Objective To analyze influence for structure and function of plasma through methylene blue method (MB) in the procedure of virus inactivation.Methods 30 fresh plasma,which were adopted through 400 ml bloods in 6 hours,were choosed randomly and connected with sterile filter with MB. The density of MB was approximately 0.9 ~ 1.3 mol/L. Blood plasma with added MB was placed into the shelf of 4 ℃ virus inactivation and shakem frequently 60 meta /min. Temperature was kept in 4 ℃ within 35min.MB and residual leukocytes were filtered by apparatus of virus inactivation. The surplus of 10 ml blood plasma was immediately placed in -80℃ refrigerator. Concentration of MB,FⅧ:C,FⅤ:C,VWF,Fib of plasma samples was tested before and after virus was inactivated.Results Recovery rates of the volume of plasma,FⅧ:C,FⅤ:C,VWF,Fib respectively were(97.29?2.03)%,(81.43?11.15)%,(80.12?14.03)%,(92.48?8.35)% and (82.86?19.13)% after virus was inactivated through methylene blue method.Conclusion Quality of blood plasma through inactivation of virus with methylene blue method was consistent with national standard and could satisfy clinical need in the precondition of blood safety.There was less influence for blood plasma component.

Objective To explore neuroprotective effect of escitalopram oxalate on cerebral ischemia reperfusion in injury rats and its possible mechanism,thus provide experimental evidence for the use of the drug in the clinical treatment of ischemic cerebrovascular disease.Methods 160 male rats of SD were selected and randomly divided into three groups:sham operation group(Sham group),negative control group(NS group),intervention group(CIT group,for 14 days and 21 days).Focal middle cerebral artery occlusion model(MCAO)of rats were constructed.Neurological deficit of rats in each group were evaluated by modified neurological severity score(mNSS)scale.Microvessel diameter,density,and total area of each group angiogenesis in cerebral ischemic area were observed by Laser cofocal technology after 14 days and 21 days at different time points;the plasma concentrations of VEGF were detected by ELASA,and expression levels of VEGF were detected by immunohistochemical assay and Western blot in each group,to explore its possible mechanism of molecular biology.Results After modeling,neurological deficit of intervention group for 14 days and 21 days were improved significantly.The indicators were as follows:scores of mNSS in NS group(6.57 ±1.13)was significantly higher than(4.39 ±0.92)in intervention group for 14 days(P<0.05);scores of mNSS in intervention group(3.23 ±0.55)for 21 days was significantly lower than(4.14 ±0.74)in intervention group for 14 days(P<0.01).Confocal 3D imaging results after 14 days showed:microvascular total area was significantly lager which illustrated that the effect of drug intervention for 14 days started to work over time.Plasma concentrations and expression levels of VEGF in intervention group for 14 days and 21 days were higher than those in Sham group,NS group.VEGF protein expression of cerebral ischemia tissues in intervention group for 21 days were higher than that of 14 days(P<0.01).Conclusion Escitalopram oxalate could significantly reduce cerebral ischemia and reperfusion in rats nerve injury and improve neurological function,which has a neuroprotective effect,the effect of drug intervention gradually increases over time,and the possible mechanism of which is related to angiogenesis mediated by VEGF.

Objective To explore the influence of pomegranate juice on cognitive behavior of chroniccerebral hypoperfusion in rats and its mechanism.Methods 48 healthy male Wistar rats were selected and randomly divided into 3 groups, sham operation group (SO), permanent bilateral persistence commancarotid artery occlusion or two-vesselocclusion (2VO) group, pomegranate juice group.Chronic cerebral hypoperfusion model was prepared in rats by permanent bilateral common carotid artery ligation.Given the intervention after operation 1 weeks, before the 2 groups were given by sugar water intragastric ( every 100 mL syrup containing 25 g,sucrose 2 g, fructose glucose 2 g) with pomegranate juice, pomegranate juice group ( polyphenol content of 2.4-4.8 mg/mL) were given by gavage,2 mL/d, a total of 7 weeks.8 th weeks after surgery, cognitive behavior ability of 3 groups was tested by space exploration target quadrant swimming time after an interval of 1day;CA1 region of 8-hydroxy deoxyguanosine (8-OHdG), 4-hydroxyl nonenal ( 4-HNE ) expression of 3 groups in cortex and hippocampus detected by immunohistochemical method; observed whether it could improve the chronic cerebral hypoperfusion in rats learning, memory ability, or had antioxidative stress injury.Results On the 4th day and 5th day, the time of rats in SO to find the platform and the shortest time, group 2VO for the longest time, compared with statistical significance between the three groups (P<0.01); the 3 groups of rats in the target quadrant emergence time in sham operation group, the longest (10.05+1.688)s, 2VO group has the shortest time (6.343 ±1.220) s, and there was statistical significance (P<0.05).The integral optical density of positive cells in 3 groups of rats cortex and hippocampal CA1 region of 4HNE, the value of the 8-OHdG IOD is the lowest in the sham operation group, 2VO group was the highest, with statistical significance.Pomegranate juice intervention, cortex of rats and hippocampal CA1 region of 8-OHdG, 4-HNE decreased significantly ( P <0.05).Conclusion Chronic cerebral hypoperfusion may cause oxidative stress injury, pomegranate juice can improve the low irrigation learning and memory ability of rats with chronic cerebral, decrease 8-OHdG and 4-HNE expression may play a protective function through antioxidative stress pathway.

