Objective To evaluate the safety and effect of the use of micro coils in endovascular embolization of anterior communicating artery aneurysms. Methods The clinical data of 27 consecutive patients with anterior communicating artery aneurysm, who were admitted to Yancheng Municipal Third People’s Hospital to receive endovascular embolization treatment with micro coils, were retrospectively analyzed. One patient had multiple anterior communicating artery aneurysms. The efficacy and safety of endovascular micro-coil embolization of anterior communicating artery aneurysm were evaluated by the occlusion rate of aneurysm, the prognosis of the patients, the complications, the neurological function, etc. Results Successful embolization treatment of anterior communicating artery aneurysm was achieved in all 27 patients. Dual catheter technique was employed in 3 patients, stent-assisted technique was used in 3 patients, and the technical success rate was 100%. Dense embolization was obtained in 21 patients, and residual aneurysm neck was observed in 6 patients. The unobstructed parent artery was reserved in all patients, no hemorrhage due to ruptured aneurysm or dropping of steel coil was found. One patient developed recurrent hemorrhage and died two days later. Mild recurrence was seen in one patient six months after the treatment. The modified Rankin scal (mRS) score showed that 0-1 point was seen in 24 patients, 2 points in one patient, and 4 point in one patient. Conclusion The anterior communicating artery aneurysm can be safely and effectively cured when appropriate endovascular embolization technique is used.

Objective To explore the effectiveness and esophageal strictures of concurrent chemoradiotherapy in patients with cervical and upper-thoracic esophageal cancer (EC) and middle-thoracic and lower-thoracic EC.Methods Between January 2011 and December 2014,ninety patients with different parts of EC were treated with radiotherapy combined with concurrent chemotherapy in People's Hospital of Subei.The median irradiation dose was 60 Gy.The chemotherapy regimens consisted of Paclitaxel and Nedaplatin.Of all the patients,48 patients had cervical and upper-thoracic EC,42 patients had middle-thoracic and lowerthoracic EC.The response rates,the local control rates,the survival rates and esophageal strictures were evaluated between two groups.Results The follow-up rate was 100％.The response rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 81.2％ and 73.8％ (x2 =0.717,P =0.397),respectively.The 1-year local control rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 90.3％ and 71.8％ (x2 =5.865,P =0.015),respectively.The 1-year survival rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 87.5％ and 69.0％ (x2 =4.580,P =0.032),respectively.The moderate-to-severe esophageal strictures rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 55.6％ and 29.4％ (x2 =5.360,P =0.021),respectively.There were no significant differences in shortterm effects between the cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC.The patients with cervical and upper-thoracic EC showed significantly higher 1-year local control rates,1-year survival rates and esophageal strictures rates than those with middle-thoracic and lower-thoracic EC.Conclusion The effectiveness of concurrent chemoradiotherapy is better in the patients with cervical and upper-thoracic EC than in those with middle-thoracic and lower-thoracic EC,but the esophageal stenosis is more severe in the patients with cervical and upper-thoracic EC than in those with middle-thoracic and lower-thoracic EC.

Objective To investigate the restricting factors of long-term care of stroke survivors in community.Methods The phenomenological methodology was adopted in the study.Sixteen stroke survivors were interviewed.Data were analyzed by Colaizzi's method.Results Three themes were found,including physical barriers,incorrect attitude towards disease,and defects of community health service.Conclusions On the basis of improving technology and ability,medical workers in community should consider of supporting the patients with information of disease and useful resources in a variety of ways,and improving the patients health literacy.

