Objective To compare the antalgic effects of ropivacaine in various doses on brachial plexus nerves. Methods 87 patients undergoing upper arm surgery were enrolled in this study. The patients were unpremed-itated. The patients were randomized to receive ropivacaine of 0.30,0.25 or 0.20% (group Ⅰ,Ⅱ and Ⅲ) with mor-phine of 0.1mg/ml and Lidocaine of 10mg/ml. In order to analygesia of brachial plexus nerves,the rejecting of load dose is firstly 10ml,the total dose is 10ml/24h interval every time,the antalgic time is about 50 hours. To compare the antalgic effects of ropivacaine in various doses based on standard of VAS. Based on standard of Bromage to assess the situation of motor neuron blocking. Results According to standard of VAS in 6,12,24 and 48 hours after underwent surgery, the group Ⅲ is more effective than group Ⅰ and group Ⅱ ; according to standard of Bromage, the group Ⅰ is more effective than group Ⅱ and group Ⅲ. it has no adverse reactions to patients. Condusion 0. 25% of ropiva-eaine with morphine of 0.1mg/ml and lidocaine of 10mg/ml have obtained good antalgic effects for patients after un-dergoing upper arm surgery,it is fit for applying in clinic.

Objective To evaluate the effect of high-level spinal cord injury(SCI)on the expression of mitochondrial voltage-dependent anion channel 2(VDAC2)in rat cardiomyocytes.Methods Forty-eight pathogen-free healthy adult male Sprague-Dawley rats,weighing 200-250 g,were divided into 2 groups(n=24 each)using a random number table:sham operation group(group S)and high-level SCI group(group H).The animals were anesthetized with intraperitoneal chloral hydrate and subjected to SCI using the modified Allen weight-drop method in group H.The spinal cord was only exposed in group S.At 6,12,24 and 48 h after SCI(T1-4),6 rats in each group were randomly selected and sacrificed,and myocardial specimens were collected from the cardiac apex for microscopic examination of the cell morphology(with a transmission electron microscope) and for determination of cell apoptosis(by TUNEL assay),expression of Bax,Bcl-2 and VDAC2 protein and mRNA in cardiomyocytes(by Western blot and real-time polymerase chain reaction,respectively).The apoptosis rate and ratios of Bax/Bcl-2 protein and mRNA were calculated.Results Compared with group S,the apoptosis rate and ratios of Bax/Bcl-2 protein and mRNA were significantly increased at T1-4,the expression of VDAC2 protein and mRNA was significantly down-regulated at T2-4(P<0.05 or 0.01),and the pathologic changes of cardiomyocytes were aggravated in group H.Conclusion The mechanism of myocardial damage is related to down-regulation of mitochondrial VDAC2 expression in cardiomyocytes and promotion of cell apoptosis in rats with high-level SCI.

Objective To investigate the effects of Notch signaling pathway on proliferation of insulin-induced endometrial carcinoma cells and apoptosis related protein expression levels.Methods The endometrial carcinoma Ishikawa 3-H-12 cell line was primarily cultured and subcultured in vitro.Then,the cultured cells were divided into five groups:the control group (3 mL PBS was added into the group),the insulin group (cells were stimulated by 1 × 106 mol/L insulin) and MW167 groups (different doses of γ-secretase inhibitor MW167 pretreated with insulin stimulation).After 48 h culturation,inhibition of endometrial carcinoma cell growth of each group was measured by MTT-colorimetric method,the apoptosis-related proteins (Caspase-3,Caspase-8) and Notch1 protein expression levels of each group were determined by Western blot.Results Insulin can promote Notch1 protein expression in endometrial carcinoma cells,after 48 h insulin stimulation,the Notch1 protein expression level was significantly higher than that in the control group (P＜0.05).MW167 can inhibit insulin-induced Notch1 protein expression in a concentration-dependent inhibition manner.The absorbance at 570 nm (A570) of endometrial carcinoma cells cultured for 24,48 and 72 h in different groups were significantly different (P＜0.05).The A570 values in the insulin group at each time point were higher than those in the control group (P＜0.05),and the insulin-induced endometrial carcinoma cell proliferation reached its highest level at 48 h.MW167 inhibited insulin-induced endometrial carcinoma cells proliferation in a concentration-and time-dependent manner,and 20 μmol/L MW167 persistently inhibited insulin-induced proliferation of endometrial carcinoma cells at 48 h.Western blot analysis showed that expression levels of Caspase-3 and Caspase-8 protein in the insulin group at each time point were lower than those in the control group (P＜0.05),and MW167 promoted the expressions of Caspase-3 and Caspase-8 in a concentration-and time-dependent manner.Conclusion MW167 can suppress the insulin-induced endometrial carcinoma cells proliferation and promote the expression of related apoptotic proteins by inhibiting Notch signaling pathway,and induce apoptosis of endometrial carcinoma ceils.

