Objective To compare the clinical intravenous anesthesia effect of sufentanil and remifentanil respectively, in order to provide data support for future clinical practice. Methods 91 surgery patients from February 2013 to October 2013 were selected and randomly divided into 2 groups, the one is sufentanil group (group A), and the other is remifentanil group(group B). The change of hemodynamic indexes, catecholamine concentration and woke up time after surgery in two groups were monitored and compared. Results Compared with T 0, levels of SP, DP, HR in two groups were signiifcantly lower (P<0.05), at the moment of T 2, the levels of SP, DP, HR level got signiifcantly higher(P<0.05), even surpass T 0(P<0.05). And the range of the rise in group A was signiifcant than that in group B(P<0.05).Epinephrine and norepinephrine of group A in T 2 and T 6, were higher than T 0 (P<0.05). The spontaneous breathing recovery time was, (5.2±1.9)min, open eyes’time, (7.2±2.0) min, and conscious time was(14.6±2.3)min in group B, which were lower than that of group A(t=14.382, 14.934, 14.382, P<0.01).There were no adverse reactions in both groups. Conclusion Remifentanil has good anesthetic effect, postoperative patients wake up soon, self breathing early. The change of hemodynamic index and catecholamine index are stable and beneifcial to internal environment balance.

MicroRNAs (miRNAs) are a class of small non-coding RNAs which involve in the regulation after gene transplantation.Researches show that miRNA is closely related to the development and progression of non-small-cell lung cancer (NSCLC).They caused a significantly change in NSCLC cells through downregulate tumor suppressor gene,or act as oncogene or work on some targets which is important in cell signal pathway,in the end it lead to oncogenesis,cell proliferation,cell apoptosis and resistance to chemotherapy or radiotherapy.Therefore,miRNA will be hopefully used in the diagnose and therapy of cancer.

10.3969/j.issn.2095-4344.2013.25.018

BACKGROUND:Autologous hematopoietic stem celltransplantation is an effective treatment for multiple myeloma. After chemotherapy, autologous hematopoietic stem celltransplantation becomes a standard therapeutic regimen for multipla myeloma, and numerous units and centers have reported that. How to reduce toxic and adverse reactions of the drugs, transplantation-related complications and improvement of long-term survival have been present foci.
OBJECTIVE:To summarize the new progress of autologous hematopoietic stem celltransplantation in the treatment of multiple myeloma.
METHODS:We retrieved PubMed and China National Knowledge Infrastructure database, Vip database, Wanfang database, free medicaljournals.com source for articles published from January 2006 to November 2012 concerning autologous hematopoietic stem celltransplantation in the treatment of multiple myeloma. The key words were“autologous hematopoietic stem celltransplantation, multiple myeloma”. A total of 46 articles were included.
RESULTS AND CONCLUSION: Large-dose chemotherapy combined with autologous hematopoietic stem celltransplantation for multiple myeloma obtained better outcomes compared with the traditional chemotherapy. However, many patients could not relieve after single autologous hematopoietic stem celltransplantation, and the disease recurred final y. Al ogeneic hematopoietic stem celltransplantation was limited by donor source, and treatment-associated fatality rate was high, so its use was confined. Therefore, present new development direction included twice autologous hematopoietic stem celltransplantation, autologous transplantation combined with al ogeneic transplantation with reduced-intensity conditioning regimens as wel as drug on the basis of single autologous hematopoietic stem celltransplantation. Novel drug proteasomes inhibitor and immunomodulator in inducer remission, pretreatment and sustaining stages obviously improved total reaction rate of multiple myeloma therapy and long-term survival.

To explore and identify the therapeutic components of traditional Chinese medicine (TCM) as a complex intervention through grounded theory, and the correlation and interaction within this model and the possible effects that they may have on the therapeutic effects of TCM.

Clinical trials play a critical role in medical research. However, only a few clinical trials conducted at present have been registered at various clinical trial registries. Clinical trial registration can prevent bias in these registered trials effectively and avoid unnecessary waste of resources due to meaningless repeats. Moreover, it will benefit the development of evidence-based medicine, and promote human welfare. Great attention has been paid to the importance and necessity of clinical trial registration. This review briefly introduced the definition, justification, contents, history, current status of clinical trial registration, and introduced the information regarding important international clinical trial registries in detail. Clinical trial registration should be developed toward a transparent, compulsory and comprehensive stage.

Injury of choledocho-pancreatico-duodenal junction refers to the penetrating injury of the bile duct, pancrea-tic duct or duodenal wall in the region of ampulla of Vater. It is often caused by improper operation of surgical instruments, and may lead to leakage of bile, pancreatic or duodenal contents into retroperitoneal space and chemical corrosion in a wide range of retroperitoneal soft tissue, which result in severe secondary infection or even death. Leakage of contrast media, hypertrophy of tissue and anatomical changes were the evidences for injury of choledocho-pancreatico-duodenal junction. Injury of choledocho-pancreatico-duodenal junction can be. divided into 4 types, and treatment selected according to different types of injury is neces-sary for the prognosis of patients.

