Objective:To investigate the application and feasibility of the night-vision puncture technique in performing peripherally inserted central catheter(PICC).Methods:Seventy patients were randomly divided into ultrasound guided puncture group or modified blind puncture group,35 cases in each group.The puncture success rate,the achievement ratio of catheterization,the puncture site,arm circumference,catheterization time and complications were recorded in two groups.Results:Two groups had no significant difference in the puncture success rate,the achievement ratio of catheterization,the puncture site,arm circumference,phlebitis incidence,subcutaneous congestion (bleeding) (P ＞ 0.05).The catheterization time in modified blind puncture group was shorter than the ultrasound guided puncture group (P ＜ 0.001).In modified blind puncture group,a negative correlation (correlation coefficient:-0.475,P =0.004)between arm circumference and the puncture success rate was found.Conclusion:The puncture success rate of the modified blind puncture technique in performing peripherally inserted central catheter (PICC) is high and close to the puncture success rate of the PICC under ultrasound.Additionally,the modified blind puncture technique does not increase the incidence of complications and delay the catheter time.

Three methods for isolation of nitrite oxidizers-dilution method, silica-gel plate method and enrichment culture-capillary pipette method were compared. Among them the dilution method was most feasible and efficient.

Objective To investigate the effects of attention training, spatial and position sensation training and lower limb coordination training on balance and movement coordination of post-stroke patients. Methods 100 stroke patients were randomly divided into control group and observation group with 50 in each. The control group received routine rehabilitation, and the observation group received attention training, spatial and position sensation training and lower limb coordination training additionally. Both groups were assessed with Static Balance Test Equipment and Berg Balance Scale (BBS) before and 1 month after training. Results The balance function improved after training (P<0.05). Compared with the control group, the length of path (L), the covered area (A) and L/A in observation group significantly decreased (P<0.001), and the BBS score significantly increased (P<0.001) after training. Conclusion Strategic and targeted training such as attention training, spatial and position sensation training and coordination training, could improve static balance of post-stroke patients.

Objective To investigate the characteristics of quality of life (QoL) and self-awareness in girls with idiopathic central precocious puberty (ICPP) and the correlation between QoL and the self-awareness.Methods The inventory of subjective life quality (ISLQ) and Children's self-concept scale (PHCSS) were employed to evaluate the level of QoL and self-awareness in 24 ICPP girls with ICPP (ICPP group) and 24 normal control girls (control group),and the correlation analysis between QoL and the self-awareness in the ICPP group was made.Results The score of overall (70.85±14.11 vs 80.21±6.07) and emotion component satisfaction (62.61± 12.91 vs 73.74±5.02),dimensions satisfaction on school life (5.80± 1.44 vs 6.69±0.65),depression experience (6.55± 1.14 vs 7.29±0.45),anxiety experience (5.93± 1.35 vs 6.96±0.82) and physical emotion (6.33±1.17 vs 7.12±0.83) in ICPP group was respectively lower than control group (P＜0.05).There was no difference in cognitive component between control group and ICPP group,as well as for other dimension satisfaction.Moreover,the score in total self-awareness,physical appearance and anxiety in ICPP group was respectively lower than those in control group (P＜0.05).In addition,a positive correlation was found between the subjective QoL and the children self-concept in ICPP group (P＜0.01).Conclusion The girls with ICPP show a lower subjective QoL and self assessment than normal girls.It is important to take care of the psychological feature of the girls with ICPP to improve the self-assessment and overall QoL during the medication.

OBJECTIVE: To analyze the clinical effect of different canalith repositioning maneuver in the treatment of the apogeotropic nystagmus of horizontal semicircular canal benign paroxysmal positional vertigo (apogeotropic HSC-BPPV). METHOD: Forty patients of apogeotropic HSC-BPPV colleted from March 2014 to May 2015 were divided into two groups, each group had 20 cases. The control group was repositioned with the Gufoni maneuver before the Barbecue maneuver, the research group with the improved Nuti maneuver. RESULT: The success rate of the research group was not lower than that of the control group, which hadn't statistical (P > 0.05). And after the Barbecue maneuver, all patients have been recovered. CONCLUSION Comparing with the Gufoni maneuver, the improved Nuti maneuver designed by us, had the same success rate to treat apogeotropic HSC-BPPV, and is easier to learn,with more compliance,more comfort and more repeatability.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Nystagmus, Pathologic ; therapy ; Patient Positioning ; methods ; Semicircular Canals ; physiopathology

