Objective To evaluate the expression and correlat ion of hTERT and p21(WAF1/CIP1) in colonic carcinoma. Methods A total of 45 cases of normal colonic carcinoma, 10 cases of colonic adenoma s and 10 cases of normal colonic tissues were studied using in situ hybridization (ISH) and immunohistochemical techniques. Results hTERT and p21 were found not only in colonic carcinoma (t he positive rate being 88.9% and 46.7%, respectively ), but also in colonic aden omas (the positive rate being 50.0% and 10.0%, respectively). The positive rate of hTERT expression increased significantly in advanced stage (C+D) of colonic c arcinoma ( P

OBJECTIVE: To determine ginsenoside Rg1 and ginsenoside Re in Jiangshen Capsules by HPLC simultaneously. METHODS: The separation was performed on Kromasil-C18 column, the mobile phase consisted of acetonitrile-0. 05% H3PO4 solution ( 21∶ 79) with flow rate of 1. 0mL? min-1 and detection wavelength of 203nm. RESULTS: The linear ranges of ginsenoside Rg1 and ginsenoside Re were 0. 502～ 4. 016? g( r=0. 999 7) and 1. 090～ 8. 720? g( r=0. 999 8) , respectively, with average recovery at 98. 8% ( RSD=1. 24% ) and 99. 4% ( RSD=1. 68% ) , respectively. CONCLUSION: This method is simple, rapid, accurate and reliable, and suitable for the quality control of Jiangshen Capsules.

Objective To explore the clinical effect of early mechanical ventilation coupled with mild hypothermia in the treatment of severe traumatic brain injury(STBI)and its effect on serum C -reactive protein (CRP)and hemorheology.Methods According to the order of admission,110 patients with STBI were divided into two groups.55 cases in the control group were given conventional symptomatic treatment and early mechanical ventilation, while 55 patients in the observation group were given early mechanical ventilation coupled with mild hypothermia.The clinical efficacy was compared between the two groups.Results The good prognosis rate was 74.55% in the observation group,which was significantly higher than 56.36% of the control group (χ2 =7.65,P <0.05).The serum CRP in the observation group admitted to hospital 2,3,5,7d were significantly decreased compared with the control group(t =7.48,8.04,7.34,7.82,all P <0.05).After treatment,the hear whole blood viscosity was (6.03 ±0.89)mPa·s, low shear whole blood viscosity was (3.18 ±0.19)mPa·s,plasma viscosity was (1.21 ±0.18)mPa·s,hematocrit was (37.56 ±3.23)%,and those were decreased compared with before treatment(t =8.45,7.54,7.04,8.02,all P <0.05).And there were significant differences compared with the control group(t =7.77,6.69,6.44,7.49,all P <0.05).Conclusion The effect of early mechanical ventilation coupled with mild hypothermia in the treatment of STBI has good effect,and it can reduce serum CRP levels,improve blood rheology,which is conducive to patients'prognosis.

Objective To explore the clinical curative effect of hyperbaric oxygen therapy for severe cranio-cerebral injury,and its influence on the level of serum interleukin -1 beta(IL -1 )and interleukin -6(IL -6). Methods 150 patients with severe craniocerebral injury were selected and divided into two groups by random and single blind method.75 patients of the control group were treated with conventional therapy,75 patients of the observation group were given hyperbaric oxygen on the basis of the conventional treatment,and the clinical efficacy was compared between the two groups.Results The total effective rate of the observation group was 94.67%,which was significantly higher than 77.33% of the control group,the difference was statistically significant(χ2 =7.83,P <0.05).There were no significant differences in GCS and ADL scores between the two groups(t =1.22,2.39,all P >0.05).After treat-ment,the GCS and ADL scores of the observation group were (12.18 ±2.13)points,(67.46 ±12.55)points,which were significantly higher than those before treatment(t =8.01,7.76,all P <0.05),and there were significant differ-ences between the two groups(t =7.23,6.82,all P <0.05).Before treatment,there were no significant differences in the serum levels of IL -6 and IL -1 between the two groups(t =2.10,1.01,all P >0.05).After treatment,the serum levels of IL -1 and IL -6 in the observation group were (127.48 ±16.35)pg/mL,(89.66 ±13.47)pg/mL, which were significantly lower than before treatment(t =8.34,7.89,all P <0.05),there were significant differences between the two groups(t =7.65,7.22,all P <0.05).Conclusion Implementation of hyperbaric oxygen in patients with severe traumatic brain injury on the basis of conventional symptomatic treatment can effectively improve the clinical symptoms and signs,reduce the serum IL -1 and IL -6 levels,promote the recovery of brain function and ability of daily life,and which is worth to be promoted in clinical.