Objective To estimate the effects of camptothecin (CPT) on the expression of hypoxia-inducible factor-1α (HIF-1α) in HaCaT cells under hypoxic conditions (2％ O2),and to explore the potential therapeutic mechanism of topical CPT for psoriasis.Methods Some HaCaT cells were classified into 6 groups:5 test groups cultured in Dulbecco's modified Eagle's medium (DMEM) with the presence of CPT at 12.5,25,50,100 and 200 nmol/L respectively,and 1 control group cultured in DMEM with the presence of dimethyl sulfoxide (DMSO).All the 6 groups of cells were cultured under normoxic conditions for 12,24,48 or 72 hours or under hypoxic conditions for 12 hours.Cell counting kit-8 (CCK-8) assay was conducted to estimate the proliferation of HaCaT cells after the normoxic culture,and Western blot to quantify the protein expression of HIF-1α after the hypoxic culture.Some HaCaT cells were classified into a normoxia group (21％ O2) and a hypoxia group (2％ O2),and each group was divided into a CPT (100 nmol/L)-treated subgroup and a non-intervention subgroup (treated with the vehicle).After 12-hour culture,real-time fluorescencebased quantitative PCR was performed to measure the mRNA expression of HIF-1α.Statistical analysis was carried out by using Levene'.s test,one-way analysis of variance,Dunnett-t test and factorial analysis with the SPSS16.0 software.Results After treatment with CPT at 12.5-200 nmol/L for 12-72 hours,the proliferation of HaCaT cells was inhibited in a concentration-and time-dependent manner.More concretely,the cell proliferation rates were inhibited by 17.66％ ± 6.46％,33.11％ ± 4.63％ and 56.31％ ± 1.69％ respectively in HaCaT cells after 12-hour treatment with 200 nmol/L CPT as well as 24-hour treatment with 100 and 200 nmol/L CPT compared with the control group at the corresponding time points (all P ＜ 0.05).The protein expression level of HIF-1 α was significantly decreased in HaCaT cells after 12-hour treatment with CPT at 12.5,25,50,100 and 200 nmol/L under hypoxic conditions compared with the control group (0.348 ± 0.065,0.261 ± 0.112,0.115 ± 0.043,0.045 ± 0.024 vs.1.445 ± 0.329,all P＜ 0.05).The mRNA expression level of HIF-1α (expressed as △Ct) in the CPT-treated subgroup and non-intervention subgroup was-5.575 ± 0.29 and -5.451 ± 0.21 respectively in the normoxia group,significantly higher than that in the hypoxia group (-6.543 ± 0.57 and -6.203 ± 0.31 respectively,F =29.856,P ＜ 0.05),while there was no significant difference between the CPT-treated and non-intervention subgroups (F =1.667,P ＞ 0.05).Conclusions CPT at 100 nmol/L could inhibit the expression of HIF-1α protein,but had no obvious effect on that of HIF-1α mRNA.

Currently, monitoring system of awareness of the depth of anesthesia has been more and more widely used in clinical practices. The intelligent evaluation algorithm is the key technology of this type of equipment. On the basis of studies about changes of electroencephalography (EEG) features during anesthesia, a discussion about how to select reasonable EEG parameters and classification algorithm to monitor the depth of anesthesia has taken place. A scheme which combines time domain analysis, frequency domain analysis and the variability of EEG and decision tree as classifier and least squares to compute Depth of anesthesia Index (DOAI) is proposed in this paper. Using the EEG of 40 patients who underwent general anesthesia with propofol, and the classification and the score of the EEG annotated by anesthesiologist, we verified this scheme with experiments. Classification and scoring was based on a combination of modified observer assessment of alertness/sedation (MOAA/S), and the changes of EEG parameters of patients during anesthesia. Then we used the BIS index to testify the validation of the DOAI. Results showed that Pearson's correlation coefficient between the DOAI and the BIS over the test set was 0.89. It is demonstrated that the method is feasible and has good accuracy.
Algorithms ; Anesthesia, General ; Decision Trees ; Electroencephalography ; Entropy ; Humans ; Intraoperative Awareness ; Monitoring, Physiologic ; Propofol

