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Objective:To establish a method for correction of tail vein extravasation based on PET images and to improve the accuracy of SUV.Methods:The simulation method was established by phantom on Nano PET/CT and images were reconstructed by a three-dimensional ordered-subsets exception maximum algorithm. PET images were analyzed by using the Interview Fusion 1.0 software. The optimal scanning time and the ROI delineated method were found. The accuracy of the simulation method was verified by comparing the activity of simulation method with the mice tail activity measured by the dose calibrator directly on Kunming (KM) mouse ( n=11). Using the simulation method, the impact of extravasation on SUV was proved. Independent-sample t test was used to analyze data. Results:Ten minutes was selected as the optimal scanning time and SUV max 42% threshold was selected as the ROI delineated method. The specific correction formula was as follows: actual activity=image activity/(4.48× V+ 77.05)×100 (0.3 MBq/ml≤leakage concentration<6.5 MBq/ml); actual activity=image activity/(6.65× V+ 71.10)×100 (6.5 MBq/ml<leakage concentration≤14.8 MBq/ml). In the verification experiment, the difference rate between simulated and standard activity was (6.10±2.43)%. In actual operation verification, SUV was underestimated by (6.07±2.67)%. The corrected SUV (0.276±0.078) was not significantly different from the standard SUV (0.277±0.078; t=0.99, P=0.353), while the uncorrected SUV (0.264±0.078) was significantly lower than the standard SUV ( t=7.02, P<0.001). Conclusion:The correction calculation method based on PET images can realize the accurate correction of tail vein leakage activity and the SUV results of animal imaging.
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Objective@#To investigate the effect of anluohuaxianwan (ALHXW) using rat model of carbon tetrachloride (CCl4) induced liver fibrosis on the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs).@*Methods@#Thirty-six male Wistar rats were randomly assigned into control, model and treatment groups. Rats in the model and treatment groups were injected intraperitoneally with 40% CCl4 (2 ml/kg), and the control group were given isotonic saline twice a week for six weeks. Meanwhile, the treatment group were gavaged with ALHXW solution daily (concentration 0.15 g/ml, 9.9 ml/kg) for 6 weeks, while the control and model groups were given isotonic saline once a day for 6 weeks. Serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at the end of third and sixth week. At the end of six weeks, liver tissues were harvested for histopathological evaluation and the detection of mRNA and protein expression levels of MMP-2/13 and TIMP-1/2. According to different data, LSD method, parametric (one-way ANOVA) and non-parametric tests (Kruskal-Wallis H-test and Mann-Whitney U test) were used for statistical analysis.@*Results@#Compared with the model group, ALHXW markedly alleviated liver injury in the treatment group, and thereby improved the general state of rats, liver and spleen morphological characteristics, and ALT and AST levels. Histopathological examination demonstrated that the extent of liver fibrosis was improved (2.75 ± 0.75 vs. 3.55 ± 0.69, P = 0.015) in the treatment group as compared with the model group. The mRNA and protein expression levels of MMP-13 in the treatment group were significantly higher than that of the model group (mRNA: 10.50 ± 7.64 vs. 4.40 ± 2.97, P = 0.029. Protein: 1.15 ± 0.09 vs. 0.78 ± 0.21, P = 0.016), whereas the mRNA and protein expression levels of MMP-2, TIMP-1/2 in the treatment group were significantly lower than that of the model group (mRNA: 4.55 ± 3.29 vs. 7.83 ± 4.19, P = 0.048; 1.66 ± 0.73 vs. 3.69 ± 2.78, P = 0.023; 2.25 ± 1.16 vs. 3.41 ± 1.51, P = 0.049; respectively. Protein: 0.44 ± 0.11 vs. 0.65 ± 0.05, P = 0.03; 0.69 ± 0.06 vs. 1.07 ± 0.21, P = 0.016; 0.46 ± 0.09 vs. 0.81 ± 0.13, P = 0.003; respectively).@*Conclusion@#ALHXW exerts anti-liver fibrosis effects mainly by improving liver function, inhibiting the activation of hepatic stellate cells, enhancing the expression of MMP-13, and inhibiting the expression of MMP-2 and TIMP-1/2.
