Objective To investigate the effect of tea polyphenols and sulforaphane on the expression of protein kinase A anchoring protein 95 and cyclin E2 in lung cancer tissue.Methods 56 cases confirmed by pathology and operation therapy for lung cancer patients,were randomly divided into combined treatment group and control group,each had 28 cases.The content of protein kinase A anchoring protein 95 and cell cycle protein E2 in all patients were determined with ELISA.The expression of protein kinase A anchoring protein 95,cyclin E2 and statistics of microvessel density(MVD) were detected by immunohistochemical SP method.The protein levels of protein kinase A anchoring protein 95 and cell cycle protein E2 protein were detected by Western Blot. Results The contents of protein kinase A anchoring protein 95 and cyclin E2 in control group were higher than that in combination group,the differences were statistically significant(P<0.01 ).Immunohistochemical SP results showed that protein kinase A anchoring protein 95 and cyclin E2 expression all had positive expression,and the MVD in control group was higher than combination group(P<0.01);Western Blot results showed that the expressions of protein kinase A anchoring protein 95 and cyclin E2 protein in control group were higher than combination group(P<0.01).Conclusion Protein kinase A anchoring protein 95 and cyclin E2 expressions are increased in both groups in lung cancer tissues,and they are positively correlated,negatively correlated with drug treatment,which can be used as the indexes of lung cancer evaluation.

Objective To investigate the effect of acute hypervolemic hemodilution(AHHD)on the onset and recovery of muscle relaxation induced by vecuronium.Methods Thirty-two ASA Ⅰ orⅡpatients undergoing elective surgery under general anesthesia were randomly divided into 2 groups(n=16 each):control group and AHHD group.A loading dose of vecuronium 0.1 mg/kg Was given at 10 min after AHHD following tracheal intubatiom The muscular relaxation was maintained at Tl/Tc 5% to 15% by supplement with intravenous vecuroninm.Blood samples were taken at various times during AHHD for chemical analysis.The onset and recovery time of muscular relaxation were recorded.Results Compared with control group ,Hct,Hb and the concentration of TP and Alb were decreased,and the onset and recovery time of vecuronium were shortened in group AHHD(P＜0.05).Conclusion Acute hypervolemic hemodihtion can shorten the onset and recovery of muscle relaxation of vecuronium in patients under general anethesia.

AlM: To observe the postoperative intraocular pressure ( lOP) and operation safety in the eyes of the neovascular glaucoma pateints treated by intraocular cyclophotocoagulation which needed vitrectomy at the same time.
METHODS: A total of 12 neovascular glaucoma cases ( 14 eyes ) secondary to diabetic retinopathy, retinal detachment surgery and trauma were reviewed in our study. This procedure mainly used intraocular photocoagulation catheter to highlight the ciliary processes until the ciliary became white atrophy or plosion after vitreous surgery treatment. The intraocular photocoagulation catheter was performed at a power of 300-500mW, for a duration of 0. 1-0. 2ms. Postoperative follow-up was at least for 6mo. The observation of 14 postoperative neovascular glaucoma was performed at 1wk, 1, 6mo observing the lOP and complications.
RESULTS:lOP of the 11 eyes was significantly declined and controlled in normal. After cyclophotocoagulation, average lOP at 1wk was 16. 7±14. 4mmHg, 15. 7±8. 8mmHg at 1mo and 12. 9±4. 5mmHg at 6mo, which compared with untreatment ( 39. 6 ± 10. 0mmHg ) was statistically significant different (P<0. 01). ln follow up time 3 cases were relapsed which were supplied with transscleral or endoscope cyclophotocoagulation. During the follow-up period no endophthalmitis and complications such as eyeball atrophy were found.
CONCLUSlON: The intraocular cyclophotocoagulation and vitrectomy simultaneously can deal with the primary disease and secondary neovascular glaucoma. The operation can be accurately performed under direct cyclophotocoagulation and it is a safe and effective way for neovascular glaucoma which needs vitreous surgery.

