Objective To understand the psychological experience of patients with malignant tu-mor of oral and maxillofaeial region surgery during early diagnosis and perioperative stage in order to supply reference for clinical staff to carry out psychological support. Methods 12 patients with malignant tumor of oral and maxillofacial region surgery participated in the in- depth interview, the data were analyzed, fin-ished and epurated. Results During the whole process of the early diagnosis and perioperative period,the patients showed negative psychological response, they had to bear significant psychological and financial burden as well as lack of social support. Conclusions Patients with malignant tumor of oral and maxillo-facial region surgery needed humanistic care and emotional support, nursing professionals should provide effective measures to release stress and improve negative emotions, make good use of social resources in or-der to assist them to get through the difficult course.

Objective Twelve cases with small advanced cole-rectal cancer less than 10 mm in diameter were examined. Methods The endoscopic findings and clinicopathologic data of 12 cases with advanced colorectal cancer less than 10 mm in diameter were compared with those larger than 10 mm in diameter. Results Approximated estimation of the macroscopic types were Ⅱ c in 5 cases, Ⅱ a in 3 cases, and I s in 4 cases respectively. As for the distribution of these lesions, there were 5 in sigmoid colon, 4 in transverse colon, 1 in cecum, and 2 in descending colon. No lesions were detected in rectum. Histologic grade at the deepest invasive portion was shown well, moderately, and poorly differentiated in 2, 8 and 1 case respectively and another case with mucinous adenocarcinomas. Lymphnode metastasis was present in 4 of 12 lesions (33% ). This incidence is rather high, as regards to the small size of each lesion. Endoscopi-cally, all lesions accompanied with converging folds and 7 lesions examined by magnifying colonoscope showed V N pit pattern. Conclusion These results indicated that the advanced colorectal cancers less than 10mm in diameter showing similar characteristics with those of superficial depressed type cancer with likely is the precurser of advanced cancer. The findings of converging folds and pit pattern are considered to be the useful indicators for estimating the depth 'of invasion.

Chlorogenic acid (5-CQA) is one of the major components in some Chinese herbal injections. However, the metabolism of 5-CQA in rats after intravenous injection has not been determined. An ultra-high performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF MS) method was applied to identify the metabolites in bile, urine, feces and plasma after a single intravenous administration of 10 mg x kg(-1) 5-CQA to rats. Using MSE and mass defect filter techniques, a total of 35 metabolites were detected in bile, urine, feces and plasma. The predominant metabolites in bile were glutathione conjugates of O-methyl-5-CQA, accounting for approximately 80% of the metabolites excreted in bile. The major components in urine were parent drug, O-methyl-5-CQA, hydrolyzed metabolites and glucuronide conjugates. The major components in feces were O-methyl-5-CQA and its cysteine conjugates. The major component in plasma was the parent drug. The urinary and fecal excretion pathways were equally important to 5-CQA in rats. These results demonstrate that 5-CQA undergoes extensively metabolism in rats and are highly reactive to nucleophiles such as GSH. This finding indicates that attention should be paid on the injections containing 5-CQA, which may covalently bind to proteins, leading to allergenic drug reactions.

Objective To review the experience of anomalous origin of the left coronary artery from the pulmonary artery.Methods 36 patients were admitted,17 males and 19 females,the median age was 9.5 months.12 were associated with severe mitral regurgitation,10 with left ventricular aneurysm,1 with patent ductus arteriosus,2 with patent foramen ovale.33 pa tients underwent surgical repair,of which 3 underwent left coronary artery (LCA) ligation,1 underwent mitral valve replacement,29 underwent reestablishment of a dual coronary system with direct aortic reimplantation of the left coronary artery into the aorta,incidental mitral valvoplasty in 7 patients,mitral valve replacement in 1,patent ductus arteriosus ligation in 1 and patent foramen ovale closure in 2.Results Two patients died in the hospital,one postoperative patient lost follow-up,one underwent LCA reimplantation suddenly died 3 days after discharged,one received coronary artery bypass graft 2 years after LCA ligation,the remainder were asymptomatic during a follow-up of 1 to 73 months.one of the patients who did not underwent surgical repair lost follow-up,when one suddenly died 2 months after discharged,the remained one was asymptomatic during a follow-up of 5 months.Conclusion Echocardiography combined with spiral CT angiography is a good method for ALCAPA diagnosis.Good surgical outcome of ALCAPA can be achieved by reestablishing a dual coronary system with direct aortic reimplantation of the left coronary artery into the aorta,and left ventricular dysfunction could be significantly improved.Incidental mitral valvoplasty may be helpful in early rehabilitation but poor in long-term prognosis.Left ventricular aneurysm could be improved so a incidental resection of left ventricular aneurysm was not suggested.