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Objective To evaluate the efficacy of ultrasound-guided adductor canal block (ACB) for analgesia after tibial fracture.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index of 18-24 kg/m2,scheduled for elective internal fixation for unilateral tibial fracture under general anesthesia,were enrolled in this study.The tracheal tube was removed after operation,and then the patients were admitted to the postanesthesia care unit.The visual analog scale score was recorded.Eighty patients with visual analog scale score＞3 were divided into 2 groups (n =40 each) using a random number table method:control group (group C) and ACB group.Patient-controlled intravenous analgesia (PCIA) was performed at the end of operation.Patients underwent ACB on the affected side,and 0.375％ ropivacaine 20 ml was injected in group ACB.Sufentanil 0.1-0.2 μg/kg was intravenously injected in group C.Ramsay sedation scores were recorded immediately after entering the postanesthesia care unit (T0) and at 15 and 30 min and 1,2,4,8 12 and 24 h after block (T1-8).When visual analog scale scores ＞3 points and the pain could not be relieved through pressing the PCA pump,tramadol 1-2 mg/kg was intramuscularly injected.Patients were followed up for 24 h after surgery,and the postoperative consumption of sufentanil,pressing time of PCA and patients' satisfaction scores were recorded.The occurrence of postoperative nausea and vomiting,respiratory depression and hypoxemia and length of postoperative hospital stay were also recorded.Results Compared with group C,the postoperative consumption of sufentanil,pressing time of PCA,requirement for and consumption of tramadol,incidence of postoperative nausea and vomiting and oversedation,and Ramsay sedation score at T1-5 were significantly decreased,and the patients' satisfaction score were increased in group ACB (P＜0.05).Conclusion Ultrasound-guided ACB exerts better analgesic efficacy after tibial fracture with fewer adverse reactions.
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Objective To investigate the effect of SVV guided fluid therapy on blood gas and lipopolysaccharide (LPS),procalcitonin (PCT) in patients undergoing resection of gastrointestinal tumor.Methods Sixty patients aged 60 85 years from Jan,2016 to Feb,2017 falling into ASA physical status Ⅱ or Ⅲ,scheduled for elective radical operations for gastrointestinal cancers,were includ ed and randomly divided into two groups (n =30 each) using a random number table:ScvO2 guided fluid therapy (group C),SVV guided fluid therapy (group G).MAP,HR and CVP of patients were recorded at the same time before anesthesia (T0),tumor removal (T1) and the end of surgery (T2)respectively.PH,BE,HCO3-and Lac of venous blood samples and artery blood samples at T0-T2,6 hours after surgery(T3) were recorded.Venous blood samples were collected at T0,T3 to detect LPS and PCT.Crystalloid requirements,colloid requirements,total volume,bleeding volume,peritoneal fluid volume and the use of dopamine were recorded.The time of PACU,time when the patients first exhausted and was fed after operation,length of hospital stay after operation were recorded.Results Compared with group C,BE of artery blood was obviously increased at T2,T3 in group G (P＜0.05);the Lac of artery at T2 and the Lac of artery and venous blood at T3 in group G was obvi ously decreased.LPS and PCT were decreased at T3 in group G (P＜0.05).Compared with group C,the needed colloid was increased in group G,the needed crystalloid and total volume of fluid infused were decreased in group G (P＜0.05).Compared with group C,the time of PACU starting to exhaust and feed,length of hospital was shortened in group G (P＜0.05).Conclusion SW guided goal directed fluid therapy is more conductive to maintain the acid base and reduce the incidence of in fection for the patients with gastrointestinal tumor operation,promote the recovery of gastrointestinal function and decrease the length of hopital after operations.