Objective To investigate the imaging features of pancreatic acinar cell carcinoma (PACC),and to assess the role of CT and MRI in the diagnosis of the disease.Methods CT and MRI data of 7 cases with PACC confirmed by surgery and pathology were reviewed retrospectively.Plan and dynamic contrast-enhanced CT were performed in 4 cases.MRI with T1 WI,T2 WI,and dy-namic contrast-enhanced series were performed in 3 cases.Results All of the PACC lesions were manifested as a single solitary mass.1 lesion was located in the pancreatic head,and the other 6 in the pancreatic body-tail.On plan CT,all of the 4 lesions ap-peared hypodense and 3 lesions had irregular more hypodense region in the lesions.On the contrast-enhanced CT,the tumor paren-chyma showed mild to moderate enhancement with non-enhanced hypodense region in the arterial phase,and lower enhancement than that of the surrounding normal pancreatic tissue in the portal and delayed phase.All of the 3 cases were heterogeneous hypointensity on T1 WI and hyperintensity on T2 WI.The manifestations of the tumors on contrast-enhanced MRI were similar with that on the contrast-enhanced CT.Dilation of the pancreatic duct was seen in 4 cases.Liver metastasis was seen in 1 case.Surrounding tissues were invaded in 4 cases.Conclusion CT and MRI can display the features of PACC and help to improve the diagnostic accuracy.

Objective To measure the renal cortex blood flow leVel in Patients with stage 3-4 chronic kidney disease, and to obserVe the effect of Probucol on renal cortex blood flow and renal function. Methods Twenty Patients with stage 3-4 chronic kidney disease in our hosPital were randomly diVided into treatment grouP ( 10 Patients ) and obserVation grouP ( 10 Patients). Ten healthy subjects were chosen as the control grouP. Dynamic sonograPhic tissue Perfusion measurement (DTPM) was used to eValuate the mean flow intensity (Imix),mean flow Velocity (Vmix) and tissue resistance index (TRI) in the three grouPs. Patients in the obserVation grouP were treated with standard theraPy;the treatment grouP was giVen Probucol 500 mg,twice daily in addition to standard theraPy for 6 months. The renal cortex blood flow leVel after treatment was measured in the treatment grouP and obserVation grouP. The serum BUN,SCr,TC,TG,LDL,HDL,hs_CRP,ox_LDL,PA,ALB before and after treatment were measured and comPared between the treatment grouP and obserVation grouP. Results Imix and Vmix were significantly lower,and TRI was significantly higher in the treatment grouP and obserVation grouP than in the control grouP (P<0. 01). After 6 months of treatment,Imix and Vmix in the treatment grouP were significantly increased and TRI significantly decreased as comPared with the baseline and the control grouP (P<0. 01). After treatment,Imix and Vmix were significantly decreased and TRI was significantly increased in the obserVation grouP (P<0. 05). In the treatment grouP,the serum BUN,SCr,TC,TG,LDL,hs_CRP and ox_LDL decreased and PA,ALB and HDL increased after treatment as comPared with the baseline and the obserVation grouP (P<0. 05 or P<0. 01). Conclusion The renal cortex blood flow leVel is significantly lower in Patients with stage 3-4 chronic kidney disease than in the healthy PeoPle. Probucol can imProVe the renal cortex blood flow leVel significantly,Protect the renal function, and imProVe microinflammatory state,nutrition status and dysliPidemia.

Objective To analyze the medium and long-term results of tricuspid valve replacement (TVR)and summarize the operative experience for tricuspid valve disease.Methods Clinical data of 27 patients with severe tricuspid valve disease from September 2005 to May 2010 were retrospectively reviewed.Biological valve prosthesis was replaced in 23 patients,while mechanical valve prosthesis was replaced in 4 patients.Accompanying procedures included mitral valve replacement in 8 cases,mitral valve replacement and aortic valve replacement in 4 cases,and repair of atrial septal defect in 4 cases.Results The operative mortality was 11.1％(3/27),among these patients,2 cases died of serious low cardiac output syndrome,1case died of muhiorgan failure on the 7th day after operation,1 case who underwent reoperation for hemorrhage postoperative was improved after treatment.During follow-up,1 patient died of biological valve prosthesis dysfuncion 3 years after operation,1 patient died of cerebral embolism 19 months after operation.Six cases were in New York Heart Association(NYHA)class Ⅰ,and 14 cases in NYHA class Ⅱ during the period of follow-up.Conclusions Because operative and follow-up mortality is high,TVR is the last selection for the treatment of tricuspid valve disease.Appropriate operative technique and perioperative therapy are the key for clinical success.For those older than 50 years,follow-up inconvenience and reproductive-age female patients,biological valve prosthesis should be recommended as a preferential choice.

