Objective To investigate the early postoperative rehabilitation condition of patients with cervical spondylotic radiculopathy and analyze its correlation with the life style.Methods A retrospective analysis for 164 cases of cervical spondylotic radiculopathy with complete follow-up data were carried out.Using modified MacNab criteria for evaluation of postoperative recovery.The clinical efficacy was evaluated 3 months after operation,and the patients were divided into satisfactory group (excellent/good) and unsatisfactory group (fair/poor).The influencing factors included general information and the lifestyle such as smoking,drinking,sleep time,the height of the pillow,working time and frequency of physical exercise.The chi-square test and Logistic multivariate regression analysis were used to analyze the effects of lifestyle on early postoperative rehabilitation patients with cervical spondylotic radiculopathy.Results Postoperative efficacy satisfaction of patients evaluated by modified MacNab standard was 88.4％ in 3 months.There were differences in age(x2 =5.819),smoking(x2 =5.074) and frequence of physical exercise(x2 =4.430),and the differences were statistically significant (all P＜ 0.05).Logistic analysis showed that age more than 50 years old(OR=3.913,95％ CI =1.321-11.594,P=0.014),smoking(OR=3.217,95％ CI =1.126-9.195,P =0.029) and frequence of physical exercise less than or equal to 3 times a week (OR=3.906,95％ CI =1.026-14.869,P=0.046) were the risk factors affecting the satisfaction of clinical curative effect of early postoperative cervical spondylotic radiculopathy.Conclusion Age,smoking and physical exercise are related to early postoperative rehabilitation of patients with cervical spondylotic radiculopathy,and then more than 50 years old,smoking and exercise less than 3 times a week have adverse effects on the early postoperative rehabilitation.

Objective To evaluate the effect of the opioid switch from morphine to sufentanil on the expression of μ-opioid receptors in the midbrain periaqueductal gray (PAG) of rats.Methods Forty healthy male Wistar rats,aged 8 weeks,weighing 250-290 g,were randomly assigned into 5 groups (n=8 each) using a random number table:control group (group C),7 day sufentanil group (group S),7 day morphine group (group M),14 day morphine group (group MM),and 14 day alternate administration of morphine and sufentanil group (group MS).Normal saline 2 ml/kg,sufentanil 0.01 mg/kg and morphine 10 mg/kg were injected subcutaneously in the cervical region twice a day for 7 consecutive days in C,S and M groups,respectively.In group MM,morphine 10 mg/kg was injected subcutaneously in the cervical region twice a day for 14 consecutive days.In group MS,morphine 10 mg/kg was injected subcutaneously in the cervical region twice a day for 7 consecutive days (1st-7th days),and sufentanil 0.01 mg/kg was then injected subcutaneously in the cervical region twice a day for 7 consecutive days (8th-14th days).The tail flick latency (TFL) to a thermal nociceptive stimulus was measured at 15 and 30 min after the initial administration every day.After the last administration,the rats were sacrificed,and the midbrain PAG was isolated for determination of the expression of the μ-opioid receptor and μ-opioid receptor mRNA using Western blot and real-time reverse transcriptase polymerase chain reaction,respectively.Results Compared with group C,the TFL was significantly prolonged on 1st-6th days after the beginning of administration in M,MM and MS groups,the TFL was significantly prolonged on 1st-7th days after the beginning of administration in group S,and the expression of the μ-opioid receptor and μ-opioid receptor mRNA in the midbrain PAG was significantly down-regulated in M,MM and MS groups (P＜0.05).Compared with group MM,the TFL was significantly prolonged on 8th-14th days after the beginning of administration,and the expression of the μ-opioid receptor and μ-opioid receptor mRNA in the midbrain PAG was significantly up-regulated in group MS (P＜0.05).Conclusion The mechanism by which the opioid switch from morphine to sufentanil reduces morphine tolerance is related to enhanced activity of μ-opioid receptors in the midbrain PAG of rats.

Efficiency, one of the key principles of economic assessment in the health service sector, has three implications: technical efficiency, cost efficiency and allocation efficiency. The paper gives an account of the various interpretations of some relevant concepts and different assessment methods. The following methods are frequently used to measure technical efficiency: ratio analysis, CPD, comprehensive index, DEA, etc. Economic efficiency is measured by production function while CEA, CUA and CBA are used to assess cost result. The major indexes for assessing allocation efficiency include the proportion between medical and preventive services, the proportion between basic and non basic medical services and the flow direction of total health expenses.

Objective To study the clinical distribution and drug resistance of Acinetobacter baumannii (AB) .Methods Clinical distribution and drug resistance of 1 190 strains of AB ,isolated in 2012 and 2013 ,were retrospectively analyzed .Results Most of AB strains were isolated from sputum ,and mainly from Intensive Care Unit ,Department of Neurosurgery and Department of Re‐spiratory .Resistance rates of AB to most antimicrobial agents were 60% -80% .Resistance rate to tobramycin ,piperacillin/tazobac‐tam and imipenem was increased significantly .Resistance rate to cefoperazone/sulbactam was decreased .Conclusion Drug resist‐ance of AB might be serious ,with increasing tendency .

