Objective To assess the diagnostic value of 3D-CE MRA for nutcracker syndrome (NCS).Methods The 3D-CE MRA appearances of 4 patients of NCS and control group ( 30 persons) were analyzed.Results The left kidney vein (LKV) crossed before abdominal aorta in 4 NCS patients and 30 controls- The average angle of the origin of the superior mesenteric artery (SMA) from the abdominal aorta was (84.50±3.60)° in control group,and became small (<30°) in 4 NCS patients.The distance of the origin of the SMA to the beginning of descent was (13.40±5.10) mm,and the SMA and abdominal aorta in the axial plane crossing the LKV was (16.40±5.10) mm in controls,and all decreased in 4 NCS patients whose LKV was obviously compressed.The average ratio of expansion to stenosis caliber of the LKV was 4,5 in 4 NCS patients,whereas 1.4 in the controls.Conclusion 3D-CE MRA can display relation between abdominal aorta,SMA and LKV,thus exactly diagnose the nutcracker syndrome.

By means of the questionnaire surveys,we try to understand the medical students' employment intentions,the problems during employment preparation and job-hunting period,and the students'requirement on the guidance work of employment. Based on the analysis of the survey and the current work,we give some constructive and operable advice to improve our guidance work of employment.

Background:Multidrug resistance of tumor cells is one of the important factors that cause failure of chemotherapy in advanced gastric cancer. Tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)may enhance the killing effect of chemotherapeutics on tumor cells,and reverse drug-resistant cell lines to sensitive cell lines,but its mechanism is not yet clear. Aims:To study the effect of TRAIL on expression of multidrug resistance gene glutathione S-transferase-π(GST-π)in drug-resistant human gastric cancer cell line SGC-7901 / VCR and the potential mechanism of TRAIL in reversing multidrug resistance of gastric cancer cells. Methods:SGC-7901 / VCR cells were treated with TRAIL in different doses (50,100,200 and 400 μg/ L)for 48 hours. After treatment,expression of GST-π mRNA in SGC-7901 / VCR cells and concentration of GST-π in culture supernatant were detected by RT-PCR and ELISA,respectively. Results:TRAIL could inhibit mRNA expression and protein secretion of GST-π in SGC-7901 / VCR cells in a dose-dependent manner within a certain range(≤200 μg/ L). The relative expression levels of GST-π mRNA in 50,100,200 and 400 μg/ L TRAIL groups were 0. 89 ± 0. 04,0. 77 ± 0. 08,0. 65 ± 0. 06 and 0. 61 ± 0. 03,respectively,and the concentrations of GST-π in culture supernatant in these groups were(57. 56 ± 1. 19)ng/ mL,(56. 30 ± 0. 80)ng/ mL,(31. 41 ± 1. 65)ng/ mL and (30. 80 ± 1. 34)ng/ mL,respectively,all were significantly lower than those in control group[1. 01 ± 0. 13 and(58. 62 ± 1. 38)ng/ mL,P all < 0. 05]. Conclusions:TRAIL may play a potential role in reversing multidrug resistance of gastric cancer cells through down-regulating GST-π expression.

Objective:To investigate the expression of Plk1 ( Polo-like kinase 1 ) and Chk1/2 ( Checkpoint kinase 1/2 ) in primary hepatic carcinoma tissue and HepG2 cell. Methods: Using immunohistochemistry chemical method detected expression of Plk1,Chk1/2 protein in 40 cases of primary hepatic carcinoma tissue and 16 cases of non-tumor tissue of liver. Western blot was applied to detect the expression of Plk1 and Chk1/2 protein in HepG2 cells, and gray value was measured by using the quantitative analysis. Results:The positive rate of Plk1,Chk1/2 protein expression in primary hepatic carcinoma was 57. 5%,75. 0% and 22. 5%respectively,compared with positive rate in the liver of non-tumor tissue were 0%,25. 0% and 56. 3%. The expression of Plk1 and Chk1 protein in primary hepatic carcinoma tissue is higher than that in non-tumor tissue of liver,and the difference was statistically sig-nificant( P<0. 05 ) . The expression of Chk2 in primary hepatic carcinoma was lower than that in hepatic non-tumor tissue, and the difference was statistically significant(P<0. 05) too. The expression of Plk1,Chk1/2 protein were detected in HepG2 cells and the relative expression rate of Plk1,Chk1/2 protein were 0.39±0.0226,0.08±0.0249 and 0.01±0.0066 respectively,the difference between them was statistically significant. The expression degree was Plk1>Chk1>Chk2. Conclusion: Plk1,Chk1 protein in primary hepatic carcinoma was up-regulated,while Chk2 protein was down-regulated in these tissues. The expression degree was Plk1> Chk1>Chk2. There were relatively selective expression in primary hepatic carcinoma tissue of Plk1,Chk1 protein,then Plk1 and Chk1 might be ideal targets for therapy of primary hepatic carcinoma.

