Objective To investigate the clinical effect of endoscopic esophageal variceal ligation (EVL)in the treatment of esophageal variceal bleeding (EVB)in patients with liver cirrhosis.Methods A total of 84 liver cirrhosis patients with EVB who were admitted to The Third People′s Hospital of Shenzhen,Guangdong Medical University,from December 2010 to July 2013 were divided into ligation group (group A,treated with EVL combined with somatostatin and esomeprazole)and control group (group B,treated with somatostatin and es-omeprazole),with 42 patients in each group.The hemostasis rate,rebleeding rate,incidence rate of complications,and mortality rate were observed in both groups,as well as the variceal eradication rate after EVL and risk factors for early rebleeding.The t -test was used for com-parison of normally distributed continuous data between two groups,and an analysis of variance was used for comparison between multiple groups;the Mann -Whitney U test was used for comparison of non -normally distributed continuous data between two groups,the Wilcoxon signed -rank sum test was used for comparison within each group,and the Kruskal -Wallis H test was used for comparison between multiple groups.The chi -square test or Fisher′s exact test was used for comparison of categorical data between groups.The Kaplan -Meier method was used to calculate survival rates,and the log -rank test was used to compare survival rates between groups.The logistic regression meth-od was used to investigate the influencing factors for dichotomous data.Results There was a significant difference in the hemostasis rate be-tween groups A and B (97.62% vs 80.95%,P =0.029).Compared with group B,group A had significantly lower rebleeding rates in 1 -2 years (15.38% vs 38.89%,χ2 =5.323,P =0.021)and 2 -3 years (15.38% vs 48.48%,χ2 =10.448,P =0.001).A total of 14 patients (33.33%)in group A and 7 patients (16.67%)in group B experienced adverse events,and 4 patients in group A and 9 patients in group B died within 3 years.Group A had significant improvements in the levels of alanine aminotransferase (ALT)and aspartate amin-otransferase at 1 week after treatment (Z =-2.177 and -2.044,P =0.029 and 0.041).Both groups had significant improvements in pro-thrombin time activity (PTA),prothrombin time (PT),international normalized ratio (INR),and albumin at 1 week after treatment (group A:Z =-4.007,t =3.866,Z =-4.152,t =-4.623,all P <0.001;group B:t =-5.069,Z =-3.870,Z =-3.909,Z =-5.245,all P <0.001).There was a significant difference in PTA at 1 week after treatment between the two groups (Z =-3.902,P <0.001).In group A,the overall disappearance rate of varices was 85.71% and the recurrence rate was 14.29%,and there was a signifi-cant correlation between the Child -Pugh score and diameter of the portal vein (F =3.319,P =0.047).Symptoms on admission,length of hospital stay,Child -Pugh score,spontaneous bacterial peritonitis,diameter of the portal vein,PT,INR,and ALT were risk factors for ear-ly rebleeding after ligation (all P <0.05).Conclusion EVL is a safe and effective method for the treatment of EVB in patients with liver cirrhosis and causes few complications.

Objective To investigate the status quo and the relationship between emotional intelligence and resilience of emergency and ICU nurses in tertiary general hospitals in Chengdu. Methods A total of 660 emergency and ICU nurses were surveyed by a pack of questionnaires including the General Information Questionnaire, the Resilience Scale and the Wong and Law Emotional Intelligence Scale. Results The average total score of the resilience scale was 123.07 ±23.76 and the average item score of the resilience scale was 4.92±0.95. The average total score of the emotional intelligence scale was 58.69±8.74 and the average item score of the emotional intelligence scale was 3.67±0.55. The correlation coefficient between the emotional intelligence and the resilience was 0.62 (P<0.01). Three subdimensions of the emotional intelligence including the usage of emotion, the appraisal of self-emotion, the regulation of emotion and the positions of nurses accounted for 43.3%of the variances of the resilience. Conclusions Emotional intelligence played an important role in affecting the psychological resilience of emergency and ICU nurses in tertiary general hospitals in Chengdu, it could positively predict the resilience of nurses.

