This paper presents the determination results of 14 macro and trace elements, such as Na, K, Cl, Mg, Ca, Al, Br, Fe, Co, Zu, Se, Mn, Cr and Rb, in breast milk, cow's milk and milk powder by instrumental neutron activation analysis. A preliminary discussion about the data is given.

Background and purpose: The precise radiotherapy in patients with breast cancer consists of multiple procedures, such as simulation, treatment planning and delivery. We assessed the impact of treatment set-up errors on accuracy of post-operative radiotherapy (RT) in patients with breast cancer receiving tangential RT. Methods: Between November 2007 and August 2008, a total of 50 patients were enrolled an institutional review board-approved study. All patients received tangential RT for either right or left breast cancer. Read-out numbers of X, Y, Z directions shown on linear accelerator were recorded according to the sequence of before and after medial tangential field and after lateral tangential field.The impact of treatment set-up errors on post-operative radiotherapy (RT) in different subgroup patients was analyzed using stata 7.0 statistics software. Results:The mean set-up errors on Z, Y, X direction were 2.55, 3.96 and 0.58 cm, respectively. The largest set-up errors in all three directions were observed in the first week during treatment and the largest movement was observed in Z direction. Conclusion: The movements after medial tangential field treatment are much more than those after lateral treatment during RT.The movements in X direction arc substantially less than Y direction or Z direction intrafraction. As interfraction differences have been observed, the movements in the beginning two weeks are more than other treatment period.

Objective To investigate the changes of hypothalamic-pituitary-adrenal axis (HPA)function, volume of the hypothalamic, pituitary and adrenal glands in elderly patients with depression. Methods Twenty-five cases of elderly patients with depression and 19 healthy elderly patients were enrolled into the patient group and the healthy control group, respectively. Enzyme linked immunosorbent assay was used to measure the level of the main hormone related with HPA axis in blood. The low dose dexamethasone suppression test was used to assessassessment the negative feedback regulation of HPA axis. The volume of the hypothalamus, pituitary and adrenal glands were determined by the magnetic resonance imaging. Results The Beck Depression Scale (BDI-II) and Montgomerie Rating Scale (MADRs) score of the elderly depression patients were significantly higher than those in the healthy control group (P < 0.01). The values of main hormone related with HPA axis in the patient group, such as CRH, ACTH and CORT, were higher than those in the healthy control group (P<0.01). The non- suppression rate of low dose dexamethasone suppression test in the patient group was significantly higher than that in the healthy control group (P < 0.05). The hypothalamus, pituitary and adrenal gland volume of patients group were 4.7%, 18.3% and 17.5% ,respectively. Significant the differences of pituitary and adrenal volume were observed between two groups (P < 0.05). Conclusion The levels of main hormone related with HPA axis in the elderly patients with depression were significantly increased, the non-suppression rate of low dose dexamethasone suppression test was also increased. Meanwhile, the volume of pituitary and adrenal gland in the elderly patients with depression increased.

Objective To explore the effects of Dimethyloxalyl Glycine(DMOG)on isehemic acute renal failure(iARF)in mice and its relationship with activation of hypoxia inducible factor 1α(HIF-1α).Method Twenty five C57/BL male mice were divided into 5 groups randomly:control group,DMOG group,sham operation group,ischemia/reperfusion(I/R)group and DMOG pretreated group(DMOG+I/R).Ischemia/reperfusion injury was induced in mice by clamping both renal pedicles for 30 minutes.The expression of HIF-1α was determined by Western blot.Renal function was reflected by blood urea nitrogen(BUN)and serum creatinine(Scr).Morphologic changes were evaluated under light microscopy.Apoptosis in the kidney was detected by TUNEL staining.Expression of Vimentin,a marker of tubulointerstitial damage was detected by immunohistochemistry.Results The elvated levels of of BUN((65.8±2.6) vs (13.6±0.7),P＜0.01],and Scr[(229.5±11.2) vs (6.5±0.8),P＜0.01]andwere found morphological injury were induced by the ischemic insult in I/R group.Administration of DMOG dramatically improved renal function[BUN,(26.3±6.5)vs(65.8±2.6);Scr,(27.0±14.1)vs(229.5±11.2),P＜0.01]associated with amelioration of tubulointerstital damage.In the DMOG treated group,the protein level of HIF-1α in the kidney of mile was also up-regulated significantly.Conclusions The protection against iARF in mice by DMOG administration is mediated by activation of HIF-1α.

