Objective To investigate the changes in intrapulmonary shunting during controlled hypotension induced by sodium nitroprusside(SNP)in patients undergoing naso-endoscopic operation.Methods Forty ASAⅠorⅡpatients of both sexes(23 male,17 female)aged 16-50 yrs weighing 50-75 kg undergoing naso-endoscopic operation under general anesthesia with muscle relaxation and mechanical ventilation were studied.Radial artery was cannulated for direct BP monitoring and blood sampling.Right internal jugular vein was cannulated and the catheter was advanced into right ventricle.Blood sample taken from right ventricle was used as mixed venous blood instead of blood from pulmonary artery.ECG,MAP,HR and P_(ET) CO_2 were continuously monitored during operation Cardiac output was monitored with noninvasive cardiac function monitor(NC-COM.)based on impedance principle.SNP infusion was started at the beginning of operation at 1-3?g?kg~(-1)?min~(-1) and was then adjusted.MAP was reduced by 30%-40% and maintained at this level until the end of operation.Blood samples were taken from artery and right ventricle simultaneously before SNP infusion(T_1,baseline)at 30 and 60 min of hypotension(T_2,T_3)and at 20 min after BP returned to the baseline level(T_4)for blood gas analysis.Qs/Qt was calculated.Results Qs/Qt was significantly increased during controlled hypotension at T_2 and T_3 as compared to the baseline value(P＜0.01)and returned to the baseline level at T_4.HR was increased and cardiac output and stroke volume was significantly reduced during hypotension as compared to the baseline value.Conclusion The intrapulmonary shunting is increased and the hemodynamics is depressed during SNP-induced controlled hypotension and they return rapidly to baseline level after SNP is discontinued.No hypoxemia develops during SNP- induced hypotension.

Objective To investigate the expression pattern of carbonic anhydrase 1 (CA1) in different clinical stages of color ectal cancers and the correlation between CA1 expression and pathologic characteristics of colorectal cancer.Methods The expression of CA1 in genetic level was detected by real-time quantitative polymerase chain reaction (PCR) and the expression of CA1 in protein level was detected by Western blot and immunohistochemical staining.Results The expression pattern of CA1 in the protein level was very similar to the genetic level.It had a very low expression level in carcinoma tissue,especially at stages Ⅲ and Ⅳ (P ＜0.01),CA1 had significantly lower expression level in the colorectal patients with metastasis (P ＜0.01).CA1 was gradually decreased from well-differentiation tissue to poorly-differentiation tissue with a significant difference between well-differentiated adenocarcinoma and poorly-differentiated adenocarcinoma (P ＜ 0.01).Kaplan-Meier survival analysis showed that the expression of CA1 was extremely related to colorectal carcinoma (CRC) prognosis.The 5-year survival rate was only 8％ in the CA1 negative expression group,and the 5-year survival rate of the patients with CA1 positive expression was 92.86％ (P ＜ 0.01).Conclusions CA1 had the similar expression patterns at genetic and protein levels.In the colorectal cancer tissue,the expression of CA1 was downregulated and even missing.CA1 had significantly lower expression level in the advanced colorectal cancers with metastasis and poorly differentiated colorectal cancer tissues.The patients with lower CA1 expression level had the worse prognosis.

Ebola hemorrhagic fever is an acute infectious disease caused by Ebola virus,the mor-tality rate of which is up to 90% . Due to its high infection rate,high mortality rate as well as being a serious threat to public health and safety,Ebola virus is listed as a World Health Organization Risk Group 4 Patho-gen(requiring Biosafety Level 4-equivalent containment). However,there is no effective control method and treatment for Ebola virus infection. Different approaches have been used to develop vaccines and therapeutic drugs against Ebola virus infection and clinical trials of some products have been initiated,such as ZMapp, BCX-4430,GS-5734,DNA vaccines,and adenovirus vector vaccines. National Institutes of Health(NIH) announced a successful development of vaccine for Ebola virus which had passed the clinical trial by the end of 2014. At the meantime,the first anti-Ebola virus medicine had also been approved in China for emergency use only. Recent advances in the research and development of therapeutic drugs and vaccines against Ebola virus will be described in this review.