Objective To evaluate the application efficacy of the whole-course optimized nursing in emergency treatment of patients with acute cerebral infarction (ACI).Methods A total of 93 patients with ACI received whole-course optimized nursing in emergency treatment,the time from diagnosis to intravenous thrombolysis (DNT) and triage time were recorded,and the changes of neurological function deficit severity and activities of daily living (ADL) before and after treatment and 3 months after discharge were observed.Results The DNT was all controlled within 60 min,with average of (51.84 ±6.21) min and triage time of (0.71 ± 0.19) min.After treatment and 3 months after discharge,National Institutes of Health Stroke Scale (NIHSS) score was markedly lower while Barthel index (BI) score was notably higher than treatment before,and differences were significant (P ＜ 0.05).Conclusion Application of whole-course optimized nursing is beneficial to the recovery of neurological function and the improvement of ADL in patients with ACI.

Objective To evaluate the application efficacy of the whole-course optimized nursing in emergency treatment of patients with acute cerebral infarction (ACI).Methods A total of 93 patients with ACI received whole-course optimized nursing in emergency treatment,the time from diagnosis to intravenous thrombolysis (DNT) and triage time were recorded,and the changes of neurological function deficit severity and activities of daily living (ADL) before and after treatment and 3 months after discharge were observed.Results The DNT was all controlled within 60 min,with average of (51.84 ±6.21) min and triage time of (0.71 ± 0.19) min.After treatment and 3 months after discharge,National Institutes of Health Stroke Scale (NIHSS) score was markedly lower while Barthel index (BI) score was notably higher than treatment before,and differences were significant (P ＜ 0.05).Conclusion Application of whole-course optimized nursing is beneficial to the recovery of neurological function and the improvement of ADL in patients with ACI.

[ ABSTRACT] AIM:To investigate the depressant effect of FK228 combined with rapamycin on the human breast cancer cell line MCF-7 and MDA-MB-435.METHODS:FK228, a new histone deacetylase inhibitor, and rapamycin, the specific inhibitor of the mammalian target of rapamycin ( mTOR) protein, were used in the study.MCF-7 cells and MDA-MB-435 cells were exposed to different concentrations of FK228 and rapamycin.The inhibitory rate of cell growth was de-termined by SRB assay.Combination index ( CI) was used to evaluate the interaction between FK228 and rapamycin.The expression of the apoptotic proteins, cycle proteins and nucleic acid proteins were detected by Western blotting.The cell cycle was analyzed by flow cytometry.RESULTS: Both FK228 and rapamycin showed growth inhibitory effects on the breast cancer cell lines in a time-and dose-dependent manner.CI of the 2 drugs was less than 1 when the inhibitory rate of the cell growth was 50%effective dose (ED50)~ED70, indicating a synergistic effect.The combination therapy of FK228 with rapamycin increased the apoptotic proteins, and induced the down-regulation of phosphorylated Akt and over-expres-sion of caspase-3 compared with a single use of the drugs.The combination therapy of FK228 with rapamycin reduced the cycle proteins, and the cell cycle was arrested in G2/M.The levels of phosphorylated H2AX and acetylated H3 were ob-viously increased after combination therapy.CONCLUSION:The combination therapy of FK228 with rapamycin inhibits the cell proliferation and increases apoptosis with a synergistic effect, which may become a new trend for treating endometri-al cancer.

Objective To explore the intervention method of PAV to improve the treatment quality of neonatal respiratory failure ( NRF) . Methods A total of 86 preemy with NFR treated with PAV, and randomly divided the into control group ( 44 cases ) and observation group ( 42 cases ) . The infants of control group received the routine nursing care, and the patients of observation group were given comprehensive nursing intervention. Results The average mechanical ventilation time, the average oxygen inhalation time and the average hospitalization time in observation group were shorter than those of control group, and the differences were statistically different ( P < 0. 05 ); the incidence of complication during the application of PAV in observation group was 9. 52%, and 25. 00% in control group (χ2 =4. 925,P <0. 05). Conclusions The standardized PAV nursing intervention can decease the incidence rate of NRF, shorten mechanical ventilation time and improve the treatment quality of NRF.

