The lymphatic vessels and regional nodes of the nasopharynx in 70 foetuses and infant cadavers were studied with the method of injection of the lymphatics of the organ.There is a network of lymphatic capillaries in the mucous membrane of the nasopharynx, which drains into the submucous lymphatics. The latter join together to form a number of efferent ducts.The efferents emerging from the posterior wall of the nasopharynx end in the retropharyngeal lateral and medial nodes, or pass to the posterior aspect of the internal carotid artery and internal jugular vein and end in the upper deep cervical nodes lying deep to the tip of the mastoid.The lymphatics emerging from the lateral wall drain into the nodes right under the base of the skull anterior to the internal carotid artery and internal jugular vein, or descend to the jugulodigastric node, and the upper deep cervical nodes between the beginning point of the lingual artery and the bifurcate point of the common carotid artery.

Objective To explore the normal reference values of infant intelligence in Fagan test of infant Method Fagan test was carried out in 315 healthy infants aged 6.5～14.0 month in Shenyang,Tieling and Jinzhou in Liaoning province.Results Infants with cognitive exponent X≥54.6 might be considered to be normal in development,49.9

Objective To investigate the effect of stellate ganglion block on the pain and quality of life in patients with lung cancer.Methods 90 patients with lung cancer were divided into observation group and control group according to random number table method.The control group was treated with morphine 10mg,orally,1 time/ 12h.The observation group was treated with stellate ganglion block and morphine.For the patients with poor analgesic effect,50％ doses were added gradually.The analgesic effect,quality of life and changes of immune function were compared between the two groups.Results After treatment,the VAS scores of the two groups were significantly decreased.And the VAS score reduction in the observation group was significantly better than that in the control group [(2.5 ± 0.7) points vs.(3.7 ± 0.9) points],the difference was statistically significant (t =7.060,P ＜ 0.05).The analgesic efficacy of the observation group was significantly higher than that of the control group(91.1％ vs.75.6％,x2 =3.920,P ＜ 0.05),the duration of analgesia of the observation group was longer than that of the control group (t =20.681,P ＜ 0.05).For the total morphine dosage method,the observation group was significantly lower than the control group[(143.5 ± 21.3) mg vs.(238.7 ± 38.3) mg] (t =14.572,P ＜ 0.05).After treatment,the scores of quality of life of the two groups were significantly improved,and the improvement degree of the observation group was significantly better than that of the control group [(86.5 ± 14.3) vs.(79.6 ± 15.7),t =2.179,P ＜ 0.05].After treatment,the TGF-beta level of the observation group was significantly reduced,which was significantly lower than that of the control group[(215.4 ± 38.7)pg/mL vs.(240.5 ± 41.2)pg/mL],the difference was statistically signifi cant (t =2.979,P ＜ 0.05).Conclusion Stellate ganglion block has good therapeutic effect in the treatment of lung cancer patients with pain.

Objective To evaluate the effect of ecoimmunonutrition enteral nutrition on systemic inflammatory response and prognosis in patients with acute severe acute pancreatitis. Methods Fifty-seven patients with severe acute pancreatitis were randomly divided into two groups: parenteral nutrition (PN) group(28 cases), and ecoimmunonutrition(EIN) group (29 cases), each of the two nutrition formulas was given to each group respectively for 7 days. The level of plasma endotoxin and serum concentrations of TNF-α ,IL-1β ,IL-6 and IL-10 and monocyte NF-κB were tested at admission,1 d,3 d,5 d,7 d after nutrition support. Statistics the two groups results of clinical prognosis. Results The levels of endotoxin, TNF-α ,IL-1β ,IL-6 and IL-10 , NF-κB activities in EIN group were no significant difference compared with PN group at admission. After nutrition support 7 d, the levels of endotoxin, TNF-α ,IL-1β ,IL-6 and IL-10 , NF-κB activities in EIN group were (2.70 ± 0.13) ng/L, (30.13 ± 8.12) ng/L, (20.17 ± 8.04) ng/L, (36.43 ± 8.24)ng/L, (86.45 ± 14.54) ng/L, (70.4 ± 3.2)% respectively, which all were significantly lower than those in PN group [(3.25 ±0.32) ng/L, (313.42 ± 144.35) ng/L,( 155.29 ±32.78) ng/L, (324.15 ± 31.47) ng/L, (472.72 ±48.55) ng/L, (88.4±53)% ](P<0.05 or <0.01). Conclusion EIN can attenuate endotoxemia.decrease NF-κB activities and concentrations of cytokines, maintain the balance of pro-and anti-inflammation, improve patients' condition and prognosis.

