The effect of Flavonoids of Gly-cyrrhiza (FG) on ethanol-induced liver injury was studied in mice. Administration of FG to mice prior to ethanol treatment ,either once daily for four days or a single dose, the increase of malondialdehyde and the decrease of reduced glutathione were inhibited dose- dependently.Electron microscopic examination showed that the ethanol-induced damage of hepatocytes could be ameliorated by FG pretreatment. However, no protective effect was observed when FG was administrated to mice after ethanol intoxication.

Objective　The authors present a retrospective analysis of 22 patients with primary central nervous system lymphoma(PCNSL) in order to provide a reasonable basis for the diagnosis and treatment of the disease. Methods　This report involves a clinicopathological study of 22 patients with histologically proven PCNSL,all diagnosed between January 1993 and May 2000. Univariate and multivariate regression analysis are used to determine prognostic factors significantly associated with an unfavorable or favorable impact on survival. Results　The cohort included 11 men and 11 women whose median age at diagnosis was 49.5 years. At the end point of follow-up, 11 died. The median survival time for the patients in study was 14.5 months. With univariate and multivariate regression analysis, prognostic factors significantly associated with survival included intrathecal injection(P=0.005) and local/diffuse neurological deficit(P=0.031). Conclusion　There continues to be a significantly increasing incidence of PCNSL. This survey throws light on the clinical and prognostic features of this uncommon disease. Through univariate and multivariate regression analysis the authors highly recommend a theraputic regime including surgery, intrathecal injection and chemotherapy, especially those drugs capable of passing blood-brain barrier, for example high dose MTX.

To reflect specialty teaching characteristics and levels in clinical standardized training of medical professional degree postgraduates and highlight the thinking of evidence-based medicine culture,in urology rotation training practice,we conducted clinical pathway teaching according to picot principle (PICOT-CP teaching).According to the requirements of the teaching syllabus,the six kinds of major diseases were brought into PICOT-CP teaching.After the screening of pre teacher training,teaching tools and teaching cases,and based on the form of PICOT-CP,we standardized the implementation of clinical teaching of Urology,fully used subject website platform to discuss the interaction between teachers and students,and assessed the effect in combination with the departmental rotation examination and the teaching questionnaire survey of the students and the training teachers.Preliminary practice shows that PICOT-CP teaching helps to stimulate students' interest in learning,improve their overall quality,expand their clinical thinking,and establish their concept of evidence-based medicine.In addition,PICOT-CP teaching is beneficial to the teaching norms of teachers' teaching and can improve teaching level.

Objective To investigate the effect of general anesthesia with sevoflurane or intravenous propofol on anesthesia recovery period in obstructive jaundice patients. Methods Thirty ASA Ⅰ or Ⅱ and Child A obstructive jaundice patients were randomly divided into two equal groups (n=15 each). The patients in group S received inhalation anesthesia with sevoflurane and those in group P intravenous anesthesia with propofol during operation for obstructive jaundice. The patients were premedicated with intramuscular phenobarbital 100mg and atropine 0.5mg, anesthesia was induced with midazolam 0.05mg/kg, atracurium 0.5mg/kg, propofol 1.5-2.5mg/kg and fentanyl 4μg/kg. Maintained with TCI of propofol (target plasmaconcentration was set at 3.5mg/L) or sevoflurane inhalation (end-tidal sevoflurane concentration was 2%-3%) and intermittent i. v. boluses of fentanyl. EGG, HR, MAP, SpO<,2> and end-tidal sevoflurane concentration were continuously monitored during operation. Duration of anesthesia, the volume of infusion and fentanyl were recorded, awaking time, extubation and regained consciousness after operation were recorded. Results There were no significant differences between the two groups in average age, sex, body-weight, duration of anesthesia, the parameters of MAP and HR (P>0.05). The awaking time was (7.9±1.5) minutes in group S and (26.1±8.8) minutes in group P. The extubation time was (8.5±2.5) minutes in group S and (27.8±11.2) minutes in group P. The regained consciousness time was (13.1±4.4) minutes in group S and (33.7±12.5) minutes in group P. The incidence of lethargy, fidget were higher in group P than those in group S. Conclusion Both sevoflurane and propofol can provide satisfactory anesthesia for the operation of obstructive jaundice, but the recovery of influence caused by sevoflurane is faster and more steady than that caused by propofol.

Among all gynecological tumors, ovarian cancer is the third most common cancer but the most lethal one. Currently, the standard first-line treatment for ovarian cancer is cytoreductive surgery combined with platinum and paclitaxel chemotherapy. Although the patients with ovarian cancer respond to the standard therapeutic approach and gain a high remission rate, the most patients relapse after about 2 years of complete remission, the recurrence rate is as high as 80%. The patients with recurrent epithelial ovarian cancer are resistant to almost all chemotherapy drugs due to the acquired resistance. Multidrug resistance to chemotherapy is a major cause of treatment failure. Therefore, it is an urgent problem to reveal the molecular mechanism of ovarian cancer resistance. In recent years, tumor microenvironment as an emerge concept has provided a new perspective for the study of tumorigenesis, progression and drug-resistance. Ovarian cancer is characterized by a unique tumor microenvironment that impairs immune surveillance and mediates therapy resistance. Explaining the mechanism of chemotherapy resistance from the perspective of ovarian cancer microenvironment is helpful to find effective targets reversing the drug resistance of ovarian cancer. This review first introduces the general situation of drug resistance and microenvironment of ovarian cancer, and then focuses on the research progress in the relationship of various components of ovarian cancer microenvironment with drug resistance, in order to explain the occurrence mechanisms of ovarian cancer resistance and find effective targets in the microenvironment to solve the problem of clinical drug resistance. In the end, the forward research directions in this field are prospected in this review.

