Objective To seek for the best clinical nursing pathway for early limbs activity of patients with high-risk hemiplegia in the department of cerebral surgery and to reduce limbs paralysis and improve their life quality.Methods Patients(112 cases)with high-risk bemiplegia in the department of cerebral surgery from January to December in 2007 were set as the experimental group.They took part in limbs early activity on the first day on admission with application of clinical nursing pathway.Patients(89 cases)of the same kind who took part in limbs activity from January to December in 2006 were set as the control group.The two groups were compared with Brunnstrom scale beth on admission and discharge.Results The Brunnstrom grade of upper limbs,hands and lower limbs of the experimental group was evidently higher than that of the control group(P＜0.05).Especially the isolated movement and coordination ability of the hands significantly increased(P＜0.01). Conclusions Early limbs activity with clinical nursing pathway for patients with high-risk hemiplegia in the department of cerebral surgery could reach the aim of recovery of limbs functional activity.

Objective To discuss total vertebrectomy and spine stability and reconstruction by pos-terior ap proach for thoracic vertebra tumor and pedicle screw system fixation and intervertebral fusion.Methods Eighteen patients of 3males and15females of thoracic total vertebral tumor were operated in this group.The age of the group were from14to58years old,with the average of 23years.There were4aneurysmal bone cysts,2hemangiomas,2osteoblastomas,1neurilemomas,5giant cell tumor,1solitary myeloma and3metastatic thoracic vertebra tumors.The locations of the tumors was T 4 in1case,T 5 in1case,T 6 in2cases,T 8 in4cases,T 9 in3cases,T 10 in4cases,T 11 in2cases and T 12 in1case respectively.Pre-operative Frankel classification was grade A in6cases,B in7cases,C in3cases and E in2cases.Cir-cumferential decompression was performed with total spondylectomy through one-stage posterior ap proach.Anterior verte bral reconstruction was provided by autograft(ribs or ilium)bone or metallic cage;Posterior reconstruction was achieved by pedi cle screws system of CD or TSRH,Scofix fixation and auto graft fusion.Results The mean follow-up was8months,ranging from3months to24months.Twelve of 16cases with neu ro logical dysfunction were recovered completely,1case recovered from Frankel grade A to C,2cases from grade A to D,1case from grade B to D.The patient with neurilemmoma recurred and became ma lig nant after20months of operation and died4months later.One case of metastatic tumor of lung cancer sur vived6months after opera tion.One patient with giant cell tumor recurred.The other patients were still alive in the latest follow-up.There were no instruments breakage and spinal instability during the follow-up.Conclusion If the thoracic total vertebral tumor compress spinal cord se riously,the patients should be indi cat-ed for surgical treatment constructively.Total vertebrectomy followed by one-stage posterior approach re con-struction could relieve the com pression caused by tumor and reconstruct the stabilization of spine effectively.

Targeted cancer therapy is one of the modalities to increase efficiency and decrease adverse effects of chemotherapy,and the selection of drug vector system is of importance for targeted therapy.An ideal adriamycin targeted vector system should have maximal efficacy and minimal adverse effects in inhibiting cancer cells through different mechanisms.This article reviews the recent progress in adriamycin targeted therapy,including the modes of adriamycin administration,the selection of drug vectors,as well as other chemotherapeutic drugs in targeted therapy of liver carcinoma.

