Echocardiography plays an important role in diagnosing cardiac tumors and is helpful for subsequent treatment decision making.However,conventional echocardiography can hardly meet the clinical requirements of sufficient diagnosis,mostly due to the fact that it usually does little on identification of benign and malignant characters of tumors.Contrast echocardiography is a new technology using microbubbles as a contrast agent to trace the blood flow,which promotes the definition of endocardium lines and helps to reveal spaceoccupying abnormities in heart.Moreover,myocardial contrast echocardiography can be used to evaluate perfusions of intracardiac masses,and thus improves the accuracy of differential diagnosis enormously.

Zinc-finger protein X-linked is a member of zinc finger protein family.Its abnormal expression has been found in a variety of stem cells and malignant tumor cells.Recent studies have shown that it plays an important role in stem cell self-renewal and cancer cell proliferation,apoptosis and migration.

Objective To discuss the effect and related mechanism on epithelial?mesenchymal transition(EMT)process and invasive ability of the trophoblasts JEG?3 by targeted silencing of Notch?1 gene. Methods Notch?1?siRNA interference fragment was designed and synthesized to sta?bly transfect JEG?3 cells. Changes in the invasive ability of trophoblasts were detected by Transwell chamber invasion assay. The expressions of Notch?1 ,E?cadherin ,vimentin and EMT transcriptive regulators slug ,snail ,twist were analyzed in transfected trophoblasts by Western blot. Results The relative expression of Notch?1 protein in JEG?3 and the invasive ability of JEG?3 were significantly decreased after transfection with Notch?1?siRNA,the expression of the epithelial indictor E?cadherin was significantly increased while the mesenchymal indicator vimentin was de?creased with the reduction of EMT transcriptive regulators slug,snail and twist. Conclusion The invasion of trophoblasts was affected by targeted si?lencing of Notch?1 gene and Notch?1 can reduce the invasion of trophoblasts through influencing EMT process.

Objective To study the perception of patients and nurses for the artificial airway suction,in order to provide theoretical reference for building the artificial airway suction clinical practice guidelines.Methods CNKI,Wanfang,VIP,Pubmed,Science direct databases were searched for papers of patients and/or nurses' perception over the limited period of 2005 to 2013.The retrieved papers were analyzed.Results Nineteen eligible papers were identified.Extract relevant contents found the majority of patients retained the memory of that airway suction,mainly for pain,choking,suffocation,and eager to get the relevant knowledge and information.There were few researches on nurses' subjective feeling about airway suction.Conclusion We should pay attention to the perception of patients,while strengthening the research on nurses' perception of artificial airway suction and improve communication with patients,in order to relieve their discomfort experience,and could be helpful for the building of airway suction clinical practice guidelines.

Objective To investigate the correlation between the Periostin and Epithelial-Mesenchymal Transition(EMT) markers(E-cadheirn and N-cadheirn) in colorectal cancer(CRC),and analyze the relationship between the expression of Periostin and clinicopathological parameters.Methods The expression of Periostin,Ecadheirn and N-cadheirn in 106 cases with primary CRC tumors and corresponding normal tissues were detected by Immunohistoehemistry and the results were analyzed.Results The expression of Periostin,E-cadheirn and N-cad-heirn in tumors were significantly high expression than those in corresponding normal tissues(62/106 vs 21/106,x2 =34.027,P ＜ 0.05 ;43/106 vs 89/106,x2 =42.480,P ＜ 0.05 ; 66/106 vs 19/106,x2 =43.382,P ＜ 0.05).The expression of Periostin in tumors was associated significantly with tumor differentiation,tumor invasion,lymph node metastasis and distance metastasis (x2 =7.752,P =0.007; x2 =5.008,P =0.031 ; x2 =10.227,P =0.002;x2 =8.001,P =0.006).It was negatively correlated with E-cadherin expression (r =-0.435,P ＜ 0.001),but positively correlated with N-cadherin expression (r =0.213,P =0.028).Conclusion Periostin may promote the occurrence and development of CRC by participating in EMT program.

