Objective To compare the clinical effects of remifentanil combined with sevoflurane or with isoflurane in elderly patients undergoing radical gastrectomy for cancer and their recovery.Methods Sixty-two patients,who scheduled for radical gastrectomy for cancer was randomly divided into remifentanil combined with sevoflurane group ( SR group,n =31 ) and remifentanil combined with isoflurane group ( IR group,n =31 ).They were classified into American Society of Anesthesiology(ASA) physical status Ⅱ and ,The procedure of two Anesthesia was same,in which remifentanil was continually pumped into at the same velocity using micro pump immediately after intubation,tili the target density in plasma increased to 6 μg/L.Sevoflurane at 1.5％ to 2.0％ was inhaled in the SR group,whereas isoflurane at 1％ to 2％ in the IR group.The inhalation was ended at 5 mins before the surgery was completed,Remifentanil was stopped while stuturing,and 0.1 mg of Remifentanil was injected at 20 mins before the surgery was completed.The heart rate(HR) and blood pressure were recorded at before induction of anesthesia (T0),after induction of anesthesia ( T1 ),immediate intubation ( T2 ),surgery after the start of 5 min ( T3 ),30 min (T4) and the time of surgery ( T5 ),respectively.The recovery time and extubation time,and quality score for awakening after extubation (OAAS) were also recorded.Results There were no significant differences in HR,SBP and DBP at every time points observed between the two groups.The recovery time( 10.4 ± 3.9)mins and extubation time(5.9 ± 3.1 )min in SR group was significantly shorter than that of(16.3 ± 5.8) min and (9.7 ±2.5) min in the IR group(t =6.25 and 4.19,P =0.02 and 0.01,respectively ).The OAAS after extubation in the two groups gradually increased,and immediately after extubation and extubation after 10 min,OAAS in the SR group was(4.1 ± 1.2),which was significantly higher than that of (2.9±1.0)in the IR group(t =3.27,P =0.03).Conclusion Either stevoflurane-remifentanil or isoflurane remifentanil anesthesia can be used safely in elderly patients undergoing radical gastrectomy for cancer.Anesthesia with Sevoflurane-remifentanil provides better faster recovery than isoflurane- remifentanil in elderly patients.

s Objective To assess the correlation between the features of optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) in clinically significant diabetic macular edema. Design Prospective case series. Participants 102 patients(177 eyes) with clinically significant diabetic macular edema. Methods Optical coherence tomography and fluorescein angiography typing were done separately in a double-masked manner in each case of clinically significant macular edema. The correlation between FFA types and OCT types were analyzed, and their associations with the best visual acuity, central foveal thickness were evaluated. Main Outcome Measures The FFA features and OCT features of clinically significant diabetic macular edema, central foveal thickness, best visual acuity. Results The prevalence of focal leakage type was higher in the OCT type 1 (70.6%) than in the diffuse leakage type (27.2%) and diffuse cystoid leakage type (2.2%) of fluorescein angiography (P

Objective To observe the correlation between nuclear factor ?B(NF-?B) expression and apoptosis after hypoxia-ischemia brain damage(HIBD).Methods Forty-eight 7-day newborn Sprague-Dawley(SD) rats were randomly divided into 2 groups: control group (n=24) and HI group (n=24).The expression of NF-?B in the hippocampus was detected by immunohistochemical techniques.The apoptosis of the hippocampal cells was detected by terminal deoxynucleotidyltransferase-mediated 2-deoxyuridine 5′-triphosphate-biotin nick end labeling(TUNEL)straining.Results The expression of NF-?B in hippocampal cells increased at 6 h after HIBD,peaked at 48 h,and lasted till 72 h when compared with control group(Pa

Objective By comparing the biological characteristics among Lewis lung cancer cells ( LLC) , LLC or-thotopic transplantation derivative cells ( R1-LLC) and R1-LLC orthotopic transplantation derivative cells ( R2-LLC) , we e-valuate their invasion and metastatic abilities in orthotopic transplantation models.Methods In vitro, we applied CCK8, clonogenic assay, and Transwell invasion assay to detect the proliferation ability, invasion ability and morphologic structures of LLC,R1-LLC, R2-LLC cells respectively, meanwhile observing morphologic structures by transmission electron microsco-py.In vivo, we constructed LLC, R1-LLC and R2-LLC orthotopic transplantation models.Herein, we observed their tumor growth and metastasis.The tumor formation rate and tumor-forming time were recorded for statistic analysis.Results In vitro:LLC, R1-LLC and R2-LLC cells showed no significant difference in proliferation ability ( P>0.05 ) , but significant differ-ences in invasion ability:R2-LLC>R1-LLC>LLC(P<0.05).In vivo:In the orthotopic group, the tumor formation rates of LLC, R1-LLC and R2-LLC cells were 66.67%、80%、93.33%(P <0.05).Conclusions In orthotopic implantation mouse models, R2-LLC cells present higher invasion and metastatic ability than R2-LLC and LLC cells.

