Objective To investigate the effect of stellate ganglion block combined with morphine sustainedrelease tablets for controlling pain of advanced lung cancer.Methods 90 cases with advanced lung cancer were randomly divided into the observation group and control group with 45 cases in each group.The control group was givenmorphine sustained-release tablets,the observation group received combination therapy with stellate ganglion block and morphine sustained-release tablets.The analgesic effects,quality of life scores and adverse reactions of two groups were compared.Results The effective rate of observation group was 93.33 ％ (42/45),which was significantly higher than that of control group 77.78％ (35/45),the difference was statistically significant (x2 =4.54,P ＜ 0.05).The morphine consumption of observation group was significantly less than that of control group(t =9.11,P ＜ 0.05),duration of analgesia was significantly longer than that of control group (t =6.72,P ＜ 0.05).Quality of life score in the observation group was significantly higher than that in the control group,the difference was statistically significant(Z =3.61,P ＜ 0.05).The incidence rate of adverse reactions was 17.78％ (8/45),which was significantly lower than that of the control group 46.67％ (21/45),the difference was statistically significant (x2 =4.54,P ＜ 0.05).Conclusion Stellate ganglion block combined with morphine sustained-release tablets for controlling pain of advanced lung cancer can significantly improve analgesia,reduce morphine consumption and adverse reactions,is worthy of clinical application.

As an income redistribution mechanism, the design of Urban Resident Basic Medical Insurance ( URBMI) should reflect the inclination to take care of vulnerable populations, such as people with chronic diseases and low incomes. Therefore, whether the healthcare services of vulnerable populations have been improved, is the most important indicator to determine the effectiveness of the URBMI. Using the DID model, this paper analyzes healthcare service utilization of invulnerable and vulnerable populations before and after the establishment of URBMI ( including both outpatient and inpatient) , based on the idea that these two populations have different socio-economic and health status. Then, based on the gap between the healthcare service utilization changes of different groups, we can measure the equity in URBMI. The results show that the establishment and implementation of URBMI has indeed narrowed the gap of invulnerable and vulnerable populations with different socio-economic and health status; health-care service utilization of vulnerable populations has increased significantly, and health status has significantly im-proved. From vertical and horizontal perspectives, the results prove that the establishment of URBMI has improved the equity of healthcare service utilization among different populations across China.

Objective To observe the change of liver sinusoid in BALB/c mice infected with Schistosoma japonicum and explore its relationship between the degree of hepatic fibrosis and liver function. Methods A model was established in BALB/c mice infected with cercariae of Schistosoma japonicum. The liver specimens of mice were used for pathological examination with routine and picric acid-sirius red staining to know the degree of hepatic fibrosis by semi-quantity. The expressions of C-IV and vWF in liver sinusoid were assayed through the immuhistochemistry staining. The serum ALT and AST were detected by the automatic biochemistry analyzer, and the ultramicrostructure of the liver tissue was observed by a transmission electron microscope. Results The number and diameter of fenestrations in SEC reduced 4 weeks after the infection. The fenestrations were disappeared and the base membrane established 8 weeks after the infection. The expressions of C-IV and vWF in liver sinusoid and the degree of hepatic fibrosis increased with the time after infection. The levels of serum ALT and AST were not correlated with the infection time. Conclusions The phenotype alteration of the hepatic sinusoidal endothelium may be a vital issue triggering the liver fibrosis induced by Schistosoma japoncium.

Objective To investigate the effects of tanshinol on the proliferation,apoptosis and NF-?B activation in rat hepatic stellate cells(HSCs) after IL-1? inducement,and to elucidate the anti-fibrotic molecular mechanisms of tanshinol.Methods The rat HSCs was isolated with collagenase in situ liver recirculation perfusion and cultured in vitro.The cells were divided into 5 groups: normal control,IL-1? treatment group(10 ng/ml),and tanshinol group 1,2 and 3.The later 3 groups were pretreated with tanshinol at the concentrations of 0.062 5,0.125 and 0.25 mmol/L respectively followed by 10 ng/ml IL-1? treatment 1 h later.MTT colorimetric assay was used to detect the proliferation of HSCs.AO/EB immunoflurorescence microscopy and combination Annexin-V-FITC/PI double-labelimmunofluorescence with flow cytometer were employed to examine the apoptosis of HSCs.Synthesis and secretion of collagen Ⅲ were detected by the quantitative immunocytochemical assay and ELISA respectively.The amounts of cytoplasm p-I?B? and NF-?B p65,and nuclear NF-?B p65 in HSCs were determined by Western blotting.Immunocytochemical staining and Western blotting were used to observe nuclear translocation of NF-?B p65.Results IL-1? increased the proliferation of HSCs(P

