Radiotherapy has been an effective non surgical treatment for brain metastases.While the benefit of survival was achieved,the potential cognitive impairment caused by radiotherapy gradually arouse people's attention.To improve patient's prognosis,ensuring tumor control and caring patients' quality of life and neurocognitive functions should be weighed equally.This article reviews the related research on the neurocognitive protection of brain metastasis radiotherapy.

Objective To explore core competency of nursing students during internship in western China,and to provide reference for the nursing education.Methods 380 nursing students during internship were investigated with Competency Inventory for Registered Nurse (CIRN).Results The total score of core competency of nursing students was (136.40±31.99) points,weighted mean scores of eight dimensions was (2.36±0.51)points;the highest mean score was the dimension of legal and ethical practice (2.88±0.57)points,and the lowest mean score was the dimension of critical thinking (1.91±0.52)points.There was significant difference of core competency in students with different education background and with varied firstchoice profession.Conclusions The core competence of nursing students during internship remains at lower middle level.The nursing educators should shift their concept of nursing education to the new mode of professional competence orientation.

Objective To explore the risk factors,composition of pathogen and drug sensitivity of pulmonary infection in neurosurgical intensive care unit(NICU) and provide basis forclinical effective prevention and appropriate treatment.Methods Retrospective analysis the detected pathogenic strains,theirdrug resistance and predisposing factors of the cases of pulmonary infection in NICU from January 2010 to September 2011.Results Among the isolated 602 bacteriastrains,363 strains (60.2％ ) were G-bacteria,71 strains ( 11.8％ ) were G + bacteria,168 strains (28 ％ )were molds.In G-bacteria,the main strains are acinetobacter and pseudomonas aeruginosa,and in G+ bacteria,staphylococcus epidermidis based most.Conclusion Acinetobacter has become the dominant flora of pulmonary infection in NICU and it has multidrug resistance to antibiotics in clinical.The Specific pathogen should be indentified through bacteriological examination of sputum as soon as possible,and the antibiotics should be used alternatively based on their drug sensitivity to control lung infection in critically ill patients.

Objective To explore the relationship between hepatitis B virus (HBV) S gene variation,genetype and immunoprophylaxis failure to intrauterine infection of HBV.Methods The serum HBV DNA levels of 35 pairs of mother-infants were amplified and quantified by real-time fluorescent quantitative polymerase chain reaction (PCR).Thereafter,the sequences of HBV S gene were determined by sequencing and compared with Genbank standard sequence using DNASTAR software.Results HBV DNA levels of the 35 pairs of mother-infants were all above 1×106 copy/mL.Nucleotide diversity rates were 11.4% in the children and 17.1% in their mothers.The sequence homology between paired mother and infant was beyond 99.3%.The HBV genotype and serotype in 23 pairs of mother-infants was C and adr respectively,while that was B and adw in the other 12 pairs.The HBV genotype and serotype were identical between paired mothers and infants.Conclusions HBV S gene variation may not be a crucial factor for immune failure to HBV intrauterine infection in women with high level viremia.Genotyping could not predict and evaluate the risk of immunoprophylaxis failure to HBV intrauterine infection in neonates.

Objective To evaluate the clinical effectiveness of interventional treatment of atrial septal defect (ASD). Methods Transcatheter closure of ASD was performed in 480 cases (198 males and 282 females), age ranged from 1.2 to 72 years (mean 24?8 years). All patients finished clinical examination, chest X-ray, electrocardiography (ECG) and trans-thoracic echocardiography (TTE) for the diagnosis of secundum ASD. The stretch diameter of ASD varied from 6-34 mm, mean 16?4 mm. Four hundred and seventy cases were simple opening secundum ASD. Results The devices were discharged successfully in all patients. The diameter of the occluders selected ranged from 10-40 mm, mean 20?6 mm. Among the patients who had multiple-openings, six cases were closed completely with one occluder, and the other four cases were closed with two occluders. Conclusion Interventional treatment is an effective, safe and optimal choice for the treatment of ASD.

