Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .

Objective:The purpose of our experiment was to use CT to observe the opening of BBB at the early stage of severely scalded rabbits. Methods:Healthy male New Zealand white rabbits were used to establish 30% and 50% TBSA Ⅲ?scalded model. Using high resolution spiral CT (SCT), the brain parenchyma were observed when plain CT scan and contrast-enhanced CT were performed. Results:CT image changes were found in 4 cases at 6 hour after scald of 30% TBSA Ⅲ?scalded rabbits, while CT image changes were found in all cases at 6 hour after scald of 50% TBSA Ⅲ?scalded rabbits. Conclusion:The larger TBSA is Ⅲ?scalded, the earlier BBB is opening . BBB of 50% TBSA Ⅲ?scalded rabbits are wider than that of 30% TBSA Ⅲ?scalded rabbits

Objective To investigate the eye lens dose to the operators who tended to test the quality control of positron emission tomography (PET).Methods Before encapsulation and in preparation of point source,line source 1 and line source 2,the two operators were worn with lens thermoluminescence dosimeter each at the left of the left eye,the front of the left eye,between the right eye and the left eye,the left of the right eye,and the front of the right eye.Measurement and analysis were made of the radiation doses to eye lens received by the operators in order to calculate their maximum annual doses.Results The maximum lens dose was 2 439.80 μSv for the test of 5 PETs.There appears to be the same trend in the eye lens doses for the first and second operators.(x2 =15.629-16.155,P ＜ 0.05).The first operator have received higher eye lens dose higher than the second(Z =2.611,P ＜ 0.05).Conclusions The dose to the eye lens for a single PET test is relatively low.

Objective To investigate the clinical value of the combined detection of Golgi protein 73 (GP73),alpha-fetoprotein variant-L3 (AFP-L3)and transforming growth factorβ1(TGFβ1)in the early diagnosis of hepatocellular carcinoma (HCC).Meth-ods 48 cases of healthy control,42 cases of hepatitis B,50 cases of posthepatitic cirrhosis and 58 cases of HCC were selected and detected GP73,AFP-L3 and TGFβ1.The detection results were compared among 4 groups.Results (1)The levels of GP73,AFP-L3 and TGFβ1 had statistical differences among 4 groups(P <0.05 );(2 )The positive rate of the 3-marker combined detection reached 96.55%,which was higher than that of the 2-marker combined detection and the single marker detection.Conclusion (1) GP73,AFP-L3 and TGFβ1 may be used as the serum indicators for the early diagnosis of HCC;(2)Compared with the traditional HCC marker AFP,AFP-L3 has relatively high sensitivity and specificity and has the important role in the differential diagnosis of benign and malignant diseases of the liver,which is considered as a better serum marker in the HCC diagnosis;(3)The 3-indicator combined detection can significantly improve the positive detection rate of HCC and has better application value.

Objective To study the roles of serum tumor necrosis factor-α (TNF-α),sTNFR-Ⅰ and sT-NFR-Ⅱ in asthmatic children.Methods The levels of serum TNF-α,sTNFR-Ⅰ and sTNFR-Ⅱ in 60 asthmatic children,including 30 cases of acute exacerbation group and 30 cases of clinical paracmasia group,and 22 cases of healthy children (control group) were detected by ELISA.Results (1) The level of serum TNF-α in acute exacerbation group was (98.87 ± 16.25) ng/L,it is significantly higher than the clinical paracmasia group (62.19 ± 15.85) ng/L and control group (44.25 ± 10.44) ng/L (F =94.78,P ＜ 0.05).The level of serum sTNFR-Ⅰ and sTNFR-Ⅱ in acute exacerbation group were (11.14 ±2.04) μg/L and (11.81 ±2.14) μg/L respectively,they were significantly higher than their own clinical remission group (8.91 ± 1.63) μg/L and (9.36 ± 1.72) μg/L,also significantly higher than the control group (5.03 ± 1.18) μg/L and (5.21 ±1.23) μg/L,(F =83.03 and 87.62,all P ＜ 0.05).The levels of TNF-α,sTNFR-Ⅰ and sTNFR-Ⅱ in clinical paracmasia group were significantly higher than that in control group (P ＜ 0.05).(2) The levels of sTNFR-Ⅰ and sTNFR-Ⅱ in asthmatic children,both acute exacerbation and clinical paracmasia,were positively correlated (r=0.908,P ＜ 0.05 and r =0.737,P ＜ 0.05).Conclusion The level of TNF-α maybe indicate the inflammatory severity of asthma,and the changes of serum sTNFR-Ⅰ and sTNFR-Ⅱ were closely related with asthmatic airway inflammation.

Objective To investigate the physiological characteristics and the association with low prevalence of metabolic syndrome in Keriyans,a nomadic tribe,in the Taklimakan Desert.Methods An epidemiological survey focusing on diet and standardized physical examinations were made in a randomly selected natural population of 508 Keriyans individuals residing in the Taklimakan desert.In addition,237 of Uyghur subjects from Yutian county were enrolled as controls.Results Between these two populations,statistical significances were observed in body mass index (BMI) [(21.25 ± 3.10 vs 22.66 ± 4.18) kg/m2,P＜0.05],blood pressure (P＜0.01),triglyceride [TG,(0.98 ± 0.77 vs 1.50 ± 1.29) mmol/L,P＜0.01],total cholesterol [TC,(2.23 ± 1.02 vs 3.26 ± 0.85) mmol/L,P＜0.01],low density lipoprotein-cholesterol[LDL-C,(1.41 ± 0.68) mmol/L,P＜0.01],fasting blood glucose [(4.43 ± 1.19 vs 5.56 ± 1.39) mmol/L,P＜0.01],fat and salt intake (P＜0.05).The Keriyans had a low incidence of hypertension(9.94％ vs 29.11％,P＜0.01),raised blood cholesterol and diabetes mellitus(2.2％ vs 11.91％,P＜0.01) compared with the control group.The prevalence of metabolic syndrome was 0.6％ (3/500) in Keriyans and 13.62％ (32/235) in the control group.The prevalence of metabolic syndrome in Keriyans was much lower than that in the control group (P＜0.01).The caloric intake in keriyans group was lower tha than in the control group [(1 502.341 vs 2106.870) kcal,P ＜ 0.01].Conclusions The preliminary results showed that the physiological characteristics with low BMI,blood glucose,and the low levels of TG,TC,LDL-C,as well as they were inured to low salt loading,little smoking and no alcohol drinking,and natural living environment free from pollution,these factors might be associated with the low prevalence of metabolic syndrome in Keriyans.And their low calorie intake might be the most important factor of their low prevalence of metabolic syndrome.

