Objective To observe therapeutic effects of compounded zedoary turmeric oil suppository com-bined with microwave therapy on cervical erosion. Methods Women with cervical erosion were randomly divided in-to two groups: single microwave therapy group (control group) and compounded zedoary turmeric oil suppository com-bined with microwave therapy group (observation group). The chnical cure rate, obvious effective rate and ineffective rate were compared between two groups. Results In mild erosion, the clinical cure rate, obvious effective rate and ineffective rate were 87.8%, 12.2% ,0 respectively in the observation group. In tbe control group were 85.7%, 14.3%,0 respectively, and there was no significant difference between them (P >0.05); In moderate erosion, were 86.1%, 12.8%, 1.2% respectively in the observation group; were 60.9%, 31.9%, 7.2% respectively in the control group and there was significant difference between them (P < 0.01); In severe erosion, were 59.4%, 34.4%, 6.2% respectively in the observation group; were 29.17%, 41.7%, 29.2% respectively in the control group, and there was significant difference between them (P < 0.05). Conclusion Single microwave therapy to the mild erosion was suf-ficient; nevertheless, compounded zedoary turmeric oil suppository combined with microwave therapy to moderate and severe erosion was better than single microwave therapy.

ObjectiveThe pre-hospital data of 839 emergency patients who were admitted to Naxiang Emergency Center of Shanghai from Dec 11 2006 to Jun 11 2007 were analyzed.The first five causes of emergency call were trauma,diseases of newborns,neuron-system diseases.eardio-vascuIar diseases and digestive diseases.The epidemiological data including gender,age of patients,distance to emergency site,duration of ambulance dispatch,results of first aid.etc were also presented in the paper.These data would be helpful for improving pre-hospital medical care of emergency patients.

Objective To investigate the influence of left ventricular-arterial coupling(VAC) on clinical prognosis of elderly patients with septic shock.Methods A total of 56 elderly septic shoek patients were enrolled in this study,all of whom were admitted to Department of Intensive Care Unit in Zhejiang Hospital from August 2014 to October 2015.The patients were divided into two groups according to the status of left ventricular-arterial coupling when septic shock was diagnosed,which were left ventricular-arterial uncoupling group(UC group) and left ventricular-arterial coupling group(C group).Various parameters were recorded,including blood lactate level,central venous oxygen saturation(ScvO2),serum level of N-terminal pro-brain natriuretic peptide(NT-proBNP) and cardiac troponin Ⅰ (cTN Ⅰ),dose of vasoactive drugs,the total fluid volume and urine volume per hour within 24 hours.The 28-day survival rate was a key index of prognosis.Multivariate logistic regression was taken to analyze risk factors related to death within 28 day.Results Compared with C group,UC group had lower values of left ventricular ejection fraction[(42.43 ±4.76)％ vs (53.17±3.01)％;P＜0.01] and cardiac index[(2.36±0.68) L· min-1 · m 2vs (2.93±0.45)L · min-1 · m-2;P ＜0.01].Yet serum levels of NT-proBNP[lg NT-proBNP 3.93 ±0.53 vs 3.40 ±0.63;P =0.004] and cTN Ⅰ [lg cTN Ⅰ-0.16 ± 0.68 vs-1.03 ± 0.69;P ＜ 0.001] in UC group were higher than those in C group.Moreover,the total fluid volume within 24 hours [(3 806.3 ± 831.4) ml vs (3 142.0±770.0) ml;P =0.016],blood lactate level[(5.61 ±2.68) mmol/L vs (3.93 ± 1.59)mmol/L;P =0.043] and dose of norepinephrine[(0.630 ±0.300) μg · kg-1 · min-1 vs (0.292 ±0.234)μg · kg-1 · min-1;P =0.001] in UC group were greater than those in C group,while ScvO2 [(60.75 ±2.91)％ vs (64.42 ±2.19)％;P＜0.001] and urine volume per hour[(0.518 ±0.358) ml vs (0.926 ±0.678) ml;P =0.007] were less than those in C group.Compared with C group,UC group had a lower 28-day survival rate [43.2％ (19/44) vs 9/12;P =0.049].Ea/Ees ratio was negatively correlated with LVEF,ScvO2 (r =-0.686,P ＜ 0.001;r =-0.411,P =0.002),positively correlated with NT-proBNP,cTN Ⅰ (r =0.294,P =0.028;r =0.363,P =0.006),yet no obvious correlation was noticed with blood lactate level (r =0.170,P =0.21).Multiple logistic regression analysis showed that VAC(OR =11.187,95％ CI 2.489-50.285;P =0.002),lactate level (OR =1.727,95 ％ CI 1.164-2.563;P =0.007) and lg cTN Ⅰ (OR =0.247,95 ％ CI 0.079-0.779;P =0.017) were independent risk factors affecting 28-day mortality.Conclutions In elderly patients with septic shock,left ventricular-arterial uncoupling indicates a lower 28-day survival rate,worse cardiac function and tissue perfusion.Ea/Ees ratio might sever as a predictive indicator of 28-day mortality.