Objective To study the diagnosis and management of extra-adrenal pheochromocytoma. Methods Eighteen patients with extra-adrenal pheochromocytoma were analyzed retrospectively.Among the 18 patients 13(72%) were men.The mean age at diagnosis was 30 years,with a range from 15 to 65 years.All the patients presented with hypertension.Other typical symptoms included headache and dizziness(67%),palpitation and sweating(44%),blurred vision (33%) and hematuria (28%).Of all the patients 89% were diagnosed with urine CA and VMA.Most of the tumors were located at the bladder (39%),para-aorta (28%) and renal hilus(22%). Results All the patients were treated with surgical operation including 14 total resection of tumor,1 simple resection of tumor and 3 biopsy.Two of the 18 cases were malignant according to the post-operative pathologic diagnosis.Five patients recurred 3 months to 10 years after operation. Conclusions The determination of CA and VMA in urine is valuable for the diagnosis and monitoring of postoperative recurrence.Ultrasonography and CT scanning are effective means for tumor localization.The perioperative management of controlling blood pressure and expansion of the blood volume are very important.Surgical extirpation is a good method for the effective treatment.Postoperative long-term follow up is necessary.

Intensity modulated radiation therapy(IMRT)has become the mainstay of treatment modal-ity for nasopharyngeal carcinoma(NPC). The whole treatment course generally continues 7 to 8 weeks. With the radiotherapy proceeding,the patients exhibit oropharyngeal reaction aggravating,weight losing and tumor shrinking,resulting in the changes of tumor target and surrounding tissue. Those changes may influence the dose distribution of tumor and organ at risk. It is necessary to modulate target volume during radiotherapy of NPC.

Objective To explore the protection effects of the reduced form of nicotinamide-adenine denucleotid(NADH) on cardiac fibroblasts apoptosis induced by hydrazine in vitro.Methods Cardiac fibroblasts isolated from neonate rats were divided into four groups.In NADH pretreatment before hydrazine treatment group,the cardiac fibroblasts were cultured first in the medium containing 400?g/ml NADH for 2 hours,and then cultured in the medium containing 400?g/ml NADH plus 2mmol/L hydrazine for 72 hours;in hydrazine treatment group,the cardiac fibroblasts were cultured first in normal medium containing 400?g/ml NADH for 2 hours and then cultured in the medium containing 2mmol/L hydrazine for 72 hours;in control group,the cardiac fibroblasts were cultured only in normal medium for 72 hours;and in NADH pretreatment control group,the cardiac fibroblasts were cultured in medium containing 400?g/ml NADH for 72 hours.After the treatments mentioned above,the changes in nuclear of apoptotic cardiac fibroblasts as stained by Hoechst33258 were observed under fluorescence microscope,the apoptotic and necrosis rates of cardiac fibroblasts stained by AnnexinⅤ/PI were assayed by flow cytometry,the mitochondria membrane potential of cells stained by rhodamine123 was also assayed by flow cytometry.Results Hydrazine could induce apoptosis of the cardiac fibroblasts.After NADH pretreatment,the number of apoptotic cardiac fibroblasts with pyknosis of nuclear was lowered,the rates of apoptosis and necrosis decreased,and the mitochondria membrane potential of cells was elevated.Conclusion NADH pretreatment could reduce the apoptosis induced by hydrazine by improving the function of mitochondria.

Objective To investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral stenosis (MS) and atrial fibrillation (Af) Methods The success rates of PBMV, changes of hemodynamic and echocardiographic indices after PBMV, restenosis rates during follow up and complications were observed in 125 patients with MS and Af (group Ⅰ) and 225 patients with MS in sinus arrhythmia (group Ⅱ) Results The success rate was 96% (120/125) and 99 6% (224/225) respectively in two groups ( P 0 05) respectively in two groups, but 5 cases of systemic embolization all occurred in group Ⅰ Conclusion PBMV was effective in patients with MS and Af, but not as good as in patients with sinus arrhythmia, so in patients with Af it should be much careful to select for PBMV and to prevent systemic embolization

To explore the effect of Problem-based learning (PBL)in the clinical clerk-ship of internal medicine,we applied PBL method and traditional method from 2006. Compared with the traditional method,PBL method and traditional method is a better way to enhance students'ability of analyzing and solving problems.But there are some problems related to the PBL in pretent stage of medical education in our country.