Objective To examine the association of employment-related events with depression and anxiety in senior college students in China.Methods Altogether 1321 senior college students were recruited from Central South University and the survey was administered anonymously. Anxiety and depression were assessed with the Self-rating Anxiety Scale (SAS) and the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Employment-related events were reflected by the employment-related options when students were surveyed. Logistic regression was used to estimate the effect of employment-related events on anxiety and depression.Results We collected 1178 valid questionnaires. Taking 50 and 16 as the cutting-point of SAS and CES-D, we found 18.9% and 55.4% of the participants showed symptoms of anxiety and depression, respectively. After controlling confounding factors, those students who had taken the entrance exam of graduate schools and were optimistic for the result, those who had taken the entrance exam of graduate schools but were pessimistic for the result, and those who neither took the entrance exam of graduate schools nor received a job offer, had a higher risk of anxiety than those who would attend a graduate school without exam, and the odds ratios were 2.5, 2.3, and 3.5, respectively. For students' depression, the odds ratios of the three categories mentioned above were 2.0, 1.5, and 2.6, respectively. Conclusion Senior college students who face bad employment-related events are at a higher risk of anxiety and depression.

Objective To evaluate bone marrow mesenchymal stem cells combined with VEGF gene in the treatment of limb ischemia in rabbits.Methods The right hind limb ischemia model of New Zealand rabbit was established by superficial femoral artery excision and deep femoral artery ligation.Rabbits then were divided randomly into 4 groups: empty plasmid control group(EP group),bone marrow mesenchymal stem cells group(BMSC group),VEGF gene therapy group(VEGF group),combination bone mesenchymal stem cells and VEGF gene therapy group(BV group).There were 8 rabbits in each group.Angiogenesis was detected by arteriography on day 28 after treatment and expression of VEGF was detected by immunohistochemical staining on day 30 after treatment.Results There were no differences of collateral vessel count between the EP group,BMSC group and VEGF group.The collateral vessel count in BV group was higher than that of the other three groups.Immunohistochemistry of VEGF showed that the integrated optical density(IOD)in BMSC and VEGF groups increased significantly compared with the EP group; the IOD in BV group was the highest compared with the other three groups.Conclusions Combination bone marrow mesenchymal stem cells and VEGF gene in the treatment of limb ischemia in rabbits can obtain stable and effective expression of VEGF along with significant improvement of limb ischemia.

OBJECTIVE: We wanted to evaluate the feasibility of catheter-directed thrombolysis with a continuous infusion of low-dose urokinase for treating non-acute (less than 14 days) deep venous thrombosis of the lower extremity. MATERIALS AND METHODS: The clinical data of 110 patients who were treated by catheter-directed thrombolysis with a continuous infusion of low-dose urokinase for lower extremity deep venous thrombosis was analysed. Adjunctive angioplasty or/and stenting was performed for the residual stenosis. Venous recanalization was graded by pre- and post-treatment venography. Follow-up was performed by clinical evaluation and Doppler ultrasound. RESULTS: A total of 112 limbs with deep venous thrombosis with a mean symptom duration of 22.7 days (range: 15-38 days) were treated with a urokinase infusion (mean: 3.5 million IU) for a mean of 196 hours. After thrombolysis, stent placement was performed in 25 iliac vein lesions and percutaneous angioplasty (PTA) alone was done in five iliac veins. Clinically significant recanalization was achieved in 81% (90 of 112) of the treated limbs; complete recanalization was achieved in 28% (31 of 112) and partial recanalization was achieved in 53% (59 of 112). Minor bleeding occurred in 14 (13%) patients, but none of the patients suffered from major bleeding or symptomatic pulmonary embolism. During follow-up (mean: 15.2 months, range: 3-24 months), the veins were patent in 74 (67%) limbs. Thirty seven limbs (32%) showed progression of the stenosis with luminal narrowing more than 50%, including three with rethrombosis, while one revealed an asymptomatic iliac vein occlusion; 25 limbs (22%) developed mild post-thrombotic syndrome, and none had severe post-thrombotic syndrome. Valvular reflux occurred in 24 (21%) limbs. CONCLUSION: Catheter-directed thrombolysis with a continuous infusion of low-dose urokinase combined with adjunctive iliac vein stenting is safe and effective for removal of the clot burden and for restoration of the venous flow in patients with non-acute lower extremity deep venous thrombosis.
Adult ; Aged ; Angioplasty, Balloon ; *Catheterization, Peripheral ; Combined Modality Therapy ; Female ; Fibrinolytic Agents/*administration & dosage ; Humans ; *Infusion Pumps ; Infusions, Intravenous ; Leg/*blood supply ; Male ; Middle Aged ; Phlebography ; *Thrombolytic Therapy/methods ; Ultrasonography, Doppler ; Urokinase-Type Plasminogen Activator/*administration & dosage ; Vascular Patency ; Venous Thrombosis/*drug therapy/radiography/ultrasonography

