Proton magnetic resonance spectroscopy is a new technique that can determine the concentrations of a few detectable metabolites altered in diseases.Proton magnetic resonance spectroscopy and spectroscopic imaging are of noninvasive and accuracy.This article focus on the role of proton MRS in preoperative diagnosis and differentiation,tumor grading,evaluation of the efficacy of brain tumor therapies and radiotherapy induced changes.

BACKGROUND: With the increase of senile population, it needs to further improve their mental health when improving their physical health. To study the depressive status of retired elderly people in order to provide basis for effective community nursing intervention.OBJECTIVE: To investigate and analyze the depression incidence among retired elderly people and conducted correlative factors analysis in order to improve the nursing service to aged people's mental health.DESIGN: Cross-sectional sampling study towards retired senior people.SETTING: Nursing department of a medical college.PARTICIPANTS: This study was completed in Nursing Department of North China Coal Medical College during September to December 2002. It conducted questionnaire survey to 1 000 retired people in Tangshan city by family visit. There were 574 male and 426 female who aged from 60 to 88years old with mean age of 67 years.METHODS: To adopt geriatric depression scale and general condition questionnaire investigation to individuals.MAIN OUTCOME MEASURES: Depression scale score, depression incidence and frequency of correlative factors RESULTS: Mild depression accounts for 17.2% while moderate and severe depression account for 5% among retired elderly people. There is close relationship between factors such as retired veterans, female, low education,lack of social support, empty life, lack of exercise and poor self-assessed health and depression incidence(x2 = 9.80 - 175.93, P ＜ 0. 05).CONCLUSION: The incidence of senile depression among retired elderly people is pretty high so that it is important to pay attention to mental care towards retried people when doing community nursing, especially to divorced, widowed, female and low educated retired people.

Objective To validate the theraputic efficacy of percutaneous ethanol injection(PEI) for hyperparathyroidism caused by parathyroid adenoma.Methods One case of parathyroid adenoma underwent PEI whose diagnosis was comfirmed by biopsy. The 22 gauge needle was punctured into the adenoma under CT guidance and ethanol was injected into the lesion at multiple points. Results The CT images obtained 6 months after 2 times of CT guided PEI revealed that the volume of the adenoma decreased markedly together obviously with decrease of enhancement after the injection of contrast media. The level of serum parathyroid hormone, calcium and phosphorous returned normal 2 days to 12 months after the management. The clinical manifestations improved markedly.Conclusions CT guided PEI is a minimally invasive and highly effective theraputic modality for hyperparathyroidism. It can serve as an important supplement to surgery.

Objective To investigate the value of P-selectin,thrombomodulin (TM) and von Willebrand factor (vWF) in identifying severe acute pancreatitis (SAP) at an early stage of the disease.Methods 80 patients with acute pancreatitis (25 mild,30 moderate and 25 severe) were selected in this study when they were admitted within 24 hours of the onset of symptoms.20 healthy volunteers were collected as the healthy control.Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of vascular endothelial cell damage markers (P-selectin,TM and vWF) in SAP patients and the control group.Results The levels of 3 markers were significantly higher in SAP patients than in the mild and moderate acute pancreatitis patients and healthy volunteers (P＜0.05).P-selectin,TM and vWF were independent markers for the development of SAP and had higher discriminative powers than conventional marker tumor necrosis factor(TNF-α)(P＜0.05).They were similar to the APACHE-Ⅱ scoring system in distinguishing SAP at an early stage.Conclusions P-selectin,TM and vWF are independent markers to identify the development of SAP at an early stage.They are obviously superior to TNF-α and similar to the APACHE-Ⅱ scoring system.

Objective To investigate the effect of early continuous veno-venous hemofiltration (CVVH) on intra-abdominal pressure (IAP) and serum interleukin-6 (IL-6) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS).Methods 41 SAP patients with ACS were selected as treatment group and treated with CVVH as well as conventional methods in ICU.The other 12 patients with the same disease were selected as the control group and were only treated with conventional methods because of economic reasons.IAP and blood level of IL-6 in the two groups were measured daily in order to investigate their changes and the correlation between the two parameters.Results The serum IL-6 level and IAP in the two groups were higher on admission day.IAP and serum IL-6 level in the treatment group were significantly decreased on the first day after treatment,and thereafter decreased rapidly.In the control group,IAP and serum IL-6 level were significantly decreased on the 3rd day after treatment.IAP and serum IL-6 level from the 1st day to the 6th day after treatment in the treatment group were significantly lower than those of the control group at the same time point (P＜0.05).There was a significant positive correlation between blood IL-6 level and IAP in SAP patients with ACS(r=0.48,P＜0.01).IL-6 difference before and after treatment was also positively correlated with the difference of IAP(R=0.39,P＜0.05).Conclusions VVH significantly decreased the IAP and the blood level of IL-6 in ACS patients of SAP.The blood level of IL-6 is significantly correlated with IAP,suggesting that IL-6 may play an important role in the pathogenesis of ACS.Therefore early CVVH may clear the cytokines such as IL-6 and lower IAP,thus to prevent multiple organ dysfunction syndrome (MODS),which should be applied in the early stage of ACS.

