Objective To observe the effects of early pulse therapy with large dose of methylprednisolone associated with cyclosporine A on mortality and incidence of pulmonary fibrosis in the patients with peroral paraquat poisoning.Methods Initial pulse therapy with large dose of methylprednisolone associated with cyclosporine A was given in early period,in addition to regular gastric lavage and hemoperfusion,after acute peroral paraquat poisoning in 38 patients.The indexes of arterial blood gas analysis,findings of lung CT,and the function of kidney and liver were all monitored periodically.At the same time,the data of mortality and incidence of pulmonary fibrosis of the patients with peroral paraquat poisoning were statistically analyzed.Results 13 of 38 patients died,the mortality was 34.2%.Among the dead,12 patients died of multiple organ failure within 1 week after paraquat poisoning,and the remaining one died of pulmonary fibrosis.During hospitalization of the other 25 patients who survived,blood oxygenation index declined in different degrees in 18 cases,the thoracic computed tomography showed interstitial changes in the lung in 17 cases,and dysfunction of more than two organs(lung,liver and kidney)was found in 13 cases.Conclusion The pulse therapy of large dose of methylprednisolone associated with cyclosporine A given in early period may markedly improve the prognosis of patients with acute peroral paraquat poisoning.But a large sample with randomized double blind study is needed in order to further evaluate the clinical efficacy.

Intrahepatic cholangiocarcinoma is the second most common intrahepatic primary liver tumor after hepatocellular carcinoma (HCC).Epidemiological study suggests a strong correlation between HBV infection and ICC development.This review focused on the potential mechanisms of HBV-induced ICC and gives a primary summary of suggested hypothesis,which included:(1) HBV infection of liver stem/progenitor cells will indirectly lead to HBV infection of intrahepatic biliary epithelial cells and lead to the development of ICC; (2) the changed microenvironment of intrahepatic biliary epithelial cells by HBV infection eventually results in carcinogenesis ; (3) the HBV infection of hepatic sten/progenitor cell can transform into tumor-like stem cells and ultimately differentiate into ICC-like tumor cells.

Objective To investigate the effects of sevoflurane anesthesia on learning and memory functions and S100β protein in anaplasis in the 7-day-old rat.Methods 48 SD rats of both sexes aged 7-day-old weighing 1 2-1 6 g were randomly divided into 3 groups (1 6 rats in each group):group A and group B inhaled 3 ％ sevoflurane in oxygen(1L/min) for 6h and 2h respectively; group C inhaled oxygen(1L/min) only.After inhalation,the effects of sevoflurane anesthesia on learning and memory function were assessed by Morris water-maze test and Y-maze test from 16d to 24d.The rats were killed in the day of 8d and 25d respectively,and the blood were collected for the expression of serum concentration S100β protein by enzyme-linked immunosorbent assay.Results (1) Results of Morris water-maze test:Compared with group C,escape latency prolonged in group A and group B in 17-20d(P ＜ 0.05 or 0.01) ;escape latency prolonged in group A compared with group B in 19-20d(P ＜ 0.01) ;but there were no significant differences in the probe time in original platform quadrant and the frequency of crossing original platform among three groups(P ＞0.05).(2) Result of Y-maze test:In 22d,the total reaction time of group A and B were longer than group C (P ＜0.05 or 0.01),and the error number was increased in group A and B compared with group C(P ＜ 0.01) ; while in 23-24d,there were no significant differences between every index of each groups (P ＞ 0.05).(3) Results of the blood serum index:In 8d,serum concentration of S100β protein was significantly increased in group A and B compared with group C (P ＜0.01),and serum concentration of S100β protein was significantly increased in group A compared with group B (P ＜ 0.05) ; But there were no significant differences in serum concentration of S100β protein of each groups in 25d(P ＞ 0.05).Conclusion Sevoflurane anesthesia in the 7-day-old rat can temporarily decrease the ability of learning and memory functions in the length of inhalation time dependent manner,and the mechanism may be related to the increased expression of serum concentration of S100β protein transiently.

