Radiotherapy and interventional thearapy are the main means for unresectable advanced primary hepatic carcinoma.However,the efficacies are restricted by their respective adaptability.The development of radiotherapy,especially the application of radiotherapy combined with transcatheter hepatic artery chemoembolization provide more suitable treatment means for patients.

A brief description of the medical treatment assurance service provided by the hospital for major international events from 2001 to 2007. The paper rounded up the practices and experiences of the hospital gained such services in a variety of international events, including the development of a detailed operative plan for medical treatment assurance, selection and preparation for medical workers, development and updating of training programs, determination of the operability of the plan and successful launch of the assurance services. It holds that provision of such services significantly upgrades the general competence of the hospital management, and its capabilities in management, emergency response, rescue and inter-department coordination.

Nerve growth factor may play its particular role in promoting the development of neuroplasticity after central nervous system and peripheral nerve injury. Its possible mechanisms are associated with regulation of TrkA receptor, activation of L-type calcium channel, promoting the release of acetylcholine, regulation of long-term potentiation and long-term depression. The study of the mechanisms of nerve growth factors for promoting neuroplasicity may provide novel therapeutic approaches for the treatment and rehabilitation of stroke, Alzheimer's disease, and peripheral nerve injury, and it may facilitate the development of the therapeutic drugs.

Objective To study the effects of butylphthalide on homocysteine (Hcy) and C-reactive protein (CRP) levels in patients with acute cerebral infarction.Methods One hundred and ten patients with acute cerebral infarction were divided into control group and treatment group by random digits table,with 55 patients in each group.Two groups were given conventional treatment for 3 weeks,and treatment group was added butylphthalide 200 mg oral application,thrice a day.Two groups were compared in the total effective rate,neurological deficit scores (NDS) and serum Hcy and CRP levels.Results The total effective rate in treatment group was significantly higher than that in control group [ 89.09％ (49/55) vs.61.82％ (34/55),x2 =11.044,P＜ 0.01 ].The NDS in two groups after treatment were significantly decreased than those before treatment [treatment group:( 11.24 ± 3.19) scores vs.(23.19 ± 4.06) scores,control group:( 18.56 ± 4.03 )scores vs. (22.31 ± 4.17) scores,P ＜ 0.01 ],and NDS in treatment group after treatment was significantly lower than that in control group (P＜ 0.01 ).The serum Hcy and CRP levels in two groups after treatment were significantly lower than those before treatment [ treatment group:( 13.12 ± 3.58 ) μ mol/L vs.(27.36 ± 6.84 )μ mol/L,( 10.33 ± 3.10) mg/L vs.( 18.96 ± 5.38) mg/L;control group:( 16.41 ± 4.76) μ mol/L vs.(28.73 ±6.32) μ mol/L,(13.16±4.02) mg/L vs. (19.17 ± 5.74) mg/L,P ＜ 0.01 ],serum Hcy and CRP levels in treatment group after treatment were significantly lower than those in control group (P ＜ 0.01 ).Conclusion Butylphthalide can reduce serum Hcy and CRP levels,reduce inflammation and improve the condition of patients with acute cerebral infarction.

