Objective To ivestigate the clinical feature and therapeutic ways of the gastroduodenal ulcer perforation(GDUP) in aged patients.Methods The clinical data of 58 GDUP patients with age more than 60 gears treated in recently tweenty yesas in our hospital were analysed retrospectively. Results Among the 58 patients,56 patients underwent operation,46cured and 12 died.Of the 12 patients,dead of cardiorespiratory function failture in 5 ; septic shock in 4 ;and renal failturl in 3 .Conclusions Aged patients with GDUP would be operated as early as possible.Repair of the performed ulcer plus modified vagotomy is a better choice.

Objective To investigate the effects of chin lift on the patency of upper airway in normal conscious adults using magnetic resonance imaging (MRI).Methods Sixteen healthy volunteers aged 21-35 yr with a body mass index of 17-26 kg/m2 were enrolled in this study.The subjects lay on their back with their heads slightly extended.The lower jaw was first left in standard position.The mouth was slightly open (the distance between the upper and lower incisors was 0.5 cm).The chin was then lifted upward.The upper airway (from the base of slull to the level of vocal cord) was scaned by MRI along the median sagital plane.The length of soft palate,root of tongue and epiglottis and the area of pharyngeal cavity were measured.The position of the rim of epiglottis was examined.The mean percentage changes induced by chin lift were calculated.Results Compared with standard position,chin lift significantly prolonged the length of soft palate,root of tongue and epiglottis and increased the area of pharyngeal cavity.The percentage change in the position of the rim of epiglottis was largest after chin lift.Conclusion Chin lift significantly improve the patency of the upper airway in conscious adult by changing the position of the rim of epiglottis and increasing the area of pharyngeal cavity.

The training of professional postgraduates is one mode of medical postgraduate training,which more emphasizes the cultivation of clinical practice and ability.The problems existing in the training of professional degree postgraduates in dermatology are analyzed in this article,such as weak foundation of scientific research foundation,lack of supervision and evaluation,and the challenges from dermatology characteristics.The solutions including the training objectives,project design,the optimization of teaching process and evaluation,the training of comprehensive ability will be discussed in this article.The purpose is to improve the quality of training,to give some advice for providing high quality professional degree postgraduates.

Objective : To investigate the characteristics of HIV/AIDS cases at ages of 15 to 24 years reported in Ningbo City from 2011 to 2021, so as to provide insights into AIDS control among adolescents. Methods : The epidemiological data regarding HIV/AIDS cases in Ningbo City from 2011 to 2021 were captured from the AIDS Comprehensive Prevention and Control Information System of Chinese Disease Prevention and Control Information System, and the temporal distribution, population distribution, and routes of infections and detection were descriptively analyzed. Results : A total of 1 218 HIV/AIDS cases at ages of 15 to 24 years were reported in Ningbo City from 2011 to 2021, accounting for 17.41% of totally reported cases, and the proportion of HIV/AIDS cases in total HIV/AIDS cases during the same year appeared a tendency towards a decline from 2011 to 2021 (χ2trend=17.170, P<0.001). There were 993 males (81.53%) and 225 females (18.47%), 123 students (10.10%) and 1 095 off-campus adolescents (89.90%), and 904 with non-local registered residence (74.22%). Sexual behavior was identified as the predominant route of HIV infections (97.45%), including 714 men who had sex with men (58.62%). There were 636 cases with passive testing (52.22%), 305 cases with active testing (25.04%) and 219 cases with diagnosis at sexually transmitted diseases clinics (17.98%). Conclusions Men, non-local registered residence and off-campus adolescents were predominant among HIV/AIDS cases at ages of 15 to 24 years in Ningbo City from 2011 to 2021, with men-men sexual behaviors as the predominant route of HIV infections.

Objective To summarize the experience of operative treatment of all types of congenital choledochal cysts (CCC).Methods Clinical data from 52 operated patients with CCC were analyzed retrospectively.(Operations) included excision of the cyst with Roux-en-Y hepaticojejunostomy in 38 cases,partial excision of the cyst with choledochojejunostpmy with Roux-en-Y loop in 2 cases etc. Results 52 cases were cured and left hospital . Among them, 45 were followed up and 42 cases had a good recovery. Conclusions (Resection) of the cyst with Roux-en-Y hepaticojejunostomy is recommended as the therapy of choice in selective operation.Adherence to the indications,the method of excision and the principle of Roux-en-Y (hepaticojejunostomy) are the key factors to increase the effect of the operation.

