Objective To observe the bipolar radiofrequency ablation maze procedure (BRAMP) combined with heart valve replacement for rheumatic heart disease (RHD) complicated with atrial fibrillation (AF), and discuss the curative effect of the new operation method. Methods Fifteen patients with RHD complicated with AF were treated with heart valve replacement and BRAMP (treatment group). At the same time, 15 patients with RHD complicated with AF were only heart valve replacement without BR AMP(control group). Results Treatment group were all cured, and they had the sinoatrial rhythm after operation.Followed up 6 months, 14 patients maintained sinus rhythm,one had AF occasionally. In control group, 13 patients had AF after operation,2 patients had the sinoatrial rhythm after operation, but they tumed to AF one or two days later,and amiodarone hydrochloride had no effect to them. The two groups had obvious differences in the length of left atria, the length of left ventricle, the size of the heart, the function of the heart and LVEF before and after operation (P ＜ 0.01 or ＜ 0.05). But in treatment group, the length of left atria and the size of the heart had obvious difference after operation compared with control group [ (31.06 ± 2.28 ) mm vs. (36.16 ±2.23) mm,t = 11.645,P =0.002; (50 ±9)% vs. (56 ± 10)% ,t =8.052,P =0.008].Conclusion Compared with the operation that heart valve replacement without BRAMP,BRAMP is simple and little, should be promising.

Objective To evaluate the efficacy of midazolam combined with remifentanil for lower eyelid blephamoplasty.Methods In a double-blind study,200 patients undergoing lower eyelid blephamoplasty were randomly and equally divided into 2 groups (100 cases each):test group (midazolam 0.05 mg/kg and remifentanil 0.5 μg/kg followed by remifentanil 0.05 μg/(kg·min) and control group (midazolam 0.05 mg/kg).Heart rate (HR),mean arterial pressure (MAP),and pulse oxygen saturation (SpO2),respiratory rate (RR),SpO2 change,operation time,recovery time,the incidence of adverse reactions and the satisfactory rate of both patients and surgeons were monitored and recorded before the medication,3 min after the medication,at beginning of the surgery,during and immediately after the surgery,and 30 min after surgery.Results Two groups of patients had no obvious difference in intraoperative MAP,HR,RR,SpO2 and postoperative recovery time (P＞0.05);the incidence of postoperative nausea and vomiting in the test group was significantly higher than that in control group (P＜0.05); Patients and surgeons satisfaction in the test group was higher than that in control group (91.3±11.6)vs (52.7±10.4) (P＜0.05).Conclusions Midazolam combined with remifentanil for lower eyelid blephamoplasty has less inhibitory effect on circulatory and respiratory functions and the patients come round fast after surgery.But there are risks of respiratory inhibition in the induce phase and nausea and vomiting in the recovery stage.

2 months) was 93%(14/15); both 1- and 2-year local control rates were 83%; and 1- and 2-year survival rates were 72.9% and 62.5%, respectively. The median survival time was 32 months. Three patients had distant metastasis. Five patients died of lung metastasis (1 case) or multiple organ failure (4 cases). No complication or side-effect was observed in the patients, except skin ulceration in one patient. Conclusions Interstitial implantation of ~(125)I seed combined with or without external beam radiation therapy is convenient, effective, safe, and minimally invasive for soft tissue tumor, especially for metastatic or recurrent tumors.

Objective A study was performed to better define the teaching outcome of computers in teaching medical imaging. Methods 150 4rd-year students were randomly assigned to four groups and experimental group exposed to 20 radiology cases as well as to a voluntary weekly radiology lecture. Group A used computer-based cases with interactive elements; group B used computer-based cases without interactive elements; group C used paper-based cases with interactive elements; and group D was not exposed to the cases and served as a control group. Results On a multiple-choice question test,groups A,B,and C showed significant improvemen(t+10.6%,+15.7%,+13.5%,respectively),whereas group D did not(+2.7%). On an image interpretation test,group A and group B showed the most improvement (+15.8%,P

