Objective To evaluate the safety and effect of the use of micro coils in endovascular embolization of anterior communicating artery aneurysms. Methods The clinical data of 27 consecutive patients with anterior communicating artery aneurysm, who were admitted to Yancheng Municipal Third People’s Hospital to receive endovascular embolization treatment with micro coils, were retrospectively analyzed. One patient had multiple anterior communicating artery aneurysms. The efficacy and safety of endovascular micro-coil embolization of anterior communicating artery aneurysm were evaluated by the occlusion rate of aneurysm, the prognosis of the patients, the complications, the neurological function, etc. Results Successful embolization treatment of anterior communicating artery aneurysm was achieved in all 27 patients. Dual catheter technique was employed in 3 patients, stent-assisted technique was used in 3 patients, and the technical success rate was 100%. Dense embolization was obtained in 21 patients, and residual aneurysm neck was observed in 6 patients. The unobstructed parent artery was reserved in all patients, no hemorrhage due to ruptured aneurysm or dropping of steel coil was found. One patient developed recurrent hemorrhage and died two days later. Mild recurrence was seen in one patient six months after the treatment. The modified Rankin scal (mRS) score showed that 0-1 point was seen in 24 patients, 2 points in one patient, and 4 point in one patient. Conclusion The anterior communicating artery aneurysm can be safely and effectively cured when appropriate endovascular embolization technique is used.

Objective To investigate the restricting factors of long-term care of stroke survivors in community.Methods The phenomenological methodology was adopted in the study.Sixteen stroke survivors were interviewed.Data were analyzed by Colaizzi's method.Results Three themes were found,including physical barriers,incorrect attitude towards disease,and defects of community health service.Conclusions On the basis of improving technology and ability,medical workers in community should consider of supporting the patients with information of disease and useful resources in a variety of ways,and improving the patients health literacy.

Objective To explore the effectiveness and esophageal strictures of concurrent chemoradiotherapy in patients with cervical and upper-thoracic esophageal cancer (EC) and middle-thoracic and lower-thoracic EC.Methods Between January 2011 and December 2014,ninety patients with different parts of EC were treated with radiotherapy combined with concurrent chemotherapy in People's Hospital of Subei.The median irradiation dose was 60 Gy.The chemotherapy regimens consisted of Paclitaxel and Nedaplatin.Of all the patients,48 patients had cervical and upper-thoracic EC,42 patients had middle-thoracic and lowerthoracic EC.The response rates,the local control rates,the survival rates and esophageal strictures were evaluated between two groups.Results The follow-up rate was 100％.The response rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 81.2％ and 73.8％ (x2 =0.717,P =0.397),respectively.The 1-year local control rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 90.3％ and 71.8％ (x2 =5.865,P =0.015),respectively.The 1-year survival rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 87.5％ and 69.0％ (x2 =4.580,P =0.032),respectively.The moderate-to-severe esophageal strictures rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 55.6％ and 29.4％ (x2 =5.360,P =0.021),respectively.There were no significant differences in shortterm effects between the cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC.The patients with cervical and upper-thoracic EC showed significantly higher 1-year local control rates,1-year survival rates and esophageal strictures rates than those with middle-thoracic and lower-thoracic EC.Conclusion The effectiveness of concurrent chemoradiotherapy is better in the patients with cervical and upper-thoracic EC than in those with middle-thoracic and lower-thoracic EC,but the esophageal stenosis is more severe in the patients with cervical and upper-thoracic EC than in those with middle-thoracic and lower-thoracic EC.

