Objective To investigate the influence of age on clinical features and prognosis of severe traumatic brain injury.Methods A total of 135 patients with severe traumatic brain injury were divided into four groups according to age:the juvenile group (＜18 years,15 cases),the young adult group (18 44 years,77 cases),the middle aged group (45 59 years,37 cases) and the elderly group (＞60 years,6 cases).Neurological functions were assessed by the Disability Rating Scale (DRS),the Mini-Mental Status Examination (MMSE),the Fugl-Meyer motor scale (FM) and the Modified Barthel Index (MBI).All the patients were followed up with DRS evaluation 1 4 years after discharge from the hospital.Results MMSE scores decreased with age,with statistically significant differences between the elderly group and the juvenile group,the young adult group and the middle aged group,respectively [(11.0±5.2) vs (21.5±8.1),(21.4±8.0) and (19.1±8.1),respectively; t=2.663、2.825、2.561,P=0.015,0.006,0.022,respectively].Similarly,when compared with the other groups,the elderly group also showed statistically significant differences in follow-up DRS scores [(12.8±6.1) vs.(4.3±3.6),(6.7±5.0) and (7.8±6.9),respectively; t=-2.382、-2.587、-2.385,P =0.040,0.013 and 0.038,respectively]; and the DRS score differentials [(2.3±4.6) vs.(6.2±4.3),(6.7±3.1) and (4.6±3.1); t=2.366、2.242、2.626,P =0.004,0.013 and 0.009,respectively].Conclusions Age may be one of the factors that affect cognitive functions and prognosis associated with traumatic brain injury,and the prognosis for elderly patients is generally unfavorable.

ObjectiveTo investigate the possibility of establishing a model of connective tissue disease-associated pulmonary arterial hypertension (PAH) in rats.MethodsPAH was induced by a single intraperitoneal injection of monocrotaline solution at a dose of 50 mg/kg.The rats of the control group were injected the same volume of 2:8 ethanol saline.After 2 and 4 weeks,a polyvinyl catheter was inserted into the pulmonary artery,and the hemodynamic variables were monitored continuously by Maclab/8 s.The pulmonary vascular pathologic remodelling was examined with hematoxylin and lectin perfusion.Thickness and area indices were calculated.ResultsFour weeks after intra-peritoneal injection of monocrotaline,the systolic,diastolic,and mean pulmonary arterial pressures [(41 ±6),(24.3±3.8),(29.8±4.2) mm Hg] were obviously increased in the experimental group [(23 ±3),(8.5 ±2.4),( 17.1 ±2.5) mm Hg] (P＜0.05) when compared with those of the control groups.Histological examination showed that the thickness of arterial wall increased,the lumen became narrowed,and the thickness and area index(TI:0.723±0.034 vs 0.314±0.023,AI:0.912±0.203 vs 0.414±0.021 ) increased in small pulmonary arteries(P＜0.05).ConclusionThe model of connective tissue disease-associated pulmonary hypertension could be established by intraperitoneal injection of monocrotaline solution.The model has been demonstratedthe characteristic morphologic changes in the pulmonary vasculature.This method may provide an economic,easy,and stable animal model for the study of the mechanisms of pulmonary vascular remodeling in connec-tive tissue disease-associated pulmonary hypertension.

To observe the effects of sera containing Liuwei Dihuang Pill (LDP), a compound traditional Chinese herbal medicine, and its monomer catalpol on transforming growth factor-β1 (TGF-β1)/Smad pathway in HK-2 cells.

Objective To investigate the dose distribution and radiation risk of Varian thoracic cone beam computed tomography (CBCT) with default parameters with reference to Monte Carlo simulation and International Commission on Radiological Protection (ICRP) report 110.Methods EGSnrc/BEAMnrc code was used to simulate the material, thickness, and geometry of the kV CBCT source (kVS) to establish the kVS model.A benchmarked MCSIM code was applied to calculate the dose distribution in the ICRP phantom after the scan with the standard thoracic parameters (110 kV, 20 mA, and 262 mAs), and the conversion coefficient of absolute dose was obtained in a spherical phantom following the TG-61 protocol.The results of Monte Carlo simulation were validated by PDD and Profile in a water phantom and the measurement of the absolute dose in the computed tomography dose index (CTDI) phantom and Alderson phantom.The models including BEIR VⅡ were used to evaluate the radiation risks.Results With reference to the criterion of 3%/1 mm, the uncertainties of PDD and Profile were less than 2%.The difference between the measured and calculated values was<2.9% in the CTDI phantom and ≤0.05 cGy in the Alderson phantom.In the ICRP110 phantom, the doses to the left lung, right lung, left breast, right breast, heart, thyroid, trachea, cancellous bone, and cortical bone were 1.28, 1.39, 1.74, 1.80, 1.46, 0.48, 0.88, 0.85, and 1.84 cGy, respectively.The relative risks of ischemic heart disease, breast cancer, lung cancer, thyroid cancer, and tracheal cancer in a standard scan were1.001 , 1.009, 1.019, 1.000, and 1.008, respectively. Conclusions The accumulated dose and long-term risks of CBCT during image-guided thoracic radiotherapy cannot be neglected and should be effectively controlled.

