Objective To investigate the role of modified Seldinger technique combined with vascular ultrasonography in the placement of peripherally inserted central catheters (PICC) in patients with breast cancer undergoing postoperative chemotherapy.Methods Totally 120 patients with breast cancer undergoing postoperative chemotherapy were equally divided into the observation group and the control group using the table of random number.In the observation group,PICC were placed using the modified Seldinger technique combined with vascular ultrasonography; in the control group,the PICC were placed using the traditional blind puncture technique.The success rate of first puncture,success rate of first placement,and the incidences of mechanical phlebitis and thrombosis were compared between two groups.Results The success rate of first puncture,success rate of first placement,and the incidences of mechanical phlebitis were 91.67％,100％,and 3.33％,respectively,in the observation group and 76.67％,86.67％,and 45％,respectively,in the control group (P =0.0061,P =0.0434,and P ＜ 0.0001).However,no significant difference was found on the incidence of thrombosis between the two groups (P =0.1187).Conclusion Modified Seldinger technique combined with vascular ultrasonography is efficient and safe for PICC placement for patients with breast cancer undergoing postoperative chemotherapy.

Objective To establish the nonalcoholic fatty liver disease(NAFLD) model in SD rats and to investigate if endoplasmic reticulum stress(ERS) plays a role in the pathogenesis of NAFLD. Methods A total of 36 male SD rats were randomly divided into 4 groups: normal control group 1(N1,n=8), normal control group 2 (N2,n=8), model group 1(M1,n=10) and model group 2(M2,n=10). The two control groups were fed with normal diets, whereas the two model groups were provided diets enriched in fat (10% lard oil and 2% cholesterol). The rats in N1 and M1 groups were sacrificed at the 12th week, and those in N2 and M2 groups were sacrificed at the 20th week. The serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), alkaline phosphatase (ALP), total protein (TP), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) were measured. The steatosis, immflamation and fibrosis of the liver were observed with HE and Masson staining. The expressions of GRP78, CHOP and procaspase-12 mRNA were tested using real-time PCR and the activation of procaspase-12 protein was detected by Western blot. Results At the 12th week, the liver index and the serum levels of ALT, AST,ALP,TP,TC,LDL in M1 group were significantly higher than those in N1 group (P<0.01), but HDL level was significantly lower in M1 group than that in N1 group (P<0.01). At the 20th week, the concentrations of TC and LDL in M2 group were significantly increased in comparison with N2 group. The histochemical study revealed that the hepatic steatosis and inflammation in M1 and M2 groups were more serious than those in N1 and N2 goups(P<0.01). The slight fibrosis was seen in M2 group. At the 12th and 20th weeks, the expressions of GRP78,CHOP and procaspase-12 mRNA and protein in M1 and M2 groups did not differ in N1 and N2 groups. Conclusions The fat-rich diet might successfully induce NAFLD in rats and there is no ERS observed in the study, which suggests that ERS may not be involved in the pathogenesis of NAFLD.

Objective To evaluate the diagnostic value of quantitative tissue velocity imaging ( QTVI ) in the detection of right ventricle function in a rabbit model of pulmonary artery embolism .Methods Twenty-two healthy adult rabbits were used in this study .The animal models of acute pulmonary embolism were created by injecting gelatin sponge into the ear vein of rabbits .The changes of right ventricle function were dynamically observed at immediately , 1 week, and 3 weeks after the establishment of acute pulmonary embolims models .QTVI images of the 4-chamber view at cardiac apex were recorded and analyzed by off-line analysis.Results The VP was significantly reduced immediately after the models were built compared with the data before modeling in both the basal and middle segments , the TQ-S was prolonged , and Ve/Va>1 (P<0.05).The VP at1 week after modeling was not significantly decreased than the data before modeling in both the basal and middle segments , and the TQ-S was prolonged, but the Ve/Va ratio was <1 (P<0.05).At 3 weeks after modeling, the VPwas decreased compared with the data before modeling , and the Ve/Va ratio was <1 (P<0.05). The intra-group comparison showed that the V P of the basal segment of right ventricle free wall was enhanced than that of the middle segment (P<0.05), butTQ-S was not obviously prolonged in both the two segments .Conclusions Quantitative tissue velocity imaging can reflect the contraction and relaxation of right ventricle in rabbits precisely .It is a good method to evaluate the function of right ventricle in animal models of pulmonary artery embolism.