Objective To evaluate effects of camptothecin on the autophagy of HaCaT cells.Methods Some cultured HaCaT cells were divided into several groups to be treated with camptothecin at concentrations of 5,10,25,50,100 and 200 nmol/L,and 0.1％ dimethyl sulfoxide (DMSO) (control group),respectively.Cell counting kit-8 (CCK-8) assay was conducted to estimate the proliferative activity of HaCaT cells after 24-and 48-hour treatment,flow cytometry to evaluate cell apoptosis after 24-hour treatment,and Western blot analysis to measure the expression of autophagy-related proteins microtubuleassociated protein 1 light chain 3 (LC3) and p62.Some HaCaT cells were divided into 2 groups to be treated with 10 nmol/L camptothecin and 0.1％ DMSO for 24 hours,respectively.Then,indirect immunofluorescence assay (IFA) was performed to determine the LC3 expression.Results Camptothecin at low concentrations of 5 and 10 nmol/L had no significant effects on the proliferation and apoptosis of HaCaT cells.Compared with the control group,the cellular proliferative rates were significantly inhibited by (31.23 ± 1.00)％,(54.21 ± 8.10)％ and (66.75 ± 10.70)％ in the 50-,100-and 200-nmol/L camptothecin groups after 24-hour treatment respectively,and by (25.81 ± 5.99)％,(44.35 ± 5.32)％,(65.81 ± 8.28)％ and (73.23 ± 9.59)％ in the 25-,50-,100-and 200-nmol/L camptothecin groups after 48-hour treatment respectively (all P ＜ 0.001).After 24-hour treatment,the apoptosis rates were significantly higher in the 50-,100-and 200-nnol/L camptothecin groups (14.46％ ± 2.38％,19.15％ ± 1.59％,29.88％ ± 1.37％,respectively) than in the control group (3.80％ ± 0.13％,all P ＜ 0.001).After 24-hour treatment with 5 and 10 nmol/L camptothecin,the protein expression of LC3 Ⅱ was significantly up-regulated,while p62 protein expression was significantly down-regulated:IFA showed that the percentage of autophagosome-positive cells was significantly higher in the 10-nmol/L camptothecin group than in the control group after 24-hour treatment (36.67％ ± 4.55％ vs.6.23％ ± 0.92％,t =6.546,P =0.003).Conclusions Camptothecin at low concentrations of 5 and 10 nmol/L can induce autophagy of HaCaT cells,but has no obvious effects on cell proliferation and apoptosis.Camptothecin at concentrations of 50,100 and 200 nmol/L can inhibit cell proliferation,promote cell apoptosis,and decrease autophagy levels.

Objective To study the effect of Eclipta alba on learning and memory ability and brain derived neurotrophic factor(BDNF) in brain of Alzheimer's disease (AD) model rats.Methods Healthy adult SD rats were randomly divided into control group,model group,low dosage group and high dosage group.There were 10 rats in each group.The model of Alzheimer's disease was established with subcutaneous injection of D-galactose and microinjection Aβ25-35 on bilateral hippocampus.All rats were treated with saline solution or different dosage of Eclipta alba respectively lasting 8 weeks.Then the ability of learning and memory of AD rats was evaluated by the Morris water maze test.The levels of expression of BDNF in brain were determined by immunohistochemical staining method and Western Blot method.Results The Morris water maze test:the average escape latent period prolonged besides the percentage of the swimming time in the target quadrant from the total swimming time and the times across the platform((34.14± 1.43) s,(33.71±3.82) ％,(3.40±0.70) times) decreased significantly in model group compared with control group((18.83±0.62) s,(41.98±3.96) ％,(5.40± 1.17) times,P＜0.01).The average escape latent period shortened besides the percentage of the swimming time in the target quadrant from the total swimming time and the times across the platform increased significantly in high dosage group compared with the model group (P＜0.01).Immunohistochemical staining and Western blot:the level of expression of BDNF in brain in model group was prominently less than control group (P＜ 0.01).The BDNF level in drug treated groups was prominently higher than model group(P＜0.01).The expression of BDNF increased with the drug dosage increasing.Conclusion Eclipta alba can improve the learning and memory function of AD rats by enhance the expression of BDNF.