Objective Knowledge?based radiotherapy ( KBRT ) can reduce the plan quality variability induced by different experiences between physicians and improve the quality of treatment plans. Methods The Varian Rapid Plan system was used to train a dose?volume histogram ( DVH) prediction model. The obtained model was preliminarily applied to semi?automatic design of the preoperative treatment plans for rectal cancer. Eighty high?quality volumetric modulated arc therapy plans were imported into the model training set of the Rapid Plan system. The structures of the plans were matched to the corresponding labels and codes as listed in the library. The training started after the verification of prescription. The residual plots,regression curves,geometric plots for organ at risk ( OAR) ,in?field DVH plots,and model training logs were examined. After removal of the mismatch, the original plans were assessed to rule out outliers and influential data points. More similar plans may be added for another round of training. Ten KBRT plans were designed using the final model and compared with the clinical plans. Results For the two major OARs,the femoral head and bladder,the average goodness of fit of the principal component were 0?999 415/1.0 and 0?999 963/1.0 for the DVH model,and 0?999 651/1.0 and 0?999 945/1.0 for geometry?based expected dose model,respectively. In all the plans, 11 had Cook ’ s distance values exceeding the tolerance and 4 had studentized residual values exceeding the tolerance. The outliers were all kept in the training set to generalize the scope of the model. The 10 KBRT plans had significantly improved homogeneity indices for PGTV and PTV than the original plans (P=0?00,0?04).The 10 KBRT plans also had significantly reduced D50% to the femoral head and bladder as well as significantly reduced mean doses to the bladder than the original plans (P=0?042,0?000,0?005). Conclusions In this study,the Rapid Plan system is used to train a KBRT model for design of preoperative radiotherapy plans for rectal cancer. The results of preliminary application meet the clinical requirements.

Objective To study the reference interval of serum iron and magnesium of healthy people in northwest region . Methods 722 healthy people aged 18- <80 were recruited according to the screening criteria of enzymatic multi-center study of International Federation of Clinical Chemistry (IFCC) .Atomic absorption spectrophotometry and Roche assay kit were employed for serum iron ,magnesium detection .Results Differences of serum iron ,magnesium detection results obtained by two different methods ,between urban and rural people and among different age periods showed no statistically significant (P>0 .05) ,and the re-sults was combined into one group .Difference of iron test results between male and female was statistically significant (P<0 .05) , and grouping was performed according to gender ,that was ,male:10 .05-36 .21 mmol/L ,female:6 .19-30 .87 mmol/L .Difference of magnesium test results between male and female showed no statistical significance (P<0 .05) ,and was combined into one group , with the reference interval of 0 .74-1 .06 mmol/L .Conclusion The iron and magnesium 95% reference intervals of healthy people in northwest region are narrower than those of the National test results .

Objective To investigate the frequency distribution of proprotein convertase subtilisin/kexin 9 (PCSK9) gene I474V polymorphisms and their relationship with patients with ischemic stroke (IS)of Uygur and Han ethnic groups in Xinjiang Uygur Autonomous Region.Methods The I474V polymorphism was identified by polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) in 407 patients with IS(including 219 Hans and 188 Uygurs)and 425 health controls (including 255 Hans and 170 Uygurs),and some specimens were sequenced.Results (1) Between IS group and control group,the genotypes Ⅱ and Ⅳ had no statistically significant differences in the levels of triglycerides (TG),high-density lipoprotein cholesterol (HDL-C) ; Total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C) levels had statistically significant differences; LDL-C levels had also statistically significant differences.Between IS and control groups,TC,LDL,HDL-C levels of genotype Ⅱ showed statistically significant difference.In the IS group,TC,LDL-C levels of Ⅳ genotype were significantly higher than the control group,the difference being statistically significant.(2) There was statistically significant difference in the genotype distribution between IS and control groups (9.5％ (77/814) vs 4.5％ (38/850),x2 =16.09,P =0.000).And the distribution of allele frequency was statistically different (18.9％ (77/407) vs 8.9％ (38/425),x2 =17.38,P =0.000).(3) The differences of I474V loci Ⅳ genotype frequency distribution in Xinjiang Uygurs and Hans were statistically significant (27.7％ (52/188) vs 11.4％ (25/219),x2 =17.40,P =0.000; 12.9％ (22/170) vs 6.3％ (16/255),x2 =5.57,P =0.018) ; So did the Ⅴ allele frenquency distribution (13.8％ (52/376) vs 5.7％ (25/438),x2 =15.58,P =0.000; 6.5％ (22/340) vs 3.1％ (16/510),x2 =10.44,P =0.001).(4) There was statistically significant difference in the genotype distribution and allele frenquency distribution between IS group and control group in the Xinjiang Uygurs (27.7％ (52/188) vs 12.9％ (22/170),x2 =11.79,P =0.001 ; 13.8％ (52/376) vs 6.5％ (22/340),x2 =10.44,P =0.001) ; But there was no statistically significant difference in the Hans.Conclusions Ⅱ and Ⅳ genotypes are dominant in the I474V polymorphism loci of PCSK9 gene.The genotype of PCSK9 gene I474V polymorphism is correlated with increasing serum levels of TC and LDL-C.I474V polymorphism is associated with cerebral IS course in Xinjiang region.There is statistically significant difference in the genotype I474V distribution between Uygur and Han groups.I474V polymorphism has a relationship with the occurrence of IS in Xinjiang Uygurs.Ⅳ may be a susceptible genotype and Ⅴ may be a genetic susceptible allele of the Xinjiang Uygurs.

