Objective:To study the change of bifrontal metabolite concentration in patients with mild cognitive impairment (MCI) and its relationship with substantia alba demyelination using magnetic resonance spectroscopy (MRS) combined with linear combination of model (LCModel) quantitative technique.Methods:From May 2016 to December 2018, 25 patients with MCI (group A; 12 males, 13 females, age (60.5±5.2) years) and 15 healthy control subjects (group B; 6 males, 9 females, age (59.5±3.5) years) in the Second Affiliated Hospital of Shantou University Medical College were prospectively enrolled. The MCI patients were classified into 2 subgroups according to MRI results: group A1 with substantia alba demyelination (7 males, 4 females, age (62.1±3.9) years) and group A2 without substantia alba demyelination (5 males, 9 females, age (59.2±5.8) years). Software LCModel was used to quantitatively analyze the MRS original data and measure the absolute concentration of N-acetylaspartate compound (NAA), creatine compound (Cr), choline-containing compound (Cho), myoinositol (mI) and ratios of NAA/Cr, Cho/Cr, mI/Cr, NAA/mI in bilateral frontal lobe. Independent-sample t test was used to analyze the inter-group differences of the above parameters, while Pearson correlation analysis was performed to analyze correlations between the above parameters and cognitive function scores. Results:Compared with group B, group A had higher mI of both left and right frontal lobes (left: (5.19±1.28) vs (4.32±0.83), right: (4.87±1.11) vs (3.85±0.98); t values: 2.34, 2.93, both P<0.05); the mI/Cr of right frontal lobe in group A was also higher (1.19±0.31 vs 0.98±0.25; t=2.21, P<0.05), while the NAA/mI of right frontal lobe was lower (1.37±0.34 vs 1.78±0.47; t=-3.16, P<0.01). Differences of other parameters between group A and group B, and those between group A1 and group A2 were not significantly different ( t values: -1.70 to 1.35, all P>0.05). The mI of right frontal lobe was negatively correlated with Montreal Cognitive Assessment (MoCA) score and Mini-Mental State Examination (MMSE) score( r values: -0.35, -0.38, both P<0.05), on the contrary, NAA/mI of right frontal lobe was positively correlated with the cognitive function scores ( r values: 0.43, 0.40, both P<0.05). Conclusion:MCI may be related to the loss or dysfunction of neurons in the right frontal lobe, and MRS can provide theoretical basis for early recognition of MCI to some extent.

Objective To observe the effects of pentifylline on hypertrophic scars in the rabbit ears. Methods An animal model for hypertrophic scars was established and treated with pentifylline in different concentrations or saline on day 49. Hypertrophic index, growth of fibroblasts and production of collagen in the section were quantitatively determined with an image analysis system. Results Hypertrophic index was found to be decreased in the pentifylline-treated group (P

Objective To observe the correlation between CD4+ CD29+ T cells and metastasis and radiotherapy for patients with pulmonary adenocarcinoma. Method Seventy-one patients with lung adenocarcinoma, 93 patients with lung adenocarcinoma ,76 cases of chronic obstructive pulmonary disease (COPD),63 cases of healthy volunteers were enrolled. Frequencies of blood CD4+ CD29+ T cells and their intracellular necrosis factor alpha(TNF-α)and interleukin 1(IL-1)were compared. Compare TNF-α,IL-1,integrin beta 1 and vascular endothelial growth factor(VEGF)levels in the patients with transferred pulmonary adenocarcinoma or with non-transferred pulmonary adenocarcinoma and their changes with the treatment of radiotherapy. Results the patients with lung adenocarcinoma and non lung adenocarcinoma were significantly higher than that of COPD and health group,and patients with lung adenocarcinoma is significantly higher than patients with non lung adenocarcinoma (P<0.05);Integrin beta 1,VEGF and CD4+CD29+T cells,TNF-αand IL-1 level in patients with lung adeno-carcinoma metastasis were significantly higher than non-transferred group(P < 0.05);After radiotherapy,CD4+CD29+T cells,TNF-αand IL-1 in patients with lung adenocarcinoma were significantly lower than before(P<0.05);CD4+ CD29+ T cells,TNF alpha and IL-1 with integrin beta 1 and VEGF had significantly positive correlations. Conclusion CD4+CD29+T cells and cytokines increase significantly in the blood of patients with lung adenocarci-noma,and are related to the prognosis of metastasis and radiation therapy,which has important clinical significance.

