OBJECTIVE:To study the mechanism of histone deacetylase inhibitor RGFP109 in reversing resistance of glioma U251 cells. METHODS:TR/U251 cells resistance to temozolomide(TMZ)was extrablished. The test was divided into normal con-trol group,TMZ group(40 μmol/L)and TMZ(40 μmol/L)+RGFP109(0-120 μmol/L)different concentrations groups. After 24 h of adding into related medicines,CCK-8 was used to detect the cell survival rate and calculate the half inhibitory concentration (IC50). TUNEL and Annexin V/PI were used to detect the cell apoptosis in normal control group,TMZ group and TMZ+RGFP109 (42μmol/L)group. Immunoblotting was used to detect the O6-methyl guanine-DNA methyltransferase(MGMT),Survivin,B lym-phoma 2(Bcl-2),B lymphoma xL(Bcl-xL)protein expression;and gel migration test was used to detect the p65 acetylation level and its binding capacity with κB-DNA. RESULTS:Compared with normal control group,cell survival rate in TMZ+RGFP109 dif-ferent concentrations groups was obviously decreased (P<0.05),showing a concentration-dependent manner. When the RGFP109 concentration was 42 μmol/L,the sensitivity of TMZ to TR/U251 cells was the same with U251 cells. Compared with normal con-trol group,MGMT,Survivin,Bcl-2,Bcl-xL protein expressions in cells of TMZ groups were enhanced(P<0.01);p65 acetyla-tion level had no obvious changes,while the binding capacity of p65 and κB-DNA was strengthened (P<0.01). Compared with TMZ group,MGMT,Survivin,Bcl-2,Bcl-xL protein expressions in cells of TMZ groups were weakened(P<0.01);p65 acetyla-tion level was enhanced (P<0.01);and the binding capacity of p65 and κB-DNA was weakened (P<0.01). CONCLUSIONS:RGFP109 can reverse the resistance of U251 cells to TMZ by down-regulating the anti-apoptotic protein expressions adjusted by transcription factorκB(NF-κB)and weakening the binding of p65 andκB-DNA.

Multifocal pontine glioblastoma exhibiting an exophytic growth pattern in the cerebello-pontine angle (CPA) is rare. We present a case of a 5-year-old girl with consecutive neurological imaging and other clinical findings indicat-ing progressive multifocal exophytic pontine glioblastoma. Three lesions were reported, of which two were initially presented, and one was developed 2 months later. One lesion demonstrated a progressing exophytic extension in the cistern of the left side of the CPA. The other two lesions were located and confined within the pons. Initial magnetic resonance imaging and positron emission tomography–computed tomography indicated low-grade glioma or inflammatory disease. However, 2 and 3 months later, subsequent magnetic resonance spectroscopy (MRS) displayed elevated choline and depressed N-acetyl aspartate peaks compared with the peaks on the initial MRS, indicating a high-grade glioma. Subtotal resection was performed for the CPA lesion. Histopathologic examination showed discrepant features of different parts of the CPA lesion. The patient received no further chemotherapy or radiotherapy and died 2 months after surgery. The multifocal and exophytic features of this case and the heterogeneous manifes-tations on neurological images were rare and confusing for both diagnosis and surgical decision-making. Our case report may contribute knowledge and helpful guidance for other medical doctors.

Recently the maintenance therapy of non-small-cell lung cancer (NSCLC) patients who completed required treatment cycles has caused widespread interests in the medical field. Traditional Chinese medicine may be a useful complement in maintenance treatment of mid-to-late stage NSCLC.