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Objective@#To investigate the postoperative prognosis and the related factors of patients with stage pT2N0-1M0 of thoracic esophageal carcinoma(EC).@*Methods@#From 2008 to 2011, clinical data of 275 cases with stage pT2N0-1M0 of thoracic EC treated by esophagectomy were enrolled. These cases includ 180 male and 95 female. Among them, 32 cases were upper thoracic EC, 186 cases were middle thoracic EC and 57 cases were lower thoracic EC. Alternatively, 205 cases were stage pN0, 70 cases were stage pN1. 155 cases received esophagectomy alone and 120 cases received esophagectomy and postoperative adjuvant therapy.@*Results@#The end of follow-up time was on September 30th, 2014. The 1-, 3-, 5-year overall survival (OS) rates were 91.6%, 70.2% and 63.7%, respectively. The 1- 3-, 5-year progression-free survival (PFS) rates were 83.9%, 64.0% and 60.0%, respectively. The result of univariate analysis showed that the depth of tumor invasion, pathological type, pN stage and number of metastatic lymph nodes were significantly associated with OS (all of P<0.05). Moreover, the gender, the depth of tumor invasion, pathological type, pN stage and number of metastatic lymph nodes were significantly associated with PFS (all of P<0.05). Cox multivariate analysis showed that the location of primary tumor and pN stage were the independent factors of OS (both P<0.05). The gender, pN stage and postoperative adjuvant therapy were the independent factors of PFS (all of P<0.05).@*Conclusion@#Among the patients with pT2N0~1M0 stage of thoracic EC, patients with upper thoracic EC or pN1 stage have poorer postoperative prognosis compared with others, and postoperative adjuvant treatment is recommended for these patients.
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Objective@#The traditional Chinese medicine Anluohuaxianwan (ALHXW) has been used to treat liver fibrosis induced by chronic hepatitis B virus (HBV) infection. However, the anti-fibrosis mechanisms of ALHXW remain to be investigated. This study used a rat model of carbon tetrachloride (CCl4)-induced liver fibrosis to explore the potential antifibrogenic mechanisms of ALHXW.@*Methods@#Twenty-seven male Wistar rats were randomly assigned to control group, model group, and treatment group (n = 9 per group). Rats in the model and treatment group were injected intraperitoneally with 40% CCl4(2 ml/kg), and rats in the control group were administered saline twice a week for 6 weeks. Starting at week 4 following model construction, rats in the treatment group received daily gavages with ALHXW solution (concentration 0.15 g/ml) daily, while rats in the control and model groups were given saline for a total of 6 weeks. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured from blood samples collected at the end of weeks 3, 6 and 9. Histopathological examination of liver tissue was performed to evaluate liver fibrosis at week 9. At the same time, the mRNA expression of TGF-β1 and Smads in liver tissues was quantified by real-time reverse transcription polymerase chain reaction (RT-PCR), and TGF-β1 protein level in the liver was measured by Western blot. Inter-group comparison was performed using analysis of variance (ANOVA) when the continuous data were normally distributed and satisfied the homogeneity of variance; otherwise, nonparametric tests were used. Categorical data were compared between groups using nonparametric tests.@*Results@#ALHXW markedly alleviated liver injury in the treatment group after 3 weeks of therapy as indicated by a significantly reduced level of ALT compared with the model group [(162.98 ± 73.14)U/L vs (322.52 ± 131.76)U/L, P = 0.047], and a 39.8% reduction in AST level compared with the model group[ (537.56 ± 306.06)U/L vs (892.98 ± 358.19)U/L, P = 0.053]. Moreover, at the end of the 6-week therapy, histopathological diagnosis showed that liver fibrosis was significantly reduced in the ALHXW-treated group compared with that in the model group (P = 0.002). The relative expression of TGF-β1 mRNA and protein in the liver were significantly lower in ALHXW-treated rats than that in model rats (1.34 ± 0.31 vs 1.78 ± 0.45, P = 0.025; 0.39 ± 0.02 vs 0.57 ± 0.04, P = 0.003).@*Conclusion@#ALHXW treatment can reverse CCl4-induced liver fibrosis in rats. Its mechanisms of anti-fibrosis may occur through the inhibition of TGF-β1 synthesis and TGF-β1/Smads signaling pathway, which in turn suppress the activation of hepatic stellate cells and thereby reverses fibrosis.