Objective To estimate the effects of camptothecin (CPT) on the expression of hypoxia-inducible factor-1α (HIF-1α) in HaCaT cells under hypoxic conditions (2％ O2),and to explore the potential therapeutic mechanism of topical CPT for psoriasis.Methods Some HaCaT cells were classified into 6 groups:5 test groups cultured in Dulbecco's modified Eagle's medium (DMEM) with the presence of CPT at 12.5,25,50,100 and 200 nmol/L respectively,and 1 control group cultured in DMEM with the presence of dimethyl sulfoxide (DMSO).All the 6 groups of cells were cultured under normoxic conditions for 12,24,48 or 72 hours or under hypoxic conditions for 12 hours.Cell counting kit-8 (CCK-8) assay was conducted to estimate the proliferation of HaCaT cells after the normoxic culture,and Western blot to quantify the protein expression of HIF-1α after the hypoxic culture.Some HaCaT cells were classified into a normoxia group (21％ O2) and a hypoxia group (2％ O2),and each group was divided into a CPT (100 nmol/L)-treated subgroup and a non-intervention subgroup (treated with the vehicle).After 12-hour culture,real-time fluorescencebased quantitative PCR was performed to measure the mRNA expression of HIF-1α.Statistical analysis was carried out by using Levene'.s test,one-way analysis of variance,Dunnett-t test and factorial analysis with the SPSS16.0 software.Results After treatment with CPT at 12.5-200 nmol/L for 12-72 hours,the proliferation of HaCaT cells was inhibited in a concentration-and time-dependent manner.More concretely,the cell proliferation rates were inhibited by 17.66％ ± 6.46％,33.11％ ± 4.63％ and 56.31％ ± 1.69％ respectively in HaCaT cells after 12-hour treatment with 200 nmol/L CPT as well as 24-hour treatment with 100 and 200 nmol/L CPT compared with the control group at the corresponding time points (all P ＜ 0.05).The protein expression level of HIF-1 α was significantly decreased in HaCaT cells after 12-hour treatment with CPT at 12.5,25,50,100 and 200 nmol/L under hypoxic conditions compared with the control group (0.348 ± 0.065,0.261 ± 0.112,0.115 ± 0.043,0.045 ± 0.024 vs.1.445 ± 0.329,all P＜ 0.05).The mRNA expression level of HIF-1α (expressed as △Ct) in the CPT-treated subgroup and non-intervention subgroup was-5.575 ± 0.29 and -5.451 ± 0.21 respectively in the normoxia group,significantly higher than that in the hypoxia group (-6.543 ± 0.57 and -6.203 ± 0.31 respectively,F =29.856,P ＜ 0.05),while there was no significant difference between the CPT-treated and non-intervention subgroups (F =1.667,P ＞ 0.05).Conclusions CPT at 100 nmol/L could inhibit the expression of HIF-1α protein,but had no obvious effect on that of HIF-1α mRNA.

Currently, monitoring system of awareness of the depth of anesthesia has been more and more widely used in clinical practices. The intelligent evaluation algorithm is the key technology of this type of equipment. On the basis of studies about changes of electroencephalography (EEG) features during anesthesia, a discussion about how to select reasonable EEG parameters and classification algorithm to monitor the depth of anesthesia has taken place. A scheme which combines time domain analysis, frequency domain analysis and the variability of EEG and decision tree as classifier and least squares to compute Depth of anesthesia Index (DOAI) is proposed in this paper. Using the EEG of 40 patients who underwent general anesthesia with propofol, and the classification and the score of the EEG annotated by anesthesiologist, we verified this scheme with experiments. Classification and scoring was based on a combination of modified observer assessment of alertness/sedation (MOAA/S), and the changes of EEG parameters of patients during anesthesia. Then we used the BIS index to testify the validation of the DOAI. Results showed that Pearson's correlation coefficient between the DOAI and the BIS over the test set was 0.89. It is demonstrated that the method is feasible and has good accuracy.
Algorithms ; Anesthesia, General ; Decision Trees ; Electroencephalography ; Entropy ; Humans ; Intraoperative Awareness ; Monitoring, Physiologic ; Propofol

Objective To investigate the relationship between positive experience and social support of spouses' of community stroke patients.Methods 100 stroke patients and their spouses in two communities were conveniently selected and investigated about their positive experience and social support with General Information Questionnaire (GIQ),Modified Barthel Index(MBI),Positive Aspects of Caregiver (PAC),Perceived Social Support Scale (PSSS).Results The mean score of the spouses' positive experience was (22.74±5.85); the dimension of serf-affirmation was (15.82±3.84),higher than the dimension of life expectation(6.92±2.95).The scores of the spouses' positive experience were significantly different among age,gender,education of spouses and age and ability of daily life of stroke patients; the score of the spouses' positive experience was positively correlated with social support,subjective support,utility of support;multiple linear regression showed that age of spouses,ability of daily life of stroke patients and utility of support were influential important factors of spouses' positive experience.Conclusions The spouses' positive experience was below average level,we must pay more attention to improve it,utility of support can improve spouses' positive experience.

