Objective To study the characteristic of memory impairment and its related factors in patients with Parkinson's disease (PD). Methods 155 PD patients were assigned to 4 age groups. Clinical memory scale, Hamilton Rating Scale for Depression (HAMD) and Hamilton Rating Scale for Anxiety (HAMA) were used to assess them. Results The memory quotient (MQ) of PD patients were significantly lower than the norm (P<0.01). The scores of associational learning, direct memory, picture recall and portrait association in each age groups were lower than norm (P<0.05), but nonsense figure recognition (P>0.05). The MQ of PD patients was significantly related with education and depression or anxiety (P<0.01), and was not correlated with age, gender and course of disease (P>0.05). Conclusion The MQ of PD patients are lower especially in associational learning, direct memory, picture recall and portrait association. The MQ of PD patients is correlated with education and depression or anxiety significantly.

Objective To analyze the validity of clinical memory scale in patients with Parkinson's disease (PD). Methods 60 PD patientswere assessed by clinical memory scale and Mini-Mental State Examination (MMSE). Results The scores of clinical memory scalesignificantly correlated with the scores of MMSE (r=0.608, P<0.001). The scores of clinical memory scale were higher in no-memory impairmentgroup than in memory impairment group (P<0.05). Conclusion Clinical memory scale is good at evaluating the memory impairmentof PD patients with good criteria validity and discriminating validity.

Objective To develop a cancer cell targeting probe based on silica-coated gold nanorods and investigate its optics properties and its targeting effect on human hepatocellular carcinoma HepG2 cells in vitro.Methods Preparation of gold nanorods (GNRs) by seeded growth method,and then the spherical core-shell silica-coated gold nanorods were successfully prepared by a sol-gel method,finally the GNRs@SiO2 was conjugated with folate (GNRs@SiO2-FA).The characteristics of GNRs@SiO2-FA were studied using transmission electron microscopy,and UV spectra.The cells were divided into 2 groups randomly,adding GNRs@SiO2-FA and GNRs solution respectively at the gold concentration of 40.0 × 10-6,20.0 ×10-6,10.0 × 10-6,5.0 × 10-6,2.5 × 10-6,and the MTT method was applied to detect the absorbance (A value) and study the cytotoxicity of GNRs@SiO2-FA and GNRs.The cells were divided into 2 groups randomly,and incubated with the same concentration of GNRs@SiO2-FA and GNRs@SiO2 solution respectively,at 2,4,8,16,24 h,and the targeting of GNRs@SiO2-FA cellular uptake were detected by ICPMS by observing the process of GNRs@SiO2-FA into the cells by transmission electron microscopy (TEM).The data represented by (-x) ± s ; single factor analysis of variance were compared between the 2 groups ; and the differences were significant when P ＜ 0.05.Results UV spectrum confirmed the successful preparation of GNRs@SiO2-FA.The A value of the same concentration group was variance analysised,and the differences between the 2 groups was statistically significant (all P ＜ 0.01) with the gold element concentration from high to low:F =191.876,265.419,77.987,52.061,18.745.The ICP-MS confirmed GNRs@SiO2-FA could specifically bind with HepG2 cells.GNRs@SiO2 group gold element content at 2,4,8,16,24 h was (256.7±3.3),(602.8±2.4),(1067.1±3.6),(1998.5±4.3),(2078.5±1.3) mg/kg and GNRs@SiO2-FA group was(693.1 ±2.0),(1432.0 ±2.6),(2331.3 ±3.5),(2484.5 ±5.0),(2589.7 ±2.1)mg/kg,and the 2 groups was statistically significant (F =3278.070,34287.199,85434.870,18333.454,42412.973,P ＜0.01).TEM results showed that a small amount of nano probes were in the cytoplasm after cultured with GNRs@SiO2-FA cells 1 h,and that,a lot of probe were in the cytoplasm,4-24 h later,but there was no probe in the nucleus.Conclusion The prepared Folate-conjugated gold nanorods has good performance on biocompatibility and targeting.

