Objective To determine the optimal suetioning negative pressure based on various sputum viscosity in brain-in-jured patients with tracheotomy. Methods Forty-three traumatic brain-injured patients with traeheotomy were recruited in the study. The negative pressure was determined based on the grade of sputum viscosity. Grade Ⅰ sputum was suetioned with the negative pressure of 13.3kPa,16.0kPa,20.0kPa and 24.0kPa, while Grade Ⅱ sputum with 20.0kPa,24.0kPa,26.TkPa and 29.3kPa,and Grade Ⅲ sputum with 26.7kPa,29.3kPa, 33.3kPa and 37.2kPa. The oxygen saturation(SpO2)was mort-itored before and lmin,3min,5min after endotracheal suctioning. At the same time,the suctioning time and tissue trauma were recorded. The data were analyzed by repeated measures analysis of variance with SPSS 13.0 software. Results The results showed that the optimal negative pressure was 13.3-16.0kPa for grade Ⅰ sputum,24.0-26.7kPa for grade Ⅱ sputum and 33.3kPa for grade Ⅲ sputum,which could ensure the minimum decrease of SpO2 and control the suctioning time within 25s or 30s respectively. Conclusion For traumatic brain-injured patients,varions negative pressure should be selected based on the sputum viscosity by the clinical nurses when suctioning is performed,in order to avoid hypoxemia and tissue trauma caused by suctioning.

Breast cancer is the most common disease in women worldwide, which not only threatened the women’s survival time, but also inlfuenced their quality of life as well. Within this challenge, it’s important to optimize the current multidisciplinary treatment stratagem for breast cancer. Radiotherapy is one of the most important treatment modality for patients with breast cancer, with the trend to shrink the irradiated volume and shorten the total fraction times in recent years. Intraoperative radiation therapy (IORT) as a fast and convenient procedure has the ability to deliver a high, single-fraction radiation dose to tumor beds with minimal exposure of surrounding tissues (lung, heart, etc.), which could be displaced or shielded right after the tumor removal during the surgical procedure. Right now, IORT has been either integrated as a boost technique in multimodal approaches using postoperative EBRT in the treatment of early breast cancer patients undergoing breast conservation surgery or used as a single dose accelerated partial breast irradiation technique for these patients. This review discussed the rationale of IORT, the beneifts and limitations of IORT, the indication and the clinical results of this procedure, including treatment related side-effects as well in order to provide the preliminary evidence based approach for early breast cancer patients.

The pathogenesis of diabetic retinopathy is complicated.The vast network of multiple factors including unifying mechanism,inflammatory reaction,neuron degeneration and metabolic memory of glucose,and the four established pathogenic molecular pathways are hotspots of mechanism research for diabetic retinopathy.Nevertheless,these researches may be only one corner of the iceberg of DR mechanism,and we still face enormous challenges in DR mechanism research.Collaboration with multiple disciplines to study the relationship between DR and diabetes and other systemic diseases,search novel therapy targets may increase the result in an unexpected windfall for DR basic research.

In vitro and in vivo animal model experiments have found that salidroside has protective effect for various causes induced injuries in various neurons and brain tissue.Its mechanisms of neuroprotection are multiple:(1)Protecting neurons from apoptotic injury by resisting oxidative stress,preventing intracellular Ca2 + overload,inhibiting caspase-3 activation,and attenuating hypoxia-induced abnormal metabolism of amyloid precursor protein;(2)promoting directional differentiation of stem cells into neurons and inducing neuronal regeneration;(3)promoting erythropoietin stimulating erythroblasts to be differentiated into erythrocytes and decreasing cerebrovascular resistance,and improving cerebral hypoxia-ischemia.Salidroside is expected to be used in the prevention and treatment of cerebral ischemic and neurodegenerative diseases,such as cerebral infarction,Alzheimer's disease,Parkinson's disease,amyotrophic lateral sclerosis,and diabetic encephalopathy.

