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Objective To observe the clinical effect of ultrasound-guided quadratus lumborum block combined with enhanced recovery after surgery (ERAS) for the laparoscopic appendectomy in children. Methods A total of 154 children undergoing laparoscopic appendectomy, 114 males and 40 females, aged 3-10 years, ASA physical status Ⅰ or Ⅱ, were divided into the ERAS group (group E) and control group (group C), n = 77 each group. Patients in group E received ultrasound-guided deep injection of 0.2％ ropivacaine 0.75 ml/kg into quadratus lumbar muscle. According to the guidelines for rapid rehabilitation fasting for 4 h and abstaining from drinking for 2 h, functional beverages were given 30 min before operation and parental escort during induction of anesthesia while given general anesthesia with laryngeal mask, that is, propofol 2-6 mg·kg-1·h-1 was continuously pumped with 2％-6％ sevoflurane. Patients in group C were given traditional anesthesia, strict fasting for 6 h and no drinking for 4 h, as while as induction with midazolam, propofol, atracurium and sufentanil and tracheal intubation. The VAS scores at 2, 3, 6 and 12 h post-operation were recorded. The awakening time, anal exhaust time, ambulation time, hospitalization days, the patient's satisfaction rates were recorded. The cases of nausea, vomiting, regurgitation and aspiration were recorded. Results The VAS scores at 2, 3, 6 and 12 h post-operation in group E were significantly lower than that in group C (P ＜ 0.05). All the postoperative rehabilitation indicators in group E were superior to group C, including the awakening time, anal exhaust time, ambulation time, hospitalization days and patient's satisfaction (P ＜ 0.05). Complication incidences in group E were significantly declined compared with group C (P ＜ 0.05). Conclusion For children undergoing laparoscopic appendectomy, ultrasound-guided quadratus lumborum block combined with the ERAS strategy could result in less postoperative complications, reduced postoperative pain, rapid rehabilitation, shortened hospitalization time and increased patients' satisfaction.
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Aim To explore the effect of miRNA-143 ( miR-1 4 3 ) on homocysteine ( Hcy ) induced-vascular smooth muscle cells ( VSMCs ) proliferation and the mechanism .Methods VSMCs were cultured and in-cubated with Hcy by using primary cultured method . Then, cells were treated with different concentrations of Hcy and folate .VSMCs proliferation was determined with MTT assay , miR-143 was measured by qRT-PCR, and methylation of miR-143 was determined with meth-ylated PCR.Results After cells were treated with dif-ferent concentrations of Hcy , the proliferation of VSMCs was significantly increased , mRNA expression of miR-143 was decreased and methylation of miR-143 was increased .The proliferation of VSMCs was signifi-cantly decreased when transfected VSMCs with miR-143 precursor , and cell proliferation was increased by using miR-143 inhibitor transfection .Conclusion Hy-pomethylation of miR-143 may inhibit VSMCs prolifera-tion.
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Objective To study the clinical value of esophageal stent placement with radiation therapy for the middle-late pa-tients with esophageal cancer.Methods To perform esophageal stent placement and radiation therapy for the middle-late 35 pa-tients,and to perform radiation therapy for the middle-late 37 patients,then observe the clinical curative effects.Results The treat-ment group were significantly alleviated with dysphagia symptom after operation,which 32 cases sticked the entire radiation,ac-counting for 91.4%,no one can′t complete the treatment because of nutritional status reason.Survival time of one month after ra-diotherapy was up to 100.0%,and survival time of six months was 85.7% (30/35).But the contrast group with dysphagia symp-tom were aggravated or no relief,and needed parenteral nutrition.There were 23 cases to complete the entire radiation,accounting for 62.2%,and 5 cases happened esophageal tracheal fistula.Survival time of one month after radiotherapy was 83.8%(31/37),and survival time of six months was 62.2% (23/37).Two groups of cases in radiotherapy resistance difference was statistically signifi-cant,one month and six months of survival time were statistically significant (all P <0.05 ).Conclusion Esophageal stent place-ment with radiotherapy is more efficient than only radiation therapy to the middle-late patients with esophageal cancer.
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〔Abstract〕 Taking Beijing University of Chinese Medicine as an example , the paper analyzes problems existing in teaching computer basic courses .It proposes to combine the teaching concept of flipped classroom with the case -based teaching method , reform the teach-ing contents, methods, processes and modes of computer basic courses in medical colleges and cultivate students ′abilities to analyze and solve problems , and analyzes the feasibility .
