Objective To investigate the influence of postoperative cognitive dysfunction (POCD) to clinical outcome in adult patients and the risk factor. Methods 122 patients after operation on chest were surveyed with Wechsler Adult Intelligence Scale-Revised China (WAIS-RC) within 3 d before operation and on the 7th day after operation. Their pulmonary functions were measured before discharged. Their time on bed, total time in hospital, time after operation in hospital, time in intensive care unit and spending for therapy were investigated. Results 45 patients were finally diagnosed as POCD (POCD group) 7 d after operation. Before operation, the age, the body weight index, the smoking index and the number of risk factor of angiosclerosis in the POCD group were all higher than those whose cognitive function were normal (normal group) (P<0.05). The sores of insight, count, digit scope, vocabulary, figure collocation, figure patch of WAIS-RC in POCD group were obviously lower than those in normal group (P<0.05). Every index of pulmonary function in POCD group was lower than those in normal group(P<0.05). The time keeping on bed, total time in hospital, time after operation in hospital, time in intensive care unit and spending for therapy in POCD group all exceeded those in normal group (P<0.05).Conclusion The adult patients with POCD may spend more time and money for therapy in hospital, and their pulmonary functions may be recovered poorly.

Objective To investigate the effects of different doses of dexamethasone used at different time on the serumal concentrations of TNF ?, IL 1? and IL 6 of rats after severe scald in order to provide experimental basis for reasonable usage of ectogenous glucocorticoids for severe traumas. Methods The serumal concentrations of TNF ?, IL 1? and IL 6 were detected by ELISA after intraperitoneal injection of different doses of dexamethasone into rats at different time after severe scald. Results High dose(5 mg/kg) and low dose (0.5 mg/kg) of dexathemasone used during the period from 4 h to 12 h after severe scald could both significantly reduce the serumal concentrations of TNF ?, IL 1? and IL 6, and the effect of high dose was much better than that of low dose. Both doses of dexathemasone used at 24 h after scald had a significant effect on IL 1? and IL 6, but there was no difference between the two doses. No obvious effects were found of high/low dose of dexamethasone used 48 h later after scald. Conclusion According to the anti inflammatory effect, the best therapeutic efficacy may result from high dose of ectogenous glucocorticoids during the period from 4 h to 12 h and low dose from 12 h to 24 h after severe scald.

Objective To investigate the changes of the expression of HSP90? in the liver of severely scalded rats at the early stage of stress Methods The expression levels of HSP90? in the liver of rats at different time points after severe scald were detected by Western blotting and then the expression of HSP90? in the nucleuses was observed by immunohistochemistry Results The expression of HSP90? significantly increased in the liver of rats after severe scald, especially during 12～48 h Abnormal high expression of HSP90? in the nucleuses around was found at 48 h after scald Conclusion The abnormal high expression of HSP90? due to severe scald may be one of the important causes resulting in the disorder of glucocorticoid receptor at the early stage of stress after severe trauma.

Objective To evaluate the repeatability of the aperture sizes based on the Iris variable aperture collimator (Iris collimator) of CvberKnife VSITM.Methods Radiochromic films were placed at 800 mm of source-to-axis distance (SAD),and Iris quality assurance (QA) software was used to extract the information from the digital images,which were exposured by X-ray beams.Results The average aperture accuracy of Iris collimator was better than 0.11 mm over the beam range 5-40 mm,and the accuracy for 50 mm and 60 mm beams was within 0.19 mm.Conclusions The results suggest a good repeatability of aperture sizes for the CyberKnife VSITM Iris collimator.

Objective To evaluate the effect of ion chamber sensitive volume on absolute dose verification in CyberKnife plan.Methods Solid water phantoms were scanned by a CT scanner, single-field plan, multi-field isocentric plan and sequential optimized plan were designed by the treatment planning system.Absolute doses were measured at the specified point in each plan using the ion chambers with sensitive volumes of 0.007 cm3(A16), 0.24 cm3(A12 s), and 0.6 cm3(PTW30013) and compared with calculated values.Results For the single-field plan, the relative error increased as the aperture size of collimator decreased;with relative errors within ±2%, the smallest aperture sizes of collimator were 12.5 mm (A16), 25 mm (A12 s), and 30 mm (PTW30013).For the multi-filed isocentric plan, the relative errors were 0.26%±3.90%(A16),-6.28%±14.33%(A12 s), and-9.41%±14.10%(PTW30013).For the sequential plan optimized with 15 mm cone, the relative error was 0.79%±1.43%;for the sequential plan optimized with 7.5 mm cone, the relative error was 2.01%±8.39%.In absolute dose verification for clinical plans, there was no significant difference between the results measured by these ion chambers (P=0.985).Conclusions There is no significant effect of ion chamber sensitive volume on absolute dose verification in CyberKnife plan under the following two situations:(1) the collimator with a relatively large aperture is used;(2) the sensitive volume of ion chamber is totally covered by the prescription isodose line.

Objective To investigate the effect of phloroglucinol on pregnancy outcome in patients with recurrent implantation failure (RIF).Methods A total of 146 patients with RIF from March 2014 to March 2016 from the reproductive medical center of the Guangxi Zhuang Autonomous Region people's Hospital was randomly divided into two groups,73 cases were included in study group [16 cases of in vitro fertilization and embryo transfer (IVF-ET) and 57 cases of frozen/thawed embryo transfer (FET)].Patients in study group were given intramuscular injection of phloroglucino140mg,two times a day before the transplantation day to three days after transplantation,73 cases without phloroglucinol injection were included as control group.The biochemical pregnancy rate,clinical pregnancy rate,embryo implantation rate,abortion rate,ectopic pregnancy rate,multiple pregnancy rate and live birth rate were compared between two groups.Results The biochemical pregnancy rate in study group of FET was significantly higher than the control group (57.9％ vs 36.8％,P ＜0.05);the biochemical pregnancy rate in study group of IVF-ET was higher than the control group (50％ vs 37.5％,P ＞ 0.05),but there was no significant difference between the study group and control group;compared to the control group,the study group was increased clinical pregnancy rate,implantation rate,live birth rate,and decreased abortion rate (P ＞ 0.05),but the difference was not statistically significant.Conclusions The application of phloroglucinol in women with RIF may improve the biochemical pregnancy rate,especially in FET cycles.