Background and purpose:Osteopontin (OPN) is a secreted glyco-phosphoprotein, which is overex-pressed by numerous human cancers, invovled in tumor occurrence, development and prognosis. OPN up-regulates matrix metal proteases (MMPs) expression in a NF-κB-dependent fashion during extracellular matrix (ECM) invasion causing degradation of cell basement membrane and ECM leading to tumor invasion and metastasis. The aim of this study was to examine the protein level of OPN in a large number of tissue samples from patients with lung squamous cell carcinoma (SCC), and evaluate its potential clinical value.Methods:The OPN protein levels in 265 tumor tissue samples and corresponding 24 normal lung tissue samples were examined by immunohistochemical (IHC) analysis.Results:IHC results showed that the positive rate of OPN was 64.5% in the SCC tissues, which was significantly higher than that in normal alveoli tissues (29.2%,P<0.001). The positive rate of OPN expression in late stage (Ⅲ+Ⅳ) tissues was 78.4%, significantly higher than that in early stage (Ⅰ+Ⅱ) tissue(positive rate 54.5%,P<0.001). The positive rate of OPN expression in T3-4 stage (Ⅲ+Ⅳ) tissue was 76.9%, significantly higher than that in T1-2 stage tissue (positive rate 59.4%,P=0.007). The expression of OPN was signifcantly correlated with the status of lymph node metastasis (LNM). The positive rate in the tumor tissue with LNM was 73.4%, significantly higher than that without (positive rate 51.4%,P<0.001).Conclusion:The level of OPN protein was overexpressed in lung cancer tissues, involved in SCC carcinogenesis and LNM. It is indicated that OPN has an impor-tant reference value in diagnosis, prognosis and therapy of SCC.

Objective To study the significance of thyroid stimulating antibody (TSAb) and thyroid stimulating-blocking antibody (TSBAb) in children with Graves' disease (GD) or Hashimoto's thyroiditis (HT).Methods Five hundred and twenty-seven cases of serum from 180 children with autoimmune thyroid disease (AITD) children were divided into 282 cases of GD and 245 cases of HT.According to the status of thyroid function,they were divided into 157 cases of hyperthyroidism,91 cases of hypothyroidism and 279 cases of normal thyroid.GD group was subdivided into 127 GD hyperthyroidism and 155 GD remission;HT group was subdivided 30 HT hyperthyroidism,124 HT remission and 91 HT hypothyroidism.Seventy-nine healthy children were taken as the healthy control group.Free triiodothyronine(FT3),free thyroxine(FT4) and sensitive thyroid stimulating hormone(TSH) were detected by chemoluminescence.Serum TSAb and TSBAb were detected by serum TSAb or TSBAb enzyme linked immunosorbent assay (ELISA),respectively.The differences in TSAb and TSBAb among each group were compared and analyzed of find out the relationship between TSAb and TSBAb was performed.Beside,the correlation between TSAb and TSBAb with FT3,FT4,and TSH were analyzed.Results (1) TSAb levels were significant (F =11.995,all P =0.000):the GD group (0.727 ± 0.157) ＞ HT group (0.605 ± 0.148) ＞ healthy control group (0.350 ± 0.105);the difference was significant(F =109.165,P =0.000) among hyperthyroidism group (0.745 ± 0.169) ＞ normal thyroid group (0.647 ± 0.153) ＞hypothyroidism group(0.612 ±0.144) ＞healthy control group (0.350 ±0.105);the difference was significant(F=156.712,P =0.000) in the GD hyperthyroidism group(0.747 ±0.17) ＞ GD remission group (0.640 ± 0.16) ＞ healthy control group (0.350 ± 0.105);the difference was significant (F =109.165,P =0.000) in the HT hyperthyroidism group(0.739 ±0.140) ＞HT remission group(0.655 ±0.135) ＞ HT hypothyroidism group(0.612 ± 0.140) ＞healthy control group (0.350 ±0.105).(2) TSBAb levels were significantly different(F =15.610,P =0.000):the HT group(0.704 ±0.633) ＞ GD group(0.567 ±0.178) ＞ healthy control group (0.334 ±0.104);the difference was significant(F =13.311,P =0.000) in the hypothyroidism group (0.693 ± 0.125) ＞ remission group (0.648 ±0.446) ＞hyperthyroidism group(0.562 ±0.181) ＞healthy control group(0.334 ±0.104);the difference was significant(F =19.269,P =0.000) in the GD remission group (0.672 ±0.572) ＞ GD hyperthyroidism group (0.550 ± 0.187) ＞ healthy control group (0.334 ± 0.104);HT hypothyroidism group (0.693 ± 0.725) was higher than HT hyperthyroidism group(0.618 ±0.142) and HT remission group (0.619 ±0.199),the difference was not significant between HT hyperthyroidism group and HT remission group(F =12.208,P =0.000).(3) TSAb level was positively correlated with TSBAb,FT3 and FT4(r =0.162,0.091,0.194,all P ＜ 0.05) and was negatively correlated with TSH (r =-0.224,P ＜ 0.05).TSBAb levels were negatively correlated with FT3 (r =-0.155,P ＜ 0.05) and was positively correlated with TSH (r =0.131,P ＜ 0.05).Conclusions Thyroid function was related to the serum levels of TSAb and TSBAb.TSAb and TSBAb could be regarded as an important predictive index for children with AITD during the treatment period.

Objective To investigate the status of diabetes distress in patients with middle-andhigh risk of diabetic foot and explore the impact of self-perceived burden and social support on diabetes distress.Methods Totally 205 patients with middle-and-high risk of diabetic foot were investigated with Diabetes Distress Scale,Self-perceived Burden Scale and Social Support Scale.Results The total average score of diabetes distress was (2.59±0.57),the diabetes distress level was correlated with self-perceived burden,dimensions of social support (r=0.481～0.653) and were influenced by gender,vocation,objective support,use of support.Conclusions Diabetes distress is widespread in patients with middleand-high risk of diabetic foot and was influenced by many factors,these provide the basis for taking effective interventions to reduce diabetes distress.