Objecfive To observe the effect of high thoracic epidural block(HTEB)for preventing myocardial isehemia(MI)in pailents with coronary heart disease undergoing upper abdominal surgery. Methods Twenty patients undergoing upper abdominal surgery were randomly divided into two groups:M group(treated with HTEB,10 patients)was given both general anesthesia and HTEB and patient controlled epidural analgesia(PCEA)after operation and C group(without HTEB.10 patients)was given only general anesthesia and patient controlled intravenous analgesia(PCIA)after operation.The hemodynamies.ECG changes and serum troponin I and myoglobin and ereatine-kinase isozyme,the analgesia efficacy in M group were compared with those in C group.Results The hemodynamics in M group Was more stable than that in C group(P＜0.05).ComparedwithMgroup,thetotalnumberofST-segment depression attracheal extuba- tion moment and 10 hours after operation were significantly increased in C group(P＜0.05).The positive rates of Serum troponin I and creatine-kinase isozyme at 10 hours and 24 hours after operation in C group were much higherthan those in M group(P＜0.05).The an~tgesia effect in M group Was superiortothat in C group (P＜0.05)Conclusion The HTEB combined with general anesthesia may reduce mvocardial is- chemia in patients with coronary heart disease undergoing upper abdominal surgery.

[Objective] This paper discusses the perioperative nursing of rectal cancer patients treated with laparoscopy. [Methods] A total of 35 rectal cancer patients with laparoscopic treatment were included in the sample. Patients were provided with preparative psychological care, and were guided in postoperative nursing including diet, position, stoma, activities and other relevant conditions. Also likely complications were under careful observation and care.[Results] Al 35 surgeries were smoothly performed with no nursing-related complication. Fol ow-up data reported satisfying postoperative recovery and a good quality of life. [Conclusion] For rectal cancer patients who receive laparoscopic treatment, safe and effective perioperative nursing contributes directly to better postoperative recovery.

OBJECTIVE:To explore the approach and starting point for the management of hospital high-alert medications so as to enhance the level of drug safety control.METHODS:By reviewing pertinent literature,the background,concept and categories of high-alert medications as well as the practice and experiences of carrying out management on high-alert medications in our hospital were introduced.RESULTS & CONCLUSIONS:The management on hospital high-alert medications has effectively lowered the risks of it.In view of the frequent occurring drug safety events,it is necessary to implement the corresponding management on high-alert medications in medical institution.It is advisable to establish a corresponding list of high-alert medications as well as a supervising system in medical institutions to improve drug control safety level and risk prevention ability.

OBJECTIVE:To investigate the effect of edelfosine on the proliferation of Hela cells and its mechanism.METHODS:Hela cells were treated with edelfosine at doses of 0(control),0.5,1.0,5.0,10.0 ?mol?L-1 for 96 h.MTT assay,flow cytometry,and staining were performed to determine the cell proliferation activity,cell cycle,and apoptotic rate.RESULTS:As compared with control,the cell proliferation activity of Hela cells was inhibited in a dose-and time-dependent manner after being treated by edelfosine for 24～96 h.After being treated by edelfosine(1.0,5.0,10.0 ?mol?L-1) for 72 h,the number of Hela cells significantly increased in G0/G1 phase but decreased in S phase(P

Objective:To explore the effectof tumor volume on pulmonary dose-volume parameters by intensity-modulated radiation therapy (IMRT) in non-small cell lung cancer (NSCLC),and to provide a basis for pulmonary dose parameters in IMRT treatment.Methods:A total of 204 patients with NSCLC received IMRT were retrospectively analyzed from June,2009 to October,2013.The prescribed dose of planning target volume (PTV) for primary tumor was 60-66Gy (2.00-2.25 Gy,27-33 times in all).The fractional volume percent of the lung received a dose ＞5 or 20 Gy (V5,V20),and absolute volume of lung received a dose ＜5 Gy (AVS5).The mean lung dose (MLD) in normal tissues were analyzed.Regression model curve was used to analyze them along with the change of primary tumor volume.Results:With the increase in lung tumor volume,the V5,V20 and MLD presented quadratic equation curve,and AVS5 presented logarithmic equation.When the tumor volume,less than a certain value (294.6,283.2,304.9 cm3,respectively),the V5,V20 and MLD increased with tumor size and presented an increased quadratic curve;when the tumor volume was higher than a certain value (294.6,283.2,304.9 cm3 respectively),the V5,V20 and MLD was declined.The AVS5 was declined in a logarithmic curve along with the increase of tumor volume.Conclusion:With the increase in lung tumor volume,the change in rule ofV5,V20,MLD and AVS5 is not completely equivalent.When the tumor volume exceeds a certain boundary value (about 300 cubic centimeter),the corresponding tumor diameter is about 7-8 cm.In addition to the focus on pulmonary V5,V20 and MLD,we should also pay more attention to AVS5 restrictions in establishment ofIMRT in NSCLC.

