Objective To systematically assess the values of B-ultrasound(US),computed tomography(CT),magnetic resonance cholangiopancreatography(MRCP)and endoscopic retrograde cholangiopancreatography(ERCP)in diagnosing cholangiocarcinoma(CCA).Methods All published literatures on bile duct cancer were collected from the literature databases of PubMed,Medline,Embase,CNKI and Wanfang.Then the patients with bile duct cancer suspected by US,CT,MRCP and ERCP were performed the systematic review.The evaluation indicators included sensitivity and specificity.The summary receiver operating characteristic(SROC)curve was adopted to obtain the area under the curve(AUC)and Q values.The diagnostic values of 4 kinds of method were analyzed.Results Forty-four articles were included,involving 4 364 patients.The pooled sensitivities of US,CT and MRCP were 0.75,0.82 and 0.85 respectively,the specificities were 0.72,0.80 and 0.87 respectively(sensitivity and specificity of ERCP cytology and image were 0.62,0.98;0.88,0.84),the Q values were 0.690 8,0.787 8 and 0.841 7(0.846 1,0.833 2 in ERCP cytology and image).Conclusion The accuracy of CT,MRCP and ERCP for diagnosing bile duct cancer is similar and higher than that of US,which is an effective assisted examination method when compared with US.The pooled specificity of ERCP cytology is obviously higher than that of other examination method and has high clinical diagnostic value in the patients with highly suspected bile duct malignant tumor.

Objective To investigate the relationship between cysteine-rich protein 61 ( Cyr61 ) and phosphatidylinositol 3-kinase ( PI3K ) signal pathway on cell proliferation and apoptotic in human ovarian carcinoma cells.Methods Recombinant human Cyr61 (rhCyr61) was pretreated with ovarian carcinoma cells.The expression of Cyr61 protein was detected by confocal spectral microscopy.Then treated the ovarian carcinoma cells with PI3K transduction inhibitors (LY294002) for 24 hours.Cell apoptosis was detected by flow cytometry (FCM).Cell viability was determined by methyl thiazolyl tetrazolium (MTT) method.The mRNA expressions of Cyr61,the protein levels of protein kinase B ( PKB),phospho-PKB and Cyr61 were assaved by real time-PCR and western blot analysis,respectively.Results The Cyr61 and phospho-PKB protein expression in two ovarian carcinoma cells (OV2008 and OVCAR-3 ) were increased in rhCyr61pretreated group.The decreasing of cell apoptosis [ ( 1.4 ±0.9)％,(2.1 ± 1.0)％ ] and increasing of cell proliferation [ ( 124.0 ± 1.8)％,( 133.0 ±2.2)％ ] was detected in the same time,compared with negative control group,there were significant difference ( P ＜ 0.05 ).After exposed to LY294002 for 24 hours,the apoptosis rate of OV2008 and OVCAR-3 in pretreated with rhCyr61 group exposed to LY294002 were (21.1 ± 1.6)％ and (26.4 ± 1.5 )％,respectively.Cells viability [ (59.0 ± 2.3 )％,(51.0 ± 2.0)％ ]was also significantly decreased in OV2008 and OVCAR-3 pretreated with rhCyr61 cells.Meanwhile,the mRNA expressions of Cyr61 (3.2 ± 0.8,6.2 ± 1.1 ) and the protein levels of phospho-PKB and Cyr61 were greatly decreased.Compared with negative control group,there were significant difference in OV2008 and OVCAR-3 cells (all P ＜ 0.0l ).Conclusions The activation of PI3K intracellular signaling pathways may lead to up-regulation of Cyr61 expression.Block PI3K signal pathway could significantly inhibit the expression of Cyr61,and may promote the apoptotic effects and inhibit the cell growth of ovarian carcinoma cells.

Objective To investigate the effects of training of Bobath position transfer technique for nurses.Methods Thirty nurses were recruited in the study using convenience sampling and received training of Bobath transfer technique.Five variables were evaluated before and after training:transfer skills,transfer intensity,sense of comfort,and sense of comfort and sense of security from simulated patients.Results Nurses' transfer skills and sense of comfort were higher after training (P＜0.05).Transfer intensity was lower than before (P＜0.05).Sense of comfort and sense of security from simulated patients were improved after the training (P＜0.05).Conclusion Training of Bobath transfer technique can improve nurses' transfer skills and promote sense of comfort and sense of security from simulated patients.