Objective To review the experience of surgical repair of aortic origin of pulmonary artery.Methods Fifteen patients underwent surgical correction for aortic origin of pulmonary artery.All of the patients had anomalous origin of right pulmonary artery,and 11 were associated with patent ductus arteriosus,6 with patent foramen ovale,3 with atrial septal defect,2with aortic pulmonic window,1 with ventricular septal defect,1 with interruption of aortic arch,1 with coarctation of aorta and 1 with pulmonary vein stenosis.All patients were associated with severe pulmonary hypertension.All patients were operated on with the implantation of the AORPA to the main pulmonary artery derectly.Results All 15 patients were cured and no died.1 lost follow-up and the other 14 were survivable during a follow-up 3 months to 81 months.one patient recepted pacemaker implantation 2 years after operation because of sinus arrest,no other patients required reoperation.Conclusion Echocardiography combined with spiral ct angiography is a good method for AOPA diagnosis.Good surgical outcome and low reoperation rate of aortic origin of pulmonary artery can be achieved by direct anastomosis.

Objective To compare negative expiratory pressure (NEP)technique with conventional test in detecting expiratory flow limitation (EFL)in chronic obstructive pulmonary diseases( COPD) patients. Methods EFL was measured with NEP technique and conventional method respectively in 72 COPD patients;EFL was measured with NEP technique in 20 COPD patients who failed to perform conventional test. Results EFL was detected in 54 of the 72 COPD patients. NEP test was successfully performed on the 20 patients, and 19 of them were found with EFL. The level of forced expired volume in one second percentage( FEV_1 % ) of the patients with 2-score group (46. 92 ± 12. 74) % and 3-score group (33. 35 ± 8.96)% were significantly lower than that of the 1-score group(63. 60 ±16.65)%. Area under curve of NEP technique and conventional test in ROC is 0. 903 and 0. 761 respectively. Conclusions As compared with conventional test, EFL detected with NEP technique is more reliable in evaluating dyspnea of COPD patients. It is simple and doesn't require any cooperation of the patients. NEP technique can be applied in COPD patients who fail to receive conventional test.

Objective To explore the difference in early symptoms between 2-3 years old autism spectrum disorder (ASD) children and healthy children through video analysis,in order to provide evidence for the identification and screening of ASD children.Methods The study involved 25 cases of ASD children who were admitted to Children Development and Behavior Center,the Third Affiliated Hospital,Sun Y at-Sen University,and confirmed with diagnosis standards of Diagnosis and Statistical Manual of Medical Disorder 5th edition (DSM-5) and 21 healthy children recruited in community.Three-minute videos of children in standard procedure were collected.Mter that,all the videos were scored on 5 items by 2 professional evaluators,unaware of diagnostic status.Comparison analysis of video scores between ASD and the healthy controls was made,and the sensitivity and specificity of video analysis were evaluated.Results Response to roll-call score was higher in ASD children [2 (2) scores] than that of the healthy children [0 (0) scores],response to audible object score was higher in ASD children [0(1) scores] than that of the healthy children [0(0) scores],social smiling score was higher in ASD children [1 (1) scores] than that of the healthy children [0 (1) scores],and total score was higher in ASD children [4 (2) scores] than that of the healthy children [2 (0) scores],and the differences were statistically significant (Z =2.272,P =0.000;Z =0.976,P =0.010;Z =1.763,P =0.001;Z =2.355,P =0.000).But,no difference was found in speech and finger pointing (all P ＞ 0.05).The consistency between three-minute video analysis and standard diagnosis was 0.652 (P =0.000),with 80.0％ of sensitivity and 85.7％ of specificity.Conclusions The ASD children perform worse than the healthy children in response to roll-call,response to audible object and social smiling.Three-minute standard video analysis can help to detect the early symptoms of ASD children.This result also demonstrates the potential of video-based analysis used as a ASD screening instrument in 2-3 years old children.

Objective To explore the current situation of knowledge,beliefs and behavior of elderly patients with COPD during their community-based rehabilitation.Methods Phenomenological research method of qualitative research was used,14 elderly patients with COPD during their community-based rehabilitation period received in-depth interviews.Results There were three themes and corresponding subthemes sublimated from the patients:self-management knowledge and skills,self-management beliefs and attitudes and self-management behavior.Conclusions It is necessary to pay close attention to spreading disease related health information,especially for patients with low health literacy.During the process of COPD self-management projects,we should focus on negative beliefs and negative attitudes on their selfmanagement behavior choice,which is as important as strengthening the patients' self-efficacy.