OBJECTIVETo investigate the effect of Src kinase inhibitor PP2 on hypoxia/reoxygenation (H/R) injury in rat astrocytes in vitro.

METHODSIn vitro cultured rat astrocytes were exposed to hypoxia for 8 h followed by reoxygenation for 24 h with or without pretreatment with PP2 (10 µmol/L) for 24 h before H/R injury. MTT assay and flow cytometry were used to detect the viability and apoptosis of the exposed astrocytes, respectively, and the protein expressions of Src, Bax, and Bcl-2 in the cells were determined using Western blotting.

RESULTSPP2 pretreatment significantly increased the viability and decreased the apoptosis rate of rat astrocytes exposed to H/R injury (P<0.01). Western blotting showed that H/R injury caused increased expression of Src kinase, which was lowered by PP2 pretreatment. The ratio of Bax/bcl-2 in the astrocytes increased after H/R injury, and was significantly decreased by PP2 pretreatment (P<0.01).

CONCLUSIONPP2 protects rat astrocytes from H/R injury possibly by inhibiting the expression of Src kinase and activating the anti-apoptotic mechanisms in the cells.

Animals ; Apoptosis ; Astrocytes ; pathology ; Cell Hypoxia ; Cells, Cultured ; Flow Cytometry ; Pyrimidines ; pharmacology ; Rats ; src-Family Kinases ; antagonists & inhibitors

OBJECTIVE: To analyze variation of ISL1 gene and explore its functional characteristics in relation with congenital heart defect (CHD). METHODS: Clinical data and peripheral blood samples of 194 CHD patients and 232 healthy controls were collected for the extraction of genomic DNA. The coding exons and flanking intronic regions of the ISL1 gene were sequenced. Expression plasmid for the wild-type ISL1 gene ISL1-pcDNA3.1 was constructed, and the corresponding variants were obtained by site-specific mutagenesis. The gene expression plasmid was transfected into CHO cells with liposome, and the functional characteristics of ISL1 variant were studied by double luciferase reporter gene analysis. RESULTS: A novel variant of the ISL1 gene c.499C>T (p.Q167X) was detected in a patient with sporadic CHD. Functional study showed that the variant has lost its transcriptional activation function for the MEF2C promoter. CONCLUSION A novel variant of the ISL1 gene related to CHD has been identified. The defect of ISL1 gene may underlay the pathogenesis for a proportion of CHD.

Objective:To investigate the overall clinical performance of nursing students and analyze its influencing factors to provide evidence for the improvement.Methods:A questionnaire survey was carried out among 288 nursing students from Qilu Hospital of Shandong University in March to May 2020. The survey included a general data questionnaire, Holistic Clinical Assessment Tool, Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, Medical Student Safety Attitudes and Professionalism Survey of nursing students. The factors associated with overall clinical performance of nursing students were analyzed by t test, analysis of variance, Pearson correlation analysis and multiple linear regression. Results:The total score of Holistic Clinical Assessment Tool was 114.95 ± 22.91. The total score of Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale was 156.70 ± 26.98. The total score of Medical Student Safety Attitudes and Professionalism Survey was 123.65 ± 31.00. The influencing factors included social practice experience and clinical learning environment, which accounted for 28.0% of the total variation of overall clinical performance of nursing students.Conclusions:Educators and managers of nursing students' schools and internship hospitals should actively explore the educational reform practice to promote the improvement of clinical ability, so as to promote the improvement of the overall clinical ability of nursing students.