A safe and effective anesthesia technique is necessary in ensuring a successful surgical operation in rabbit experiments.A variety of anesthesiamethod have been reported, yet, no one matured and widely accepted anesthesiamethod is available so far.This article aims to provide an information basis for further research on general anesthesia in rabbits by reviewing the literature on single and combined anesthesia techniques in rabbits reported in the last decade.

ObjectiveTo analyze the prognosis of 784 patients according with clinical staging of esophageal carcinoma treated with non-surgical methods,investigate the predictive value and deficiency of the clinical staging.MethodsFrom July 2003 to January 2009,784 patients with esophageal carcinoma received 3DCRT treatment.The prescribed doses ranged from 50 Gy-70 Gy with median dose of 60 Gy,1.8-2.0 Gy/fraction,1 fraction/day,5 fractions/week.65 patients received prescription dose of＜60 Gy and all the others'≥60 Gy.All the patients were divided into subgroups according to different T,N and TNM stages.Therapeutic effect was evaluated.ResultsThe follow up rate was 97.1％,503 patients were followed up for more than 3 years and 122 were followed up for more than 5 years.The 1-,3-,5-year local control rates and overall survival rates were 77.2％,54.2％,46.5％ and 69.5％,34.9％,23.9％,respectively,with median survival time of 21 months.There were significant differences of survival curves for different T stages,N stages and TNM stages.For the groups of stage Ⅰ,Ⅱ and Ⅲ,the 1-,3-,5-year survival rates were 86.4％,47.6％,45.1％ ;84.7％,46.3％,36.4％ and 64.0％,30.9％,19.1％,respectively ( x2 =29.34,P =0.000).There were 752 patients with squamous cell carcinoma ( 95.9％ )and 32 patients with non-squamous cell carcinoma (4.1％ ),the median survival time were 21 and 16 months,respectively ( x2 =4.44,P =0.035 ).There were significant difference of survival rates for the subgroups whose GTV volume ≤20 cm3,20 -40 cm3,40 -60 cm3 and ＞60 cm3 (54 months,29 months,21months and 14months,x2 =68.71,P =0.000).ConclusionsThe clinical staging of esophageal carcinoma treated with non-surgical methods could predict the prognosis accurately,for patients with different pathology and GTV volumes,there were variance in the prognosis,so we advised the complement of the two factors in the draft of clinical stages.

Objective To explore the significance and the change of miRNAs expression profile in different period of HBV infection.Methods Establish the detection method of microRNA(miRNA) by RNA DNA probe liquid chip (flexible multi-analyte profiling,xMap) and estimate the specificity,repeatability and accuracy of this method.From October 2010 to October 2011,collect HBV infected patients' periphcral blood of the First affiliated hospital of SooChow University,including acute hepatitis B,chronic hepatitis B,hepatits B liver cirrhosis,liver cancer patients and health control,each group contains 40 cases.The levels of miR-191,-223,-222,-145,-21,-31,-126,-20a,-372 of peripheral blood mononuclear cell were detected by xMap liquid chiptechnology.The level of miR-103 was taken as reference.The ratio of (the mean fluorescence intensity of target miRNAs-corresponding backgroud mean fluorescence intensity)/( the mean fluorescence intensity of miR-103-corresponding backgroud mean fluorescence intensity) as a valid data and analysis the characteristics of miRNAs expression.The SPSS 17.0 was used as statistical software.The single factor analysis of variance was used as the method to analysis group comparison,and make multiple comparison by the LSD-t method if the result with a significant difference.Results The specificity of Xmap liquid chip method to detect miRNAs was 100％ ;The repeated experiment proved that the CV value was less than 5％ in the high value reference miRNA test,less than 10％ in the low value reference miRNAs test;the accruracy experiment proved that the recovery rate was ( 100 ± 5)％ in the nine miRNAs.There were no statistically differences with miR-222 ( F =1.32,P ＞ 0.05),-191 ( F =1.98,P ＞ 0.05),-145 ( F =0.78,P＞0.05),-21(F=0.64,P ＞0.05),-31 (F =0.83,P ＞0.05),-372(F =1.75,P ＞0.05)in different groups; There was statistically significant differences in miR-223 ( F =14.56,P ＜ 0.05) among different groups,with the highest expression level in actue hepatitis B group (15.37 ± 4.01),and the lowest expression level in liver cancer group (6.91 ±3.18) ; There was statistically significant differences in miR126 (F =17.43,P ＜ 0.05)among different groups,with the highest expression level in health control group (6.33 ±2.75) and the lowest expression level in liver cancer group (2.38 ± 1.07).There were statistically significant differences in miR-20a ( F =19.484,P ＜ 0.05) among different groups,with the highest expression level in health control group (0.33 ±0.18) and the lowest expression level in liver cancer group (0.81 ±0.24).Conclusion The detection method of miRNA by Xmap liquid chip has strong specificity,high accuracy and good repeatability,suitable for large throughput clinical testing.The study for miRNA in HBV infected diseases provides a new clue to the research of chronic progress mechanism.