Objective To study the expression of nuclear transcription faetor-KB(NF-κB)and nm23-H1 protein in hepatocellular carcinoma(HCC)and its relationship with clinical pathologic features.Methods The expression of NF-κB and nm23-H1 in 41 cases of HCC were examined by immunohistochemical technique.The corresponding cancerous adjacent tissue or cirrhosis tissue(10 cases)and normal liver tissue (11 cases)collected from specimens of benign liver hemangioma were served as a control group.Results NF-κB protein was detected in 68.3%(28/41)cases of HCC tissues compared with 12.2%(5/41)in noncancerous adjacent tissues,1/10 cases in liver cirrhosis,0/11 cases in normal liver tissues(P＜0.01).NF-κB expression has no correlation with clinical pathological feature of HCC patients fourteen cases of 41 HCC tissues were found nm23-H1 protein positive staining,compared with 27 cases negative staining;negative expression of nm23-H1 protein correlates closely with portal vein invasion and serosal infiltration(χ2=4.16χ2=4.19,P＜0.05),and its negative expression correlates well with survivin expression(χ2=20.25,P＜0.01).Conclusion High expression of NF-κB protein in HCC tissues suggests that it probably played an important role in the origin and development of HCC,and it may be as targets for gene therapy.Negative expression of nm23-H1 protein correlates with malignant biological feature of HCC,and probably suggests poor prognosis.

Objective To determine normal reference ranges for venous blood count among children aging from 1 year old to 12 years old.Methods These normal reference ranges were defined in a population of 526 healthy children who had no blood system diseases,allergic diseases,respiratory system diseases,urinary system diseases,digestive system disease,rheumatoid disease,thyroid disease,parasitic infections,malignancies and genetic disease,etc.Values of white blood cell count (WBC),red blood cell count (RBC),hemoglobin (Hb)concentration,red blood cell specific volume (Hct),mean corpusular volume(MCV),mean cell hemoglo-bin (MCH),mean corpuscular hemoglobin(MCHC),platelet (PLT),percentage of neutrophil (NE%),percentage of lymphocyte (LY%),percentage of mononuclear cells (MO%),percentage of acidophilic granulocyte (EOS%).Statistical analysis was done on various parameters that we recorded,and then for every parameter,we could get the various reference ranges for different age groups.Results The subjects were divided into 4 groups based on age.Besides the parameters of WBC count and classification of WBC,the rest of parameters were proved to be of no statistical difference between 4 groups..After an integration of the values,we could get the results as follows:RBC(4.02-5.2)×10 1 2/L,HGB 108-144 g/L,Hct 35.2%-40.4%,MCV 74.6-89.9 fL,MCH 20.9-34.7 pg,MCHC 332- 340 g/L,PLT(157 - 409 )× 10 9/L.WBC count did not have statistical difference between the age group 6-<9 and 9-12,but did have between the rest groups.After an integration of the values of WBC count,it could be conclu-ded that WBC count of age group1-<3 was(4.88-13.38)×10 9/L,that of age group 3-<6 was(4.26-1 1.6)×10 9/L and that of age group 6-12 was (4.24-10.24)×10 9/L.WBC classification results were various in different age groups.The values showed as follows:age group 1-<3 NE:29%-32%,LY:58%-61%;age group 3 -<6 NE:43%-46%,LY:43%-46%;age group 6-<9NE:49%-52%,LY:38%-40%;age group 9 to 12NE:5 1% - 58%,LY:33% - 39%.Conclusion WBC classification re-sults and WBC count do have statistical difference in different age groups.Besides the parameters of WBC count and classification of WBC,the rest of parameters are proved to be of no statistically difference in different age groups.The values of WBC count decrea-ses as the age increases.From WBC classification results,the most apparent fact is that the percentage of neutrophil increases as the age increases but the percentage of lymphocyte is just the contrary.As mentioned above,we suggest that we should establish a spe-cific whole blood count normal reference range for each age group during our laboratory testing work.

