Non-verbal information refers to the information besides the linguistic information.It is an important part in interpersonal communication and can't be replaced by verbal information.The cultivation of medical students obtaining the non-verbal information may begin from the carrier to build a curriculum system and practice system and combine them,thus cultivating the ability of nonverbal information communication,improving professional quality and laying a solid foundation for a harmonious relationship between medical professionals and patients.

[Objective] To confirm the effects of Neiguan massaged to prevent ache nausea and vomit after laparoscopic cholecystectomy(LC).[Methods] 400 patients were randomly divide into 2 groups;the group 1 were treated by Neiguan massage during the LC,the group 2 nothing during the operation.[Results]Group 1 suffered the same ache in the 1st hour as group 2,but less in the last 24h,and less nausea and vomit too.[Conclusions ]Neiguan massage could obviously prevent ache nausea and vomit after LC.

Neurofibroma is an autosomal dominant genetic disease which is originated from the abnormal differentiation of neural crest cells and would cause system damage.NF can occur at most organs in the body,while it is rarely seen in the common bile duct.In February 2007,1 old patients with NF was admitted to the Lishui Central Hospital of Zhejiang Province.The results of preoperative magnetic resonance cholangiopancreatography (MRCP) revealed that the common bile duct was slightly dilated,and the diameter of the common bile duct was 1.2 cm.A nodular short T2 signal lesion was detected at the middle part of the common bile duct with the size of 1.4 cm × 1.6 cm.The results of intraoperative rapid frozen section pathological examination showed that the lesion was cholangiocarcinoma,then cholangiocarcinoma resection + biliojejunal Roux-en-Y anastomosis was applied to the patient.Postoperative pathological examination confirmed that the lesion was neurofibroma.The patient was followed up for 7 years and died of pulmonary infection in June 2014.The clinical presentation of neurofibroma of the common bile duct is untypical.Space-occupying lesions detected in the patients with history of bile duct injury or operation should be considered to be diagnosed as neurofibroma.Special attention should be paid to the accuracy of the results of rapid frozen section pathological examination in order to avoid missdiagnosis.

Objective To evaluate argon-helium cryoablation combined with transcatheter arterial chemoembolization (TACE) in treating advanced hepatocellular carcinoma (HCC). Methods The clinical data of 66 patients with pathologically-proved HCC were retrospectively analyzed. Based on the therapeutic scheme the patients were divided into TACE group (n=31) and combination group (TACE+argon-helium cryoablation, n=35). All the patients were followed up for 5-35 months. The complete remission rate, total effective rate and survival time were evaluated. The short-term and the long-term effectiveness were compared between the two groups. Results Both the complete remission rate and total effective rate of the combination group were significantly higher than those of TACE group (P<0.05). The median survival time of the combination group was significantly longer than that of TACE group (P=0.038). The half-year, one-year and 2-year overall survival rates of the combination group were higher than those of TACE group, although the differences were not statistically significant (P>0.05). Conclusion For the treatment of advanced hepatocellular carcinoma, argon-helium cryoablation combined with TACE can improve the short-term effect and prolong the progression-free survival time, although its exact effectiveness still needs to be confirmed by large sample, multi-central and randomized controlled studies.

Objective To assess the clinical value of transcatheter arterial chemoembolization (TACE) together with radiofrequency ablation (RFA) and sorafenib in treating recurrent hepatocellular carcinoma (HCC) after surgery.Methods A total of 40 patients with recurrent HCC after surgery, who were encountered at authors' hospital during the period from December 2009 to May 2014, were collected. The patients were divided into the study group (n=20) receiving TACE combined with RFA and sorafenib and the control group (n=20) receiving TACE plus RFA. Within 7-10 days after TACE, RFA was carried out. In the study group, oral sorafenib therapy (400 mg, two times everyday) started at 4 days after TACE. Withdrawal of sorafenib would be ordered if drug resistance occurred. Each patient underwent TACE combined with RFA not less than two times. Results The median survival time of the study group and the control group was 31.0 months and 24.8 months respectively, and statistically significant difference existed between the two groups (P<0.05). The one-year, 2-year and 3-year survival rates of the study group were 85%, 70% and 50%respectively, while the one-year, 2-year and 3-year survival rates of the control group were 80%, 55% and 30% respectively; the differences between the two groups were not statistically significant (P>0.05). The progression free survival (PFS) time of the study group and the control group was 6.8 months and 5.7 months respectively, the difference between the two groups was statistically significant (P<0.05). Conclusion TACE combined with RFA and sorafenib can prolong the overall survival time and the progression free survival time of patients with recurrent HCC after surgery.