Objective To study the effects of Zhishang Sanfang (ZS) in promoting the union of radius fracture. Methods Twenty-eight rabbit models with fr acture were randomly allocated to ZS group (Group A) and control group (Group B).His tological, histochemical and histomorphological quantitative detection was used to observe the morphological features of the frature end in the 14th and 28th da y after operation. Results The formation of blood capillaries and bone trab eculae in Group A was superior to those in Group B. The scores of the four callu s and th e depth of the lateral callus in Group A were higher than those in Group B. Con clusion ZS has obvious effect in promoting the union of fracture.

Objective To evaluate the efficacy and toxicity of induction chemotherapy with nedaplatin and docetaxel plus concurrent intensity?modulated radiotherapy ( IMRT) with nedaplatin or cisplatin in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 223 patients with pathologically diagnosed locally advanced NPC in five treatment centers from 2011 to 2012 were randomly divided into two groups. In the test group, one hundred and thirteen patients received two cycles of induction chemotherapy with docetaxel (65 mg/ m2 on day 1) and nedaplatin (80 mg/ m2 on day 1) plus concurrent IMRT with nedaplatin (40 mg/ m2 on day 1). In the control group, 110 patients received two cycles of induction chemotherapy with the same regimens plus concurrent IMRT with cisplatin (40 mg/ m2 on day 1). The survival rates were calculated with the Kaplan?Meier method and the differences in the survival rates between the two groups were analyzed using the log?rank test. Comparison of the incidence rates of adverse reactions between the two groups was made by the chi?square test. Results The follow?up rate was 99?? 1%.The response rates at 3 months after treatment in the two groups were both 100%. The 2?year local recurrence?free, regional recurrence?free, distant metastasis?free, and overall survival rates were 94?? 0%, 94?? 2%, 88?? 2%, and 90?? 3%, respectively, in the test group, versus 93?? 4%, 94?? 1%, 86?? 7%, and 87?? 3% in the control group ( P= 0?? 757、 0?? 478、 0?? 509、 0?? 413). The incidence rates and severity of leucopenia, neutropenia, and thrombocytopenia were significantly higher in the test group than in the control group ( P= 0?? 027 , 0?? 028 , 0?? 035 ) . The incidence rates and severity of hemoglobin reduction and nausea /vomiting were significantly lower in the test group than in the control group (P= 0?? 000,0?? 023). There were no significant differences in the incidence rates of mucositis and xerostomia between the two groups ( P=0?? 483,0?? 781). Conclusions The short?term efficacy of induction chemotherapy with nedaplatin and docetaxel plus concurrent IMRT with nedaplatin is similar to that with cisplatin in the treatment of locally advanced NPC. The mild gastrointestinal reactions can be tolerated by patients. However, the severe myelosuppression should be closely monitored during the treatment.

Objective:To investigate the content and mode of pharmaceutical care for the patients with severe burn and promote the rational use of drugs. Methods:Taking the treatment for one patient with severe burn as example,pharmacists provided pharmaceu-tical care in respects of anti-infection therapy,organ preservation,nutritional support, drug interactions, drug precautions, drug incom-patibility, adverse drug reactions and the effect evaluation . Results:The program of rational drug use was provided for clinics through the implementation of pharmaceutical care. The vital signs of the patient were stable, and then the patient left on pass and continued to be treated with rehabilitation therapy. Conclusion:It is necessary for clinical pharmacists to perform pharmaceutical care for the pa-tients with severe burn,reduce the abuse of drugs and improve the medication safety and effectiveness. Meanwhile, the collaborative service of doctors,pharmacists,nurses and inspectors to patients reflects the value of clinical pharmacists.

Objective To evaluate the treatment efficacy,toxicities and prognostic factors of nasopharyngeal carcinoma ( NPC ) treated with intensity modulated radiation oncology ( IMRT ).Methods Between January 2006 and August 2008,300 patients with pathologically diagnosed NPC from 6 center received IMRT.The number of patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳa+b disease (UICC/AJCC 2002 staging system) were 6,45,141 and 108,respectively.The prescription doses were as follows:70-74 Gy/30f toplanning target volume of primary nasopharynx tumor ( PTVRλ),68-70 Gy/30f to planning target volume of positive lymphnode (ptvnd),60-64 Gy/30f to higher risk region (PTV1),50-54 Gy/30f to lower risk region (PTV2).Patients with stage Ⅲ and Ⅳa+b disease also received cisplatin-based chemotherapy.Cox method was used for Multivariate analysis.ResultsThe follow-up rate was 99.7％.The 4-year rate of local control,regional control,metastasis-free survival (DMFS),disease-free survival (DFS) and overall survival (OS) was 94.0％,95.5％,87.4％,80.8％,86.1％,respectively.Mucositis was the most severe acute toxicity,with 18.0％grade 1,48.7％grade 2,33.3％grade 3.No patient suffered from grade 4mucositis.Xerostomia was the most common late toxicity,with 12.0％ grade 0,75.7％ grade 1,12.3％grade 2.No grade 3-4 xerostomia was observed.There were 18,15 and 42 patients failed in local,regional and distant metastasis,respectively.Multivariate analysis showed that N stage was the only prognostic factor for OS (x2 =5.17,P=0.023),DMFS (x2 =6.91,P=0.009) and DFS (x2 =8.15,P=0.004) in these patients.ConclusionsIMRT can improve the treatment efficacy of NPC.The acute and late toxicities were tolerated.Distant metastasis becomes the main treatment failure.N stage is a significant prognostic factors.