Objective To investigate the mechanism and clinical characteristics of rapid spontaneous resolution of acute subdural hematoma in children. Methods The clinical data of 9 children with rapid spontaneous resolution of acute subdural hematoma were retrospective analyzed. Results Subdural hematoma of three cases were completely dissolved within 8 h, while those of the other 6 cases were significantly reduced which were completely dissolved in 48-72 h. Conclusions Rapid spontaneous resolution of acute subdural hematoma in children is rare in clinical practice. The redistribution and dilution of hematoma and the anatomical characteristics of the children patient determine the possibility of hematoma dissipation. The conservative treatment can get a good prognosis.

Objective To investigate the relationship between inflammatory bowel disease (IBD) activity and choroidal thickness,and evaluate the utility of a choroidal thickness measurement in assessing IBD activity.Methods A total of 100 eyes of 50 patients of IBD with different disease activity,including 23 patients of ulcerative colitis,27 patients of Crohn's disease (CD).Ninety-six eyes of 48 healthy volunteers were recruited as control group.Choroidal thickness was measured using enhanced depth imaging(EDI)optical coherence tomography.Results Compared with the subfoveal choroidal thickness (294.37 ± 35.04) μm in healthy volunteers,the subfoveal choroidal thickness (349.28 ± 76.57) μm in UC patients with severe disease activity,the subfoveal choroidal thickness (326.71 ± 59.71) μm and (354.24 ± 66.34) μm,respectively,in CD patients with moderate and severe disease activity were found to be increased significantly (all P ＜ 0.05).Conclusion Choroidal thickness should be considered as a potential marker to assess the disease activity in patients with IBD,especially in patients with CD.

Objective To systemically assess impact on postoperative outcomes after red blood cell transfusion(RBCT) in coronary artery bypass graft surgey.Methods A meta-analysis was performed on the comparison and synthesis of findings from included studies published from January 1980 to January 2014.Pooled odds ratio(OR) and 95 ％ confidence interval(CI) were calculated using RevManS.3 software.Sensitivity analysis was conducted and possible publication bias was tested as well.Results Seven retrospective studies including 71 228 patients(33 872 RBCT cases,37 356 control cases) were eligible for inclusion.The pooled analysis revealed difference in the 30-day mortality OR =1.85 (95％ CI:1.35-2.54),1-year mortality OR =2.02 (95 ％ CI:1.44-2.84),shock OR =2.92 (95 ％ CI:1.96-4.35),renal dysfunction OR =7.67 (95 ％ CI:1.44-40.94),mediastinitis OR =2.26 (95 ％ CI:1.72-2.97),and myocardial infarction OR =3.53 (95 ％ CI:2.89-4.29).Conclusion Perioperative RBCT can incresase the risk of postoperative mortality and complications in coronary artery bypass graft surgey.High-quality randomized case cohort studies are still needed for the further proof of the risk.