Background:Galectin-3 is a member of the galectin family that participates in a variety of physiological and pathological events including cell growth and apoptosis,cell adhesion,angiogenesis,as well as tumor invasion and metastasis,and has been reported to be overexpressed in many human cancers.Aims:To investigate the effect of galactin-3 targeted RNA interference on proliferation,apoptosis and chemosensitivity of human gastric cancer cell line SGC-7901. Methods:Galectin-3 targeted siRNA was constructed and transfected into SGC-7901 cells.Efficacy of RNA interference was evaluated by real time PCR and Western blotting,while cell proliferation was assessed by CCK-8 assay and cell apoptosis by flow cytometry.Results:The transfection efficiency at 24 hours after transfection was 83.8%;expression of galectin-3 in SGC-7901 cells was significantly inhibited at mRNA and protein levels with a decreasing of 87.8% and 90.4%,respectively (P <0.01).Proliferation inhibition rates of SGC-7901 cells in galectin-3 siRNA group at 24,48 and 72 hours after transfection were 15.57% ±1.45%,32.90% ±0.76% and 57.35% ±1.05%,respectively,and the apoptosis rate at 72 hours after transfection was 46.17% ±2.39%;all were significantly higher than those in blank control,liposome control and negative siRNA control groups at the same time points (P <0.01).Proliferation inhibition of SGC-7901 cells induced by oxaliplatin,a chemotherapeutic agent,was also markedly increased in galectin-3 siRNA group (P <0.01).Conclusions:Expression of galectin-3 in SGC-7901 cells can be inhibited successfully by RNA interference;cell proliferation is decreased,cell apoptosis is increased and sensitivity to chemotherapeutic agent is augmented,which indicates that galectin-3 is a promising target for gastric cancer gene therapy.

BACKGROUND: Stellate ganglion block (SGB) has become a technique frequently used in the field of pain management for its wide indication spectrum. Its ameliorative effect on cephal-facial pain may be achieved by regulating the cerebrovascular diastolic and systolic functions and intensifying cerebral perfusion.OBJECTIVE: To observe the influence of SGB on the blood velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) and vertebral artery with three-dimensional transcranial Doppler (TCD) in patients with caphal-facial diseases caused by is chemia or vascular spasm.DESIGN: A before-after control observation.SETTINGS: Department of Pain Management, Guizhou Provincial Orthopaedic Hospital; Department of Anesthesiology, the First Affiliated Hospital of Guangzhou Medical College; Department of Anesthesiology, the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Twenty patients of 18-50 years old were selected from the Department of Pain Management of Guizhou Provincial Orthopaedic Hospital from March 2004 to December 2005, including 6 cases of migraine,3 of cluster headache, 4 of muscle tension-type headache, 2 of nervous tinnitus and earache, and 5 of derangement of temporomandibular joint.METHODS: Unilateral SGB was performed by means of paratracheal anterior technique, with the following compound prescription: lidocaine (20 g/L)2.5 mL and dexamethasone 1 mg in normal saline with a total volume of 10 mL. SGB was performed once a day for 7 consecutive days as one course.MAIN OUTCOME MEASURES: The changes of blood velocity of ACA,MCA, PCA and vertebral artery were observed with three-dimensional TCD before SGB and at 30 minutes after SGB.RESULTS: All the 20 patients finished the treatment and entered the analysis of results. After treatment, the blood velocities of ACA, MCA and PCA of the blocked side were increased remarkably as compared with those before treatment [(76.20±3.83), (61.95±2.50) cm/s; (83.65±2.36),(77.55±2.69) em/s; (65.20±2.99), (58.70±2.2.35) cm/s; P ＜ 0.01], but that of vertebral artery had no significant change before and after treatment [(47.20±2.04), (45.55±2.23) cm/s, P ＞ 0.05]. CONCLUSION: The blood velocities of the blocked side are obviously increased after treatmeut, the increased blood velocities of ACA, MCA and PCA have important clinical significance for the blood supply of cerebral hemisphere, especially the anterior 2/3 part, but had little great influence on vertebral artery, indicating that SGB has great pertinence to the caphalfacial diseases caused by ischemia or vascular spasm, and can ameliorate the cerebral blood perfusion.