Objective The objectives of this study were to investigate the relationship between DKK1 protein expression and lymph node invasion,and prognosis in patients with intrahepatic cholangiocarcinoma.Methods From January 2005 to December 2012,78 patients with intrahepatic cholangiocarcinoma were treated with endoscopic resection.Tissue microarray of intrahepatic cholangiocarcinoma and adjacent tissues were done and biochemical indexes were measured before operation.The patients were recruited every 3 months after operation.The Kaplan-Meier method was used to analyze the recurrence-free survival curve and the overall survival curve.The Cox proportional hazards regression model was used to analyze the multivariate analysis and to determine the factors that affect the disease-free survival(RFS)and overall survival(OS).Results There were significant differences in the expression of GGT,hepatic portal lymph node invasion,Child-Pugh grade,MMP9 and DKK1 protein in the negative and positive expression of intrahepatic cholangiocarcinoma(P ＜ 0.05).The positive expression rate of DKK1 protein in intrahepatic cholangiocarcinoma was 35.90％ (28/78),and the positive expression rate of DKK1 protein in hilar cholangiocarcinoma was 14.10％ (11/78).RFS and OS in 78 cases of intrahepatic cholangiocarcinoma were 51.28％ (40/78) and 50.00％ (38/78),41.03 ％ (32/78) and 38.46％ (30/ 78),25.64％ (20/78) and 23.08％ (18/78) after surgery for 1,3 and 5 years,respectively.The results from univariate and multivariate analysis showed that GGT,CA19-9,CEA,tumor size,DKK1 and hilar lymph node invasion were the prognostic factors of OS in patients with intrahepatic cholangiocarcinoma.CEA,tumor size,DKK1 and hilar lymph node involvement were prognostic factors for RFS in patients with intrahepatic cholangiocarcinoma.DKK1 protein expression positive and negative OS curve or RFS curve showed that 5 years after intrahepatic cholangiocarcinoma patients DKK1 protein expression positive and negative OS were 28.20％ and 20.51％;RFS were 24.36％ and 21.79％.Conclusion The expression of DKK1 protein is closely related to lymph node invasion in patients with intrahepatic cholangiocarcinoma.The expression of DKK1 protein is the prognostic factor of OS and RFS in patients with intrahepatic cholangiocarcinoma.

Objective To study the dose rate distribution on cultured cell plane and establish a reference dose rate table of in vitro cell line ~(125)I seed irradiator.Methods Thermoluminescence dosimetry(TLD) was used to measure the irradiation dose rate of a single 6711 model(~(125) I) seed with apparent activity of 10.323 MBq in water at point P.Meanwhile,the theoretic value of the irradiation dose rate at point P was calculated with theoretic formula.The difference between the calculated and observed values within 10% was set as standard to analyze the accuracy of the measurement.The irradiation dose rate of a single 6711 model(~(125) I) seed was measured in 1mm-thick polystyrene + water medium at point P.The value was applied to differential or non-differential proof along with the value from water medium to study the effect of 1 mm thick polystyrene on distribution of irradiation dose in water.Finally,by simulating the(~(125) I) seed plane irradiator with nine(~(125) I) seeds,the distribution table of irradiation dose rate on the cultured cell plane was calculated with theoretical formula.Results The observed value(n= 10) of irradiation dose rate with one(~(125) I) seed in water at point P was(0.359?0.023)cGy/h and the calculated value was 0.347cGy/h,the difference was within 10%.The observed value(n=10) of irradiation dose of one(~(125) I) seed in 1mm-thick polystyrene + water medium at point P was (0.350?0.027)cGy/h,which showed no statistical difference from the observed value in water under differential and non-differential proof.The reference table on dose rate distribution for cells exposed to(~(125) I) seed irradiation in vitro was developed.Conclusions 1mm-thick polystyrene gives no significant effect on irradiation dose rate distribution from(~(125) I) seeds in water.A reference table on the dose rate distribution for cells exposed to(~(125) I) seed irradiation in vitro has been developed,which can be used to determine an optimal irradiating strategy for future work.

Objective To evaluate the therapeutic effects and safety of trabeculectomy combined with Schlemm canal suture implantation in patients POAG). Design Retrospective, noncomparative case series. Participants 11 patients (19 eyes)with POAG. Methods Two layers of scleral flap were made and the deeper one was dissected. The outer wall of Schlemm canal was cut away. 6-0 nylon thread was implanted between the two cut ends of the canal. Penetrating trabeculectomy was performed and followed with peripheral iridectomy. Superficial scleral flap was sutured. Main Outcome Measures The postoperative observation included intraocular pressure (IOP), formation of the anterior chamber, inflammatory reaction, visual acuity, complications and situation of filtering bleb. Results The mean postoperative follow-up period was 18.05?12.78 months (ranging from 6 to 48 months). There was significant statistical difference between preoperative and postoperative IOPs(31.23?9.72mmHg VS 15.11?6.13mmHg) (t=6.769, P=0.000). The postoperative investigation of IOP for 11 cases (19 eyes) after using medicine showed that IOP≥22mmHg only 1 case. The efficiency was 94.74%. Filtering blebs formed in 6 cases (8 eyes)(42.11%), including the case with IOP≥22mmHg. There was no significant difference in change of preoperative and postoperative IOP in patients with or without filtering blebs with t-test (t=-1.662, P=0.071). The anterior chamber formed well in each case postoperatively. Hyphemia appeared in 4 eyes (21.05%). Hypertonia oculi (IOP≥22mmHg) and hypotonia oculi (IOP≤6mmHg) appeared occasionally in 3 eyes(15.78%) and 11 eyes(57.89%) respectively. Postoperatively,no fibrinous exudates in anterior chamber, choroidal detachment and other complications occurred in any case. Conclusions The control of IOP appears to be good after the surgery of trabeculectomy combined with Schlemm canal suture implantation. It is a promising approach for glaucoma and good with fewer postoperative complications, easier postoperative management and deserve further development.