Objective To evaluate the clinical features and early management of combined thoracoabdominal injury (CTI).Methods A retrospective study was carried out in 29 cases with CTI treated surgically.There were 21 cases with penetrating injuries and 8 cases with blunt injuries.All cases were associated with penumothorax and/or hernothorax at various degrees and 13 cases complicated with shock.In this study thoracotomy was performed in 17 cases,laparotomy in 6 cases,thoracotomy plus laparotomy in 5 cases and combined thoraco-laparotomy in 1 case.Results The injury severity score in this series was (40.16±15.23) scores.Four cases were died from hemorrhagic shock (2 cases),pericardial tampenade(1 case) and multiple organ failure(1 case).Conclusions CTI has high mortality rate,and the most frequent cause of death is hypovolemic shock.The operative approach is based on individual injury condition.Early diagnosis and timely surgical intervention are key to improving the cure rate and reducing mortality in severe CTI.

AIM: To investigate the process of human bone marrow stromal cells (hBMSCs) differentiation into neural-like cells and to determine the role of 26S proteasome in neuronal differentiation. METHODS: Purified hBMSCs were treated with β-mercaptoethanol (β-ME) for 1 day and retinoic acid (RA) for 3 days, followed by growth factor (10 μg/L bFGF or 20 μg/L NGF) for another 3 days. Immunofluorescence was performed to detect the expression of nestin (a neural precursor cells marker), Tuj1 (a premature neuronal marker), and neurofilament (NF, a mature neuronal marker) at all stages of induced differentiation. Immunostaining and RT-PCR were used to analyze the expression of 26S proteasome during neuronal differentiation of hBMSCs. To further confirm the role of 26S proteasome in hBMSCs differentiation, cells were treated with β-ME/RA and then followed by protesome inhibitor MG132 and growth factor. Immunostaining was performed to detect NF-positive cells. RESULTS: Quantification results showed that the untreated cells were almost never positive for nestin, Tuj1 and NF. After treated with β-ME/RA, the numbers of nestin-positive cells (34.41%±1.27%) and Tuj1-positive cells (27.79%±1.27%) were increased. Notably, the numbers of NF-positive cells were significantly increased to 56.72%±2.4% after induction with β-ME/RA/GF. Immunofluorescence analysis showed that undifferentiated hBMSCs cells were weakly stained by antibody against 26S proteasome, but the numbers of cells with high-intensity of 26S proteasome were increased after treated with β-ME/RA. The RT-PCR result of 26S proteasome further confirmed that the mRNA level of the cells differentiated by β-ME/RA (1.33), as well as by β-ME/RA/GF (1.77), was significantly increased compared to the undifferentiated cells. Moreover, hBMSCs incubated with protesome inhibitor MG132 significantly decreased the numbers of NF-positive cells (37.59%±1.52%). CONCLUSION: After induction with β-ME/RA/GF, hBMSCs can be differentiated into neural-like cells, which is concomitant with the increase in 26S proteasome expression. Inhibitor of 26S protesome prevents hBMSCs differentiation, suggesting that 26S proteasome may be involved in the differentiation of hBMSCs into neural-like cells.

