Objective To investigate the clinical and radiologic features of posterior reversible encephalopathy syndrome (PRES) associated with preeclampsia-eclampsia.Methods Twenty-one cases of PRES associated with preeclampsia-eclampsia were retrospectively studied on some aspects of clinical and radiologic features.Results The most common clinical presentations were seizures( 18 cases ),headache (16 cases),altered mentation (15 cases) and vision change (12 cases). Vasogenic edema lesions distributed in the parietal or occipital lobe (20 cases),the frontal lobes (14 cases),temporal lobes ( 11 cases), and basal ganglia (11 cases). The splenium involvement occurred in 4 cases,cerebellar hemispheres and brain stem involvement was prcscnted in 3 cases and 1 case separately. Three major patterns of PRES included dominant parietal-occipital (7 cases),the holohemispheric watershed (7 cases),and superior frontal sulcal (6 cases).Partial and asymmetric expression of PRES only occurred in 1 case.Conclusions The clinical features of PRES associated with preeclampsia-eclampsia are typical.Except the parietal or occipital lobe,involvement of the frontal lobe,temporal lobe and basal ganglia is common,followed by the occasional presence of the splenium,cerebellar hemispheres and brain stem.Three primary PRES patterns are noted,occasional with partial and asymmetric expression of PRES. Awareness of these typical and variable characteristics is important to recognize the PRES ncurotoxicity morc accurately when PRES present.

Objective To observe the prevention effect of glutathione on acute radiation enteritis in pelvic radiation therapy.Methods All 80 pelvic tumor patients treated with radiotherapy were randomly assigned to the control group (40 patients)and the treatment group (40 patients)by the number table method.40 cases in the con-trol group treated with radiation were not treated with preventive drugs,but the patients in the treatment group were treated with glutathione.The occurrence time of acute radiation enteritis and the severity of acute radiation enteritis after treatment were evaluated.Results 15.0% of the treatment group suffered from acute radiation enteritis in the second week and 72.5% in the third week.however,62.5% of the control group were suffered from acute radiation enteritis in the second week and 27.5% in the third week.The difference was statistically significant (χ2 =18.775, 15.998,all P <0.001).Glutathione delayed the occurrence time of acute radiation enteritis.The grade 1 and grade 2 acute radiation enteritis effective rate in the treatment group were 77.5% and 17.5%,and that in the control group were 20.0% and 72.5%,the difference between the two groups was significant(χ2 =26.136,24.139,all P <0.001).The glutathione could reduce the incidence of acute radiation enteritis extent.Conclusion Glutathione could delay the occurrence time of acute radiation enteritis and reduce the incidence of acute radiation enteritis extent.It is worth clinical application.

Objective To judge the prognosis of adult recipients after first liver transplantation by stepwise discriminant analysis,and screen out the main influencing factors.Methods The clinical data of 221 patients who received liver transplantation at the Nanfang Hospital of Southern Medical University were retrospectively analyzed.A total of 218 patients who met the criteria were divided into the training samples (188 patients admitted from August 2004 to June 2010) and checking samples (30 patients admitted from July 2010 to February 2011),and then all patients were re-divided into dead group (survival time ≤ 90 days,34 patients) and surviving group (survival time ＞ 90 days,184 patients).Factors which had significant difference after the univariate analysis was further analyzed by the stepwise discriminant analysis method.All data were analyzed by the t test,rank sum test,chi-square test or Fisher exact probability test.Results The ages of the recipients in the dead group and the living group were (54 ± 11)years and (51 ± 11)years,respectively,with no significant difference between the 2 groups (t =-1.681,P ＞ 0.05).The preoperative levels of hemoglobin in the dead group and the living group were 106.7 g/L and 119.2 g/L,respectively,with a significant difference between the 2 groups (t =2.809,P ＜ 0.05).There were significant differences in the levels of serum creatinine,urea nitrogen,albumin,total bilirubin,indirect bilirubin,Na+,prothrombin time,activated partial thromboplastin time,international normalized ratio,fibrinogen,prothrombin activity,platelet,nutrition risk index,model for end-stage liver disease score,number of patients with preoperative hepatic encephalopathy (HE),preoperative hepatorenal syndrome (HRS),preoperative digestive tract bleeding,preoperative infection,preoperative diabetes,Child-Turcotte-Pugh score,cardiac function classification and anesthesia risk rating operation time,anhepatic time,volume of intraoperative blood transfusion,volume of peritoneal effusion ; intraoperative urine output,between the 2 groups (Z =-2.277,-2.595,-3.290,-3.486,-2.562,-2.577,-3.670,-3.882,-3.625,-3.557,-3.837,-1.974,-3.693,-3.815,x2 =19.632,9.756,28.143,Z =-4.175,-3.905,-4.865,-3.564,-5.822,P ＜ 0.05).Preoperative HE,preoperative HRS,duration of operation,intraoperative blood transfusion and intraoperative volume of urine were the independent influencing factors of early prognosis after liver transplantation.The standardized partial regression coefficients were 0.146,0.188,0.257,0.181,-0.340,89.9％ (169/188) of the training samples and 90.0％ (27/30) of the checking samples were correctly classified.Conclusion Based on factors including HRS,HE,intraoperative blood transfusion,intraoperative volume of urine and duration of operation,the early prognosis can be judged in adult recipients after first liver transplantation.

