ObjectiveTo delineate the anatomy of left gastric artery (LGA) by CT imaging before radical gastrectomy in gastric cancer patients to facilitate intraoperative N07 lymph node dissection.MethodsPreoperative 64 spiral CT angiography (CTA) was applied to observe the origin and course of LGA in gastric cancer patients.ResultsThere were 731 gastric cancer patients undergoing preoperative image evaluation with LGA origin identified from celiac axis in 635 cases. Among those, LGA originated respectively at the crotch of splenic artery and common hepatic artery in 176 cases, from the proximal 1/3 in 292 cases, middle 1/3 in 135 cases and distal 1/3 in 32 cases. There were 9, 28, 27, 4, 4, 1, 4 and 1 cases in whom LGA originates respectively at the angle between celiac trunk and abdominal aorta, from the abdominal aorta, arteria gastrolienalis, splenic artery, common hepatic artery, left hepatic artery, artery gastrohepatica and superior mensentaric artery. LGA has not been observed in 15 cases and the origination of LGA could not be delineated in 3 cases. ConclusionsBeing familiar with the anatomy of LGA as visualized by preoperative CTA in gastric cancer patient, facilitates lymph node dissection around the LGA and decreases iatrogenic injury to vital blood vessels.

Objective To observe the therapeutic effect and safety of dexmedetomidine for sedation in ICU. Methods We selected 40 patients who transferred to the ICU with retained endotracheal intubation after abdominal surgery under general anesthesia in this study. 40 patients were randomly divided into the dexmedetomidine group (D group,20 cases) and midazolam group (M group,20 cases) . Patients in group D were treated with loading dose 1 μg/kg from central vein pump injection 20 min, 1h according to Ramsay score for each adjustment of drug dose is pumped into 0.2 ~ 0.7 μg/(kg.h). Patients in M group were given a loading dose of midazolam 0.05mg/kg intravenous injection 1 min, depending on the degree of sedation maintenance dose of 0.02 ~ 0.1 mg/(kg.h). Pain scores every 2 h (NRS),when the NRS score>4 sharing,plus fentanyl 1μg/kg. When the patients achieved the offline condition, the endotracheal tube was pulled out. The sedation efficiency, dosage of fentanyl, after discontinuation wake-up time, extubation time, duration of mechanical ventilation, the incidence of cardiovascular events and delirium were compared between two groups.Results The sedation efficacy in Group D sedation was significantly higher than in group M ( <0.05) . Compared with group M, the dosage of fentanyl in patients in D group was significantly reduced ( <0.05), the wake time after stopping, extubation time were significantly shorter ( <0.05) . The incidence of cardiovascular events has no significant difference between two groups during the treatment. The incidence of postoperative delirium in D group was significantly lower than in that in group M ( <0.05) . Conclusions Dexmedetomidine has good sedative effect, and can shorten the time of extubation with hemodynamic stability and low incidence of delirium for patients in the ICU. It is an ideal ICU sedative.

Objective To understand the situation of prevention and control knowledge of echinococcosis in students in Qin?ghai Province,so as to provide an evidence for effective prevention and control of echinococcosis. Methods The students of Grade Four or above were randomly selected with the multi?stage stratified cluster sampling method and investigated with the questionnaire about echinococcosis in Qinghai Province. Results Totally 23 600 students were selected and surveyed,with the pass rate of 66.0%(15 566 cases). The pass rates of the male and female students were 65.1%(7 947 cases)and 66.9%(7 619 cases)respectively,and the difference was significant(χ2=8.454,P<0.01). The difference of pass rates among different dis?tricts of Qinghai Province was statistically significant(χ2=3 848.619,P<0.01). Conclusion The general aware rate of echino?coccosis knowledge in students is not high in Qinghai Province,and therefore,it is necessary to enhance the health education, especially for students in pasturing areas.