Objective:To assess the value of spiral CT in diagnosis and treatment of chronic otitis media.Methods:The spiral CT findings of 74 cases including 93 ears proved by operation and pathology were studied.Results:The lesions such as the disruption of the ossicular chain showed in spiral CT or three-dimensional image were in accord with those seen in the operation,the accuracy was 95.7%,the disruption of the ossicular chain and bony erosion in the tympanic cavity and antrum were severe in the typeⅢ chronic otitis media.Conclusion:Spiral CT is helpful to diagnose and definite the chronic otitis media,three-dimensional image can provide valuable information for surgery.

Objective:Intensive physicians have relatively insufficient knowledge and experience in treating patients with decompensated schistosomiasis cirrhosis (DSC) admitted in intensive care unit (ICU), but are relatively familiar with patients with decompensated alcoholic cirrhosis (DAC). For this purpose, the clinical characteristics and prognosis of these patients were compared and analyzed.Methods:A retrospective analysis was performed from January 2013 to May 2019 in our hospital and Quzhou People’s hospital. The demographic data, laboratory examination, liver function, Child-Pugh classification, complications of cirrhosis, ultrasonic imaging gastroscopy manifestations were recorded and analyzed. In addition, the treatments and prognosis were also compared.Results:A total of 30 patients (12 males and 18 females) with DSC (aged 57-88) and 31 patients with DAC (aged 41-75) were collected. Compared with patients with DAC, DSC patients were more likely to have coronary heart disease, lower proportion of hyponatremia and lower need of ventilator support. Although the incidences of jaundice and hepatic encephalopathy were significantly reduced ( P<0.05), but parameters of liver function and coagulation were no significant differences in both groups ( P>0.05). B-mode ultrasound of liver in patients with DSC displayed more proportion of patchy and diffuse echo changes and liver volume reduction ( P<0.05), whereas the manifestations of gastroscope in both groups were similar. No significant difference in main treatment measures like uses of somatostatin and three-chamber and two-capsule tube was observed. After treatment, the stop time of gastrointestinal bleeding was similar between groups of DAC and DSC [1.25 (0.5-4.125) days vs. 1.75 (1-2.375) days] ( P>0.05). In addition, the length of ICU stay in DAC group was similar to DSC group [(4.96±3.58) days vs. (3.82±1.99) days], so did the 28-day mortality [14.29% (2/14) vs. 18.18% (2/11)] (both P>0.05). Conclusions:In genenal, patients with decompensated schistosomiasis cirrhosis have the similar clinical characteristics, major biochemical indicators and accessory examination results like ultrasound and gastroscopic examinations to patients with decompensated alcoholic cirrhosis. After timely treatments, both of these patients could achieve a good prognosis.

Objective:To evaluate the relationship between long-term learning and memory impairment induced by sevoflurane anesthesia and postsynaptic density protein-95 (PSD-95)/Kalirin-7/Ras-related C3 botulinum toxin substrate 1 (Rac1) signaling pathway in neonatal rats.Methods:Sixty SPF male Wistar rats, aged 7 days, weighing 12-18 g, were divided into 5 groups ( n=12 each) using a random number table method: control group (group C), 1% sevoflurane anesthesia for 2 h group (group S 1), 1% sevoflurane anesthesia for 4 h group (group S 2), 2% sevoflurane anesthesia for 2 h group (group S 3) and 2% sevoflurane anesthesia for 4 h group (group S 4). Morris water maze test was performed at 4, 8 and 12 weeks after anesthesia.The rats were sacrificed after the last Morris water maze test, and the hippocampal tissues were obtained for microscopic examination of the pathological changes (using HE staining), neuron apoptosis (by TUNEL staining), and expression of PSD-95, Kalirin-7 and Rac1 protein and mRNA (by Western blot and quantitative real-time polymerase chain reaction). The apoptosis rate was calculated. Results:Compared with group C, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the time of stay in the target quadrant was shortened, and the apoptosis rate of hippocampal neurons was increased at 4th, 8th and 12th weeks after anesthesia, phosphorylated Rac1/Rac1 ratio was decreased, and the expression of PSD-95 and Kalirin-7 protein and mRNA was down-regulated in S 1, S 2, S 3 and S 4 groups ( P<0.05). Compared with group S 4, the escape latency was significantly shortened, the number of crossing the original platform was increased, the time of stay in the target quadrant was prolonged, and the apoptosis rate of hippocampal neurons was decreased, phosphorylated Rac1/Rac1 ratio was increased, the expression of PSD-95 and Kalirin-7 protein and mRNA was up-regulated, and the histopathological changes of hippocampal tissues were attenuated in S 1, S 2 and S 3 groups ( P<0.05). Conclusions:The mechanism by which sevoflurane anesthesia induces long-term learning and memory impairment may be related to inhibition of activity of PSD-95/Kalirin-7/Rac1 signaling pathway in hippocampi of neonatal rats.