Magnetic induction method aims at the noninvasive detection of liver iron overload by measuring the hepatic magnetic susceptibility. To solve the difficulty that eddy current effects interfere with the measurement of magnetic susceptibility, we proposed an improved coil system based on the static field magnetization principle in this study. We used a direct current excitation to eliminate the eddy current effect, and a rotary receiver coil to get the induced voltage. The magnetic field for a cylindrical object due to the magnetization effect was calculated and the relative change of maximum induced voltage was derived. The correlation between magnetic susceptibility of object and maximum magnetic flux, maximum induced voltage and relative change of maximum induced voltage of the receiver coil were obtained by simulation experiments, and the results were compared with those of the theory calculation. The contrast shows that the simulation results fit the theory results well, which proves our method can eliminate the eddy current effect effectively.
Computer Simulation ; Humans ; Image Processing, Computer-Assisted ; Iron Overload ; diagnosis ; Liver ; physiopathology ; Magnetic Fields ; Magnetics ; instrumentation

AIM To investigate the anti oxidation activities of new systhesized nitroxides in liver, liver mitochondria and RBC from rats and in egg phospholipid. METHODS The homogenates of liver, liver mitochondria from rats and the suspensions of egg phospholipid were used to determine malondialdehyde (MDA) formation induced by Fe 2+ Vit C system using TBA colorimetric method. H 2O 2 caused hemolysis was measured spectrometrically. Superoxide anion was assayed spectrometrically. RESULTS Nitroxides A, B with one active group (NO?) could inhibit MDA generation caused by ?OH generation system significantly, antagonized hemolysis induced by H 2O 2, but did not affect O ? 2 formation; Nitroxide C with two active group (NO?) possessed similar potent anti lipoperoxidative activities,IC 50

Electroencephalogram (EEG) is the primary tool in investigation of the brain science. It is necessary to carry out a deepgoing study into the characteristics and information hidden in EEGs to meet the needs of the clinical research. In this paper, we present a wavelet-nonlinear dynamic methodology for analysis of nonlinear characteristic of EEGs and delta, theta, alpha, and beta sub-bands. We therefore studied the effectiveness of correlation dimension (CD), largest Lyapunov exponen, and approximate entropy (ApEn) in differentiation between the interictal EEG and ictal EEG based on statistical significance of the differences. The results showed that the nonlinear dynamic char acteristic of EEG and EEG subbands could be used as effective identification statistics in detecting seizures.
Brain ; physiopathology ; Electroencephalography ; Entropy ; Epilepsy ; physiopathology ; Humans ; Nonlinear Dynamics ; Seizures

Objective To study the feasibility and effectiveness of liquid embolic agent HEMA-MMA in the arterial embolization therapy for the rabbit renal VX2 tumor models. Methods Renal VX2 tumor models were inoculated with the method of percutaneous CT-guided implantation of a small fragment of tumor into the inferior pole of the right kidney and were embolized when the max diameter was 1.5 cm. One model was embolized with the mixture of HEMA-MMA and carbonyl iron powder and was harvested immediately after embolization, the sample was fixed by paraformaldehyde for histopathological examination with methylene blue staining and HE staining to demonstrate the sizes of the vessels that the HEMA-MMA could reach. The remaining models were treated with pure HEMA-MMA by superselective or nonselective embolization (SSE or NSE). In SSE group, only the renal artery branch supplying the tumor was superselectively catheterized and embolized until the presence of“artery casting”change. In NSE group, the microcatheter was catheterized into the main renal artery then the whole renal artery branches and the renal capsular artery were embolized simultaneously until the presence of“artery casting”shape. Non-enhanced CT scans at immediate postoperation, on postoperative day 1 and day 3 were performed. The enhanced CT scans at the postoperative 1, 2 , 4 and 6 weeks were performed. Necrotic zone of the tumor was defined as non-enhancement in parenchyma phase, residual tumor was defined as delayed enhancement around the necrotic zone or obvious thickness and enhancement of the adjacent renal capsule. When detecting residual tumor, the model was followed up another 1 week and then harvested for histopathological examination. If there was no residual tumor and lung metastasis in 6 weeks follow-up after operation, we defined this as complete necrosis and then harvested the kidney for histopathological examination. Results Eleven of the 12 rabbits were successfully inoculated VX2 tumors. The mixture of HEMA-MMA and carbonyl iron powder deposited in the arterial vessels demonstrated mazarine in methylene blue staining and brownness in HE staining. The diameter of the tumor vessels which the agent could reach was 30—150 μm, there was no embolic agent detected in the venous blood vessels. 5 models were performed with superselective embolization and the other 5 were embolized with nonselective embolization. The embolic agent demonstrated high density and obviously deposited in the surrounding zone of the tumor on immediate postoperative CT images, density of the surrounding zone decreased accompanied by density increase in the central area of the tumor on the first day postoperative CT images. Density difference between the embolism zone and normal renal tissue disappeared on the third day postoperative CT images accompanied by swelling changes of the embolized area. Residual tumor was detected in all 5 superselectively treated cases (2 in 1 week, 3 in 2 weeks), which located in the area of junctional zone and subrenal capsule. The necrotic zone was demonstrated coagulative necrosis on histopathologic images, the boundary between the residual tumor and the necrotic zone was clearly showed both on histopathologic images and gross specimen. Renal capsular artery participating in the residual tumor blood supply was also shown on gross specimen. There was no residual tumor and lung metastasis detected in nonselective treated group during the period of 6 weeks follow-up. Atrophy of the whole tumor-burdened kidney was shown on gross specimen and complete coagulative necrosis of the total tumor and the renal capsule adjacent to the tumor was demonstrated on histopathologic images. Conclusions Liquid embolic agent HEMA-MMA can embolize tumor blood vessels with a diameter of 30—150 μm. The renal capsular artery participates in the blood supply of the VX2 kidney tumor, so only superselective embolization of the renal artery branch with this liquid embolic agent may not induce the whole necrosis of the tumor, but complete necrosis of the tumor can be obtained by embolizing of all the tumor vessels and the adjacent normal renal arteries with this liquid embolic agent.

