Oral fluid resuscitation in early period of hypovolemic shock is an important measure in the treatment of casualties in the battlefield as well as in mass casualties in lieu of the means of establishing a venous line. The main tasks in the study of oral rehydration resuscitation are the proposition of appropriate prescriptions of the liquids to be given and methods of administration on the basis of a clear elucidation of the mechanism underlying the function of the digestive system in regard to transportation and absorption of the given ingredients. The aim of the study is to fully replenish maximal amount of fluid containing glucose and electrolytes in a convenient, expeditious, and effective way in a minimal span of time, in order to increase circulating blood volume. At the same time, ischemia and tolerance to oral fluids of the gastro-intestinal tract should be improved, electrolyte imbalance and incidence of secondary infection should be alleviated, and finally hypovolemic shock is corrected, so that the victim is kept alive and prepared for further definitive surgical intervention.

Adult ; Cardiac Catheterization ; instrumentation ; Device Removal ; Heart Septal Defects, Atrial ; therapy ; Humans ; Male ; Retreatment

Adult ; Cardiac Catheterization ; Heart Septal Defects, Atrial ; surgery ; Humans ; Male ; Septal Occluder Device ; Treatment Outcome

Objective To investigate the situation of the activities of daily living(ADL)for elderly people in Changsha,and analyze the influencing factors. Methods Questionnaire survey on ADL was held in 2239 elderly people(ranging from 60 to 91 years old),and the influencing factors including age,sex,family structure,marital status,education level,occupation,common chronic diseases and medical care consciousness were analyzed. Results Going to the toilet irregularly hadthe highest injury rate in physical self-maintenance viability(18.2%).But in instrumental ADL,the highest injury rate occurred while shopping(26.3%).Advanced age,living alone,losing spouse,sickness and the lack of medical care awareness were the major factors that influenced the ADL of the elderly people. Conclusions The ADL is an important indicator which reflects the health condition of elderly people.Advanced age,living alone,losing spouse,having many chronic diseases and lacking in medical care awareness are risk factors.

In general,the students in Chinese medical universities have technophobia in nuclear medicine experiment,which gives reduction to the cognition and learning of the students.Based on the analysis of the students' psychology and learning,special countermeasures in teaching,therefore,should be used in the conquest of the students' psychological obstacle in order to improve teaching quality of nuclear medicine experiment.

Objective:To compare the therapeutic effects between sequential therapy of external-internal fixation and internal fixation alone in the treatment of high-energy pilon fracture.Methods:A total of 61 patients with high-energy pilon fracture were enrolled by our team for this retrospective analysis who had been treated from January 2015 to July 2017. They received sequential therapy of external-internal fixation (the sequential group) or internal fixation alone (the internal group). In the sequential group of 26 cases, there were 19 males and 7 females (aged from 18 to 65 years), 4 cases of type C1, 8 cases of type C2 and 14 cases of type C3 by the OTA classification, and 7 cases of closed injury and 19 cases of open injury. In the internal group of 35 cases, there were 25 males and 10 females (aged from 19 to 64 years), 6 cases of type C1, 13 cases of type C2 and 16 cases of type C3 by the OTA classification, and 21 cases of closed injury and 14 cases of open injury. The 2 groups were compared in terms of postoperative infection, fracture reduction, fracture union time, nonunion, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, short form 36 health survey questionnaire (SF-36) and reduced range of motion between healthy and affected ankles.Results:There was no significant difference between the 2 groups in gender, age, fracture type, injury cause or follow-up time ( P>0.05), but a significant difference in soft tissue injury favoring the sequential group ( P=0.010). There were no significant differences between the 2 groups in postoperative infection rate [15.4% (4/26) versus 17.1% (6/35)], fracture reduction, fracture union time [(7.4±3.4) months versus (6.5±3.2) months], nonunion rate [7.7% (2/26) versus 8.6% (3/35)], AOFAS ankle-hindfoot score (71.7±29.4 versus 74.4±19.5), or SF-36 (83.1±9.9 versus 83.8±7.9) ( P>0.05). The reduced range of motion between healthy and affected ankles at 6 months postoperation in the sequential group (34.6°±7.2°) was significantly greater than that in the internal group (23.7°±5.1°) ( P<0.05), but there was no significant difference between the 2 groups in the reduced range of motion between healthy and affected ankles at 2 years postoperation (26.0°±11.1° versus 21.8°±11.3°) ( P>0.05). Conclusion:Although both sequential therapy of external-internal fixation and internal fixation alone can lead to fine clinical efficacy in the treatment of high-energy pilon fracture, the former may be more suitable for the patients with severe soft tissue injury.

