Objective To study the effects of lanthanum on cell multiplication and intracellular Ca2+([Ca2+]i) concentration in primary cultured astrocytes of rats.Methods The primary cultured astrocytes of rats were exposed to 0.25,0.5,1.0 and 2.0 mmol/L LaCl3 for 24 h and 48 h.The cell multiplication was measured by MTT;[Ca2+]i concentration was determined by the fluorescent Ca2+ indicator Fura-2/AM.Results After astrocytes were incubated with 0.25,0.5,1.0 and 2.0 mmol/L LaCl3 for 24 h and 48 h,the survival rate of astrocytes was 86.24% and 82.99%,82.26% and 79.14%,52.32% and 49.97%,38.04% and 35.15% respectively,which was significantly decreased compared with the control group(P

Objective To investigate the effect of Xuebijing injection on release of high mobility group box 1 (HMGB1) in endotoxin-induced cells. Methods HMGB1 concentration and mRNA expression were analyzed by enzyme-linked immunosorbent assay (ELISA) and RT-PCR, respectively. The effects of Xuebijing injection with 2, 10 and 50 mg/ml on HMGB 1 concentration in the culture medium of 200 ng/ml lipopolysaccharide-induced macrophage-like RAW 264.7 cells and BRL-3A hepatocytes, and HMGB1 mRNA expression in lipopolysaccharide-induced macrophages were observed. Results 50 mg/ml Xuebijing injection significantly decreased HMGB1 concentration in the culture medium of lipopolysaccharide-induced macrophages and hepatocytes(P< 0.01), and inhibited HMGB1 mRNA expression in macrophages. Conclusion Xuebijing injection inhibits endotoxin-induced release of HMGB1.

Objective:To access the feasibility and safety of application of flexible laryngeal mask air-way ( FLMA) in oral&maxillofacial day surgery. Methods:Retrospective study was conducted of 40 oral& maxillofacial day surgery patients (3 to 61 years of age) using FLMA under general anaesthesia in De-partment of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology. All the patients were with American Society of Anesthesiologists ( ASA ) physical status Ⅰ -Ⅱ, including 19 males and 21 females. The patients' vital signs were recorded at five different time points:baseline before anesthesia ( T0 ) , time right after the FLMA insertion ( T1 ) , time at incision ( T2 ) , 15 min after incision ( T3 ) and time at the end of the operation ( T4 ) . The first attempted FLMA insertion successful rate and the number of timed of changing to endotracheal intubation were recorded. During operation, frequencies of movement, hypoxia and obstruction of airway were noted and the operation time, anesthesia time, time from the end of the operation to extubation, movement and coughing following extubation and sore throat within 24 h were taken down. Operation-related complications of bleeding, hematoma and injury of local nerves were recorded within 24 h as well. Results:The operations of all the 40 patients were successfully done under general anaesthesia. The 36 ( 90%, 36/40 ) patients using FLMA successfully were under steady process, including 16 males and 20 females. The first attempted successful rate of FLMA insertion was 80% (32/40), and the second 50% (4/8). Three out of the 4 failed FLMA patients were changed to endotracheal intubation after the second attempt failed. The other patient was changed to endotracheal intubation before operation because of leak. The average operation time was (46. 58 ± 22. 57) min, the anesthesia time was ( 77 . 97 ± 26 . 82 ) min and the time from the end of operation to extubation was (8. 31 ± 3. 33) min. All the patients were recorded without obvious body movement during the operation procedure. There were 4 patients (11. 11%, 4/36) with slight body movement during extubation. The incidence of sore throat was 13. 89% (5/36) within 24 h postoperatively. There were no complications of bleeding, hematoma and injury of local nerves. The vital signs of baseline T0 were significantly different from those at other time points T1, T2, T3, and T4 (P<0. 01). As to the hearts rate after anesthesia, the values at T1, T2, T3 and T4 for two-two comparison, there was no statistical difference (P>0. 05). As to the values of systolic blood pressure and diastolic blood pressure after anesthesia at T1 and T4 , T2 and T3, for two-two comparison, there was no statistical difference (P>0. 05). As to the respiratory rate from the start of the surgery, the values at T2, T3 and T4 showed no statistical difference (P>0. 05). Conclusion:Flexible laryngeal mask airway is a supraglottic airway management method. It is suitable and safe for securing the airway in oral & maxillofacial day surgery. The advantages of fewer haemody-namic changes and postoperative complications are confirmed.