Objective: To investigate the use of new types of drugs among HIV/AIDS patients in Ningbo City, Zhejiang Province, so as to provide insights into surveillance and interventions for use of new types of drugs among HIV/AIDS patients. Methods: The HIV/AIDS patients in Ningbo City were randomly sampled from the HIV/AIDS Prevention and Control Information System of Chinese Disease Prevention and Control Information System. Patients' demographics, use of new types of drugs and sexual behaviors were collected using questionnaire surveys. Patients' hair samples were collected, and new types of drugs were determined in hair using liquid chromatography-mass spectrometry (LC-MS). In addition, factors affecting the use of new types of drugs were identified using a multivariable logistic regression model. Results: A total of 254 HIV/AIDS patients were enrolled, including 214 men (84.25%), 31 cases aged under 25 years (12.20%), 66 cases aged 25 to 30 years (25.98%), and 157 cases aged 31 to 75 years (61.81%). There were 30 cases reported previous use of new drugs (11.81%), including 27 cases reported previous use of methamphetamine (90.00%). There were 48 cases tested positive of new types of drugs, with a positive rate of 18.90%, including 44 cases tested positive for methamphetamine (91.67%). Multivariable logistic regression analysis identified age (25 to 30 years, OR=6.926, 95%CI: 1.412-33.969), occupation (students/teachers/cadres/employees/retirees, OR=6.971, 95%CI: 2.123-22.889; housekeeping and housework servants/unemployed, OR=3.356, 95%CI: 1.289-8.739; business/public place servants, OR=2.447, 95%CI: 1.033-4.448) and syphilis infection during recent six months (OR=3.491, 95%CI: 1.664-7.326) as factors affecting the use of new types drugs among HIV/AIDS patients. Conclusions The use of new types of drugs exists in HIV/AIDS patients in Ningbo City. Age, occupation and syphilis infection were associated with the use of new types of drugs among HIV/AIDS patients.

Objective To investigate the role of nuclear factor-kappa B (NF-κB)signaling pathway in propofol-induced suppression of up-regulation of inducible nitric oxide synthase (iNOS) gene expression in LPSstimulated RAW264.7 cells.Methods RAW264.7 cells were purchased from cell bank of Chinese Academy of Sciences and cultured in DMEM culture medium containing 10％ fetal bovine serum.The cells were seeded in 6 cm diameter dishes (3 ml/dish) or in 6-well plates (2 ml/well) with a density of 5 × 105/ml and randomly divided into 3 groups ( n =18): normal control group (group C),group LPS (group L)and group LPS + propofol (group LP).The cells were incubated with LPS 1 μg/ml in groups L and LP.Propofol 50μmol/L was added to the culture medium at 2 h before LPS in group LP.Cells were harvested at 30 min after being stimulated with LPS.Phosphorylation of IκB kinase(p-IKK) and NF-κB activity were detected by Western blot.The expression of iNOS mRNA was determined after 6 h exposure of the cells to LPS.Results LPS significantly up-regulated the expression of p-IKK and iNOS mRNA and increased NF-κB activity in group L as compared with group C.Propofol pretreatment significantly attenuated the effects of LPS on p-IKK,iNOS mRNA expression and NF-κB activity.Conclusion NF-κB signaling pathway is involved in the propofol-induced suppression of up-regulation of iNOS mRNA expression in LPS-stimulated RAW264.7 cells.