Objective:To explore the regular variation pattern of tumor volumes of the patients with non-small cell lung cancer (NSCLC) before and after targeting treatment of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI),and to clarify its clinical value.Methods:The materials of 39 NSCLC patients with EGFR-TKI targeting treatment were retrospectively analyzed. The tumor volumes were detected by volume measurement software of TPS and Image J image processing software,then the absolute and relative tumor volume changes of the NSCLC patients before and after targeting treatment were analyzed by paired sample comparison symbol Wilcoxon rank test. Results:The absolute tumor volumes (mm3 )of the patients with NSCLC before and 1 month after targeting treatment were 14 822.11 (7 524.73,54 999.41)and 7 954.42 (3 499.73,29 396.83),respectively, and there was statistically significant difference (Z=-3.257,P=0.001);the absolute tumor volumes of the patients with NSCLC 1 and 2 months after targeting treatment were 8 358.47 (4 394.36,24 430.05)and 7 028.76 (3 634.98,21 056.71),respectively,and there also was statisticaliy significant difference (Z=-2.213,P=0.027).When the original tumor volume before targeting treatment was regarded as 1,the relative tumor volume of 1 month after targeting theatment was 0.612 6 (0.313 8,0.853 7),and there was significant difference (Z=-3.855,P<0.001);the relative tumor volumes of 1 month and 2 months after targeting treatment were 0.608 4 (0.364 3,1.044 3)and 0.423 0 (0.248 8,0.877 7),respectively,and there also was statistically significant differernce (Z=-2.173,P=0.030);but the differences between other consecutive months (from 3 months to 6 months)had no statistically significant differences (P>0.05);the changes of tumor relative volume presented platform stage after 3 months.The tumor relative volumes of 7-9 months after EGFR-TKI treatment reached the bottom.Conclusion:The average primary tumor volume of the NSCLC patients is obviously reduced 1 and 2 months after TKI targeting treatment. It may be optimal to carry out radiotherapy in 3-9 months after EGFR-TKI targeting treatment.

To analyze the correlation between lipid profile and disease activity in patients with inflammatory bowel disease (IBD).A total of 307 Crohn′s disease (CD) patients, 232 ulcerative colitis (UC) patients and 165 healthy subjects from the same geographic region were included. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a)[Lp(a)] were retrieved from their medical records. Crohn disease activity index (CDAI) and Mayo scores were calculated as measurement of disease severity for CD and UC separately. Patients with CD and UC had lower TC, TG, HDL-C and LDL-C levels than those in control group ( P<0.05). Additionally, CDAI was negatively associated with TC, HDL-C and LDL-C levels ( r=-0.218, -0.210, -0.176, P<0.05), while TG level was not associated with CDAI. Mayo scores was not significantly associated with TC, HDL-C, LDL-C and TG. Patients with CD had higher Lp(a) levels than those in UC and control group ( P<0.05). Furthermore, patients with active CD had higher Lp (a) levels than those with inactive disease ( P<0.05).The Lp(a) levels in CD patients were positively associated with CDAI ( r=0.151, P<0.05), while Lp(a) level in UC group was nor assocriated with Mayo score. Patients with IBD have dyslipidemia and lipid profile is associated with disease activity in CD patients.

Objective:Mesenteric fat hypertrophy is present in about a quarter of Crohn′s disease (CD) patients and it can be easily detected by bowel ultrasound (US). The purpose of this research was to assess the correlation between mesenteric fat hypertrophy and behavior and activity of CD.Methods:A total of 89 CD patients who admitted to the First Affiliated Hospital of Nanjing Medical University from August 2018 to November 2019 were recruited in this study. The total CD patients were divided into two groups depending on with or without mesenteric fat hypertrophy by US tests. Crohn′s disease activity index (CDAI), simplified endoscopic score for Crohn′s disease (SES-CD), serum inflammatory indicators and fecal calprotectin were assessed.Results:Mesenteric fat hypertrophy was significantly associated with stricturing behavior (B2, P<0.01). CDAI ( P=0.002) , blood platelet ( P=0.001) , C-reactive protein ( P=0.024) , fecal calprotectin ( P=0.004) and bowel wall thickness ( P<0.01) in patients with mesenteric fat hypertrophy were significantly higher than those without, but not the erythrocyte sedimentation rate ( P=0.110) and SES-CD ( P=0.115) . Serum albumin ( P=0.001) in patients with mesenteric fat hypertrophy was lower than that in patients without mesenteric fat hypertrophy. Conclusion:Mesenteric fat hypertrophy is correlated with intestinal stenosis and disease activity in patients with Crohn′s disease.

