Objective To evaluate patient-controlled epidural analgesia (PCEA) with morphine on breastfeeding neonatal neurological arid adaptive capacity after cesarean section.Methods Thirty healthy parturients after cesarean section under epidural block were randomly selected as test group, and thirty healthy parturients with natural childbirth served as control group without any opioids administration. In test group the patients received PCEA after cesarean section. The regimen included a loading dose of morphine 2mg, bupivacaine 12.5mg and droperidol 0.5mg in 10ml of normal saline, followed by background infusion at 2 ml?h~(-1) with an 2ml bolus dose and a 20min lockout interval. The PCEA solution contained morphine 20mg, bupivacaine 125mg and dreporidol 5 mg in 100ml of normal saline. The samples of intravenous blood and colostrums were taken 2, 4, 8,12 and 24 h after the loading dose administration for measurement of plasma and colostrums concentrations of morphine. The neonatal neurological and adaptive capacity scores(NACS) of both groups were recorded at corresponding time points, Results Concentrations of morphine in colostrum and plasma kept decreasing following the loading dose administration. There was a significant positive correlation between concentrations of morphine in colostrum and plasma (r=0.998, P

Surgical treatment is the primary curative treatment for hepatocellular carcinoma and liver metastasis of colorectal cancer, but most patients are ineligible for the treatment upon initial diagnosis. And the overall efficacy of topical treatments such as radiofrequency ablation or transcatheter arterial chemoembolization remains limited. As an important supplementary treatment for surgery, radiotherapy plays an increasingly important role in the treatment of hepatic malignancies with the development of radiotherapy and the progress of liver cancer research. At the same time, the focus of liver radiation is on the safety of radiotherapy, especially the risk of radiation-induced liver disease. In this review, the recent advances in the clinical studies and safety of radiotherapy for hepatocellular carcinoma and liver metastasis of colorectal cancer were summarized.

Objective: To introduce the diagnosis and treatment of a case of male primary mediastinal choriocarcinoma, and to summarize the diagnosis and treatment of the disease by literature review. Methods: The diagnosis and treatment process of a male patient with primary mediastinal choriocarcinoma was reported. The clinical characteristics, diagnosis and treatment of 132 cases of primary mediastinal choriocarcinoma were retrospectively analyzed, in order to summarize the experience of diagnosis and treatment of this disease. Results: A 19-year-old male was admitted to hospital in September 2017 due to “chest pain and dyspnea for 1 week”. After 2 times of CT-guided mediastinal punctures, he was diagnosed with “choriocarcinoma”. After 8 times of chemotherapy and local radiotherapy for mediastinal and lung masses were completed in the hospital from October 2017 to March 2018, the response evaluation was partial remission. Following up to December 2018, the patient was generally in good condition, and no progression of tumor was observed; but he died in March 2019 due to suspected tumor recurrence. The literature review showed that the disease was rare in clinical practice, lacking of large-scale clinical studies and consensus on treatment options, so the median survival time of patients was generally short. Conclusion: Primary mediastinal choriocarcinoma in male is a rare disease that lacks specific clinical features. The treatment mainly relies on the comprehensive treatment including surgery, chemotherapy and radiotherapy, but the disease progresses rapidly with poor prognosis.

Objective　To study the survival motor neuron (SMN) gene exon 7 and 8 and neuronal apoptosis inhibitory protein (NAIP) gene exon 5 and 6 in Chinese patients with Type Ⅰ～Ⅲ SMA, and to confirm the relationship between the deletions of SMN and NAIP genes with SMA phenotype. Methods　PCR and PCR-enzyme methods were used to detect the deletions of NAIP gene exon 5 and 6 and SMN gene exon 7 and 8 in 15 SMA (Ⅰ～Ⅲ) patients, 20 healthy relatives and 30 normal controls. Results　Deletions of exon 7 and 8 of the telomeric SMN gene were 4/4, 2/3, 1/8 in Type Ⅰ, Ⅱ, Ⅲ SMA patients, respectively. One patient with Type Ⅱ lacked exon 7 but retained exon 8. No deletion was found in the controls (0/50). No deletion of exon 5 and 6 of the NAIP gene was detected in the patients, healthy relatives and controls. Conclusions　Deletions of SMN gene exon 7 and 8 examined by PCR-enzyme digestion could be recommended as an accurate gene diagnostic method for SMA with Type Ⅰ and Ⅱ. However, the method was not as useful in Type Ⅲ as in Ⅰ and Ⅱ for the diagnosis of SMA. The frequency of NAIP deletion was lower in Chinese SMA patients.

