Objective To determine the independent risk factors for postoperative nausea and vomiting (PONV) after endoscopic retrograde cholangio-pancreatography (ERCP) under total intravenous anesthesia.Methods Ninety patients,47 males and 43 females,aged 18 years old or more,falling into ASA physical status Ⅰ-Ⅲ,undergoing ERCP under total intravenous anesthesia from July 18,2016 to August 31,2016 in Ruijin Hospital were included in our study.General information and intraoperative situation of patients were collected.The incidence of PONV within 24 h was recorded.A multivariate Logistic regression model was performed to analyze the independent risk factors of PONV after ERCP under total intravenous anesthesia.Results In total,90 patients were included in this study,with 33 patients (36.7%) suffering PONV.Logistic analyses showed that female (OR=3.73,95%CI 1.36-10.27),history of PONV/motion sickness(OR=4.39,95%CI 1.40-13.76),and serum-amylase greater than 3 times the normal value (OR=5.22,95%CI 1.30-20.95) were the independent risk factors for PONV after ERCP under total intravenous anesthesia.Conclusion Female,history of PONV/motion sickness,and serum-amylase greater than 3 times the normal value were the independent risk factors for PONV after ERCP under total intravenous anesthesia.

Cardiovascular disease is a major cause of morbidity and mortality in the contemporary society. Cardiac gene therapy has already been investigated in clinical studies profoundly. Adenovirus vector could transfer the gene efficiently, but low organ specificity and immuno- genie properties limited its application, With adenovims vector improved in the last few years, the third adenovims vector is probably the most potential vector systems for cardiovascular disease. This review will give a broad overview of the molecular basis of the adenovims vectors, their advantages, the development of increasingly efficient gene transfer approach, and experimental and clinical studies targeting the heart, application barriers and modified strategies.

Objective To investigate the effect of Rho GDP dissociation inhibitor 2 (RhoGDI2) and Bcl-2 in pathogenesis of hypoxic-ischemic brain damage (HIBD).Methods Neonatal 7-day-old Sprague Dawley rats were randomly divided into sham-operation control group,HIBD 6 h group and HIBD 48 h group (n =10 per group).The apoptosis rate of brain cell was measured by flow cytometer and the expression of RhoGDI2 mRNA and Bcl-2 mRNA were detected by Real-time RT-PCR.Results ( 1 ) The ligated cerebral hemisphere of neonatal rats showed obvious edema at 48 h after hypoxia-ischemia.( 2 ) Apoptotic cell appeared at 6 h in HIBD group,the apoptosis rate was ( 1.40 ± 0.12 ) ％.The apoptosis rate obviously increased to (15.86 ±0.98)％ at 48 h after HIBD,which showed a significant increase compared to sham-operation control group ( P ＜ 0.01 ).( 3 ) The expressions of both RhoGDI2 mRNA and Bcl-2 mRNA were 4.12 ±0.74 and 2.55 ± 0.65 respectively in sham-operation control group.In HIBD group,the expressions of both RhoGDI2 mRNA and Bcl-2 mRNA began to decrease at 6 h after HIBD ( 3.19 ± 0.77,1.96 ± 0.36) and decreased furthermore at 48 h after HIBD ( 1.04 ±0.18,1.06 ±0.17 ).The differences of expression levels among three groups were statistically significant (P ＜0.01 ).(4) The expression of RhoGDI2 mRNA positively correlated with the expression of Bcl-2 mRNA ( r =0.831,P ＜ 0.05 ).Conclusion With the emerging of apoptosis after HIBD,the expressions of both RhoGDI2 mRNA and Bcl-2 mRNA are decreased.The imbalance of expression of RhoGDI2 is involved in pathogenesis of HIBD by regulating Bcl-2 expression.

ObjectiveTo discuss the effects of apoptosis and invasion of RBE cells caused by miRNA 21 suppression and further investigate the potential role of miRNA-21 plays on target mRNA regulation. MethodsThe RNAi technology was employed to suppress the expression of RBE cells.The changes in RECK mRNA and protein expressions were detected by RT-PCR and Western blotting respectively. Changes occurred in apoptosis was closely monitored by flow cytometry (FCM). The invasion of RBE cells was analyzed in vitro by invasion assay (transwell). ResultsThe expression of miRNA-21 was clearly suppressed while the RECK mRNA and protein were over-expressed. The rate of apoptosis was significantly accelerated and there was a dramatic decrease in RBE cells' ability to invade after miRNA-21 knockdown. ConclusionThrough miRNA-21 suppression, the rate of apoptosis of RBE cells was accelerated whereas their invasion ability was greatly reduced. RECK was found to be the target gene of miRNA-21 which participates in the regulation process of regulation.