Objective To study a new method of minimally invasive balloon kyphoplasty (PKP)for treatment of chronic osteoporotic vertebral compression fractures. Methods The study involved 27 patients with chronic osteoporotic vertebral compression fractures treated with PKP in our hospital from February 2007 to February 2009. There were 11 males and 16 females, at mean age of 72.4 years (range 55-86 years). The history of chronic osteoporotic vertebral compression fractures ranged 3-17 months (mean 7.6 months). The pathological changes were determined at one stage in 25 patients and at two stage in two. According to the Genant classification, there were 10 patients (11 vertebrae) at grade two and 17 patients (18 vertebrae) at grade three. Before operation, the visual analog scale (VAS) score was average 8.3, the ratio of compression height of the anterior vertebral body to the posterior vertebral body was 39% by X-ray measurement and the kyphosis angle was average 15.60°. All patients received PKP under local anesthesia. Results Patients were followed up for average 11.2 months, which showed that all the patients achieved significant pain relief and ambulation at days 3 or 4 after operation. Cardiorespiratory function was significantly improved, with no reoccurrence of pain or severe complications found.After operation, the VAS score was average 2.8, ratio of compression height of the anterior vertebral body to the posterior vertebral body was average 47.6% and the kyphosis angle was average 15.60°. Conclusions Minimally invasive PKP can achieve rapid relief of pain, help early ambulation, decrease various complications resulting from long-term confinement to bed and improve cardiorespiratory function for elderly patients with chronic osteoporotic vertebral compression fractures of the vertebral body mainly with pain but without nerve injury.

Objective To investigate the effect of enteral nutrition support on prognosis in patients with severe acute stroke.Methods Ninety-eight cases of severe acute stroke were divided into nutrition supported group(50 cases) and control group(48 cases) randomly.All patients were treated by conventional therapy.Nutrition supported group received high energy nutrition diet and control group received common liquid diet by nasal feeding.The levels of hemoglobin,serum albumin,neurologic impairment score (NIHSS)and the incidence rates of complications were assessed at the 1st,10 th and 21st day after admission.Results Hemoglobin was (122.5 ± 2.4),(106.4 ± 2.8) g/L and serum albumin was (36.5 ± 4.7),(34.2 ± 5.1) g/L at the 21st day after admission in nutrition supported group and control group,and there was significant difference between two groups (P < 0.05).The complication rate in control group was higher than that in nutrition supported group (P< 0.05).NIHSS score was(8.45 ± 3.02) scores in nutrition supported group and (10.24 ± 2.57)scores in control group at the 21st day after admission,and there was significant difference between two groups (P <0.05).Conclusion Early enteral nutrition support can significantly improve nutritional status and decrease the incidence rates of complications in patients with severe acute stroke,and it is helpful for clinical prognosis.

AIM: To establish HPLC fingerprint of Sishen Pill and a determination of main component of Sishen Pills(Fructus Evodiae, Semen Myristicae, Fructus Psoraleae, etc.) by HPLC. METHODS: The samples were extracted with the solvent methanol. The separation was performed on YWG-C 18(4.6mm?250mm, 10?m) column with water- methanol-acetonitrile as a mobile phase gradient elution. The flow rate was 1.0mL?min -1, the column temperature was at 30℃ and the wavelength of UV detector was at 225nm. RESULTS: There are 21 higher peaks and 12 marker peaks in the fingerprint of eight batches of samples. For evodiamine, the regression equation was Y=147.37X+1186.32, r=0.9999, the liner range was from 5 to 1000?g?mL -1 and the recovery was 99.83%. For rutaecarpin, the regression equation was Y=101.19X+279.81, r= 0.9999, the liner range was from 4.5 to 900?g?mL -1. The recovery was 98.72%. CONCLUSION: The quality standard of Sishen Pill was established firstly. It can be used for quality cantrol of Sishen Pill.

Objective To settle the "bottleneck" disputes existed in the key aspect of emergency treatment care of emergency department, long delayed time of medical workers or patients, perplexity of first-aid personnel, less standard in medical records. Methods Comparison experiment was carried out with the traditional model of emergency care in contrast with the new model, besides the service attitude was improved,the awareness of responsibility was strengthened and the first-aid technique was increased. Number of nursing errors and disputes, hospitalization time, satisfaction degree of patients and record trace-ability were observed. Results The nursing errors and disputes reduced by 46%, hospitalization time re-duced by an average of (7.2±0.2) minutes, satisfaction degree of patients increased by 10.99%, leaving 1673 record traceability of care. Conclusions The application of new management processes of nursing interface in emergency department can settle the "bottleneck" disputes of key interface, make the green passage of emergency patients more convenient and is conducive to safe care, less mortality, high work effi-ciency, which proves to be a reference for fellows.