Objective To validate the feasibility and accuracy of iterative decomposition of water and fat with asymmetry and least squares estimation-quantitative fat imaging (IDEAL-IQ) in fat quantification using fat-water model. Methods A homogeneous fat-water mixture model consisting of various known fat-fractions were described, and the fat fraction was 0.00, 0.01, 0.02, 0.04, 0.06, 0.08, 0.10, 0.14, 0.18, 0.22, 0.26, 0.30 g/ml respectively. A water-vaseline separated model was also described. IDEAL-IQ was performed. Thin slices were acquired for fat-water mixture model and repeated 3 days later. Nineteen slices of 14 mm-thick parallel to the water-vaseline boundary in 1 mm steps from vaseline to water
were acquired. The fat-fractions in 11 slices of fat-water mixture model were measured on FatFrac images. Accuracy was assessed through single sample t test or Kolmogorov-Sirmov test. Measured fat-fractions of the same known fat-fraction were assessed through independent samples t test between two scan times. Linear regression was used to assess the relationship between known fat-fractions and measured fat-fractions. Slices containing the water-vaseline boundary were measured with ROI in the middle of the FatFrac images. The relationship between measured fat-fractions and locations of scanning was exploded using curve fitting. Results (1) Fat-water mixture model: no significant difference(P>0.05) was found between measured fat-fractions and known fat-fractions when it was 0.00, 0.02, 0.06 and 0.08 g/ml with the measured fat-fractions 0.60%, (2.30 ± 0.60)%, (5.76 ± 1.40)%, (7.62 ± 1.40)% respectively for the first time. No significant difference(P>0.05) was found between measured fat-fractions and known fat-fractions when it was 0.00, 0.02, 0.10 g/ml with the measured fat-fractions 0.04%, (2.32 ± 0.60)%, (9.41 ± 1.00)%respectively for the second time. Measured fat-fraction was inlinear relation with known fat-fraction:Y=0.898X+0.224, r2=0.993, P<0.01, F=36 129.548.(2) Water-vaseline separated model: measured fat-fraction increased as scanning location changed, Y=0.045X2-0.499X-4.474, r2=0.978, P<0.05, F=350.623.Conclusions IDEAL-IQ can be used to quantify fat content with good repeatability and can accurately assess the actual fat content from the linearrelationship.

In this study, the time-dependent changes on dynamic computed tomograph (CT) of radiation-induced liver injury in gastric cancer patients was examined. The CT images of 52 gastric cancer patients who had received chemoradiotherapies were reviewed on the PACS system. Dynamic CT scan was performed in all the subjects. Our results showed that 18 patients were found to have radiation-induced liver injury. The CT findings of radiation-induced liver injury in gastric cancer patients tend to show up one month after radiation treatment. The damaged area was of low density on all three phases, and then it was enhanced on portal vein phase or delay phase. The focal radiation reaction of liver without basic disease vanished 9-11 months later after treatment. We are led to conclude that dynamic CT is of help in the diagnosis of CRT-induced liver injury, and it may be the method of choice for following up the whole course of the CRT-induced liver injury, i.e., form hepatic damage to healing. The classification of CT findings we recommend can avoid the influence of technological factors, and thereby serve as a better guide for treatment of CRT-induced liver injury.

