Cocaine is usually used in clinical local anesthesia. However, because of its excitatory effect, it is also abused by some people, and thus results in the onset of disease. Since the first cocaine-related stroke was reported in 1977, many researchers have gradually realized that cocaine abuse causes many cerebrovascular diseases; its exact pathophysiological mechanism remains unknown and it may be involved in a variety of mechanisms.

Objective To investigate the clinical effect of Yimucao Injection combined with oxytocin in preventing postpartum hemorrhage after cesarean section.Methods 500 cases of pregnant women with cesarean section who were treated in Leshan Maternal and Child Health Hospital from January 2011 to June 2016 were divided into two groups randomly.The patients in the control group were only given oxytocin,while the patients in the observation group were given Yimucao Injection combined with oxytocin.To observe the clinical effect of the two groups,the amount of intraoperative hemorrhage volume,postoperative 2h bleeding,postoperative 24 h bleeding volume,the duration time of postpartum hemorrhage and hospitalization time,and the occurrence of adverse reactions in the two groups.Results The total effective rate of observation group was 90.40％ (226/250),which was significantly higher than the control group 73.20 (183/250) (P ＜ 0.05).Compared with the control group,the amounts of blood loss,2 h postoperative bleeding volume and 24 h postoperative bleeding volum in observation group were significantly decreased (P ＜ 0.05).The duration time of postpartum hemorrhage and hospitalization time in observation group were significantly shorter than the control group (P ＜ 0.05).24 h hemoglobin and red blood cell of the observation group were significantly lower than that of the control group (P ＜ 0.05).The incidence of adverse reactions was significantly lower than that of the control group (P ＜ 0.05).Conclusion Yimucao Injection combined with oxytocin can effectively reduce the amount of bleeding,shorten the time of bleeding and hospitalization time,safe and effective,which is worthy of clinical application.

Objective To study the changes of serum high mobility group box 1 protein ( HMGB-1 ) in patients with traumatic acute lung injury (ALI) and determine its correlations with MODS,acute physiology and chronic health evaluation ( APACHE Ⅱ ) scores and whether it can predict the incidence of MODS and mortality.Methods Forty cases of ALI were divided into MODS group (n =13) and nonMODS group (n =27) according to the MODS evaluation standard.The serum HMGB-1 was determined in the control group ( 10 healthy persons) and the MODS and non-MODS groups at days 1,4 and 7.The MODS and APACHE Ⅱ scores were also evaluated.Results Between the groups,the HMGB-1 level at days 1,4 and 7 in non-MODS group was higher than that in the control group,while lower than that in MODS group (P＜0.05).Within the non-MODS group,the expression of HMGB-1 showed a high level at day 4 compared with that at day 1 ( P ＜0.01 ) ; the HMGB-1 showed a low level at day 7 with clinical symptom improvement compared with that at day 4,and was even lower than that at day 1 ( P ＜ 0.01 ).Within the MODS group,the serum HMGB-1 level was significantly increased,and continued for several days; the HMGB-1 was decreased slightly at day 7 in comparison with that at day 4,but was still higher than that at day 1.The difference of MODS and APACHE Ⅱ score was significant,with the dynamic change of HMGB-1 level at days 1,4 and 7 after traumatic ALI.The correlative analysis showed that HMGB-1 expression level was remarkably related with MODS score and APACHE Ⅱ score.Conclusions HMGB-1 shows a high expression in patients with traumatic ALI.As a late mediator of inflammation,HMGB-1 usually increases relatively late and lasts for a long duration.HMGB-I level and concurrency MODS are closely related.Routine test of serum HMGB-1 level and joint assessment of MODS and APACHE Ⅱ score are contributive to the prediction of organ dysfunction after traumatic ALI.

Objective To discuss the correlation between procrastination and the mentalities of anxiety and depression among medical postgraduates,so as to carry out mental health work effectively.Methods 423 medical postgraduates in Central South University were assessed randomly, using General Procrastination Scale (GPS),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale (SDS).Results Procrastination score and incidence in medical postgraduates was 54.92±8.40 and 60.99%respectively,the differences of procrastination scores(53.3l±8.21,55.90±8.30,55.75±8.49,P=0.013)and incidences(52.60%,66.09%,65.58%.P =0.028)among three grades were statistically significant.Both total coarse score of anxiety and that of depressionwere higher than that of the whole country(31.24±7.40,29.78±10.07,P=0.000;34.8±8.11,33.46±8.55,P=0.000),the differences were statistically significant.Procrastination had a positive correlation with anxiety and depression significantly(r=0.304,P=0.000;r=0.369,P=0.000),the higher the grade was,the weaker the intensity of correlation was.Hish-delay group,low-delay group and normal-behavior group had different deglees of anxiety(46.63±10.55,44.01±10.12,38.32±7.57,P=0.000)and depression(51.45±10.12,47.81±10.78,40.69±8.23,P=0.000),which was statistically significant.Conclusion Anxiety and depression among medical postgraduates were outstanding and had a close relationship with procrastination behavior,which should be taken seriously and handled by strengthening mental health education.