Traditional Chinese Medicine(TCM) makes great contributions to the prosperous growth and people's health.But understanding deviation and imperfect evaluation system of TCM affect the healthy development of TCM.Clinic practice is the motive power of TCM,and curative effect is the key of TCM researches,and the scientific evaluation system is the safeguard for a healthy development of TCM.So we should focus on clinical researches of stubborn diseases and emergency cases to satisfy social demand and upgrade the position of TCM in the medical system.At the same time,functional disease must be explored to show the advantage of TCM.Our mission is to establish a scientific objective evaluation system to accurately understand TCM and take it as the turning point to give an impetus to theoretical breakthrough of the basic studies to promote an overall and healthy development of TCM.

ObjectiveTo explore the application of diffusion-weighted magnetic resonance imaging (DWMRI) in precise radiotherapy of esophageal carcinoma.MethodsThirty-seven patients with biopsy proven esophageal cancer from March 2010 to January 2011 were included.To delineate the gross tumor volume (GTV) using CT and DWMRI images,each patient was examined by DWMRI and CT scan using the same position before radiotherapy.To compare the maximum diameters and volumes of tumor between CT and DWMRI. The tumor lengths measured by esophagogram,esophagoscope,CT and DWMRI were compared.ResultsTumor lengths under esophagogram,esophagoscope,CT and DWMRI were 5.70 cm,6.06 cm,7.97 cm and 5.79 cm respectively. The lengths between CT and esophagogram,CT and esophagoscope,CT and DWMRI had statistical significance respectively (F=4.88,P=0.003).The maximum diameters of tumor shown on CT and DWMRI were 3.79 cm and 3.81 cm respectively ( t =-0.32,P=0.751 ).The GTV were 45.75 cm3 and 38.05 cm3 in CT and DWMRI respectively (t=5.30,P =0.001 ).53 lymph nodes were assessed positive on both CT and DWMRI.DWMRI excluded 25 positive lymph nodes assesed by CT; also confirmed 15 negative lymph nodes excluded by CT,6 of which were paraesophageal lymph nodes.The addition of DWMRI information altered the clinical stage in 6 patients.ConclusionsTumor lengths measured on DWMRI and esophagogram had the optimal approximation.It was easy to find paraesophageal lymph nodes via DWMRI.With the addition of DWMRI information,the target range and clinical stage were alerted in some patients.