Osteosarcoma and ewing sarcoma are the two most common types of primary malignant bone tumors. Receptor tyrosine kinases(RTKs),including varieties of cell growth factors and proto-oncogene pro-ducts,are the high-affinity cell surface receptors which play an important role in the normal physiological func-tion of cells. A large number of studies have demonstrated that the abnormal RTKs signaling pathways may pro-mote the tumorigenesis and development of osteosarcoma and ewing sarcoma by affecting tumor cell survival, proliferation,invasion and metastasis. Targeting treatment of RTKs is a promising therapeutic approach for osteosarcoma and ewing sarcoma.

Objective To investigate the perinatal outcomes of isolated single umbilical artery (ISUA) in full-term birth. Methods We performed a retrospective study of 82 252 pregnant women (aged<35 years;singleton; full-term live birth; no known chromosomal/structural anomalies) who delivered between January 1, 2011 and January 1, 2012 in 39 hospitals in 14 cities in China. There were 273 cases with ISUA as study group and 1 092 cases with a three-vessel cord selected in a 1∶4 ratio as control group. Perinatal outcomes including delivery modes (vaginal delivery or emergency cesarean section for fetal reasons), birth weight and height, placental weight, umbilical cord length, Apgar scores at 1 min, and rate of neonatal asphyxia were analyzed retrospectively. Data were analyzed using the Chi-square test, two independent samples t-test or rank sum test. Results The incidence of ISUA was 0.3%(273/82 252). There was no difference between the two groups with regard to maternal age, parity, gravidity, smoking status, gestational age at birth, or rate of complications during pregnancy (gestational diabetes mellitus or pregnancy-induced hypertension) (all P>0.05). The birth weight in ISUA group and control group was (3 259±463) and (3 344±411) g (t=3.689), birth hight was (48.6±2.7) and (49.7±1.9) cm (t=8.368), placental weight was (508±72) and (543±153) g (t=3.114), umbilical cord length was (52.6±8.1) and (53.7±7.5) cm (t=1.983), and Apgar scores at 1 min were 9.0 (8.0-10.0) and 10.0 (9.0-10.0) (Z=11.831), respectively; the values in the ISUA group were lower than those in control group (all P < 0.05). No significant differences were observed in the rate of vaginal delivery and emergeny cesarean section for fetal reasons between the ISUA group and control group [52.8%(144/273) and 49.9%(545/1 092),χ2=0.704;19.4%(25/273) and 15.7% (86/1 092), χ2=1.162; both P>0.05]. Conclusions ISUA does not increase emergency cesarean delivery rates for the fetal reasons, but the fetal growth and development may fall behind those with a three-vessel umbilical cord. Monitoring during pregnancy and delivery should be intensified for fetuses with ISUA.

Objective To investigate the protective effect and its mechanism of edaravone against rat renal tubular epithelial cell injury induced by cisplatin. Methods The rat renal tubular epithelial cells (NRK-52E) were divided into the control, model control (50μmol·mL-1 cisplatin), group A (50μmol·mL-1 cisplatin plus 10μmol·mL-1 edaravone), B (50μmol·mL-1 cisplatin plus 20 μmol·mL-1 edaravone), and C (50 μmol·mL-1 cisplatin plus 40 μmol·mL-1 edaravone). The cell proliferation ability, content of malondialdehyde, activity of superoxide dismutase(SOD), level of reactive oxygen species ( ROS) , rate of apoptosis, express of protein and mRNA of Bax, Bcl-2 and Caspase-3 activation of cell were detected. Results The proliferation and SOD activity in NRK-52E cells declined, malondialdehyde and ROS were elevated upon being co-cultured with cisplatin. Moreover, the rate of apoptosis, express of protein and mRNA of Bax and Bcl-2, and Caspase-3 activation of cells were upregulated compared to the control group. However, edaravone stimulated cell proliferation, SOD activity and protein and mRNA of Bcl-2 and lowered content of malondialdehyde, level of ROS, rate of apoptosis, express of Bax protein and mRNA and Caspase-3 activation of cell(P<0. 05). Conclusion Edaravone can alleviate rat renal tubular epithelial cell injury induced by cisplatin, via inhibiting oxidative stress and down-regulating cell apoptosis.

