AIM: To observe the effect of continuous epidural analgesia (CEA) of tramadol on postoperative gastrointestinal function and serum motilin level in the patients with cholecystectomy. METHODS: Twenty eight ASAⅠ-Ⅱpatients (8 male, 20 female) aged 24-56 yr, scheduled for elective cholecystectomy under epidural anesthesia, were randomly divided into tramadol group (T, n=14) and control group (C, n=14). The combination of tramadol 800 mg+ bupivacaine 150 mg+ droperidol 5 mg, which diluted with normal saline to 100 ml and pumped 2 ml?h -1, was administered in group T. The combination in group C was bupivacaine 150 mg+ droperidol 5 mg. The VAS values, the first anorectum exhaust timing (FAET), and the time of the first eliminating stool timing (FEST) were recorded, and serum motilin level measured with radioimmunoassay at the different times after surgery. RESULTS: There was a significant difference in the mean VAS values between group T ( 1.2? 1.2) and group C ( 3.3? 1.3) (P

Objective To observe the expressions of CD26, Ki67 and epidermal growth factor receptor(EGFR) proteins in thyroid neoplasms, to explore their value in differential diagnosis between benign and malignant thyroid neoplasms and to search for molecular marker in well-differentiated thyroid carcinomas.Methods The expressions of CD26,Ki67and EGFR proteins were examined by immunohistochemistry in 50 differentiated thyroid carcinomas (TC) and 50 thyroid adenomas (TA) and their relationships were analyzed.Results The positive rate and expression intensity of CD26,Ki67and EGFR proteins in TC were significantly higher than those in TA, and especially higher in follicular TC than those in follicular TA.Conclusion The abnormal expressions of CD26, Ki67and EGFR proteins appear to be valuable in differential diagnosis and predicting prognosis of thyroid carcinomas, especially CD26 can be used as a diagnostic marker in well-differentiated carcinoma of follicular cell origin.

OBJECTIVE:To observe the effects of clarithromycin and fleroxacin on Pseudomonas aeruginosa(PA) biofilm METHODS:Clinical isolates of 7 strains of PA from respiratory tract were cultured with modified plate culture method;bacterial biofilm model was identified by silver nitrate staining;MICs were determined by broth microdilution The number of viable bacteria in biofilm was measured by using MTT method and bacterial adherence was measured by crystal violet staining RESULTS:1/16MIC and 1/4MIC of clarithromycin could inhibit the adherence of PA to silica-gel film(P

Objective To evaluate the effects of cranial electrotherapy stimulation therapy combined with psychological intervention for treating depression after cerebral infarction.Methods Eighty persons diagnosed with depression after cerebral infarction were divided randomly into a treatment group and a control group.Both groups were given routine rehabilitation training and psychological intervention, but the treatment group also received microcurrent transcranial electrical stimulation treatment.All the patients were evaluated with Hamilton's depression scale (HAMD) and the mini-mental state exam (MMSE) and given Barthel index (BI) scores before and after 4 weeks of treatment.Results There was no significant difference between the 2 groups in terms of any of the measures before treatment.After 4 weeks of treatment, both groups had improved significantly, but the improvements on all measures were significantly better in the treatment group.Conclusion Cranial electrotherapy combined with psychological intervention can significantly improve symptoms of depression and cognitive function in patients with post-stroke depression, and play an important role in improving their daily life.

