0.278 ～-0.427,P＜0.01).The correlations among AAQ-Ⅱ,CFQ,SAS,SDS were positive(r=0.359～0.784,P＜0.01).The SAS scores and SDS scores in postoperative thyroid carcinoma patients were higher than that in norm group(z=72.28,P＜0.01;z=2.25,P＜0.05).When stepwise multiple regression analysis was conducted on SAS and SDS scores,AAQ-Ⅱ,MLQ-P,CFQ could explain 24.2％ variance in anxiety,and AAQ-Ⅱ,MLQ-P could explain 24.4％ variance in depression.Conclusion The level of anxiety and depression in postoperative thyroid carcinoma patients is much higher than that in norm.The higher the psychological flexibility,the lower the depression level.Psychological flexibility has significant explanatory power on anxiety and depression.

Objective To explore the efficacy and prognostic factors of postoperative intensity?modulated radiotherapy ( IMRT) with or without chemotherapy in rectal cancer. Methods A retrospective analysis was performed on the clinical data of 218 patients with rectal cancer, who underwent postoperative IMRT in our hospital from January 2009 to December 2013. The Kaplan?Meier method was used to calculate survival rate;the log?rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The follow?up rate was 97. 7%. The 1?and 3?year overall survival rates were 90. 8% and 75. 2%, respectively, the 1?and 3?year disease?free survival rates were 85. 3% and 70. 5%, respectively, and the 1?and 3?year locoregional recurrence?free survival rates were 96. 7% and 88. 1%, respectively. The incidence of grade 3?4 acute adverse reactions was 28. 4%, mainly manifested as leukopenia ( 13. 8%) and diarrhea ( 11. 0%) . Univariate prognostic analysis showed that preoperative carcinoembryonic antigen ( CEA) and CA199 levels, maximum tumor diameter, tumor location, degree of differentiation, depth of tumor invasion, number of lymph node metastases, TNM stage, perineural invasion, surgical procedure, total mesorectal excision, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 006, 0. 000, 0. 000, 0. 017, 0. 000, 0. 016, 0. 000,0. 011,0. 001,0. 006,0. 037 and 0. 010) . Multivariate prognostic analysis showed that preoperative CEA level, tumor location, TNM stage, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 000,0. 000,0. 000,0. 001 and 0. 001) . Conclusions Postoperative IMRT with or without chemotherapy is an effective method for rectal cancer with mild adverse reactions and high compliance. Preoperative CEA level, tumor position, TNM stage, preoperative bowel obstruction, and preoperative anemia are independent prognostic factors for the overall survival.