Objective To explore the expression and clinical significance of secretagogne (SCGN) in neuroendocrinal tumors.Methods Immunohistochemistry was applied for detecting expression of SCGN,chromogranin A (CgA),synaptophysin (Syn) and neuronspecific enolase (NSE) in 45 cases of neuroendocrinal tumors.The difference between the expression of SCGN and the remaining indicators were compared.And different expression profiles of SCGN between groups categorized by sex,age and degree of differentiation were also compared.Results The positive expression rate of SCGN,CgA,Syn and NSE in neuroendocrinal tumors was 95.56％ (43/45),100.00％ (45/45),46.67％ (21/45) and 88.89％ (40/45) respectively,and the differences among them were statistically significant(P ＜ 0.01).Expression of SCGN was not correlated with the patient's sex,age and degree of differentiation (P＞ 0.05).Conclusions Most cases of neuroendocrinal tumors are positive for SCGN and SCGN is more sensitive than CgA.Syn is the most sensitive one for diagnosis of neuroendocrinal tumors.SCGN can be seen as a novel neuroendocrinal marker in the clinical diagnosis of neuroendocrinal tumors.

Objective To study the benefits and drawbacks of endoscopic thyroidectomy via breast approach by using gasless anterior neck skin lifting method.Methods A total of 21 patients with thyroid diseases were enrolled in this study,including 16 cases of nodular goiter and 5 cases of primary hyperthyroidism.All the cases underwent endoscopic subtotal thyroidectomy through breast approach while the operational space was established by using an abdomen suspending device and 2 Kirschner pins to mechanically suspend and retract the anterior neck skin.Results The endoscopic subtotal thyroidectomy was completed successfully in all of the cases without conversion to open surgery.The mean operation time was 82.5 minutes(ranging from 57 to 125 minutes).Intraoperative blood loss was less than 20 ml.Post-operational recovery was satisfying in all the patients.Drainage volume averaged 80.6 ml(50 to 150 ml).The patients were followed up for 1 to 12 months after the operation,during which no complications occurred.Conclusions Endoscopic thyroidectomy via breast approach using gasless anterior neck skin lifting method is a safe and low-cost procedure.By using the method,CO2 insufflation-related complications can be avoided.Although the operational space established by this method is relatively small,the operation can be completed without much difficulies.

BACKGROUND: Astragalus membranaceus plays an important role in the adjustment of immunological function. Whether does it have protective effect on neuron in the intervention of acute craniocerebral injury and what is the pathway in effect?OBJECTIVE: To observe the effect of astragalus membranaceus on activity of nitric oxide synthetase after brain injury.DEDIGN: Randomized controlled trial.SETTING: Neurosurgery institute of Lanzhou Military Area Command of Chinese PLA.MATERIALS: This experiment was completed in the Laboratory of Neurosurgery Institute of Lanzhou Military Area Command of Chinese PLA. Fifty-four healthy SD rats were divided randomly into 3 groups: brain injury group( n=24), astragalus membranaceus group( n = 24) and control group( n = 6). Injury and astragalus membranaceus groups were sampled at 4different time points(0.5 hour, 2 hours, 6 hours, and 24 hours) after injury,6 rats were sacrificed at each time point.METHODS: The brain injury and astragalus membranaceus groups were prepared by improved Feeney' s free falling method. Bone windows were opened for the control group, but no brain injury produced. After injury, rats in astragalus membranaceus group were immediately injected 200 mg/kg astragalus membranaceus intraperitoneally rat cerebral injury models were established and the nitric oxide synthetase concentration was tested at different time points.MAIN OUTCOME MEASURES: Activity of nitric oxide synthetase in the brain tissue of rats in each group.RESULTS: All 54 rats entered the final analysis. Nitric oxide synthetase activity in brain injury and astragalus membranaceus groups increased sharply contrasting with control group at 30 minute after injury [ (46.44 ± 13.45),(43.15 ± 12.43), (40. 46 ± 12. 85) nkat/L, P ＜0.05], reaching the peak at 2hours[ (67.49 ± 22.45), (64. 26 ± 19.78) nkat/L, P ＜ 0.01 ], starting to drop from6 hours [(63.46±24. 68), (52.91 ±21.36) nkat/L, P ＜0. 01], and getting to basic level at 24 hours[ (41.23 ± 12. 57), (40.92 ± 12. 25) nkat/L,P ＞ 0.05 ]. In the astragalus membranaceus treated group, nitric oxide synthetase activity dropped at 2 hours and 6 hours after injury contrasting with injury group( P ＜ 0. 05, P ＜ 0. 01 respectively).CONCLUSION: Nitric oxide synthetase activity increases in the injured brain tissue and astragalus membranaceus can protect injured neuron by inhibiting nitric oxide synthetase activity.