Objective: To analyze the therapeutic effect of repeated hepatectomy on recurrent hepatocellu-lar carcinoma and prognostic factors. Methods: We retrospectively analyzed the clinicopathologic data of 48 patients who underwent repeated hepatectomy for recurrent hepatocellular carcinoma between July 1995 and July 2003. Overall survival rate and disease-free survival (DFS) rate were calculated by Kaplan-Meier meth-od. Prognostic factors were analyzed by univariate and multivariate analysis. Results: The median survival of 48 patients was 36.4 months. The overall 1-, 3-, and 5-year survival rates were 81.3%, 45.8%, and 27.1%, re-spectively. The disease-free 1-, 3-, and 5-year survival rates were 70.8%, 25.0%, and 16.7%, respectively. Univariate analysis showed that TNM stage of primary tumor, TNM stage of the recurrent tumor, vascular in-vasion, recurrent tumor size (>5cm) and recurrence-free interval were prognostic risk factors for overall surviv-al. While TNM stage of primary tumor, recurrent tumor size (>5cm), TNM stage of recurrent tumor, vascular in-vasion, pathological grading of recurrent tumor, preoperative AFP and recurrence-free interval were prognos-tic risk factors for DFS. Multivariate analysis showed that recurrence-free interval and TNM stage of recurrent tumor were independent prognostic risk factors for overall survival. While recurrence-frae interval and recur-rent tumor size (>5cm) were independent prognostic risk factors for DFS. Conclusion: Short recurrence-free in-terval (≤24 months), recurrent tumor size (>5cm) and TNM stage of recurrent tumor indicate poor prognosis of patients who received repeated hepatectomy for recurrent hepatocellular carcinoma.

Objective To compare the efficacy of percutaneous radiofrequency ablation (PRFA) and repeat hepatectomy for solitary recurrent hepatocellular carcinoma (HCC) with the diameter≤3 cm. Methods The clinical data of 151 patients with recurrent HCC (diameter≤3 cm) who were admitted to the Cancer Center of Sun Yat-Sen University from January 1999 to December 2009 were retrospectively analyzed. Of all the patients, 79received PRFA (PRFA group) and 72 received repeat hepatectomy (repeat hepatectomy group). The survival rate, morbidity and recurrence of the tumor between the two groups were compared. All data were analyzed using t test, chi-square test or Log-rank test, and the survival of the patients were analyzed using the Kaplan-Meier method. Results The mobidities of the PRFA group and repeat hepatectomy group were 13% (10/79) and 36%(26/72), respectively, with a significant difference between the two groups (x2=11.411, P＜0.05). The cumulative 1-, 2-, 3-, 4-, 5-year survival rates were 89.7%, 75.2%, 67.1%, 61.5%, 56.6% in the PRFA group, and 86.0%, 67.6%, 53.6%, 44.1%, 40.2% in the repeat hepatectomy group, with no significant difference between the two groups (x2=1.610, P＞0.05). The cumulative 4-, 5-year survival rates of the PRFA group were significant higher than those in the repeat hepatectomy group (x2=4.682, 4. 196, P ＜ 0.05). The local tumor recurrence rate of the PRFA group was 5% (4/79), and the incisal margin recurrence rate was 3% (2/72) in the repeat hepatectomy group, with no significant difference between the two groups (x2=0.565, P＞0.05). Conclusion As a less invasive treatment method, PRFA is superior to repeat hepatectomy for solitary recurrent HCC with the diameter≤3 cm.

Objective To investigate the relationship between positive experience and social support of spouses' of community stroke patients.Methods 100 stroke patients and their spouses in two communities were conveniently selected and investigated about their positive experience and social support with General Information Questionnaire (GIQ),Modified Barthel Index(MBI),Positive Aspects of Caregiver (PAC),Perceived Social Support Scale (PSSS).Results The mean score of the spouses' positive experience was (22.74±5.85); the dimension of serf-affirmation was (15.82±3.84),higher than the dimension of life expectation(6.92±2.95).The scores of the spouses' positive experience were significantly different among age,gender,education of spouses and age and ability of daily life of stroke patients; the score of the spouses' positive experience was positively correlated with social support,subjective support,utility of support;multiple linear regression showed that age of spouses,ability of daily life of stroke patients and utility of support were influential important factors of spouses' positive experience.Conclusions The spouses' positive experience was below average level,we must pay more attention to improve it,utility of support can improve spouses' positive experience.