OBJECTIVE To investigate the protective effect of velvet antler polypeptides(VAP)on hydrogen peroxide( H2 O2 )-induced injury in vascular endothelial cells and the possible mechanism.METHODS The EVC-304 cells cultured invitrowere incubated with H2 O2 for another 12 h after pretreat-ment with VAP 20,40 and 80 mg·L-1 for 24 h. Cell viability was determined by MTT assay, Hoechst333258 staining was used to observe cell morphology,the activity of superoxide dismutase (SOD)and the level of malondialdehyde( MDA)were detected with kits and the expression of heat shock protein(HSP70)and caspase 3 was detected by Western blotting. RESULTS Compared with the normal control group,the cell survival rate was decreased significantly in H2 O2 injury group( P ﹤0.01),cell shrinkage,chromatin condensation,and nuclear fragmentation were seen,the intracellular SOD activity decreased while MDA content increased(P﹤0.01),and caspase 3 and HSP70 expression increased(P﹤0.01). Compared with H2 O2 group,the cell survival rate in VAP 20,40 and 80 mg·L-1 pre-treatment groups increased significantly(P﹤0.01),the apoptosis ratio declined from(25.3±1.0)% to (15.2±1.2)%,(10.3±0.9)% and(7.9±1.4)%(P﹤0.01),the SOD activity increased to 19.2±0.5,22.3± 1.7 and(24.9±0.6)kU·g-1 protein(P﹤0.01),MDA concentration decreased to 1.51±0.2,1.48±0.3 and (1.02±0.1)μmol·g-1 protein(P﹤0.01),and the expression of caspase 3 and HSP70 declined significant-ly(P﹤0.01). CONCLUSION VAP has exert protective effect on H2 O2-induced injury in vascular endothe-lial cells. The possible mechanism might be related to improvement of intracellular oxidative stress level.

Objective To evaluate the therapeutic effect of ESWL combined with urinary stone decoction and ear acupoint pressure for the patients with renal and ureteral calculi.Methods A total of 110 patients with renal and ureteral calculi were randomly divided into the Chinese medicine (CM) and conventional groups, 55 in each group. Both groups were given ESWL treatment as basic treatment. Chinese medicine group were given the urinary stone decoction and auricular acupressure, and the conventional group used stone granules. Both groups were treated for 2 weeks. According to the photography of ultrasound, the changes of calculi, time of lithagogue, pain relief after operation and the effect rates of pain relief on abdomen and waist, of remission of haematuria, and of urinate pain. ResultsAfter treatment, the successful rates of operation in the CM group was 90.9% (50/55), and conventional group was 76.4% (42/55). There was significant difference between 2 groups (χ2=4.251,P=0.009). The time of stone removal in CM group was significantly shorter than that in the conventional group (7.3 ± 3.8 dvs. 11.2 ± 4.3 d,t=4.032,P<0.001). After 1st, 3rd, 5th, 7th days, the VAS pain scores in the CM group were significantly lower than those in the conventional group (4.1 ± 0.8vs. 5 ± 1.2,t=4.783;4.5 ± 0.9vs. 5.3 ± 1.3,t=4.492; 3.8 ± 0.8vs. 4.5 ± 0.8,t=4.503; 2.2 ± 0.8vs. 2.9 ± 0.9,t=3.691; allP<0.01). After 7th day, the rates of abdominal pain relief was 60% (33/55), pain relief was 79.1% (34/43), the remission of hematuria was 81% (17/21) in the CM group, and the control group were 40% (22/55), 59.6% (28/47), 52% (13/25). There were significant differences between 2 groups on these indices (χ2 values were 4.400, 3.982, 4.217,P values were 0.036, 0.046, 0.040).Conclusions The ESWL combined with urinary stone decoction and ear acupoint pressure could improve the symptoms of patients with kidney ureteral stones.

Colorectal cancer is currently the third most common cancer worldwide,and there are still half of the patients undergoing recurrence and metastasis after surgical treatment,so it is necessary for colorectal cancer patients to receive radiation therapy routinely.Due to the side effects brought by radiotherapy,it is of great importance to solve how to minimize the radiation dose in radiation therapy and improve radiation sensitivity.In recent years,people discovered that microRNAs can not only be involved in the origins of colorectal cancer and progress,but also play a increasingly important role in cancer radiosensitivity.MicroRNAs can regulate tumor radiosensitivity by influencing tumor microenvironment and function on target genes.DNA damage response caused by radiation includes the activation of ATM,histone modification and chromatin remodeling,cell cycle arrest,damage repair and apoptosis.microRNAs can regulate tumor radiosensitivity through above processes.This review focuses on the mechanism of microRNAs in affecting DNA damage repair and prospects the future of microRNAs in influencing the sensitivity of cancer radiotherapy in clinical application.