Air Pollutants ; analysis ; Chromatography, High Pressure Liquid ; methods ; Urea ; analysis ; Workplace

Objective To evaluate the radiation dose and image quality of MinDose techniques in dual-source CT coronary artery angiography.Methods 120 consecutive patients undergoing cardiac CT scans were randomly assigned into 2 groups: Group A1 with the tube current reduced to 20% of the normal tube current outside the pulsing window,and Group A2 with the tube current reduced to 4% of the normal tube current outside the pulsing window (MinDose).The image quality,noise,volume CT dose index (CTDIvol),and effective dose (E) of these two groups were evaluated.Results The mean score of imaging quality of Group A1 was (4.3 ± 0.3 ),not significantly different from that of Group A2 [(4.5 ±0.4),t=0.16,P＞0.05].The value of CTDIvol of Group A1 was (40.2 ±9.6) mGy,significantly higher than that of Group A2 [( 36.4 ± 9.1 ) mGy,t = 3.2,P ＜ 0.05].The E value of Group A1 was (9.1± 2.2) mSv ,significantly higher than that of A2 [( 8.1 ± 1.9) mSv,t = 2.7,P ＜ 0.05].Conclusion Application of the MinDose technique not only reduces the radiation dose to the patient,but also meets the requirement of diagnosis.

Objective With the increasing of the CT examination, the dose of x-ray has been brought to public attention. For the sake of making the MDCT technology better applied, available optimal technology has to be used to reduce the x-ray dose to the patients. Methods Many optimal technologies were involved in, such as ECG modulation, cardiac bowtie, 3D dose modulation, compact geometry design, electron collector and speed 4D CARE dose. Results The result of the research showed that the dose of scanning x-ray of CT could be decreased sharply by using optimal technologies. The Q2 values was the standard which could well evaluate the quality of the CT′s images and the dose of x-ray. Conclusion The quality of images and the dose of x-ray can′t be separated, which must be quoted together.

Objective To apply a complete evaluation system for clinical teaching quality and improve the objective and method of the quality control of clinical teaching procedure. Methods Clinical teachers and staff from four clinical medical colleges(Ruijin,the Sixth,the Ninth,and Tongji) were investigated.The data of their cognition about clinical teaching,weakness in teaching procedure,situation,and quantity and quality control of clinical teaching were collected and analyzed. Results The appraisal system for clinical teaching quality was established in all four clinical medical colleges.The improvement was required in evaluation of executive supervision of the present system.The quality control about clinical ability teaching was the key point to perfect the system. Conclusion It is necessary to further discuss consummation of system,establishment of evaluation method and standard so as to perfect the evaluation system of clinical teaching.We should begin with the weakest procedure,and then improve the present condition step by step.

Acidolysis kinetics on the process of the hydrolysis acidification by using glucose as the only energy sources was researched.It was concluded that the acidolysis kinetics constants are V_(max)=8.45d~(-1) and K_s=1089mg/L,under the circumstances of a temperature 37℃?0.5℃and the influent pH value 6.5.The results show that the rate of anaerobic acidification process is greater than that of completed an- aerobic or anoxic process.

Objective To explore the expression of EphB4 and VEGF in esophageal cancer tissues and their relationship with microvessel density (MVD ) ,and analysis the curative effect of postoperative esophageal cancer radical under thoracoscope . Methods Theexpression of EphB4 and VEGF was detected by immunohistochemistry in tumor specimens from 76 cases of esopha-geal squamous cell carcinoma and paratumor normal specimens ,used CD34 as marker to count MVD .According to the situation of expression of EphB4 and VEGF ,we analysis their relationship with lymph node metastasis rate ,recurrence and 5-year survival rate . Results The positive expression rate of EphB4 and VEGF in cancerous tissue (57 .89% and 61 .84% ) ,were significantly higher than that in tissue adjacent to carcinoma(0 and 7 .89% )(P<0 .05) .The positive expression rate ofEphB4 and VEGF in high MVD values of patients (67 .44% and 76 .19% ) ,were significantly higher than thatin low MVD values of patients (45 .45% and 44 .11% )(P<0 .05) .The positive expression rate ofEphB4 and VEGF in the patientswith lymph node metastasis group and associ-ated with recurrence ,were significantly higher than that of group without lymph node metastasis and group without recurrence (P<0 .05) .The positive expression rate of EphB4 and VEGF in patients of greater than or equal to 5 years of survival rate(45 .00% and 45 .45% ) ,were significantly lower than in patientsof Less than 5 years of survival rate (80 .36% and 85 .19% )(P<0 .05) .Conclu-sion EphB4 and VEGF are highly expressed in esophageal cancer tissue ,which may be closely associated withmicrovessel density , and lymph node metastasis ,recurrence and 5 years survival rate ;the curative effect of positive expression rate of EphB 4 and VEGF is poor .