Objective To observe the clinical efficacy and inflammation of tangential excision within 24 hours after burn with massive deep Ⅱdegree burn wounds for elderly patients. Methods From Jan. 2010 to Dec. 2013, a total of 82 elderly patients with massive deepⅡdegree burn wounds were divided into the observation group ( giveing tangential excision within 24 hours after burn) and the control group ( giveing tangential excision within 3~5 d after burn) according the time of tangential excision treatment. The amount of infused fluid, u-rine, levels of serum inflammatory factors, survival rate of skin grafts, wound healing time, hospitalization time and the complications were compared between the two groups. Results There was no significant difference in the amount of infused fluid, plasma and urine between the two groups in the first day and fifth day (P>0. 05). The levels of TNF-αsignificantly decreased after 3 days of therapy compared with the control group (P<0. 05). The levels of IL-6 significantly decreased and IL-10 significantly increased from the first day of therapy in the ob-servation group compared with the control group (P<0. 05). The survival rate of skin grafts in the observation group was significantly higher than that in the control group, and time of wound healing and hospitalization in the observation group was significantly shorter than that in the control group (P<0. 05). The complication rate of the observation group was 11. 1% which was significantly lower than that in the control group 29. 7% (P<0. 05). Conclusion To treat burn with massive deepⅡdegree burn wounds for elderly patients with tangential excision within 24 hours which can effectively reduce the inflammatory, reduce wound infection and improve the success rate of skin grafting.

Objective To discuss the effect of deep pharyngeal muscle nerve stimulation combined with Xingnao-Kaiqiao acupuncture on patients with Pharyngeal dysphagia after stroke . Methods According to the digital table method, 99 patients with Pharyngeal dysphagia after stroke were randomly divided into A group, B group and C group, 33 cases in each group. A group received deep pharyngeal muscle nerve stimulation combined with Xingnao-Kaiqiao acupuncture; B group received deep pharyngeal nerve stimulation; and C group received Xingnao-Kaiqiao acupuncture treatment. The conventional treatment were used in all groups After 4 weeks of treatment, the relevant evaluation indexes were compared before and after treatment. Results After treatment, the Grade of aspiration (4.2 ± 0.5, 4.0 ± 0.4 vs. 3.0 ± 0.5, F=6.117) was significantly higher than A group (P<0.05), dysphagia score (5.3 ± 1.3, 5.1 ± 1.1 vs. 7.6 ± 1.4, F=6.541) in B and C groups was significantly lower than A group (P<0.05). The total effective rate [96.4% (27/28), 85.7% (24/28) vs. 82.1% (23/28), χ2=4.766, 7.791] of A group was significantly higher than that of B group and C group (P<0.05). Conclusions The deep pharyngeal nerve stimulation combined with Xingnao-Kaiqiao acupuncture could treatthe patients with dysphagia after stroke.

ObjectiveTo investigate the effect of primary duct closure and T-tube drainage after laparoscopic common bile duct exploration, as well as the criteria for clinical application of primary duct closure. Methods A retrospective analysis was performed for the clinical data of patients with common bile duct stones who were treated in The First Hospital of Jilin University from July 2014 to July 2015, and 51 patients who met the inclusion criteria were enrolled. Among these patients, 26 underwent primary closure of the common bile duct and 25 underwent T-tube drainage. The change in total bilirubin after surgery, time to recovery of gastrointestinal function, volume of peritoneal drainage at 1 day after surgery, time of removal of peritoneal drainage tube, complications, length of postoperative hospital stay, and total hospital fee were analyzed and compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe length of postoperative hospital stay and total hospital fee showed significant differences between the two groups (t=-7.067, P＜0.001; t=-3.126, P=0.003). One patient in each group experienced a complication and was cured after treatment. ConclusionOn the basis of strict control of surgical indications, the primary closure of common bile duct after laparoscopic common bile duct exploration has the advantages of a short length of hospital stay, low hospital fee, and high quality of life, and is safe and feasible. Therefore, it holds promise for clinical application.

