Anti-neoplasic angiogenesis therapy is a rising new treatment model for cancer in recent years, and it has been established the status of first-line treatment in the relevant anti-neoplasic fields. With the extensive clinical applications, the anti-neoplasic angiogenesis therapy have gradually showed some of its limitations and shortcomings,such as drug resistance, uncertain therapeutic window, lack of effective biomarkers, et al. However, we can overcome these disadvantages through combined chemotherapy, reasonable chemotherapy protocols and anti-VM therapy.

Objective To evaluate the effect of sitaxsentan on renal microcirculation in beagle dogs undergoing cardiopulmonary bypass(CPB)when ultrasound microbubble angiography was used to monitor renal microcirculation.Methods Eighteen male Beagle dogs,weighing 10-15kg,aged 2-4 yr,were allocated into 3 groups(n=6 each)using a random number table:sham operation group(Sham group),CPB group and sitaxsentan group(S group).Sitaxsentan 0.7 mg/kg was infused over 30min starting from 1 h before CPB in group S.Before CPB(T1),at 1 h of CPB(T2),at the end of CPB(T3)and at 2h after the end of CPB(T4),the time-intensity curve of renal parenchyma perfusion was obtained using ultrasound microbubble angiography,and quantitative parameters including the slope rate of ascending curve(A),area under curve(AUC),derived peak intensity(DPI)and time to peak(TTP)were fitted.Results Compared with Sham group,the value of A was significantly decreased at T2-4,AUC and TTP were increased at T3,4,DPI was decreased at T4 in renal cortex and medulla in CPB group,and the value of A was significantly decreased and TTP was increased at T2-4,AUC was increased at T3,4(P<0.05),and no significant change was found in DPI in renal cortex and medulla in S group(P>0.05).Compared with CPB group,the value of A was significantly increased and AUC and TTP were decreased at T3,4 in renal cortex and medulla(P<0.05),and no significant change was found in DPI in renal cortex and medulla in group S(P>0.05).Conclusion Sitaxsentan can improve renal microcirculation in beagle dogs undergoing CPB.

Objective To explore the effect of positive end expiratory pressure (PEEP) on arterial oxygenation and intrapulmonary shunt during one-lung ventilation (OLV) and pulmonary function during perioperation. Methods Forty patients with normal pulmonary function,ASA I - II :scheduled for pulmonary lobectomy, were divided into control group and PEEP group by random digits table with 20 cases each. Patients were induced by double-lumen tubes under intravenous anesthesia and were received 10 ml/kg tidal volume, 12 frequents/min breathing rate during the two-lung ventilation (TLV), secondary reduced to 6 ml/kg tidal volume, 16-18 frequents/min breathing rate without PEEP (control group) or with 5 cm H2O cm H2O =0.098 kPa) PEEP (PEEP group) during OLV.Hemodynamics and respiratory mechanical parameters were continuously monitored, lung function before operation and at 72 h after operation was detected. Results Compared to before OLV,arterial oxygen tension (PaO2), arterial oxygen saturation (SpO2), oxygenation index (OI) were decreased and intrapulmonary shunt ratio (Qs/Qt) was increased in control group and PEEP group at 30 min after OLV (P < 0.01 or < 0.05). However,PaO2 and SpO2 and OI were higher and Qs/Qt was lower in PEEP group than that in control group at the same time point (P<0.05). In addition, FEV1%, FVC% and FEV1/FVC were (121.8 ± 25.0% ,(117.2 ± 24.3)% , (87.6 ± 15.7)%before operation and (84.9 ± 21.6)%, (77.2 ± 18.3)% , (70.5 ± 12.5)% at 72 h after operation respectively in control group, (116.9 ±24.5)% , (112.1 ±23.6)% , (85.3 ± 13.8)% before operation and (96.3 ± 20.4)%, (88.1 ± 19.8)% , (78.4 ± 10.2)% at 72 h after operation respectively in PEEP group. Although decreased in control group and PEEP group at 72 h after operation comparing with preoperation (P< 0.01 or < 0.05 ), FEV1%, FVC% and FEV1/FVC were higher in PEEP group than those in control group at 72 h after operation (P<0.05). Conclusion Appropriate PEEP increases arterial oxygenation,reduces Qs/Qt and improves pulmonary function during OLV,reduces the risk of hypoxernia and lung injury induced by OLV during perioperation.

