The study on indocyanine green excretion test to predict mild hepatic encephalopathy / 中国实用护理杂志

Objective:To explore whether the 15-minute retention rate (R15) of indocyanine green (ICG) in the indocyanine green excretion test and the effective hepatic blood flow (EHBF) can predict the occurrence of mild hepatic encephalopathy (MHE).Methods:Using the convenience sampling method, we collected clinic data from 153 patients diagnosed with liver cirrhosis or liver failure from June 2019 to December 2019 in the Third Affiliated Hospital of Sun Yet-sen University in Guangzhou. We screened the MHE patients with the number connect test-A and the digital symbol test, and analyzed the clinical data. By taking different values for R15 and EHBF as cut-off points, the significance of the two factors in predicting MHE is explored respectively.Results:The incidence of MHE was 38.56% (59/153). Single factor analysis showed that the difference of Child-Pugh grade between the MHE group and the non-MHE group was statistically significant ( χ2 value was 7.606, P<0.05), while the differences between cirrhosis and liver failure diagnosis, fasting blood glucose, and serum creatinine were not statistically significant ( P>0.05). When most points between 0.11 and 0.61 were selected as normal and abnormal cut-off points of R15, R15 had statistical significance ( P<0.05) and when R15 selected 0.18, it was most significant (Fisher exact test P=0.00024). When most points between 0.08 and 0.76 were selected as normal abnormal cut-off points of EHBF, EHBF had statistical significance ( P<0.05) and when EHBF selected 0.25, it was most significant (Fisher exact test P=0.00022). Through Logistic stepwise regression analysis, the risk factors for MHE were R15 and EHBF. The ROC curve was used to illustrate the predictive effects of two factors on MHE. Conclusions:The incidence of MHE in patients with cirrhosis or liver failure is high. When R15≥0.18 or EHBF≤0.25 L/min, R15 and EHBF in indocyanine green excretion test can better predict the occurrence of MHE than Child-Pugh classification, and can be help to evaluate and manage patients in time.

Research progress on the relationship between TET1 and tumor invasion and metastasis / 国际外科学杂志

TET1 has been discovered capable of promoting DNA demethylation by mediating 5-methylcytosine to inhibit the genesis and development of cancer.Epithelial-Mesenchymal transition is a complex cellular program in cancer progression and metastasis,whose hallmark is loss of cell polarity and cell adhesion and acquirement of migration and invasion abilities,leading tumor cells into blood vessel and lymphatic vessels to form new metastatic lesions.Epigenetics plays a vital role in epithelial-mesenchymal transition.This review focuses on the relationship of TET1,epigenetics and epithelial-mesenchymall transition,and the research progression of TET1's role in cancer invasion and metastasis.

Qualitative research on experiential teaching in the core midwifery curriculum / 中国实用护理杂志

Objective To understand the practice of experiential teaching in the core midwifery curriculum. Methods Phenomenology as a qualitative research method was utilized and fifteen students participated in the non-structured interviews. Results Four themes were found: comprehension of knowledge;professional thought; teacher- student relationship;gratitude. Conclusions Experiential teaching can increase the teaching effect of core midwifery curriculum, and develop good ideological and professional qualities.

The effect of flupentixol and melitracen tablets combined with Yueju pills in the treatment of functional gas-trointestinal disorders / 中国基层医药

Objective To observe the effect of flupentixol and melitracen tablets combined with Yueju pills in the treatment of functional gastrointestinal disorders ( FGID) .Methods According to the digital table ,308 patients with FGID were selected and randomly divided into 4 groups,77 cases in each group.The control group were given conventional treatment .The treatment group was divided into 3 groups:group 1:flupentixol and melitracen tablets was added on the basis of routine therapy;group 2:Yueju pills was added on the basis of routine therapy;group 3:patients in this group used conventional treatment combined with flupentixol and melitracen tablets and Yueju pills .The period of treatment was 6 week,then their clinical symptoms were compared .Results The effective rate in group 1,2,3 was 79.2%,62.3%,94.8%,respectively,which was significantly higher than 19.4% in the control group(χ2 =54.96, 29.24,89.18,all P<0.05);while compared each treatment group ,the total effective rate in group 3 was obviously higher than that in group 1 ang group 2(χ2 =8.27,24.08,all P<0.05),and the total effective rate in group 1 was higher than that in group 1(χ2 =4.09,P<0.05).Conclusion Flupentixol and melitracen tablets combined with Yueju pills are more effective for treating functional gastrointestinal disorders than that of single drugusing .