Objective:To explore imaging characteristics of children with 2019 novel coronavirus (2019-nCoV) infection.Methods:A retrospective analysis was performed on clinical data and chest CT images of 15 children diagnosed with 2019-nCoV infection. They were admitted to the Third People′s Hospital of Shenzhen from January 16 to February 6, 2020. The distribution and morphology of pulmonary lesions on chest CT images were analyzed.Results:Among the 15 children, 5 were males and 10 females, aged from 4 to 14 years. Five of the 15 children were febrile and 10 were asymptomatic on the first visit. The first nasal or pharyngeal swab samples in all the 15 cases were positive for 2019-nCoV nucleic acid. For their first chest CT images, 6 patients had no lesions, while 9 patients had pulmonary inflammatory lesions. Seven cases had small nodular ground glass opacities and 2 cases had speckled ground glass opacities. After 3 to 5 days of treatment, 2019-nCoV nucleic acid in a second respiratory sample turned negative in 6 cases. Among them, chest CT images showed less lesions in 2 cases, no lesion in 3 cases, and no improvement in 1 case. The remaining 9 cases were still positive in a second nucleic acid test. Six patients showed similar chest CT inflammation, while 3 patients had new lesions, which were all small nodular ground glass opacities.Conclusions:The early chest CT images of children with 2019-nCoV infection are mostly small nodular ground glass opacities. The clinical symptoms of children with 2019-nCoV infection are nonspecific. Dynamic reexamination of chest CT and nucleic acid are important.

Objective To evaluate the risks of malnutrition and nutritional status of patients with esophageal cancer during radiotherapy , so as to explore nursing countermeasures to improve their nutritional status.Methods 60 inpatients with esophageal cancer receiving routine radiotherapy from June 2012 to April 2013 were investigated with anthropometric indicators and laboratory data for weekly nutritional evaluation on admission, during radiotherapy, and after radiotherapy.Meanwhile, the patients were conducted with Nutritional Risk Screening ( NRS2002 ) per week .Results NRS2002 score showed that the malnutrition risk values of patients with esophageal cancer gradually increased after radiotherapy .The score was (2.06 ±1.22) after 2 weeks of radiotherapy, suggesting that the difference was statistically significant (t=-2.457, P<0.05). After the radiotherapy , the scores of body mass index ( BMI ) , triceps skinfold ( TSF ) , arm circumference (AC), total protein (TP), albumin (ALB) and total lymphocyte count (TLC) were (20.21 ±2.69)kg/m2, (7.27 ±3.20)mm, (24.71 ±2.68)cm, (65.50 ±5.25)g/L, (38.48 ±5.00)g/L and (6.55 ±3.42) × 109/L, respectively, compared with those of admission , they decreased gradually in the subsequent weekly examinations and had statistical significance ( t=3.204,2.777, 3.053,7.174,5.685,12.508, respectively;P<0.05).After 2 weeks of radiotherapy, the incidence of malnutrition increased compared to that of admission, and the scores of TSF, TP and TLC were 95.00%, 11.67% and 98.33% respectively, which showed the statistically significant difference (χ2 =11.800, 7.792, 73.024, respectively; P <0.05 ). Conclusions Patients with esophageal cancer gradually have higher risk of malnutrition and worse nutritional status during radiotherapy and their incidence of malnutrition increased after 2 weeks of radiotherapy .

Objective:To explore the application value of four-dimensional ultrasound combined with maternal serological screening in fetal facial deformities.Methods:A total of 106 pregnant women at mid pregnancy,whose fetuses with suspected fetal facial deformities and who conducted prenatal screening in Sanya Maternal and Child Health Hospital(Sanya Women and Children's Hospital)from January 2020 to December 2022,were selected.All of them underwent four-dimensional ultrasound and maternal serological screening.The results of delivery or induced labor were used as the gold standard of diagnosis to compare the diagnostic values of single four-dimensional ultrasound,single maternal serological screening and the combination of them for fetal facial deformities.Results:The analysis of the receiver operating characteristic(ROC)curve showed that the area under curve(AUC)values of four-dimensional ultrasound,maternal serological screening and the combination of them were respectively 0.932,0.863 and 0.981 in diagnosing fetal facial deformities.Both the sensitivities and accuracies of four-dimensional ultrasound and maternal serological screening were significantly lower than those of the combined diagnosis of them in diagnosing fetal facial deformities,and the differences of them were statistical significance(x2=11.173,0.064,P<0.05),respectively.Conclusion:Four-dimensional ultrasound combines with maternal serological screening can improve the diagnostic accuracy for fetal facial deformities.