Objective: To detect the gene expression of Ku70, Ku80, ERCC4, lig4 and DNA-PKcs in non-homologous end joining pathway in human pdmary glioma tissues and normal brain tissues and to explore the underlying mechanism. Methods: The expression levels of Ku70, Ku80, ERCC4, lig4 and DNA-PKcsin in 36 glioma samples and 12 normal brain tissue samples were measured by SYBR Green real-time quantitative PCR. Methylation of DNA-PKcs was detected by methylation-specific PCR (MSP). Results: There was no significant difference in Ku70, Ku80, ERCC4 and lig4 expression between human primary glioma and normal brain tissues (P<0.05), while DNA-PKcs was significantly up-regulated (P= 0.002). The expression of DNA-PKcs was significantly higher in grade Ⅲ and Ⅳ glioma than that in grade Ⅱ glioma and normal brain tissues (P<0.05). Moreover, glioma tissues showed weaker methylation than normal brain tissues. Conclusion: The up-regulation of DNA-PKcs may be associated with pathogenesis of glioma. Demethylation of DNA-PKcs promoter is an important reason for its up-regulated expression in glioma.

Medical students face higher levels of stress compared to the general population. Statistical analyses of questionnaire surveys were made to compare the teaching effect between traditional teaching and PBL.The results indicate that the PBL teaching is more conducive to students to relief from the course-related stress in medical colleges.

Objective To observe the anesthesia related effect of dexmedetomidine conscious sedation on Laryngeal mask airway general anesthesia in Parkinson patients with deep brain electric stimulus implantation.Methods Forty patients (72 males, 8 females, aged 18-75 years, ASA physical status Ⅰ or Ⅱ) of Parkinson disease with selective operated bilateral subthalamic nucleus deep brain electric stimulus implantation were selected and randomly divided into dexmedetomidine group (group D) and contrast group (group C), 20 cases in each group.The operation divided into two stages: in the first stage, the electrode was put under the local anesthesia, CT examination proof of electrode placement satisfaction was the end of the first stage.The second stage needed to bury the pulse generator under of the chest skin under general anesthesia.For group D, dexmedetomidine 0.5 μg/kg was pumped venously within 15 min after entering the operating room, the speed of 0.1-0.3 μg·kg-1·h-1 was kept subsequently until the end of the first period.For group C, the same dosage of normal saline was pumped.The times of micro-electrode interference, tremor relief were recorded.Ramsay scores of two groups of patients were recorded at the entry of operating room (T0), partial infiltration anesthesia (T1), unilateral electrode implantation (T2), contralateral electrode implantation (T3), the end of the first period (T4);the time needed to vanish consciousness, implant laryngeal mask airway, recover the spontaneous breathing and extubation were recorded;the propofol, remifentanil dosage from the beginning of general anesthesia induction to the end of the surgery were recorded.Results The micro-electrode was intervened and tremble was relieved in both two groups.Compared with group C, the ramsay scores of T1-T4 were obviously increased in group D (P<0.05), the time needed to vanish consciousness, implant laryngeal mask airway, recover the autonomous respiration, extubation were significantly shortened in group D (P<0.05), the dosage of propofol, remifentanil from the beginning of the general anesthesia starts to the end of the surgery were significantly reduced in group D (P<0.05).Conclusion Dexmedetomidine provided the excellent sedation to the first period of Parkinson patients with deep brain electric stimulus implantation;it can shorten the time of the anesthesia induction and awakening time, as well as decreases propofol and remifentanil dosage.

Through the addition of discussion course associated with judicial expertise during the pre medical education, integration of true and typical forensic pathological cases into basic medical theory and experimental education, further addition of optional course of forensic medicine,and guiding the medical students applying the scientifically training projects about forensic pathology, students may improve their learning interesting and clinical thought, and are made early warning and increase the abilities of preventing and dealing with the suddenly medical tangles in the future, at the same time, the medical teachers also increase their professional levels and teaching qualities.These benefit the growing up of high quality medical doctors, decrease and even prevent the happening of medical tangles.

