Objective To observe the outcomes of satellite ganglion block(SGB)via posterior edge of stcmoclcidomastoid approach.Methods SGB was performed in 2 400 patients,who wererandomly divided into two groups with l 200 cases each.The puncture of SGB in group SPA was via posterior edge of sternocleidomastoid approach and that in group TPA via traditional paratracheal approac}L The same local anesthetics was used in two groups.The success rate(Horner'S syndrome appearance)and complications were compared.Results The success rate was higher in group SPA than that in group TPA(97% VS.92%)(P<0.05).Repeated puncture was needed in 16 cases ingroup SPA,which were less than 98 cases in group TPA(P<0.05).Laryngeal nerve block wasoccurred in 24 cases in group SPA.which were less than 37 cases in group TPA(P<0.05).Conclusion Compared to the traditional paratracheal approach,SGB via posterior edge ofsternocleidomastoid approach has the advantages of clear positioning,easy puncture,higher success rate and less complications.

AIM: To investigate atypical protein kinase C(aPKC), extracellular signal regulated kinnase (ERK) regulating NF-E2-related factor 2 (NRF2)-?-gutamylcysteine synthetase (?-GCS) and the effect on lung of rats with chronic obstructive pulmonary disease (COPD). METHODS: The rat COPD model was established by intratracheal instillation of lipopolysaccharide twice and exposure to cigarette smoke daily. The ?-GCS activity was measured. The expression of ?-GCS mRNA in lung tissue was examined by in situ hybridization (ISH) and reverse transcription-polymerase chain reaction (RT-PCR). The protein expressions of p-aPKC?/?, p-ERK, NRF2 and ?-GCS in lung tissue were detected by immunohistochemistry (IH) and Western blotting, respectively. RESULTS: (1) The ?-GCS activity was higher in COPD group than that in control group. (2) The expression of ?-GCS mRNA in the COPD group was stronger than that in control group. ISH showed that the ?-GCS mRNA was expressed in alveolar epithelium and bronchiolar smooth muscle cell in the COPD group. (3) The protein expressions of p-aPKC, p-ERK, NRF2, ?-GCS were significantly higher than those in control group. IH showed that p-aPKC, p-ERK, NRF2, ?-GCS proteins were expressed in alveolar and bronchiolar epithelium in the COPD group. (4) There was a positive correlation between NRF2 and ?-GCS. ?-GCS mRNA, p-aPKC?/?, p-ERK were also positively correlated with NRF2. CONCLUSION: By upregulating the signal transduction of NRF2-?-GCS, the ERK and aPKC?/? may play an important role in the mechanism of COPD formation.

CD5 Antigens ; metabolism ; Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 14 ; Chromosomes, Human, Pair 18 ; Cyclin D1 ; metabolism ; Diagnosis, Differential ; Humans ; Ki-67 Antigen ; metabolism ; Lymphoma, B-Cell, Marginal Zone ; genetics ; metabolism ; pathology ; Lymphoma, Follicular ; genetics ; metabolism ; pathology ; radiotherapy ; Lymphoma, Mantle-Cell ; genetics ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Pseudolymphoma ; metabolism ; pathology ; Translocation, Genetic

Objective To understand the condition of anxiety and analyze the influencing factors related to anxiety among nurses working in department of infectious diseases.Methods 206 nurses from 6 third class hospitals in Wenzhou were selected by simple random sampling method.A survey was carried out by using the socio-demo-graphic information questionnaire,working conditions questionnaire,self-rating anxiety scale and social support rating scale.Results The SAS score among nurses ranged from 36 to 72 points,and the average score was (48.32 ± 12.06)points,which was higher than the norm SAS value(t=14.39,P<0.01).The percentage of anxiety was about 55.33%.The percentage of moderate and severe anxiety was 16.51%.The main factors related to the anxiety among nurses were age(t=11.34,P<0.01),working years(t=5.68,P<0.01),moonlit night shift(t=4.42,P<0.05), worrying about making mistakes(t=7.18,P<0.01),worrying about occupational exposure(t=19.93,P<0.01) and nursing management of much criticism(t=5.68,P<0.01).Conclusion The condition of anxiety was serious among nurses working in department of infectious diseases.Interventions should be taken to reduce the anxiety level among nurses.