Objective To explore the effect on traditional experiment and case teaching method in regional anatomy study. Methods 80 students from 2014 medical students were randomly selected as the teaching subjects and divided into traditional group and case teaching group. The traditional group con-tained 40 students, using the traditional teaching method, while case teaching group had also 40 students with case teaching method. In the process of teaching, three clinical cases were introduced, including thesubtotal thyroidectomy thoracic outlet syndrome andpancreatic cancer. After the end of the course, the students conducted a unified questionnaire and examination. SPSS 18.0 was used for data line t test or chi square test between the two groups. Results The scores of the students in the case group in the selection questions, blanks and essay questions in the final exam were higher than those of the traditional group; The average total score of the case group was (85.69 ±11.61), while the traditional group was (73.19 ±18.66), and the difference was statistically significant (t=3.597, P=0.002). The results of the questionnaire showed that the students in the case group were higher than the traditional group, and the difference was statistically significant ( χ2=14.753, P=0.001). Conclusion The effect on regional anatomy study with case teaching method is better than the traditional teaching method, and it is a promising teaching reform for the med-ical students.

Objective:To observe the expression of molecular chaperone-mediated autophagy in hippocampal neurons and its relationship with brain injury after recurrent-status seizures.Methods:Seven-day-old SD rats were divided into two groups according to simple randomization: the control group (NS group, 6 rats) and the recurrent-seizure group (RS group, 39 rats). Rats in the RS group were subjected to recurrent seizures after repeated inhalation of flurothyl, with 30 minutes once each day for consecutive 7 days.A total of 30 convulsive models were successfully established (9 rats that failed to establish models were discarded), and they were further divided into 0 h, 1.5 h, 3 h, 12 h and 24 h after the last seizure according to simple randomization, with 6 rats in each group.Western blot and reverse transcription-polymerase chain reaction (RT-PCR) were adopted for the observation of the expression of molecular chaperone-mediated autophagy markers [heat shock cognate protein 70 (Hsc70), lysosome-associated membrane protein type 2a (LAMP-2a), heat shock protein 40(HSP40) and heat shock protein 90(HSP90)] in hip-pocampal neurons, and apoptosis was detected by TdT-mediated dUTP nick-end labeling (TUNEL).Results:(1) RT-PCR and Western blot showed that, compared with the NS group, the expression of Hsc70, as a molecular chape-rone, started to increase at 1.5 h and continued until 24 h after the last seizure in the RS group ( P<0.05). HSP90 increased immediately after the last seizure and lasted until 24 h after the seizure ( P<0.01); the expression of HSP40 and LAMP-2a also showed high expression after the last seizure episode ( P<0.05). (2) The TUNEL method showed that the number of apoptotic cells in the hippocampal CA1 region increased significantly at 3 h (36.33±5.16)/40 field, 12 h (44.83±4.83)/40 field and 24 h (54.83±7.16)/40 field after the last seizure compared with NS group(15.16±2.48)/40 field ( P<0.01). (3) Pearson correlation analysis showed that the level of apoptosis in hippocampal CA1 region of rats after recurrent seizures was positively correlated with the expression of molecular chaperone marker molecules (Hsc70: r=0.734, P=0.001; LAMP2a: r=0.790, P<0.001). Conclusions:After recurrent seizures in developmental rats, the presence of increased expression of multiple molecular chaperone-mediated autophagy, which may positively correlate with apoptosis, may be involved in the process of brain injury.