Objective To evaluate the differences of α-fetoprotein (AFP), ffeeβ-human chorionic gnnadotropin (HCG) indexes in 3 foreign median databases for antepartum risk screening, and establish the median databases of normal pregnant women in Wenzhou for antepartum screening of AFP, free-β-HCG indexes through the suitable median computational models. Methods The levels of AFP and free β-HCG of 20054 normal pregnant women in Wenzhou were detected by time-resolved fluorometry. The data in this paper were compared with the data of 2T-risk ( 2T), Lifecycle-2. 2 (LC2.2 ) and Lifecycle -3.0 (LC3.0) by double-factor ANOVA. The differences between the data in the paper and the data from Shenyang and Ningbo were analyzed. The median database of Wenzhou pregnant women was established by the suitable regression model, with the stability of nonlinear regression models of the 3 software assessed by model correcting fitting, distribution mean of model fitting logarithmic and standard deviation. Results The levels of AFP and freeβ- hCG reported here were 10% and 16% higher than the data of 2T-risk, 15% and 20% higher than that of LC 2. 2, 6% and 17% higher than that of LC 3.0 respectively. The differences were statistically significant. ( FAFP = 161. 757 ,P < 0. 01 ; Ffree-β-HCG = 58. 261, P < 0.01 ). The levels of AFP and free β- hCG in Wenzhou were 2% higher and 3% lower than that of Shenyang, 1% and 2% higher than that of Ningbo. There was no statistical difference of AFP levels among Wenzhou , Shenyang and Ningbo( FAFP = 0. 174 ,P =0. 840) while the differences of free-β-hCG were statistically significant( F<,free-β-HCG> = 13.303 ,P < 0. 01 ). The differences of quadratic equation regression model, exponent quadratic function regression model and exponent quadru-function regression model of 2T, LC-2. 2 and LC-3.0 were not remarkable. The exponent quadru-function regression model was the best. Conclusions There are significant differences between the data from Wenzhou, Shenyang and Ningbo and the data of T-2 risk, LC-2. 2, LC -3.0. The discrepancy is due to the ethnic and different parameters of regression models. So the model parameters and the median databases are urgently required in China. The differences of large sample size of AFP from Wenzhow, Shengyang and Ningbo are not significant, while the differences of free-β- hCG from Wenzhow, Shengyang and Ningbo is remained because of its instability. The levels from Wenzhow and Ningbo are near. It is suggested that the laboratories with small sample size can establish their own laboratory parameters using the reference obtained from large sample size under the same experimental conditions. There are no significant differences of stability among regression computational models in the 3 software. The exponent quadru-function regression model can be used to establish the median databases for the screening with the similar data distribution in the paper.

Objective To evaluate the effects of combined model of contract signing,team cooperation and telehealth care on social support and quality of life for empty nest elders at home.Methods A total of 320 empty nest elders at home were randomly divided into experimental group and control group.The elders in experimental group received contract signing,team cooperation and telehealth care for 1 year; For control group,routine nursing model was implemented.The elders were examined with social support (SSRS) and quality of life (SF-36) before and after intervention.Results Mter intervention,the scores of SSRS for experiment and control groups in subjective support 21.4 ±4.2 and 18.4 ±3.7,objective support 7.0 ± 1.6 and 6.0 ± 2.3,social support availability 7.6 ± 2.2 and 6.1 ± 2.5 ; the scores of SF-36 between experiment and control groups in physical functioning 74.8 ± 14.9 and 66.3 ± 15.6,role-physical 72.3 ±15.8 and 65.9 ± 14.7,bodily pain 71.3 ± 19.8 and 62.4 ± 15.0,general health 54.2 ± 13.0 and 47.8 ±13.1,vitality 58.4 ± 17.4 and 50.2 ± 13.9,social functioning 58.0 ± 17.9 and 48.8 ± 21.3,roleemotional 74.0 ± 18.9 and 64.8 ± 18.0,mental health 59.5 ± 12.8 and 50.1 ± 11.3 ; the rate of standard management of hypertension between experiment and control groups were 97.0％ and 86.1％,the control rate of hypertension between experiment and control groups 72.3％ and 61.7％,the control rate of diabetes between experiment and control groups 85.4％ and 64.7,there were significant inter-group differences in all the above indicators (P ＜ 0.05).Conclusion The combined model of contract signing,team cooperation and telehealth care can significantly improve social support and quality of life for elders.

Objective To evaluate the immunoprotection by the inactivated whole bacteria(IWB) of Stenotrophomonas maltophilia K279a in mice.Methods Mice were immunized by inactivated whole bacteria of S.maltophilia K279a made from formaldehyde.When the indicated the antibody titer of the mice reached the require level, the protective effect of the IWB was evaluated by performing the opsonophagocytic killing test in vitro and the poison attack experiments in vivo. Results It was found that IgG in serum of the immunized mice measured by ELISA was significantly increased after the second immune enhancement, and antiserum in vitro had strong phagocytic effect.Meanwhile, immunoprotection of the immunized groups was also significantly increased when challenged by S.maltophilia K279a.Conclusion Effective humoral immune response can be predominantly induced by the inactivated whole bacteria of S.maltophilia K279a, providing protection against challenge by S.maltophilia K279a in BALB/c mice.