OBJECTIVE: To explore the expression and significance of vasoactive intestinal peptide and Pituitary adenylate cyclase activiting polypeptide (VIP/PACAP) of nasal mucosa in rats with allergic rhinitis (AR), and the function of botulinum toxin-A(BTX-A) to inhibit the expression of VIP/PACAP in AR. METHOD: Thirty Sprague-Dawley rats were randomly divided into 3 groups, which were the AR group, the intervention group, and the control group. In the AR group, ovalbumin was used to sensitize healthy rats. In the intervention group, BTX-A was dripped into the nasal cavity of AR rats 7 times. In the control group, only physiological saline was used to drip into the nasal cavity of AR rats. Changes of the rats' behavior were observed. ELISA were used to detected the concentration variation of serum IFN-γ and IL-4. Histopathology and immunohistochemistry were employed to observe morphology in the rats' nasal mucosal and the expression of VIP/PACAP. Statistical analysis was also made. RESULT: (1)The typical symptoms marks of nasal scratching, sneezing, nasal blockage and rhinorrhea of AR group (7.5 ± 0.50) were higher than intervention group (1 ± 0.27) and control group (0.8 ± 0.31). (2) Comparing to intervention group and control group, the serm IFN-γ of the AR group obvious reduced (P < 0.05), the serm IL-4 of the AR group obvious rose (P < 0.01), and the serm Th1/Th2 (IFN-γ/IL-4) of the AR group obvious reduced (P < 0.01). (3) Comparing to intervention group and control group, the cilium loss, inflammatory cells infiltration, and inflammatory cells exudation of nasal mucosa in AR group were more obviously (P < 0.01), and the intervention group of the 3 indexes was obviously than control group. (4) The expression of VIP in the rats' nasal mucosa of the AR group (13.27 ± 2.74) were more intense than intervention group (5.21 ± 2.18) and control group (3.56 ± 5.30) (P < 0.01), and the expression of PACAP in the rats' nasal mucosa of the AR group (20.97 ± 2.14) were more intense than intervention group (6.33 ± 3.04) and control group (4.63 ± 1.25) (P < 0.01). (5) In all the 3 groups, there was positive correlation between expression of negative in VIP/PACAP and Thl/Th2 cell infiltration(r were respectively -0.340 and -0.223, P < 0.05). CONCLUSION The VIP/PACAP in the rats' nasal mucosa may play an important role in pathogenesis of AR, and BTX-A could improve the symptoms of AR through inhibition of the expression of VIP/ PACAP.
Animals ; Botulinum Toxins, Type A ; pharmacology ; Disease Models, Animal ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Nasal Mucosa ; drug effects ; metabolism ; Ovalbumin ; Paranasal Sinuses ; Pituitary Adenylate Cyclase-Activating Polypeptide ; antagonists & inhibitors ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic ; drug therapy ; Vasoactive Intestinal Peptide ; antagonists & inhibitors ; metabolism

OBJECTIVE: To research the serum levels of BDNF, H2S and S-100β as metabolic product of hippocampus and cerebral cortex in moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS) patients before and after surgery, and to analyze their correlations with cognitive impairment. METHOD: Forty-four randomly selected diagnosed OSAHS patients were divided into two groups according to Montreal Cognitive Assessment (MoCA), 19 cases in cognitively normal group and 25 cases in cognitive dysfunction group. Cases in cognitive dysfunction group underwent UPPP oriented surgery, and received 6 months follow-up, 21 cases were remained as treament group, 4 cases lost. 19 cases of healthy subjects were randomly selected as the normal control group. All groups were detected for the serum BDNF, H2S and S-100β levels to analyze the correlations between the biochemical indexes and sleep disorders indexes, hypoxia levels and cognitive function scores. RESULT: (1) In the comparison between the treatment group and the normal control group regarding PSG monitoring results, the AHI, I + II, LA/HT and SLT90% indexes of OSAHS patients increased, and the III + IV phase, REM phase, MSaO2 and LSaO2 decreased. In the comparison between the cognitive dysfunction group and the cognitively normal group, the III + IV, REM and LSaO2 indexes of the cognitive dysfunction group decreased. (2) In the comparison between cognitive dysfunction group and cognitively normal group, and between the treatment group and the normal control group, BDNF and H2S levels increased and S-100β levels decreased, and the MoCA total scores, attention, memory/delayed recall scores decreased. (3) The correlation between biochemical indexes with PSG indexes was as follows. The serum BNDF and H2S levels were negatively correlated with AHI index. The serum BNDF and H2S levels were positively correlated with III + IV stage, REM stage and MSaO2 indexes. The S-100β level was positively correlated with AHI index, and S-100β levels were negatively correlated with III + IV stage, REM stage, MSaO2 and LSaO2 indexes. (4) The correlation between biochemical indexes and MoCA scores was as follows. The serum BNDF and H2S levels were positively correlated with MoCA total scores, attention, and memory/delayed recall scores. The serum S-100β levels were negatively correlated with MoCA total scores, attention and memory/ delayed recall scores. (5) The linear regression equation between MoCA total scores in cognitive dysfunction group of OSAHS patients and the serum BNDF, H2S and S-100β levels was as follows: Y(MoCA) = 40.131 + 0.22 X(BDNF) + 0.012 X(H2S)-0.647X(S-100β) (R2 = 0.461). CONCLUSION OSAHS patients with sleep disorder and nocturnal hypoxemia might suffer from cognitive dysfunction in which attention and memory predominates. Serum BNDF, H2S and S-100β levels, which could indirectly reflect the metabolic abnormalities degree of hippocampus and cerebral cortex, are sensitive indicators of early cognitive dysfunction in OSAHS patients.
Brain-Derived Neurotrophic Factor ; metabolism ; Cerebral Cortex ; physiopathology ; Cognition Disorders ; complications ; Hippocampus ; physiopathology ; Humans ; Hypoxia ; Memory ; Metabolic Diseases ; physiopathology ; S100 Calcium Binding Protein beta Subunit ; metabolism ; Sleep Apnea, Obstructive ; complications