Objective To investigate and evaluate the clinical value of full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas.Methods Seventy-two patients,who underwent full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas,were selected from the Medical Center of Pituitary Adenomas of our hospital from January 2009 to March 2012.To retrospectively investigate pre- and post-operation symptoms,hormone levels,images information,operation information,complications,following-up information and so on.Results Among the 72 consecutive patients,there were 22 nonfunctioning adenomas,twenty-four prolactin secreting adenomas,seven somatotropin secreting adenomas,five adrenocorticotropic hormone secreting adenomas,one thyrotropin secreting adenomas,and 13 multi-secreting adenomas.The tumor removal was total in 56(77.8％),subtotal 13(18.0％),and partial 3(4.2％).Five cases had CSF leaks,and 6 diabetes insipidus.After 3-24 months of follow-up,the levels of increasing-hormone declined to normal levels in most patients.Conclusion Full endoscopic transnasal transphenoidal approach for the surgery of pituitary adenomas is a kind of technique which is safe,minimally invasive,having less complications and fast recovery.However,it is necessary for surgeons to accept systematic and specialized training,and own advanced equipments.

Objective:To investigate the effect of timing it right family support program-based care on patients′ uncertainty in illness and relatives care ability of acute myocardial infarction patients with percutaneous transluminal coronary intervention treatment, and to provide reference for family continuous care of such patients.Methods:A total of 88 patients and relatives admitted to the department of cardiology in Hebei People′s Hospital from March 2018 to May 2019 were randomly divided into intervention group (44 cases) and control group (44 cases). The control group received routine care, while the intervention group received timing it right family support program based on the routine care. Two groups were given follow-up for 6 months, the patients′ uncertainty in illness and relatives care burden and care ability were compared between two groups.Results:3 months, 6 months after discharge, the ambiguity, unpredictability and total uncertainty in illness scores were significantly decreased in the intervention group compared to the control group [(17.89±3.67), (14.56±3.15), (11.82±1.68), (10.31±1.62), (43.21±4.71), (38.31±4.19) vs. (19.83±3.43), (16.85±2.56), (13.29±2.37), (11.90±2.26), (47.34±5.58), (42.24±3.89)], the differences were statically significant ( t value was 2.435-4.351, P<0.05). At discharge and 3 months, 6 months after discharge, the scores of sociability burden were significantly decreased in the intervention group compared to the control group [(4.49±0.99), (3.59±0.79), (2.92±0.35) vs. (5.14±1.22), (3.98±0.82), (3.61±0.67)]; 3 months and 6 months after discharge, the scores of time-depending burden and total burden scores were significantly decreased in the intervention group compared to the control group [(12.79±2.50), (10.51±3.08), (37.31±4.22), (31.72±3.39) vs. (14.61±2.86), (13.32±3.09), (40.34±3.97), (36.19±3.27)]; 6 months after discharge, the scores of development-limited burden were significantly decreased in the intervention group compared to the control group [(7.36±1.11) vs. (8.07±1.31)], the differences were statically significant ( t value was 2.146-6.020, P<0.05). At discharge and 3 months, 6 months after discharge, the scores of learning to cope with new role, providing care according to care-receiver`s needs, managing own emotional needs, appraising supportive resources balancing care-giving needs and own needs and total care ability scores were significantly decreased in the intervention group compared to the control group, the differences were statically significant ( t value was 4.957-25.242, P<0.01). Conclusion:Timing it right family support program can alleviate patients′ uncertainty in illness and improve relatives care abilily of acute myocardial infarction patients with percutaneous transluminal coronary intervention treatment.

Objective To determine the optimal electron beam energy at different field size through a Monte Carlo-based simulation of the therapy head of Varian X 6 MV linear accelerator so as to study the influence of radial intensity on depth dose.Methods Firstly,keeping the radial intensity unchanged for the field of interest while changing electron beam energy,compassion was carried out of calculated percentage depth doses between measured values.Thus,the optimal energy was identified for this field size.Then,the obtained energy was set the optimal value to study the radial intensity influence on the depth doses.Results The optimal electron energy for 4 cm ×4 cm,10 cm × 10 cm,20 cm × 20 cm and 30 cm × 30 cm field sizes was 5.9,6.0,6.3 and 6.4 MeV respectively.Changes in radial intensities resulted in negligible changes in percentage depth doses for4 cm ×4-cm and 10 cm × 10 cm fields,but led to observable discrepancy for 20 cm × 20 cm and 30 cm × 30 cm fields.Conclusions The optimal electron energies for different field sizes are slightly different.Change in radial intensity distribution has significant influence on the depth dose for large field.To improve simulation accuracy,the field size needs to be taken into consideration in determining the electron beam energy and radial intensity distribution.