Objective: To explore the effects of 17 β-estradiol (E2) and 2-methoxyestradiol (2ME) on endothelium-1/nitric oxide (ET-1/NO) cascade in experimental rats with hypoxic pulmonary hypertension. Methods: A total of 48 female SD rats were randomly divided into 6 groups:①Sham operation group,②Ovariectomy (OVX) group,③Hypoxia group,④OVX+hypoxia group,⑤OVX+hypoxia+E2 group, the rats received subcutaneous E2 at 20μg/(kg?d) and⑥OVX+hypoxia+2ME group, the rats received subcutaneous 2ME at 240μg/(kg?d).n=8 in each group. Blood levels of ET-1, NO, eNOS activity and the expressions of pulmonary tissue endothelium A receptor (ETAR), ETBR and eNOS were compared among different groups. Results: Compared with Sham operation group, Hypoxia and OVX+hypoxia groups showed small pulmonary artery thickening with lumen narrowing, increased mean pulmonary arterial pressure (mPAP), allP<0.01; the above morphological and mPAP changes were reduced by E2 and 2ME intervention. Compared with Sham operation group, OVX and Hypoxia groups had increased blood ET-1 and pulmonary mRNA, protein expressions of ETAR, decreased pulmonary ETBR, all P<0.01; the above changes were more obvious in OVX+hypoxia group; E2 and 2ME intervention reduced blood ET-1 and pulmonary ETAR expression, but they were still higher than Sham operation group, meanwhile, ETBR expression was elevated, but it was still lower than Sham operation group, allP<0.01; blood ET-1 was lower in OVX+hypoxia+2ME group than OVX+hypoxia+E2 group,P<0.05. Compared with Sham operation group, OVX group had decreased pulmonary eNOS protein expression,P<0.01; Hypoxia group had decreased blood NO and pulmonary eNOS protein expression,P<0.05 orP<0.01; OVX+hypoxia group had decreased blood NO, eNOS activity and decreased pulmonary mRNA and protein expressions of eNOS, allP<0.01; E2 and 2ME intervention elevated the above indexes,P<0.05 orP<0.01, but they were still lower than Sham operation group, allP<0.05. Conclusion: E2 and 2ME could decrease blood ET-1 and pulmonary ETAR expression, increase pulmonary ETBR expression; elevate blood NO, eNOS activity and pulmonary eNOS expression. E2 and 2ME may partially reverse pulmonary hypertension via improving ET-1/NO cascade in experimental rats.

To observe the effects of sera containing Liuwei Dihuang Pill (LDP), a compound traditional Chinese herbal medicine, and its monomer catalpol on transforming growth factor-β1 (TGF-β1)/Smad pathway in HK-2 cells.

Objective:To compare the accuracy and timeliness of 3-lead electrocardiography (ECG) and pulse oximetry (POX) in neonatal heart rate (HR) monitoring after birth.Methods:This prospective study recruited 42 high-risk newborns with gestational age ≥37 weeks and birth weight >1 500 g who were born through cesarean section without resuscitation requirement in Xi'an People's Hospital (Xi'an Fourth Hospital) from October 2019 to August 2020. 3-lead ECG electrodes and POX sensors were attached to the neonates immediately after drying to continuously monitor the HR within 10 min after birth. All procedure was recorded by video camera, and data were independently analyzed by a clinician after the procedure was completed. Differences in time required to connect the devices, time to obtain a reliable HR and the interval between them, the time needed for obtaining a reliable HR after birth, the proportion of neonates with reliable HR obtained within 5 min after birth and the consistency in the reliable HR readings between the two devices were compared using Wilcoxon signed-rank test, McNemar test, Spearman's correlation coefficient, intraclass correlation coefficient or Bland-Altman bias analysis.Results:The median time required to connect POX and 3-lead ECG and to acquire a reliable HR were 13.0 s (10.0-17.0 s) vs 23.0 s (18.0-28.3 s) ( Z=-5.050, P<0.001), and 79.5 s (56.2-128.0 s) vs 11.0 s (10.0-13.3 s) ( Z=-5.646, P<0.001), respectively. The total time from the beginning of connecting the devices and birth to acquiring a reliable HR were both longer for POX than those for 3-lead ECG [92.0 s (71.3-139.0 s) vs 35.0 s (30.0-39.5 s), Z=-5.579, P<0.001; 110.5 s (85.8-153.5 s) vs 52.0 s (45.0-66.3 s), Z=-5.579, P<0.001]. Reliable HRs were obtained in 69.1% (29/42) and 2.4% (1/42) of the infants by 3-lead ECG and POX within 1 min after birth, respectively. The percentage of infants for obtaining a reliable HR detected by 3-lead ECG within 5 min after birth were more than those by POX, but with statistically significant differences only at the first 60 s, 90 s, 120 s and 150 s (all P<0.001). The median HRs obtained by 3-lead ECG and POX within 10 min after birth were 161 beats/min (147-175 beats/min) and 160 beats/min (146-176 beats/min), respectively ( r=0.966, P<0.001). The mean difference of HR detected by the two devices was 0.56 beats/min (95% CI:-4.3 to 5.4 beats/min). The intraclass correlation coefficient was 0.961, showing good internal consistency. Conclusions:Neonatal HR can be assessed accurately by 3-lead ECG within 1 min after birth, which is far earlier than that by POX. Therefore, 3-lead ECG can be an option for continuously HR monitor in neonatal resuscitation.

