Objective To explore the feasibility of microinvasive technique in high level malignantesophageal obstruction and to provide the palliative therapy that can't be dredged by traditional methods. Methods There were 39 patients suffered from high level esophageal obstruction,involving the segments from esophageal circular pharynx to 12mm below. Tube-reticular nitinol metal stents woven by single thread were placed in orally to dredge the esophagus under fluoroscopic guidance after repeated tolerant expanding performance through expandable catheter. Interventional chemical therapy were administrated through blood-supply vessels. Results Thirty nine patients were grafted with 46 high level esophageal stents. 34 patients accepted 156 times of interventional chemical therapy. All patients restored with fine residue diet without showing side-effects except slight pain and tolerant uncomfortable feeling. The survival rate of the patients with both interventional chemical therapy and stents was longer than those with stent therapy alone. Conclusion Cervical high level segment of esophagus shouldn't be the restricted zone in the management of inner-stents. Interventional chemical therapy showed tumor-inhibiting effect in the cervical malignant diseases.

Aim To investigate the gender differences in electrophysiology and neuroanatomy of myelinated and unmyelinated visceral and baroreceptor afferent neurons(VANs and ABNs) of adult rats.Methods VANs and ABNs were isolated enzymatically and Vagus-nodose slice preparation was also applied in this study.For identification of ABNs,aortic depressor nerve(ADN) was labeled using fluorescent dye.Whole-cell patch technique was used to record action potential(AP).Electronic microscopy was selected for morphological analysis of ADN.Results(1) A-and C-type VANs were identified and significant differences of AP discharge profiles between female and male were not established;(2) except for the traditionally classified A-and C-types,myelinated Ah-type VGNs were also identified with faster conduction velocity,lower firing threshold,and higher neuronal excitability.Importantly,these Ah-types were found in female rats with a similar frequency like A-types but rarely seen in males.(3) Ah-type ABNs were also identified by fluorescence.(4) Morphological data showed that myelinated fiber in ADN was ~25% of total and this result was consistent with our electrophysiological data.(5) Firing frequency of Ah-types(20~40 Hz) was lowered than that of A-types(40~150 Hz,P

Objective To investigate the necessity of primary neurorrhaphy (direct end-to-end anastomosis) when the recurrent laryngeal nerve(RLN) is severed during thyroid surgery.Methods 15 patients who suffered from iaotmgenic unilateral complete RLN injury or whose unilateral RLN had to be sacrificed because of disease invasion had a primary repair of RLN by direct end-to-end anastomosis.In control group,26 patients who did not have a nerve repair were enrolled into this study.Subjective evaluation of aspiration and voice quality were based on patient reports and hearer reports for all patients.9 patients with neurorrhaphy and 12 patients without nerve repair were followed with videolaryngoscopic examination.Results 14 patients undergoing neurorrhaphy restored normal voice at 2-5 months postoperatively.Although there were no significant functional motion of the vocal fold,slight adductory movement of the affected arytenoid was found with good tension vocal cords and symmetric arytenoids of the glottis during phonation.Only 2 patients without nerve repair had nearly restored normal voice.The patients with hoarseness had stiff arytenoids and atrophic folds resulting in glottal gap.Conclusions Neurorrhaphy is a simple and effective method to restore the normal aspiration and voice quality of patients with unilateral complete recurrent laryngeal nerve injuries.

Objective:To investigate the level of rumination and its influential factors among Chinese psychiatry nurses who go through work place violence.Methods:In this study, 150 psychiatry nurses were recruited from Affiliated Brain Hospital of Guangzhou Medical University (specialize in psychiatry), via the combination of convenient sampling and snowball sampling. Chinese Event-related Rumination Inventory (C-ERRI) was applied in the survey.Results:The total score of C-ERRI was (22.11±9.62) points, and the scores of intrusive rumination subscale and deliberate rumination subscale were (12.99±5.58) and (9.12±6.01) points, respectively. Multiple Linear Regression Analysis show that assault frequency in recent year ( B=-3.195, P<0.01) and whether got injury in the recent assault ( B=8.591, P<0.01) were predictors of deliberate rumination, which account for 26.8% variance of the equation. Gender (male) ( B=-2.415, P<0.01), Injury frequency in recent year ( B=2.864, P<0.01) and whether got injury in the recent assault ( B=8.949, P<0.01) were predictors of intrusive rumination. They account for 36.0% variance of the equation. Conclusion:In this study, the level of rumination among Chinese psychiatry nurses was low. Their rumination style was deliberate rumination.

ObjectiveTo explore the best practice and normalization of arterial blood collection by comparing performance of BD preset syringe with regular syringes in arterial blood collection in standardized nursing process. MethodsThe nurses were trained to use BD preset syringe and regular syringes to collect arterial blood sample.Five hundred subjects were randomly divided into the preset syringe group and the regular syringes group,250 subjects in each.Agglutination of blood samples was observed.Time spent in every step of collections was recorded for 23 subjects in each group to calculate workflow efficiency.A questionnaire was used for nurses participated in arterial blood collection for their evaluation of both types of syringes. Results The incidence of micro-clot formation in the preset syringe group was 2 cases,lower than 15 cases in the regular syringes group,the preset syringe group also showed higher workflow efficiency as well as safe and easy-to-use characters.The difference between two groups was statistically significant. ConclusionsUsing BD preset syringe in nursing process management has lower incidence of micro-clot formation,higher workflow efficiency,safe and easy-to-use character.It should be promoted in clinical practice.