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Objective To observe the analgesia effects of ropivacaine with sufentanil or dezocine on continuous femoral nerve block (FNB)after total knee arthroplasty (TKA).Methods Sixty un-dergoing selective unilateral TKA patients,received postoperative analgesia with continuous FNB for 48 hours,were randomly divided into three groups according to the drug formulations:0.225% ropiv-acaine (group R),0.1 5% ropivacaine mixed dezocine 10 mg (group D),and 0.1 5% ropivacaine mixed sufentanil 1 μg/kg (group S);the visual analogue scale (VAS)in resting state (RVAS), active functional exercise state (AVAS),passive functional exercise state (PVAS)were recorded at 1,3,7 d after surgery.The other analgesics dosage and the incidence of nausea and vomiting and other complications were recorded.Results Compared with preoperative state,the RVAS scores in three groups were significantly lower at 1,3,7 d after surgery,the PVAS scores were significantly lower at 7 d after surgery (P <0.05).Compared with group R,the RVAS scores were significantly higher ei-ther in groups S or D at the 3 d postoperatively (P <0.05).There were no significantly difference in adverse reaction among three groups.Conclusion Ropivacaine combined with sufentanil or dezocine through continuous FNB can provide a effectual postoperative analgesia in TKA patients without an increase in adverse events.But compared to 0.225% ropivacaine,0.1 5% ropivacaine with sufentanil or dezocine may not keep a longer analgesia duration,this is more obvious observed in dezocine group.
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Objective]To research professor Chang's experience in treating adolescaria functional metrorrhagia . [Method]By following professor Chang diagnosis long time,it summarizes professor Chang's experience in treating adolescaria functional metrorrhagia from the aspects of the reason and mechanism,syndrome differentiation and treatment,treating characteristics,and for a case. [Result]Professor Chang considers the adolescaria functional metrorrhagia connected with stagnation of liver Qi,insufficiency of kidney and deficiency of spleen Qi,weakness,stagnation,dampness.Treatment must address both the symptoms and root causes in accordance with seasonal conditions .She regulating menstrual cycle attaches great importance to the liver , spleen and kidney,and uses the auricular points,couplet medicines.The prescription rule is convenient and specialized.The recipe case embodies the evidence-based medicines, according to the menstrual period, the late, and the inter-phase and premenstrual period of drug treatment of yin and yang change. Professor Chang's ideas and characteristics curative effect are outstanding. [Conclusion]Professor Chang thinks the adolescaria functional metrorrhagia is complicated,then perfect pragmatic value is worthy of study and understanding.
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BACKGROUND:The homing ability of mesenchymal stem cells is closely associated with the effects of celltransplantation. Clarifying the mechanism of chemotaxis and migration wil contribute to enhance the clinical application of mesenchymal stem cells. OBJECTIVE:To investigate the effect of Cdc42 in the homing of human umbilical cord mesenchymal stem cells. METHODS:First, mesenchymal stem cells were isolated from human umbilical cord, and co-cultured with tumor necrosis factorα, interleukin-1β, and transforming growth factorβ. Western blot assay was used to test the level of Cdc42. Besides, Cdc42 siRNA was synthesized by chemical method to transfect the cells, and cellmigration and adhesion were measured by Transwel and Matrigel separately. Meanwhile, the activity of signal molecule, extracellular regulated protein kinase 1/2, was evaluated by western blot. RESULTS AND CONCLUSION:The results indicated that the inflammation factors induced the highly expression of Cdc42 in human umbilical cord mesenchymal stem cells, almost double level to controls. siRNA notably inhibited the migration and adhesion of human umbilical cord mesenchymal stem cells through Cdc42 down-regulation, and the extracellular regulated protein kinase 1/2 and phosphorylation form were also decreased simultaneously. In a word, we speculate Cdc42 plays a role in the chemotaxis of human umbilical cord mesenchymal stem cells in vitro.