Objective To investigate the clinical curative effect and security of Kanglaite injection in combination with low power ultrasound microbubble agents (cavitation) in the treatment of vascular embolization therapy.Methods Thirty-eight patients with abdominal malignant tumor,in accordance with the random number table,were divided into two groups:treatment group (Kanglaite combined with ultrasonic cavitation,21 cases) and control group (Kanglaite,17 cases).Intravenous drip with Kanglaite injection for 21 days,200 ml per day.Ultrasonic cavitation therapy treatment for three weeks,5 days a week and once a day.Tumors size,Karnofsky score,grade of the degree of pain and blood biochemical indicator detection were measyred before and after treatment.Results There was no complete remission,4 cases with partial remission,10 cases with stable disease in the treatment group,and the clinical benefit rate was 66.7％ (14/21).There was no complete remission,1 case with partial remission,3 cases with stable diseasein in control group,and the clinical benefit rate was 23.5％ (4/17).The treatment group was better than control group in clinical benefit rate (66.7％ ∶ 23.5％),pain improvement (76.2％ ∶ 41.2％),Karnofsky score [(66.67 ± 5.77) ∶ (82.86 ± 6.44);(64.12 ±5.07) ∶ (69.41 ±6.59)],and one year survival rate (57.1％ ∶23.5％) (x2 =7.012,P =0.008;x2 =4.821,P=0.028;t=4.575,P＜0.001;x2 =4.354,P=0.037).Conclusion Kanglaite injection in combination with cavitation shows higher clinical efficient,tolerated adverse recations,and significant improvement of quality of life.

Objective To evaluate the treatment effect of sustained low-efficiency diafiltration( SLEDF) on patients with severe acute pancreatitis( SAP). Methods Forty-two patients with SAP were randomly divided into continuous veno-venous hemofiltration( CVVH)group with 22 patients and SLEDF group with 20 patients. In addition to routine treatment,patients in CVVH and SLEDF were administrated to patients respectively in two groups. Mortality,incidence of complication,clinical symptoms,sign and laboratory examination and recovery time were recorded and measured. The scores of acute physiology and chronic health evaluation( APACHE)II and multiple organ dysfunction syndrome( MODS ) were performed. The level of C-reactive protein( CRP ),tumor necrosis factor-α( TNF-α),interleukin( IL )-6 and IL-8 were measured. Results There were no significant differences in terms of the mortality(90. 91% vs. 90. 00%;χ2 =0. 010,P=0. 920),incidence of complication (18. 18% vs. 20. 00%;χ2 =0. 023,P =0. 881)and recovery time of clinical symptoms,sign and laboratory examination in CVVH group and SLEDF( P﹥0. 05 ). There were also no significant differences between CVVH and SLEDF group in terms of scores of APACHE II((12. 1 ± 6. 1)vs.(11. 9 ± 7. 2);t=0. 097,P=0. 920), MODS((4. 3 ± 1. 7)vs.(4. 4 ± 1. 8);t=0. 185,P=0. 850),CRP((161. 7 ± 22. 9)mg/L vs.(157. 6 ± 21. 8) mg/L;t=0. 594,P=0. 550),TNF-α((5. 8 ± 1. 9)ng/L vs.(5. 7 ± 1. 8)ng/L;t=0. 175,P=0. 860),IL-6 ((4. 1 ±1. 2)pg/L vs.(4. 2 ± 1. 1)pg/L;t =0. 282,P =0. 780)and IL-8((3. 3 ± 1. 4)pg/L vs.(3. 2 ± 1. 0)pg/L;t=0. 268,P=0. 790)at 72 h post-treatment. However,the above test indices were decreased at 72 h post-treatment than those at admission(P﹥0. 05). Conclusion SLEDF and CVVH are proved with same treatment effect based on the levels of inflammatory cytokine,alleviating pathogenetic condition and improving prognosis in patients with severe acute pancreatitis.

The etiology of nasopharyngeal carcinoma is still not very clear.Epigenetics is proved to play an important role in the occurrence and development of nasopharyngeal carcinoma (NPC).Detection of epigenetics can serve as molecular index of NPC,and it is advantageous to the prognosis and disease of NPC.Different intervention measures in the epigenetics can be used as a new treatment of NPC,as well as the development of new NPC radiotherapy sensitization agent and new drugs.Study of epigenetics changes in nasopharyngeal carcinoma provides a new idea for the diagnosis and treatment in NPC and so on.