BACKGROUND:The low oxygen environment after femoral fracture and cerebral trauma wil induce series of related cytokines expression, including hypoxia-inducible factor 1αand core binding factorα1, which play key roles in regulating bone healing. However, whether the accelerated bone healing is correlated with the expression of hypoxia-inducible factor 1αand core binding factorα1 is stil unknown.
OBJECTIVE:To construct rat models of brain injury, to compare the expression level of hypoxia-inducible factor 1αand core binding factorα1 in femoral fracture combined with cerebral trauma rats and simple femoral fracture rats, and to assess the influence of cerebral trauma on bone healing.
METHODS:Rats were randomly divided into blank group, simple femoral fracture group and femoral fracture combined with cerebral trauma group. At 1, 2, 3 and 5 weeks after modeling, rats were executed. Bone healing was evaluated using femoral fracture end X-ray score and hematoxylin and eosin staining at cal us tissues. Besides, the expression levels of hypoxia-inducible factor 1αand core binding factorα1 of three groups were determined with immunohistochemistry.
RESULTS AND CONCLUSION:Bone healing in the femoral fracture combined with cerebral trauma group was better than that of simple femoral fracture group. There was significant difference in the expression level of hypoxia-inducible factor 1αand core binding factorα1 between the simple femoral fracture group and femoral fracture combined with cerebral trauma group (P<0.05). At the same time, the level of simple femoral fracture group and femoral fracture combined with cerebral trauma group was significantly higher than that of blank group, and that in femoral fracture combined with cerebral trauma group was significantly higher than that of simple femoral fracture group (P<0.05). Results verified that the expression levels of hypoxia-inducible factor 1αand core binding factorα1 of rats with femoral fracture combined with cerebral trauma were significantly high, which may be the major reason why the bone healing was accelerated after fracture combined with brain injury.

Objective To evaluate the application value of situational simulation method based on SimMan 3G in anesthesiology teaching. Methods 5-years anesthesiology under-graduates of 2012 grade and 2013 grade in Wannan Medical Colloge anticipating in clinical practice of anesthesia were selected as observation group. All students were divided into two groups: control group (teachers demonstrated cases, 2012 grade, n=35) and observation group (students role-played simulation cases, 2013 grade, n=36). In control group, teachers firstly applied a multimedia courseware, and then demonstrated the cases to adopt the SimMan 3G simulated system. In observation group, SimMan 3G situational simulation method was used to teach the course , and then the students played roles and videotaped the whole course in the simulated operating room. After training, the students discussed their performance in the simulated training (by the playback of the simulated video), and the teachers commented and summarized the case. The effect of teaching was evaluated by questionnaire and examination. The date were analyzed through Chi-square and t-test test. Results There was no significant difference in essential characteristics, including age, gender, the scores of specialized theory at routine examination between two groups (P>0.05). Statistical difference was found in the theoretical assessment between observation group and control group [(79.44±5.41) vs. (73.46± 4.62), P=0.001]. Meanwhile, questionnaire survey of teaching effect showed that in observation group 31 students (86.1％) were satisfied with the teaching contents, 33 students (91.7％) had consolidated clinical thinking, and 34 students (94.4％) believed it improved their teamwork and communication ability (P=0.031, P=0.018, P=0.013). Conclusion Using SimMan3G for role-playing situational simulation teaching can significantly improve student's comprehensive theoretical scores, facilitate the exercise of clinical thinking, and improve their teamwork and communication skills.

Objective To study the effect of axitinib on the proliferation and apoptosis of human lung adenocarcinoma PC9 cells and its mechanism. Methods PC90 cells were treated with different concentrations (0, 0.125, 0.25, 0.5, 1, 2, 4, 8, 16, 32, and 64 μmol/L) of axitinib for 72 h, and half-inhibitory concentration (IC50) was calculated. The cell proliferation ability was detected by CCK-8 method. Plate cloning experiments were performed to observe the effect of axitinib on the formation of PC9 cell clones. The mitochondrial membrane potential and apoptosis of PC9 cells were detected by flow cytometry. The expression of cleaved-Caspase-3 protein in PC9 cells was detected by Western blot. Results Asitinib inhibited the proliferation of PC9 cells in a concentration-dependent manner. The IC50 at 72 h was 10.18μmol/L. The clone formation rates of PC9 cells were (100.0±3.2)％, (58.6±2.7)％, (29.3±3.3)％, and (10.9±3.0)％10 d after treatment with 0, 1, 2 and 4 μmol/L axitinib, and the difference was statistically significant (F= 316.922, P< 0.01). The apoptotic rate of PC9 cells at early and late stages increased after treatment with different concentrations of axitinib for 48 h, and the differences were statistically significant (both P< 0.01). After treatment with 0, 4, 8 and 16 μmol/L axitinib for 24 h, the percentage of PC9 cells with low mitochondrial membrane potential was (11.9±1.9)％, (38.5±2.3)％, (56.3±2.7)％, and (76.9±3.1)％, and the difference was statistically significant (F=234.320, P<0.01). The expression level of cleaved-Caspase-3 protein in PC9 cells increased, and the relative expression levels were 1.00±0.04, 1.26±0.09, 1.78±0.12, and 2.10±0.11, respectively, and the difference was statistically significant (F=55.670, P<0.01). Conclusions Axitinib could inhibit the proliferation of human lung adenocarcinoma PC9 cells. Axitinib induces the apoptosis of PC9 cells possibly through decreasing the mitochondrial membrane potential of PC9 cells.

