Application of ultrasound-guided stellate ganglion block in patients with aneurysmal intracerebral hemorrhage / 中国医师进修杂志

Objective To explore the application value of ultrasound-guided stellate ganglion block in patients with aneurysmal cerebral hemorrhage.Methods Eighty patients with subarachnoid hemorrhage caused by aneurysm from November 2017 to March 2019 in Hangzhou Hospital of Zhejiang Medical Health Group were selected.The patients were divided into observation group and control group by random digits table method with 40 cases in each group.All patients were treated with craniotomy hematoma removal.At the conclusion of the surgical procedure,the control group was treated with nimodipine,while the observation group was treated with ultrasound-guided right stellate ganglion block on the basis of nimodipine.The blood flow velocity of middle cerebral artery before operation and 6,24 h after operation by transcranial Doppler sonography were detected to reflect cerebral vasospasm status;the blood samples from the radial artery and internal jugular bulb 24 h after operation were used to detect and count cerebral oxygen metabolism indexes,including the blood oxygen saturation of internal jugular bulb,arteriovenous oxygen content difference and cerebral oxygen uptake rate;the IgG,IgA and IgM 24 h after operation were detected.The patients were followed up at 1 week after operation,and the complication was observed.Results There was no statistical difference in the blood flow velocity of middle cerebral artery before operation between 2 groups (P＞0.05);the blood flow velocity of middle cerebral artery 6 and 24 h after operation in observation group was significantly lower than that in control group:(100.8± 8.2) cm/s vs.(123.5 ± 9.9) cm/s and (89.7 ± 5.3) cm/s vs.(118.9 ± 7.1) cm/s,and there was statistical difference (P＜0.01).The blood oxygen saturation of internal jugular bulb,cerebral oxygen uptake rate,IgG,IgA and IgM 24 h after operation in observation group were significantly higher than those in control group:0.704 ± 0.035 vs.0.598 ± 0.058,(57.5 ± 6.5)％ vs.(49.7 ± 3.6)％,(12.5 ± 0.3) mg/L vs.(5.0 ± 0.1) mg/L,(5.5 ± 0.3) mg/L vs.(2.1 ± 0.1) mg/L and (4.3 ± 0.3) mg/L vs.(1.9 ± 0.2) rg/L,the arteriovenous oxygen content difference and incidence of complication were significantly lower than those in control group:(40.8 ± 3.2) ml/L vs.(58.3 ± 8.6) ml/L and 5.0％ (2/40) vs.25.0％ (10/40),and there were statistical differences (P＜0.01 or ＜0.05).Conclusions For patients with aneurysmal intracerebral hemorrhage,ultrasound-guided stellate ganglion block therapy can effectively improve cerebral blood flow,ensure cerebral oxygen supply,improve humoral immunity,reduce the incidence of postoperative complication,and achieve the purpose of improving clinical therapeutic effect.

Relationship between expression of PIK3CA protein and the clinicopathology of esophageal squamous cancer / 中国基层医药

Objective To analyze the expression and clinical significance of PIK 3CA protein in squamous cell carcinoma of the esophagus .Methods Forty -five samples of surgical resection of esophageal squamous cell carcinoma were collected as the observation group ,and 45 normal tissues adjacent to the carcinoma were selected as the control group.The expression of PIK3CA protein in the tissues of esophageal squamous cell carcinoma and the corresponding para cancerous tissue was detected by immunohistochemistry ( IHC).Results The results of IHC showed that the positive expression rate of PIK 3CA protein in esophageal squamous cell carcinoma was 53.33%, which in adjacent normal tissues was 0.00%,the difference was statistically significant (χ2 =32.727,P<0.01).The positive expression rate of PIK3CA protein was correlated with lymph node metastasis ,differentiation and clinical stage of esophageal squamous cell carcinoma (χ2 =5.180,8.201,13.566,P=0.023,0.017,0.001),and was not correlated with the degree of tumor invasion (χ2 =0.952,P =0.329).Conclusion The expression of PIK3CA protein is abnormal in esophageal squamous cell carcinoma ,and the expression of PIK3CA protein plays a role in the occurrence and development of esophageal squamous cell carcinoma .