Objective: To investigate the influence of edaravone on the expression of growth arrest and DNA damage-inducible protein 34 (GADD34). Methods: A total of 108 healthy male Sprague-Dawley rats were randomly divided into sham operation group, model group and edaravone group (36 cases for each group). Transient focal cerebral ischemia was induced by middle cerebral artery occlusion for 2 h followed by reperfusion in Sprague-Dawley rats. Then, GADD34 expression was measured with immunohistochemistry at different time-points after reperfusion in the peri-infarct regions of all rats. Results: The GADD34 expression was detected in the peri-infarct regions of rats 1 h after reperfusion, which reached its peak 24 h after reperfusion. And edaravone could significantly down-regulate the GADD34 expression. Conclusions: Edaravon could down-regulate GADD34 expression, which suggests that edaravone may exert an important function in inhibiting endoplasmic reticulum stress reaction by scavenging free radicals in the upper stream.

Breast Neoplasms ; epidemiology ; China ; epidemiology ; Female ; Humans ; Occupational Diseases ; epidemiology ; Risk Factors ; Stress, Psychological

This article summarizes methods of repair of massive and deep wounds, elucidates how to improve wound healing quality and avoid scar deformity after deep burn. A part of denatured dermis (non-necrotic) in deep partial-thickness burn, "mixed degree" burn, even in full-thickness burn wounds before forming eschar can be preserved and covered with autologous skin, thereby to avoid secondary damage to the structure of subcutaneous tissue and the junction of dermis-adipose, thus to result in good functions, appearance, and survival rate. After skin grafting, wound healing quality and appearance are improved, joint function and elasticity of skin are enhanced, the degree of scar contracture is relieved due to preservation of normal adipose tissue after escharectomy. The study of composite artificial skin will be actively developed in the future. Tissue-engineering skin and stem cells can be successfully used in patients with deep burns for scarless healing with restoration of physiological functions in a short period.
Adipose Tissue ; transplantation ; Burns ; surgery ; therapy ; Humans ; Reconstructive Surgical Procedures ; Skin Transplantation ; Tissue Engineering ; Wound Healing

The history and application of surgical flap transplantation in burn wound were briefly reviewed. We outlined skin flap, musculocutaneous flap, fascia flap and neurocutaneous vascular flap in this paper and recommended repair deep wounds with flap. All in all, in this review, we hope to provide a meaningful option for clinical application of surgical flap in the future.
Burns ; surgery ; China ; Humans ; Skin Transplantation ; Surgical Flaps ; classification

This article presents the anatomical basis, different kinds of perforator flaps and the distribution regularity of perforator vessels, principle of terminology, range of application, and their advantages and disadvantages. The procedure in harvesting and transplantation of perforator flaps are also discussed, in order to promote clinical application of perforator flaps, and to provide a more efficacious way to reconstruct the deep burn wound.
Burns ; surgery ; Humans ; Perforator Flap ; transplantation ; Reconstructive Surgical Procedures ; methods

To construct a plasmid expressing MDR1 short hairpin RNA (shRNA) mediated by pEGFP-C1/U6 vector, two coding sequences of 19 nucleotides were selected from MDR. Two pairs of oligonucleotides were designed for these two fragments. After annealing the formed double-stranded DNAs were ligated with plasmid pEGFP-C1/U6 (pEGFP-C1 vector with U6 promoter). The plasmids producing MDR1 shRNA were constructed from the inverted motif containing 9 spacers and four Ts. The results showed that the constructed plasmids were named pEGFP-C1/U6/A and pEGFP-C1/U6/B, and the constructs were identified by restriction and sequence analysis, no any base mutation was observed. It is concluded that plasmids of pEGFP-C1/U6/A and pEGFP-C1/U6/B expressing MDR1 shRNA were successfully constructed, providing a highly effective method for reversing the multidrug resistance in clinic.
ATP-Binding Cassette, Sub-Family B, Member 1 ; biosynthesis ; genetics ; DNA-Binding Proteins ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; genetics ; Humans ; Plasmids ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; RNA, Small Interfering ; biosynthesis ; genetics ; RNA, Small Nuclear ; genetics