BACKGROUND:Kidney deficiency and blood stasis syndrome are common traditional Chinese medicine syndromes observed in knee osteoarthritis,which serve as fundamental pathogenesis factors.There exists a significant connection between the two.Previous studies have demonstrated that kidney deficiency and blood stasis syndrome effectively contribute to knee joint cartilage degeneration and the progression of knee osteoarthritis.However,the mechanisms underlying the promotion of knee joint cartilage damage remain unclear and require further investigation. OBJECTIVE:To investigate the influence of kidney deficiency and blood stasis syndrome on the progression of knee osteoarthritis in Sprague-Dawley rats. METHODS:Sixteen Sprague-Dawley rats were randomly divided into two groups:a model observation group and a control group,with eight rats in each group.Animal models of kidney deficiency were induced by ovary removal in the model observation group,while the control group was given a sham procedure for ovarian removal.Two months after modeling,both groups underwent modified HULTH surgery to induce knee osteoarthritis.One week after modified HULTH surgery,the model observation group was subcutaneously given adrenaline hydrochloride to make blood stasis models,while the control group was subcutaneously given normal saline.At the 5th week after modified HULTH surgery,blood rheology,coagulation parameters,triiodothyronine,tetraiodothyronine,and estradiol levels were measured.Knee joint X-ray images were taken,and knee joint sections were stained with safranin O-fast green,hematoxylin-eosin,and immunohistochemistry. RESULTS AND CONCLUSION:Compared with the control group,the model observation group exhibited significant increases in whole blood viscosity at low,medium,and high shear rates,as well as increased plasma viscosity.Fibronectin levels in the coagulation parameters were significantly increased,while prothrombin time and activated partial thromboplastin time were significantly decreased.Triiodothyronine,tetraiodothyronine,and estradiol levels were all significantly decreased.Radiographic results showed that the model observation group exhibited more severe degree of knee joint space narrowing and surface roughness,with the appearance of high-density shadows.Hematoxylin-eosin and safranin O-fast green staining demonstrated more severe cartilage damage in the model observation group,with significantly higher OARSI and Mankin scores compared with the control group.Compared with the control group,immunohistochemistry results showed a significant reduction in the expression of extracellular matrix type II collagen and aggrecan protein in the cartilage of the model observation group rats.Moreover,there was a significant increase in the expression of matrix metalloproteinase 13 and aggrecanase 5,which are inflammatory factors.These results indicate that the Sprague-Dawley rat model of knee osteoarthritis with kidney deficiency and blood stasis was successfully established.Kidney deficiency and blood stasis syndrome further aggravate cartilage extracellular matrix degradation and cartilage degeneration by promoting the expression of inflammatory factors,thereby promoting the progression of knee osteoarthritis in rats.

Objective: To calculate out the Hausdorff distance based on the scripting in RayStation treatment planning system, which was then applied in measuring the deformation error of brain stem during image automatic registration between CT and MR. Methods: Scripting was edited in RayStation system (version 4.7) by using IronPython. The set of point coordinates on the contour of any two region of interest (ROI) had been found firstly, then the Hausdorff distance between the two point sets was calculated out. A graphical user interface (GUI) was designed by using XAML to acquire the visualized output of Hausdorff distance. GUI appeared when the script was run, where two ROIs was selected, then the corresponding Hausdorff distance and the running time were displayed by pressing the "Calculate" button. Results: The mean Hausdorff distance of brain stem in 20 patients with head and neck neoplasms was 1.20 cm while the mean elapsed time was 11.01s. Conclusions Hausdorff distance of any two ROIs can be calculated out by using the developed method. GUI is designed to realize the visual interaction with RayStation system. Therefore, the RayStation system satisfies the demands of Hausdorff distance calculation in both clinical and research work.