Clinical value of endoscopic ultrasound in the diagnosis of minute gastric small stromal tumor / 中国基层医药

Objective To investigate the clinical value of endoscopic ultrasonography (EUS)on minute gas-tric stromal tumor (MGST).Methods 90 patients diagnosed with MGST were randomly divided into two groups. 45 patients in A group were given conventional endoscopic diagnosis,45 cases in B group were treated with endoscopic ultrasound diagnosis.After the two groups of patients with endoscopic treatment,the coincidence rate of preoperative diagnosis and pathological inspection test results was recorded,clinical features in MGST under EUS diagnosis were analyzed.Results All patients were diagnosed in the case of endoscopic surgery,endoscopic submucosal dissection (ESD)accounted for 94.44%,which was significantly higher than the use of endoscopic full -thickness resection (EFR)percentage of 5.56%,and the difference was statistically significant (χ2 =14.22,P <0.05);The two groups of patients after endoscopic treatment,were diagnosed as pathological inspection MGST.Preoperative diagnosis showed that EUS MGST suspected cases of 40 patients,conventional endoscopy MGST suspected cases of 31 cases.The diag-nosis coincidence rate of B group (88.89%)was significantly higher than that in A group (68.88%),the difference was statistically significant (χ2 =5.40,P <0.05);MGST of EUS images could be clearly observed in patients with tumor morphology,size,location,growth pattern,internal parenchyma,echo pattern,strengthening methods,the compo-sition ratio in line with the results of endoscopic treatment,diagnosis results in line with the pathological diagnosis. Conclusion EUS has significant value for the diagnosis of MGST,it has advantages in the clinical guidance and treatment.

Clinical efficacy and safety of rabeprazole in combined with flupentixol melitracen in treatment of non -erosive gastroesophageal reflux disease with anxiety and depression / 中国基层医药

Objective To explore the clinical efficacy and safety of rabeprazole in combined with flupentixol melitracen in treatment of non -erosive gastroesophageal reflux disease with anxiety and depression.Methods 84 cases with non -erosive gastroesophageal reflux disease with anxiety and depression of outpatient and inpatient admitted from October 2012 -October 2013 and they were randomly divided into two groups according to the order,all had 42 cases.The control group was given rabeprazole treatment,observation group used flupentixol melitracen treat-ment on the basis of the control group.The clinical efficacy and the occurrence of adverse reactions of the two groups were compared.Results The total effective rate of the observation group was 95.24%,which was significantly higher than 76.19% in the control group,the difference was significant (χ2 =11.20,P 0.05 ).Conclusion Rabe-prazole in combined with flupentixol melitracen in treatment of non -erosive gastroesophageal reflux disease with anxi-ety and depression had good effect,and the adverse reactions were mild and safe.

Effects of early pain intervention provided by an acute pain service team on efficacy of postoperative patient-controlled analgesia / 中华麻醉学杂志

ObjectiveTo evaluate the clinical effects of early pain intervention provided by an acute pain service team on the efficacy of postoperative patient-controlled analgesia ( PCA).MethodsOne thousand four hundred and sixty-seven patients receiving postoperative PCA in November and December 2011 were enrolled in this study.Patients were excluded from the study if they were ＜ 12 yr,unconscious or uncoorperative.The patients were divided into control group (group C,n =725) and intervention group (group 1,n =742).Group 1 received preoperative systematic pain education on the significance and conect use of PCA including pharmacology of analgesic (sufentanil 100 μg in normal saline 100 ml) by an acute pain service team made up of anesthesiologists and nurses specializing in pain management.The education was repeated immediately before operation and when the patients were discharged from recovery room.While in grup C the correct use of PCA was explained routinely before operation by anesthesiologists and nurses taking care of the patients.The incidence of incomplete analgesia and adverse reactions and patient' s satisfaction were rated.ResultsThe incidence of incomplete analgesia was significantly lower and the patient's satisfaction higher in group 1 than in control group.There was no significant difference in adverse reactions between the two groups.ConclusionEarly pain intervention provided by an acute pain service team is effective in improving the efficacy of postoperative PCA and patient's satisfaction.