Objective: To investigate the effects of complex prescription astragalus mongholicus injection(复方黄芪注射液) on the serum concentrations of neuron-specific enolase(NSE),myelin basic protein(MBP) and S100 protein B(S100B) in cases with acute severe craniocerebral injury.Methods: One hundred and ninety-six patients with acute severe craniocerebral injury were randomly divided into two groups.The treated group was treated with complex prescription astragalus mongholicus injection plus conventional treatments including dehydration,antibiotics,organ functional support,nerve nutrition,prevention of complication,etc;the control group was treated with conventional treatments alone.The concentrations of NSE,MBP and S100B in plasma at admission and at 4,7 and 10 days after treatment were determined;the Glasgow coma score(GCS) at admission and at 1 week and 2 weeks after hospitalization and the Glasgow outcome scale(GOS) after 3 months were compared to observe the long-term efficacy in the patients.Results: After treatment,the concentrations of serum NSE,MBP and S100B in the treatment group were all lower than those in the control group,the differences being significant(NSE(14.62?3.38)?g/L vs.(21.54?5.68) ?g/L,MBP(7.52?1.06) mg/L vs.(10.21?2.01) mg/L,S100B(0.90?0.28) ?g/L vs.(1.20?0.34) ?g/L,all P0.05);the GCSs of the patients at 1 week,2 weeks and GOS at 3 months after treatment in the complex prescription astragalus mongholicus injection group were significantly higher than those in the control group(GCS, 1 week(9.8?2.6)score vs.(7.2?2.1) score,2 weeks(10.6?3.0) score vs.(7.8?2.2) score;GOS,3 months after treatment(4.8?1.0) score vs.(3.6?0.8) score,all P

ObjectiveTo compare the effects of Qishen Fukang capsules and Fluoxetine on cognitive function in first-episode depressions.MethodsBetween December 2011 and January 2012,63 depressed patients with first-episode from Center for Mental Disease Control and Prevention of Third Hospital of PLA were enrolled,and were divided randomly into the Qishen Fukang capsules-treated group ( Chinese medicine group,CMG,31 cases) and fluoxetine treated group (Western medicine group,WMG,32 cases; Jiangsu changzhou pharmaceutical Co.,LTD production) by the method of the random number table.The therapeutic dose was oral 0.2～0.6 g (three times/d) for each CMG patient,and morning oral 20～40 (20 ± 5) mg/d for each WMG patient.Meanwhile,each patient was given the short - term small dosesof benzodiazepine drugs,but no other antidepressants.Each patient and control was assessed with 17-item Hamilton Depression Scale (HAMD).A total of 32 healthy subjects were involved as control group.Each patient was measured with evoked event-related potential P300 change before and after 6 weeks treatment.And compared the effects of Qishen Fukang capsules and Fluoxetine on cognitive function in first-episode depressions before and after treatment.Results(1) Compared with prior-treatment [ CMG ( 29.1 ± 5.1 )score vs WMG(29.0 ± 4.5)score],the HAMD scores of post-treatment [ CMG( 10.1 ± 3.2) score vs WMG (12.3 ± 3.4) score] were decreased significantly ( P＜0.05).The HAMD scores in CMG were significantly lower than the WMG( P＜0.05).The HAMD reductive rate in CMG was significantly higher than the WMG [ (65.6 ± 2.1 ) ％ vs (57.9 ± 3.2 ) ％,P ＜ 0.05 ].(2)compared with prior-treatment,the latency periods of post-treatment were shortened[ P2 (152.8 ± 54.1)ms vs (208.9 ± 57.6)ms,(174.5 ±63.2)ms vs (207.3 ± 55.8) ms;N2(208.7 ± 57.9)ms vs (273.4 ± 62.0) ms,(239.2 ± 59.2) ms vs (275.6 ± 60.8)ms; P3(319.1 ±60.2)ms vs (396.3 ± 66.3)ms,(315.6 ± 61.1)ms vs (394.7 ±55.6)ms ],while the amplitudes were prolonged [ P2 (7.8 ± 1.7 ) μV vs ( 3.3 ± 1.2 ) μV,( 7.0 ± 1.4 ) μV vs　(3.4±1.4)μV; N2 (3.6±1.4)μV vs (1,0±0.7)μV,(2.4±1.3)μV vs (1.2 ± 1.0)μV; P3 (9.6±2.2)μV vs (4.5 ± 1.0)μV,(7.5 ±2.2)μV vs (4.6 ± 1.2)μV] in the CMG and WMG (all　P ＜0.05).Compared with the CMG,the latency periods of F2,and N2 were signiflcantly longer (all P ＜ 0.05 ),and the latency period of p3 was no difference ( P＞0.05 ),and the amplitudes of N2,and P3 were lower ( all P ＜ 0.05 ),and the amplitude of P2 was no difference ( P＞0.05 ) in the post-treatment of WMG.(3)Compared with the controls,the latency periods of P2,N2,and P3 were shortened,while the amplitudes were prolonged in the post-treatment of CMG and WMG ( all P ＜ 0.05 ).The latency periods and amplitudes of P2,N2,and P3 did not show any difference in the CMG after treatment ( all P ＞ 0.05).The latency period of P2,and N2 were still significantly longer (all＜0.05) and the latency period of P3 was no difference ( P＞0.05) while the amplitude of P2,N2,and P3 were still significantly lower (all P ＜ 0.05) in the post-treatment of WMG.ConclusionsQishen Fukang capsules and Fluoxetine can improve significantly cognitive function in first-episode depressions.Qishen Fukang capsules is superior to fluoxetine on improving the early preparation efficiency of information processing.