Objective To research the effect of the Kiss-1 gene promoter methylation on the Kiss-1 gene expression in colorectal carcinoma tissue,and to analyze the relationship between the Kiss-1 gene methylation and the clinical pathological features of colorectal carcinoma and its clinical significance.Methods The Kiss-1 gene promotor region methylation,Kiss-1 gene mRNA and protein expressions were detected respectively by methylation-specific PCR, Real-time PCR and Western blotting method in 126 cases of colorectal carcinoma tissue and para-cacinoma normal colorectal tissue.Results The positive rate of Kiss-1 gene methylation in colorectal carcinoma tissue (83.33%)was significantly higher than that in normal tissue (30.16%)(P<0.05).In the cancer tissue,the expression levels of Kiss-1 gene mRNA and protein in Kiss-1 gene promoter methylation positive group was lower than that in Kiss-1 gene promoter methylation negative group (P < 0.05 ). The positive rate of Kiss-1 gene promoter methylation in T3+T4 stage group was higher than that in T1+T2 stage group (P<0.05),but the Kiss-1 gene mRNA and protein expression levels were lower than those in T1+T2 stage group (P<0.05).In the poorly and moderately differentiated group,the positive rate of Kiss-1 gene promoter methylation was higher than that in well differentiated group (P<0.05 ), but the mRNA expression level of Kiss-1 gene was lower than that in well differentiated group (P<0.05 ). In lymph node metastasis group, the positive rate of Kiss-1 gene promoter methylation was higher than that in lymph node negative group (P<0.05),but the mRNA and protein expression levels were lower than those in lymph node negative group (P<0.05 ). And the positive rate of Kiss-1 gene promoter methylation in distant metastasis group was higher than that in non-distant metastasis group (P<0.05), but the mRNA and protein expressions levels were lower than those in non-distant metastasis group (P<0.05). There were no significant associations between the positive rate of Kiss-1 gene promoter methylation and the gender, age,tumor location, and tumor diameter of the patients (P>0.05 ). Conclusion The Kiss-1 gene promoter methylation in colorectal carcinoma tissue is associated with the Kiss-1 gene expression level and the malignant characteristics of colorectal carcinoma;Kiss-1 gene promoter methylation may be used as a reference indicator for predicting the risk of metastasis of colorectal carcinoma.

Objective To determine the dose-response relationship of 0.2％ ropivacaine for ultrasoundguided stellate ganglion block (SGB).Methods Seventy-five ASA physical status [or Ⅱ patients with migraine,aged 23-55 yr,with body mass index of 22-28 kg/m2,scheduled for elective ultrasound-guided SGB,were randomly divided into R1-5 groups (n =15 each) using a random number table.In R1,R2,R3,R4 and R5 groups,the patients underwent ultrasound-guided SGB with 0.2％ ropivacaine 1,2,3,4 and 5 ml,respectively.A successful SGB block was confirmed by the onset of ptosis (Horner syndrome) on the injected side.Probit analysis was used to calculate the effective dose of 0.2 ％ ropivacaine in 50 ％ and 95 ％ of the patients (ED50 and ED95) and 95％ confidence interval (95％ CI).Results The ED50 of 0.2％ ropivacaine for ultrasound-guided SGB was 2.2 ml (95％CI 1.9-2.5 ml) and ED95 was 3.2 ml (95％CI 2.8-4.1 ml).Conclusion The ED50 and ED95 of 0.2％ ropivacaine for ultrasound-guided SGB are 2.2 and 3.2 ml,respectively.

Objective To investigate and analyze the health care seeking behavior,financial burden and relative factors of patients with rheumatic diseases in Fujian Province.Methods Patients diagnosed with rheumatic diseases were investigated in Fujian Provincial Hospital from December 2013 to February 2014,including demographic data,health care seeking behavior and financial burden.Relevant factors were analyzed by Logistic regression.Results ① In this study,474 patients were enrolled.The ratio of male to female was 1∶2.38.② At the onset of symptoms,51.9％(246 cases) of patients visited a doctor as soon as possible,and 36.1％(171 cases) of them went to hospital within a month after disease onset.③ 74.1％(351 cases) of patients could adhere to medication regimen prescribed by doctors,and the most common reason for stopping medication was symptoms relieved (33.3％,41 cases).④ 63.1％(299 cases) of patients learned about the knowledge of rheumatic diseases from hospitals and doctors.⑤ 34.2％(162 cases) of patients spent 1 000-5 000 yuan every month on treatment.⑥ Insurance type could affect the time of first visit to hospital (P=0.004),while income and cost of therapy might impact patients' compliance (P=0.013,P=0.004).Conclusion Most patients will go to hospital as soon as possible and adhere to treatment.Economic situation is the main factor influencing health care seeking behavior of patients with rheumatic diseases.

