Acupuncture Points ; classification ; Acupuncture Therapy ; Adult ; Aged ; Female ; Hiccup ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

The rupture of vulnerable carotid atherosclemtic plaques and distal embolization of atherornatous debris are the most important pathogenesis of atherosclerotic stroke.The serolog- ic(and plasma)markers associated with vulnerable plaques will change significantly in this process,and show their different meanings.The studies in this field are in its infancy and still need to be further validated,This article reviews the advances in research on the correlation of these biomakers with vulnerable plaque and ischemic cerebrovascular disease,and briefly intro- duces the clinical application prospect of some of the biomakers.

Objective To investigate the safety and clinical prognosis of breast conserving operation in treat-ment of triple negative breast cancer.Methods 157 patients with breast cancer were divided into the non triple nega-tive breast cancer group (n=76) and triple negative breast cancer (n=81) according to its receptor expression,clin-ical pathological features, local recurrence after 5 years.Distant metastasis and survival situation were compared between two groups.Results The age<35 years patients of triple negative group accounted 17.3%,significantly higher than 7.9%of the non triple negative group(χ2 =5.331,P<0.05);the size of tumor≥5cm of triple negative group accounted 79.0%,significantly higher than 59.2% of the non triple negative group(χ2 =7.022,P<0.05);The patients with positive family history and lymph nodes of the triple negative group were 9.9%and 28.4%,signifi-cantly higher than 2.6%and 17.1%of non triple negative group,the difference between the two groups was statisti-cally significant (χ2 =6.283,4.865,all P<0.05);The local recurrence,distant metastasis rate and 5 year survival rates between the two group were not significantly different(χ2 =2.559,2.829,2.361,all P>0.05);The 5 year dis-ease free survival rate of the triple negative group was 80.25%,significantly lower than 94.74%of the non triple neg-ative group (χ2 =6.572,P<0.05).Conclusion The patients with triple negative breast cancer is younger,their tumor size is large and has a high proportion of family history.Their recurrence rate,distant metastasis rate and 5 year overall survival rate are as better as the patients with non triple negative breast cancer after breast preservation opera-tion,which has high security and good clinical application value.

Objective:To comprehend morphology changes of temporomandibular joint in adults with mandible deviation,and the correlation in these changes.Methods:The mesofault radiographs of temporomandibular joint were taken in 21 adult patients with mandible deviation.The data described morphology of temporomandibular joint were analysed.Results:In adult patients with mandible deviation,the condyle process of opposite side was anterior and inferior when compared with deflected side.The height of condyle process,the upper height of condyle process,the gradient of prosobevel of condyle process and the gradient of back bevel of glenoid fossa were augmented when compared to deflected side.The gradient of prosobevel of condyle process showed positive correlation to the prosoblank of joint and the deep of glenoid fossa,and the height of condyle process showed positive correlation to the upper height of condyle process in both sides.The gradient of back bevel of condyle process showed positive correlation to the gradient of back bevel of glenoid fossa in deflected side.The gradient of back bevel of condyle process showed negative correlation to the supper blank of joint and the height of articular tubercle in opposite side.Conclusion:There are some differences in morphology of both temporomandibular joint in adults with mandible deviation,and there is some correlation between these changes.

Objective To evaluate the accuracy of performance of Engstrom Eas 9010 vaporizerMethods Using Datex Capnomac AS/3 monitored the output of Gambro-Engstrom Eas 9010 anesthetic agent vaporizer under various situations l Determing the output of vaporizer at different gas flow rates of 0 5,1 0,2 0,4 0,6 0 and 8 0 L?min -1 2 The effects resulting from up stream oxygen flushing 3 The effects due to additional nitrous oxide as carrier gas 4 Effects of different airway pressure at the same flow rate Results 1 The output of the vaporizer was highly correlated with the dial setting at various gas flow rate except dial setting was more than 8% and gas flow rate less than 0 5L?min -1 2 Upstream oxygen flush could not decrease the concentration remarkably 3 The output of the vaporizer was not affected by additional carrier gas 4 The effect on vaporizer output was not remarkable under different airway pressure at the same flow rate Conclusions The anesthetic vaporizer principle used in the Gambro-Engstrom Eas 9010 apparatus is innovative Electronically controlled vapor quanta injection is used with safety feed back Its accuracy can't be influenced by temperature,pressure and carrier gas indicating to be safely applied to the low or even minimal flow anesthesia

Objective To study the antibacterial substances produced by Musca domestica and heattreatment and electrophoresis isolation of the substances. Methods After the 3rd instar larval of Musca domestica being induced for 48 hours by pricking,the hemolymph was collected and bathed at 100 ℃ for 0,0.5,1,3,5 min. Antibacterial substances of Musca domestica was isolated by electrophoresis with acide polyacrylamide gel using 5,10,20,30 ?l doses. Results 20 ?l was the optimum dose both for bathed and non-bathed hemolymph. Water bath at 100 ℃ for 1 min was the optimum bath time for hemolymph. Comparing induced hemolymph with non-induced hemolymph,the protein of the induced hemolymph was increased in the number and content. After 100 ℃ bathed for 1 min,it showed that the bonds of hemolymph increased both in quantities and contents. Conclusion Optimum treatment is 100 ℃ bath for 1 min and 20 ?l of adding dose. Pricking inducing can produce new proteins in hemolymph, which are the new induced antibacterial substances.

