Capacity assessment is of significant priority for medical treatment and clinical research invol-ving mental disorder patients,as to protect an individual's fundamental rights.Clinical judgment of individual's ca-pacity to consent most focus on medical situation,well-designed capacity assessment instruments should be used to support experienced clinical judgment.Capacity to consent can be adequately captured by measuring the constructs of understanding,appreciation,reasoning and communicating /expressing a choice.A large number of instruments designed by foreign developers to assess capacity to consent need validation and implementation in China,the in-strument designed by Chinese researchers has not been widely agreed.Establishing an effective capacity assessment instrument with psychometric properties (validity and reliability),which considering the clinical practice and culture background in china would be a breakthrough in methodology.

Objective To investigate the influence of setting up of Division of Neonatology and Neonatal Intensive Care Unit(NICU) on neonatal mortality rate(NMR) in local perinatal center. Methods (1) NMR and survival rate of very low birth weight (VLBW) infants and triplet and quadruplet from 17283 newborns during Jan 1,1990 and Dec 31,1992 before NICU was set up (group A) were cmpared to that from 32 716 newborns during Jan 1,1993 and Dec, 31,2000, after NICU was set up(group B).(2) NMR and survival rate of VLBW infants in the process of NICU was developed was investigated. (3)NMR after the NICU was opened to the whole community. Results (1)NMR was 8.62 per 1000 in group A and 3.00 per 1000 in group B. Corrected Mortality Rates was 6.36 per 1000 and 1.74 per 1000 respectively (P

Objective To establish a new method for inducing the primordial germ cells to differentiate into hepatocyte-like in vitro.Methods The primordial germ cells(PGCs) from the gonadal ridges of the mouse embryos of 13 days postcoitum from Kunming pregnant mice were cultured in vitro.Then embryonic hepatocytes enclosed in microcapsule and liver tissue extract of newborn mice were added into medium to co-culture with PGCs for committed differentiation.Albumin(ALB) and ?-1-antitrypsin(AAT) were assayed by immunocytochemistry.Results The morphology of cells differentiated from PGCs likes star or ovum,the ALB and AAT immune positive expression were detected in those differentiated cells.The ratio of positive cells was above 70% in 2 weeks.Conclusion Microenvironment of embryonic hepatocyte microcapsules and liver tissue extract could effectively induce PGCs to differentiate into hepatocytes.

Objective To explore the effect of constraint-induced movement therapy on upper limbs of hemiplegic cerebral palsy in occupational therapy. Methods 30 children of hemiplegic cerebral palsy were divided into control group (n=15) and observation group (n=15). Both groups received conventional occupational therapy, the observation group received constraint-induced movement therapy additionally. Their upper limb function were assessed before and 6 months after treatment. Results The scores improved in both groups after treatment (P<0.05). The score were significantly higher in observation group than control group (P<0.01). Conclusion Constraint-induced movement therapy can improve the upper limb function of hemiplegic cerebral palsy in occupational therapy.

Objective To determine the effect of cetuximab(C225)on the radioresistant human esophageal squamous carcinoma eell line KYSE-150R.Methods A radioresistant human esophageal squamous carcinoma cell line KYSE-150R was established by fractionated irradiation.Morphological changes from KYSE-150 to KYSE-150R were observed by phase-contrast microscopy.Karyotype analysis was performed by G-banding.The radiosensitivities were analyzed by colony formation assays.Results The population doubling time of KYSE-150 and KYSE-150R were(23.6±0.2)h and(25.9±0.6)h (t=6.6,P<0.01),respectively.The chromosome number of KYSE-150R was increased and chromosome aberrations were observed from(69.3±1.9)h to(73.7±1.2)h(t=-8.83,P<0.01).The SF2,D0,Dq and N values of KYSE-150R were all higher than those of KYSE-150.After 5μg/ml of C225 added,the SF2,D0,Dq and N values were significantly decreased as compared to the control.After C225 treatment,the G0/G1 and G2/M phase cells were increased,while S-phase cells decreased(t=-4.478-4.308,P<0.05).Conclusion Cetuximab can enhance the radiosensitivity of radioresistant human esophageal squamous carcinoma cell line KYSE-150R.

Objective 　To investigate the effect of risperidone on regional cerebral blood flow (rCBF) and the relationship between efficacy and rCBF ratio. Methods　Twenty four naive schizophrenic patients (diagnosed according to the ICD 10) completed 8 weeks treatment with risperidone. Ten patients were male and 14 were female. Twenty six healthy controls were enrolled as control group. The treatment dose of risperidone was 3～6 mg/d. After 8 weeks treatment, brain imaging was conducted again. Results　Before treatment with risperidone, compared to the control group, the baseline rCBF ratios of left and right inferior posterior temporal of patients were higher and the cognitive activated rCBF ratios of left mid-lateral frontal was lower. After treatment, the baseline state rCBF ratios of right lateral temporal, left and right superior posterior temporal were significantly decreased. The cognitive activated rCBF ratios of left and right inferior medial frontal, left inferior lateral frontal, left superior fronto temporal and left superior lateral fronal significantly increased. The efficacy was correlated with changes of the baseline rCBF ratio in some RIOs. Conclusions　Risperidone could change the blood perfusion in some ROIs. It suggested that the perfusion in these ROIs could be useful for predicting treatment efficacy.