Background:Gastrointestinal dysmotility is frequently seen in patients with chronic obstructive pulmonary disease ( COPD). Simo Decoction is used for promoting gastrointestinal motility in clinical practice. Aims:To study the effect of Simo Decoction on gastrointestinal symptoms and motility in patients with COPD. Methods:Thirty-six patients with stable COPD in Shiyan Renmin Hospital from Sep. 2012 to Jun. 2013 were enrolled and received a 28-day course treatment of Simo Decoction oral solution,19 healthy volunteers were served as controls. All subjects were assessed with gastrointestinal symptom rating scale(GSRS). Electrogastrography was performed and levels of vasoactive intestinal peptide(VIP)and intestinal fatty acid-binding protein( I-FABP)in peripheral blood were measured. Patients with COPD were re-examined for the above-mentioned parameters after treated with Simo Decoction. Results:The baseline GSRS score and serum I-FABP level in COPD patients were significantly increased as compared with controls(P<0. 05),while the baseline serum VIP level,as well as the fasting and postprandial normal gastric slow wave percentage in COPD patients were significantly decreased(P <0. 05). After 28-day course of Simo Decoction treatment,all these parameters in COPD patients were improved as compared with those before treatment(P<0. 05),serum levels of VIP,I-FABP and normal gastric slow wave percentage were similar to those of controls. Conclusions:Simo Decoction can ameliorate the gastrointestinal symptoms and dysmotility in patients with COPD. The regulatory effect of Simo Decoction on gastrointestinal motility might be bidirectional.

Regional saturation technique has been applied in MR scaning widely. It is possible to obtain MRA or MRV by putting the REST slab on one side of slice or another. REST eliminates artifacts caused by motion or blood flow and minimizers wrap artifacts along the phase encoding and high quality of images can be provided.

OBJECTIVETo compare therapeutic effects of acupuncture plus massage and medicine on chilblains.

METHODSTwo hundred and sixty-four cases of chilblains were randomly divided into an acupuncture group of 136 cases and a medicine group of 128 cases. The acupuncture group were treated by acupuncture at 9 acupoints such as Yamen (GV 15), Laogong (PC 8), Sanyinjiao (SP 6), etc. plus massage, and the medicine group by dong chuang Plaster.

RESULTSIn the acupuncture group, 111 cases were cured and 136 cases were effective, the effective rate being 100.0%; and in the medicine group, 55 cases were cured and 98 cases were effective, the effective rate being 76.6%, with a very significant difference between the two groups in the therapeutic effect (P < 0.01).

CONCLUSIONAcupuncture plus massage is superior to dong chuang plaster in therapeutic effect on chilblains.

Atherosclerosis ; Autophagy ; Endothelial Cells ; Humans

Objective To understand the epidemic status of alveolar echinococcosis in Tibetan children in south Qinghai Province. Methods The imageology and serology methods were applied to investigate the epidemic status of alveolar echinococ?cosis of elementary school students in Yushu and Guoluo prefectures. Results Totally 19 629 children were investigated by the portable B ultrasound and 221 children were diagnosed as alveolar echinococcosis with the morbidity of 1.13%. Totally 9 888 were investigated by the indirect ELISA,and the positive rate of serum tests was 12.59%(190/9 888). The total morbidity of al?veolar echinococcosis of children in Yushu Prefecture was 0.42%(31/7 454)and it was 1.57%(190/12 175)in Guoluo Prefec?ture and there was a significant difference between them(χ2=53.42,P<0.005). The sero?positive rates of children in Yushu and Guoluo were 4.26%(302/7 081)and 18.56%(1 835/9 888),respectively(χ2 =765.77,P<0.005). The counties with the highest prevalence of alveolar echinococcosis in children were Dari County (4.31%,106/2 461) and Banma County (1.92%,26/1 351)of Guoluo Prefecture ,and Chengduo County(1.11%,18/1 612)of Yushu Prefecture. The total morbid?ity rates of alveolar echinococcosis of male and female children were 0.91%(91/9 954)and 1.34%(130/12 175)respective?ly(χ2=7.35,P<0.005). The total sero?positive rates of alveolar echinococcosis of male and female children were 12.10%(1 037/8 568)and 13.09%(1 100/8 406)respectively(χ2=3.63,P>0.05). The total morbidity of alveolar echinococcosis of children in different age groups was from 1.00%to 1.13%,and there was no significant difference among the age groups(χ2=2.73,P>0.05). The P1a type,P1b type and P2 type accounted for 67.76%(145/214),10.75%(23/214)and 16.36%(35/214)respectively among the alveolar echinococcosis patients. The diameters of nidus of 87.38%(187/214)patients were less than 5 cm,and 2.80%(6/214)were more than 10 cm. Conclusions The epidemic status of alveolar echinococcosis of Tibetan children in south Qinghai Province is serious,but most of the patients were at early stage of the disease. The screening work of al?veolar echinococcosis should be strengthened in Tibetan children,so as to perform the early diagnosis and treatment.