Objective To investigate the application and significance of the MS/MS method and the HPLC method for the screening and diagnosis of genetic metabolic disease phenylketonuria (PKU) .Methods The MS/MS method and the HPLC method were adopted to analyze the concentrations of phenylalanine(Phe) and tyrosine(Tyr) and its ratio in the dried blood spot specimen on filter paper and the whole blood specimen in 1 860 children aged from 3 d to 11 years old .Results The linear ranges of Phe by the MS/MS method and the HPLC method were 26 .02 - 101 .11 μmol/L and 32 .04 - 132 .50 μmol/L ,which of Tyr were 41 .50 -253 .07 μmol/L and 32 .85 - 111 .50 μmol/L ,the average recovery rates of Phe were 97 .36% and 98 .43% ,which of Tyr were 96 .71% and 98 .99% ,in‐run CV of Phe were 4 .31% and 3 .97% ,which of Tyr were 4 .09% and 4 .01% ,between‐run CV of Phe were 5 .73% and 4 .58% ,which of Tyr were 6 .01% and 5 .24% ,respectively .Conclusion Both methods can sensitively and specif‐ically detect blood Phe and Tyr concentrations and meet the requirements of screening and diagnosis of PKU .

Objective To explore the expression and significance of Dickkopf-1 (Dkk-1) and cell lymphoma/leukemia-2 (Bcl-2) protein in sinonasal squamoucell carcinoma(SNSCC) .MethodThe immunohistochemical SP method and Western blomethod were adopted to determine the expression of Dkk-1 and Bcl-2 in 30 specimenof SNSC(SNSCgroup) ,38 specimenof sinonasal inverted papillomas(SNIP group) and 20 specimenof middle turbinate mucosa(control group) .ResultThe expression of DKK-1 protein in the SNSCgroup wasignificantly down-regulated compared with the SNIP group and the control group ,while the expression of Bcl-2 protein in the SNSCgroup wasignificantly up-regulated compared with the SNIP group and the control group;in the SNSCgroup ,the positive rateof DKK-1 protein and Bcl-2 protein in the high and middle differentiation group and the low differentiation group were 100 .00% ,68 .75% ,33 .33% and 50 .00% ,62 .50% ,100 .00% respectively ,the differencewere statistically significan(P＜0 .05) .Conclusion Dkk-1 protein may play an importanpromoting role in the developmenand pro-gression procesof SNSC,the expression of Dkk-1 protein hanegative correlation with the expression of Bcl-2 protein in SNSC,which may become new targespoof SNSCgene therapy .

0bjective To investigate the serum total bilirubin level of healthy population in northwest area of China.Methods According to the guiding principle and the screening standard of C28-P3,722 individuals conforming to the screening standard from October 2011 to January 2012 were collected.Serum total bilirubin was determined with diazo reagent method(Roche)on the P module of Hitachi 7600 automatic biochemistry analyzer,and the vanadate reagent method(WAKO)on the D module of the Hitachi 7600 automatic biochemistry analyzer,respectively.The detection results were analyzed between different analysis systems,between country and city and among different age groups by SPSS13.0.The top and bottom limitations of 95% reference interval recommen-ded by the C28-P3 file were calculated by the non-parametric method.Results Serum total bilirubin detection results had no statis-tically significant differences between the two kinds of detection methods,between rural and urban populations,among all ages and genders (P >0.05).The ultimate reference interval of serum total bilirubin in the northwest area was 2.19 -29.29 μmol/L.Con-clusion The differences of serum total bilirubin reference interval exist between the healthy population in the Northwest area of China and the current reference interval used in domestic and foreign population.Establishing the reference intervals of new bio-chemical test item suitable for China′s population will provide the scientific basis for the evaluation of disease diagnosis,treatment, prognosis judgment and health assessment in the Chinese population.