Objective To evaluate the feasibility and effectiveness of four closure techniques ,large incision with plastic distal at‐tachment and clip with suction ,1 .1 cm small incision with plastic distal attachment and clip with suction in natural orifice translu‐minal endoscopic surgery(NOTES) .Methods Forty‐one ex vivo porcine stomachs were involved in this research .According to the size of incision and different methods of incision closure ,all ex vivo porcine stomachs were divided into four groups .Group A in‐volved 8 ex vivo porcine stomachs ,their size of incision were 1 .2-2 .0 cm ,and their incisions were closured by a clip closure direct‐ly ;group B involved 10 ex vivo porcine stomachs ,their size of incision were 1 .2-2 .0 cm ,and their incisions were closed by plastic end attachment with suction and clip enclosure technique;group C involved 10 ex vivo porcine stomachs ,their size of incision were smaller than 1 .1 cm ,and their incisions were by a clip closure directly ;group D involved 13 ex vivo porcine stomachs ,their size of incision were smaller than 1 .1 cm ,and closured by plastic end attachment with suction and clip enclosure technique .Stomach leaks were evaluated by leaking studies after the procedure .Results In group A ,1 incision was closed successfully ,7 incisions were clo‐sured unsuccessfully ;in group B ,2 incisions were closed successfully ,8 incisions were closed unsuccessfully ;in group C ,2 incisions were closed successfully ,8 incisions were closured unsuccessfully ;in group D ,11 incisions were closed successfully ,2 incisions were Closured unsuccessfully .Fisher′s exact test showed that group D was significantly related to the success of incision closure .The were significant differences between group A and D ,group B and group D(P<0 .05) .Conclusion Small incision(smaller than 1 cm) and plastic end attachment with suction and clip enclosure technique are optimal in NOTES procedure in this ex vivo porcine stomachs study .

Objective:To investigate the optic nerve subarachnoid space area (ONSSA) in patients with normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG) and its correlation with related factors.Methods:Fifty-three patients with NTG (Group A) and 46 patients with POAG (Group B) were selected from January 2016 to May 2019 in Gaozhou Traditional Chinese Medicine Hospital of Guangdong Province. None of them received any treatment. Another 40 patients with health examination (Group C) were selected. Body mass index, blood pressure, 24-hour intraocular pressure, visual field damage, visual axis length and central corneal thickness were measured in each group. Two-dimensional ultrasound was performed to analyze the difference of ONSSA in the retrobulbar 3 to 7 mm range in each group, and the correlation between ONSSA and clinical related factors was analyzed.Results:The ONSSA in group A was significantly smaller than that in group B and group C: (5.07 ± 0.83) mm 2 vs. (6.19 ± 0.90) and (6.57 ± 1.43) mm 2, the differences were statistically significant ( t = 5.219 and 6.107, P < 0.05). ONSSA in group A was positively correlated with the mean intraocular pressure and maximum intraocular pressure of 24 hours ( r = 0.658 and 0.479, P < 0.05), while ONSSA in group B and C was not correlated with the mean intraocular pressure and maximum intraocular pressure of 24 hours ( P > 0.05). ONSSA was not correlated with age, body mass index, mean arterial pressure, central corneal thickness, visual field damage and visual axis length ( P > 0.05). Conclusions:ONSSA of NTG patients is lower than that of POAG patients and healthy people, and the ONSSA of NTG patients is correlated with the mean intraocular pressure and maximum intraocular of 24 hours.

To screen for serum biomarkers for lung squamous carcinoma, two-dimensional gel electrophoresis (2-DE) was performed to separate serum proteins from healthy individuals and stage 1 lung squamous carcinoma(LSC) patients, respectively. PDquest software was used to analyze 2-DE images, and the differential serum protein spots between the healthy individuals and LSC patients were identified by ESI-Q-TOF MS/MS. Then Western blot and immunohistochemistry were used to detect the expression levels of haptoglobin-2(HP-2), one of the differential proteins, in the sera and tumor tissues in the patients with LSC, respectively. 2-DE maps of serum proteins from healthy individuals and stage 1 LSC patients were established. Ten differential serum protein spots were detected, four proteins of which were identified by MS/MS. Western blot showed that the serum level of HP-2 in the LSC patients was significantly higher than that in healthy individuals, but was not associated with LSC staging. Immunohistochemistry showed that the expression level of HP-2 in the LSC tissues was significantly higher than that in the normal bronchial epithelial tissues adjacent to tumors. The results indicated that serum HP-2 protein is a candidate biomarker for LSC, and might be useful for diagnosis of LSC. Up-regulation of HP-2 in the LSC tissues may contribute to the high serum level of HP-2 in the patients.

Objective The optimal access for natural orifice transluminal endoscopic surgery is still uncertain .This study was designed to compare the practicability and maneuverability of transgastric ,transunmbilical ,and transrectal approach in abdominal surgery in a canine model .Methods Three dogs were used in this research .Three approach :trangastric ,transunmbilical and tran-srectal approach were carried out for abdominal exploration ,liver biopsy ,bladder biopsy and an attempted cholecystectomy .The ma-neuverability ,endoscopic image ,performer′s perception ,and spatial orientation were evaluated .Results The maneuverability of trangastric ,and transrectal approach NOTES were better than transunmbilical NOTES .Abdominal exploration ,live biopsy ,and bladder biopsy were completed successfully .The cholecystectomy was failed because of poor exposure and difficulty of separating the around tissure .Conclusion The optimal approach for upper abdomen NOTES is transrectal route .For lower abdomen NOTES , the trangastric approach is superior to other accesses .Further study is needed to develop more flexible and precise equipment for NOTES and to evaluate more feasible access approach .