Abstract: Objective To investigate the nutritional status of patients with pulmonary tuberculosis and its effects on conventional anti-tuberculosis treatment, so as to provide a basis for improving the efficacy of conventional treatment of pulmonary tuberculosis. Methods The relevant data of 168 patients with pulmonary tuberculosis admitted to Suining Central Hospital from April 2020 to April 2022 were retrospectively analyzed. Nutritional status of the patients before treatment was investigated using the Mini Nutritional Assessment (MNA) score, and the influencing factors of nutritional status before treatment were analyzed. Therapeutic effects of anti-tuberculosis drugs in the non-nutritional risk group and the nutritional risk group were comparatively analyzed. Results Among the 168 patients, 64 were assessed as having good nutritional status before treatment, 59 had the risk of malnutrition and 45 were malnourished according to the MNA score. Univariate analysis and linear regression analysis showed that age, underlying diseases, and clinical symptoms were factors affecting the MNA score before treatment (t=3.173, 3.718, 2.018, P all<0.05); whereas gender and education level were not factors affecting MNA score before treatment (t=0.065, 0.059, P all>0.05). According to the MNA score before treatment, the patients were dividedinto a non-nutritional risk group (MNA score > 23.5) and a nutritional risk group (MNA score ≤23.5). The negative conversion rate of sputum bacteria, effective rate of focal absorption in the non-nutritional risk group were 92.19% (59/64)and90.63% (58/64) , respectively, which were significantly higher than corresponding 79.85% (82/104)and76.92% (80/104) in the nutritional risk group. The drug resistance rate, adverse reaction rate, and average treatment cost of the no nutritional risk group and nutritional risk group were 7.81% (5/64) and 21.15% (12/104), 15.63% (10/64) and 31.73% (33/104), (0.62±0.13) million yuan and (0.89±0.26) million yuan, respectively, with significant differences (χ2=5.228, 5.071, 7.685, 5.396, 7.728, P all<0.05). Conclusions Patients with pulmonary tuberculosis exhibit poor nutritional status before treatment. The patients’nutritional status is easily affected by age, underlying diseases, and clinical symptoms, thereby affecting the effect of anti-tuberculosis treatment. Therefore, early nutritional intervention for tuberculosis patients should be recommended in order to prevent malnutrition and enhance the effectiveness of anti-tuberculosis treatment.

Objective To evaluate the effects of different smoking cessation interventions on cigarette consumption for young soldiers.Methods Sixty-eight soldiers were prospectively investigated in this randomly controlled clinical trial and assigned to the psychological intervention group,auricular acupuncture group,and smoking cessation medication group.Results All the participants showed significant reduction(33.3％ to 73.9％)in post-treatment cigarette consumption.The highest quit rate was found at 7 days,although this declining trend was faded over time.One-year follow-up indicated a 6-month quit rate of 16.7％,23.8％ and 30.4％ in three groups,respectively.Conclusion Psychological intervention,auricular acupuncture and smoking cessation medication may be effective methods of reducing cigarette consumption and improving quit rate in young soldiers.

Objective To investigate the value of the intraoperative real-time three-dimensional transesophageal echocardiography (RT 3D-TEE) in therapeutic application of surgery for the mitral valve prolapse.Methods Thirty-five patients underwent surgical treatment were diagnosed as mitral valve prolapse by 2-dimensional transthoracic echocardiography (2D-TTE),with or without ruptured chordae tendineae.RT 3D-TEE was performed for assessing the segment of prolapse and its complications before cardiopulmonary bypass and after heart resuscitation respectively.The echocardiographic results were compared with the surgical findings.Results The accuracy of RT 3D-TEE to identify segments with prolapse was significantly higher than that of 2D-TTE (91.4％ vs 82.9％,P =0.003).RT 3D-TEE was more accurate than 2D-TTE for identifying ruptured chordae tendineae,vegetation and thrombus since higher sensitivity,specificity and Youden index.Among all 35 patients,valvuloplasty was performed in 28 cases,whereas,only 7 cases underwent replacement of prosthetic valves.Three patients were benefited by accurate evaluation of therapeutic effect using RT 3D-TEE in time.ConclusionsIntraoperative RT 3D-TEE can be used to provide “ surgical view”,acquired adequate valuable information of mitral valve,and more reliable functional and anatomical assessment of the mitral valve components and its geometry.Suitable surgical intervention can be designed for improving outcomes of patients.