Objective:To explore the protective effect of sodium channels antagonists HOE642 on lung ischemia reperfusion and the role of the p38 mitogen activated protein kinase (p38MAPK) signaling pathway in this process.Methods:A total of 36 mice were randomly divided into a sham operation group (SHAM group),a lung ischemia reperfusion group (I/R group) and a lung ischemia reperfusion+HOE642 group (HOE group).The water content was detected by electronic scales,and the lung tissue pathological changes were observed under optical microscope.The inflammatory cytokines including IL-6 and TNF-α were examined by ELISA.The intracellular calcium fluorescence intensity was examined and observed under fluorescence microscope,and the protein expression of p38MAPK was detected by Western blot.Results:Lung water content in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).Lung interstitial edema,hemorrhage,lung tissue inflammatory cells infiltration were significantly alleviated in the HOE group than those in the I/R group,while the injury in the HOE group was aggravated than those in the SHAM group (both P＜0.05).T he IL-6 and TNF-α in lung tissues in the HOE group were lower than those in the I/R group,but higher than those in the SHAM group (both P＜0.05).Intracellular calcium fluorescence intensity in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).The protein expression of p38MAPK in lung tissues in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).Conclusion:HOE642 may exert protective effect on pulmonary I/R injury through regulation of the p38MAPK signaling pathway,resulting in reduction of intracellular calcium ion concentration and calcium overload,and decrease of inflammatory response.

Background and purpose:In recent years, energy-based instruments have been widely used in today’s open surgeries. Harmonic Focus? (HF) and Ligasure Small Jaw? (LSJ) are both custom-made for thyroid open surgery. This study aimed to explore the effcacy and safety of HF and LSJ in open thyroidectomy.Methods:The data from patients who undertook total thyroidectomy with central neck dissection by the same surgeon during last year in this hospital were reviewed. HF was used in 100 patients, and LSJ was used in 104 patients. The effectiveness was appraised by comparing operation time and postoperative volume of drainage on the ifrst postoperative day. The safety was appraised by comparing the incidence of postoperative complications.Results:The results of the effectiveness:the average duration of operation was (95.8±18.0) min for HF group, and (97.8±19.1) min for LSJ group, there was no statistical signiifcance (P=0.363). Postoperative volume of drainage on the ifrst postoperative day was (35.2±20.3) mL for HF group, and (36.3±23.8) mL for LSJ group, there was no statistical signiifcance (P=0.977). One patient (1.0%) had temporary vocal cord paralysis in HF and one had postoperative hematoma (1.0%) in LSJ group. Temporary hypo-parathyroidism was detected in 18 patients (18.0%) of HF group, and 16 patients (15.4%) of LSJ group. The decline of parathyroid hormone during the ifrst postoperative day was (12.3±12.8) pg/mL in HF group, and (13.9±13.4) pg/mL in LSJ group. The decline of serum calcium was (0.20±0.13) mg/dL in HF group, and (0.20±0.16) mg/dL in LSJ group. There were all no statistical signiifcances (P>0.05).Conclusion:Both HF and LSJ are safe and effective in open thy-roidectomy without similar operative complications.