Objective To investigate the gender difference in the smile aesthetic features in aged Han Chinese with normal occlusion and its clinical significance.Methods Fifty-six aged Han Chinese (male:28,female:28,aged 60-66 years)with normal occlusion were included in this study.Smiling images of the resting-position and mandibular postural position were obtained in an anteriorposterior view.The CoSmileMAA1.0 software was used to evaluate the indices associated with the smile-aesthetic features,and its clinical significance was analyzed.Results Significant differences were noted in the nasal ala width,upper lip length,lip clearance,angle oris width in resting-position/ smiling position together with the changes of lip clearance,angle oris width,distance of inferior margin of upper lip to cutting edge of the maxillary incisor teeth,distance of superior border of lower lip to cutting edge of the maxillary incisor teeth,smile line ratio and type of smile (all P＜0.05).When the subjects were smiling,the changes of lip clearance was greater in females than in males [(10.7±1.9)mm vs.(11.3±1.6)mm,P＜0.05],the changes of angle oris width was greater in males than in females [(14.1±1.6)mm vs.(13.4±1.3)mm,P＜0.05],and the smile line ratio was less in males than in females [(0.9±0.2) vs.(1.1±0.5),P＜0.05],which indicate that the females had more attractive smile in aged Han Chinese with normal occlusion than males.The type of smile was mainly high smile in elderly females and median smile in elderly males [53.6％ (15 cases) and 60.7％ (17 cases),x2 =6.43,P＜0.05].Conclusions Significant gender difference is noted in the smile-aesthetic features in aged Han Chinese with normal occlusion.Modulation of maxillary incisor teeth length and smile line ratio can contribute to the aesthetic appearance of smiling.

Objective To evaluate the role of reperfusion injury salvage kinase signaling pathway in reduction of myocardial ischemia-reperfusion (I/R) injury by sevoflurane postconditioning in rats.Methods Seventy SPF healthy adult male Sprague-Dawley rats,weighing 300-350 g,were divided into 7 groups (n =10 each) using a random number table:sham operation group (group S),group I/R,sevoflurane postconditioning group (group SP),phosphatidylinositol 3-kinase inhibitor LY294002 group (group LY),sevoflurane postconditioning plus LY294002 group (group SPLY),mitogen-activated protein kinase kinase 1/2 inhibitor U0126 group (group U) and sevoflurane postconditioning plus U0126 group (group SPU).Myocardial I/R was induced by occlusion of the left anterior descending branch of the coronary artery for 30 min followed by 120 min of reperfusion.In group SP,1.8％ sevoflurane was inhaled for 5 min starting from the beginning of reperfusion.In LY and U groups,LY294002 0.3 mg/kg and U0126 0.5 mg/kg were intravenously injected,respectively,at 10 min before reperfusion.In SPLY and SPU groups,LY294002 0.3 mg/kg and U0126 0.5 mg/kg were intravenously injected,respectively,at 10 min before reperfusion,and 1.8％ sevoflurane was inhaled for 5 min starting from the beginning of reperfusion.At 15 min of reperfusion,myocardial specimens were obtained from the left ventricular area at risk for determination of the phosphorylation of protein kinase B (Akt) and extra-cellular signal-regulated kinase 1/2 (ERK1/2) (by Western blot) and NAD+ content in myocardial tissues (by fluorescence spectrophotometry).At the end of reperfusion,blood samples were collected from the jugular vein for measurement of serum cardiac troponin Ⅰ (cTnI) concentrations (by photoelectric colorimetry),and myocardial specimens were obtained from the left ventricular area at risk for determination of myocardial infarct size (IS).Resuits Compared with group S,the IS and serum cTnI concentrations were significantly increased,the NAD+ content was decreased (P＜0.05),and no significant change was found in the phosphorylation of Akt or ERK1/2 in group I/R (P＞0.05).Compared with group I/R,the IS and serum cTnI concentrations were significantly decreased,and the NAD+ content and phosphorylation of Akt and ERK1/2 were increased in group SP (P＜0.05),and no significant change was found in the parameters mentioned above in LY,SPLY,U and SPU groups (P＞0.05).Compared with group SP,the IS and serum cTnI concentrations were significantly increased,and the NAD+ content was decreased in SPLY and SPU groups,the phosphorylation of Akt was significantly decreased in group SPLY,and the phosphorylation of ERK1/2 was significantly decreased in group SPU (P＜0.05).Conclusion The mechanism by which sevoflurane postconditioning reduces myocardial I/R injury may be related to activation of reperfusion injury salvage kinase signaling pathway in rats.

This paper described the measures taken by Sir Run Run Shaw Hospital of Zhejiang University School of Medicine in development of general medicine,and differential care of acute and chronic diseases. Rational allocation of medical resources and leveraging of tertiary hospital′s advantages in medicine and education effectively improved the utilization ratio of medical resources for better health of the people.