Objective? To explore the experience of patients with mechanical ventilation in Intensive Care Uni(t ICU) during early ambulation, and explore the process of early ambulation from the perspectives of patients. Methods? Applying the interview method in qualitative research, in-depth interviews were conducted for 15 conscious patients with artificial airway for mechanical ventilation in ICU of Affiliated Hospital of Ji'ning Medical University from January of 2017 to December of 2018. Colaizzi's 7-step phenomenological data analysis method was used to analyze and sort out the data obtained and get the theme. Results? Six themes were summarized:patients worried about the high risk of early ambulation, discomfort caused by early ambulation, lack of correct understanding on the importance of early ambulation and its benefits, early termination of ambulation caused by unacceptable ambulation way, patients hope to be encouraged by medical staff, patients look forward to social support and economic assistance. Conclusions? Early ambulation is not a separate experience, but interwoven with the experience of mechanical ventilation in ICU. In the process of early ambulation, patients are eager to get more professional, safe and comprehensive care.

Objective:To investigate the efficiency of the ultrasonic-assisted positioning technique for lumbar anesthesia in elderly patients with hip fractures through the paramedian approach compared with body surface labeling.Methods:Patients(aged ≥65 years)with hip fractures were randomized(1∶1)to receive either ultrasound-assisted or landmark-guided paramedian spinal anesthesia in a lateral position.The primary outcome was the number of needle passes needed for a successful dural puncture.The secondary outcomes included one-pass success rate, number of needle attempts, one-attempt success rate, total time of spinal anesthesia and adverse effects.Results:A total of 88 subjects were randomized.The ultrasound-assisted approach significantly reduced the number of needle passes, compared with the landmark-guided approach[2.0(1.0-3.0) vs.5.0(3.0-8.8); Z=-4.708, P<0.001]. The one-pass success rate was higher in the ultrasound-assisted approach than in the landmark-guided approach[40.9%(18/44) vs.4.5%(2/44); χ2=16.565, P<0.001]. There was no statistical difference in the number of needle attempts and one-attempt success rate between the two groups( P>0.05 for both). The total time of spinal anesthesia was longer in the ultrasound-assisted group than in the landmark-guided group[252(218-317) s vs.168(143-195) s; Z=-5.592, P<0.001]. In the ultrasound-assisted group, fewer patients developed bloody cerebral spinal fluid taps than in the landmark-guided group[0%(0/44) vs.18.2%(8/44); χ2=6.738, P=0.009]. Conclusions:In elderly hip fracture patients, ultrasound-assisted paramedian spinal anesthesia is superior to the landmark-guided approach in reducing the number of needle passes and should be recommended for these patients.

Objective:To explore effects of different lower limb placement angles on venous drainage among patients undergoing thoracolumbar surgery in prone position.Methods:From January 2017 to January 2018, we selected patients underwent elective thoracolumbar surgery in prone position of Operating Room in Beijing Hospital as research objects. According to the need of surgery, it was divided into 51 cases in low-angle group and 54 cases in traditional-angle group. We compared effects of different lower limb placement angles on patients by taking the changes of lower limb venous blood flow under ultrasound before and after surgery as main observation indicators and taking changes of lower limb skin temperature and leg circumference as the secondary observation indicator.Results:There were statistical differences in the changes of blood flow on the left and right popliteal veins, the left and right posterior tibial veins of patients under ultrasound between two groups before and after surgery ( P<0.05) . There were no statistical differences in the changes of the leg circumference of 10 cm above the left and right ankles and the changes of the leg circumference of 15 cm above the left and right patellae of patients between two groups ( P>0.05) ; there was also no statistical difference in the change of bilateral skin temperature ( P>0.05) . Conclusions:The lower limb placement angles among patients undergoing thoracolumbar surgery in prone position may affect the venous drainage which nurses of Operating Room should pay attention to when placing positions.

The elderly represent a segment with a high incidence of pain.Consciousness impairment and language dysfunction increase the difficulty of pain assessment.At the same time, a lack of understanding of neuropathic mechanisms and assessment scales often leads to inappropriate pain assessment in the elderly with dementia.This article reviews the relationship between dementia and pain, pain assessment protocols and the use of scales in the elderly with dementia.

Homeostasis ; Taste/physiology* ; Zinc