No data were available on the acute oral toxicity, short-term oral toxicity of vegetable carbon in animals. This study was designed to evaluate the safety of two commercially available dietary bamboo charcoal powders (BCP1 and BCP2). The size distribution of the two powders was determined by a Mastersizer 2000 laser particle size analyzer prior to the in vivo safety studies. For the acute toxicity study, a single dose of 11.24 g/kg body weight of BCP1 and BCP2 was given once orally to healthy Sprague-Dawley (SD) rats. Mortality and clinical symptoms were observed and recorded for the first 30 min after treatment, at 4 h post-administration, and then at least once daily for 14 days after administration. In the repeated dose 28-day oral toxicity study, BCP1 and BCP2 were administered orally at doses of 2.81, 5.62, and 11.24 g/kg body weight for 28 days to SD rats. Animals were sacrificed and organs and blood samples were analyzed. Results showed that both BCP1 and BCP2 were micro-sized and various in size. In the acute toxicity and the repeated dose 28-day oral toxicity studies, BCP caused neither mortality nor visible signs of toxicity in rats. No significant differences were found in the relative organ weights or in biochemical parameters in BCP treated groups compared to a control group. No treatment-related histological changes were observed in the organs of these animals. Based on these data, it is concluded that the median lethal dose (LD50) of BCP for both male and female rats is more than 11.24 g/kg body weight and the no-observed-adverse-effect level (NOAEL) is >11.24 g/kg body weight for 28 days.
Animals ; Bambusa ; chemistry ; Diet ; Female ; Male ; Powders ; Rats ; Rats, Sprague-Dawley ; Toxicity Tests, Acute

Objective To investigate the significance of computed tomography(CT)and 3.0 T magnetic resonance imaging(MRI)in intensity-modulated radiotherapy(IMRT)for esophageal carcinoma. Methods Thirty-five patients newly diagnosed with esophageal carcinoma who received radical radiotherapy in our hospital from November 2013 to April 2015 were enrolled as subjects. Target volume was delineated on the CT images and MRI images(T2-weighted and diffusion-weighted fusion images). The MRI-and CT-based IMRT plans were designed using the same dose prescription and dose constraints for organs at risk(OAR). The target volume,prescribed dose,and doses for OAR were compared between the two plans. Results In the two plans, dose distribution and planning parameters met the clinical requirement. The length of lesion,gross tumor volume (GTV),and planning target volume(PTV)defined by 3.0 T MRI were significantly smaller than those defined by CT(P=0.00,0.03,0.03). There were no significant differences in the D 2%,D 98%,D 50%,homogeneity index,or conformity index for primary GTV(PGTV)and PTV-PGTV between the two plans(all P>0.05). Compared with the CT-based plan,the 3.0 T MRI-based plan had a significantly smaller mean dose to the lungs and an insignificantly smaller actual dose to the lungs(P=0.00;P>0.05).There were no significant differences in maximum doses tolerated by the spinal cord or heart between the two plans. Conclusions In terms of target volume delineation and dosimetric parameters, both CT-and 3.0 T MRI-based plans meet the clinical requirement. The 3.0 T MRI-based plan may provide potential benefits for some OAR due to a smaller target volume compared with the CT-based plan.

Objective To investigate the effect of nutritional intervention upon the clinical efficacy of chemoradiotherapy in patients diagnosed with esophageal carcinoma. Methods A total of 46 patients who were diagnosed with esophageal cancer in Anhui Cancer Hospital from November 2016 to August 2017 were enrolled in this prospective study. All patients were randomly and evenly divided into the nutritional intervention (NI) and routine treatment (RT) groups. The changes in body mass index (BMI),PG-SGA, serum albumin ( ALB), hemoglobin ( HB), white blood cell ( WBC) and other objective nutritional parameters and the incidence of chemoradiotherapy-induced complications were recorded before and after chemoradiotherapy. Results Prior to chemoradiotherapy,age,sex,BMI,ALB,PLT and clinical staging did not significantly differ between two groups (all P>0. 05).In the NI group,the BMI was (21.52±2. 67) after chemoradiotherapy,significantly higher than (21.13±2. 73) before radiotherapy (P= 0. 000).Moreover,the PG-SGA score after chemoradiotherapy was significantly lower compared with that before chemoradiotherapy (P= 0. 000).In the RT group,the BMI,Hb,ALB,PLT and WBC after chemoradiotherapy were significantly lower than those before radiotherapy, and thePG-SGA score was worse after chemoradiotherapy ( all P<0. 05).In the NI group, the incidence of grade 3 myelosuppression was 4. 34％, significantly lower than 8. 68％ in the RT group ( P= 0. 000 ). Conclusions Patients with esophageal cancer treated with chemoradiotherapy have a high nutritional risk. Nutritional intervention can improve the nutritional status, reduce the incidence of chemoradiotherapy-induced complications,and probably improve the quality of life and clinical prognosis.