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ObjectiveTo investigate the efficacy of invasive-noninvasive sequential mechanical ventilation (MV) in senile patients with severe community-acquired pneumonia (CAP).Methods A prospective study was conducted. The patients with severe CAP aged≥ 75 years admitted to Department of Respiratory Intensive Care Unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University from November 2012 to July 2014, with refusal to have tracheostomy, were enrolled. All patients meeting the diagnostic criteria of CAP and severe CAP were first admitted into the Department of Emergency, and they were found to need MV without absolute contraindication for noninvasive ventilation (NIV) in RICU. The patients were mechanically ventilated via endotracheal intubation (ETI), and they were randomly divided into invasive-noninvasive sequential MV group (sequential MV group) and conventional MV group. NIV was initiated immediately when patients matched the conditions for early extubation in the sequential MV group. Oxygen therapy (5 L/min) via a Venturi mask was provided when the indications of conventional extubation were met. The baseline data and clinical characteristics were recorded, the risk factors of death were analyzed by logistic regression analysis, and 60-day survival rate was analyzed by Kaplan-Meier curve. Results Ninety-one senile patients with severe CAP were enrolled, among them 28 patients died within 60 days, with a mortality rate of 30.77%. No significant difference in 60-day mortality was found between sequential MV group (n = 44) and conventional MV group [n = 47, 25.0% (11/44) vs. 36.2% (17/47),χ2 = 1.331,P = 0.249]. In the sequential MV group, the incidence of ventilator-associated pneumonia (VAP) was significantly decreased [27.3%(12/44) vs. 55.3% (26/47),χ2 = 7.350,P = 0.007], and the rate of ETI≥2 times was increased [59.1% (26/44) vs. 29.8% (14/47),χ2 = 5.095,P = 0.024] as compared with conventional MV group. Compared with survival group, the patients in non-survival group showed a higher incidence of cerebrovascular disease (60.7% vs. 25.4%,P = 0.002), higher acute physiology and chronic health evaluationⅡ (APACHEⅡ) score (26.46±2.59 vs. 24.41±2.47,P = 0.001), British Thoracic Society confusion, uremia, respiratory rate, blood pressure,≥75 years (CURB-75 score, 4.00±0.47 vs. 3.68±0.53,P = 0.013), a longer total duration of MV (days: 21.18±10.02 vs. 14.56±7.62,P = 0.002), and a higher ratio of ETI≥ 2 times (53.6% vs. 33.3%,P< 0.001). It was revealed by multivariate logistic regression analysis that ETI≥ 2 times and comorbidity of cerebrovascular infarction were independent predictors of a worse outcome in the senile patients [odds ratio (OR) = 9.677, 95% confidence interval (95%CI) = 3.075 - 30.457,P< 0.001;OR = 5.386, 95%CI = 1.781 - 6.284,P = 0.003]. It was showed by Kaplan-Meir survival analysis that ETI times and concurrent cerebrovascular infarction imparted significant effects on the 60-day survival rate (χ2 = 40.805,P= 0.000;χ2 = 4.425, P = 0.035).ConclusionInvasive-noninvasive sequential MV may not improve the outcome of senile patients with severe CAP, and ETI≥ 2 times and concurrent cerebrovascular disorders drastically lowered the survival rate.
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<p><b>OBJECTIVE</b>To investigate the effect of adrenomedullin (ADM) on renal arteriole remodeling and phosphorylation of extracellular signal-regulated protein kinases 1/2 (p-ERK1/2) in spontaneous hypertensive rats (SHR).</p><p><b>METHODS</b>Male SHR (4 weeks old) were randomized into hypertensive group (SHR) and ADM-treated group (ADM) to receive subcutaneous saline and ADM injections (daily dose of 1.0 nmol/kg, 5 days a week), respectively, with age-matched Wistar-Kyota (WKY) rats as the blank control. The systolic blood pressure (SBP) was measured at the end of each week, and histological changes of the renal arterioles were observed using HE and Weigert staining; the expression of P-ERK1/2 in the arterioles was detected with immunohistochemistry and Western blotting.</p><p><b>RESULTS</b>At 16 and 24 weeks of age, the rats in both SHR and ADM groups showed significantly higher SBP levels than WKY rats (P<0.05), and at 24 weeks, SBP was significantly lower in ADM group than in SHR group (P<0.05). The intima thickness/lumen diameter (IT/LD) ratio of the renal arterioles increased in both SHR and ADM groups at 16 and 24 weeks as compared with that of WKY rats (P<0.05), and for arterioles with an outer diameter <40 µm, the IT/LD ratio was significantly lower at 24 weeks in ADM group than in SHR group (P<0.05). The renal expression of p-ERK1/2, which increased significantly in SHR and ADM groups at 16 and 24 weeks (P<0.05), was significantly lower in ADM group than in SHR group at 24 weeks (P<0.05).</p><p><b>CONCLUSIONS</b>Long-term ADM treatment can control SPB elevation in SHR rats and reduce renal arteriole remodeling by inhibiting the phosphorylation of ERK1/2.</p>