Objective To investigate the effects of different methods of volume therapy on the inflammatory response in patients undergoing liver cancer resection.Methods Forty ASA Ⅰ or Ⅱ patients,aged 40-60 yr,with body mass index 20-25 kg/m2,undergoing liver cancer resection,were randomly divided into 2 groups ( n =20 each):routine fluid replacement group (group Ⅰ ) and goal-directed fluid replacement group (group Ⅱ ).The fluid replacement regime in group Ⅰ =compensatory volume expansion (CVE) + physiological requirements + cumulative loss + confinued loss + the third space losses.CVE was replaced with lactated Ringer's (LR) solution 5 mg/kg before anesthesia induction.The physiological requirements and cumulative loss were replaced with LR solution according to the principle of 4-2-1.The continued loss equal to the intraoperative blood loss was replaced with the equal volume of 6％ hydroxyethyl s tarch ( HES 130/0.4).The 3rd space losses were replaced with LR solution 5 ml·kg-1 ·h-1.In group Ⅱ,CVE was replaced with LR sol6ution as in group Ⅰ.LR solution was infused after anesthesia induction at 5 ml·kg-1 ·h-1.6％ HES was infused to maintain left ventricular ejection time (LVETc) between 350-400 ms.When 350 ms ＜ LVETc ＜ 400 ms and the amplitude of stroke volume ( SV ) increased by ＞ 10％,6％ HES was infused continuously until the amplitude of SV increased by ≤ 10％.Blood samples were taken before anesthesia induction and at the end of operation for measurement of serum TNF-α,IL-2,IL-4,IL-6 and IL-8 concentrations.The adverse cardiovascular reactions were recorded.Results Compared with group Ⅰ,the serum TNF-α,IL-6,IL-8 concentrations were significantly decreased,the serum IL-2 and IL-4 concentrations were significantly increase,and the incidence of hypotension and tachycardia was significantly decreased in group Ⅱ ( P ＜ 0.05).No adverse cardiovascular reactions were found in both groups.Conclusion LVETc and SV-guided volume therapy can maintain the blood volume and inhibit the inflammatory response and is suitable for the patients undergoing liver cancer resection.

Objective To evaluate the predictive performance of propofol target-controlled infusion (TCI) system incorporating the Schnider pharmacokinetic parameters in Chinese patients. Methods Forty ASA Ⅰ or Ⅱ patients, aged 25-45 yr, with body mass index 20-25 kg/m2 , scheduled for gynecological laparoscopic surgery un der general anesthesia, were enrolled in this study. Anesthesia was induced with TCI of propofol (target plasma concentration (Cp) 3 μg/ml) and remifentanil (Cp 4 ng/ml) . Propofol was infused by Orchestra TCI system incorporating the Schnider pharmacokinetic parameters. Tracheal intubation was facilitated with rocuronium 0.6 mg/kgafter the patients lost consciousness. The patients were mechanically ventilated. PETCO2 was maintained at 30-40 mm Hg. Anesthesia was maintained with TCI of remifentanil (Cp 4 ng/ml) and propofol (Cp 3-5 μg/ml) and intermittent iv boluses of atracurium 0.2 mg/kg. BIS value was maintained at 40-45. Venous blood samples were obtained at 15, 30, 45 and 60 min after pneumoperitoneum for measurement of blood propofol concentrations by high performance liquid chromatography with fluorescence detector. Performance error, median prediction performance error, median absolute performance error, wobble and divergence of propofol TCI system were calculated. Results The value for performance error was 21 % (13%), for median prediction performance error 6.7 % (37.4%),for median absolute performance error 19% (18%), for divergence - 0.65%/h (0.82%/h) and for wobble 16.3% (15.2% ) . Conclusion The accuracy of propofol TCI system incorporating the Schnider pharmacokinetic parameters is high in Chinese patients and its predictive performance is acceptable clinically.

