Radiotherapy (RT) is the primary treatment for nasopharyngeal carcinoma (NPC). In order to achieve tumor control, nearby normal brain tissues, especially the temporal lobes, often receive unnecessary radiation. Patients with NPC treated by RT may occur cognitive impairments, which significantly compromises the quality of life. The symptoms of cognitive dysfunction induced by RT in NPC patients can exhibit at the early or later stage after RT, which may be related to temporal lobe injury or brain damage induced by radiation. However, the relationship between the cognitive declines induced by RT and the radiation dose or volume of the temporal lobe (or the dosimetry to treat NPC) has not yet been definitively established, and few reports have focused on cognitive impairment following intensity modulated RT. Therefore, this paper will review the progress in radiation-induced cognitive decline of NPC patients in order to provide the basis for preventing side effects of RT and improving the quality of life after RT.

Culture ; Drugs, Chinese Herbal ; Formularies as Topic ; Humans ; Language ; Medicine, Chinese Traditional ; Tablets ; Translations

Objective To explore the clinical effect of mobilization and harvesting by autologous peripheral blood stem cell transplantation (APBSCT) on treating myasthenia gravis (MG).Methods One patient with MG was enrolled in the study. Autologous peripheral blood stem cells(APBSCs) were mobilized with cyclophosphamide(CTX) and granulocyte colony-stimulating factor(G-CSF). PBSCs harvesting was performed by continuous flow leukapheresis using a CS-3000 plus blood separator.CD +_ 34 cells were analyzed by flow cytometer and granulocyte-macrophage progenitors (GM-CFU) was detected by semisolid methlcelluose after mobilization. The clinical effect was evaluated by a relative score system.Results The numbers of mononuclear cells (MNC),GM-CFU and CD +_ 34 cells were 8.08?10 8/kg,7?10 5/kg or 81/10 5/MNC and 1.09?10 6/kg after mobilization in graft respectively. The clinic relative score of the patient was 7/8.Conclusion CTX and G-CSF can mobilize effectively and provide enough peripheral blood stem cells for transplantation in treating MG.

0.05).Meanwhile,they both had significant differences compared with group C(P

Objective To investigate the telephone information-memory-concentration test (TIMCT) in evaluating the cognitive function of patients with nasopharyngeal carcinoma(NPC)after radiotherapy. Methods The cognitive function were evaluated by TIMCT and mini mental state examination (MMSE) in 2 weeks for 30 normal persons and 90 NPC patients. And the 90 NPC patients were divided into the 3 months, 2 years and 5 years after radiotherapy groups. All patients were carried out firstly face to face interview and telephone interview 1 time after 2 weeks. Results The correlation coefficient of all groups between TIMCT(telephone) and TIMCT (face to face) were bigger (R = 0.850) when MMSE wasn't control variable. And the correlation coefficients between TIMCT (telephone) and TIMCT (face to face) were lower (R = 0.366) when MMSE was control variable. As for examining time was classification factor, TIMCT (telephone) and TIMCT (face to face) were analyzed by partial correlation analysis. Only normal group was correlated with group of 3 months after radiotherapy and group of 2 years after radiotherapy wasn't correlated with group of 5 years after radiotherapy (R = 0.447,0.970,0.200 and 0.062). In addition, the difference plot of TIMCT(telephone) and TIMCT (face to face) indicated that telephone was consistent with face to face interview (MMSE≥28). Both telephone and face to face interview reflected the cognitive function downtrend of rescareh objects. Conclusions TIMCT (telephone), TIMCT(face to face) and MMSE (face to face) can reflect cognitive function downterend of patients with NPC after radiotherapy. But TIMCT(telephone) used in clinical screening cognitive function impairment of patients with NPC after radiotherapy should be improved further.

Objective To evaluate the curative effect of urokinase combined with low molecular heparin sodium in managing arteriovenous fistula embolism. Methods Toally 48 patients with arteriovenous fistula embolism treated from January 2014 to October 2015 were selected for the study, where 22 were assigned into control group and 26 as trial group according to the registration time. The former group were treated with urokinase and the latter with urokinase combined with low molecular heparin sodium. The rate of recanalization, the rate of thrombosis recurrence, and the adverse reactions were compared between the two groups. Results The recanalization rate in the trial group was higher than that in the control group (P<0.05). The rate of thrombosis recurrence in the trial group was significantly lower than that the control group. There was no statistical difference in adverse reactions between the groups. Conclusion The thrombolytic effect of urokinase combined with low molecular heparin sodium is superior to that of urokinase alone, with a higher rate of recanalization.

Objective To survey the current status of job stressor and exhaustion among nursing staff in the catheter room of grade Ⅲ-A general hospitals and to look for regularities.Methods 178 nursing staff coming from catheter room,operating room,and outpatient department of Shenzhou Hospital and Fengtian Hospital accepted questionnaires of Chinese Nursing Stressor Scale and Exhaustion Scale in Spring 2010.Results Chinese Nursing Stressor Scale indicated that scores of subitem and total score of job stressor in the catheter room were significantly higher than those in the outpatient department; however,there were no significant differences in scores of subitem and total score of job stressor between catheter room and operating room.On the other hand,Exhaustion Scale showed that scores of emotional exhaustion and job unconcerned feeling in the catheter room were significantly higher than those in the outpatient department,but scores of job achieved feeling in the catheter room were significantly lower than those in the outpatient department.There were no significant differences in Exhaustion Scale between catheter room and operating room nurses.Conclusions Job stressor and exhaustion were serious among nursing staff in the catheter room of grade Ⅲ-A general hospitals,which should cause the attention of management department.