BACKGROUND: Seizures are common following many cerebral insults, include global and focal ischemia. However, while the mechanism must relate to some change in the relative activities of excitatory and inhibitory pathway, the specific alterations in neurotransmitter concentrations and/or receptor sensitivities which underlie these events, remain unknown. The principal aim of this study was therefore to evaluate the effects of moderately severe forebrain ischemia on lidocaine-induced seizure thresholds, in hopes of gaining some insights into these processes. METHODS: Halothane-anesthetized, normothermic Sprague-Dawley rats were chronically instrumented with screw electrodes and vascular catheters, and were then subjected to 10 min of forebrain ischemia, produced by bilateral carotid occlusion combined with hypotension (MAP = 30 mmHg). After reperfusion, animals were awakened. 6, 24 and 46 hours later, separate groups of awake animals were subjected to intravenous infusion of lidocaine at the rate of 2.6 mg/kg/min. The total dose of lidocaine infused prior to generalized tonic-clonic seizures were noted. Another group of Sham animals (no ischemia) served as control. RESULTS: The lidocaine-induced seizure threshold was significantly increased at 24 h after forebrain ischemia (65.39 12.9 mg/kg vs 36.47 4.24 mg/kg, P < 0.05). Interestingly, at 6 h post-ischemia, rats treated with lidocaine consistently died before seizures. There were no significant differences in seizure threshold between the control and 48 h post-ischemia groups. CONCLUSIONS: Ten minutes of forebrain ischemia is followed by a transient increase in the seizure threshold to infused lidocaine. By 48 h following reperfusion, lidocaine induced seizure threshold had returned to normal.
Animals ; Electrodes ; Hope ; Hypotension ; Infusions, Intravenous ; Ischemia* ; Lidocaine ; Neurotransmitter Agents ; Prosencephalon* ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Seizures* ; Vascular Access Devices

No abstract available.
Estrogens* ; Female* ; Humans ; Progesterone* ; Receptors, Progesterone*

Objective To investigate the gene carrying rate,gene type and composition ratio of thalassemia among pre-pregnant population in Chongqing area.Methods A total of 1054 people were enrolled in the hospital from April 2014 to March 2016 for thalassemia screening.The content of screening included mean corpuscular volume (MCV),mean corpuscular hemoglobin (MCH) and hemoglobin electrophoresis.Thalassemia gene was examined in people with any abnormal term of screening result.Results In 10854 cases,1117 cases showed positive in thalassemia primary screening,and the positive rate was 10.29％.458 cases were tested positive of thalassemia gene,the carrying rate of thalassemia was 4.21％.In which,253 cases of pure a-thalassemia were tested.The carrying rate of α-thalassemia was 2.33％.The most common kind in α-thalassemia was--SEA whose constituent ratio were 52.17 ％.197 cases of pure β-thalassemia were tested,the carrying rate of β-thalassemia was 1.81％.The most common kind in β-thalassemia was CD17 (A→T),whose constituent ratio were 31.47 ％.11 cases were diagnosed with αβ-thalassemia.Conclusion Chongqing is high-prevalence area of thalassemia.It is important to conduct thalassemia genetic screen before pregnancy which plays a vital role in improving population quality and achieving prepotency.

ObjectiveTo observe the effect of equilibrium therapy of decontamination living creature of blood dilution (ETBD) on acute cerebral infarction.Methods124 inpatients were divided randomly into the treatment group and control group with 62 cases in each group. The patients of the treatment group were treated with routine medicine and ETBD. The patients of the control group were treated only with routine medicine. The blood-lipid and blood viscosity were tested and nerve function evaluation was performed before and on the 15th day after the treatment in two groups.ResultsAfter treatment, the levels of blood-lipid, blood viscosity and nerve functions of all patients in two groups were better than that before the treatment, but the effect of the treatment group was better than that of the control group ( P<0.05), and no obvious adverse reaction was found.ConclusionETBD is a safe, effect, simply and convenient therapeutic method for acute cerebral infarction and it is suitable for primarily medical units.