Objective:To investigate the clinical efficacy of atomoxetine combined with cognitive-behavioral therapy (CBT) on children with attention deficit hyperactivity disorder (ADHD).Methods:Totally 104 children diagnosed with ADHD were randomly divided into atomoxetine group ( n=34), CBT group ( n=35) and atomoxetine combined with CBT group ( n=35). After 12 weeks of treatment, questionnaire-children with difficulties (QCD), Swanson child behavior checklist (SNAP-Ⅳ) and Conners parents rating scales (CPRS) were used to evaluate the efficacy and recorded the adverse reactions during the treatment. SPSS 23.0 software was used for statistical analysis. Paired sample t-test was used to compare the scores of the same group before and after treatment, and one-way ANOVA was used to compare the difference between the three groups after treatment. Results:(1)Compared with baseline, the score of QCD increased(32.96±3.01, 43.00±2.22) ( t=-13.35, P<0.01) , while the attention deficit(15.67±3.46, 6.07±1.73), hyperactivity/impulse(13.59±3.41, 7.30±2.43), opposition disobedience(9.85±3.98, 2.59±2.17) and total score(39.11±6.65, 16.59±3.91) of SNAP-Ⅳ decreased in atomoxetine combined with CBT group after treatment ( t=14.96, 10.87, 11.77, 21.49, all P<0.01). The factor scores of behavior problems(0.81±0.30, 0.70±0.26), learning problems(1.58±0.31, 0.32±0.13), psychosomatic disorders(0.22±0.25, 0.16±0.20), impulse hyperactivity(1.27±0.37, 0.71±0.18), anxiety(0.32±0.26, 0.23±0.17) and hyperactivity index(1.19±0.40, 0.79±0.22) of CPRS also decreased ( t=2.71, 21.23, 2.41, 8.87, 2.96, 6.19, all P<0.05) in atomoxetine combined with CBT group after treatment. (2) After treatment, the changes of QCD scores, attention deficit dimension in SNAP-Ⅳ scale, learning problems and impulse hyperactivity dimension in CPRS scale of the three groups before and after treatment were statistically significant (all P<0.05). (3) Post LSD comparison showed that the change in CBT group was significantly lower than that in atomoxetine group and atomoxetine combined CBT group in QCD score(both P<0.05). In the dimension of attention deficit of SNAP-Ⅳ, the difference in CBT group was significantly lower than that in atomoxetine combined CBT group ( P<0.01). In the learning problems and impulse hyperactivity dimensions of CPRS, the changes of atomoxetine combined with CBT group were significantly higher than those of atomoxetine group and CBT group (all P<0.01). Conclusion:Atomoxetine combined with CBT has better curative effect than atomoxetine or CBT alone in patients with ADHD. It can effectively improve the core symptoms and daily life function of ADHD children, and has high safety.

OBJECTIVETo study the effects of polypeptide extract from scorpion venom (PESV) on immune escape of Lewis lung carcinomas (LLC) and its mechanism.

METHODForty C57BL/6J mice were inoculated with LLC cells suspension (1 x 10(7) cells/ mL) in right armpit subcutaneously. The tumor-bearing mice were randomly divided into two groups: the control group and the PESV group. PESV was intragastrically subjected to the mice of the experimental group for 18 days. The tumor volume and tumor inhibitory rate were determined. The expression levels of VEGF,TGF-beta1 and IL-10 in tumor microenvironment were determined by immunohisto-chemistry-staining and ELISA. Surface co-stimulatory molecules CD80 and CD86 of tumor infiltrating dendritic cells (DC) were determined by immunohistochemistry-staining and flow cytometry.

RESULTThe growth inhibitory rate of PESV was 56. 60%. The expression levels of VEGF,TGF-beta1 and IL-10 were decreased in tumor and serum, while the expression of co-stimulatory molecules CD80 and CD86 on DC were increased in tumor. Compared with the control group, the differences were all significant (P < 6.05).

CONCLUSIONPESV was effective in recovering immuno-surveillance and intervening immune escape of lung cancer through multi-pathway. And its effects might be attained by decreasing the level of VEGF, TGF-beta1 and IL-10 in tumor microenvironment and increasing the expression of co-stimulatory molecules CD80 and CD86 on DC.

Animals ; B7-1 Antigen ; immunology ; B7-2 Antigen ; immunology ; Carcinoma, Lewis Lung ; drug therapy ; immunology ; Disease Models, Animal ; Humans ; Interleukin-10 ; immunology ; Lung Neoplasms ; drug therapy ; immunology ; Male ; Mice ; Mice, Inbred C57BL ; Peptides ; administration & dosage ; immunology ; isolation & purification ; Scorpion Venoms ; chemistry ; immunology ; Tumor Escape ; drug effects

Building an integrated health care service system is key to the Healthy China strategy. Based on the integrated health care service conceptual framework, the authors took two pilots regions of health-centered medical alliances in Zhejiang province as an example, and analyzed their conception framework, organizational structure, operation elements and effects. The study found initial success of the two alliances in terms of the contents, capabilities, effects and satisfaction of primary health care service. Such alliances feature a health-centered multi-entity participation mechanism, carry out health care and prevention integration leveraging the information platform, hence conducive to the effective governance of the alliances. However, the contents of their health related services are expected to be broadened and deepened; functionalities of health-related institutions need to be clarified and refined, while their performance appraisal needs to be further improved.