Tangdu hospital of the fourth military medical university explored the aim,method,critical points and effect for organizing a neurosurgical continuous education Journal club and summarized the key factors important for its successful organization and the improvement of its short-term and long-term educational effects in order to discover a Journal club education pattern which could satisfy the demand of for neurosurgical refresher doctors.Paying attention to these factors could better satisfy the demand of for neurosurgical refresher doctors,achieve their participating aims,promote their understanding of the advancing front of the discipline and improve their literature analyzing competence and problem solving ability.The wide application of continuous education Journal club is helpful to improve the level of neurosurgical continuing education in our country.

Objective To investigate the diagnostic significance of combined detection of neuron specific enolase (NSE ) , cytokeratin 19 fragment(CYFRA21-1) ,carcinoembryonic antigen(CEA) ,carbohydrate antigen 125(CA125) ,carbohydrate antigen 19-9(CA19-9) and serum ferritin(SF) in non-small-cell lung cancer(NSCLC) .Methods NSE ,CYFRA21-1 ,CEA ,CA125 ,CA19-9 and SF were detected by chemiluminescent immunoassay in 52 patients with NSCLC(NSCLC group) ,35 patients with benign lung diseases(benign lung diseases group) and 44 healthy controls(control group) .Results These serum tumor markers in NSCLC group were significantly higher than those in benign lung diseases group and control group(P<0 .01) .Serum level of CEA was ob-viously higher ,while CYFRA21-1 was lower in patients with adenocarcinoma than those in patients with squamous carcinoma(P<0 .05) .The sensitivity(96 .2% ) ,specificity(87 .3% ) and accuracy(90 .8% ) of combined detection of these tumor markers preceded any single ones .Conclusion The combined detection of NSE ,CYFRA21-1 ,CEA ,CA125 ,CA19-9 and SF can improve the diagnos-tic sensitivity and accuracy of NSCLC ,which could provide higher clinical value in the diagnosis of NSCLC .

BACKGROUND:Psychological factors could influence the degree of pain after total knee arthroplasty. However, the effects of perioperative psychological intervention on postoperative pain and joint function are rarely reported. OBJECTIVE:To study the efficacy and safety of alprazolam for patients with anxiety and depression before total knee arthroplasty. METHODS:Sixty-one patients with anxiety and depression before unilateral total knee arthroplasty were recruited. The patients were given the treatment of alprazolam (experimental group) or placebo (control group) at 2 weeks preoperatively. Baseline data were collected, preoperative anxiety and depression were assessed with Hamilton Anxiety Scale and Beck Depression Inventory, perioperative pain at rest and in activity at each time point was evaluated, postoperative NSAIDs drugs and intravenous self-control analgesia pump usage were recorded, the peripheral neurotransmitters were detected by ELISA, short-and mediate-term joint fuction was evaluated through Western Ontario and McMaster Universities Osteoarthritis Index and Knee Society Score after joint replacement, patient satisfaction and in-hospital relevant indexes and adverse reactions were detected. RESULTS AND CONCLUSION:(1) After the application of alprazolam, anxiety and depression were improved notablely, and the levels of 5-hydroxytryptamine andγ-aminobutyric acid in peripheral blood were increased at 2 weeks. (2) The visual analogue scale scores at rest in the experiemntal group were significnatly lower than those in the control group at 12 hours, 1, 2, 3, 5 and 7 days postoperatively (P<0.05);the visual analogue scale scores in activity in the experiemntal group were significnatly lower than those in the control group at 12 hours, 1, 2, 3, and 5 days postoperatively (P<0.05). (3) Analgesia pump and analgesic drug usage in the experiemntal group were significantly less than those in the control group, and the analgesic drug dosage and preoperative anxiety depression were correlated. (4) There were no significant differences in the Western Ontario and McMaster Universities Osteoarthritis Index and Knee Society Score between two groups. (5) The patient satisfaction, sleep index and hospitation time in the experimental group were superior to those in the control group. No obvious adverse reactions occurred during medication. (6) Our results suggest that for patients diagnosised with anxiety and depression before total knee replacement, the preoperative application of alprazolam can alleviate anxiety and depression, improve perioperative pain at rest and in activity, reduce postoperative analgesia drug useage, and increase patient satisfaction.

OBJECTIVETo explore the correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of Chinese medicine (CM) in colorectal cancer patients.

METHODSTotally 112 colorectal cancer patients undergoing open abdominal surgery or laporoscopic surgery were syndrome typed as five types, i.e., inner-accumulation of damp and heat, blockage of stasis and toxin, Pi-Shen yang deficiency, blood-qi deficiency, Gan-Shen yin deficiency. Signs of living body in abdominal and pelvic cavities were collected. The correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of CM were analyzed.

RESULTSRed colorectal canals or mass were dominated in colorectal cancer patients with inner-accumulation of damp and heat syndrome. Dark purple colorectal canals or mass were dominated in colorectal cancer patients with blockage of stasis and toxin syndrome. Reddish colorectal canals or mass were dominated in colorectal cancer patients with blood-qi deficiency syndrome. Pale colorectal canals or mass were dominated in colorectal cancer patients with Pi-Shen yang deficiency syndrome. Whitish or red-white stripes were dominated in colorectal cancer patients with Gan-Shen yin deficiency syndrome. Dropsy colorectal canal was associated with Pi-Shen yang deficiency syndrome. Intracavitary effusion was often seen in colorectal cancer patients with inner-accumulation of damp and heat syndrome. The effusion was yellowish in less amount. Intracavitary adhesion was often seen in colorectal cancer patients with blockage of stasis and toxin syndrome. There was no correlation between the maximum diameter of mass or each syndrome type of CM.

CONCLUSIONThere existed correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of CM, which could be taken as one of references for syndrome typing of colorectal cancer patients.