Objective To observe the effects of dendrobium nobile Lindl(DNL) on Nuclear factor(NF)-κB and interleukin(IL)-6 expression of renal tissue in diabetic rat model .Methods The diabetes mellitus rat model was induced by streptozotocin .All rats were divided into four groups at random :the normal control group(group N) ,diabetic control group(group diabetes mellitus) ,drug group one(group DNL1) ,drug group two(group DNL2) ,and administrated for 12 weeks .The levels of the fasting plasma glucose , urea nitrogen ,serum creatinine ,urine creatinine ,24 hours urinary protein were determined .NF-κB and IL-6 protein expression levels were measured by Western-Blot .IL-6 mRNA expression levels were measured by Real-time fluorescence quantitative PCR . Results Compared with group N ,the blood sugar ,urea nitrogen ,24 hours urinary protein of group diabetes mellitus were signifi-cantly higher(P<0 .01) ,creatinine clearance was significantly reduced (P<0 .01) ,the NF-κB、IL-6 protein expression levels and IL-6 mRNA level increased significantly (all P<0 .05) .Compared with group diabetes mellitus ,the blood sugar ,urea nitrogen ,24 hours urinary protein of group DNL1 and group DNL2 were significantly decreased(P<0 .05) ,creatinine clearance increased significantly (P<0 .05) ,the NF-κB、IL-6 protein expression levels and IL-6 mRNA level decreased significantly(all P<0 .05) .Conclusion The DNL could protect the kidney of diabetic rats ,reduce the levels of NF-κB 、IL-6 protein and IL-6 mRNA expression in renal tissue of diabetic rats .

Humans ; Neurilemmoma ; Paranasal Sinus Neoplasms ; Paranasal Sinuses ; pathology

Objective To investigate the histochemical changes of 3?-hydroxysteroid dyhydrogenase(3?-HSD), sucinic dehydrogenase(SDH) and lipid on rat adrenal cortex in the carcinogenesis-resistance with selentum. Methods Wistar rats stomach carcinogenesis (formation of aneuploid cells in the glandular stomach mucosa) was induced by MNNG(N-methy1-N-nitroso-guanidine,20 mg/kg)gavage. The changes of the adrenal cortex were studied by histochemistry and image analysis during preventing glandular stomach cancer with selenium(0.1 mg/kg and 2.0 mg/kg) Results 1.Dietary Se inhibited the aneuploid cell formation,which induced by MNNG gavage in Wistar rat stomach; 2.The histochemical reactions of 3?-HSD and SDH were both significantly stronger in experimental group than that in normal control group in the course of the rat stomach carcinogenesis(P

Objective To study the effect of Na-2SeO-3 on experimental carcinogenesis of stomach and on p53 and p16 expression. Methods Weaning male Wistar rats were divided into four groups randomly:high selenium group(4mg/L),low selenium(2mg/L)group,experiment control group and normal control group.Wistar rat gastric cancer was induced by N-methyl-N′-nitro-N-nitrosoguanidine(MNNG,20mg/kg)given daily for 10days.Na 2SeO 3 was given by piped drinking before one week of MNNG administration.Rats were killed at the 43th week.The surface characters of gastric mucosa were observed with noked eyes.Histopathologic changes were observed by methods of HE staining and Alcian Blue Periodic acid Schiff reaction(AB-PAS).Changes of p53 and p16 were detected by SP immunohistochemical method.The immunohistochemical results were quantitatively analysed by image analysis.Statistical analysis was taken by SPSS. Results Dietary Na-2SeO-3(2mg/L,4mg/L)aggravated gastric erosion and hemorrhage and promoted intestinal metaphasia of gastric cancer (P0.05).Conclusion These results suggest that dietary Na-2SeO-3 by piped drinking might not decrease incidence of Wistar rat gastric cancer induced by MNNG.The mechanism may be associated with the mutations of p53 and abnormal expression of p16 gene.

Objective:To construct an eukaryotic expression vector of enhanced green fluorescence protein(EGFP) gene driven by telomerase catalytic subunit(hTERT) gene promoter and observe the specific expression of EGFP in lung cancer cell lines.Methods:The 1100bp promoter fragment was obtained by enzyme digestion from a recombinant plasmid of pGL3-hTERTp containing the hTERT promoter.The hTERT promoter was then subcloned into the upstream of the report gene EGFP of pEGFP-1 without promoter.The expression vector pEGFP-hTERTp was successfully constructed.The vector pEGFP-N1 containing cytomegalovirus(CMV) promoter was used as a positive control.The vector pEGFP-1 without promoter was used as a negative control.The vectors were transfected into human lung cancer cell lines 95D,NCI-H446,A2,A549,LTEP-a-2,YTMLC and normal MRC-5 through lipofectamine respectively.EGFP expression was detected under the fluorescence microscope.Results:pEGFP-hTERTp was confirmed by enzyme digestion with correct result.That the EGFP expression was detected in all of eight lung cancer cells transfected with pEGFP-hTERTp,but not in MRC cells.By contrast,high intensity EGFP expression was observed in both lung tumor cells and normal cells,which were transfected with pEGFP-N1.Conclusion:The EGFP controlled by hTERT promoter can be expressed specifically in lung cancer cell lines.hTERT promoter may be used as an excellent regulation element in tumor-targeting gene therapy.