Correlation of serum cyclophilin A level with occurance of essential hypertension in Xinjiang Xibo and Mongolia populations and its clinical significance / 天津医药

Objective To investigate the correlation of cyclophilin A (CyPA) level in patients with essential hyperten?sion(EH)in Xinjiang Xibo and Mongolia populations and to investigate its clinical significance. Methods EH patients (n=76) and healthy control subjects (n=62) were selected from Xinjiang Xibo populations. On the other hand, EH patients (n=66)and healthy control subjects (n=57) were selected from Xinjiang Mongolia populations. Serum cyclophilin A was measured using enzyme-linked immunosorbent assay(ELISA). Parameters such as age, body mass index(BMI), waist, waist hip ratio, blood pressure were measured in each group. The correlation of cyclophilin A with each parameter was analyzed. Results The levels of serum cyclophilin A in EH patients in Xinjiang Xibo and Xinjiang Mongolia populations were significantly high?er than those in their corresponding healthy control groups(P<0.05). Serum cyclophilin A in patients with essential hyperten?sion(EH)in Xinjiang Mongolia population was signifantly higher than that in EH patients from Xinjiang Xibo population (P<0.05). There was a positive correlation between serum cyclophilin A level and occurance of EH in both Xinjiang Xibo and Xinjiang Mongolia populations. Conclusion The serum cyclophilin A is significant higher in EH patients in both Xinji?ang Xibo and Xinjiang Mongolia populations so it is positively correlated with occurance of EH (P<0.05). Cyclophilin A lev?el is a risk factor of essential hypertension in both Xinjiang Xibo and Xinjiang Mongolia populations.

Application of fiberoptic bronchoscopic-assisted nasotracheal intubation under awake induction with dexmedetomidine in ankylosing spondylitis patients / 中华全科医师杂志

A total of 60 ankylosing spondylitis patients scheduled for elective surgery with anticipated difficult airway were enrolled and randomly assigned into either dexmedetomidine (D) or midazolam plus sufentanil (MF) group.Group D:topical nasal anesthesia and a loading dose of dexmedetomidine at 1.0 μg/kg in 10 min; group MF:intravenous infusion of 0.05 mg/kg midazolam plus 3 μg/kg sufentanil.Fiberoptic bronchoscopic (FOB)-assisted awake nasotracheal intubation was performed.Mean arterial pressure (MAP),heart rate (HR),Pulse oxygen saturation (SpO2),Ramsay score and success rate of intubation were recorded and compared between two groups.The intubation conditions and level of comfort were also evaluated.MAP and HR of group D at FOB through postnaris (T1),peep the epiglottis(T2),intubation success immediately(T3)and 1 min after intubation(T4) were significantly lower (P ＜ 0.05 or P ＜ 0.01) than those of group MF while Ramsay sedation scores were obviously higher (P ＜ 0.05) than those of group MF.Group D with endotracheal intubation comfort level 5 score of grade 1-2 were 8 and 14 cases and were significantly higher than 4 and 10 cases of group MF.Immediately after intubation,level 3 scores in grade 1 of group D (n =21) were significantly higher than group MF (n =12) ; initial success rate of intubation in group D was obviously higher than that in group MF (70％,n =21 vs.47％,n =14).And the incidence of unpleasant intubation memory in group D was lower than that in group MF (37％,n =11 vs.67％,n =20).Fiberoptic bronchoscopic-assisted nasotracheal intubation offers better conditions for intubation and reduces the incidence rate of intraoperative awareness.

Correlation between the level of Ca2+/calmodulin-dependent protein kinases IV and essential hypertension in Shihezi community / 实用医学杂志

Objective To study the correlation between the level of CaMKIV and essential hypertension (EH) in Shihezi community. Methods One hundred and forty-six patients with EH and 142 with normal blood pressure are enrolled from 15 communities in shihezi. We collected the clinical data, including blood pressure, body mass index, waist circumference, blood lipids. The serum level of CaMKIV was detected using an enzyme linked immunosorbent assay. Results The serum level of CaMKIV in the EH group was significantly lower than that in the normal blood pressure group (P < 0.05). The serum CaMKIV was negatively correlated with systolic BP and diastolic BP (r = -0.304, -0.452, all P < 0.05), with more obvious correlation with patients whose diastolic blood pressure was over 100 mmHg (r = -0.571, P < 0.05). Conclusions The serum level of CaMKIV is negatively correlated with EH, which is an independent factor of EH.

Discussion on management of medical equipment measuring instruments / 中国医学装备

Objective:To enhance hospital equipment information management standards for the purpose of measurement instruments.Methods:Using solutions based on Web technology, database technology, database through the establishment of measurement devices, implement life cycle management method.Results: To solve the many hospital only attach importance to the management of medical equipment, ignore the metering device management, lead to measuring instruments record disorder, query the inconvenience problem.Conclusion: Medical device measurement equipment management system improves the ability of the hospital information management, strengthens the efficiency of communication and exchanges of various departments and produces good economic and social benefits.