Objective The beam data is compared with those obtained from Monte Carlo (MC)simulation and measurement to investigate their feasibility and reliability for X-ray small fields.MethodsThe beam data,including the total scatter factor (Scp),percentage depth dose (PDD) was acquired byneasurement and calculation with the field size ranging from 0.5 cm × 0.5 cm to 10 cm x 10 cm.The resultswere compared and analyzed.Results All the data is most consistent for the fields size of ≥3.5 cmx 3.5cm,but they are obvious different for the fields size of ≤ 3.0 cm × 3.0 cm.The measurements seem toreliable using the chambers of CC04 and CC13 for the fields size of ≥2.0 cm x 2.0 cm.Conclusions It isdemonstrated that the accurate measurements and calculations of Scp and PDD can be obtained for the fieldssize of ≥2.0 cm ×2.0 cm,but they needed morc rcscarchcs for thc smaller fields.

Objective The clinical features of elderly patients with severe acute pancreatitis (SAP) were atypical and these patients were often misdiagnosed as having paralytic ileus. The clinical presentations of elderly patients with SAP whose first diagnosis as paralytic ileus were analyzed. Methods 18 patients of elderly SAP who were misdiagnosed as having paralytic ileus were included and the clinical data were compared with 58 elderly patients with SAP. Results Among the misdiagnosis group, the first symptom onset were fleus, abdominal distension, vomiting, constipation, abdominal pain, diarrhea for 5, 4, 3, 3, 2, 1 case, respectively. Among SAP group, the first symptoms onset were 2, 31, 9, 3, 11, 2 cases, respectively. For misdiagnosis group, 13 cases were correctly diagnosed by CT scan, 3 cases by ultrasound and 2 cases by serum amylase test. For SAP group, 32, 15, 11 cases were diagnosed by CT scan, ultrasound and serum amylase, respectively (P < 0.05). 4 and 13 patients died in misdiagnosis and SAP group, respectively; among these 13 patients, 10 were female and 3 were male. Conclusions The elderly patients with paralytic ileus should consider the possibility of SAP, and CT scan was valuable for correct diagnosis.

Objective To investigate the possible pathogenesis of the cognitive function in unilateral frontal bottom laceration by follow-up study in patients after one month of the onset. Methods MMSE, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Montreal Cognitive Assessment (MoCA), Wisconsin Card Sorting Test (WCST) scales were used to evaluate neurocognitie function in 42 patients after one month of onset of unilateral frontal bottom laceration and 45 normal controls. The wave amplitude and the latency of the endogenous composition N2, P3 of P300 were measured at the cognitive potential instrument. Level of AChE was determined by ELISA and active AChE was analyzed by the ration analyses. Stepwise multivariate regression analyzed the correlation of the overall cognitive function and the lever and active of AChE. Results The cognitive test scores in patients were significantly worse than those in normal controls. The ability of recite sentences, fluency of words, reading, understanding language,cognitive transfering decreases in the left frontal bottom laceration patients (Group A, 23 cases), while the ability of attention, action, organization, graphics depicting, abstract epitoming, logical thinking were all seriously impaired in the patients with right frontal bottom laceration (Group B, 19 cases). The latency of the endogenous composition N2, P3 in patients ( Group A: (322. 4 ± 17.0), (410. 1 ± 19.9) ms; Group B:( 308.4 ± 15.6), (385.5 ± 17.4) ms) is more lengthen ( F = 4. 084, P = 0. 018; F = 3.467, P = 0. 038 )than the normal controls ( (268.6 ± 14. 7 ), ( 369. 2 ± 15. 4 ) ms) and the wave amplitude is lower ( F =2. 986 ,P =0. 047 ;F =3. 313 ,P =0. 041 ). The latency of N2 ,P3 in Group A of is more lengthen than Group B, while the wave amplitude is higher. The difference of the active of AChE in patients and control groups had no statistical significance, however, the level of AChE in two groups had statistical significance. The comparison of the active and the total AChE in patients has also not statistical significance. The correlation of the overall cognitive function has the linear regression with the parts of the brain and the level of AChE ( rY1.2 = 0. 584, P = 0. 039; rY2.1 = 0. 726, P = 0. 017 ). The standardized regression coefficients showed the level of AChE has the biggest influence to the overall cognitive function ( |Beta| =0. 3601, rY2.1 =0. 726).Conclusions AChE may be one of the important factors in the cognitive function after frontal bottom laceration. The specific damages of cognitive function in unilateral frontal bottom laceration patients closely relate with the lesion locations in the injured frontal bottom laceration.