Objective To observe the acute side effects, local control rate and survival rate of concurrent chemoradiotherapy (CC) and radiotherapy alone (R) for patients with esophageal carcinoma.Methods From June 2006 to February 2009, 209 patients with esophageal carcinoma were observed, 105 of them were treated with CC.Of all the patients, 117 received three-dimensional conformal radiotherapy, 92 received intensity modulated radiotherapy, the median prescription dose was 60 Gy.The regimen of LFP (5-FU, cisplatin and calcium folinate) was selected for this study, side effects, local control rate and survival rate were observed and subsets analysis were performed.Results The overall follow-up rate was 99.0%,there were 99 and 44 patients whose follow-up time was more than 2 and 3 years, respectively;for the CC group, the data were 45 and 14, respectively;and for the R group, 54 and 30, respectively.The 1-,2-,3-year local control rates of CC group and R group were 88.1%,69.2%,66.2% and 81.0%,64.0%,54.9%(χ2=2.31,P=0.128), respectively.The 1-,2-,3-year overall survival rates of CC group and R group were 84.4%,52.9%,45.6% and 75.2%,50.7%,37.0%(χ2=1.57,P=0.210),respectively.Subset analysis indicated that for the patients of N0 group and whose length of GTV>7 cm, the local control rate of CC was significantly higher than that of radiotherapy alone (χ2=5.11,7.66;P=0.024, 0.006).For N0 group, the survival rate of CC was higher than that of R alone.(χ2=5.07,P=0.024).The incidence of WBC, PLT and HGB reduction for the two groups were 81.9% and 49.0%(χ2=36.45,P=0.000),14.3% and 1.9%(χ2=10.54,P=0.006),and 24.8% and 2.9%(χ2=22.95,P=0.000),respectively.The incidence of nausea, vomiting and constipation for the two groups were 63.8% and 7.7%(χ2=71.52,P=0.000), respectively.The incidence of ≥2 grade esophagitis of CC group and R group were 48.57% and 38.46%(χ2=2.17,P=0.141), respectively.The incidence of ≥2 grade radiation pneumonitis of CC group and R group were 15.24% and 7.69%(8/104)(χ2=2.93,P=0.087),respectively.ConclusionsCompared to radiotherapy alone, the local control rate and overall survival rate of concurrent chemoradiotherapy were not improved significantly, the patients with N0 may be the conspicuous beneficiary.About side effects, only marrow depression and gastrointestinal tract reaction were significantly different between the two groups,the value of addition of concurrent chemoradiotherapy for esophageal carcinoma needs further investigation.

Objective To observe the relationship between computed tomography-gross tumor volume (GTV) and non-surgical T stage in patients with esophageal squamous cell carcinoma (ESCC) and the survival rates of patients with different GTVs,and to investigate the impact of GTV on the prognosis of ESCC after three-dimensional radiotherapy.Methods A retrospective analysis was performed on 223 ESCC patients without lymph node metastasis and distant metastasis who were hospitalized from July 2003 to January 2009.The prescribed doses of three-dimensional radiotherapy ranged from 50-70 Gy.These patients were divided into 3 or 4 groups according to different percentile intervals of GTVs.The Spearman rank correlation analysis was used for investigating the relationship between non-surgical T stage and GTV.The Kaplan-Meier method was used for calculating survival rates,and the log-rank test was used for survival difference analysis.Results The follow-up rate was 98.2％.A total of 163 patients were followed up for at least 3 years.The median GTVs of patients with T1 +2 ESCC,T3 ESCC,and T4 ESCC were 19.31 cm3,33.69 cm3,and 41.25 cm3,respectively,exhibiting a positive correlation between non-surgical T stage and GTV (P =0.000).The 5-year survival rates were 59％,43％,and 24％ (P =0.000) in 3 GTV-based groups and were 55％,51％,31％,and 24％ (P =0.004) in 4 GTV-based groups.The primary cause of death for the patients with GTVs of ≤35 cm3 and ＞35 cm3 was failure of local control (57.9％ vs 52.1％) ; 21.9％ and 13.8％ of the patients with a GTV of ＞ 35 cm3 died of uncontrol and excessive bleeding,versus 9.4％ and 3.1％ of the patients with a GTV of ≤ 35 cm3 (P =0.046 ; P =0.029) ;2 of the patients with a GTV of ＞ 35 cm3 died of grade 5 radiation pneumonitis.Conclusions GTV is positively correlated with nonsurgical T stage in esophageal cancer patients who receive radiotherapy.The 3-level and 4-level grading of GTV can be used for prognostic evaluation,and the 3-level grading of GTV is more closely related to prognosis.The patients with a larger GTV have higher incidence of uncontrol and bleeding and risk of treatment-related death than those with a smaller GTV after radiotherapy.