At present, a large quantity of patients with end-stage liver diseases are still waiting for liver transplantation. Evaluation of donor liver quality with rapid, convenient, non-invasive and accurate methods plays a pivotal role in improving the prognosis and quality of life of liver transplant recipients. No standard evaluation criteria of donor liver quality have been established in clinical practice. Comprehensive evaluation methods have been primarily adopted, including clinical parameters of donors, laboratory examination, imaging examination and pathological examination, etc. Conventional ultrasound and contrast-enhanced ultrasound may evaluate the quality of donor liver before liver transplantation and predict the incidence of complications after liver transplantation, which are of significant application prospect in liver transplantation. In this article, the basic methods and research progress on conventional ultrasound and contrast-enhanced ultrasound in evaluating the vascular variation of donor liver, micro-circulatory perfusion of liver parenchyma, degree of steatosis of donor liver, degree of fibrosis of donor liver, volume and quality of donor liver were reviewed, aiming to provide more methods and ideas for clinical evaluation of donor liver quality.

BACKGROUNDThis study was designed to detect methylation of E-cadherin gene promoter and gene mutation of beta-catenin in exon 3 and their expression of protein and mRNA in primary tumor and lymph node metastatic tumor of nasopharyngeal carcinoma (NPC), and investigate the mechanism of invasion and metastasis of neoplastic cells in NPC.

METHODSFourty-two fresh biopsy samples were taken from untreated NPC patients at the Affiliated Hospital of Sun Yat-sen Medical College, Sun Yat-sen University, Guangzhou, China during the period of 1999-2002. Among them 21 were taken from primary tumors and the other 21 from lymph node metastatic tumors. The gene promoter methylation of E-cadherin was detected by methylation-specific PCR (MSP). The mutation in exon 3 of beta-catenin was detected by direct sequencing analysis. RT-PCR, Western blot and immunohistochemical staining were used to detect the mRNA and protein expression patterns in both primary and metastatic tumors of NPC.

RESULTSDown-regulated expression of E-cadherin in metastatic tumor was compared with that in primary tumor. Reduced expression of E-cadherin was found to be correlated with lymph node metastatic tumor of NPC (P = 0.004); but there was no obvious correlation between primary and metastatic tumors in the expression of beta-catenin (P = 0.698). The mRNA expression level of E-cadherin in metastatic tumors decreased significantly compared with that in primary tumors. However, little change was observed in the mRNA level of beta-catenin in different tumor tissues. Only 4 samples (19.1%) displayed gene promoter methylation of E-cadherin in primary tumor and 10 samples (47.6%) showed methylated form of E-cadherin. The gene promoter methylation of E-cadherin was more common in metastatic tumor than in primary tumor of NPC (P = 0.024). Only 2 (4.76%) of the 42 samples showed mutations in exon 3 of beta-catenin at 41 (T41A, ACC-->GCC) and codon 47 (S47T, AGT-->ACT). The cytoplasmic and nuclear expression of beta-catenin in tumor was not found in any samples of NPC.

CONCLUSIONSThe results suggest that the downregulation of E-cadherin results from the gene promoter aberrant methylation of E-cadherin and that the methylation of E-cadherin plays an important role in invasion and metastasis of tumor cells in NPC. However, beta-catenin mutation is an infrequent event in NPC, and beta-catenin is not a critical factor influencing the invasion and metastasis of tumor cells in NPC.

Adult ; Aged ; Blotting, Western ; Cadherins ; analysis ; genetics ; Cytoskeletal Proteins ; analysis ; genetics ; DNA Methylation ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Mutation ; Nasopharyngeal Neoplasms ; chemistry ; genetics ; pathology ; Neoplasm Metastasis ; Promoter Regions, Genetic ; Trans-Activators ; analysis ; genetics ; beta Catenin