Objective To assess the risk factors for the occurrence of hypokalemia in patients with hepatic cancer after transcatheter arterial chemoembolizaion (TACE) therapy,and to discuss the corresponding nursing countermeasures.Methods The clinical data of 214 patients with hepatic cancer,who received TACE during the period from August 2014 to February 2015,were retrospectively analyzed.The risk factors causing hypokalemia were analyzed.Results Among the 214 patients,post-TACE hypokalemia occurred in 23 (10.7％).The main risk factors that could cause hypokalemia included anorexia,hydration,vomiting,ascites drainage,sweating.After actively symptomatic treatment,the serum potassium level returned to normal in 22 patients.One patient developed hepatic encephalopathy coma complicated by hepatorenal syndrome,the patient's family members gave up treatment and,according to family members' will the patient left hospital.Conclusion anorexia,vomiting,hydration,ascites drainage,sweating are the risk factors that can cause hypokalemia in patients with hepatic cancer after TACE therapy.The use of low potassium risk scale is helpful for the formulation of nursing countermeasures.

Objective To investigate the efficacy of proton pump inhibitors (PPI) combined with flupethixol melitracen in the treatment of non-erosive gastroesophageal reflux disease (NERD) with anxiety and depression.Methods Fifty six NERD patients with anxiety and depression were evenly divided into the positive treatment group and positive control group.Thirty NERD patients without anxiety and depression were set as negative control group.Both flupethixol melitracen (20 mg per day after breakfast) and PPI esomeprazole magnesium (20 mg per day,20 minutes before breakfast) were administrated in positive treatment group.Only esomeprazole magnesium was given in positive control group and negative control group and the dosage was same as that of positive treatment group.The treatment course of three groups was eight weeks.Before and after the treatment,the symptoms of patients were scored according to gastroesophageal reflux disease questionnaire (GERDQ),Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD) and Pittsburgh sleep quality index (PSQI).Adverse effects were also observed.Variance analysis was performed for the comparison among three groups.Variance analysis or Post-hoc analysis were used for comparison between two groups.Results The differences of different score value before and after treatment of three groups were statistically significant in total score of GERD Q,score of type A,score of type C,score of HAMA,score of HAMD and PSQI (F=6.32,3.93,5.63,49.61,78.69 and 7.07,all P＜ 0.05).The differences of the score value before and after treatment of positive treatment group in total score of GERD Q,score of type A,score of type C,score of HAMA,score of HAMD and PSQI (4.24±2.05,3.16±1.46,1(0,3),9.32±3.21 and 8.88±2.92) were all higher than those of positive control group (2.38±2.22,1.68±1.33,0(0,2),3.72±2.95 and 3.84±1.97) and negative control group (2.32±2.18,2.48±1.34,0(0,1),2.36±1.25 and 2.36±0.79).And the differences were statistically significant (positive treatment group vs positive control group:Post-hoc analysis,P=0.002,0.022,0.003,0.002 and 0.002; positive treatment group vs negative control group:Post-hoc analysis,P=0.001,0.021,0.004,0.001 and 0.001).The difference of the score value before and after treatment of positive treatment group in PSQI (4 (2,6)) was higher than that of negative control group (2 (1,3),Post-hoc analysis,P=0.001).Two cases of positive treatment group had mild dizziness and the symptom relieved after three to four days.Conclusions For NERD patients with anxiety and depression,anti-depression drug flupenthixol melitracen can be used and the effect is superior to using PPI alone.

BACKGROUND:Intertrochanteric fracture is one of the most common fractures in older adults. The surgical treatment methods include artificial joint replacement (total hip and femoral head replacement) and internal fixation (proximal femoral nail anti-rotation and dynamic hip screw), but there is no clear evidence to evaluate the effect of them. OBJECTIVE: To compare the effect difference of arthroplasty and internal fixation in the treatment of intertrochanteric fracture in the elderly people. METHODS:We retrieved randomized controled studies on artificial joint replacement (total hip and femoral head replacement) and internal fixation (proximal femoral nail anti-rotation and dynamic hip screw) in the treatment of intertrochanteric fracture from 1990 to 2015. Meta-analysis was used to compare operation time, intraoperative bleeding volume, one-year postoperative Harris hip scores, and one-year postoperative complication between the arthroplasty and internal fixation. RESULTS AND CONCLUSION:(1) Twenty-one studies were included. (2) Intraoperative bleeding volume and one-year postoperative Harris hip scores were higher in the arthroplasty group than in the internal fixation group. (3) Operation time was similar between the arthroplasty and internal fixation groups. (4) Complication rate was lower in the arthroplasty group than in the internal fixation group. Incidence of complications was closed between the arthroplasty and internal fixation groups. (5) Results suggested that the effect of arthroplasty was better than internal fixation for treating intertrochanteric fracture in the elderly. However, prospective large-sample long-term randomized controled trials are needed for verification.