Epithelial-mesenchymal transition in digestive system tumors / 国际肿瘤学杂志

Recent studies show that tumor cells get rid of the connections between cells,and induce tumor invasion and metastasis through epithelial-mesenchymal transition (EMT).EMT becomes an important way to invasion,metastasis and chemotherapy resistance of epithelial cell carcinoma which accounting for more than 90％ of malignant carcinomas.Members of Snail family,especially Snail is regarded as important adjustment factor of EMT,which induce the transformation from epithelial cell to mesenchymal phenotype through competitive inhibition E-calcium protein gene expression.Many researches show that EMT exists widely in digestive system tumors,which is closly related to the invasion,metastasis and chemotherapy resistance of digestive system tumors.

Construction of pEGFP-C1-HSP27 recombinant eukaryotic expression vector and screening of human pancreatic cancer SW1990 cell line stably expressing HSP27 / 中华胰腺病杂志

Objective To construct pEGFP-C1-HSP27 recombinant eukaryotic expression vector and establish human pancreatic cancer SW1990 cell line stably expressing HSP27.Methods RT-PCR was applied to amplify human HSP27 cDNA from human pancreatic cancer SW1990 cells with a pair of specific primers carrying a restriction enzyme site BamH Ⅰ or Hind Ⅲ on each 5' end.HSP27 cDNA was inserted into pEGFP-C1 vector and then identified by restriction enzyme digestion and sequencing.Successful constructed pEGFP-C1-HSP27 or empty vector was transfected into SW1990 cells by lipofectamine 2000,respectively.The location of HSP72 was determined by fluoroscopy,RT-PCR and Western blot was used to detect the expression of HSP27 in transfected cell.Results The DNA sequence of pEGFP-C1-HSP27 recombinant plasmid was completely correct,and it was successfully transfected into SW1990 cell lines and stably transfected SW1990 cell lines were obtained,which were confirmed by restriction enzyme and sequencing.The expression of EGFP was distributed in cytoplasm,the HSP27mRNA expression was significantly increased (1.458 ± 0.160vs0.897 ±0.051,P ＜0.05).In addition,it was showed that EGFP-HSP27 fusion protein was expressed.Conclusions The eukaryotic expression vector pEGFP-C1-HSP27 was constructed successfully and stably transfected SW1990 cell line expressing HSP27 was obtained.

The effects of thalidomide on proliferation of endothelial cells of human umbilical vein and angiogenesis / 中华消化杂志

Objective To investigate the mechanism and effect of thalidomide on gastrointestinal bleeding of angiodysplasia. Methods The endothelial cells of human umbilical vein were cultured in vitro to exponential phase of growth, then were divided into blank control, solvent control and different concentrations (10- 100 μg/ml) of thalidomide incubated with or without basic fibroblast growth factor (bFGF). The cell proliferation was measured by MTT assay 72 h after stimulation. The expressions of vascular endothelial growth factor (VEGF) and tumor necrosis factor-α (TNF-α) were detected by ELISA and real-time PCR, respectively. Results The proliferation of endothelial cells of human umbilical vein was inhibited by thalidomide (≥40 μg/ml) both in presence or absence of bFGF. The expression of VEGF could be inhibited by 20 μg/ml of thalidomide in the absence of bFGF and 10 μg/ml in the presence of hFGF. No expression of TNF-α was detected. Conclusions The in vitro study reveals that thalidomide can inhibit the proliferation and the expression of VEGF, which may treat gastrointestinal bleeding of angiodysplasia by suppressing the angiogenesis.