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To compare the effectiveness and safety of spinal versus general anesthesia for arthroplasty with respect to deep vein thrombosis(DVT),pulmonary embolism (PE) and epidural hematoma.Randomized controlled trials involving spinal and general anesthesia for arthroplasty were searched.Quality assessment were analyzed according to the Cochrane Collaboration's rule.A total of 12 trials involving 1023 participants met the inclusion criteria,Meta-analyses showed that spinal anesthesia may reduce the incidence of DVT or PE after arthroplagty without anticoagulant.There is no difference in the incidence of DVT and PE when anticoagulant is used.Whether anticoagulant was used or not,no epidural hematoma was observed after using the two anesthesia methods.
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OBJECTIVE To explore the methods of centralized disinfection for bed units in the hospital.METHODS Choose the appropriate methods to disinfection the bed units,make the basic condition,set up the administration rules and validation disinfection process.RESULTS The centralized disinfection for bed units could supply inpatients safety,clear and comfortable treatment environment and living space.CONCLUSIONS Applying the centralized disinfection for bed units is the necessary tendency for modern hospital.
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OBJECTIVE To prove the batch monitoring system to be effective and practicable.METHODS The sterilization process of each batch with the batch monitoring system was monitored.RESULTS Among monitored 7057 6 batches failed,the failure rate was 0.09%.CONCLUSIONS By analyzing the failure causes,we should enhance the maintenance of the sterilizator and limit the using times of the monitor device.It proves that the batch monitoring system is effective and practicable to monitor the pulse-vacuum-pressure-steaming sterilizator.
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In handling crises in hospitals caused by natural disasters like earthquake, systemati cpractical measures of crisis management are needed, which include: early contact with top managements for support in counter disaster supplies, immediate organization of temporary first aid stations by hospital staff, logistic support by full time personnel to solve problems such as drugs and medical equipments as well as food and drinking water, and psychological consultation to patients and staff members.
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OBJECTIVE To probe how to avoid the complication after intravenous infusion for the elders. METHODS The cause of the complication in infusion therapy for the elders with a total of 80 cases in the past three years was analyzed retrospectively. RESULTS Among the complications after intravenous infusion for 80 elders,leakage injury accounted for 47 cases(58.5%), and phlebitis accounted for 21 cases(26.8%),respectively. CONCLUSIONS As the elders′ blood vessel wall is very thin,the intravenous infusion often causes injury,the nurses should pay more attention to operating of intravenous infusion for the elders,observing regularly,and prolonging the time for pressing the pinprick after pulling out the dropper,in order to reduce the coming of injury.
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OBJECTIVE To verify the effect of batch monitoring system insteod of the indicator in the package.METHODS From Apr 17,2007 to Jul 29,2008,the batch monitoring system was used to monitor the sterilization effect of each batch,at the same time,inside each package we placed the indicator as control.RESULTS A total of 7057 batches were monitored,in which 7051 were eligible,and among 166870 packages in all,the indicators were all eligible,which included 56600 dressing packages and 110270 instrument packages.There was no difference between batch monitoring system and indicators.CONCLUSIONS The effect of batch monitoring system is credible,and the indicator inside package can be replaced.
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OBJECTIVE To evaluate the methods of improving the air quality in the outpatient departmant area.METHODS The amount of outpatients in different time periods in the morning were calculated in the specialist consulting area;the bacteria in the air collected from the clinic room were collected and cultured in general nutrition agar medium and compared the efficacy for the improvement of air quality between the new and the old methods.RESULTS The air quality of the specialist consulting area was improved significantly through the ventilation and cleaning-floors depending on the amount of outpatients(P