[Objective] To study the correlation between kidney cell DNA degradation and postmortem interval within the span of 6-48 hour after the subject rats′ death.[Methods] To select 18 healthy mature female SD rats and equally divide them into 6 groups.To execute the rats with cervical spine articulation and put the rats under the incubator temperature of 25.1℃ (the average temperature of the 5 previous Decembers in Guangzhou prefecture).Sample kidney tissue from the rat separately 0 hour,6 hours,12 hours,24 hours,36 hours,48 hours,and 60 hours after the rats′ execution to prepare monoplast suspension,which is committed to comet assay.The comet images were captured by fluorescence CCD.Kinetic Comet 4.0 software was used to analyze images.Relevant data were collected by kinetic Comet 4.0 software and were subjected to Kruskal-Wallis test.[Results] Within the postmortem interval of 6-48 h,the number of SD rat kidney cell DNA fragments increased as the postmortem interval lengthens.So did the comet tail length.The Oliver tail moment and tail DNA of comet also showed sign of increase in positive proportion to the postmortem interval (their values corresponding to 60-hour-postmortem-interval were not obtainable.Kruskal-Wallis test indicated:the discrepancies of TL among the 6 groups were all significant (P ＜ 0.01).The difference of TM between 6 h group and 12 h group was not significant (P ＞ 0.05).The difference of TM between 24 h and 36 h was significant (P ＜ 0.05).The difference of TDNA among 6 h,12 h,and 36 h groups were not significant (P ＞ 0.05).The difference of TDNA between 36 h and 48 h was significant (P ＜ 0.05).[Conclusion] Degradation of nuclear DNA of the rat kidney cells increases as the postmortem interval lengthens and comet assay may provide important empirical evidence for determining the postmortem interval.

Objective To explore the lived study feeling and experience of nursing upgrade students during blended learning model so as to provide the evidence of reforming teaching model of nursing educators.Methods Phenomenological research of qualitative research was used.Four focus groups,25 upgrade nursing students were interviewed in-depth.Results Six themes were sublimated:relief the contradiction between work and study,promote communication in double interaction,improve self-learning ability,improve selfconfidence as learning controllability,online courses lack a sense of belonging,lack of skills support.Conclusions Blended learning model meets students,needs,provides students with personalized learning and improves comprehensive quality.However,the development of blended learning model in China is in the primary stage,we should combine conditions and reference foreign experience to develop it.

OBJECTIVETo evaluate the efficacy of bevacizumab in combination of irinotecan,fluorouracil and leucovorin for metastatic colorectal cancer treated by failed prior oxaliplatin -based regiment.

METHODSSixty-two patients were randomly divided into two groups, group A of 30 patients received bevacizumab plus irinotecan, fluorouracil and leucovorin, group B of 32 patients received irinotecan, fluorouracil and leucovorin. The response rate,change of tumor markers,one year survival rate and safety were observed.

RESULTSTumor response rate was 30% in group A, 21.8% in group B respectively. Disease control rate(CR+PR+SD) was 80% in group A, 50% in group B. The obvious change of concentration of tumor markers was observed between pre-treatment and post-treatment, which was significantly different in group A(P<0.05). One year survival rate, median of time to progression and median duration of survival between group A and group B were 26.7% vs 18.8%, 5.9 months vs 3.9 months, 10.9 months vs 8.9 months(P<0.05). The adverse effect in group A was the same as group B. Bevacizumab was associated with hypertension and bradycardia.

CONCLUSIONSThe chemotherapy of bevacizumab combined with irinotecan, fluorouracil and leucovorin results in better efficacy in patients with progressive metastatic colorectal cancer.

Adult ; Aged ; Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bevacizumab ; Camptothecin ; administration & dosage ; analogs & derivatives ; Colorectal Neoplasms ; drug therapy ; pathology ; Female ; Fluorouracil ; administration & dosage ; Humans ; Leucovorin ; administration & dosage ; Male ; Middle Aged ; Neoplasm Metastasis ; drug therapy ; Neoplasm Staging ; Survival Rate

