With artificial intelligence,the authors designed an Expert System for the Differential Diagnosis and Treatment of Lumbago.ESSDTL shows that it not only helps doctors to diagnose the illness of lumbago but also helps young doctors and medical students to gain experience by running practical cases and explaining their procedures for diagnosing and treting the diseases through ESDDTLexplanation facilities.

Objective:To observe the changes of structure and function of pharyngeal muscle in SD rats with altitude hypoxia induced obstructive sleep apnea syndrome(OSAS),in an attempt to investigate the remodeling of pharyngeal space and the possible biomechanical mechanism of OSAS.Methods:Twenty-four SD rats(12 male and 12 female) were randomly assigned to 4 groups with 6 rats in each group.Rats in group A and B were male and those in group C and D were female.Rats in group A and C were placed in altitude chamber and treated with altitude hypoxia 6 h per day for 22 days.The pressure in the chamber was 53.9 kPa with an oxygen concentration of 10.0%-11.2%.Rats in group B and D,serving as controls,received no treatment.All rats were sacrificed on the 23~(rd)day.The open-angle and the inside diameter of rats′ pharyngeal-ring and the pathology of pharyngeal tissues were examined in all rats.Results: The open-angles of rats′ pharyngeal-ring of group A, B,C and D were(55?24)?,(15?8)?,(38?20)?,and(35?15)?,respectively;and the inside diameters of the pharyngeal-ring(cm) were(0.4?0.2,) 0.2?0.1,0.3?0.1,and 0.3?0.1,respectively.The open-angle and the inside diameter of rats′ pharyngeal-ring in group A were significantly higher(P

The breast cancer stem cells are a subpopulatiom of breast tumor cells that selectively possess tumor initiation and self-renewal capacity. Recent findings suggest that it may correlate with the failure treatment and relapse of breast cancer. The isolation of phenotypically distinct tumorigenic of breast cancers will find a way to elucidation of the pathways that account for their tumorigenic potential to cure the disease.

Objective To investigate the efficacy of rabeprazole combined with mosapride in the treatment of reflux esophagitis. Methods A total of 92 patients with reflux esophagitis admitted from April 2016 to April 2017 in our hospital were divided into study group and routine group (n = 46). The routine group was treated with omeprazole and Mosapride,the study group was treated with rabeprazole and mosapride. The clinical efficacy and adverse reactions in the two groups were observed and compared. Results The total effective rate was 91.30％ in the study group and 76.09％ in the conventional group, the difference was statistically significant (P<0.05). The total effective rate of reflux symptoms, esophageal irritation and esophageal irritation was significantly higher in the study group than in the conventional group (P<0.05)The adverse reaction rate was 4.35％ in the study group and 6.52％ in the conventional group, the difference was not statistically significant (P<0.05). Conclusion In the course of clinical treatment of reflux esophagitis, attention should be paid to the two aspects of acid suppression and gastric motility. In the inhibition of acid, the effect of Bella is obviously higher than that of omeprazole. In gastric motility, mosapride in clinical effect is better. Reflux esophagitis by rabeprazole combined with mosapride treatment, clinical efficacy is significant, and adverse reaction rate is low, safe and reliable, worthy of clinical application.

Proliferative diabetic retinopathy (PDR) is one of the serious ocular complications of patients with diabetes mellitus and also the leading cause of blindness.Pars plana vitrectomy (PPV) is an effective treatment for severe vitreous hemorrhage and PDR.The intraocular concentration of vascular endothelial growth factor (VEGF) of patients with PDR usually increase abnormally,which promote growth of neovessels and make it early to leak and bleed.Numerous neovessels in vitreous cavity and retinal surface can lead to intraoperative bleeding and may affect the definition and precision of operation and prolong surgical time.If we conduct gas/fluid exchange regardless of severe active bleeding,proliferate membrane may reoccur at a high rate postoperatively due to the residual platelet and impair the success rate of surgery seriously.In addition,with the high activity of neovessels,anterior chamber,vitreous and retinal hemorrhage may appear as well as other postoperative complications like postoperative high intraocular pressure caused by inflammation or hemorrhage and traction retinal detachment because of reoccurrence of fibro membrane,which directly affect the postoperative visual function recovery and long-term prognosis.As wide clinical application of anti-VEGF agents in recent years,studies found that preoperative intravitreal injection of anti-VEGF drugs assisted PPV can limit the activity of neovessels and significantly reduce the incidence of intraoperative and postoperative bleeding,facilitate operation,shorten surgical time and improve the success rate of surgery.In this paper,the mechanism,effectiveness,clinical utility and safety of anti-VEGF therapy assisted vitrectomy for the treatment of PDR are reviewed.