Objective To investigate the beneficial effect on enterocyte-like cells HT-29 through adhesion of Lactobacillus. Methods Using viable bacteria counting method to evaluate inhibition of Escherichia coli adhesion and invasion to enterocyte-like cells by incubation with Lactobacillus together. Cellular membrane permeability and cell viability were examined in vitro by LDH level and MTT method respectively. Results Adhesion and invasion of enteropathogenic Escherichia coli to enterocyte-like cells was inhibited by high adhesiveness strain Lactobacillus reuteri JCM1081. In vitro, no significant changes of the morphology, structure and function of the HT-29 cells after being treated with Lactobacillus alone for 3 hours, especially cellular LDH level, viability and membrane permeability. Lactobacillus reuteri JCM1081 did not alter cell integrity and prevented the increase in permeability induced by enteropathogenic Escherichia coli infection. Conclusion Lactobacillus reuteri JCM1081 interact with intestinal epithelial cell receptor to competitively inhibit the adhesion and invasion of enteropathogenic Escherichia coli to HT-29 cells by incubation and enhance the integrity of the cells.

Glucose-6-phosphatase (G6Pase) activity in the skeletal muscle cells was observed with electron microscope in rats.It was found that the reaction product of G6Pase activity was localized in the sarcoplasmic reticulum (SR) and nuclear envelope and a heterogenous distribution of G6Pase activity in the SR was shown.On the basis of the position relationship between SR and sarcolemmal system,the skeletal couplings can be classified as follows.1.The coupling between the terminal cisternae and the transverse tubules such as a triad.2.The peripheral coupling between the peripheral SR and the surface sarcolemma.3.The coupling between the subsarcolemmal SR and the subsarcolemmaltransverse tubules.The significance of the findings was discussed.

Objective To obtain the molecular epidemiological data of Human Papilloma virus(HPV) 16 and HPV 18 and screen new HPV strains. Methods Common type HPV, HPV16 and HPV18 were amplified by PCR and then cloned and sequenced. Results The infection rates of HPV16、 HPV18 accounted for 10.51% of total HPV infection rate in the area. The infection rate of HPV16 was higher than that of HPV18 ( P

Objective To investigate the incidence and occurrence time of PICC-related upper extremity asymptomatic and symptomatic venous thrombosis in cancer patients;to explore the risk of asymptomatic venous thrombosis' developing into symptomatic venous thrombosis.Methods A total of 246 cancer patients who were scheduled to receive PICC between April and October 2014 were prospectively studied and divided into 2 groups by random digits table method.The time-phased follow-up observation on PICC cathertering cancer patients was conducted by Doppler ultrasound.The follow-up visiting inspection on the cathering upper limb vein by Doppler ultrasound at the 2nd,7th,14th,21st,28th,35th,42nd day were arranged after insertion of the catheter in experimental group (127 cases) to understand the incidence and occurrence time of asymptomatic venous thrombosis,while the control group (119 cases) were investigated for inspecting whether there were venous thrombosis through clinical symptoms or not.Once the clinical symptoms occurred,the incidence and time of occurrence of symptomatic venous thrombosis would be diagnosed by Doppler ultrasound and recorded.Results The incidence rate of asymptomatic thrombosis in the experimental group was 48.82％(62/127),the median time was 3 days,and there was no symptomatic thrombosis.Among them,85.48％(53/62) of the asymptomatic thrombosis occurred within 1 week,11.29％ (7/62) occurred in 2-3 weeks,and 3.23％ (2/62) occurred in 4-6 weeks after catheter insertion.Meanwhile,the incidence and median time of symptomatic thrombosis was 23.53％(28/119) and 12 days respectively in the control group.And 32.14％ (9/28) of these cases occurred within 1 week,50.00％ (14/28) occurred in 2-3 weeks,and 17.86％ (5/28) occurred in 4-6 weeks after catheter insertion.Conclusions The incidence of PICC-related upper extremity venous thrombosis in cancer patients is relatively high,and most cases have no symptoms and occur in an early time.Cancer patients are high-risk patients of venous thrombus.We should take early preventive intervention and treatment to reduce the incidence of venous thrombosis after catheter insertion.

Stroke-associated pneumonia (SAP) refers to the stroke patients suffering from infectious lung parenchyma (including the alveolar wall,i.e.the general pulmonary interstitial) inflammation without previous pulmonary infection.It is one of the most common major complications resulting in death and affecting functional recovery in patients with stroke.Dysphagia resulting in aspiration is the main reason of SAP.Therefore,avoiding aspiration and preventing SAP have important significance for patients with stroke through early correct tube feeding.This article reviews the tube feeding methods of preventing SAP.