Progress in the development of metabolic and breast cancer / 国际外科学杂志

With the social development,the number of obese people is increasing.Recent studies have shown that obese women to have breast cancer disease's risk is higher than normal body weight,and etabolic disorders growing threat to human health.Estrogen,aromatase have contributed to the occurrence and development of breast cancer after menopause.AMPK is a negative regulator of aromatase,it can inhibit proliferation of cancer cells by metabolic pathways.What's more metformin,resveratrol inhibited proliferation by this route has been confirmed in breast cancer cells.Here,the author do an overview of the role of obesity-related factor for postmenopausal breast tissue estrogen synthesis and metabolic abnormalities affect aromatase expression in breast.

Role of p21 and p27 in carcinogenesis and drug resistance / 国际外科学杂志

Human cancers arise from an imbalance of cell growth and cell death.Critical factors that control the balance are those regulate the cell cycle.Several molecular effectors have been identified to be able to regulate specific phases of the cell cycle,including cyclins,cyclin-dependent kinases (CDKs) and CDK inhibitors.Notably,deficiency of two G1-checkpoint CDK inhibitors-p21 (CDKN1A) and p27 (CDKN1B)-has been implicated to be correlated with initiation or progression of many human malignancies or cancer cells drug-resistance.However,contradict reports also suggested that p21 and p27 could promote tumor progression.Here,we summarized the historic and recent studies on these two CDK inhibitors,including their identification as well as their roles in carcinogenesis and drug resistance.

Progress of versican in the occurrence and development of neoplasms / 国际外科学杂志

Versican comes from fibroblasts and belongs to chondroitin sulfate proteoglycan.It distributes in various tissues.The versican have functions including regulate cell growth and differentiation,promote cell proliferation,invasion and metastasis,and stimulate angiogenesis.Experiments have confirmed that the expression of versican is involved in various cancers.Here,the author do an overview of versican in the occurrence and development of breast cancer,liver cancer and chondrosarcoma aimed to further explore the pathogenesis of tumors.

Research on epidermal growth factor receptor in breast cancer / 国际外科学杂志

Decades researches of molecular oncology have found some moleculars which can promote tumor growth and help cancer surrive.This brings new hope for the treatment of tumors.Epidermal growth factor receptor (EGFR) is the first important molecular to inhibit tumor growth.Fifty percent triple negative breast cancer (TNBC) and inflammatory breast cancer (IBC) overexpress EGFR.EGFR and its downstream pathway can regulate epithelial-mesenchymal transition,promote tumor cell migration.EGFR therapy can improve the chemosensitivity of TNBC cells,apoptotic signal transduction occur.These studies suggest that the EGFR targeted therapy may have an important role in the treatment of TNBC and IBC.

Feasibility of induction with sevoflurane-midazolam-remifentanil for tracheal intubation without muscle relaxants in patients with huge mediastinal tumor / 中华麻醉学杂志

Objective To evaluate the feasibility of induction with sevoflurane-midaaolam-remifentanil for tracheal intubation without muscle relaxants in patients with huge mediastinal tumor.Methods Twenty-two ASA Ⅰ-Ⅲ patients with huge mediastinal tumor,aged 22-64 yr,weighing 48-76 kg,scheduled for surgery under general anesthesia,were enrolled in this study.Anesthesia was induced with iv injection of midaaolam 0.03 mg/kg and inhalation of 8％ sevoflurane through a mask.Sevoflurane was inhaled at the initial concentration of 8％,followed by decrement of 2％ every 30 s until 4％.When the eyelash reflex disappeared,remifentani1 2 μ g/kg was injected slowly over I min and sevoflurane inhalation was stopped 30 s later.The patients were mechanically ventilated after tracheal intubation.MAP and HR were recorded before induction and immediately before and 1 min after inlubation.The time of disappearance of eyelash reflex was recorded.The inlubation condition was evaluated using VibyMogensen score.Results The time period from sevoflurane inhalation to disappearance of eyelash reflex was(110 ± 14)s.The success rate of tracheal intubation at the first attempt was 86％.The position of the glottis was higher in 2 patients,and tracheal intubation was successfully performed under the guide of fiberoptic bronchoscope.The satisfactory intubation conditions were found in 86％ of cases.Compared with that before anesthesia induclion,MAP and HR were significantly decreased immediately after intubation and at 1 min after intubation(P ＜ 0.05).SpO2 ＞ 95％ in all patients.BIS was maintained at 45-55 during the period(before intubation until 1 min after intubation).Conclusion Induction with sevoflurane-midazolam-remifenlail is rapid and smooth,provides good conditions for intubation and can be applied to tracheal intubation without muscle relaxants in patients with huge mediastinal tumor.