【Objective】 To investigate the role of dopamine D3 receptor deficiency in depression-like behavior in perimenopausal depression and to explore the role of dopamine D3 receptor in the pathogenesis of perimenopausal depression. 【Methods】 Based on the perimenopausal depression animal model， RT-PCR was used to study the changes of D3 receptor mRNA in the nucleus accumbens （NAc） in mice. Furthermore， dopamine D3 receptor knockout （D3RKO） mice and wild type （WT） mice of the same genetic background were used， respectively. Forced swim test （FST） and tail suspension test （TST） were used to assess depressive-like behavior in mice. 【Results】 D3 receptor mRNA in the NAc decreased significantly in perimenopause （P<0.05）. Chronic immobilization stress （CIS） induced the decrease of D3 receptor mRNA in young mice （P<0.05）. CIS induced a further decrease of D3 receptor mRNA in perimenopausal mice （P<0.05）. The immobility in the FST was significantly prolonged in perimenopausal D3RKO mice， compared with perimenopausal WT mice （P<0.05）. The immobility in both FST and TST was significantly prolonged in perimenopausal D3RKO mice， compared with young D3RKO mice （P<0.05）. No significant difference was found between the groups of the WT mice （P>0.05）. 【Conclusion】 Dopamine D3 receptor in the NAc is significantly decreased during perimenopause. Obvious decrease or deficiency of dopamine D3 receptors may be involved in the regulation of perimenopausal depression.

【Objective】 To explore the effect of Lactobacillus rhamnosus on postpartum depression （PPD） and its potential mechanism. 【Methods】 The mouse model of PPD was established by using dexamethasone sodium phosphate during pregnancy. At the end of adaptive feeding， 50 pregnant female mice were randomly divided into low-dose group （group Ⅰ）， high-dose group （Group Ⅱ）， positive control group （Group Ⅲ）， model control group （Group IV）， and blank control group （Group Ⅴ）. The mice in Group Ⅰ and Group II were given Lactobacillus rhamnosus 1×10⁷ and1×10⁸CFU（kg·d）. The mice in Group Ⅲ were given 1.8 mg /（kg·d） paroxetine， and the mice in Groups IV and V were given the same amount of normal saline for 4 weeks. The 24-hour food consumption test， open field test and sugar water consumption test were used to detect the behavior of mice in each group. The concentrations of 5-hydroxytryptamine （5-HT）， norepinephrine （NE）， and dopamine （DA） were determined by RP-HPLC. The changes in Enterococcus faecalis， Bifidobacterium， Lactobacillus and Escherichia coli in the cecum of mice were detected by Real-time fluorescence quantitative PCR （RT-qPCR）. 【Results】 Before modeling， there were no significant differences in food intake， weight change rate， open field moving distance and speed， and percentage of sugar consumption among the groups （P>0.05）. After modeling， there was no significant difference in food intake or weight change rate among the five groups， but the open field moving distance， moving speed and percentage of sugar preference were significantly reduced （P<0.05）. After intervention with Lactobacillus rhamnosus， compared with Group Ⅳ， the depression-like behavior in Group Ⅰ and Group Ⅱ mice was improved； the weight change rate， open field moving distance and speed， percentage of sugar preference， and monoamine neurotransmitter concentration in Group I and Group Ⅱ were significantly increased compared with those in Group Ⅳ （P<0.05）， while Enterococcus faecalis， Escherichia coli and lactobacillus were significantly decreased （P<0.05）， and Bifidobacterium had an upward trend， but without significant difference. There was no significant change in food intake. 【Conclusion】 Lactobacillus rhamnosus can improve the depression-like behavior， affect monoamine neurotransmitters in mice， and regulate intestinal flora， which provides a new direction for studies on postpartum depression.

Objective: To discuss the strategy of therapeutic management of T3 supraglottic carcinoma. Methods: A retrospective analysis of 459 patients with T3 supraglottic carcinoma treated in our hospital was performed. We evaluated the results of different managements, including surgery alone, preoperative radiotherapy, postoperative radiotherapy and radiotherapy alone. The extent of the lesion was also put into analysis. Statistical analysis of the overall survival (OS), cause-specific survival (CSS), local control (LC), regional control(RC), function-conservation (FC) were performed with the statistical package from SPSS. Results: In all patients, the rates of 5-year OS, CSS, LC, RC and FC were 64.2%, 71.2%, 87.8%, 78.8% and 64.5% respectively. The OS, LC and FC of the patients treated by surgery alone, preoperative radiotherapy and postoperative radiotherapy had no significant difference, and were remarkably better than that of patients treated by radiotherapy alone (P<0.001). In 412 patients treated by surgery, 300 patients received function-conservation laryngectomy. 209 patients (50.7%, 209/412) survived and maintained well-function of larynx for 5 years, which was significantly better than those in the radiotherapy alone group (27.7%, 13/47). The patients with the lesion invading the pre-epiglottic space but limited in supraglottic area had better OS (70.2%), LC (93.5%) and FC (85.1%). The rate of 5-year neck lymphatic metastasis was 56.2%(258/459), and the 5-year OS of patients with N0, N1, N2 and N3 stage were 76.0%, 66.2%, 50.5% and 13.0% respectively. Conclusions Surgical treatment was the best therapeutic approach for T3 supraglottic laryngeal carcinoma. Most patients with T3 lesions are suitable for function-conservation laryngectomy. Surgical procedure was determined by tumor invaded location and extension. The combined therapy of surgery and radiotherapy had no significant advantage.