Objective To evaluate the clinical value of fasting blood glucose (FBG) in the diagnosis of multiple organ dysfunction syndrome (MODS) caused by pulmonary infection in elderly patients with diabetes. Methods Patients over 65 years old with diabetic pulmonary infection admitted to Department of Cadres Ward of Bethune International Peace Hospital of PLA from July 2015 to December 2016 were enrolled. According to the patient's highest FBG level during pulmonary infection, all patients were divided in two groups. The cases whose FBG ≥8.83 mmol/L were served as suspicious multiple organ dysfunction syndrome in the elderly (MODSE) group, and those had FBG < 8.83 mmol/L were served as suspicious non-MODSE group. The incidence of MODSE in suspicious MODSE group and suspicious non-MODSE group was compared. The receiver operating characteristic curve (ROC) was drawn, and the clinical value of highest FBG in the diagnosis of MODSE caused by pulmonary infection in elderly patients with diabetes was assessed. Results 119 elderly patients with diabetes and pulmonary infection were enrolled in the analysis. All patients were male, with age of 76-105 years with an average of (89.41±4.16) years. Among 119 patients, 55 of them with suspected MODSE, 64 of them with suspected non-MODSE. The incidence of MODSE in suspicious MODSE group was significantly higher than that in suspicious non-MODSE group (78.2% vs. 12.5%), with statistically significant difference (χ2 = 52.108, P = 0.000). The area under the ROC curve of the highest FBG for diagnosis of MODSE was 0.895, and 95% confidence interval (95%CI) was 0.839-0.951 (P < 0.001). When using FBG ≥ 8.83 mmol/L to diagnose MODSE induced by pulmonary infection in elderly patients with diabetes, the sensitivity was 84.3% and the specificity was 82.4%. Conclusion FBG ≥ 8.83 mmol/L, as an indicator reflecting the changes of metabolic function, have a diagnostic value for MODSE caused by pulmonary infection in elderly patients with diabetes.

Objective To analyze the epidemic characteristics of multidrug-resistant tuberculosis(MDR-TB)in Hunan Province from 2013 to 2016,and provide theoretical basis for the prevention and control of tuberculosis.Methods Information about TB patients in Hunan Province reported by China Information System for Disease Control and Prevention between January 2013 and December 2016 was analyzed retrospectively.Results From 2013 to 2016,the total drug resistance registration rate in Hunan Province was 5.53/million(1 496/270 330 000),multidrug registration rate was 5.40/million(1 459/270 330 000),drug resistance rate and multidrug resistance rate showed an upward trends(trend x2 =113.605,96.590,respectively,both P<0.001).Among MDR-TB patients,male were more than females(74.09%vs 25.91%),most were more than 25 years of age,especially 45～age group(27.07%);the proportion of patients with MDR-TB retreatment was higher than that of the initial treatment(69.91%vs 30.09%).From 2013 to 2016,distribution range of MDR registration rates in different regions were 4.07/million-7.23/million.Conclusion MDR-TB in Hunan Province in 2013-2016 is increasing year by year,and mainly concentrate on young people over 20 years old.There are more cases of male and retreatment;it is necessary to strengthen regular treatment and prevention of key population,enhance the ability to identify and diagnose MDR-TB patients,and reduce the spread of MDR-TB.