Objective:To investigate the effects of body mass index (BMI) on lung function in patients with chronic obstructive pulmonary disease (COPD).Methods:A total of 3 312 patients with COPD were selected from outpatients and inpatients in Department of Gerontal Respiratory Medicine of the First Hospital of Lanzhou University from August 2016 to August 2020, including 1 103 patients in stable period and 2 209 patients in acute exacerbation period. According to body mass index (BMI), these COPD patients were divided into four groups: low weight (56 cases, 131 cases), normal weight (448 cases, 945 cases), overweight (424 cases, 773 cases) and obesity groups (175 cases, 360 cases) respectively in stable stage and in acute exacerbation stage. The lung function of inspiratory capacity (IC), vital capacity (VC), residual volume (RV)/total lung capacity (TLC), forced expiratory volume in 1 second (FEV 1), forced vital capacity (FVC), FEV 1/FVC, maximal mid-expiratory flow (MMEF), diffusing capacity of the lung for carbon monoxide (DLCO), DLCO normalized per liter alveolar volume (DLCO/VA), respiratory impedance (Zrs), respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20) and respiratory reactance at 5 Hz (X5) were measured using MasterScreen PFT in all patients, and the influence of BMI on lung function was analyzed respectively. The risk factors of impaired lung function were analyzed by ordered logistic regression with lung function grade as dependent variable and age, gender, smoking history, smoking index and BMI as independent variables (“%pred”represents the percentage of predicted value). Results:The proportion of patients with lung function grade Ⅲ/Ⅳ in acute exacerbation period (64.9%, 37%, 27.4%, 24.4%) was higher than that in stable stage (42.9%, 25.9%, 13.7%, 9.1%), while the proportion of patients with lung function grade Ⅰ in stable stage (21.4%, 34.2%, 38.2%, 40.0%) was higher than that in acute exacerbation period (7.6%, 20.0%, 25.4%, 22.8%) (all P<0.05). The IC%pred, VC%pred, FEV 1%pred, FVC%pred, FEV 1/FVC, MMEF%pred, DLCO%pred, DLCO/VA%pred and R20 in low weight group were significantly lower than other groups both in stable period and acute exacerbation period (all P<0.05). The RV/TLC was higher in low weight group than that of normal weight and overweight groups in both periods (all P<0.05). The IC%pred, FEV 1%pred, FEV 1/FVC, DLCO%pred, DLCO/VA%pred, R5 and R20 in overweight and obesity groups were higher than those of normal weight group (all P<0.05). The RV/TLC, FEV 1/FVC, DLCO%pred, DLCO/VA%pred, Zrs, R5 and R20 in obesity group were higher than those of overweight group (all P<0.05). The ordered logistic regression analysis showed that low weight was independent risk factor for impaired lung function of COPD both in stable period [ OR (95% CI) 2.316 (1.206-3.554)] and acute exacerbation period [ OR (95% CI): 2.457 (1.647-3.669)]. Conclusion:Lower BMI has an adverse effect on lung function, and it is an independent risk factor for impaired lung function in COPD patients.