Subject(s)
Animals , Male , Rats , Adrenomedullin , Pharmacology , Arterioles , Blood Pressure , Hypertension , Kidney , Mitogen-Activated Protein Kinase 1 , Metabolism , Mitogen-Activated Protein Kinase 3 , Metabolism , Rats, Inbred SHR , Rats, Wistar , Vascular RemodelingABSTRACT
Objective To comprehensively evaluate the effect of the program of treatment and assistance to advanced schis-tosomiasis patients in Hunan Province from 2004 to 2013. Methods The fund investment of the program,the profits of hospi-tals and the improvement of the patients’health were investigated by data collection and questionnaire survey. The evaluation index system of treatment and assistance to advanced schistosomiasis in Hunan Province was constructed by the Delphi method and analytic hierarchy process,and the program was assessed comprehensively. Results The evaluation index system includ-ing 6 primary indices and 33 secondary indices was established. Among all the primary indices,the score of the treatment and assistance(22.25)was the highest,and that of the satisfaction assessment(8.15)was the lowest,and the score of the compre-hensive assessment was 87.06. The average cure rate of the patients was 13.08%from 2004 to 2013. More than 60%of the pa-tients’disease condition got better,and nearly 70%of the patients’psychological condition improved,and more than 70%of patients’self-help ability and social contact improved,as well as family happiness increased. In addition,the annual average cost for caretakers decreased by 2000 Yuan,and the profits of all the fixed-point hospitals for treatment and assistance in-creased. Conclusion The effectiveness and efficiency of the treatment and assistance to advanced schistosomiasis patients in Hunan Province is obvious,and the government should continuously invest in the program.
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Dongting Lake area is one of the major marshland schistosomiasis endemic areas in China. In recent years spatial epidemiology is widely used in the research of schistosomiasis which is a new opportunity to break through the current wander-ing situation of schistosomiasis control. In this article both the generalized and Dongting-Lake-specific epidemic indicators of schistosomiasis are reviewed to provide the basis to construct the schistosomiasis Geographic Information System GIS database of Hunan Province.
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Background It is well known that diabetic retinopathy(DR) involves in complex pathogenesis.Worse outcome of brain ischemia with hyperglycemia is mediated by mitogen-activated protein kinases (MAPK).However,the effect of phosphorylation of MAPK signal pathway on DR needs further investigation.Objective This study was to explore the the possible role of extracellular signal-regulated kinase1/2(ERK1/2)in DR.Methods Sixty SPF SD rats aged 8-weeks were grouped into the control group and diabetes group.Diabetic models were established by intraperitoneal injection of streptozotocin (STZ) (60 mg/kg) dissolved in citric acid buffer.Blood glucose level was more than 16.7 mmol/L were used as the diabetic group.The equivalent amount of citric acid buffer was injected in the same way in the rats of the control group.The rats were sacrificed and retinas were isolated in 4 weeks and 12 weeks after modeling.The morphology of rat retinas was examined by hematoxylin and eosin staining.The relative expression levels of phosphorylated-ERK1/2 and glial fibrillary acidic protein (GFAP)(absorption,A value) in rat retinas were detected by immunohistochemistry.Results Blood glucose levels of rats were significantly higher than those in the diabetic group compared with the control group at both 4 and 12 weeks after modeling(t=14.174,13.771,both at P＜0.05).In addition,the body weight was significantly lower and the drinking was much more in the rats of the diabetic group in comparison with the control group in 12 weeks(t=8.670,18.725,both at P＜0.05).Twelve weeks after modeling,the decrease of retinal thickness,swelling of outer plexiform layer and decline of number of retinal ganglion cells,rods and cones were seen under the optical microscope.The relative expression levels of GFAP in the retinas were 3 197.1 ±13.1 and 7 202.0±56.8 in the diabetic group at the 4 and 12 weeks,which were significantly higher than those in the control group (2 152.8 ± 16.1 and 2 337.0±8.6) (t =6.327,16.417,both at P＜0.05).In 12 weeks after modeling,the relative expression level of phosphorylated-ERK 1/2 was significantly higher in the diabetic group compared with the control group (2 850.6±2.4 versus 1 274.6± 1.3),showing a significant difference between them (t =12.771,P ＜ 0.05).Conclusions Phosphorylation of ERK1/2 signal transduction pathway is involved in the STZ-induced DR through mediating the activation of Müller cells and inducing the apoptosis of photoreceptor and ganglione cells.