Objective To compare the efficacy of percutaneous radiofrequency ablation (PRFA) and repeat hepatectomy for solitary recurrent hepatocellular carcinoma (HCC) with the diameter≤3 cm. Methods The clinical data of 151 patients with recurrent HCC (diameter≤3 cm) who were admitted to the Cancer Center of Sun Yat-Sen University from January 1999 to December 2009 were retrospectively analyzed. Of all the patients, 79received PRFA (PRFA group) and 72 received repeat hepatectomy (repeat hepatectomy group). The survival rate, morbidity and recurrence of the tumor between the two groups were compared. All data were analyzed using t test, chi-square test or Log-rank test, and the survival of the patients were analyzed using the Kaplan-Meier method. Results The mobidities of the PRFA group and repeat hepatectomy group were 13% (10/79) and 36%(26/72), respectively, with a significant difference between the two groups (x2=11.411, P＜0.05). The cumulative 1-, 2-, 3-, 4-, 5-year survival rates were 89.7%, 75.2%, 67.1%, 61.5%, 56.6% in the PRFA group, and 86.0%, 67.6%, 53.6%, 44.1%, 40.2% in the repeat hepatectomy group, with no significant difference between the two groups (x2=1.610, P＞0.05). The cumulative 4-, 5-year survival rates of the PRFA group were significant higher than those in the repeat hepatectomy group (x2=4.682, 4. 196, P ＜ 0.05). The local tumor recurrence rate of the PRFA group was 5% (4/79), and the incisal margin recurrence rate was 3% (2/72) in the repeat hepatectomy group, with no significant difference between the two groups (x2=0.565, P＞0.05). Conclusion As a less invasive treatment method, PRFA is superior to repeat hepatectomy for solitary recurrent HCC with the diameter≤3 cm.

Objective To establish a rapid and accurate method, and to determine the density of mice and rats sperm with enzyme-labeled instrument.Methods ①The optimal wavelengths and the regression equation set up: After six Kunming mice and six Sprague-Dawley rats were sacrificed, the left epididymis was separated and fully cut up in phosphate buffer saline.With water bath, the sperm were fully dissociated.Using the enzyme-labeled instrument to detect the wavelength absorbance respectively under different wavelength and fitting absorbance curve.The best wavelength will be the most close to 1 of the correlation coefficient ( R2 ) and the standard deviation of minimum.After ten Kunming mice and ten Sprague-Dawley rats were sacrificed,the sperm suspension of different concentration gradient were got.The regression equation of the sperm density and absorbance was established by using enzyme-labeled instrument and haemocytometer.②The test of sperm absorbance stability: Mice and rats,six respectively,were used to make the sperm suspension.Samples were put in room temperature (25℃) or 37℃water bath continued,and after water bath about 0,20,30,40,50, 60 min,the change of absorbance was recorded.③The regression equation verification:The mice were administrated orally with 20% ethanol solution for 30 days to make oligospermia.In order to verify the new method, two different method were used to get the sample sperm.Results The optimal absorbancy-sperm density curve could be established at 380 nm.The means of KM mice sperm count ( x1 ) and absorbance ( y1 ) are showed to be the linear function,and the linear regression equation is y1 =2 ×10 -9 x1 +0.0648, R2 =0.9743.The means of SD rat sperm count ( x2 ) and absorbance (y2) are showed to be the linear function,and the linear regression equation is y2 =5 ×10 -9x2 +0.0621,R2 =0.9940.SD rat sperm suspension liquid after 60 min in water bath, absorbance value at 0 min significantly decreased(P<0.05), but at room temperature after 40 min significantly increased ( P<0.05); KM mice sperm suspension in the water bath and under the condition of normal temperature after 50 min, compared with the 0 min, absorbance value increased significantly(P<0.05).Compared with control group, sperm density of ethanol oligozoospermia group by enzyme standard detector and standard curve calculation were significantly decreased ( P <0.05 );compared with absorbancy-sperm density equation, determination of ethanol oligozoospermia group of sperm density by cell counting plate method had not significant difference.The results suggested absorbancy-sperm density equation could effectively detect the reduction of the mice sperm in oligospermia.Conclusion Using enzyme-labeled instrument to set up the curve of absorbancy-sperm density equation can estimate the sperm density of mice and rats rapidly and exactly.