This paper analyzed the necessity of training of interdisciplinary and innovative think-ing for medical postgraduates and proposed many specific programs for interdisciplinary training con-struction including the building of interdisciplinary curriculum system,comprehensive experiment and communication platform,construction of interdisciplinary innovative tutor team,double or multi-tutorial system,interdisciplinary projects,et al.

OBJECTIVE:To observe the clinical efficacy and safety of pregabalin assisting anti-histamine drugs in the treat-ment of secondary skin pruritus in uremic patients underwent maintenance hemodialysis. METHODS:140 uremic patients with sec-ondary skin pruritus underwent maintenance hemodialysis were randomly divided into control group and treatment group,with 70 cases in each group. Control group was given loratadine orally,10 mg,qd. Treatment group was additionally given pregabalin on the basis of control group,75 mg,po,at night of hemodialysis end,increasing by 75 mg every week if no obvious relief was found,maximal dose of 300 mg. Both group received 3 months of treatment. Clinical efficacy,VAG itching score,modified Duo score,PSQI score before and after treatment and the incidence of ADR were compared between 2 groups. RESULTS:Total effec-tive rate of treatment group (90.00%) was significantly higher than that of control group (71.43%),with statistical significance (P<0.05);VAG itching score,modified Duo score and PSQI score of treatment group after treatment were significantly lower than control group and before treatment,with statistical significance(P<0.05). There was no significant difference in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Pregabalin assisting anti-histamine drugs in the treatment of secondary skin pruritus in uremic patients with maintenance hemodialysis can efficiently relieve the itching symptoms,improve sleep quality,and not increase the risk of ADR.

ObjectiveTo investigate the effect of comprehensive rehabilitation therapy on movement function of stroke patients.Methods121 cases of acute stroke were randomly divided into the rehabilitation group (n=59) and control group (n=62). Patients of the rehabilitation group were treated with Bobaths and motive relearning method. Cases of the control group were treated with ordinary rehabilitation. All patients were assessed by the clinical neural function-defect assessment, concise Fugl-Meyer assessment (FMA) and modified Barthel index (MBI).ResultsThe scores of the clinical neural function-defect assessment set, FMA, and MBI of two groups were not different before treatment (P>0.05), while there was a significant improvement after treatment (P<0.01), and scores of the rehabilitation group was significantly higher than that of the control group.ConclusionComprehensive rehabilitation therapy can facilitate the function recovery, and gain a good functional prognosis to the stroke patients.

Epidemics of hand, foot and mouth disease (HFMD) have mainly been caused by Coxsackievirus A16 (CVA16) and Enterovirus A 71 (EV-A71), which circulated alternatively or together in the affected area. CVA16 has caused numerous outbreaks and epidemics in multiple countries and geographical regions, and has become an important public health problem. Based on an analysis of the complete VP1 coding region, all CVA16 strains can be divided into genotypes A, B1, and B2. Furthermore, genotype B1 can be divided into subgenotypes B1a, B1b, and B1c. After 2000, no reports of genotype B2 virus strains have been reported. All of the CVA16 strains reported in mainland China have belonged to subgenotypes B1a and B1b. Most CVA16-associated infections cause only mild symptoms; however, some CVA16 infections can lead to severe complications and even death. Vaccination is considered to be the most effective method to control the transmission and infection rate of this virus. A number of research groups are studying various vaccine types, including inactivated vaccines, genetic engineering vaccines, and DNA vaccines, amongst others. In this review, an overview is provided of the research advances in molecular epidemiology and vaccines of CVA16.
Animals ; China ; Coxsackievirus Infections ; epidemiology ; immunology ; prevention & control ; virology ; Enterovirus A, Human ; classification ; genetics ; isolation & purification ; Humans ; Molecular Epidemiology ; Viral Vaccines ; administration & dosage ; genetics ; immunology