Objective The aims of this study were to compare the clinical and laboratory responses to ursodeoxycholic acid (UDCA) monotherapy with the combination therapy of UDCA plus prednisolone/azathioprine in primary biliary cirrhosis(PBC),and to investigate the risk factors affecting the therapeutic responses.Methods Eighty-two patients with untreated PBC were divided randomly into three groups.Group U (28 patients) received UDCA alone,group UP(27 patients) received UDCA and pr ednisolone,while group UA (27 patients ) received UDCA and azathioprine.The clinical and laboratory data were recorded after treated for 3,6 and 12 months.Repeated measures ANOVA and COX regression model were used for statistical analysis.Results Fatigue and pruritus were improved only in group UP(P=0.015 and P=0.037 respectively).Alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),gamma-glutamyl transferase (GGT),total bilirubin (TBIL),direct bilirubin (DBIL) and IgM in the 3 groups were decreased (P＜0.05),while there was no statistical significant difference between the three groups (P＞0.05).The patients with disease progression had higher Mayo risk score (MRS) (P=0.018) and prolonged prothrombin time (PT)(P=0.042).In group UP,side-effect associated with glucocorticosteroids occurred in eight patients while there was no side-effect in group U.High baseline levels of ALP、GGT and CHO were risk factors for biochemical remission(P=0.015).The increase of DBIL,TBIL,total bile acid(TBA) and PT did not contribute to the prediction of biochemical remission ( P=0.075 ).Conclusion There are no differences among the three groups in the improvement of hepatic biochemical data and IgM.The combination therapy of UDCA with prednisolone could relieve fatigue and itching.The disease of patients with higher Mayo risk score and prolonged PT tend to progress.High baseline levels of ALP,GGT and CHO are risk factors for biochemical remission.High baseline levels of TBIL,DBIL,TBA and PT could not predict biochemical remission.The incidence of adverse effect is lowest when treated with UDCA alone.

Objective To explore and set up the nurse post ability of the leveling exam plan in a third-grade class-A hospital.Methods The entry of more than one year of nurses will participate in the examination of N1-N4 is divided into four levels.According to different levels to set up the post ability of the leveling exam plan,through the review and interview,evaluate its effects and satisfaction in a third-grade class-A hospital.Results After the post ability of the leveling exam plan,nurses of different levels get more satisfied with the score on the assessment form,specialized knowledge,the core system,emergency plan,communication skills,ability of operation and emergency disposal,which significantly higher than the traditional methods,there were statistical differences between two groups.(t value was as follows:1.46,2.13,1.98,2.57,2.69,1.87,P ＜ 0.05),but the difference of foundation knowledge was not obvious (P ＞ 0.05).The new program get higher scores of nurses in critical thinking,clinical care,ethical,legal practice and professional ability,results were significant differences (t value was as follows:2.18,2.01,1.46,2.78,P＜ 0.05),but the scores in scientific research ability,leadership,interpersonal relationship,education and consulting capacity was not significantly different (P ＞ 0.05).Conclusion It is concluded that nurses of different levels on the leveling exam plan get a higher satisfaction.Through the new program,to assess the level of nurses,effectively improve the capacity on critical thinking,clinical nursing,ethical standards,law practice and professional development.

ObjectiveTo investigate the effect of early induced finger function training on motor function and activities of daily living (ADL) of stroke patients.Methods60 stroke patients with hemiplegia were randomly divided into the early induced finger function training group (treatment group) and control group with 30 cases in each group. The patients of the control group were treated with routine rehabilitation; while those of the treatment group were added with training of early induced flexion and extension of fingers. All patients of two groups were assessed with Brunnstorm Scale, Fugl-Meyer Assessment, scores of Neurological Functional Deficit, and Modified Barthel Index before and 8～12 weeks after treatment.ResultsAfter treatment, upper limb motor function, hand function and fingers' fine function in the sick side of the patients in the treatment group improved significantly better than that in the control group ( P<0.05～0.01).ConclusionThe early induced finger function training can obviously improve the upper limb motor function and ADL of stroke patients.

Objective To summarize the results of valve re-operative cases after cardiac valve replacement, to find the better re-operative time, and to estimate the re-operative methods and influencing factors of the operation. Methods Thirteen valve re-operative cases after cardiac valve replacement from October 2008 to February 2010 were retrospectively studied. According to NYHA classification, 9 cases belonged to class Ⅳ, and only 4 cases belonged to class Ⅲ preoperatively. Mitral valve replacement (MVR)was performed in 7 cases, aortic valve replacement (AVR) in 3 cases, MVR + AVR in 3 cases. Results The early-stage postoperative mortality was 7.7%( 1/13),and the reason was low cardiac output syndrome. Two cases who underwent re-operation and re-intubation respectively after operation for hemorrhage were improved after treatment. Twelve cases were discharged in 3-6 weeks after heart valve surgery and all were followed up for 6-15 months. The cardiac function of all the discharged patients recovered well and no death occurred during follow-up. Conclusion The key factors to reduce the death of re-operation are improving preoperative heart function,setting up extracorporeal circulation as soon as possible,consummating myocardial preservation,perfecting operating skills,correcting low cardiac output syndrome in time and preventing complications.