Objective:To explore the predictive value of HACOR score [heart rate (H), acidosis (A), consciousness (C), oxygenation (O), and respiratory rate (R)] on the clinical outcome of non-invasive positive pressure ventilation in patients with pulmonary encephalopathy due to chronic obstructive pulmonary disease (COPD).Methods:A prospective study was conducted. The patients with COPD combined with pulmonary encephalopathy who were admitted to Henan Provincial People's Hospital from January 1, 2017 to June 1, 2021 and initially received non-invasive positive pressure ventilation were enrolled. Besides non-invasive positive pressure ventilation, standard medical treatments were delivered to these patients according to guidelines. The need for endotracheal intubation was judged as failure of non-invasive ventilation treatment. Early failure was defined as the need for endotracheal intubation within 48 hours of treatment, and late failure was defined as the need for endotracheal intubation 48 hours and later. The HACOR score at different time points after non-invasive ventilation, the length of intensive care unit (ICU) stay, the total length of hospital stay, and the clinical outcome were recorded. The above indexes of patients with non-invasive ventilation were compared between successful and failed groups. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive effect of HACOR score on the failure of non-invasive positive pressure ventilation in the treatment of COPD with pulmonary encephalopathy.Results:A total of 630 patients were evaluated, and 51 patients were enrolled, including 42 males (82.35%) and 9 females (17.65%), with a median age of 70.0 (62.0, 78.0) years old. Among the 51 patients, 36 patients (70.59%) were successfully treated with non-invasive ventilation and discharged from the hospital eventually, and 15 patients (29.41%) failed and switched to invasive ventilation, of which 10 patients (19.61%) were defined early failure, 5 patients (9.80%) were late failure. The length of ICU and the total length of hospital stay of the non-invasive ventilation successful group were significantly longer than those of the non-invasive ventilation failure group [length of ICU stay (days): 13.0 (10.0, 16.0) vs. 5.0 (3.0, 8.0), total length of hospital stay (days): 23.0 (12.0, 28.0) vs. 12.0 (9.0, 15.0), both P < 0.01]. The HACOR score of patients at 1-2 hours in the non-invasive ventilation failure group was significantly higher than that in the successful group [10.47 (6.00, 16.00) vs. 6.00 (3.25, 8.00), P < 0.05]. However, there was no significant difference in HACOR score before non-invasive ventilation and at 3-6 hours between the two groups. The ROC curve showed that the area under the ROC curve (AUC) of 1-2 hour HACOR score after non-invasive ventilation for predicting non-invasive ventilation failure in COPD patients with pulmonary encephalopathy was 0.686, and the 95% confidence interval (95% CI) was 0.504-0.868. When the best cut-off value was 10.50, the sensitivity was 60.03%, the specificity was 86.10%, positive predictive value was 91.23%, and negative predictive value was 47.21%. Conclusions:Non-invasive positive pressure ventilation could prevent 70.59% of COPD patients with pulmonary encephalopathy from intubation. HACOR score was valuable to predict non-invasive positive pressure ventilation failure in pulmonary encephalopathy patients due to COPD.

Objective: To investigate the expression of survivin, fibronectin-1, vascular endothelial growth factor (VEGF) and ezrin in thyroid tumors and their relationship with the pathological characteristics of thyroid tumors. Methods: Ninety patients with thyroid tumors admitted to the third affiliated hospital of Zunyi Medical University and the first hospital during Oct. 2016 and Oct. 2018 were selected as the observation group. Seventy-five patients with normal thyroid confirmed by pathology in the same period were selected as the control group. The protein levels of survivin, fibronectin-1, VEGF and ezrin were detected by immunohistochemical method. Results: The positive rates of survivin, fibronectin-1, VEGF and Ezrin in the control group were 2.67%, l4.00%, 1.33% and 1.33%, which were lower than 97.78%, 96.67%, 93.33% and 95.56% in the observation group, respectively (all P<0.05 or P<0.01). The expressions of survivin, fibronectin-1, VEGF and ezrin were significantly correlated with TNM staging, tumor diameter, extrathyroid invasion and lymphatic metastasis (all P<0.05). Conclusion: Survivin, fibronectin-1, VEGF and ezrin proteins are all involved in the occurrence and development of thyroid tumors. The combined detection of these four indicators is of great significance in the diagnosis, treatment and prognosis of thyroid tumors.