Feasibility of induction with sevoflurane-midazolam-remifentanil for tracheal intubation without muscle relaxants in neck brake patients / 中华麻醉学杂志

Objective To evaluate the feasibility of induction with sevoflurane-midazolam-remifentail for tracheal intubation without muscle relaxants in neck brake patients.Methods Forty ASA Ⅰ or Ⅱ patients with cervical spine fracture with dislocation,aged 13-68 yr,scheduled for surgery under general anesthesia,were enrolled in this study.Anesthesia was induced with iv injection of midazolam 0.03 mg/kg and inhalation of 5%sevoflurane through a mask.Sevoflurane was inhaled at the initial concentration of 5%,followed by decrement of 1% every 30 s until 3%.When the eyelash reflex disappeared,remifentanil 2 μg/kg was injected slowly over 45s and 30 s later sevoflurane inhalation was stopped.The patients were mechanically ventilated after tracheal intubation.The time of disappearance of eyelash reflex was recorded.The intubation condition was evaluated using VibyMogensen score.Results All patients were successfully intubated at the first attempt.The time period from sevoflurane inhalation to disappearance of eyslash reflex was(69 ± 4)s.Coughing occurred in 3 cases during intubation.The satisfactory intubation conditions were found in 100% of cases.SpO2 ＞ 95% in all patients.BlS was maintained at 45-55 during the period(before intubation until 3 min after intubation).Conclusion Induction with sevoflurane-midazolam-remifentail is rapid and smooth,provides good conditions for intubation and can be applied to tracheal intubation without muscle relaxants in neck brake patients.

Algorithm of non-standard video transformation based on FPGA / 医疗卫生装备

Objective To study a kind of video transformation algorithm based on FPGA in view of the present situation that the video output of X-ray equipment can not be connected to common video adapter.Methods Through the control of non-standard video signal AD sampling data read-write succession in FIFO,800 digital sampling data was output(output resolution:800?600,refresh rate:60Hz)in the period of every line of effective signal.The output module combined these data with line and field synchronized signal and transform them into standard VGA signal.Results Non-standard medical video signal could be transformed into standard medical video signal by using VHDL in normal FPGA.Conclusion The speed of this algorithm is high,and the transformation effect is clear and smooth.

Clinical and pathological analysis in one case of antiepileptic drug hypersensitivity syndrome / 重庆医科大学学报

Objective: To discuss the clinical features,diagnosis,pathogenesis and treatment of antiepileptic drug hypersensitivity syndrome(AHS).Methods: A retrospective analysis of one case of AHS was focused on his clinical data.Results: About six weeks after carbamazepine treatment the patient presented fever firstly.The highest temperature is up to 39.6℃.Subsequently he developed diffusible red maculopapular rash and swollen superficial lymph nodes.Physical examination found internal organs involvement(mainly liver and lung).Laboratory examinations showed that the leucocyte increased to 54.21?109/L,and the percentage and absolute count of eosinophil rose,while IgG and IgM decreased.The CT of thoracic part showed the lymph nodes of hilum of lung and mediastina swelled together with pleural effusion.A biopsy study of lymph node suggested the reactive hyperplasia which was not equal to lymphoma.The bone marrow smear showed granulocytic cell line hyperplasia and abnormal lymphocyte were observed.After discontinuing carbamazepine in time and applying corticosteroids,the temperature descended rapidly and the swollen lymph nodes recovered soon.Conclusion: AHS is an idiosyncratic reaction.It usually occurs within 2 to 8 weeks after initiation of antiepileptic drug therapy,and typically manifests itself as fever,eruption and internal organ involvements.Pathogenesis is still not definite.Important basis for diagnosis and differential diagnosis depends on clinical manifestations and laboratory examinations.Early recognition of AHS and timely discontinuing of the suspected drugs are the essential therapy.

Investigation in the types of gliding contusion of brain in 132 cases and on its mechanism with site of force / 中国法医学杂志

Objective To investigate the relationship between the type of gliding contusion and its mechanism with site of force.Methods The site undergoing contusion and ways of force are respectively determined by skull anatomy location and details of these cases.Then,the 132 specimens of brain,which have been fixed by formalin,are sliced in coronal section and sagittal section and stained with HE,observed under microscope.ResultsGliding brain contusion could appeared at the top and bottom region of brain respectively.Top-injury type,were observed in 65 cases(49.24%),base-injury type,were found in 38 cases(28.78%).There were 29 cases(21.96%) in which contusion could be found at both top and base of brain,we called mixed type.We found that the injury area depend on the ways of force-act:the top-injury type mostly caused by the force on cupular part of pars zygomatica in acceleration,the base-injury type mainly caused by the force on occipitalia in deceleration and the mixed type caused by the force on the boundry of the calvaria and occipital in deceleration.Conclusion The type of gliding contusion is relevant with mechanism and site of force.