Objective To investigate the effects of GGNBP2 on proliferation,migration and invasion of human gli-oma U251 cells and the potential mechanism. Methods U251 glioma cells were transfected with lentiviral vector carrying GGNBP2 to establish a stable overexperssion of GGNBP2 in U251 cell line. After verification of the efficiency of transfec-tion by real-time PCR, Western Blot, PCR and CCK-8 were applied to detect the proliferation of U251 cells. The Tran-swell chamber assay was applied to measure the migration and invasion of human U251 glioma cells. Western blot was applied to measure protein levels of AKT, p-AKT, PCNA and MMP9. Result The stable U251 glioma cell line overex-pressing GGNBP2 was successfully established. Compared with the control group, overexpression of GGNBP2 significant-ly inhibited the proliferation(P<0.05),invasion(57±6 vs. 203±6,205±7,F=512.4,P < 0.05)and migration (74±7 vs. 254±14,248±13,F=242.5,P<0.05) of U251 cells. The protein expression levels of p-AKT (F=45.4, P<0.05), PCNA (F=348.5, P<0.05) and MMP-9 (F=88.7, P<0.05) in GGNBP2 group were markedly decreased compared with the control group. Conclusion GGNBP2 may suppress the proliferation, invasion and migration of glioma though down-regulation of p-AKT, which in turn inhibits PCNA and MMP-9 expression.

As induction chemotherapy goes on,target volume,dose distribution in the surrounding organs at risk (OARs),and target dose conformity all change.Therefore,the question is how to develop reasonable radiotherapy plans in clinical practice.Induction chemotherapy followed by radiotherapy is commonly used around the world,but it is recommended to delineate the target volume based on the gross tumor volume before induction chemotherapy and not to reduce the dose.This point of view lacks the basis of evidence-based medicine.The experts and scholars in China clarify the advantages of radiotherapy plans after induction chemotherapy from the aspects of reducing the target volume,reducing the volume of high-dose region in the target volume,increasing the uniform dose coverage in target volume,reducing dose to OARs,and increasing dose conformity.However,at present,there are no objective data on its long-term efficacy and benefit.Besides,no consensus has been reached on how to delineate the target volume and determine the dose distribution after induction chemotherapy,and further studies are needed.

0.05). Conclusion When TOFR recovers to 0.55,antagonism of residual neuromuscular blockade is still necessary.Different doses of neostigmine may antagonize vecuronium-induced residual neuromuscular blockade,and lower dose of neostigmine(10-20 ?g/kg) is recommended.

Objective To observe the effects of the preconditioning of ulinastatin on GES-1 cell injury induced by oxygen and glucose deprivation (OGD). Methods GES-1 cells were cultured in vitro and divided into three groups: normal control group (group N), oxygen and glucose deprivation group (group O), and ulinastatin preconditioning group (group U). The OGD model of GES-1 cells were established by glucose-free medium and three-gas incubator for 6h. Ulinastatin was added to group U 12h before the deprivation of oxygen and glucose. The cell viability and apoptosis were determined by cck-8 and flow cytometry respectively. Western Blot was used to examine the protein expression of Caspase-3 and Cleaved Caspase-3. The TRPV1 mRNA expression was measured by quantitative real-time PCR. Results As compared with group N, the viability of GES-1 was decreased, the apoptotic rate and the expression of Caspase-3 and Cleaved Caspase-3 were increased, and the TRPV1 mRNA expression decreased greatly in group O (P < 0.05). As compared with group O, the aforementioned changes were significantly inhibited in group U. Conclusions Ulinastatin preconditioning could effectively inhibit GES-1 cell injury induced by OGD, which may be related to the inhibition of apoptosis and the upregulation of TRPV1 mRNA expression.

At present, the clinical skills training process for ultrasound medicine professional postgraduates is still facing many problems, such as inadequate guidance from tutors, little accumulation of clinical knowledge and practice, not solid basic ultrasonic skills, imperfect assessment system, and disconnection between scientific research and clinical practice. Analyzing the cause of problems, combining with the characteristics of ultrasound medicine and our experience in the clinical skills training process, we have put forward targeted solutions, such as building a complete and efficient training team, attaching importance to rotation and cultivation of relevant clinical departments, realizing teaching objectives by different levels and stages, establishing a perfect management, supervision and assessment system, paying attention to the combination of clinical and scientific research ability, so as to improve the quality and efficiency of clinical skills training process of ultrasound medicine.

Objective To observe the curative effect of Bairui Granules combined with amoxicillin and clavulanate potassium tablets in treating acute tonsillitis. Methods A total of 200 patients with acute tonsillitis treated in Dongfang Hospital from February to November in 2017 were randomly divided into the treatment group and the control group according to the random number table method. A total of 100 cases in the control group was treated with amoxicillin and clavulanate potassium tablets, 100 cases in the treatment group received Bairui Granules combined with amoxicillin and clavulanate potassium tablets, each group was treated for 5 d as one course. The clinical symptoms and signs improving time of two groups were observed and the therapeutic effects of the two groups were compared and analyzed. Result In the treatment group, the time of heat withdrawal and sore throat disappeared was significantly less than that of the control group (P < 0.01); After one course of treatment, the total effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). In the two groups, there was no adverse reaction during the treatment. Conclusion Bairui Granules combined with amoxicillin and clavulanate potassium tablets had the advantages of short course and higher effect in the treatment of acute tonsillitis.