Objective To investigate the therapeutic effect of the fourth ventricle tumors through lateral wall type of the transcerebellomedullary fissure approach under endoscope.Methods Clinical data of 14 cases with the fourth ventricle lesions were analyzed retrospectively.All the patients were treated by lateral wall type of the transcerebellomedullary fissure approach surgery.The endoscope was used if the lesions develop to the aqueduct and hard to be exposed.Both neurophysiological monitoring and intraoperative ultrasound were used regularly.Results Tumors were totally removed in 12 cases,subtotally in 1,and partially in 1.All the patients were diagnosed in postoperative histopathology,including 4 medulloblastoma,three epidermoid cyst,two ependymoma,two hemangioblastoma,one meningioma,one cavernous hemangioma and 1 astrocytoma.Hypopnea occurred immediate after operation in 1 patient.Ventilatory support was performed by Ventilator,and the respiration was restored 1 day later.Normal cerebrospinal fluid circulation was return in all cases.Neither aggravation of preoperative symptoms nor nuclei injury related complication had been found.The follow-up interval between 3 months to 28 months,one patient was dead with unexplained,and 1 medulloblastoma patient was relapse.Conclusion Lateral wall type of the transeerebellomedullary fissure approach,under endoscope,combined with the usage of neurophysiological monitoring and intraoperative ultrasound,can degrade the surgical related complications such as facial palsy and amblyacousia.

OBJECTIVETo compare the difference of therapeutic effect between acupuncture combined with Tuina and Nobex for treatment of birth brachial plexus injury.

METHODSForty cases with birth brachial plexus injury were randomly divided into a acupuncture combined with Tuina group (group A) and a Nobex group (group B), 20 cases in each group. The group A was treated with acupuncture at 3 points, i. e. Jianyu (LI 15), Jianliao (TE 14), Jianzhen (SI 9) on shoulder, Binao (LI 14), Shouwuli (LI 13), Quchi (LI 11), etc. combined with Tuina using a single thumb and rolling method, and the group B was treated with intramuscular injection of Nobex. The clinical effects and the changes of the symptom, scores and the electromyogram were observed before and after treatment.

RESULTSThe total effective rate of 90.0% (18/20) in the group A was better than that of 55.0% (11/20) in the group B, with a significant difference between the two groups (P < 0.05). The effective rate of the electromyogram improvement in the group A was 90.0% (18/20), which was better than 45.0% (9/20) in the group B (P < 0. 05), and the symptom scores in the group A were lower than those in the group B (P < 0.01).

CONCLUSIONAcupuncture combined with Tuina can improve the recovery of nerve and upper extremity function and its therapeutic effect is superior to that of intramuscular injection with Nobex.

Acupuncture Therapy ; Birth Injuries ; physiopathology ; therapy ; Brachial Plexus ; injuries ; physiopathology ; Combined Modality Therapy ; Female ; Humans ; Infant ; Male ; Massage

Objective To analyze the survival rate of HIV /AIDS patients receiving highly active antiretroviral therapy(HAART)since the implementation of the national Four Free and One Carepolicy against HIV in Hangzhou.Methods Clinical data of 2370 AIDS patients were collected from National AIDS Comprehensive Treatment Information System Treatment Library from 2004 to 2014.The data, including basic information,viral load,CD4 +T lymphocyte counts,starting time of treatment,WHO clinical stage,infection pathways and follow-up were respectively analyzed.Kaplan-Meier and Cox proportional hazards models were used to analyze the survival rate and the factors affecting survival.Results The total follow-up time was 3968.14 person years and 57 patients died in 2370 patients with a mortality rate of 1 .44 /100 person years (57 /3968.14).Kaplan-Meier method showed that the cumulative survival rates of the first,third and fifth year were 98.08%,96.20% and 95.24%,respectively.The overall mortality rate fell from 6.06 /100 person years in 2006 to 1 .44 /100 person years in 2014.The mortality rate of AIDS-related disease declined from 1 .10 /100 person years in 2009 to 0.90 /100 person years in 2014.Multivariate Cox regression analysis showed that the risk of death for patients with CD4 +T 200-349 cells/μL was 0.466 times(95%CI 0.246-0.882)as that for patients with CD4 +T cells <200 /μL.The risk of death was 3.408 times(95%CI 1 .365-8.506)in patients aged≥ 50 years,3.788 times(95%CI 1 .645-8.718)in patients aged 40 to <50 years,and 2.593 times(95%CI 1 .139-5.905)in patients aged 30 to 40 years as that in patients aged <30 years.The mortality risk for patients with baseline WHO stage Ⅲ and Ⅳ was 1 .960 times as patients with WHO stage Ⅰ and Ⅱ (95% CI 1 .117-3.439 ).Conclusions Patients with increased age,low CD4 +T counts and baseline WHO stage Ⅲ or Ⅳ are main risk factors affecting survival rate of HIV /AIDS patients,early antiviral therapy is the key for improving the survival rate of patients.