BACKGROUND: Opiate drugs are widely used to control chronic cancer pain, which brings many adverse reactions. Transplantation of sodium alginate-polylysine-alginate microencapsulated bovine adrenal chromaffin cell (BCC) has reported to be used as chronic cancer pain controllers. However, the high price and poor strength of polylysine limited its clinical application. Chitosan is characterized by sufficient resource, low price and good biocompatibility, which is a substitute for polylysine.OBJECTIVE: To study the effect of xenotransplantation of sodium alginate-chitosan-alginate (ACA) microencapsulated BCC on patients with advanced cancer pain.DESIGN, TIME AND SETTING: A retrospective case analysis. All cases were obtained from Department of Oncology, Affiliated Zhongshan Hospital of Dalian University from January 2007 to December 2008.PARTICIPANTS: Totally 10 patients with advanced cancer, including 1 female and 9 males, aged 46-78 years. According to visual algetic mimic scale (VAS), 3 patients suffered moderate pain and 7 cases suffered severe pain.METHODS: Microencapsulation method was applied to encapsulate BCC with ACA membrane and transplant the microencapsulated BCC (5-7)×10~6 into the subarachnoids pace of 10 patients.MAIN OUTCOME MEASURES: The degree of pain release, duration of analgesic effect, as well as adverse reaction.RESULTS: All 10 patients had pain relief rapidly after transplantation in varying degrees. Complete pain relief was shown in 2 cases, medium relief in 1 case, slight relief in 4 cases. Slight irritation of cauda eguina was presented after transplantation, which could disappear within 3-5 days.CONCLUSION: Xenotransplantation of ACA microencapsulated BCC into the spinal subarachnoids pace of patients with cancer pain can produce analgesic effect promptly, significantly, and safely.

The top-quality course construction,in comprehensive medical university,is very important for the undergraduate teaching evaluation. The paper discussed the top-quality course construction in forensic pathology and the relevant issues in medical college course teaching,such as the status of the course,characteristic in school-running and enforcement measures,which aimed to improve cognition and enhance teaching quality and teaching level.

Objective To observe the effects and traits of applying locking anatomic plates to the proximal femur for the old-aged aroundtrochanteric fractures. Methods From January 2006 to August 2010, 56 cases with old-aged aroundtrochanteric fractures were selected as samples. Clinical and radiographic data were retrospectively reviewed at the 1st, 3rd, 6th, 12th month after operations. In the meantime, analysis of comparison between them and ones with the DHS treatment was conducted. Results All of the operations were successful. Altogether 56 patients were followed up, average 9.4 months. All of their fractures were healed in a mean time of 5.3 months without delayed union, nonunion, hip equinovarus, failure of screws and plates or death. Comparison of the excellent and goodrate of two groups, the dif-ferences was significant (P<0.05). Conclusion Applying locking anatomic plates to the proximal femur can provide sta-ble fixation with a good functional outcome, which is an effective method for the old-ageed aroundtrochanteric fractures and reducing death rate.

Objective:To compare the safety and effectiveness of direct stenting versus deferred stenting for the treatment of acute ST segment elevation myocardial infarction(STEMI)with a high thrombus load in patients aged 60 years and above.Methods:In this study, we analyzed 252 elderly STEMI patients with a high thrombus load(thrombus score ≥ 4 points)who received percutaneous coronary intervention(PCI)at Beijing Anzhen Hospital Affiliated or at the Affiliated Hospital of Beihua University from January 2015 to December 2018.They were divided into the direct stent group(n = 126)and the deferred stent group(n = 126)according to whether the stent was inserted immediately or not.Baseline information, surgical information, clinical outcomes and major adverse cardiac events were compared between the two groups at 1 year follow-up.Cox regression analysis was used to determine whether deferred stent implantation was a prognostic factor.Results:There were no significant differences in the distribution of infarct-related arteries, time from onset to balloon dilatation, thrombus load scores and the number of stents between the two groups(all P> 0.05). The diameter and length of the stent were(3.20 ± 0.47)mm and(18.33 ± 5.06)mm in the deferred stent group and(3.03 ± 0.50)mm and(22.60 ± 5.08)mm in the direct stent group, respectively, with a significant difference between the two groups( t=2.926, 6.678, P=0.004, 0.000). The incidences of slow blood flow, distal embolism and low myocardial perfusion staining in the deferred stent group were 2.38%(3/126), 3.17%(4/126)and 2.38%(3/126), respectively, significantly lower than those in the direct stent group, which were 15.87%(20/126), 24.60%(31/126)and 20.63%(26/126), respectively( χ2=13.827, 24.188, 20.614, all P=0.000). The left ventricular ejection fraction(LVEF)at 1 year in the deferred stent group was (0.60±0.05)%, significantly higher than that in the direct stent group(0.57±0.05)%( t=3.859, P=0.000). There was no significant difference in major adverse cardiac events between the two groups at 1 year follow-up( P> 0.05). Cox regression analysis results showed that deferred stent implantation was not a factor affecting the clinical outcome( HR=0.827, 95% CI: 0.288~2.372, P=0.724). Conclusions:Deferred stent implantation and direct stent intervention are equally safe and effective for STEMI patients aged over 60 with a high thrombus load if admitted to the hospital within 12 hours after onset.Deferred stent implantation can significantly improve the infarct-related artery blood flow classification, reduce the distal embolism rate, increase the grade 3 rate of myocardial perfusion staining, increase the diameter of the stent, reduce the length of the stent and improve left ventricular ejection fraction.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.