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

Objective To explore the short and long term curative effects of percutaneous transhepatic cholangioscopic lithotomy (PTCSL) in the treatment of intrahepatic stone (IHS).Methods 38 IHS patients were enrolled,who were treated with PTCSL between January 2008 and July 2013.Results PTCSL was successfully completed in all the 38 IHS cases.Stone clearance rate was 84.2％ and the average episode of stone removal was (2.6 ± 0.9) times.Average diameter of percutaneous transhepatic fistula was (18.4 ± 0.6) F and the average time from percutaneous transhepatic puncture and fistulization to cholangioscopic lithotomy was (7.2 ± 0.7)d.The average operation time was (68 ± 20) min,intraoperative blood loss was (20 ± 13) ml,and hospitalization was (4 ± 2) days.The hepatolith recurrence rate in patients with stones completely removed was 37.5％ (12/32),and 1 case developed into biliary cirrhosis.Patients with calculi residual suffered from higher hepatolith recurrence rate of 83.8％ (5/6),with biliary cirrhosis found in 1 case.Conclusions PTCSL is safe and effective in treating primary IHS,which is indicated in multiple recurrent IHS especially in after biliary surgery patients.It has the advantages of minimally invasion,less bleeding,less postoperative pain,less complications,and fast postoperative recovery.

Objective To design an electrical system of extracorporeal shock wave lithotripter for children and adults uses.Methods The shock wave kernel parameters of child energy section of Dornier Delta Ⅱ lithotripter were tested such as peak sound pressure,pressure pulse width and pressure pulse rise time,and then energy calibration was executed for HK.ESWL008 child extracorporeal shock wave lithotripter to make the kernel parameters of the two lithotripters the same or similar to each other.An electrical system was designed with PLC system as the core control unit,involving in wave source 3D motion,large and small C-arms motion,water circulation system,B-type ultrasound positioning system,high-frequency X-ray imaging system,high-voltage condenser charging and discharging system,console and bedside-box-controlled display system as well as electromagnetic compatibility.Results Within A,B,C,1 and 2 energy sections for child lithotripsy the maximum and average differences between the kernel parameters of the two lithotripters were 7.1％ and 3.8％ respectively.There was no difference between the clinical experience by the two lithotripters,and HK.ESWL-008 child extracorporeal shock wave lithotripter passed EMC and safety detections by Guangdong Medical Devices Quality Surveillance and Test Institute of CFDA.Conclusion HK.ESWL-008 child extracorporeal shock wave lithotripter can be used for children lithotripsy clinically.

Cocrystal separation technology is a technology that utilizes coformers to selectively form cocrystals with target compounds and separate them from mixed systems. Our study used puerarin (PUE), daidzein (DDZ), and genistein (GEN) as model drugs, which have similar structures and are the main isoflavones in Pueraria lobata root. The separation and purification processes in the modern traditional Chinese medicine (TCM) of these three components use conventional column chromatography, recrystallization, and other technologies, which have the issues of lengthy separation cycles, high solvent consumption, and inefficient preparation. Different with existing separation technology, our team used the early-found cocrystal separation method to design a step-by-step extraction and separation experiment of GEN-PUE-DDZ ternary mixture. Caffeine and L-proline were added to the mixed system in turn, GEN-caffeine cocrystal and PUE-proline cocrystal were prepared by suspension method. The cocrystals precipitated out of the solution. The purities of the GEN-caffeine cocrystal and the PUE-proline cocrystal could achieve 93% (the purity of GEN) and 99% (the purity of PUE). Besides, the purity of DDZ could also be increased by 6.76 times. This study proposed a simple operating, low cost and wide application range separation method different from the traditional separation method and realized the separation of structurally similar chemical components in TCM, laying a foundation for the application of cocrystal technology in the separation and refining of TCM.