Objective To investigate the impact of pelvic muscle training (PFMT) on the quality of life (QOL) and incidence of postoperative complications in stress urinary incontinence (SUI) patients after tension-free vaginal tape surgery (TVT). In order to provide evidence for clinical nurses taking measures to promote rehabilitation of postoperative patients. Methods A total of 101 female SUI patients who underwent TVT surgery were included in this study. 50 patients in the trial group received pelvic muscle training guidance by one-to-one for 3months while 51 patients in the control group were instructed to the routine discharge guidance. All patients were asked to finish the Incontinence-specific Quality of Life questionnaire (I-QOL) at the day before surgery and 3 months after the surgery, respectively. And incidence of postoperative complications were evaluated at 3 months after the surgery. Results A total of 94 participants completed all questionnaires, including 48 patients of the trial group and 46 patients of the control group. The postoperative score of I-QOL in the trial group were higher than that of control group (94.32 vs. 90.34, Z=3.863, P<0.01). Further analysis found that avoidance and limiting behaviors domain score (90.63 vs.87.50, Z=3.227, P<0.01) and psychosocial impacts domain score (97.22 vs. 90.28, Z=4.186, P<0.01) in the trial group were higher than that of control group. The incidence of postoperative urgency urinary incontinence was significantly difference between the two groups (χ2=4.953,P=0.026), the proportion were 16.67% (8/48) in the trial group and 36.96% (17/46) in the control group, respectively. According to the results, the patients′overall quality of life of the trial group was better than that of control group after surgery. Conclusions Postoperative SUI patients′implementation of pelvic muscle training can significantly increase their quality of life and can decrease the incidence of urgency urinary incontinence.

Objective To examine the hemodynamic changes and oxygen metabolism during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty patients (18 male, 2 female) aged (60?8)yr, weighing (71?9)kg undergoing OPCABG were studied. The patients were premedicated with diazepam 10 mg PO 2h before operation and morphine 10 mg and scopolamine 0.3 mg im 30 min before operation. Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1, fentanyl 5-10 ug?kg-1 and vecuronium 0.12-0.15 mg?kg-1 and maintained with 0.5%-2% isoflurane inhalation, fentanyl 10-20 ug?kg-1 and intermittent iv boluses of vecuronium and in some patients propofol infusion. Radial artery was cannulated. Swan-Ganz catheter was placed via internal jugular vein into pulmonary artery. Hemodynamic parameters including MAP, HR, cardiac index (CI), stroke volume (SV), MPAP, PCWP, SVR, left ventricle stroke work index (LVSWI) and RVSWI; oxygen metabolism including oxygen delivery (DO2) , oxygen consumption (VO2) and oxygen extraction ratio (ERO2); regional cerebral oxygen saturation (rSCO2) and arterial blood lactate level (ABL) were measured and recorded before skin incision (A), when pericardium was incised before operation on the heart (B), during operation on the heart (C), 10 min after operation on the heart (D) and at the end of surgery (E) . Results During surgical manipulation on the heart (C) MAP, SV and CI decreased while CVP and HR increased, but the decrease in CI and SV was not significant. During manipulation on the heart(C) DO2 decreased whereas ERO2 increased, but there was no significant change in VO2. After manipulation on the heart (D) DO2 and ERO2 returned to the pre-manipulation level. Arterial blood lactate concentration increased at E. Conclusion OPCABG can be performed uneventfully under our general anesthetic regimen. During operation while the beating heart is being manipulated MAP tends to decrease while CVP and HR increase. The changes are of short duration and do not result in any serious consequeaces.

Objective To explore the value of brainstem auditory evoked potential(BAEP),visual evoked potential(VEP)and Revised Visual Retention Test(VRT)in detecting impairment of central nervous system in patients with acute leukemia(AL).Methods Neuropack-Ml type evoked potential machine(Japan)was used to check brainstem auditory evoked potential(BAEP)and visual evoked potential(VEP).BAEP,VEP and VRT were examined in 30 cases with acute leukemia(group AL)and in 30 age and sex matched healthy subjects as a control(groupC).Indexes of BAEP including peak latency(PL)of waves I ,IB ,V and inter-peak latency(IPL)of waves Ⅰ～Ⅲ,Ⅲ ～Ⅴ,Ⅰ～Ⅴand indexes of VEP(P100PL)were determined.VRT was accomplished meanwhile applying B method with C pattern,C method with D pattern,D method with E pattern.The correct scores and error scores were recorded separately.Results BAEP:the abnormal rate of the group AL was 23.3 %.Compared with control group,we found significant longer latency of wave Ⅲ、Ⅴ(P＜0.05)and significant elongation in the mean inter-peak latencies of Ⅰ～Ⅴ(P＜0.05).VEP:the abnormal rate of the group AL was 26.7% ,the P100 PL of the patients was longer than that in the control group(P＜0.05).VRT:the abnormal rate of the group AL was 33.3%.The results of VRT showed that the score in the group AL in D method with E pattern was lower than that in the control group(P＜0.05).Conclusion BEAP,VEP and VRT could detect the impairment of central nervous system in patients with acute leukemia sensitively,and give clues to early diagnosis of central nervous system leukemia(CNSL).