Objective To assess the risk factors of intradialytic-hypotension (IDH) and the prognosis of IDH among maintenance hemodialysis (MHD) patients for the prevention and treatment of IDH.Methods 276 MHD patients were enrolled during Jan.2009 to Mar.2009.Intradialytic blood pressure was monitored during a 3-month period.IDH was defined as an event characterized by a sudden drop in systolic BP more than 20 mmHg or in mean artery pressure (MAP) more than 10 mmHgassociated with clinical events and need for interventions.Dialysis-related information was collected.Kaplan-Meier method,log-rank test,logistic regression and Cox regression analyses were performed to examine the association between IDH and survival,using a follow-up through 31 May 2014.Results A total of 276 patients were recruited.The incidence rate of IDH was 40.9％.163 patients with no-IDH (＜ 1/10 hypotensive events/3 months) served as controls.113 patients with IDH (≥ 1/10 hypotensive events/3 months) were identified among all 276 patients.Multivariate logistic regression analysis showed that age,ultrafiltration rate,gender,serum NT-proBNP,serum albumin and aortic rool inside dimension (AoRD) were associated with IDH among MHD patients.During the 5-year follow-up,74 patients died,with a mortality rate 5.2 per 100 person-year.Kaplan-Meier survival curve showed significant difference of overall and CV mortality rates between 2 groups.The multivariate Cox regression model indicated that IDH increased the risk of death (HR=1.572,95％CI 1.077-2.293,P=0.019).So did the rise of LVMI (HR=1.010,95％CI 1.009-1.085,P=0.020).Conclusion Elderly,female,high ultrafiltration rate,high level of serum NT-proBNP,hypoalbuminemia and shorter AoRD are independent risk factors for IDH among MHD patients.LVMI can predict the outcome of MHDpatients.Intradialytic hypotension is an independent risk factor for long-term mortality in MHD patients.

Objective To evaluate the effect of ischemic postconditioning on myocardial injury in the patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Thirty patients of both sexes,aged 21-59 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),with left ventricular ejection fraction ≥ 40％,scheduled for elective cardiac valve replacement under CPB,were divided into 2 groups (n=15 each) using a random number table:control group (C group) and ischemic postconditioning group (P group).In group P,ischemic postconditioning was induced by 3 cycles of 30 s aortic unclamping followed by 30 s cross-clamping starting from 5 min before complete opening of the ascending aorta.After induction of anesthesia and before operation (T1),at 1 h after opening of the ascending aorta (T2),at the end of operation (T3),and at 12,24 and 48 h after opening of the ascending aorta (T4-6),blood samples were taken from the radial artery for determination of plasma concentrations of heart-type fatty acid-binding protein (H-FABP),ischemia-modified albumin (IMA),and cardiac troponin Ⅰ (cTnI).Myocardial specimens in the right auricle were obtained at T2,and the pathological changes were examined using an optical microscope.Results The concentrations of plasma cTnI at T2-6 and H-FABP and IMA at T2-5 were significantly higher than those at T1 in the two groups (P＜0.05).Compared with group C,the concentrations of plasma cTnI at T2-6,H-FABP at T2-4,and IMA at T2,3 were significantly decreased (P＜0.05),and the pathological changes of myocardial tissues were significantly reduced in group P.Conclusion Ischemic postconditioning can reduce myocardial injury in the patients undergoing cardiac valve replacement under CPB.

Objective To explore and evaluate the effects of participatory teaching approach in the teaching of medical research methods. Methods The students of clinical medicine of Grade 2007 who took the elective course of medical scientific research method were taken as traditional teaching group, taught by teachers only, while the students of clinical medicine of Grade 2008 and 2009 as participatory teaching group, adopting the way of teachers' lectures and students' participation. At the end of the course, the questionnalre survey method combining interviews was used to investigate the teaching effectiveness, using descriptive analysis and chi-square test to compare the effectiveness between the traditional teaching methods and the participatory teaching methods. Results Compared with the traditional 'teachers centered' method, the 'participatory teaching approach' had better teach-ing results. Through the study of this course, 54 students (42.9%) learned how to conduct scientific research topics, 44 students (34.9%) mastered the design of the questionnalre, 59 students (46.8%) enhanced their ability of data analysis. Students' learning motivation and satisfaction were higher, and 117 student's participation (92.8%) were satisfied with the curriculum setting. Conclusion In medical research method teaching, the effect of participatory teaching method teaching is superior to the tradi-tional teaching method, and students' motivation and satisfaction are higher.