Objective To observe the effects of the preconditioning of ulinastatin on GES-1 cell injury induced by oxygen and glucose deprivation (OGD). Methods GES-1 cells were cultured in vitro and divided into three groups: normal control group (group N), oxygen and glucose deprivation group (group O), and ulinastatin preconditioning group (group U). The OGD model of GES-1 cells were established by glucose-free medium and three-gas incubator for 6h. Ulinastatin was added to group U 12h before the deprivation of oxygen and glucose. The cell viability and apoptosis were determined by cck-8 and flow cytometry respectively. Western Blot was used to examine the protein expression of Caspase-3 and Cleaved Caspase-3. The TRPV1 mRNA expression was measured by quantitative real-time PCR. Results As compared with group N, the viability of GES-1 was decreased, the apoptotic rate and the expression of Caspase-3 and Cleaved Caspase-3 were increased, and the TRPV1 mRNA expression decreased greatly in group O (P < 0.05). As compared with group O, the aforementioned changes were significantly inhibited in group U. Conclusions Ulinastatin preconditioning could effectively inhibit GES-1 cell injury induced by OGD, which may be related to the inhibition of apoptosis and the upregulation of TRPV1 mRNA expression.

Objective To establish a candidate reference method for the determination of serum lithium based on ion chromatog-raphy and evaluate its analytical performance.Methods A simple sample treatment procedure,which can be remove the proteins and/or organics in human serum,has been developed for the determination of serum lithium.Method precision was evaluated with different concentration of fresh human serum and EQA sample RELA-A/B.Method accuracy was investigated with the recovery ex-periments in fresh human serum and RELA-A/B sample.Results The linear equation was Y =0.817 1X -0.001 3 with a correla-tion coefficient of 0.999 95 under the optimum experimental conditions,the detection limit (3S/N)for lithium was 6 μg/L and the imprecision was less than 1.0%.The results of the recovery experiments indicated that the recoveries were reasonable for the deter-mination of serum lithium,in a range of 99%-101%.Conclusion The candidate reference method of lithium was successfully es-tablished and which can be used for traceability and standardization.It may provide an effective way for routine testing of lithium traceable to the reference method/reference material.

Objective To study the binding performance of 99Tcm labeled anti-human prostatic specific membrane antigen (PSMA) monoclonal antibody J591 (99Tcm-J591) and prostate cancer cells in vitro,the biodistribution and SPECT imaging of 99Tcm-J591 in nude mice bearing human prostate cancer in vivo.Methods The monoclonal antibody J591 was labeled with 99Tcm by improved Schwarz method.Labeled antibody was purified by Sephadex G-50.The labeling efficiency and radiochemical purity were measured by paper chromatography and trichloroacetic acid method.The binding performance of J591 and prostate cancer cells was measured by flow cytometry in vitro.The nude mice bearing PSMA-positive C4-2 prostate carcinoma xenografts served as experiment group,mice bearing PSMA-negative PC3 tumors served as control group.6.2-8.5 MBq of 99Tcm-J591 (25 μg) was intravenously injected into mice.Gamma imaging was performed 2,6,12 and 24 h after injection,T/NT was calculated by ROI technique.After scanned 12 h post injection,4 mice of the experiment group and 5 mice of the control group were sacrificed and the tracer in vivo biodistribution was measured by gamma-counting,and the ％ ID/g was calculated.Two-sample t test was carried out to validate significant difference of ％ID/g between two groups.Results The labeling efficiency and radiochemieal purity of 99Tcm-J591 were (78.9±6.2)％ and (92.3±5.1)％,respectively,and the specific activity of 99Tcm-J591 was 68.7 MBq/mg.The antibody J591 and 99Tcm-J591 could strongly combine with PSMA-positive C4-2 cells in vitro,and didn't combine with PSMA-negative PC3 cells in vitro.SPECT imaging results showed that radioactive concentration was obvious in tumor 6 h post injection,the concentration scope became large and the tumor image was clear 12 h post injection.T/NT was 1.9±1.1 at 2 h,4.3±1.8 at 6 h,5.6±2.7 at 12 h,1.4±0.6 at 24 h,respectively.In the control group,no radioactivity concentration was found in tumor,and T/NT was less than 2.The biodistribution results showed that ％ID/g of tumor tissue was 20.1±5.2 in the experiment group and 5.8±2.6 in the control group,and there was significant difference (t=5.37,P＜0.001).No significant tracer uptake occurred in other tissues and organs between the two groups (all t＜ 1.98,all P＞0.05).Conclusion The immunoactivity,characteristics of biodistribution and tumor targeting property of monoclonal antibody J591 show promising future and potential values in diagnosis and therapy of prostate cancer.

