Objective To evaluate a new computer-aided technique applicable for myocardial contrast echocardiography(MCE) to quantitate automatically calibrated myocardial contrast intensity(CD and to test the feasibility of calibrated CI in assessing myocardial perfusion. To analyze the relationship on myocardial perfusion,regional contractile function and cell apoptosis in stunned myocardium. Methods According to coronary occlusion and reperfusion at different times, rabbits were divided into three groups: 15 min occlusion/30min reperfusion (group Ⅰ ),30 min occlusion / 60min reperfusion (group Ⅱ ) and 120 min occlusion / 60min reperfusion (group Ⅲ ). MCE was performed on all rabbits at baseline,occlusion and after reperfusion,and its images were analyzed by a new computer-aided technique. Myocardial calibrated CI of each segment was measured automatically by software. Percentage wall thickening (WT) of each risk segment at each stage were also measured by echocardiography. The apoptotic index(AI) in regional left myocardial dysfunction was calculated by terminal deoxynucleotidyl transferease-mediated biotinylated deoxyuridine triphosphate nick end labeling(TUNEL ). Results (1) During occlusion, WT in the areas at risk decreased to zero or negative and the calibrated CI values were significantly lower than those at baseline ( P ＜0.01 ). After reperfusion, WT in all risk segment remained depressed, but calibrated CI significantly improved in group Ⅰ and Ⅱ while those remained unchanged in group Ⅲ. (2)AI in risk myocytes were (13. 70 ± 5.48 ) %, (36.25 ± 5.55 ) % and ( 62.06 ± 6. 70 ) %, respectively, both statistically significant difference between the two groups ( P ＜0.05 or P ＜ 0.01 ). AI were negatively correlated to WT and calibrated CI ( r = - 0. 87 and r = - 0. 77, P ＜0.05). Conclusions MCE with computer-aided technique can assess quantitatively myocardial perfusion and regional contractile function. Short-term ischemiareperfusion does not cause myocardial necrosis, but it will lead to myocardial cell apoptosis and the phenomenon of myocardial stunning. Prolonged ischemia, even if given sufficient reperfusion, can lead to apoptosis and necrosis simultaneously.

Objective To develop a clinical practice satisfaction scale for the nursing interns,and to test its reliability and validity.Methods Original scale was formed on the basis of literature review and existing clinical practice satisfaction measurement tools of nursing interns.Totally 270 nursing interns of six tertiary first-class hospitals were investigated with the clinical practice satisfacfion scale of nursing intern by convenience sampling.SPSS13.0 and AMOS 17.0 were used to test the reliability and validity.Then the original scale was modified and the eventual scale was formed.Results The Cronbach's Alpha between each entries and the total scale were 0.548～0.752.The Cranbach's Alpha of total scale was 0.965and the split-half reliability of Guttman was 0.885.Five factors were extracted by exploratory factor analysis and they could explain 65.307％ of the total variance.The confirmatory factor analysis revealed a good model fit of the first and second order,and the fit indices x2/df,GFI,AGFI,RMR,RMSEA,NFI,CFI,TLI were 1.176/1.095,0.893/0.900,0.856/0.864,0.034/0.033,0.026/0.019,0.918/0.924,0.987/0.993,0.983/0.991.Conclusions The clinical practice satisfaction scale of nursing intern is reliable and valid,and can be used to assess the clinical practice satisfaction of nursing intern.

Objective To investigate the effects of different doses of dexmedetomidine pretreat-ment on cardiac toxicity of bupivacaine in rats.Methods Forty eight adult male SD rats weighing 250-300 g were randomly divided into 4 groups (n=12):saline control group (group C),dexmedetomi-dine 5 μg/kg group(group D5),dexmedetomidine 10 μg/kg group(group D10)and dexmedetomidine 1 5 μg/kg group(group D1 5 ).A Ⅱ-lead electrocardiogram(ECG)was continuously monitored,the femoral artery was cannulated for direct measurement of MAP and the femoral vein was cannulated for infusion of drugs.Groups D5,D10 and D1 5 were received infusion of dexmedetomidine 5,10 and 1 5μg/kg respectively 1 5 minutes before administration of bupivacaine,while the equal volume of saline was given in group C,then all rats received infusion 0.75% bupivacaine at the rate of 2 mg·kg-1· min-1 until asystole occurred.The doses of bupivacaine and the times of bupivacaine-induced convul-sions,arrhythmia and asystole were recorded respectively,and the myocardial concentration of bupiv-acaine was observed.Results Compared with group C,the doses of bupivacaine and the times of bupivacaine-induced convulsions,arrhythmia and asystole were all increased in groups D5,D10 and D1 5 (P <0.05).Compared with group D5,the above parameters were increased in groups D10 and D1 5 (P <0.05 ).There was no statistical significance of the above parameters between groups D10 and group D1 5.Conclusion Dexmedetomidine pretreatment can raise the threshold toxic dose of bupi-vacaine,delay the time of occurrence of cardiotoxicity of bupivacaine,so that to prevent the cardiac toxicities of bupivacaine in rats,and it produces a dose-dependent protective effect within a certain dose range.