Objective To explore the image characteristics of the opening of the blood brain barrier (BBB) at the early stages of severely scalded rabbits. Methods Twenty-six rabbits inflicted with 50% total burn surface area (TBSA) of Ⅲ degree were randomized into 7 groups: pre-scald, post-scald at 1, 2, 3, 4, 5, and 6 h groups. The spiral CT (SCT) and MRI were used to observe the image changes during the corresponding phases. Samples from the anterior cortex, temporal lobe, posterior cortex, cerebellum, and brain stem were examined by light and transmission electron microscopy (TEM), respectively. Results The pathological features showed that neurons and oligodendrocytes swelled lightly and blood vessels were congested and dilated at 3-4 h after scald. CT image changes were found at 5 h after scald and became more remarkable at 6 h after scald. MRI image changes could not be found within 6 h after scald. Conclusion The opening of BBB is earlier than the formation of edema. Enhanced CT plays an important role in manifesting the opening of BBB at the early stages of severely scalded rabbits.

Objective To investigate the protective effect of a COX inhibitor,flurbiprofen (Flurb) on hepatic ischemia/reperfusion (IR) injury in rats and the action mechanism.Method C57BL/6 mice were randomized into sham,IR and Flurb (4 different doses) groups.The model of segmental (70％) warm hepatic ischemia was established in IR and Flurb groups.Flurbiprofen of different doses (5,7.5,10 and 15 mg/kg) was injected via the tail vein 20 min before ischemia.At different time points after reperfusion,liver cell necrosis and apoptosis were evaluated by HE and TUNEL staining.The COX and inflammatory cytokine gene expression was detected by using realtime PCR.Liver mitochondria were separated and mitochondrial permeability transition (MPT) pore sensitivity was examined by using swelling assay and fluorescence spectrophotometry assay.Result In flurbiprofen groups of different doses,the serum AST and ALT levels were significantly decreased at 6 h after reperfusion as compared with IR group.Moreover,10 mg/kg Flurb pretreatment significantly inhibited the mitochondrial permeability transition (MPT) pore opening,and thus alleviated liver cell damage and prevented mitochondria-related cell death and apoptosis by inhibiting COX-2 and inflammatory factor genes expression such as IL-1β,IL-6 and TNF-α.Conclusion Flurbiprofen protects mice from hepatic I/R injury possibly by inhibiting mitochondrial permeability transition and IL-1β,IL-6 and TNF-α expression,which may provide experimental evidence for clinical use of flurbiprofen to protect liver function in surgical settings other than its conventional use for pain relief.

ObjectiveTo study the morphology, normal values and lateral asymmetry of Chinese calcarine sulcus on MRI. Methods High-resolution and transverse MRI were obtained from 40 female volunteers. Brainvisa software was used to reconstruct the calcarine sulcus and measure its average length, depth and width automatically. Results The posterior branch of calcarine sulcus showed six types in the median sagittal plane: bifurcation(32.50%), single peak(25.00%), flat (16.25%), S-shaped (15.00%), double peak(7.50%) and other shape (3.75%); its location had three types: inferior(72.50%), middle(21.25%)and superior(6.25%). The depth of left calcarine sulcus was (15.24±2.67)mm, and the right one was (16.97±3.25)mm, which revealed great statistical significance (P＜0.000 1). The width of left calcarine sulcus was (3.14±0.91)mm, and it was (3.19± 0.83)mm in the right side. The bottom length of calcarine sulcus: the left was (86.47±16.85)mm, the right was (83.62±17.10)mm. The top length of calcarine sulcus: the left was (70.52±12.40)mm, the right was (64.90±15.17)mm. There were not statistical significance in width, bottom length and top length between left and right calcarine sulci. More than half of the end part of calcarine sulci turned to the lateral surface of cerebral hemisphere.Totally 63 cases (78.75%) were found with prominent calcar avis. Conclusion Significant difference of depth between left and right calcarine sulcus of female was found. Three-dimensional reconstruction is an effective method to study the anatomy of calcarine sulcus.

Objective To review the clinical experiences of modified Nuss procedure and technique for complicated pectus excavatum. Methods From September 2006 to October 2009,45 children (27 boys and18 girls), aged 3 - 16 years [mean (6.4 ± 3.5 )years] with complicated pectus excavatum underwent modified Nuss procedure. VATS was used in 6 cases. 3 patients associated with lung cyst were treated by open surgery and 1 case with ASD was treated by Hybrid procedure.Results The surgery was successfully performed in all patients. The mean operative time was 54 minutes and the average hospital stay was 7 days. Postoperative evaluation was"excellent"in 30 cases , "good"in 13, and"moderate"in 2. Conclusion Modified Nuss procedure is a safe and effective method for correction of complicated pectus excavatum.