Objective To evaluate the relationship of peripheral blood Th17 and regulatory T (Treg) cells with disease activity in patients with systemic sclerosis (SSc).Methods This study recruited 21 patients with active SSc,24 patients with inactive SSc and 24 normal human controls with informed consent.Peripheral blood samples were obtained from these subjects.Flow cytometry was used to detect the percentages of Th17 and Treg cells in peripheral blood CD4+ cells,a fluorescence-based quantitative PCR to determine the levels of interleukin (IL)-17A,retinoid-related orphan receptor gamma t (RoRγt),forkhead box P3 (FoxP3) mRNA in peripheral blood mononuclear cells (PMBCs),and enzyme linked immunosorbent assay to measure the serum level of IL-17.Results Increased percentage of Th17 cells in peripheral blood CD4+ cells was observed in patients with active SSc compared with those with inactive SSc and normal human controls (2.34％ ± 1.19％vs.0.68％ ± 0.39％ and 0.57％ ± 0.49％,respectively,both P ＜ 0.05).No statistical difference was noted in the percentage of Treg cells in CD4+ cells or the mRNA expression levels of FoxP3 between the patients with active SSc,inactive SSc and normal human controls (all P ＞ 0.05).There was a significant increase in the mRNA expression of IL-17A,RoRγt in PBMCs and serum levels of IL-17 in patients with active SSc compared with patients with inactive SSc and normal human controls ( 11.73 ± 0.80 vs.9.77 ± 1.30 and 10.79 ± 0.74,respectively,both P ＜ 0.05; 18.48 ± 1.09 vs.15.89 ± 1.48 and 17.77 ± 1.64,respectively,both P ＜ 0.05; 53.60± 9.90 pg/ml vs.15.18 ± 3.24 pg/ml and 15.53 ± 4.12 pg/ml,respectively,both P ＜ 0.05).The percentage of Th17 cells in CD4+ cells and serum IL-17 levels were both positively correlated with disease activity in patients with active SSc (r =0.675,0.644,respectively,both P ＜ 0.05).Conclusions Th17 cells are highly proliferative in patients with active SSc,which may be closely correlated with the activity of SSc.

The electrical pain perception were determined in healthy Chinese adults and factors were assessed. The anxiety-depression state of one hundred healthy Chinese were evaluated and the general information was recorded. Then electrical pain perception (perception threshold, pain threshold, pain tolerance) were assessed by neuromuscular monitor at the same time. Further study of influence factors such as gender, age, body mass index (BMI), left and right sides, degree of anxiety and depression, etc. were carried out on the pain perception. The results showed that 95% of the reference range of electrical perception threshold, pain threshold, pain tolerance were 4-7mA, 7 26mA and 15-60mA, respectively. The bilateral pain perception in males were significantly higher than that in females. There was no difference of effect between left and right sides. Age was positive related to pain perception, degree of depression was negative related to pain perception. BMI, degree of anxiety did not show association with pain perception. Therefore, gender, age and degree of depression were significantly related to electrical pain perception in healthy Chinese adults.
Adult ; Anxiety ; Body Mass Index ; Depression ; physiopathology ; Electric Stimulation ; Female ; Humans ; Male ; Pain Perception ; Pain Threshold ; Reference Values