Objective To monitor right heart hemodynamic changes of patients with lung cancer during and after the procedures of pneumonectomy and discuss the effect of pneumonectomy on right heart function and risk of postoperation morbidities. Method 16 patients with lung cancer were randomly selected and the clinical database was queried and Swan-Ganz catheter was applied awake from jugular vein to pulmonary artery ,measuring mean arterial pressure(MAP) ,heart rate(HR) ,central venous pressure(CVP) ,mean pulmonary artery pressure (MPAP),mean pulmonary capllary wedge pressure(MPCWP) ,and eardiaoc output(CO) and calculating cardiac index (CI),left ventricular-stroke work index (LVSWI), right ventricular stroke work index (RVSWI) , and stroke volume index(SVI) instantaneously before anaesthesia, after anaesthesia with single lung ventilation, after pulmonary artery and pulmonary vein occlusion and supine chest dosed during the procedure of pneumonectomy. Pre-and post-operative complications were recored. Results Cardiovascular complications occurred in 6 patients(37.5%) postoperatively. There were no operative or perioperative deaths. MPAP increased significantly after the procedure of pneumonectomy compared with that of preoperation, and MPAP > 26 mm Hg was in 4 patients who got cardiovascular complications postoperatively with morbidity of 100% ,which was "significantly higher than the morbidity of 16.7% (2/12) when MPAP < 25 mm Hg. Conclusion Pneumonectomy has significant effects on right heart hemodynemic changes and as MPAP increases postoperatively, the risk of cardiovascular complications becomes higher.

Histaminergic neurons solely originate from the tuberomammillary nucleus (TMN) in the posterior hypothalamus and send widespread projections to the whole brain. Experiments in rats show that histamine release in the central nervous system is positively correlated with wakefulness and the histamine released is 4 times higher during wake episodes than during sleep episodes. Endogeneous prostaglandin E2 and orexin activate histaminergic neurons in the TMN to release histamine and promote wakefulness. Conversely, prostaglandin D2 and adenosine inhibit histamine release by increasing GABA release in the TMN to induce sleep. This paper reviews the effects and mechanisms of action of the histaminergic system on sleep-wake regulation, and briefly discusses the possibility of developing novel sedative-hypnotics and wakefulness-promoting drugs related to the histaminergic system.

Objective To investigate the effect of split-bolus spectral computed tomography(CT) on the portal venography and radiation dose.Methods The prospective study was adopted.The clinical data of 119 patients who underwent spectral CT at China-Japan Union Hopital from September 2014 to March 2015 were collected.Patients were randomly divided into the portal venography with split-bolus spectral CT single-phase enhanced scan group and portal vein multi-phase scan group by random sequence method.In the portal venography with split-bolus spectral CT single-phase enhanced scan group,the spectral CT was used with the method of split-bolus single phase imaging,and in the portal vein multi-phase scan group,standard spiral CT was used to perform three-phase scan.Two observers evaluated CT portal venography subjectively and objectively,measured CT values,contrast to noise ratio (CNR),signal noise ratio (SNR),and calculated radiation dose.Observed indices included (1) choice of optimal monochromatic images.(2) CT values of portal veins,measurement of CNR and SNR.(3) Subjective scoring of portal venography quality.(4) Comparison of radiation dose.Measurement data with normal distribution were presented as x ± s,comparison between groups was analyzed by independent sample t test.Comparison of count data was analyzed by chi-square test.Results The 113 patients were screened for eligibility,including 59 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 54 in the portal vein multi-phase scan group.(1) Choice of optimal monochromatic images:optimal monochromatic images were abstracted at 60 keV from spectral CT portal venography.(2) CT values of portal veins and measurement of CNR and SNR:the CT values of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were (319 ± 44) HU,(328 ± 53) HU,(294 ± 45) HU in the reconstructed images at the energy level of 60 keV in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (213 ±41)HU,(228 ±49)HU,(210 ±41)HU in the portal vein multi-phase scan group,with significant differences between the 2 groups(t =8.04,6.34,6.82,P ＜ 0.05).The CNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 15 ± 5,24 ± 8,22 ± 7 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 13 ± 4,20 ± 6,19 ± 6 in the portal vein multi-phase scan group,respectively,with no significant difference (t =-1.13,-1.89,-1.51,P ＞ 0.05).The SNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 31 ± 6,29 ± 6,27 ± 6 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 29 ± 7,28 ± 9,26 ± 6 in the portal vein multi-phase scan group,respectively,with no significant differences (t =-0.688,0.615,0.600,P ＞ 0.05).(3) Subjective scoring of portal venography quality:the subjective score of image quality of portal venography was 14.3 ± 1.0 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 12.5 ± 1.8 in the portal vein multi-phase scan group,with a significant difference (t =12.43,P ＜ 0.05).(4) Comparison of radiation dose:the radiation dose was (8.1 ± 1.1)mSv of patients in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (17.4 ± 7.5) mSv in the portal vein multiphase scan group,with a significant difference (t =24.14,P ＜ 0.05).Conclusion Spectral CT portal vein imaging combined with split-bolus protocol can achieve better manifestations of portal vein and its branches,and reduce radiation dose in the scanning process.