Objective: To investigate the clinical results of permanent implantation of radioactive 125 I seeds in treatment of advanced pancreatic adenocarcinoma.Methods:Eight patients with advanced pancreatic adenocarcinoma were treated with 125 I implantation from May 2002 to December 2002 and the data was retrospectively analyzed.Results: The mean number of 125 I seeds implanted was 22.8 with minimum of 19 to maximum of 38 each. The matched peripheral dose was 65 Gy.The postoperative courses were uneventful and no bone marrow suppression was recorded.The preoperative efractory abdominal and back pain in 2 patients were relieved completely (2/2).The postoperative CT scan which were done in four cases showed that tumor disappeared completely in 2 cases,were well locally controlled in 1 and slightly controlled in one.No acute pancreatitis and pancreatic leakage were encountered in all patients.Conclusion: The implantation of radioactive 125 I was effective in local control of the tumor and pain relief and is a safe alternative for the treatment of unresectable pancreatic adenocarcinoma.

Objective To investigate the clinical value of preventive analgesia in patients with radical gastrectomy for gastric cancer.Methods The clinical data of 161 patients undergoing radical gastrectomy for gastric cancer at the Xijing Hospital from July 2012 to June 2013 were prospectively analyzed.A single-blind,randomized,controlled study was performed in the eligibe patients who were randomly divided into the preventive analgesia group and the control group based on a random number table.All the patients received major gastrectomy + Billroth Ⅱ anastomy or total gastrectomy + esophagojejunastomy,and then they received vein combined anesthesia and tracheal intubation.In the preventive analgesia group,10 mg dexamethasone and 200 mg parecoxib were administered by intravenous infusion before operation,7-8 mL ropivacaine (0.5％) were injected at the incisional site and transversus abdominis infiltration at open and close surgery and celecoxib was taken orally for 3 days.In the control group,vein analgesia pump was used after operation.The visual analogue scale (VAS),proportion of patients with postoperative out-off-bed activity time ＞ 8 hours,time of flatus,time of defecation and duration of hospital stay were recorded between the 2 groups.The measurement data with normal distribution were presented as x ± s.The comparison between groups was evaluated with the t test and repeated measures ANOVA.The data with skew distrubution and ordinal data were analyzed by the analysis of variance,and the count data were analyzed using the chi-square test.Results All the 161 patients who were screened for eligibility were randomly divided into the preventive analgesia group (87 patients) and the control group (74 patients).The scores of the VAS at postoperative day 1,2 and 3 were 2.8 ± 0.6,2.6 ± 0.4 and 1.8 ± 0.4 in the preventive analgesia group,and 5.3 ± 0.5,4.2 ± 0.6 and 2.4 ± 0.3 in the control group,with a significant difference between the 2 groups (F =4.25,P ＜ 0.05).The proportion of patients with postoperative first abmulation time ＞ 8 hours at postoperative day 1,2 and 3 were 8,17 and 20 in the preventive analgesia group,and 0,3 and 11 in the control group,with a significant difference between the 2 groups (x2 =7.60,10.26,3.16,P ＜ 0.05).The time of flatus,time of defecation and duration of hospital stay were (51 ± 24) hours,(61 ± 24) hours and (5.5 ± 3.0) days in the preventive analgesia group,compared with (71 ± 23) hours,(83 ± 30) hours and (6.3 ± 2.1) days in the control group,showing a significant difference between the 2 groups (t =5.32,5.04,0.17,P ＜ 0.05).All the patients in the 2 groups normally survived after surgery without respiratory depression,incision infection and adverse drug reaction.Conclusions Preventive analgesia in the perioperative treatment of patients with radical gastrectomy for gastric cancer could relieve the postoperative pain of patients,improve the bowel function and enhance the recovery of patients.Registry This study was registered with the Chinese Clinical Trial Registry with the registry number of ChiCTRTRC-11001440.

Objective To observe the effect of acupuncture penetrated from Tiaokou (ST38) to Chenshan (BL57) combined with exer-cise on affected limbs of shoulder-hand syndrome (SHS) at stage I after stroke. Methods 40 inpatients with SHS at stage I after stroke from January, 2013 to December, 2014 were randomly divided into treatment group (n=20) and control group (n=20). The treatment group accept-ed acupuncture from Tiaokou to Chenshan on unaffected sides and exercise of affected upper limbs, and the control group accetpted routine acupuncture on Triple Shoulder Acupoints on affected sides. They were assessed with Pain Rating Index (PRI), Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) before and 4 weeks after intervention. Results The incidence of improvement was 90% in the treatment group, and 80%in the control group (χ2=0.784, P=0.376). The scores of PRI decreased (t>5.37, P<0.001), and the score of FMA and MBI increased (t>4.66, P<0.001) significantly after intervention. The score of FMA and MBI improved more in the treatment group than in the control group (t>2.25, P<0.05). Conclusion Acupuncture from Tiaokou to Chenshan combined with exercise is more effective on SHS at stage I after stroke than conventional Triple Shoulder Acupoints.