The mechanisms of thalidomide in treatment of angiodysplasia due to hypoxia / 中华内科杂志

Objective To investigate the inhibitory effect of thalidomide on angiodysplasia.Methods Excisional intestinal specimens were collected and immunohistochemical examination was carried out.The human umbilical vein endothelial cells were cultured in vitro to exponential phase of growth,divided into six groups and synchronized for 24 hours.They were then stimulated with thalidomide (40-100 μg/ml) for 72 hours.MTT assay was used to assess cellular proliferation.ELISA,real-time quantitative PCB and western blot were applied to detect the expression of VEGF/HIF-1α of human umbilical vein endothelial cells (HUVEC).Results Immunohistochemical analysis of intestinal pathological specimens demonstrated higher expression of VEGF.ELISA showed that the expression of VEGF under hypoxia was obviously higher than that under normoxia [ ( 1199.3 ± 61.4) ng/L vs ( 864.7 ± 41.2 ) ng/L,P < 0.05 ].Real-time quantitative PCR and Western blot discovered that thalidomide inhibited the expression of VEGF/ HIF-1α of HUVEC (P < 0.05).The effect of thalidomide was dose-dependent.Conclusions Thalidomide can suppress the expression of HIF-1α and VEGF in HUVEC in vitro and then inhibit angiodysplasia,which may play a significant role in stopping the rebleeding in patients with recurrent gastrointestinal bleeding.

Efficacy of epidural autologus blood patch under X-ray guidance in patients with spontaneous intracranial hypotension / 中华麻醉学杂志

Six patients(3 male,3 female)aged 33-66 yr, Course of disease 6-35 days, diagnosed with spontaneous intracranial hypotemion in Sir Run Run Shaw Hospital from November 2007 to May 2008,Were treated with on epidural autologus blood patch trader X-ray guidance. According to the results of CT myelography. the puncture site Was chosen in the 1-2 vertebral interspaees below the site of a single eerebrospinal fluid leak. For patients with multiple cerebrospinal fluid leaks.the procedure was performed at the spinal cord segment of the most severe leak. The mixture of augous blood and Omnipaque(300g/100 ml)at a ratio of 2:1 was injected into the epidural space to cover the spinal cord segment of the leaks under C-arm fluoroscopic guidance.Side effects were recorded during and after the injection of autologus blood.The treatment was repeated one week later if the former one failed.One patient was treated with epidural blood patch 3 times.and the rest 5 patients were treated with epidural blood patch 1 time.During the injeetion of autologus blood,5 patients complained of pain in the purtclure site,2 experienced pain radiating to the upper limb,2 felt,numbness in the right leg and all of these syndromes could be self-relieved.No side effects were observed after the injection of autologus blood.All the patients were Cured and no recurrence was observed during a 2-6 month follow-up.

The therapeutic effect of thalidomide on gastrointestinal bleeding of angiodysplasia:an observational study / 中华消化杂志

Objective To observe and investigate the therapeutic effect of thalidomide on gastrointestinal bleeding of angiodysplasia.Methods Eighteen patients with recurrent gastrointestinal bleeding of angiodysplasia were treated with thalidomide 100 mg daily for 4 months.Median follow-up time was 16.7 months.The changes of clinical setting and serum.vascular endothelial growth factor(VEGF)and tumor necrosis faetor-α(TNF-α)level between pre-therapy and post-therapy were compared.Results The clinical setting of patients in post therapy was significantly better than that in pre-therapy.The overall symptom score,the median bleeding frequency and median transfusion volume of patients after therapy was significantly lower than those before the therapy[(15.000±3.630)vs(5.330±3.325),(11.220±6.404)vs(1.000±1.237),(1422.22±1556.601)ml vs(100.00±240.098)ml,respectively,all P＜0.01],while median hemoglobin was obviously higher than that before the therapy[(5.950±1.656)g/ml vs(9.533±2.278)g/ml,P＜0.01].Serum VEGF and TNF-α levels decreased obviously after the therapy(118 pg/ml vs 58 pg/ml,116 pg/ml vs 34 pg/ml,P＜0.01).Conclusions Thalidomide can suppress the serum VEGF and TNF-α levels of the patients with recurrent gastrointestinal bleeding of angiodysplasia,then play a significantly role in preventing the rebleeding in patients with recurrent gastrointestinal bleeding of angiodysplasia.