β-Amyrin synthase (β-AS) genes of Glycyrrhiza uralensis from 6 different regions were analyzed by PCR-SSCP and sequenced, then the correlationship between β-AS SNP and regions of Glycyrrhiza uralensis were determined. According to the 1 coding single nucleotide polymorphism on the first exon of β-AS gene at 94 bp site, Glycyrrhiza uralensis could be divided into 3 genotypes. In these genotypes, the percentage of 94A type in genuine regions was much higher, and it had significant differences with the percentage in non-genuine regions (P < 0.001). The results of the experiment proved that different β-AS genotypes at 94 bp site from different regions may be one of the important reasons to result in the genuineness of Glycyrrhiza uralensis.

BACKGROUND:WIF-1 is a tumor suppressor gene. Promoter hypermethylation causes WIF-1 down-regulationin most tumors. DNA methylation inhibitor can lead to gene demethylation and restore its expression. OBJECTIVE:To observe the differences of tumor pathology and, WIF-1 mRNAand proteinchanges using WIF-1 or 5-aza-2'-deoxycytidine demethylation in animalmodels of osteosarcoma.
METHODS:Murine osteosarcoma models were established and divided into three groups. In the control group, no treatment was given. In the 5-aza-2'-deoxycytidine group, an appropriate amount of 5-aza-2'-deoxycytidine was injected ineach mouse daily. In the WIF-1 group, an appropriate amount of Wnt/β-catenin signal transduction pathway inhibitor WIF-1 was injected in each mouse daily. Seven days after medication, the weight of nude mouse was weighed every 7 days. Short tumor diameter (a) and the long diameter (b) were measured. Therelative tumor volume was calculated. The relative growth rate of tumor was calculated at 7, 14, 21, 28 and 56 days. Four nude mice from ach group were sacrificed by puling the neck at 7, 14, 21, 28 and 56 days after medication. Tumor tissues were stripped and the weight of them was weighed. Pathological analysis of the tumor was conducted. The expression of WIF-1protein and WIF-1 mRNA was detected in osteosarcoma at 56 days after medication in the three groups.
RESULTS AND CONCLUSION:(1) Compared withthe medication and control groups, the weight of nude mice was increased at 7, 14, 21, 28 and 56 days in the treatment group. No significant difference was found between the medication and control groups. (2) The tumor size was significantly smaler in themedication group than in the control group. WIF-1 mRNA and WIF-1 protein expression was increased in the medication group compared with the control group to different degrees. (3) Results suggested that WIF-1 gene promoter methylation is one of the mechanisms of the development of osteosarcoma. Use of WIF-1 or 5-aza-2'-deoxycytidine demethylation can inhibit tumor growth in animal models of osteosarcoma.

Objective To evaluate the value of 18F-FDG and 18F-FLT PET/CT for the detection of primary and regional lymph node metastasis of gastric cancer.Methods Thirty-seven patients with gastric cancer underwent preoperative 18F-FLT and 18F-FDG PET/CT within one week from March 2011 to April 2013.Postoperative histopathology confirmation was obtained in all patients.The PET/CT images were assessed visually and semi-quantitatively.Two-sample t and x2 tests were analyzed using SPSS 13.0.Results For the detection of primary gastric cancer,the sensitivities of 18 F-FLT and 18 F-FDG PET were 89.2％ (33/ 37) vs 91.9％(34/37),respectively (x2=0.158,P＞0.05).The 18F-FLT SUVmax of 16/37 cases with diffuse-type gastric cancer was significantly higher than that of 21/37 cases with intestinal-type gastric cancer (6.89±1.38 vs 3.79±2.45,t=4.533,P＜0.05) ; while 18F-FDG SUVmaxwas not significantly different between the two subgroups (7.13± 1.97 vs 6.36±2.32,t =1.066,P＞0.05).For the detection of regional lymph node metastasis,the sensitivity,specificity and accuracy of 18F-FLT and 18F-FDG were 64.8％(35/54) vs 88.9％(48/54),97.6％(246/252) vs 82.9％(209/252),91.8％(281/306) vs 84.0％(257/306),respectively (x2 =8.796,30.948,8.854,all P＜0.05).The overall sensitivity,specificity and accuracy by both tracers were 92.6％(50/54),98.8％(249/252) and 97.7％(299/306).Conclusions 18F-FLT might be a better or complementary tracer to 18F-FDG for the detection of diffuse-type gastric cancer.Compared with 18FFDG PET/CT,18F-FLT PET/CT may be less sensitive but more specific and accurate for the detection of regional lymph node metastasis.The overall diagnostic accuracy can be improved by using both tracers.