Objective To investigate the value of cytokinesis-block micronuclei(CBMN)assay in estimation of the biological doses of the victims of radiation accident.Methods Samples of peripheral blood were collected from the 5 victims(Subjects 1-5)at 16 h after the radiation accident of Taiyuan,Shanxi Province.And the peripheral blood samples and bone marrow sample were collected from the victim No.1 at 23 and 24 h after the radiation.Eight days after the accident Subject 1 underwent allogeneic peripheral blood hematopoietic stem cell transplantation.At difierent time points in the period of 1 year after the accident.peripheral blood samples were collected from these 5 victims.CBMN assay was conducted on the peripheral blood lymphocytes on the samples,and the biological doses were estimated based on the micronuclei(MN)frequencies.The nuclear division index(NDI)obtained from in vitro irradiation experiment using high dose of 60Coγ-rays was used to estimate the exposed doses for Subject 1. Dynamic arialysis of the MN frequency for the 5 victims was performed in the period of 1 year after the accident.Results The MN frequency of Subject 1 surpassed the value corresponding to the upper limit of the MN dose.effective curve.The dose range estimated bv the combination of the CBMN and NDI (CBMN+NDl)assay was 10-20 Gy for Subject 1.The doses estimated by MN frequency for Subjects 2,3,4,and 5 were 3.6,2.9,2.3,and 2.9 Gy,respectively.The estimated doses were in accordance with those estimated by physicat method.chromosome aberration analysis.and clinical symptoms.Prominent decrease of the MN frequency was observed at 26 d after the accident(18 d after the transplantation)for Subject 1(u=3.295,P<0.05).Gradual decrease of MN frequency was observed after the accident for Subjects 2,3,4,and 5.The MN frequencies 1 month after the accident of Subjects 3,4,and 5 were all significantly lower than those 16 h later(u=6.874,4.526,and 7.811,P<0.05).Conclusions Quick and accurate.CBMN assay reinforces and verifies the result of chromosome aberration analysis.The new index CBMN+NDI assay is of reference valne for estimating higher dose of irradiation.

Objective　To investigate what effects BmKAS-1 (a polypeptide purified from the Chinese scorpion Buthus martensi Karsch ［BmK］ and named as BmK activator of skeletal-muscle ryanodine receptor) and its upstream mixture BmK1-3-2 have on Na+ channels in dorsal root ganglion (DRG) small diameter neurons. Methods　The whole-cell patch-clamp technique was used to investigate the effects of BmKAS-1 and BmK1-3-2 on Na+ current in rat small diameter DRG neurons. Results　About 50% peak Na+ current was suppressed by 10*!μg/ml of BmK1-3-2. 1.62*!μg/ml of BmKAS-1 also blocked 50% peak Na+ current, and there was an obvious dose-dependent relationship. Conclusion　Both BmK1-3-2 and BmKAS-1 have a blocking effect on Na+ channels, and this may one of the mechanisms for the analgetic effect of BmK1-3-2 and BmKAS-1.

Objective To evaluate and compare the clinical efficacy and safety of intense pulsed light (IPL) versus 595-nm pulsed dye laser (PDL) for the treatment of post-acne erythema.Methods A randomized split-face clinical trial was conducted.A total of 20 patients with post-acne erythema were enrolled,and randomized to receive treatment with IPL on one half of the face and 595-nm PDL on the other facial side once every 4 weeks for 3 sessions.Digital photographs were taken using the VISIA,and erythema index was recorded before each treatment and one month after the last treatment.The severity of bilateral facial erythema was evaluated based on a 4-point grading scale before the first treatment and after the last treatment.Pain scores and adverse reactions were recorded using a visual analogue scale (VAS) after each treatment,and a patient satisfaction survey was conducted by questionnaire at the last follow-up.Results The mean erythema index on the IPL side before and after treatment was 472.25 ± 86.02 and 357.15 ±82.71 respectively,and that on the PDL side before and after treatment was 476.40 ± 74.25 and 360.05 ± 64.83 respectively.Repeated measures analysis of variance (ANOVA) showed that the erythema indices on both treated sides significantly decreased over time (F =197.666,P ＜ 0.001),and the efficacy of IPL was better than that of PDL (F =1 173.909,P ＜ 0.001).Erythema severity grades on the IPL side as well as on the PDL side significantly differed between before and after treatment (Z =28.735,31.450,respectively,both P ＜ 0.001).As VAS showed,the pain score on the PDL side was significantly lower than that on the IPL side (t =2.468,P ＜ 0.05).Among the 20 patients,17 and 15 assessed their improvement as good or excellent after PDL and IPL treatment respectively,but there was no significant difference between the two groups (Z =2.696,P ＞ 0.05).The adverse reactions included erythema,burning sensation,tense sensation,blistering and hyperpigmentation on IPL-treated side,and erythema and purpuric reactions on the PDL-treated side,which all disappeared in a few hours to several days.Conclusions Both IPL and 595-nm PDL are effective and safe for the treatment of post-acne erythema,and are worthy of clinical promotion and application.IPL shows superiority in the efficacy,but elicits higher pain sensation compared with PDL.