Objective To study the effects caused by novel antipsychotics quetiapine and aripiprazole on concentrations of platelet 5-HT in patients with schizophrenia,and to explore the relationships among the change of platelet 5-HT concentrations, psychiatric symptoms and the sensitivity of therapy. Methods Sixty-eight patients with schizophrenia meeting International Classification of Diseases-10 (ICD-10) were enrolled in the study. They were divided into quetiapine group(n=34) and aripiprazole group(n=34) according to the sequence of admis-sion. The platelet 5-HT concentrations were measured with high performance liquid chromatography method(HPLC-ECD). The positive and negative syndrome scale (PANSS) was used to evaluate the psychopathology. Treatment emergent symptom scale (TESS) was used to evaluate the side effects. PANSS,TESS were used at pre-treatment,the end of 4th and 8th week of treatment. Results The platelet 5-HT concentrations in two groups were higher af-ter 8 weeks treatment,but had no statistically significant difference (P>0.05). In quetiapine group, the platelet 5-HT concentration was (458.89±233.36) ng/10~9 at the pre-treatment, and (554.31±313.22) ng/10~9 at the end of treatment (t=1.709, P=0.099). In aripiprazole group, the platelet 5-HT concentration was (409.83±149.32)ng/10~9 at the pretreatment, and (421.27±245.96)ng/10~9 at the end of treatment (t=0.321, P=0.819). There was no difference between two groups(P>0.05). Stepwise regression analysis showed the changing rate of platelet 5-HT concentrations was positively correlated with the dosage of quetiapine (r=0.385, P=0.039).It was positively correlated with the decreasing rate of PANSS in aripiprazole group(r=0.391, P=0.040). Con-dusion The changes of psychiatric symptoms and the dosages of antipsychotics maybe have intimate relationships with platelet 5-HT concentrations in the course of medication.

Objective To evaluate the value of the muhifunctional angle regulator with shields in skeletal fluorosis X-ray radiography.Methods Conventional radiography,regulator with shields and regulator for radiography were used to examine the forearms and shanks of 78 patients,and then the quality of the photos and the diagnostic results were compared.The dose rates on patients' foresides,sides,and bottoms of division 1 and 2 m were measured by pressure ionization instrument.Results Regulator with shields and regulator for radiography had a higher rate of good quality than conventional radiography by 39 %,and consequently the diagnostic accuracy rate were improved by 37%(X2 = 43.33,43.98 and 17.76,14.56,P < 0.01).By conventional radiography the average dose rates on forearms and shanks I and 2 m away from X-ray axis were 1198,934 and 1439,1175 μSv/h,respectively;while regulator with shields and single regulator were used,corresponding average dose rates were 80.6,39.4 and 95.6,59.5/JSv/h and 375.7,187 and 447,226.3 μSv/h,respectively.Conclusions Angle regulator with shields is effective devices to examine the forearms and shanks of the patients who are suffering from dysfunction of skeletal fluorosis.

Objective · To investigate the effect of metformin on insulin resistance (IR)-related metabolic parameters in olanzapine-bearing rats.Methods · Thirty female SD rats were randomly divided into metformin intervention group, olanzapine group and control group. During the first 6 weeks,5 mg /(kg·d) olanzapine was given to the two test groups . The control group was given the same amount of saline. From the 7th week, the intervention group began to combine with metformin 500 mg / (kg·d), while the olanzapine group combined with the same amount of saline, continuing for 4 weeks.At the end of 6th week and 10th week, intraperitoneal glucose tolerance and homeostasis model assessment IR index were assessed. Results · The area under the glucose tolerance curve (P=0.040) and the IR index (P=0.000) were significantly higher for the intervention group and the olanzapine group than the control group at the end of 6th week. At the 10th weekend, the glucose tolerance (P=0.015) and IR index in the intervention group were significantly lower than those in the olanzapine group (P=0.001). Conclusion · Metformin may rectify the impaired glucose tolerance and improve IR induced by olanzapine partly.

Objective To explore the clinical manifestation, diagnosis and prognosis of Leigh syndrome in children. Method Clinical data from 4 cases of Leigh syndrome conifrmed by genetic testing were retrospectively analyzed. The related literature were reviewed. Results In 4 cases, 3 were boys and one was a girl, 3 cases were onset in infant and one case was in school age. The main manifestations were mental retardation, low muscle tone, convulsions, feeding dififculties, drooping eyelids, extraocular muscle paralysis and nystagmus, irritation, activity intolerance etc. The brain magnetic resonance imaging (MRI) revealed symmetry long T1, T2 abnormal signal in brainstem, bilateral globus pallidus, thalamus, cerebellar dentate nuclei, and periaqueductal, 3 cases involved midbrain, one case involved thalamus, and one case involved cerebellar dentate nuclei;2 cases had encephalatrophy. Electromyography was normal in all cases. The levels of lactate in blood and cerebrospinal lfuid were increased. Mitochondrial DNA (mtDNA) detection found the mutation of mtDNA 8993 T>G in one case, and the mutation of mtDNA 9176 T>C in another 3 cases. The case onset in school age died of respiratory failure one month later, and another 3 cases were still in follow up, there were mental retardation, but no signiifcant setback. Conclusion The clinical manifestations of Leigh syndrome in children are diverse. The diagnosis is based on the typical clinical manifestations and MRI, blood and/or cerebrospinal lfuid lactate levels. The genetic testing is the golden standard for diagnosis.