Objective To evaluate the value of selecting and locating coronary artery severe stenosis by the segmental longitudinal strain imaging diastolic indexes (LSI-DI).Methods 94 subjects with left ventricular ejection function (LVEF) ≥50％ and without regional wall motion abnormalities (RWMA) were divided into A group (coronary artery sever stenosis),B group (coronary artery light or mid stenosis) and C group (normal control) using coronary angiography.Some indexes were measured such as early diastolic mitral annulus velocity of septum (e),diastolic peak flow velocity of mitral valve (E,A) and E/e ratio.Using two-dimensional speckle tracking,indexes were measured such as segmental peak systolic longitudinal strain (PSLS),segmental longitudinal strain imaging diastolic indexes (LSI-DI) and global peak systolic longitudinal strain (GPSLS),global longitudinal strain imaging diastolic indexes (GLSI-DI).Compared these indexes among the three groups,the most valuabe segments were obtained and the optimal values were found out by ROC curve.Results There were no significant differences about GPSLS among the three groups.Coronary artery severe stenosis group were significantly lower than the other two groups on GLSI-DI (P ＜0.05);GLSI-DI of B group was lower than that of normal control group but the difference was not significant(P ＞0.05).The optimal cutoff values of LSI-DI were 45.5％ in the middle anteroseptal segment for detecting left anterior descending (LAD) artery severe stenosis (sensitivity 81.8％,specificity 84.2％),44.8％ in the basal anterolateral segment for detecting left circumflex (LCX) artery stenosis (sensitivity 87.3％,specificity 85.3％),and 48.3 ％ in the basal inferior segment for detecting right coronary (RCA) artery stenosis (sensitivity 79.6％,specificity 86.9 ％).Conclusions Patients with coronary artery severe stenosis can be screened by LSI-DI among patients with LVEF ≥50％ and without RWMA through conventional echocardiography.The middle anteroseptal segment,the basal anterolateral segment and the basal inferior segment can better locate the branches of coronary artery severe stenosis and the cutoff values were separately 45.5 ％,44.8 ％ and 48.3 ％.

Objective To explore the effect of comprehensive management of cardiac rehabilitation on the quality of life of patients after percutaneous coronary intervention(PCI). Methods A total of 60 patients with PCI were randomly divided into the rehabilitation group and the control group with 30 cases each by convenience sampling method. The control group received routine treatment and nursing care of postoperative PCI, and the rehabilitation group received cardiac rehabilitation management on the basis of the control group, including training guidance, management of double heart psychological intervention, nutritional intervention diet guidance, evidence-based medicine, and set up system etc. The Hospital Anxiety and Depression Scale(HADS) score, 6 minutes walking distance (6MWD), coronary heart disease risk factors and Seattle Angina Score (SAQ score) were observed at 6 months after PCI. Results HADS score anxiety rate, depression rate, anxiety and depressive state at 6 months after PCI was 10.0%(3/30), 10.0%(3/30), 0 respectively in the rehabilitation group, and 33.3%(10/30), 36.7%(11/30), 13.3%(4/30) in the control group respectively, and there was significant difference between 2 groups (χ2=4.504, 5.963, 1.071. all P<0.05). 6MWD was (451 ± 48) m in the rehabilitation group and (402 ± 42) m in the control group, and there was significant difference between 2 groups (t=6.155, P=0.022). Compared two groups of coronary heart disease risk factors control level: there was significant difference in total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glycosylated hemoglobin, body mass index, systolic pressure, diastolic pressure(t=-2.927-5.981, P<0.01 or 0.05). SAQ score in physical limitation, angina stability , angina pectoris, treatment satisfaction, disease awareness scores were (73.79 ± 6.04), (80.35 ± 7.63), (75.31 ± 8.11), (80.23 ± 5.44), (76.59 ± 14.29) points in the rehabilitation group, and (53.19 ± 5.13), (65.87 ± 18.85), (64.41 ± 6.31), (70.49 ± 8.01), (45.83 ± 8.65) points in the control group, there were significant differences between 2 groups (t=-21.630-18.959, all P<0.01). Conclusions The comprehensive management of cardiac rehabilitation alleviates the anxiety and depression of patients after PCI, reduces the risk factors of coronary heart disease, and improves the exercise ability and quality of life.