Venous thromboembolism (VTE) is a kind of venous disorder that the abnormal condensation of blood within the vein,leading to complete or incomplete vein obstruction.VTE is mainly a combination of deep vein thrombosis (DVT)and pulmonary embolism (PE) and is an important complication after major orthopedic surgery (total hip arthroplasty,total knee arthroplasty,hip fracture surgery).Foreign literature reported that incidence rate of VTE after arthroplasty was as high as 42％-57％.Conventional notion was that DVT and PE were two different but interrelated types of VTE,while the latest research reported that the formation of DVT and PE after arthroplasty may be two events individually.Prevention of VTE after major orthopedic surgery includes general,pharmacological and mechanical methods.The efficacy of physical combined with pharmacological methods was better than drug prevention alone in preventing distal DVT.Dabigatran,apixaban,rivaroxaban and other new oral anticoagulants were better than low molecular weight heparin and other traditional medicines in effectiveness and safety.The effects of low molecular weight heparin are remarkable,while it cannot take orally.A recent study found that staged VTE prophylaxis,namely patients received low molecular weight heparin injection in hospital,and received aspirin,rivaroxaban or dabigatran orally after discharge is safe and effective in prevention of VTE.

Objective To investigate mechanism of cyclooxygenase-2 ( COX-2) in bone loss in a postmenopausal osteoporosis (PMOP) rat mode with ovarietomy (OVX).Methods Forty female Sprague Dawley adult rats at age of 3 months were randomly divided into 4 groups,10 in each group,including shamoperated (sham) group,OVX group,OVX treated with nilesteriol (OVX + E) group and OVX treated with aspirin ( OVX + P) group.All rats in OVX,OVX + E and OVX + P groups underwent ovarietomy under abdominal anesthesia with 10％ chloral hydrate.Rats in sham group were only taken with fat tissue with same weight under bilateral ovary.After surgery,penicillin was administered to prevent infection.At day 7 after surgery,agents were given by intragastric administration for 12 weeks.Nilestriol at 1.0 mg/kg was used in OVX + E group once a week,aspirin at 45 mg · kg - 1 · d- 1 was used in OVX + P group once a day.Saline with same volume was used in rats in sham and OVX groups.All agents were administered one time per day.Dose of agents were adjusted by weight per week.At end of study,bone mineral density (BMD) of right femurs and lumbar vertebrae 3 -5 (L3-5) were measured.Morphology of bone was detected by hematoxylineosin,and expression of COX-2 was determined by immunohistochemistry staining.Results ( 1 ) BMD:BMD of right femur and L3-5 was (0.209 ±0.010) g/cm2 and (0.230 ±0.012) g/cm2 in sham group and (0.181 ±0.008) g/cm2 and (0.201 ± 0.016) g/cm2 in OVX group,which reached statistical difference (P＜0.01).BMD of right femur and L3-5 was (0.203 ±0.009) g/cm2 and (0.224 ±0.028) g/cm2 in OVX + E group and (0.200 ± 0.011 ) g/cm2 and (0.204 ± 0.003 ) g/cm2 in OVX + P group,which were all higher than those in OVX group (P ＜0.01,P ＜0.05).However,there was no statistical difference in BMD between OVX + E and OVX + P group ( P ＞ 0.05).(2) Morphology of bone:bone trabeculae became fewer and degenerated in OVX group.However,bone trabeculae were regular and dense in OVX + P group and OVX + E group,which were similar to those in sham group.(3) Expression of COX-2:cells with COX-2 positive and expression of COX-2 around bone trabeculae in OVX group were more than those in sham,OVX + E and OVX + P group.Conclusion COX-2 plays an important role in PMOP.Aspirin could prevent bone loss by decreasing COX-2 expression in OVX rats.

AIM: To study the effect of ginsenoside Rg 2 on cardiac hemodynamics in dog. METHODS: The parameters of cardiac hemodynamics were determined by using anesthetized open chest dog. RESULTS: In dogs treated with ginsenoside Rg 2 in a dose of 0.5、 1.0、2.0mg?kg -1 respectively, the heart rate (HR) slowed, the diastolic blood pressure (DBP)、 left ventricular systolic pressure (LVSP) and maximum decreasing rate ( dp/dtmax) increased; the cardiac output (CO)、 cardiac index (CI) and stroke index (SI) decreased; The coronary vascular resistance (CVR)、 the renal vascular resistance (RVR) and total periphery resistance (TPR) increased. CONCLUSION: Effect of ginsenoside Rg 2 on cardiac hemodynamics in dogs is similar to strophanthin K(SK), and can support the blood circulation of important organs.