Objective To investigate the effects of edaravone pretreatment on the lung injury during onelung ventilation (OLV) in patients.Methods Forty ASA Ⅰ or Ⅱ male patients, aged 48-64 yr, with body mass index 18-26 kg/m2, undergoing elective resection of esophageal carcinoma, were randomly divided into 2 groups (n = 20 each): control group (group C) and edaravone group (group E). Anesthesia was induced with fentanyl,propofol and rocuronium and maintained with sevoflourane, remifentanil and atracurium. The patients were mechanically ventilated (during OLV VT 8 ml/kg, RR 15 bpm, I:E 1:1.5). In group E edaravone 0.5 mg/kg (in normal saline 100 ml) was infused over 30 min after skin incision. PETCO2 and peak airway pressure (Ppeak) were recorded during operation. Venous blood samples were obtained before opening the thoracic cavity and at the end of operation for determination of serum SOD activity and the levels of serum surfactant protein A (SP-A), MDA and TNF-α. Results There was no significant difference in PETCO2 and Ppeak during operation between the two groups (P ＞ 0.05). Serum SOD activity was significantly decreased, while the levels of serum SP-A, MDA and TNF-α were significantly increased after OLV in both groups (P ＜ 0.05). Serum SOD activity was significantly higher,while the levels of serum SP-A, MDA and TNF-α were significantly lower at the end of operation in group E than in group C (P ＜ 0.05). Conclusion Edaravone pretreatment can reduce the lung injury during OLV through inhibiting oxidative response and inflammatory response in patients.

The gap between foreign and domestic medical and health information construction levels was described and the major factors that influence the domestic medical and health information construction level were analyzed by analyzing the medical and health information construction levels in USA, Britain, Canada, Germany, Japan, Aus-tralia and China according to the input-output data in WIOD, with suggestions put forward for the improvement of domestic medical and health information construction.

Objective: To evaluate the intervention effect of clinical pharmacists in hypertension chronic disease management. Methods:All the patients with hypertensive chronic diseases from Ziyang community, Xingan Street, Beilun district were involved in the study. Combined with community doctors, clinical pharmacists provided pharmaceutical care for the patients, such as regular face-to-face medication guide, telephone communication, home follow-up, special lectures on health and so on. The cognitive level, blood pressure control level and medication compliance were statistically analyzed and compared before and after the pharmacy intervention. Results:After the intervention of clinical pharmacists, the level of hypertension cognition and the level of antihypertensive drug under-standingof the patients was improved significantly (P<0. 05 or 0. 01), the level of blood pressure control and medication compliance of the patients were improved significantly (P<0. 01), and unscheduled outpatient rate, emergency rate, hospitalization rate and fre-quency were decreased (P<0. 05 or 0. 01). Conclusion: Pharmacy intervention carried out by clinical pharmacists for the patients with hypertension chronic diseases can provide reasonable medication security and improve the quality of life, and the pharmacy inter-vention mode for the hypertension chronic disease management is worthy of promotion.

Based on three aspects of academic research, academic morality and academic publication, this pa-per discussed the ethical quality that medical journal editors should possess. Medical knowledge and knowledge of medical ethics are the basic ethical qualities that a good medical editor should possess. Editor should strictly control the manuscript process, abide by the professional ethics, and contribute to the fast and correct spread of medical information.