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Objective To observe the effects of calcium cyanamide (Rongbao) on the histological and morphological changes of Oncomelania hupensis snails in order to explore its molluscicidal mechanisms.Methods The serial snails' slides were fixed after soaking in a concentration of Rongbao leached liquor at different time.The histological and morphological changes of the snails were compared among these slides.Results After soaking in the Rongbao leached liquor for 48 h,the mantle epithelia,respiratory epithelia of the gill,liver cells,and muscle cells of gastropods were injured seriously,which resulted in the death of the snails directly.The death rates of the snails were 96.70% and 100% after soaking in the Rongbao leached liquor for 48 h and 72 h,respectively.Conclusion Rongbao is an effective molluscicide by damaging the several snail tissues.
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Objective To investigate the expression of neuronal extracellular signal-regulated kinase 1/2 (ERK1/2) and its significance after cerebral isehemia reperfusion in diabetic rats. Methods Seventy-two healthy adult SD rats were randomly divided into sham-operation, normal glucose with cerebral ischemia and diabetes with cerebral ischemia groups. Each group was redivided into ischemia 15 minutes and reperfusion 1, 3 and 6 h subgroups according to the different time points of ischemia reperfusion (n = 6 in each subgroup). Streptozocin was used to induce diabetes, and a global cerebral ischemia model of diabetic rat was established by the bilateral vascular occlusion combining with bloodletting, TUNEL and immunohistochemistry were used to observe neuronal apoptosis and the expression of the phosphorylation of ERK1/2 in hippocampal CA4 region. Results The incidences of neuronal apoptosis in hippocampal CA4 region for ischemia 15 minutes and reperfusion 1, 3 and 6 h in the diabetes with cerebral ischemia group were significantly higher than those in the normal glucose with cerebral ischemia group (P < 0. 05); the expressions of the phosphorylation of ERK1/2 at all time points in the diabetes with cerebral ischemia group were higher, and reperfusion 1 and 3 h were significantly higher than those in the normal glucose with cerebral ischemia group (P < 0.01). Conclusions ERK1/2 might involved in the mechanism of neuronal injury after diabetes aggravating cerebral ischemia-reperfusion.
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Objective To explore the expression of extracellular signal-regulated kinase 1/2 (ERK1/2) in the hippocampus CA4 region of diabetic rats after global cerebral ischemia-reperfusion injury. Methods Diabetic rat was established by intraperitoneal injection of streptozocin (STZ) and then global cerebral ischemia model was induced by bilateral clamping of the carotid arterial plus hypotension by withdrawing blood. Apoptosis of neuron and expression of the phosphorylation of ERK1/2 (P-ERK1/2)were observed in the hippocampus CA4 region of diabetes operation groups (DCI) and normoglycemia operation groups (NCI) by TUNEL,immunohistochemistry at 15 min after ischemia and at 1 h after reperfusion. Results Compare with the NCI,neuronal apoptosis of DCI was significantly higher at each time point of cerebral ischemia and reperfusion in the hippocampus CA4 (P
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Purpose:To investigate the correlation between the biological behavior of gastric carcinoma and the expression of cyclin D1,p53 and c myc genes.Methods:Immunohistochemical technique(SP) was applied to detect the expression of cyclin D1,P53 and c myc proteins in 63 cases of gastric carcinoma. Results:The rates of positive immunostaining of cyclin D1,P53 and c myc in gastric carcinoma were 32.75% ,25.40% and 52.38%,respectively.The expression of cyclin D1,P53 and c myc proteins in gastric carcinoma ≥ 4 cm in diameter was significantly higher than those 0.05).Conclusions:The over expression of cyclin D1, P53 and c myc proteins may contribute to the proliferation of gastric cancer cells, making them more aggressive.
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Objective To compare the pathological changes of the kidney in two-kidney one-clip hypertension and spontaneous hypertension rats so as to provide some experimental basis for clinical prevention and treatment of primary and secondary hypertension. Methods Conventional histopathology and elastic staining methods were used to observe the morphological changes of kidney tissues and renal arterioles from two-kidney one-clip (2K1C) and spontaneously hypertensive rats (SHR) of different weeks of age. Results The blood pressure of 2K1C rats after 4 weeks of operation reached (187?24)mmHg,which was significantly higher than that of controls (P