Objective To investigate the effects of adenovirus containing human beta-nerve growth factor (Ad-hNGFβ) gene on substance P (SP) and calcitonin gene-related peptide (CGRP) content of the spinal cord in a rat model of neuropathic pain by chronic constrictive injury (CCI). Methods Forty-eight male SD rats weighing 200-250 g were randomly divided into 3 groups (n=16 each) : group Ⅰ sham operation; group Ⅱ CCI and group Ⅲ CCI + Ad-hNGFβ gene IT. The animals were anesthetized with intraperitoneal choral hydrate 300-350 mg/kg. The right sciatic nerve was exposed and 4 ligatures were placed on the sciatic nerve at 1-2 nun intervals as described by Bennet and Xie[5]. In sham operation group, right sciatic nerve was exposed but not ligated. In group Ⅰ and Ⅱ artificial cerebrnspinal fluid was injected IT instead of Ad-hNGFβ gene. The behavior score and the paw-withdrawal latency (PWL) to radiant heat and mechanical stimulus were measured one day before operation and every 4 days within the 28 days after gene transfection. Four animals were killed at 4, 7, 14 and 28 day after IT gene transfection in each group and lumbar segment (L4-6 ) of the spinal cord was removed for determination of SP and CGRP content by immunohistochemistry. Results The behavior scores were significantly higher and PWL to radiant heat and mechanical stimulus were significantly lower in group Ⅱ and Ⅲ than in group Ⅰ. There was no significant difference in the behavior score and PWL to mechanical stimulus between group Ⅱ and Ⅲ while the PWL to radiant heat was significantly higher in group Ⅲ than in group Ⅱ. After operation SP and CGRP content were significantly higher in group Ⅱ and group Ⅲ than in group Ⅰ , and significangly lower in group Ⅲ than in group Ⅱ 7-28 days after operation. Conclusion The recomhinant Ad-hNGFβ gene transfection can attenuate heat hyperalgesia by reducing SP and CGRP content of the spinal cord in a rat model of neuropathic pain induced by CCI.

Objective:To assess whether Veronicastrum axillare (V. axillare) can ameliorate ethanol-induced gastric mucosal lesions in rats, reduce the production of pro-inflammatory cytokines, suppress apoptosis and improve local microcirculation disturbances.
Methods:Totally 48 male Sprague-Dawley rats were randomly divided into six groups, eight rats in each group. Rats in the normal group and the model group were administered with 0.9%normal saline respectively. Rats in the positive group and ranitidine group were administered with 0.18% ranitidine suspension by intragastric administration respectively. Those in the high dose V. axillare group, the medium dose V. axillare group and the low dose V. axillare group were administrated with V. axillare at the daily dose of 2.8 g/kg, 1.4 g/kg and 0.7 g/kg by intragastric administration. Gastric mucosal lesions were produced by intragastric administration of absolute ethanol. Water extract of V. axillare was successively injected for 14 d and last day was injected 1 h before ethanol administration. Gastric mucosal ulcer index and ulcer inhibitory rate were counted by improved Guth methods. The tissue sections were made for pathological histology analysis. Also, we measured the concentrations of tumor necrosis factor-α (TNF-α) and endothelin-1 (ET-1) in gastric mucosal, as an index of the pro-inflammatory cytokines, apoptosis and local microcirculation. Besides, the mRNA contents of TNF-αand ET-1 were measured to verify effects on gene expression by real-time fluorescent quantitative PCR.
Results: Water extract of V. axillare significantly ameliorated the gastric mucosal lesions induced by ethanol administration (P<0.01). Pro-inflammatory cytokines, TNF-αand ET-1 were increased after ethanol administration and significantly reduced by water extract of V. axillare. The expressions of TNF-αand ET-1 mRNA were also be inhibited by water extract of V. axillare.
Conclusion: Current evidences show water extract of V. axillare is effective for defending against ethanol-induced gastric mucosal lesions, significantly inhibiting the production of pro-inflammatory cytokines and the expressions of TNF-αand ET-1 mRNA, which may be useful for inhibiting apoptosis and improving local microcirculation.