OBJECTIVE: To investigate the application of modified cesarean hysterectomy for placenta previa percreta in the third trimester via peritoneum lateral approach. METHODS: Data of 8 patients at 34 weeks or more gestation, who underwent cesarean hysterectomy for placenta previa percreta in Xiangya Hospital, Central South University, between January 2008 and December 2011, were analyzed retrospectively. The patients were divided into a modified cesarean hysterectomy by peritoneum lateral approach group (modified group, n=4) and a conventional cesarean hysterectomy group (conventional group, n=4), according to the principles of the case-control and the operation performed by the same doctor. The incidence of blood loss, the number of transfusions of RBC, and the ocurrnce of complications were compared between the 2 groups. RESULTS: The blood loss in the modified group and the conventional group was (2280±687) mL and (6150±2023) mL, and the number of transfusions of RBC was (4.5±2.1) U and (11.7±8.9) U, respectively. There was no coagulation disorder and ureteral injury in the modified group whereas there were 2 disorders and 1 injury in the conventional group. Two patients with bladder laceration were observed in the 2 groups. CONCLUSION Large amounts of bleeding will be onset in the placenta previa percreta. Modified cesarean hysterectomy for placenta previa percreta can reduce the blood loss and the incidence of related complications in the operation.
Adult ; Cesarean Section ; methods ; Female ; Humans ; Hysterectomy ; methods ; Peritoneum ; surgery ; Placenta Accreta ; surgery ; Placenta Previa ; surgery ; Pregnancy ; Pregnancy Trimester, Third

OBJECTIVE: To evaluate the value of selective arterial occlusion in the treatment of placenta percreta in late trimester of pregnancy. METHODS: Fifteen clinical patients ( gestational age ≥34 weeks), diagnosed with placenta percreta in Xiangya Hospital of Central South University from January 2003 to December 2010, were retrospectively analyzed. According to whether the selective arterial occlusion was used or not, the 15 patients were divided into 2 groups: an arterial occlusion group (n=8) and a non-arterial occlusion group (n=7). Based on the time of occlusion, the arterial occlusion group was divided into a prophylactic occlusion subgroup (n=4) and a remedial occlusion subgroup (n=4) (including 1 patient who was performed after the iliac artery balloon was taken out ). The blood loss, the rate of hysterectomy and complications were compared between the arterial occlusion group and the non-arterial occlusion group. RESULTS: In all 15 patients, the average amount of blood loss was 3813 mL, and the rate of hysterectomy was 73.3% (11/15). The recent complication rate was 20.0% (3/15, including 2 blood coagulation dysfunctions and 1 lower extremity thrombosis), and long-term complication was not found. The average amount of blood loss in the occlusion group was 2512 mL, the hysterectomy rate was 62.5%(5/8); while the average amount of bleeding was 5549 mL and the hysterectomy rate was 85.7% in the non-occlusion group (6/7). There was significant difference between the 2 groups (P<0.05). The average amount of blood loss and the rate of hysterectomy in the prophylactic occlusion subgroup were lower than those in the remedial occlusion subgroup (1350 mL vs 3600 mL, 60.0% vs 66.7%, P<0.05). CONCLUSION Patients with placenta percreta in the third trimester of pregnancy may encounter severe postpartum hemorrhage, and the rate of hysterectomy is high. The amount of blood loss and the rate of hysterectomy may be reduced by the selective arterial occlusion before or in the cesarean section, but cannot be avoided completely.
Adult ; Balloon Occlusion ; methods ; Embolization, Therapeutic ; Female ; Humans ; Hysterectomy ; statistics & numerical data ; Iliac Artery ; Placenta Accreta ; therapy ; Postpartum Hemorrhage ; prevention & control ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Treatment Outcome