The effects of insulin or insulin in combination with chemotherapeutic drugs on the proliferation and apoptosis of endometrial carcinoma cells were examined with an aim to determine the efficacy and safety of insulin in endometrial cancer therapy. Ishikawa and Hec-1A cells were treated with insulin and/or paclitaxel. Cell proliferation was assessed by MTT assay. Cell cycle and cell apoptosis were determined by flow cytometry (FCM). Survivin gene expression was detected by RT-PCR. Our results showed that in a certain range of working concentrations and action time, insulin could mildly augment cell proliferation and the percentage of S phase cells in endometrial cancer (Ishikawa/Hec-1A) cells. Insulin plus paclitaxel (combination group) could significantly inhibit cell proliferation (69.38%±2.32% vs 40.31%±4.52% with Ishikawa; 64.11%±6.33% vs 45.89%±3.27% with Hec-1A) and increase cell apoptosis compared with treatment with paclitaxel alone (paclitaxel group). Survivin gene expression was also significantly decreased in combination group as compared with paclitaxel group. We are led to conclude that insulin can mildly augment cell proliferation and present chemotherapy sensitivity in endometrial cancer cells. Insulin can be to used safely and efficiently in endometrial cancer therapy.

Objective:To investigate the effect of enteral nutrition support by CT-guided percutaneous gastrostomyon the nutritional status of patients with esophageal cancer complicated with dysphagia during radiotherapy.Methods:Therewere46 cases of esophageal cancer patients with dysphagia treated with CT-guided percutaneousgastrostomy.Others 43 cases of esophageal cancer by oral feeding in patients with dysphagia as control groupduringthe sametimein our hospital radiotherapy center.Patients in the observation group were ingested daily through the gastrostomy,and the nutritional intake of the control group included oral ingestion and intravenous infusion.All patients were measuredthe body height,body weight (BW).body mass index (BMI),Serum levels of serum albumin (ALB),pre-albumin (PA) and hemoglobin (HB) before and after radiotherapy.We also observed the incidence of acute radiation esophagitis and the completion of the treatment plan during radiotherapy in both groups,and to observe the two groups of patients the incidence rate of radiotherapy and treatment plan during the completion of acute radiation esophagitis.Results:There was no significant difference in BW,BMI,ALB,PA,HB before radiotherapy between the two groups (t =0.84,0.63,-1.07,-0.81,1.48,P ＞ 0.05).The BW,BMI,ALB,PA and HB of the observation group were significantly higher than those of the control group at the end of radiotherapy,which werestatistically significant (t=3.30,4.65,6.82,43.56,31.91,P ＜ 0.01).During the radiotherapy,the total incidence of acute radiation esophagitis in the observation group was significantly lower than that in the control group,(x2=3.971,P＜ 0.05).In addition,the completion rate of the observationgroup was significantly higher than that of the control group (x2 =6.811,P ＜ 0.01).Conclusion:To the Patients with dysphagia of esophageal cancer,enteral nutrition byCT guided percutaneous gastrostomy,can improve the malnutrition,the immune function of the patients and reduce the acute radiation esophagitis during radiotherapy and ensure the successful completion of the treatment plan.

Objective To introduce a new computer-aided technique applicable for myocardial contrast echocardiography(MCE)to quantitate automatically calibrated myocardial contrast intensity(CI)and to test the value of color-coded images of calibrated CI in assessing myocardial perfusion.Methods There were two experimental groups of anesthetized rabbits,which underwent 30 min(group I)and 120 min(groupⅡ)coronary occlusion followed by 60 min reperfusion.MCE was performed on all rabbits during occlusion and after reperfusion,and its images were analyzed by a new computer-aided technique.Myocardial calibrated CI of each segment was measured and a color-coded map was produced automatically by software.The risk areas and infarct sizes obtained by myocardial perfusional defect(MPD)and color-coded map were compared with those by fluorescent microsphere and triphenyl-tetrazolium chloride(TTC)staining.Results Compared with non-risk segments,myocardial CI values were significantly decreased in risk segments in group Ⅰ and Ⅱ before calibration (P＜0.01),however,myocardial calibrated CI values were significantly decreased in risk segments in group Ⅱ(P＜0.01)and not different in group Ⅰ after calibration.Calibrated CI in-70 pix was an optimal cutoff point to identify infarcted segments and to yield the sensitivity of 95% and specificity 87%.The correlation between the risk area by MPD and fluorescent staining was 0.84(P=0.003)whereas color-coded map and staining was 0.91 (P＜0.001).The correlation between the infarct size by MPD and TTC was 0.75(P＜0.001),and between color-coded image and TTC was 0.89(P＜0.001).Conclusions MCE with a new computer-aided technique canassess quantitatively myocardial perfusion and identify automatically risk area and infarct region.