Objective To explore students nurses′acceptance of case-based group assessment. Method A total of 100 student nurses participated in the survey by a self-designed questionnaire to evaluate the perception and acceptance of the student nurses. Results The score on the acceptance of case-based group assessment was (2.44 ± 0.46). The items with higher acceptance included teamwork spirit, clinical reasoning and decision-making ability, and the items with lower acceptance were improving of nurse-patient communication and the nursing skills. Conclusions The student nurses have a good acceptance of the case-based group assessment and think this assessment method can contribute to development of teamwork spirit and competency of clinical reasoning and decision-making. On the other hand, they suggest we should strengthen the ability in nurse-patient communication and optimize the links in ability assessment.

Thrombus is a major factor leading to cardiovascular diseases such as myocardial infarction and stroke. Although fibrinolytic anti-thrombotic drugs have been widely used in clinical practice, they are still limited by narrow therapeutic windows, short half-lives, susceptibility to inactivation, and abnormal bleeding caused by non-targeting. Therefore, it is crucial to effectively deliver thrombolytic agents to the site of thrombus with minimal adverse effects. Based on the long blood circulation and excellent drug-loading properties of human serum albumin (HSA), we employed genetic engineering techniques to insert a functional peptide (P-selectin binding peptide, PBP) which can target the thrombus site to the N-terminus of HSA. The fusion protein was expressed using Pichia pastoris and purified by Ni-chelating affinity chromatography. After being loaded with gold nanoparticles (Au NPs), the fusion protein formed homogeneous and stable nanoparticles (named as PBP-HSA@Au) with a diameter of 17.7 ± 1.0 nm and a zeta potential of -11.3 ± 0.2 mV. Cytotoxicity and hemolysis tests demonstrated the superb biocompatibility of PBP-HSA@Au. Platelet-targeting experiments confirmed the thrombus-targeting ability conferred by the introduction of PBP into PBP-HSA@Au. Upon near-infrared ray (NIR) irradiation, PBP-HSA@Au rapidly converted light energy into heat, thereby disrupting fibrinogen and exhibiting outstanding thrombolytic efficacy. The designed HSA fusion protein delivery system provides a precise, rapid, and drug-free treatment strategy for thrombus therapy. This system is characterized by its simple design, high biocompatibility, and strong clinical applicability. All animal experiments involved in this study were carried out under the protocols approved by the Animal Experiment Ethics Committee of Jiangnan University [JN. No20230915S0301015(423)].

OBJECTIVETo improve the X-ray diagnosis of cervical spondylosis of vertebral artery type (VCS).

METHODSA blinded design research. The X-ray signs both 60 patients with VCS and 60 patients with cervical spondylotic radiculopathy were collected from January 2011 to November 2012. There were 36 males and 84 females, aged from 25 to 65 years old with an average of (48.4 ± 12.3) years old. Cervical curvature, atlanto-occipital joint angle, atlanto-axial joint angle, C2/C3 joint angle and lower cervical instability condition and segmental distribution were measured and recorded by X-rays. These data were analyzed and compared between the two groups after unblended. Combined with clinical manifestations,the X-ray imaging features of VCS were further analyzed.

RESULTSThere was significant difference in cervical curvature between two groups in anteflexion X-ray films (P < 0.05). There was significant difference in extension degree of atlanto-occipital joint angle between two groups (P < 0.01). There was significant difference in atlanto-axial joint angle between two groups in lateral X-ray films (P< 0.05). There was significant.difference in anteflexion degree of atlanto-axial joint angle between two groups (P < 0.05). There was no significant difference in C2/C3 joint angle between two groups. There was no significant difference in the lower cervical instability condition and segmental distribution between two groups. In VCS group, the mild and moderate dizziness was main symptom, flexion and extension activities of neck was most common cause in the dizziness; and always accompanied with headache; tenderness mostly concentrated in the upper cervical area.

CONCLUSIONBoth X-ray signs and clinical manifestations can prompt the abnormalities of the upper cervical structure or function in patients with VCS. Anteflexion activities of neck observed by functional position of X-ray films should be emphasized in diagnosis of VCS.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Radiculopathy ; diagnostic imaging ; Radiography ; Spondylosis ; diagnostic imaging ; Vertebral Artery ; X-Rays