Objective To assess the diagnostic value of 99Tcm-ECD SPECT for hyperacute cerebral ischemia using rats models.Methods A stable and permanent acute cerebral ischemia model using unilateral middle cerebral occlusion was tested in 24 healthy SD rats.The rats were randomly divided into 6 groups according to the time duration between imaging and induced-ischemia (1,2,3,4,5 and 6 h,respectively).The rats were sacrificed immediately after 99Tcm-ECD SPECT/CT imaging and then the brain tissue was dissected for triphenyl tetrazolium chloride (TTC) and HE staining.The count ratio of affected cortex to the contralateral cortex of ＜ 50％ was defined as ischemia on micro SPECT/CT.The volume of the ischemic area was calculated on both SPECT/CT and TTC images.Paired t test was used to determine the statistical difference between the volumes on SPECT/CT and TTC staining.Results The ischemia volume evaluated by TTC staining at 1,2,3,4,5 and 6 h after occlusion was (73.98 ± 27.76),(90.75 ±29.00),(135.00±40.83),(136.25±22.51),(158.50±32.72) and (168.00±32.75) mm3,respectively.The corresponding ischemia volume evaluated by micro SPECT/CT was (98.50 ± 27.77),(110.40±26.80),(157.00±36.82),(165.50±26.54),(175.75±31.16) and (177.25 ±34.33) mm3,respectively,which was concordant with that by TTC staining at each time point (t:-1.681 to-0.390,all P ＞0.05).The ischemic area on micro SPECT/CT imaging was consistent with the pink area by TTC staining.The volume evaluated by micro SPECT/CT tended to be constant 3 h after the occlusion.The ischemia volume showed no significant difference among 3,4,5 and 6 h (all P ＞ 0.05).Conclusions Micro SPECT/CT may have an haemodynamic value for evaluating in vivo cerebral ischemia applied in a rat model.It might have clinical value for the evaluation and decision-making of ultra acute cerebral infarctions.

BACKGROUND AND OBJECTIVERadiation sensitivity is closely related to tissue oxygen, and rh-endostatin can induce the high level of oxygen content in tumor by "normalizing" tumor angiogenesis which is associated with radiotherapy sensitivity. The aim of this study is to observe the effect of combination of radiotherapy with rh-endostatin in the rats with lung cancer.

METHODSImmediate lewis cancerous ascetic injection method was used to make rats tumors bearing model, then the rats was divided into four groups randomly: group A was treated with saline; group B was treated with rh-endostatin; group C was treated with irradiation and group D was treated with rh-endostatin and irradiation. After all rats were treated, inhibition rates and the tumor growth curve were calculated. Immunohistochemisty was adopted to check the expressions of vascular endothelial growth factor (VEGF) and microvessel density (MVD).

RESULTSCompared with group A, the growth rates of the tumors in the other group were obviously slower, and the tumor weights were significantly different form group A (P < 0.05). Compared with the other groups, the tumor weights of group D were obviously reduced (P < 0.05). Compared with group A, VEGF and MVD of other three groups were reduced (P < 0.05), and group D were significantly cut down.

CONCLUSIONCombination with radiotherapy and rh-endostatin could inhibit the lung cancer significantly in rats. The possible mechanisms are to decrease the expression ofVEGF and inhibit the production of angiogenesis.

Animals ; Carcinoma, Lewis Lung ; drug therapy ; metabolism ; pathology ; radiotherapy ; Endostatins ; therapeutic use ; Female ; Immunohistochemistry ; Lung Neoplasms ; drug therapy ; metabolism ; radiotherapy ; Mice ; Mice, Inbred C57BL ; Microvessels ; pathology ; Random Allocation ; Vascular Endothelial Growth Factor A ; metabolism

Objective to investigate the clinical effect of constant temperature vaginal mould in preventing vaginal stricture in patients with cervical cancer treated with radiotherapy. Methods from January 2017 to December 2018, 80 patients with cervical cancer were selected and divided into vaginal irrigation control group (n = 40) and observation group (n = 40). The incidence of vaginal stricture was compared between the two groups. Results the incidence of vaginal stenosis was 32.50% in the observation group and 70.00% in the control group (P < 0.05). Conclusion vaginal mould is helpful to reduce the incidence of vaginal stenosis caused by external irradiation and close irradiation, which is worth popularizing in the future.

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.