Background and purpose:The prognosis of high grade gliomas remains poor, and multidisciplinary treatment strategy has been much investigated recently. This study was to explore the efficacy of Temozolomide as first-line treatment combined with radiotherapy and followed by adjuvant chemotherapy for the treatment of newly diagnosed high grade gliomas. Methods:18 patients who had been pathologically proven to be high grade gliomas were enrolled into the study. The patients received 40 Gy/20fractions for the whole brain and followed by 20Gy/10fractions as a boost to tumor bed. All of the patients were given daily oral temozolomide 75mg/ m2 during radiotherapy. 4 weeks after radiotherapy, all of the patients received 6 cycles of Temozolomide, each cycle lasted 5 days with 28 days interval between each cycles. 150 mg/m2 of temozolomide was given for the first cycle for five days,followd by 200 mg/m2 of drug for the rest of the cycles if no significant drug related toxicities were observed. Results:Median follow-up was 12.5 months, 11 cases had either recurrence or progression, 5 of them died from the disease. The median time for disease progression-free survival was 9.8 months (95% CI, 6.1~9.8months), the median time for overall survival was 14 months (95% CI, 8.5 ~ 19.5months), 1-year overall survival rate was 55.6% ,6-month progression-free survival rate was 81.8%. there were no severe temozolomide related toxicities. Conclusion: Concurrent temozolomide with radiotherapy and followed by 6 cycles of temozolomide in the treatment of high grade gliomas had better clinical efficacy, the patients tolerated the strategy well and no severe toxicities were observed.

Background and purpose:At present,the treatment of metastatic breast cancer has remained diff icult for patients who have failed after the use of anthracycline and taxane,so the treatment options for those with advanced metastatic breast cancer are very limited.Therefore,pemetrexed combined with cisplatin in the treatment of anthracycline and taxane failed advanced metastatic breast cancer patients,its effi cacy and adverse reactions were studied.Methods:10 patients with advanced metastatic breast cancer patients received pemetrexed and cisplatin chemotherapy,pemetrexed 500mg/m2 intravenous infusion,cisplatin 75mg/m2 intravenous drip,repeated every 3 weeks.Evaluation of response and adverse reactions were practiced every 2 cycles.Results:10 patients were evaluable,CR 1 patient,PR 4 patients,SD 2 patients,PD 3 patients.With a median follow-up of 6 months(4-18 months),8 patients survived and 2 patients died.The median time to progression was 4 months(3-14 months),the median survival time was 8 months(4-18 months).The most common adverse reaction was fatigue,white blood cells decrease and the digestive tract reactions,followed by oral ulcers.Conclusion:Pemetrexed combined with cisplatin in the treatment of anthracycline and taxane treatment failed patients with advanced metastatic breast cancer could improve survival,adverse reactions could be tolerated.