Objective To investigate the cerebral ischemia/reperfusion protection mechanism of viper venom nerve growth factor(vNGF) by the change of expression of growth associated protein-43 (GAP-43) and neurological function.Methods 45 adult male Wistar rats (weight 220～280 g) were divided randomly into 3 groups: sham group(S, n=9), balanced salt solution group (BSS, n=9) and venom nerve growth factor group (vNGF, n=27). Each group was observed for 7 days. vNGF group was divided into 25 U, 50 U and 100 U subgroups respectively. The following indexes in 3 groups were observed respectively: neurologic deficits and the expression of GAP-43 (immunohistochemistry method).Results Neurological function: The scores of neurological function was 0 in S group. The neurological deficits score was lower at the same time in vNGF group than that in BSS group (P<0.05). Immunohistochemistry: GAP-43 expressed in both BSS group and vNGF group. The expression of GAP-43 in vNGF group increased in 25 U, and to maximum in 100 U. The expression of GAP-43 in BSS group was significantly lower than in vNGF group (P<0.05). Conclusion vNGF can effectively enhance and prolong the expression of GAP-43, increase the survival rats of nerve cells, and has the protection effect on nerve cells after cerebral ischemia injured.

The guidelines for standard nursing in the PET/MR imaging examination included preparation of examination,injecting drug,observing during scanning,post scanning care,management of adverse reaction of contrast agent and radiation protection.The purpose of these guidelines could were to provide the practical and effective management for nursing care in PET/MR imaging,and offer a framework for nurses that could provide useful and helpful in clinical practice and research.

Objective To explore the association of frailty and postoperative complications among older patients with surgery. Methods From November 2016 to November 2017, a total of 245 older patients with surgery were included in this study, demographic data, frailty status and potential risk factors were collected by using general information questionnaire, frailty phenotype and risk factors questionnaire. The outcome was the occurrence of postoperative complications in hospital. The mehod of t test, chi-square test or Wilcoxon-Mann-Whitney test were used for univariate analysis; Logistic regression analysis was used for multivariate analysis. Results The prevalence of postoperative complication among surgical older patients was 25.71％, frailty patients were more prone to postoperative complications in hospital (χ2=51.385, P<0.01). After adjusted of age, activities of daily living, anesthesia classification, serum albumin, hemoglobin and other confounding factors, frailty still as a predictor of adverse outcome, OR=10.978, 95％CI=4.651-25.906 (P<0.01). The time of surgery and American Society of Anesthesiolgists anesthesia classification of could also influence the occurrence of outcome. Conclusions Frailty is an effective predictor of postoperative complication among older patients with surgery. Nurses could evaluate the frailty status about older patient and provide inventions to prevent the occurrence of adverse outcome.

Multiple system atrophy can have various forms of sleep disorders, including insomnia, rapid eye movement sleep behavior disorder, sleep-disordered breathing, periodic leg movements during sleep and excessive daytime sleepiness. This article will focus on the concept, classification, pathogenesis, clinical features, diagnosis and treatment, aiming to deepen clinicians′ understanding of the disease, which will be helpful for early diagnosis and treatment.