Objective:To explore the efficacy and safety of endoscopic esophageal varix ligation (EVL) combined with omeprazole and octreotide in the treatment of esophageal variceal bleeding.Methods:127 patients with cirrhosis complicated with esophageal variceal hemorrhage diagnosed and treated in our hospital from May 2014 to May 2016 were divided into the study group and the control group.The control group was treated with omeprazole and octreotide on the basis of conventional therapy,while the study group was treated with endoscopic esophageal variceal ligation (EVL) on the basis of control group.The clinical efficacy,hospitalization condition,incidence of adverse reactions and rebleeding rate after treatment of the two groups were analyzed.Results:All the patients in the study group were successfully operated.In the control group,10 patients showed hematemesis and melena,among which 1 patient wastreated with surgery.After treatment,the c lini cal effi cacy of the study group was superi or to the control group,and the di fference was stati sti cally significant (P＜0.05).During the treatment period,the hemostasis time,blood transfusion time,hospital stay and hospitalization expenses of the study gronp were significantly lower than those of the control group (P＜0.05).In the study group and the control group,10 cases and 7 cases respectively had nausea and vomiting,esophageal foreign body sensation,dizziness,palpitations,pain,bloating,increased facces frequency,fever and other adverse reactions,and the incidence of increased faeces frequency of control group was significantly higher than that of the study group (P＜0.05),but the incidence of other adverse reactions and the total incidence showed no significant difference between two groups (P＞0.05).The rate of rebl eeding was si gni fi cantly lower in the study group at 0.5,1,3,6 and 12 months after treatment than those in the control group(P＜0.05).Conclusion:Endoscopic ligation combined with omeprazole and octreotide was effective in the treatment of esophageal variceal bleeding,which could be effective,rapid hemostasis,reduce the hospital stay,hospitalization cost and rebleeding rate with high safety.

Objective To prepare and characterize specific monoclonal antibodies( McAbs) against the heavy chain of botulinum neurotoxin serotype A ( BoNT/AHc ) .Methods BALB/c mice were immunized with purified BoNT/AHc protein.After the fusion of mouse splenic cells with SP2/0 cells, hybridoma cell lines secreted McAbs against BoNT/AHc. The McAbs obtained were characterized by indirect ELISA, Western blotting and rapid isotypingassay before being used in ELISA to detect interaction sites in McAbs and BoNT/AHc preliminarily.Results Antigen protein BoNT/AHc of high purification was obtained.Four hybridoma cell lines secreting McAbs against BoNT/AHc were screened,named 1A4,3H3, 3H7 and 5H8,respectively.Their titers of McAbs were all above 3.0 ×103 .They were specifically combined with BoNT/AHc protein by Western blotting.The isotype of 1A4 and 3H7 was IgG1(Κ),that of 3H3 was IgM(Κ),and that of 5H8 was IgG2b(Κ).Additive ELISA showed that epitopes recognized by the four McAbs were close.ELISA analysis confirmed the interaction epitopes in McAbs and BoNT/AHc.Conclusion Monoclonal antibodies against BoNT/AHc are prepared and characterized,providing effective tools for studying the neutralizing antibody and antibody epitopes of BoNT/AHc.

Objective To investigate the relationship between clinical presentation and pathological characteristics in HBeAg negative chronic hepatitis B(CHB) patients with steatosis, and to find out the predictors of hepatic inflammation and fibrosis. Methods HgeAg negative CHB patients with (n=56) or without (n=60) steatosis confirmed clinically and pathologically were enrolled in the study. All patients were examined for fasting blood glucose(FBG), fasting insulin (FINS), triglyceride (TG), cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyhransferase (GGT), alkaline phosphatase (ALP) albumin (Alb), globulin(Glb), homeostatic model assessment of insulin resistance (HOMA-IR), HBV-DNA and body mass index(BMI). The association of above parameters with hepatic inflammation, fibrosis and fatty deposition were analyzed statistically. Results It was demonstrated that BMI, FBG, FINS, TG, TC, GGT, ALP , Glb and HOMA-IR were significantly higher in HBeAg negative CHB patients with steatosis than those without steatosis (P<0.05). Whereas the levels of HBV-DNA, Alb, ALT and AST were significantly lower in HBeAg negative CHB patients with steatosis compared with those without steatosis (P<0.05). The hepatic inflammation and fibrosis were aggravated in patients with steatosis. It was implicated that BMI,FBG, FINS, TG, TC, GGT and HOMA-IR(all P values 0.05) were significant predictors for hepatic steatosis, while ALT, AST, Glb and HBV-DNA(all P values <0.05) were significant predictors for hepatic inflammation. And the predictors for hepatic fibrosis were ALT, AST, Alb, Glb and HBV-DNA(all P values <0.05). Conclusions Hepatic steatosis is common in HBeAg negative CHB patients which is positively associated with parameters including BMI, FBG, FINS, TG, TC, GGT, ALP and HOMA-IR. Besides steatosis, the hepatic inflammation and fibrosis are also aggravated in these patients.

Objective To observe the shenqifuzheng injection (SFI) combined with PG therapy (gemcitabine and cisplatin) in patients with non-small cell lung cancer (NSCLC). Method 76 patients with NSCLC were selected from August 2011 to August 2013 and randomly divided into observation group and control group. Each group had 38 cases. The control group received gemcitabine and cisplatin, observation group were gave SFI on the basis of control group. The total efficiency, disease control rate, quality of life and incidence of adverse reactions were observed after treatment in each group. Results The total effective rate was 47.37%in observation group , 42.11%in control group, there was no significant difference between two groups. The disease control rate in observation group was 81.58%higher than 57.89%in control group, the difference was statistically significant (χ2=3.990, P<0.05). The improvement rate in quality of life was 60.53%in observation group better than 31.58%in the control group , the difference was statistically significant (χ2=5.296, P<0.05).The decrease incidence of white blood cell (χ2=4.491, P<0.05) and platelets (χ2=4.491, P<0.05) in observation group were significantly lower compared with the control group, while, there were no difference of liver damage and gastrointestinal reactions between two groups. Conclusion SFI is helpful to improve the efficacy of PG therapy in patients with NSCLC and relieve the side effects of chemotherapy.