Background and purpose:Advanced and metastatic colorectal cancer is the second leading cause of cancer death. In the past ,the standard treatment for patients with advanced CRC was fluorouracil(5-FU) biochemically modulated by leucovorin(LV), which demonstrated a response rate of about 23% .In 1990s, a number of new treatment options have been available. In particular, one new cytotoxic agent ,irinotecan (CPT-11), which is a specific inhibitor of topoisomerase I, have been proven to have efficacy in the tretment of CRC .Furthermore, several first-line phase Ⅲ trials show a significant improvement in result with the addition of CPT-11 to FU-LV combination therapy (FOLFIRI).We observed the survival situation, efficacy and safety of irinotecan plus 5-FU/LV after first-line chemotherapy failure for Chinese patients with advanced or/and metastatic colorectal cancer. Methods:Twenty-four patients with metastatic colorectal cancer whose disease had progressed after treatment with first-line oxaliplatin or other chemotherapeutics were included to receive biweekly FOLFIRI regimen (irinotecan 180mg/m~ 2 on day 1,with LV 200mg/m~ 2 adiministrated as a 2-hour infusion before 5-FU 400mg/m~ 2 administrated as an intravenous bolus injection and FU⒉4g/m~ 2 as 46-hour infusion immediately after 5-FU bolus ).All the patients were planned to receive at least 6 cycles of chemotherapy .They were assessed on the basis of WHO evaluation standard of objective therapeutic effect for solid tumor.Results:24 patients were assessable to observe the efficacy and safety. No case was CR.5 case were PR, response rate was 20% (5/24). 17 case were SD , rate was 70% (17/24). 2 case were PD, rate was 8%(2/24). Median time to progression (TTP) were 6.6 months (6 to 24 months ),median overall survival was 10.7 months. The majority of adverse reaction were nausea, vomiting, anorexia, diarrhea, leucopenia, alopecie. Most of them were Ⅰ/Ⅱ degree, only 6 cases reached III/IV degree. 3 cases had diarrhea with leucopenia and fever.Conclusions:The biweekly regimen of irinotcan in combination with 5-FU/LV results in significant and clinically meaningful improvement in survival and quality of life among patients with metastatic colorectal cancer. Toxicity is manageable.

Objective To evaluate the feasibility of interventional catheterization via saphenous artery route in treating hepatic and renal lesions, to compare its advantages and disadvantages with trans-femoral approach catheterization, and to discuss the feasibility of using saphenous artery route to replace femoral artery approach.Methods A total of 24 rabbits bearing VX2 liver and kidney tumor were randomly divided into via femoral artery catheterization group (control group,n=8) and via saphenous artery catheterization group (study group,n=16). Surface distribution and variation of saphenous artery were recorded. After the saphenous artery was isolated, blood vessel was punctured with a 22 G needle, through which a 0.018 inch micro guide wire together with a 5-F micro catheter sheath was inserted into the artery, then, a Y-valve was connected to the sheath. DSA was performed to determine the diameters of the saphenous artery, femoral artery and iliac artery. The used time for isolating the artery and indwelling the sheath, the depth of sheath insertion, the success rate of catheterization, the incision infection rate and the occurrence of claudication in both groups were recorded, and the results were compared. Results Saphenous artery could be clearly observed on body surface in 91.67%of rabbits (22/24). Successful insertion of catheter sheath was achieved in all rabbits of both groups. The used time of isolating artery, the depth of sheath insertion, the incision infection rate and the occurrence of claudication at 7 and 14 days after the treatment in the study group were(367.30±37.30) seconds, (20.20±2.60) mm, 0%, 6.25%and 0%respectively, while those in the control group were (978.20±156.30) seconds,(58.60±9.50) mm, 37.50%, 62.50% and 25% respectively. The differences in above mentioned measurement items between the two groups were statistically significant (P<0.05). The used time of indwelling the sheath and the occurrence of claudication at one day after the treatment in the study group and in the control group were (42.80 ±9.90) seconds, 70% and (43.60 ±7.0) seconds, 100%respectively, and no statistically significant differences existed between the two groups (P>0.05). The diameters of the saphenous artery, superficial femoral artery, common femoral artery, external iliac artery and common iliac artery were (1.29±0.12) mm,(1.91±0.27) mm, (2.18±0.15) mm, (2.22±0.13) mm and(2.39± 0.15) mm respectively. Conclusion In rabbits, the saphenous artery is usually superficially located, its anatomical variation rate is very low, and its internal diameter can match 5- F micro catheter sheath. Catheterization via saphenous artery is convenient, time-saving with less damage and fewer complications. Therefore, in treating hepatic and renal lesions in rabbits the catheterization via saphenous artery can be used as the technique of first choice to replace the femoral approach catheterization.