Abdominal Cavity ; pathology ; Colorectal Neoplasms ; diagnosis ; surgery ; Humans ; Medicine, Chinese Traditional ; Pelvis ; pathology ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis

Objective To observe the therapeutic effect of pericarpium zanthoxylum oil on experimental hyperlipemia in mice. Methods Hyperlipemia model was reproduced in mice, and then pericarpium zanthoxylum oil was garaged for 4 weeks. Blood samples were obtained from retro-ocular vessel. The levels of blood lipids were determined, the hemorrheology parameters were determined by hemorrheometer, and the pathological changes in the liver of mice were observed microscopically. Results Zanthoxylum oil could obviously reduce contents of TC, TG, LDL-C (P

Pollution and control of microcystins released during the toxic bloom was reviewed in the present paper. As a risk factor in safety assessment, microcystins aroused broad attention. It was a topic of general interest that how to control microcystins reproduction and how to enhance the degradation of microcystins in the water treatment procedure. Based on the state of China, it was considered that a combined method of biological, physical and chemical treatment should be the best way to control microcystins pollution in drinking water.

Objective:To investigate the application of in vitro fenestration endovascular aortic repair(fEVAR) in the juxtarenal abdominal aortic pseudoaneurysm and its up to mid-term results.Methods:The clinical data of 5 cases of juxtarenal abdominal aortic pseudoaneurysm from Oct 2016 to Jul 2019 at the Department of Vascular Surgery, Henan Provincial People′s Hospital was retrospectively analyzed, including therapy options, accesses, techniques of fenestration, bundle of the stent-graft, near to medium-term effects.Results:All patients were treated with fEVAR, the technical success rate was 100%. Stent modify time ranged from 50 to120 minutes, fEVAR time ranged from 75 to 210 minutes. The follow-up period was 15~42 months. All of the stents are in good position, there is no stent-related complications, and no deaths. Primary diseases are well controlled.Conclusion:The treatment for juxtarenal abdominal aortic pseudoaneurysms with fEVAR , as a full-intraluminal method, is of minimal invasion, few perioperative complications, low mortality. Result of up to mid-term follow up is satisfactory.

Excess energy has become a main reason for increasingly serious human health hazards. Excess energy, mainly ectopically deposits in the liver, pancreas and other organs in the form of triglycerides, and produces chronic oxidative, nitrosative stress (ONS) , and fat toxicity, resulting in insulin resistance and impaired insulin secretion, and further impaired glucose regulation (Pidan). By combining Chinese medical pathogeneses and symptoms analyses, authors found this process has features of Gan disease transferring to Pi. Based on a number of related guidelines and clinical practice, we demonstrated treating sputum and stasis by the same method was one treatment method for intervening liver disease transferring to spleen in metabolic diseases. This idea helps to organic integrating prevention and treatment of major metabolic diseases including non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus, which can improve clinical effectiveness and efficiency of Chinese medicine.
Diabetes Mellitus, Type 2 ; therapy ; Early Intervention (Education) ; Humans ; Insulin ; Insulin Resistance ; Metabolic Diseases ; Non-alcoholic Fatty Liver Disease ; Risk Factors ; Triglycerides

Objective To explore the effects of colon carcinoma cells on stimulating canalization of human lymphatic endothelial cells(hLECs)in vitro.Methods hLECs in experiment group were cultured with the supernatant of colon carcinoma cell SW480,and they were cultured in endothelial culture medium in control group.The difference of the 2 groups in the ability of canalization was observed,the changes in cytoskeleton and the expression of Prox1 were detected by immunofluorescence assay,and the expression of integrin ?9 was determined by Western blotting.Results In comparison to the control group,hLECs in experiment group showed stronger ability of canalization,as a copious net-structure appeared on day 7 of cultivation,and the typical tube-structure formed finally on day 14.The number of tube-structure,including lymphatic branches,were greater in hLECs of experiment group(2.93?0.56)than control group(1.56?0.26)from day 6 on(P

Objective To compare the effect of low concentration versus ultra-low concentration of ropivacaine in combination with sufentanil delivered via programmed intermittent epidural bolus (PIEB) with patient-controlled epidural analgesia (PCEA) during labour on obstetric and anesthetic outcomes.Methods Seventy-six ASA Ⅰ or Ⅱ nulliparous parturients who were at full term with a singleton fetus in vertex presentation were randomized to receive 0.1 ％ ropivacaine with 0.5 μg/mL sufentanil (Group L,38 cases) or 0.06％ ropivacaine with 0.5 μg/mL sufentanil (Group UL,38 cases).Another matched 76 cases of primiparas without labor analgesia (Group C) served as controls.For primiparas received analgesia,an epidural catheter was inserted when the cervical dilatation was up to 2-3 cm.The analgesia level was controlled below T8,and VAS score was controlled below 4.Thirty minutes after analgesia started,Group L and UL received PIEB with PCEA regimen including basal infusion of 8 mL/h of ropivacaine with sufentanil,patient-controlled bolus 6 mL and lockout interval 10 minutes.The duration of labor,delivery mode,Apgar score,VAS score and anesthetic drug consumption of each group were recorded.Results The second stage of labor were not statistically different between Group UL and C.The second stage of Group L was longer than that of Group C (P＜0.05).Furthermore,with similar performance in pain score and satisfactory level at each time point,Group UL consumed much less ropivacaine than Group L (P＜0.05).The cesarean section rate,instrumental delivery rate and the Apgar score were not significantly different among the 3 groups.Conclusions While using PIEB with PCEA,0.06％ ropivacaine was capable of providing satisfactory analgesia effects for primipara and has less effects on the obstetric outcome.Therefore,it could be recommended for labour analgesia.