Objective To investigate the effect of stellate ganglion block (SGB) on the postoperative cognitive function in aged rats.Methods Sixty-four male Sprague-Dawley rats,aged 18-20 months,weighing 500-700 g,were randomly divided into 4 groups (n =16 each):control group (group C),operation group (group O),normal saline + operation group (group NS) and SGB + operation group (group SGB).Group SGB received right SGB with 0.25％ bupivacaine 0.15 ml,while the equal volume of normal saline was given in group NS.Groups O,SGB and NS underwent 30 min of exploratory laparetomy starting from 15 min after the end of administration.Morris water-maze test was performed at days 1-6 after operation in 10 rats chosen from each group.The escape latency and frequency of crossing the original platform were recorded.Two rats were chosen from each group at 1,2 and 3 d after operation and sacrificed and the hippocampi were removed for microscopic examination.Results Compared with group C,the escape latency wag significantly prolonged on 1-5 days after operation in groups O and NS,the escape latency wag significantly prolonged on 1 and 2 days after operation in group SGB,and the frequency of crossing the original platform was decreased in groups O,NS and SGB (P ＜ 0.05).Compared with group NS,the escape latency wag significantly shortened,and the frequency of crossing the original platform was increased on 1-5 days after operation in group SGB (P ＜ 0.05).The number of hippocampal neurons was significantly larger at 2 and 3 d after operation in group SGB than in group NS.Conclusion SGB can improve the postoperative cognitive function in aged rats.

Objective To validate the 2010 Edition kidney cancer TNM staging in China.Methods Data were collected from 695 operated kidney cancer patients from Jan.1981 to Dec.2003.These patients were staged based on the 6th Edition and 7th Edition kidney cancer TNM staging system,respectively.The Kaplan-Meier method,log-rank test and Cox regression models were used to analyze survival functions.Results Compared to the 6th edition staging system,the number of patients with stage T3a,T4changed from 98 to 88,from 29 to 42 in new staging system,respectively.According to the 6th edition staging system,there was significant difference comparing perirenal fat invasion only with adrenal gland only ( P =0.08 ),there was no significant difference comparing Gerota fascia invasion ( stage T4 ) only with adrenal gland invasion only (P =0.412).According to the new staging system,there was no significant difference comparing stage T2b with stage T3a ( P =0.714). Conclusion The new kidney cancer staging system has better staging specificity and clinical application results in high accuracy.

There have been many reports of clinical and experimental researches of microacupuncture therapy, the relevant systematic works, teaching materials and national standards in recent decades. It shows that microacupuncture system has been formed and its influence has been promoted. While the rapid development of microacupuncture therapy, there are the problems and contradictions on nomenclature, explanation of theoretical basis, optimal indications, and multiple systems and schools, etc. All the above have blocked the clinical application and development. It is considered that we need to unify the nomenclature, condense the theoretical basis, clear the optimal indications, promote the exchange and blend among different schools and sum up the outcomes by systematic review and data mining technique.
Acupuncture Therapy ; instrumentation ; methods ; trends ; Humans ; Needles

Objetive To explore bacteriological changes and susceptible factor of nosocomial infection in neonatal intensive care unit (NICU). Methods The clinical data from 5543 hospitalized neonates during January 2010 to December 2015 were retrospectively analyzed. Results Nosocomial infection rate during the study period was 8 . 75 %. The most common pathogen of nosocomial infection was Staphylococcus epidermidis, followed by Escherichia coli and Klebsiella pneumoniae. Respiratory infection accounted for 37.73% and blood infection 37.53%. 36.74% blood samples were tested to be positive, and 32.67% sputum were positive. In the first three years, the main pathogens of nosocomial infection were Candida albicans, Klebsiella pneumonia, and Staphylococcus aureus; in the last three years, the main pathogens were Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. The susceptible factors of nosocomial infection in NICU were gestational age?