ObjectiveTo observe the spatial-temporal distribution of mouse leptomeningeal lymphatic endothelial cells and their effects on behavior. MethodsImmunofluorescence was used to detect the number of Lyve-1⁺and CD68⁺ cells in the dorsal， temporal， ventral， and lateral paraventricular leptomeningeal of 1-week， 2-week， 4-week， 10-week， 15-week， and 15-month-old wild-type C57BL mice and 15-week-old APP/PS1 transgenic mice. Two-week-old C57BL mice were randomly grouped as follows： PBS-injected group， anti-Lyve-1-injected group and SAR131675-injected group， which were injected with corresponding reagents into lateral ventricle. Two weeks after injection （i.e.， 4 weeks old）， the three groups of mice were subjected to the open field experiment， the three-chamber social interaction experiment， and the novel object recognition experiment. Then their ratio of leptomeningeal lymphatic cells were detected by immunofluorescence. ResultsThere was no statistical difference in the distribution of leptomeningeal lymphatic endothelial cells in different regions （F=0.8700， P=0. 4668， df=3）. The percentage of Lyve-1⁺ cells in the leptomeninges of mice decreased with ages （F=17.30， P<0.0001， df=5）. There was no statistical difference in the proportion of Lyve-1⁺ and CD68⁺ cells in the dorsal leptomeninges of mice of different ages （F=0.2686， P=0.9244， df=5）. Proportion of Lyve-1⁺ cells in the leptomeninges of 15-week-old APP/PS1 transgenic mice was lower than that of wild-type C57BL/6 mice （t=6.381，P=0.0078）. The ratio of Lyve-1⁺ cells was lower in the leptomeningeal of anti-Lyve-1-injected mice than that in the control group （M_PBS=0.4513， M_anti-Lyve-1=0.2692， q=8.726， P<0.0001）. The ratio of Lyve-1⁺ cells in the leptomeningeal of SAR131675-injected mice was lower than that in the control group （M_SAR131675=0.3230， q=5.588， P=0.0006）. In the open field tests， SAR131675-injected mice showed reduced exploratory locomotion， but increased willingness to explore the central area. The anti-Lyve-1-injected mice showed an increased willingness to explore the central area. In the social interaction tests， the anti-Lyve-1-injected mice showed no reduction in social behavior or social preference. The SAR131675-injected mice showed reduced social behavior in terms of frequency of interaction but no social preference， suggesting that the SAR131675-injected mice had a social interaction decrease. In the novel object recognition tests， the anti-Lyve-1-injected mice showed no change in frequency， time and distance， indicating that the anti-Lyve-1-injected mice showed no change in short-term memory. The SAR131675-injected mice showed a decrease in short-term memory. ConclusionLeptomeningeal lymphatic endothelial cells play an important role in the early development of mice， which can be related to their phagocytosis of macromolecular substances.

OBJECTIVETo evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder (PSPD).

METHODSTotally 108 PSPD patients were randomly assigned to the floating needle treatment group, the duloxetine treatment group, and the placebo treatment group, 36 in each group. Patients in the floating needle treatment group received floating needle therapy and placebo. Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy. Those in the placebo treatment group received the placebo and simulated floating needle therapy. All treatment lasted for six weeks. Efficacy and adverse reactions were evaluated using Simple McGill pain scale (SF-MPQ) and Treatment Emergent Symptom Scale (TESS) before treatment and immediately after treatment, as well as at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Hamilton Depression Scale (HAMD, 17 items), Hamilton Anxiety Scale (HAMA) were assessed before treatment and at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index (PRI) ≥ 50% after 6 weeks' treatment were involved in the follow-up study.

RESULTS(1) Compared with the same group before treatment, SF-MPQ score, HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st, 2nd, 4th, and 6th week of treatment (P < 0.05, P < 0.01). Besides , each item of SF-MPQ significantly decreased immediately after treatment in the floating needle treatment group (P < 0.01). Compared with the placebo treatment group, SF-MPQ, HAMD, and HAMA total score in the floating needle treatment group significantly decreased after 1, 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). SF-MPQ score, HAMD score and HAMA total score in the duloxetine treatment group also significantly decreased after 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). (2) There were 3 patients (8.3%) who had adverse reactions in the floating needle treatment group, 17 (50.0%) in the duloxetine treatment group, and 7 (21.2%) in the placebo treatment group. Compared with the placebo treatment group, the incidence of adverse reaction increased in the duloxetine treatment group (χ² = 6.04, P < 0.05). Besides, it was higher in the duloxetine treatment group than in the floating needle treatment group (χ² = 14.9, P < 0.05). (3) There were 19 patients in the floating needle treatment group and 17 patients in the duloxetine treatment group involved in the follow-up study. Compared with 6 weeks after treatment, no significant difference was observed at 3 and 6 months after treatment in the score of SF-MPQ, HAMD, and HAMA in the floating needle treatment group and the duloxetine treatment group. No significant difference was observed between the two groups (P > 0.05). There were 5 patients (29.4%) who had adverse reactions in the duloxetine treatment group, and no adverse reactions were observed in the floating needle treatment group. The adverse reaction rate was significantly different between the two groups (χ² = 4.26, P < 0.05).

CONCLUSIONSFloating needle therapy and duloxetine were effective in treatment of patients with PSPD. However, floating needle therapy could relieve pain more rapidly than duloxetine, with obviously less adverse reactions.

Acupuncture Therapy ; methods ; Analgesics ; therapeutic use ; Anxiety Disorders ; Duloxetine Hydrochloride ; therapeutic use ; Follow-Up Studies ; Humans ; Needles ; Pain ; Pain Management ; methods ; Pain Measurement ; Psychiatric Status Rating Scales ; Somatoform Disorders ; therapy ; Treatment Outcome