Mutations analysis in a pedigree with maternally inherited sensorineural hearing loss / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the mutations in a pedigree with maternally inherited sensorineural hearing loss, and to investigate whether 235delC heterozygote mutation in gap junction protein beta 2 (GJB2) gene modulates the severity of hearing loss associated with the A1555G mitochondrial mutation.</p><p><b>METHODS</b>The PCR products were digested with the Alw26 I restriction enzyme, followed by direct sequencing to detect the mitochondrial mutations in 72 members of a core pedigree of an extensive family with matrilineal nonsyndromic deafness; 235delC mutation of the GJB2 gene was screened in this family by using the Apa I restriction enzyme and direct sequencing.</p><p><b>RESULTS</b>The A1555G mutation of the mitochondrial DNA was present in all 27 members of maternal line, out of them, 21 members had phenotype of deafness (77.8%), with a high penetrance. Only three maternal line members of 72 members possessed 235delC heterozygote mutations, and the three had different phenotypes.</p><p><b>CONCLUSION</b>The A1555G homozygous mutation of mitochondrial DNA is the susceptive etiological factor of nonsyndromic deafness in this family, but in the study of this pedigree, the 235delC heterozygous mutation in GJB2 gene may not aggravate the symptoms of hearing loss associated with the A1555G mitochondrial mutation.</p>

Probing into the Effect and Countermeasures on Quality of Medical Students after University Combination / 中华医学教育探索杂志

Some problems were present with the universities combination,such as the relative scarcity of medical students and some students'lower enthusiasm for medicine.The university should establish policies to improve the quality of medical students,such as enlarging self-determination right to recruit medical students,strengthening the specialty thought of students.And further reformation and self-enhancement of medical college were more important for attracting excellent students.

On the Questions of Bilingual Teaching in Medicine in Comprehensive University / 中华医学教育探索杂志

Through the questionnaire on bilingual teaching in medical students,some problems were presented. This paper is intended to discuss the necessity and the present condition of bilingual teaching and find out some measures to improve bilingual teaching quality.

Effects of curcumin on the expressions of NR2A,NR2B and apoptotic neurons in hippocampus after ischemia-reperfusion in rats / 中国药理学通报

Aim To investigate the effect of curcumin on the expressions of NR2A, NR2B and apoptotic neurons in hippocampus after global brain ischemia-reperfusion in SD rats. Methods Global ischemic model induced by 4-vessel occlusion was adopted. Rats were randomly divided into 5 groups: sham group (SH), ischemia-reperfusion group (I/R), curcumin 30(Cur 30), 100 (Cur 100) and 300 mg?kg-1 group (Cur 300). At different time points after ischemia, animals were designated as subgroups 2 h, 6 h, 1 d, 3 d, 7 d. Cell morphology was observed on HE stain slides. The apoptotic neurons were detected in CA1 region by TUNEL method. Expressions of NR2A and NR2B in hippocampal CA1 and CA3/DG regions were detected by Immunohistochemical technique. Results At each time point the number of apoptotic neurons was much more in I/R group than that in SH group and Cur 100 group,and in Cur 300 group than that in Cur 100 group. The expression of NR2A was higher in the hippocampal CA1 and CA3/DG regions in Cur 100,Cur 300, Cur 30 and SH groups than that in I/R group at each time point(P