Objective To study the correlations between DLN and clinical pathological factors and provide clinical data for assessing the operation scopes and prognostic evaluations aims at further clarify its clinical values.Methods The research aimed at the 69 cases who undertook first-time surgery and confirmed thyroid papillary carcinoma by intraoperative frozen pathology from 2013 to 2014 in Wannan Medical college affiliated Yijishan Hospital.The groups was divided by whether the DLN had been detected and metastasized.And we made chi-square test or t test by using SPSS 22.0 to analysis between the clinical and pathological factors.Results The groups was divided by whether DLN had been metastasized from the detected cases and the results shown that there was no relationship with gender,age,tumor size,Hashimoto's thyroiditis and the number of COLN (which not including DLN).For multifocal cases (21.05％ vs 57.14％,P =0.047);for vascular infiltration,the positive cases of (10.53％ vs 71.43％,P＜0.001);for the metastasized rate of COLN,the positive cases of (65.79％ vs 14.29％,P =0.011);for the metastasized number of COLN,[(0.84 ± 1.48) vs (3.86 ± 3.08),P ＜ 0.001].All the data above illustrated that the two groups are statistically correlative in mulifocality,vascular infiltration,the metastasized rate of COLN and for the metastasized number of COLN.17.39％ of PTC cases can be detected by CD34 and D2-40.According to the presence of vascular infiltration,it can be divided into two groups,We contrast analyzed of the number of TCLN (include DLN),metastasized number of TCLN and the metastasized rate of TCLN.The results shown that the number of TCLN had no statistical differences,but significant in metastasized number of TCLN [(0.74 ± 1.83) vs (4.50 ± 2.20),P ＜ 0.001) and the metastasized rate of TCLN (29.82％ vs 100.00％,P ＜ 0.01)].Conclusions The DLN positive patients are more likely to have distant lymph node metastasized.If DLN positive,total thyroidectomy and bilateral central compartment neck dissection (CCND) has been necessary.Lateral selective neck node dissection (LSND) can be underwent after evaluating carefully combining with the history and preoperative images.CD34 and D2-40 could be the detection indexes of vascular infiltration for PTC.For the cases with vascular infiltration,it has a higher proportion to have the metastasized number and metastasized rate of TCLN and higher possibility of distant metastasis.So we should expand the scope of operation moderately and strengthen postoperative follow-up according to the history and preoperative images so as to reduce postoperative recurrence,distant metastasis rate and improve the living quality of patients.

Objective To study the influence of pharmacy intravenous admixture servers(PIVAS)on human resource prioritized allocation.Methods We compared the time consumption and efficiency of drug dispensing as well as the human resource allocation before and after the establishment of PIVAS.The influence of PIVAS on the human resource allocation of nursing and pharmacy staff and work efficiency were analyzed.Results Nursing human resource were economized and we realized human resource prioritized allocation after the establishment of PIVAS.Conclusions Establishment of PIVAS facilitated the human resource prioritized allocation of nursing and pharmacy staff.It can promote the development of nursing cause and possesses wide application value.

Objective To design simulated pulmonary air embolism demonstration model,so as to solve the problem of pathological anatomy of pulmonary air embolism in experiment teaching. Methods According to the principle of the disturbance of local blood circulation and air embolism, we designed a pulmonary air embolism model. We took 223 school nursing students as the object of this study,and randomly divided them into 2 groups:animal experiment teaching group and model control group,then we compared the teaching effect between the two groups. Result The test scores of students in the animal experiment teaching group were higher than control group (P<0.05) . Conclusion The use of simulated pulmonary air embolism demonstration model teaching can improve the students’experimental test scores,and can be repeatedly used,stimulate students' study interest,reduce the cost of teaching,and improve the teaching quality.

Objective To investigate the efficacy of individualized interferon (IFN)-alpha therapy in HBeAg-negative chronic hepatitis B patients. Methods Seventy- six Chinese HBeAg-negative chronic hepatitis B patients proven by liver biopsy were treated with 5 MU recombinant IFN-alpha 1b subcutaneously thrice every week. All the patients were followed up for at least 24 months the combined responses were defined as normalization of serum alanine transaminase (ALT) and HBV DNA＜3 log10 copy/mL. An intention-to-treat (ITT) analysis was used in this paper in which all 76 patients were included. Results Six patients were lost. Treatment duration was in the range 2-24 months with a median of 8.5 months, and combined responses were achieved at a median of 6.0 months (range 2-19 months) of treatment duration.Seventy-five-percentile of treatment duration to endpoints was 10.0 months. The combined response rate was 46.1% (35/76) at the end of treatment, 43.3% (33/76) at 12-month follow-up and 40.8% (31/76) at 24-month follow-up. The relapse rate was 20. 0% (7/35) and 25. 7% (9/35) at 12-month and 24-month follow-up, respectively. Higher necroinflammatory activity in liver biopsy predicted a good response, while gender, age, liver fibrosis, baseline ALT, aspartate aminotransferase levels and baseline HBV DNA levels were not impact factors of therapeutic effects by binary Logistic regression analysis.Conclusion Individualized prolonged IFN-alpha regimen lead to considerable sustained disease suppression in patients with HBeAg-negative chronic hepatitis B.