Objective:To analyze the clinical guidance value of 3.0 T three-dimensional time of fly magnetic resonance angiography (3D-TOF-MRA) in patients with trigeminal neuralgia (TN) who underwent microvascular decompression (MVD) treatment.Methods:The clinical and imaging data of 60 TN patients who underwent MVD treatment in Jinhua People′s Hospital from January 2019 to December 2019 were retrospectively analyzed. All patients underwent 3D-TOF-MRA examination before the surgery. The relationship and direction of the trigeminal neuralgia and surrounding blood vessels were observed, the responsible blood vessels that compressed the nerves before the surgery were determined, and vascular nerve compression (NVC) was clarified.Results:Among the 60 TN patients, pain symptoms of 52 patients (86.67%) completely disappeared after the surgery, and the pain symptoms of the remaining 8 patients (13.33%) were also significantly relieved. There was no statistically significant difference between 3D-TOF-MRA examination and MVD surgery in the judgment of the responsible vessel ( P>0.05). The positive rate of TN diagnosed by MVD surgery was 98.33% (59/60), and the positive rate of TN diagnosed by 3D-TOF-MRA was 91.67% (55/60), with no statistically significant difference ( P>0.05), and with highly consistency by Kappa test ( Kappa value=0.867). The area under the curve (AUC) of TN diagnosed by 3D-TOF-MRA through receiver operating characteristic (ROC) curve analysis was 0.730 (95% CI 0.526~0.934). The incidence of NVC diagnosed by 3D-TOF-MRA was 63.33%(38/60), and the incidence of NVC seen by MVD surgery was 61.67%(37/60). There was no statistically significant difference in the diagnosis of NVC between 3D-TOF-MRA and MVD surgery. ( P>0.05). Conclusions:The 3D-TOF-MRA examination can more accurately know the position, orientation, shape and compression degree of the responsible blood vessel in TN patients, which has important guiding value for the clinical diagnosis of TN and preoperative evaluation of MVD.

Objective To investigate possible changes of lipoprotein(a) [Lp(a)] and oxidized Lp (a) [ox-Lp(a) ] levels after PCI and it mechanisms. Methods Bloods were selected from 75 patients with ACS undergoing PCI, and at 24 hours, 2 and 3 days, and 6 months pre-and post-PCI treatment, and from 29 control patients pre-and post-coronary angiography without undergoing PCI. The levels of Lp(a) , ox-Lp(a) , Lp(a) immune complexes (IC) and its autoantibody were determined by ELISA. The extents of CAD were determined by coronary angiography. The differences of variants pre-and post-operations were analyzed by paired samples t test. The differences of levels of Lp(a) and ox-Lp(a) among time points after PCI were analyzed by ANOVA. Correlations between Lp(a) and ox-Lp(a) , and between angiographic variables and Lp(a), ox-Lp(a) levels were calculated. Results Compared to pre-PCI, Lp(a) [233.10 (152.86-328.79) mg/L vs 202.05 (106.15-271.42) mg/L, t=6. 81, P<0.01], ox-Lp(a) [19.05 (10.98-31.80) mg/L vs 10. 51 (4.98-17.97) μg/ml, t = 13. 22,P <0. 01] and Lp(a)-IC [2.72 (1.604.91) AU vs 2. 11 (1.04-3. 97) AU, t = 3. 34, P < 0. 01 ] levels significantly increased immediately in post-PCI, while its antoantibody levels significantly decreased (A = 0. 81 ± 0. 33 vs A = 0. 72 ± 0. 28, t = 5.58, P < 0. 01). Strong correlations were noted between levels of ox-Lp( a) and Lp( a) both in pre-PCI (r =0. 66, P <0.01) and post-PCI (r = 0. 62, P <0. 01). PCI resulted in rapidrise of Lp(a) and ox-Lp(a) levels and then decreased quickly in 24 hours, returned to baseline in 2-3 days. The changes of Lp(a) and ox-Lp(a) levels in pre-and post-PCI were positively related with severity of ACS. In contrast, in the angiography-only control group, no significant changes were noted in Lp(a) , ox-Lp(a) , Lp(a)-IC and Lp(a) autoantibodies levels between the pre-and post-angiography samples. Conclusion PCI results in acute plasma acute increases of levels of Lp(a) and ox-Lp(a) ,and the changes are related with lesion severity of the coronary artery.