Objective To investigate the expression of transforming growth factor β1,transforming growth factor beta receptor(TBR)Ⅰ,TβR Ⅱ,Smad4 and C-Jun in rats with nonalcoholic fatty liver disease(NAFLD)and to find out the mechanisms of liver fibrosis in patients with NAFLD.Methods A total of 18 male SD rats were randomly divided into normal control group(n=9)and model group(n=9).The rats in control group were fed with normal diet,and those in model group were fed with fat-rich diet(consisted of 10%lard oil+2%cholesterol).An rats were sacrificed at the 20th week.The levels of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were examined by RT-PCR.The expressions of TGFβ1 and Smad4 in liver tissue were detected by immunohistochemistry.The expression of C-Jun protein was detected by Western blotting.Results The NAFLD model was successfully established.The immunohistochemistry examination revealed that TGFβ1 and Smad4 were expressed weekly in control group,but strongly expressed in model group.RT-PCR showed that A values of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were 0.46±0.12,5.z4±2.70 and 3.35±1.95,respectively,in model group,which were higher than those in control group(0.21±0.09,1.36±0.77 and 0.52±0.19,all P values＜0.01).The Western blotting results demonstrated that the expression of C-Jun protein in model group(0.93±0.41)was higher than that in control group (0.32±0.25,P=0.001).Conclusion TGFβ1/Smad4 signal pathway might be involved in the development of hepatic fibrosis in NAFLD.Blocking TGFβ1/Smad4 signal pathway will be helpful in treatment of NAFLD.

OBJECTIVETo evaluate the influence of small-dose dexmedetomidine infusion on recovery of patients undergoing vertebral operation.

METHODSSixty ASA I-II patients undergoing vertebral operation were randomly divided into two groups (n=30). In group I, dexmedetomidine infusion was pumped at the rate of 0.5 µg·kg(-1)·h(-1) from tracheal intubation to incision suture, and in group II, 0.9%saline was pumped instead. The mean arterial pressure, heart rate, Riker Sedation-Agitation Scale and Ramesay sedation score were recorded at the time points of autonomous respiration (T1), eye opening (T2), extubation (T3), 1 min after extubation (T4), 10 min after extubation (T5), and 30 min after extubation (T6).

RESULTSThe recovery time of autonomous respiration and eye opening time in group I were significantly longer than those in group II, and the extubation time was significantly shorter in group I (P<0.05). Riker Sedation-Agitation Scale scores in group II were significantly higher than those in group I at T2 and T4, and Ramesay sedation scores in group I were significantly higher than those in group II at T1, T2 and T5 (P<0.05). The mean arterial pressure and heart rate at each time point was significantly lower in group I than in group II (P<0.05), especially at T3 and T4 (P<0.01). In both groups, the mean arterial pressure and heart rate at T3 and T4 were significantly higher than those at rest (P<0.05).

CONCLUSIONSSmall-dose dexmedetomidine infusion can reduce dysphoria and lower the risks during recovery from general anesthesia following vertebral operation.

Adult ; Aged ; Anesthesia Recovery Period ; Dexmedetomidine ; administration & dosage ; pharmacology ; Humans ; Middle Aged ; Spine ; surgery

OBJECTIVETo study the alteration of peripheral lymphocyte subsets in severe acute respiratory syndrome (SARS) patients and to help improve the early diagnosis of the disease.

METHODSAnti-coagulating blood samples from 98 SARS patients in the acute phase, 56 normal healthy blood donors, and from patients infected by HIV, CMV and EBV were collected. The T lymphocyte subsets were counted by flow cytometry using fluorescence-labeled specific monoclonal antibodies.

RESULTSA significant decrease was observed in all SARS patients in their peripheral CD4(+) and CD8(+) T lymphocyte absolute counts [256 (104) x 10(6)/L and 256 (117) x 10(6)/L, respectively], which were also lower than those of the patients infected with HIV, CMV and EBV. All patients infected with HIV, CMV and EBV had significantly higher CD8(+) T lymphocyte counts in comparison with normal controls.

CONCLUSIONSDecrease of both CD4(+) and CD8(+) T lymphocytes of patients is related to onset of SARS. T lymphocyte subset analysis would help improve the early diagnosis of the disease.

Adult ; CD4-Positive T-Lymphocytes ; cytology ; CD8-Positive T-Lymphocytes ; cytology ; Female ; Humans ; Leukocyte Count ; Male ; Severe Acute Respiratory Syndrome ; diagnosis