Objective To explore the clinical value of pulse indicates continuous cardiac output (PICCO) in fluid resuscitation of patients with ARDS complicated with septic shock caused by severe pneumonia. Methods Thirty-nine ARDS patients complicated with septic shock caused by severe pneumonia were divided into two groups, namely PICCO group and control group. The data of demographics and clinical findings of both groups were collected. At the same time, the data of serum lactic acid, Pa02/Fi02, MAP, the volume of fluid input, the amount of vasoactive agent, APACHE Ⅱ Scores of both groups at 6 hours and 24 hours after admission were collected, and the data of EVLWI, PVPI, CI, SVRI, GEDVI in PICCO group were documented at admission and 24 hours later, as well as the duration of mechanical ventilation, length of stay in the respiratory ICU and 30-day mortality were recorded. SPSS software of version 21.0 was used to statistically analyze the data. Results ① There were no statistically significant differences in in age, gender, APACHEII score and other relevant physiological parameters between two groups.② Compared with control group at 6 h and 24 h, the PICCO-guided treatment significantly reduced the level of Lac, elevated the MAP value and decreased the volume of fluid input (all P＜0.05) At the same time, this approach improved 24 h-Pa02/ Fi02(P=0.001).More importantly, the PICCO-guided treatment significantly reduced the duration of mechanical ventilation[(8.83 ± 3.57) vs (13.54 ± 4.06)d, P=0.000],shortened the stay in the respiratory ICU[(10.12 ± 4.46) vs (14.10 ± 5.65)d,P=0.020]and decreased the 30d mortality 15.79％ vs 50％,p=0.041. ③ In PICCO group, EVLWI and PVPI were significantly decreased[(12.27 ± 4.42) vs (16.11 ± 5.99) mL/ kg,P=0.028; (3.66 ± 1.71) vs (6.88 ± 2.93) mL/m2, P=0.000]; respectively and SVRI and GEDVI were significantly increased[(1212.70 ± 304.10) vs (958.50 ± 192.40)kPa·s/(min·m2),P=0.004; (676.57 ± 77.86) vs (616.33 ± 57.49)mL/(min · M2),P=0.010]; respectively at 24h compared those at admission. Conclusions Compared with conventional fluid resuscitation, PICCO-oriented treatment can quickly improve the relevant physiological parameters, direct the fluid resuscitation more accurately, shorten the duration of mechanical ventilation as well as the stay in ICU, and decrease the 30d mortality in patients with ARDS complicated with septic shock caused by severe pneumonia. Therefore, PICCO-oriented fluid resuscitation has noticeable clinical value, and be worthy of further clinical application especially in this kind of patients.

Objective:To observe the activation of cerebral regions during swallowing by magnetoencephalography (MEG), and discuss the temporal and spatial characteristics of neural circuit.Methods:Ten healthy subjects were selected, and the magnetic signals of their brains were recorded using 148 channel full head type MEG system in the magnetic shielding room.Data were analyzed using CURRY8 analysis software and the localization algorithm was based on minimum modulus low resolution electromagnetic imaging method (LORETA). Every 300 ms data were set as an independent analysis stage and made the highest position of the cerebral cortex F-distribution values (F-distributed) as the activation area.The activation areas were analyzed during swallowing through time and space location.Results:Paracentral lobule, anterior central gyrus, medulla oblata, posterior central gyrus, inferior frontal gyrus, parietal lobules, angular gyrus, corpus callosum, middle frontal gyrus, cingulate gyrus, orbital gyrus, thalamus, bottom of third ventricle, corona radiata, precuneus, frontal insula, cerebellopontine angle, superior frontal gyrus and basal ganglia area were activated during swallowing, in which the top eight brain regions were paracentral lobule, anterior central gyrus, corpus callosum, posterior central gyrus, superior parietal lobule, middle frontal gyrus, cingulate gyrus, and basal ganglia.When the 10 subjects performed the deglutition, MEG signals of 8 subjects were mainly activated by the left cerebral hemisphere at 0-300 ms, the bilateral cerebral hemisphere or intermediate region at 301-600 ms, and the right cerebral hemisphere at 601-900 ms.MEG signal of 1 subject was activated by the right cerebral hemisphere at 0-300 ms, and the left cerebral hemisphere at 301-600 ms and 601-900 ms.MEG signal of 1 subject was mainly activated by the right cerebral hemisphere at 0-300 ms and 601-900 ms, and in the intermediate region at 301-600 ms.Conclusion:During swallowing the MEG signals appeared left laterality in the early stage and right laterality in the later stage, and showed a close correlation with time.There may be a swallowing neural circuit composed by the central region, corpus callosum, superior parietal lobule, middle frontal gyrus, cingulate gyrus and basal ganglia, in which the central region is the core.