Acetyltransferases ; genetics ; Breast Neoplasms ; genetics ; Female ; GPI-Linked Proteins ; Gene Expression Regulation, Neoplastic ; genetics ; Humans ; Membrane Glycoproteins ; genetics ; Neoplasm Metastasis ; genetics ; physiopathology ; S100 Proteins ; genetics ; Transcription Factors ; genetics

Foreign Bodies ; surgery ; Head ; Humans ; Imaging, Three-Dimensional ; Jaw Fractures ; surgery ; Maxillofacial Injuries ; diagnostic imaging ; surgery ; Radiography, Dental, Digital ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed

Objective To compare the impacts of four different intravenous anesthetic agents on middle cerebral artery blood flow velocity(V‐MCA) during the anesthesia induction period .Methods Totally 80 cases were randomly divided into four groups (n=20) ,maintenance drugs of anesthesia were propofol 2 .00 mg/kg ,etomidate 0 .30 mg/kg ,midazolam 0 .15 mg/kg and dezocine 0 .20 mg/kg respectively ,the bispectral index (BIS) value was dropping to below 50 ,the endotracheal intubation and mechanical ventilation were performed .The transcranial Doppler (TCD) monitoring was adopted to monitor and record middle cerebral artery mean flow velocity (Vm‐MCA) ,mean arterial pressure (MAP) ,heart rate (HR) ,systolic blood pressure (SBP) ,diastolic blood pressure (DBP) in the four groups before induction after entering operation room (T0 ) ,at1 min before intubation (T1 ) ,immediate intubation (T2 ) ,at 1 min after intubation (T3 ) ,3 min after intubation (T4 ) ,5 min after intubation (T5 ) .Results Except for the midazolam group ,Vm‐MCA at T1 in the other three groups were significantly lower that that in the T0 group (P< 0 .05);Vm‐MCA ,SBP ,DBP after intubation in the midazolam group and the etomidate group were significantly increased compared with the basic values ,while the difference between the propofol group and the dezocine group had no statistical significance (P>0 .05) .Con‐clusion midazolam and etomidate are weaker than propofol and dezocine in the aspect of inhibiting the middle cerebral arterial blood flow fluctuations caused by intubation .

The relapse and refractoriness of multiple myeloma is still the most tough problems in clinical practise.With the increasing cognition of pathogenesis on multiple myeloma, lots of new drugs are constantly emerging with its clinical efficacy and side-effect are gradually acknowledged. There are a serial of new agents and therapies targeted relapsed and refractory multiple myeloma have spring up. This paper will summarize the advancement of treatment for relapsed and refractory multiple myeloma.

BACKGROUND:An increasing number of studies have shown that mesenchymal stem cels have the potential to treat acute kidney injury. Umbilical cord-derived mesenchymal stem cels have general characteristics of stem cels and many advantages, such as easy to isolate and culture, in vitrofast amplification, low immunogenicity and no ethical problems, which have garnered increasing attentions. OBJECTIVE:To study the repairing effects of human umbilical cord-derived mesenchymal stem cels on acute kidney injury in rats. METHODS: Thirty rats were randomized into three groups: a normal control group, a model group and a cel transplantation group. Rats in the model and cel transplantation were subjected to clamping the renal pedicles for 45 minutes, and then injected 1 mL of DAPI-labeled umbilical cord-derived mesenchymal stem cels or 1 mL of saline via the tail vein. In the normal control group, the kidney was only exposed with no treatment. At 7 days after treatment, the rats were kiled to take left kidney tissues for pathological observation under light microscope and right kidney for observation of DAPI-positive cel counting. Automatic biochemical analyzer was used to detect serum creatinine and urea ammonia levels. RESULTS AND CONCLUSION: Compared with the model group, the levels of serum creatinine and urea ammonia were significantly lower in the cel transplantation group (P < 0.05), suggesting that human umbilical cord-derived mesenchymal stem cels can improve the kidney function to a certain extent. Pathological findings showed that the pathological damage was improved more remarkably in the cel transplantation group than the model group, and the tubular necrosis index decreased significantly in the cel transplantation group. At 7 days after cel transplantation, blue fluorescent cels were scattered on renal tissue frozen sections. These results indicate that human umbilical cord-derived mesenchymal stem cels can migrate to the injured tubular epithelial tissues, and promote the repair of the injured kidney.