AlM:To investigate the effect of teaching mode of problem- based learning ( PBL ) in the teaching of medical students' clinical ophthalmology.
METHODS: Five classes ( total 148 students ) were randomly selected as experimental group, using PBL method, at the same time another 5 classes ( total 151 students) were also randomly selected as control group, using lecture-based learning ( LBL) mode in 2010 grade. The scores of the experimental group were compared with control at the end of term. ln addition, students and teachers were respectively interviewed using self -administered questionnaire to obtain their evaluation for PBL practice.
RESULTS:The mean scores of PBL group (78. 35±7. 63) were significantly higher than control group (71. 68±6. 37) (P<0. 001). Most of students thought that their ability of referring, synthesizing and analyzing information was enhanced by PBL, and their skills both in written and oral were also improved. PBL made it easier to understand the contexts of course. lt was the best way to improve the effect of teaching in ophthalmology based on the increase of quality in novitiate that gives more chance to students of contacting with practice, developing the ability of clinical thinking and verifying the theory in clinical novitiate. Lots of teachers considered that the classroom atmosphere was more active, students were becoming more and more proactive on their classes and the relationship between students and teachers were more harmonious when PBL was used.
CONCLUSlON:Using PBL teaching mode can highly improve the teaching effectiveness of clinical epidemiology, which is worth popularizing.

The information entropy, H = - Pk log Pk, has been proved in this paper to be always positive and invariant for a linear coordinate transformation, so that it can be used as a measuring index. On the contrary, the integral term of the information entropy, H(x) = -f(x) log f(x) dx, is not always positive and invariant for a linear coordinate transformation. Therefore, H(x) can not be used as a measuring index. An example of a probability density function for response of nerve to electric current with different intensities is given to confirm above conclusions.

This article introduced the features and categories of emergency medicine.Combining the comprehension of teaching practices for many years,we considered that paying great attention to basic concepts is the primary problem in emergency medicine teaching.

Obj ective To explore yhe effecy of cogniyive behavior inyervenyion in payienys wiyh chronic renal failure.Methods 60 payienys wiyh chronic renal failure were randomly divided inyo yhe observayion group and yhe conyrol group,yhe conyrol group was received rouyine nursing, yhe observayion group was given cogniyive behavior inyervenyion,nursing effecys were compared be-yween yhe ywo groups.Results Life syyle score in yhe aspecy of self realizayion,healyh responsibili-yy,nuyriyion and oyhers in yhe observayion group was higher yhan yhay in yhe conyrol group;Healyh belief was beyyer yhan yhay in conyrol group,yhe resulys revealed yhay yhe difference was syayisyically significany (P<0 .05 ).Life qualiyy in physical funcyion,role funcyion and social funcyion in yhe ob-servayion group was higher yhay in yhe conyrol group;Nursing sayisfacyion was higher yhan yhay in yhe conyrol group,so yhe difference was syayisyically significany(P<0.05).Conclusion Cogniyive behavioral inyervenyion can effecyively improve life syyle and life qualiyy in payienys wiyh chronic renal failure.

Obj ective To explore yhe effecy of cogniyive behavior inyervenyion in payienys wiyh chronic renal failure.Methods 60 payienys wiyh chronic renal failure were randomly divided inyo yhe observayion group and yhe conyrol group,yhe conyrol group was received rouyine nursing, yhe observayion group was given cogniyive behavior inyervenyion,nursing effecys were compared be-yween yhe ywo groups.Results Life syyle score in yhe aspecy of self realizayion,healyh responsibili-yy,nuyriyion and oyhers in yhe observayion group was higher yhan yhay in yhe conyrol group;Healyh belief was beyyer yhan yhay in conyrol group,yhe resulys revealed yhay yhe difference was syayisyically significany (P<0 .05 ).Life qualiyy in physical funcyion,role funcyion and social funcyion in yhe ob-servayion group was higher yhay in yhe conyrol group;Nursing sayisfacyion was higher yhan yhay in yhe conyrol group,so yhe difference was syayisyically significany(P<0.05).Conclusion Cogniyive behavioral inyervenyion can effecyively improve life syyle and life qualiyy in payienys wiyh chronic renal failure.

Objective To explore the influence of tranSCription factor FOXC2 in angiogenesis of breast cancer MCF-7 cells and to clarify the action mechanism of FOXC2 in promoting tumor angiogenesis.Methods FOXC2 gene and empty vector gene were transfected into breast cancer of MCF-7 cell line with FOXC2 lentivirus gene transfection technique to obtain stable transfection cell line. The MCF-7 cells were devided into non-transfected group,empty-vector group and over-expression group.Matrigel assay and Transwell chamber test were used to observe the changes of tube formation and migration ability of human umbilical vein endothelial cells (HUVECs)in MCF-7 cells supernatant in various groups. PT-PCR and Western blotting methods were applied to detect the expressions of FOXC2,DLL4 and Notch1 mRNA and protein.Results Compared with non-tranfected group and empty-vector group,the tube formation and the migration number of HUVECs in FOXC2 over-expression group were increased(P<0.05);the expressions of FOXC2,DLL4 and Notch1 mRNA and proteins were significantly increased(P<0.05).Conclusion The FOXC2 over-expression in MCF-7 cells can increase the tube formation ability and migration ability of HUVECs,and its mechanism may be related to Notch signaling pathway.

Child, Preschool ; Female ; Humans ; Infant ; Interleukin-1beta ; blood ; cerebrospinal fluid ; Male ; Seizures, Febrile ; blood ; cerebrospinal fluid ; Zinc ; blood ; cerebrospinal fluid