Objective To verify the infantile amnesia phenomenon and discuss the effect of rapamycin injection on infantile amnesia and hippocampal neurogenesis.Methods (1) In experiment one,17-day-old (P17) and 60-day-old (P60) male Sprague-Dawley rats (n=84) were trained in a passive-avoidance task (they were randomly sub-divided into the shocked group and non-shocked group);all rats were tested immediately,2 and 7 days after training for memory retention.(2) In experiment two,P17 rats (n=84) were randomly divided into three groups:vehicle group,20 mg/kg rapamycin group and 40 mg/kg rapamycin group (they were sub-divided into the shocked group and non-shocked group);P17 rats were immediately injected with either vehicle or rapamycin after passive-avoidance training,and memory retention was evaluated 2 and 7 days after training.(3) In experiment three,P1 7 rats (n=48) were randomly divided into four groups:normal group,vehicle group,20 mg/kg rapamycin group and 40 mg/kg rapamycin group;immunofluorescence staining of BrdU/DCX was detected to observe the hippocampal neurogenesis at post-natal day 19 (P19) and post-natal day 24 (P24) after vehicle or rapamycin injection at P17 rats.Results In experiment one,P17 and P60 shocked rats exhibited comparable levels of crossing latencies when being tested immediately (P＞0.05),when being tested after 2 days and 7 days,P17 rats forgot more rapidly than P60 rats (P＜0.05);there were no age-related differences in crossing latencies between the non-shocked groups (P＞0.05).In experiment two,three shocked groups exhibited comparable levels of crossing latencies when being tested 2 days after training (P＞0.05),however,administration of rapamycin could enhance the memory retention 7 days after training;significant differences were noted between the vehicle group and each of the rapamycin treated groups (P＜0.05);there were no dose-related differences in crossing latencies among the non-shocked groups (P＞0.05).In experiment three,less BrdU-positive and BrdU/DCX-positive cells were found in the DG of the hippocampus at 20 mg/kg and 40 mg/kg rapamycin groups as compared with those in the vehicle group at P19 and P24 rats (P＜0.05).Conclusion The infantile amnesia phenomenon is verified,and rapamycin may enhance the memory retention in infant rats by reducing the hippocampal neurogenesis.

Objective To investigate the regulating mechanism of Notch1 signaling pathway on the invasion and migration ofglioma initiating cells (GICs).Methods (1) Box-plotting was conducted to analyze the mRNA expression of Notch1 in normal brain tissue and glioblastoma tissue using Bredel Brain,Sun Brain and TCGA databases;Kaplan-Meier survival analysis was conducted to analyze the association between the prognosis of glioma patients with the expression of Hes1 in TCGA database;Heatmap was conducted to analyze the expression of Notch1 and CXCR4 in GICs and common cell line in GEO database.(2) Magnetic activated cell sorting was adopted to establish cell lines of U87 GICs and U251 GICs;immunofluorescence staining was used to detect expression of CXCR4 and Notch1.After the cell lines of U87 GICs and U251 GICs were divided into DMSO,shNC,MK0752 and shNotchl groups,the shNotch1 and shNC groups were transfected respectively with recombinant lentivirus of Notch1-shRNA and its control sequence while the MK0752 and DMSO groups were added respectively with MK-0752 of 80 nmol/mL and the same amount of DMSO.The protein expression of Notch1,CXCR4 and p-mTOR was detected by Westem blotting in the 4 groups.The capabilities of invasion and migration of the GICs were detected by Transwell assay in the shNotch1 and shNC groups.Results (1) The box-plotting showed the mRNA expression of Notch 1 in the glioblastoma tissue was significantly higher than in the normal brain tissue (P＜0.05).The Kaplan-Meier survival analysis showed that the life span ofglioma patients with high expression of Hes1 was significantly shorter than that of those with low expression of Hes1 (P＜0.05).Heatmaps showed that the expression levels of Notch1 and CXCR4 in GICs were higher than in the common cell line.(2) The immunofluorescence staining showed that Notch1 and CXCR4 were highly expressed and colocalized in cell lines of U87 GICs and U251 GICs.The Western blotting showed that the protein expression of Notch1,CXCR4 and p-mTOR in the cell lines of U87GICs and U251 GICs in the MK0752 and shNotch1 groups was lower than that in the DMSO and shNC groups.Transwell assay showed that the penetrating-membrane cells per visual field in the shNotch1group were significantly fewer than those in the shNC group (P＜0.05).Conclusion Notch1 signaling pathway can promote invasion and migration of GICs through regulating CXCR4 expression.

Objective:To analyze the risk factors for bile leakage in patients undergoing cystic echinococcosis surgery to establish a nomogram model to predict the risk of bile leakage.Methods:The clinical data were retrospectively analyzed that 203 patients with cystic echinococcosis treated in Qinghai University Affiliated Hospital from January 2015 to October 2018. Logistic regression was used to screen out independent risk factors of biliary leakage in patients undergoing cystic hydatid surgery. Then the R software was used to establish a predictive nomogram model. Bootstrap method was used to validate the nomogram model and ROC curve was used to explore the predictive efficacy of the model in predicting the bile leakage.Results:There were 54 cases of biliary leakage in 203 patients with cystic echinococcosis, the incidence was 26.1%. ALP ( OR=11.193, 95% CI 5.066-24.731), GGT ( OR=2.728, 95% CI 1.246-5.975), cyst diameter ( OR=3.491, 95% CI 1.550-7.861), hilar cyst ( OR=2.503, 95% CI 1.176-5.329) were all independent risk factors for biliary leakage of cystic echinococcosis. The consistency index was 0.835 for predicting PPC risk, and the area was 0.823 (95% CI 0.754-0.892) under the curve for predicting the risk of cystic echinococcal bile leakage. Conclusions:ALP, GGT, cyst diameter and hepatic hilar cyst are independent risk factors for cystic echinococcal bile leakage. Nomogram model can evaluate the risk of cystic echinococcal bile leakage more intuitively, with potentially high clinical application value.