Objective To determine the feasibility and toxicity of the addition of cetuximab to paclitaxel,cisplatin,and concurrent intensity modulated radiation therapy (IMRT) for patients with esophageal squamous cell carcinoma (ESCC).Methods Nineteen patients with stage Ⅰ to Ⅲ ESCC,without distant organ metastases,were eligible.All patients received cetuximab,an initial dose of 400 mg/m2 in the first week followed by weekly injection of 250 mg/m2,paclitaxel 45 mg/m2 and cisplatin 20 mg/m2 weekly for 7 weeks with IMRT of 59.4 Gy/33 fractions.Results Two patients discontinued because of severe adverse events.Seventeen patients completed the planned treatment protocol.Of whom,12 patients achieved completeremission.The objective response rate was 100％.A median follow-up time was 29.3 months.The 1-year overall survival and recurrence-free survival rate was 100％ and 82％,respectively.Main toxicities including myelosuppression,esophagitis and skin rash happened in 19 patients.Grade ≥2 neutropenia,esophagitis and skin toxicity noted rates was 89％,84％ and 58％,respectively.Local recurrence was found in two patients.Neck lymph node and lung metastasis found in one patient.Conclusions Cetuximab,when combined with paclitaxel,cisplatin and IMRT,is efficient and safe for esophageal squamous cell carcinoma,Further clinical study is needed.

Objective To understand the situation of prevention and control knowledge of echinococcosis in people,and analyze the influencing factors of prevention and control knowledge of echinococcosis,so as to provide efficient and targeted evidence for taking intervention measures against echinococcosis.Methods All the districts (counties) in agricultural and pastoral area-based cities (zhous) in Qinghai Province were selected,3 townships were selected in each district (county),and 100 residents were randomly selected in each township via the stratified random sampling method.In each district (county),students of Grade Four or higher were randomly selected via the multi-stage stratified cluster sampling method,they were all investigated through a questionnaire survey about echinococcosis in Qinghai Province in 2012-2014.The influencing factors of prevention and control knowledge of echinococcosis were analyzed using Logistic regression analysis,including age,gender and district.Results Totally 11 959 residents and 23 600 students were selected and surveyed,and the qualified rate of residents and students in prevention and control knowledge of echinococcosis was 62.4％ (7 464 cases) and 66.0％(15 566 cases),respectively,and the difference was statistically significant (x2 =43.695,P ＜ 0.01).The aware rate of echinococcosis knowledge between residents and students was significantly different (x2 =113.680,60.712,1 204.943,273.296,P ＜ 0.01) except the question "washing hands before eating".Logisitic regression analysis showed that the main factors influencing the qualified rate of echinococcosis of residents were age (OR =0.989,95％CI:0.986-0.991) and district (compared with Huangnan Zhou,Haidong City OR =3.478,95％CI:2.978-4.063;Haixi Zhou OR =10.284,95％CI:8.578-12.330;Hainan Zhou OR =7.750,95％CI:6.468-9.286;Haibei Zhou OR =11.056,95％CI:9.089-13.448;Guoluo Zhou OR =7.309,95％CI:6.132-8.713;and Yushu Zhou OR =0.319,95％CI:0.258-0.393);and the main factors influencing the qualified rate of echinococcosis of students were age (OR =0.981,95％CI:0.964-0.998),gender (OR =1.103,95％CI:1.040-1.170) and district (compared with Huangnan Zhou,Xi'ning City OR =5.428,95％CI:4.823-6.109;Haidong City OR =3.860,95％CI:3.437-4.334;Haixi Zhou OR =6.557,95％CI:5.750-7.477;Hainan Zhou OR =2.757,95％CI:2.444-3.112;Haibei Zhou OR =9.968,95％CI:8.498-11.692;Guoluo Zhou OR =4.306,95％CI:3.653-5.075;and Yushu Zhou OR =0.616,95％CI:0.545-0.695).Conclusions The general aware rate of echinococcosis knowledge in people is not high in Qinghai Province.The main factors that have influenced the qualified rate of echinococcosis knowledge of residents are age and district,and of students are age,gender and district.It is necessary to implement the targeted intervention measures to improve mastering level of prevention and control knowledge of echinococcosis of people in Qinghai Province.