Background and purpose: Resistance of cancer cells to chemotherapy is a major clinical obstacle to successful treatment and leads to poor prognosis for the patients. MicroRNA (miRNA) plays a vital role in tumor cells response to chemotherapeutic agents. This study plans to investigate the expressions of miRNA27a and miRNA451 in ovarian cancer and breast cancer cells and its correlation with drug resistance. Methods:A2780/Taxol cells were established using stepwise selection;Stem-loop quantitative real-time PCR (stem-loop RT-PCR) was used to detect expression of miRNA27a and miRNA451 in ovarian cancer and breast cancer cells. The A2780 and A2780/Taxol cells were transfected with the mimics or inhibitors of miRNA27a or negative control (NC) RNA and the mimics of miRNA451 or NC were transfected into MCF-7/ADM cells by LipofectamineTM 2000. The expression levels of MDR1 mRNA and P-glycoprotein (P-gp) were examined using RT-PCR and Western blot respectively. MTT method was used to analyze drug sensitivity. Results:The expression of miRNA27a was an average of (2.2±0.30) times higher in A2780/Taxol cells than in A2780 cells, with a significant difference between the two groups (P<0.05). The expression of miRNA451 was lower by 84%in MCF-7/ADM cells than in MCF-7 cells, with a signiifcant difference between the two groups (P<0.05). A2780/Taxol cells transfection with inhibitors of miRNA27a showed that the levels of MDR1 mRNA was decreased by (39±0.14)%, P-gp level [(26±5.3)%] decreased compared with the NC group [(43±6.7)%], the IC50 (0.53μmol/L) was less than the NC group (6.8μmol/L), and there was a signiifcant difference between two groups (P<0.05). Transfection of A2780 cells with mimics of miRNA27a led to increase MDR1 mRNA expression by (121±0.11)%and decrease the sensitivity to paclitaxel (IC50:0.2μmol/L vs 0.06μmol/L). There was a signiifcant difference between two groups (P<0.05). Transfection of MCF-7/ADM cells with mimics of miRNA451 showed that expression of MDR1 mRNA was decreased by (65±12)%, P-gp [(31±19)%] was less than the NC group [(83±12)%], the sensitivity of cells to adriamycin enhanced and the IC50 of adriamycin (4.61μmol/L) was less than the NC group (26μmol/L), and there was a signiifcant difference between two groups (P<0.05). Conclusion:The expressions of miRNA27a and miRNA451 are deregulated in A2780/Taxol and MCF-7/ADM cells respectively, which may play vital roles in drug resistance by regulating MDR1/P-gp expression directly or indirectly.

Objective To study the clinical and pathological characteristics of HPV-negative cervical cancer patients. Methods Retrospective analysis of 785 cervical cancer patients in Guangdong Women and Children Hospital from Jan. 2005 to Oct. 2015. By detecting high-risk HPV infection by flow-through hybridization genechip technique. Results (1) Among 785 cases of cervical cancer, 71 cases were negative for HPV infection tested by genechip technique, accounting for 9.0%(71/785), and the relative light units/cut off (RLU/CO) ratios of these 71 cases were less than 1 by hybird captureⅡ(HC-Ⅱ) methods. The results showed that the positive coincident rate of genechip technique detecting result with HC-Ⅱmethod was 100.0%(71/71). (2) There was no difference between 43 (60.6%) cases from 41-55 years old of 71 cases of HPV-negative patients and 392 (54.9%) cases from 41-55 years old of 714 cases of HPV infection patients (χ2=15.63, P=0.571). Among 71 cases of HPV-negative patients, 32 cases of patients with doing TCT, 6 (18.8%) cases for normal, 10 (31.2%) cases for atypical squamous cells of undetermined significance (ASCUS), 3 (9.4%) cases for atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 3(9.4%) cases for low-grade squamous intraepithelial lesions (LSIL), 8 (25.0%) cases for hight-grade squamous intraepithelial lesions (HSIL), 2 (6.2%) cases for squamous cell carcinoma (SCC). And there were 391 cases of patients with doing thin-prep cytologic test (TCT) of 714 HPV infection patients, 60 (15.3%) cases for normal, 61 (15.6%) cases for ASCUS, 28 (7.2%) cases for ASC-H, 29 (7.4%) cases for LSIL, 164 (41.9%) cases for HSIL, 49 (12.5%) cases for SCC. There was no difference of TCT between HPV infection and HPV-negative patients (P>0.05). Among 70 cases from 71 patients with negative for HPV infection, there were 8(11.4%) cases in stage Ⅰa, 26 (37.1%) cases in stage Ⅰb1, 12 (17.1%) cases in stageⅠb2, 11 (15.7%) cases in stageⅡa, 10 (14.3%) cases in stageⅡb, 3 (4.3%) cases in stageⅢ-Ⅳ. There were 118(16.6%) cases in stageⅠa, 261 (36.8%) cases in stageⅠb1, 72 (10.1%) cases in stageⅠb2, 152 (21.4%) cases in stageⅡa, 87 (12.3%) cases in stageⅡb, 20(2.8%) cases in stageⅢ-Ⅳin 710 cases of HPV infection patients, in which there were no difference of clinical stage between HPV infection and HPV-negative patients (P>0.05). Among 69 cases from 71 patients HPV-negative infection, there were 51 (73.9%) cases for squamous carcinoma, 13 (18.8%) cases for adenocarcinoma, 5(7.2%) cases for adenosquamous carcinoma;and 593 (87.2%) cases for squamous carcinoma, 38 (5.6%) cases for adenocarcinoma, 39 (5.7%) cases for adenosquamous carcinoma, 10 (1.5%) case for others were in 680 patients of HPV infection, in which there was significant difference of adenocarcinoma between HPV infection and HPV-negative patients (χ2=11.96, P=0.001). Conclusions Flow-through hybridization genechip technique is the method of high sensitivity to detect high-risk type HPV, as like HC-Ⅱ method. HPV-negative of cervical cancer occurs mainly in 41-55 years old. Adenocarcinoma incidence is significantly higher in HPV-negative cases than those patients with infection of HPV positive.