AIM: To observe the effect of continuous epidural analgesia (CEA) of tramadol on postoperative gastrointestinal function and serum motilin level in the patients with cholecystectomy. METHODS: Twenty eight ASAⅠ-Ⅱpatients (8 male, 20 female) aged 24-56 yr, scheduled for elective cholecystectomy under epidural anesthesia, were randomly divided into tramadol group (T, n=14) and control group (C, n=14). The combination of tramadol 800 mg+ bupivacaine 150 mg+ droperidol 5 mg, which diluted with normal saline to 100 ml and pumped 2 ml?h -1, was administered in group T. The combination in group C was bupivacaine 150 mg+ droperidol 5 mg. The VAS values, the first anorectum exhaust timing (FAET), and the time of the first eliminating stool timing (FEST) were recorded, and serum motilin level measured with radioimmunoassay at the different times after surgery. RESULTS: There was a significant difference in the mean VAS values between group T ( 1.2? 1.2) and group C ( 3.3? 1.3) (P

0.05).No severe adverse reactions involved for the treatment group.Administered directly at a high dose,methadone control group had a higher incidence of adverse reactions such as dizziness,drowsiness,nausea and so on.CONCLUSION:methadone concomitant with lornoxicam is effective and safe in treating severe cancerous ostalgia

Objective: To understand the current situation of blood-borne occupational exposure among health care workers and evaluate the intervention effect of PDCA. Methods: Retrospective survey was adopted to investigate and analyze the blood-borne occupational exposure incidents in a hospital from January 2015 to December 2018, and to compare the intervention effects after PDCA management. Results: A total of 82 cases of occupational exposure occurred from 2015 to 2017, and only 9 cases happened after the implementation of PDCA intervention. The exposed population was mainly consisted of nurses (59 cases, 64.83%) , and mainly with low-working age (1-5 years) (56 cases, 61.54%) , and the main source of exposure was hepatitis B (34 cases, 37.36%) . In addition, after the implementation of PDCA, the vaccination rate of personnel was 77.78%, the standardized field treatment rate was 100%, the preventive drug use rate was 88.89%; The qualified rate of occupational protection assessment was higher than that before intervention, which all shows the difference was statistically significant (P<0.05) . Conclusion With the guide of PDCA management, Strengthen the training of new employees or ones with low working years as well as their awareness of protection, and standardize the relevant operational procedures, which can significantly improve the prevention of blood-borne occupational exposure and stress management of medical staff.

Objective To assess the value of spectral CT in reducing artifacts caused by metallic implants. Methods Porcine lumbar spines were chosen as anthropomorphic phantom. The model was examined before and after implanting the titanic nail into the second and fourth lumbar vertebral body using gemstone spectral CT protocol and standard 120 kVp spectra. Specific pest-processing technique was applied to generate 11 kinds of images of monochromatic energy and Metal Artifacts Reducing system (MARs) with the interval of 10 keV ranging from 40-140 keV. The image quality was compared subjectively between 120 kVp group and GSI group after implantation. Three regions of interest based on distances along the most pronounced artifact were chosen and marked as ROInear, ROImid, ROIfar successively. Artifacts parameters including CT value and SD value were measured. The CT value of different ROIs were compared with LSD and Bonferroni test. Contrast-to-noise ratio and artifacts index were calculated. An optimal range of keV was determined according to artifacts index. Results Image quality of Gemstone spectra images was rated superior to the standard images. An optimized spectrum of keV based on artifacts index was from 80 keV to 100 keV. For ROInear,CT value was ( 80. 25 ± 16. 00) HU and ( 30. 10 ± 10. 45 ) HU respectively in group Mono before implantation and group Mono + MARs after implantation. The differences were significant( Z =2. 978, P ＜ 0. 05 ). For ROImid and ROIfax, CT value was ( 63.21 ± 6. 61 ) HU and ( 54. 84 ± 10. 60 ) HU,(76. 54 ±9.07)HU and (73.20 ±5.39)HU respectively. There was no significant differences (t =0. 530,P ＞ 0. 05; t = 0. 822, P ＞ 0. 05 ). Conclusions Metal artifacts could be reduced effectively at the site 3 cm away from implants using gemstone spectral CT. An accurate CT value of surrounding tissue can be obtained.