Objective． Bone mineral density（BMD） was measured in normal Chinese women with single X-ray absorptiometry （SXA） and dual energy X-ray absorptiometry （DEXA）． These two methods were compared to evaluate the sensitivity in reflecting bone loss．Methods． Measurements were performed in 300 women aged 20～79（5 for each age）． The 8mm distal，1／4 distal， ultra distal site of the nondominant forearm were measured with SXA； the AP spine（L2-4）， right femoral neck（Neck）， Ward's triangle（Ward）and trochantor （Troch） were measured with DEXA． Ten women had 5 repeated measurements to evaluate the reproducibility of the equipments．Results． The BMD peak for Neck and Ward was found between age 20～29， for ultra distal and L2-4 at age 30～39， for 8mm distal， 1／4 distal and Troch at age 40～49． After reaching the peak values， BMD at all sites decreased with increasing age． The highest rate of yearly loss of BMD was at 8mm distal． Results of measurement showed significant correlation between SXA and DEXA． Comparing with premenopausal women， the bone loss rate in postmenopausal women was faster and highest up to 11～15 years and the highest rate was at the Ward．Conclusion． The present study gives the normal values of BMD at seven sites for normal Chinese women． The ages of BMD peak were different at seven sites． The yearly loss of BMD was highest at 8mm distal， it seemed to be the sensitive region for bone loss with age． The postmenopausal women had highly significantly loss bone mass than the premenopausal women． Comparing with premenopause， postmenopause BMD for Ward's triangle with DEXA seemed to be most sensitive to the effect of menopause．

OBJECTIVETo study the whole body bone mineral changes in normal subjects.

METHODSBone mineral was measured by dual X-ray absorptiometry (DXA) in 292 normal subjects aged 10-79 years, including 152 females and 140 males. They were divided into age-groups by decade.

RESULTSIn males, the ages with peak value of total bone mineral content (TBMC), total bone mineral density (TBMD), anteroposterior spine BMD (L2-4 BMD) were in the 30-39, 20-39, 20-29 age-groups respectively. In females, they were all in the 30-39 age-group. Peak values of TBMC, TBMD, L2-4 BMD were higher in males than those in females. Loss of bone mineral for females was more pronounced than that for males. Loss of L2-4 BMD was more pronounced than TBMD.

CONCLUSIONThis study provides the normal bone mineral data of whole body for males and females, and the characteristic of changes.

Absorptiometry, Photon ; Adolescent ; Adult ; Age Factors ; Aged ; Bone Density ; Child ; Female ; Humans ; Male ; Middle Aged ; Reference Values ; Sex Factors

Objective To measure the actual absorbed dose of the target in the QUASAR Respiratory Motion Phantom using the CyberKnife Synchrony Respiratory Tracking System, and to evaluate the effect of density heterogeneity on the absorbed dose of tumor gross target volume ( GTV ) . Methods Nine groups were obtained by making different patterns of QUASAR phantom:rib thickness of 0, 20, and 50 mm, and motion amplitudes of 0, 10, and 15 mm. The nine groups were treated with static computed tomography (CT) in different time phases of four-dimensional CT (4DCT) plan, with the same beam and number of monitor units, and the 4D accumulated dose was calculated. The doses of static and 4D plans were calculated using Ray-tracing and Monte Carlo algorithms, and the absorbed doses of GTV in the nine groups were measured at the same time. Results There were a decrease in calculated absorbed dose of GTV and an increase in deviation between the planned and actual dose, with the increases in simulated rib thickness and motion amplitude. Conclusions The density heterogeneity has an impact on the absorbed dose of GTV. Both static CT and 4DCT plan can evaluate the absorbed dose of GTV in case of small rib thickness and motion amplitude, and 4DCT plan with Monte Carlo algorithm may be the optimal method for evaluation of the absorbed dose of GTV in case of large rib thickness and motion amplitude ( deviation<3%)

Objective To investigate the effects of stellate ganglion block(SGB)on attention and executive function in middle-aged and elderly patients after surgery.Methods Middle-aged and elderly patients aged 55-75 years who underwent hip replacement surgery under lumbar anesthesia were randomized into a control group and an SGB group.Patients in the SGB group received ultrasound-guided stellate ganglion block 30 min before surgery,and patients in the control group were given no additional treatment before surgery.All patients were tested with a modified version of the Trail Making Test-Part A (TMT-A)and a modified version of the Symbol Digit Modalities Test (SDMT)1 day before surgery and 7 days after surgery.The Z-score method was used to diagnose postoperative attention and/or executive function impairment.Results The modified versions of TMT-A and SDMT had good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Age was the main influencing factor for the two tests,and their two parallel versions had good alternate-form reliability.There was no significant difference between the control group and the SGB group in scores of modified TMT-A and SDMT at 7 days after surgery(P＞0.1).However,the incidence of attention and/or executive function impairment was lower in the SGB group than in the control group(19.3％ vs.36.6％,P＜0.05).Conclusions The modified TMT-A and SDMT have good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Preoperative SGB may protect attention and executive function in middle-aged and elderly patients.