Objective To investigate the correlation between white matter hyperintensities (WMH)and hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging(MRI)in old adults and to explore the risk factors and pathogeneses of WMH.Methods We retrospectively collected imaging and clinical data of patients who had received both head and neck CTA and brain MRI within one month at our hospital from 2013 to 2016.The Fazekas visual scale was used to evaluate periventricular white matter hyperintensity(PWMH)and deep white matter hyperintensity(DWMH)in each brain hemisphere.According to the presence or absence of HVS in a cerebra[hemisphere,patients were assigned into an HVS-positive group or an HVS-negative group.Clinical data,PWMH,and DWMH differences were compared between the two groups.Results A total of 271 patients(542 cerebral hemispheres)were included in this study.HVS-positive imaging occurred in 79(14.6％)cerebral hemispheres and negative imaging was observed in 463 (85.4％) cerebral hemispheres.There was a significant difference between the HVS-positive and negative groups in the ipsilateral CIA stenosis(x2 =126.840,P＜0.01).The incidence of ipsilateral severe carotid artery stenosis in the HVS-positive group was 62.0％ (49/79),which was significantly higher than 9.9％ (46/463)in the HVS-negative group.The incidence of moderate-severe DWMH was 65.8％(52/79) in the HVS-positive group,which was higher than 34.8％ (161/463)in the negative group(x2 =34.962,P ＜20.01).Nevertheless,the incidences of moderate-severe PWMH in the two groups were 65.8％ (52/79) and 55.5％ (257/463),respectively,without a significant difference between them (x2 =6.944,P =0.074).After adjusting for age,gender,ipsilateral ICA stenosis,hypertension,diabetes,etc.multivariate analysis suggested that HVS-positive imaging was still an independent risk factor for DWMH(OR =2.653,95％CI:1.489-4.726,P =0.001).Conclusions HVS-positive imaging is an independent risk factor for DWMH in the elderly,but no clear correlation with PWMH is found.It suggests that hypoperfusion is a possible mechanism for the development of DWMH in the elderly.

Objective:To compare the quantitative measurements of the retinal capillary nonperfusion areas in a cohort of proliferative diabetic retinopathy (PDR) patients with fluorescein fundus angiography (FFA) and swept source optical coherence tomography angiography (SS-OCTA), and to determine the intrapersonal variability between examiners.Methods:A cross-sectional study. Eighteen eyes of eleven PDR patients diagnosed in Department of ophthalmology of Henan Provincial People's Hospital from September 2019 to January 2020 were included in this study. FFA was performed using Spectralis HRA+OCT (Germany Heidelberg Company) from and SS-OCTA was performed using VG200D (China Vision Micro Image Corporation). SS-OCTA was used to collect images of retinal layer, superficial capillary plexus (SCP) and deep capillary plexus (DCP). The same observation area was 80°×60° for SS-OCTA and 55° for FFA with both setting centered on the fovea. The forty-nine retinal capillary nonperfusion areas were observed. The area measurement was completed independently by three examiners. Paired sample t test or paired sample Wilcoxon test were used to compare the measured values of retinal capillary nonperfusion areas between the two examination methods and among the three examiners. Results:There was no significant difference in the retinal layer, SCP and DCP nonperfusion area measured by FFA and SS-OCTA among the three examiners ( P>0.05), and the consistency is good (consistency correlation coefficient> 0.9, P<0.05). The nonperfusion area measured by FFA was 0.786 mm 2. The median nonperfusion area of retinal layer and SCP measured by SS-OCTA were 0.787 mm 2 and 0.791 mm 2, respectively, and the average nonperfusion area of DCP was 0.878±0.366 mm 2. The nonperfusion area of retinal layer and SCP measured by FFA and SS-OCTA showed no statistically significant difference ( P=0.054, 0.198). The nonperfusion area of DCP measured by SS-OCTA was significantly larger than that of FFA, and the difference was statistically significant ( P<0.001). The results of repeatability analysis showed that 93.88% (46/49) of the DCP nonperfusion area data measured by SS-OCTA were greater than those measured by FFA. Conclusion:The retinal nonperfusion area of DCP in PDR patients measured by SS-OCTA is larger than that of FFA.

Objective To evaluate laparoscopic radical resection of metachronous colorectal carcinoma.Methods A total of 13 patients with metachronous colorectal carcinoma undergoing laparoscopic resection in Department of Gastrointestinal Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2013 to December 2015 were analyzed retrospectively.Results The mean time of surgery was (156 ± 9) min.Tumors were located in the right hemicolon in 3 cases,in the transverse colon in one,in the left hemicolon in 2,in the sigmoid colon in four and in the rectum in 4.The mean blood loss was (66 ± 21) ml.There was no conversion to open surgery.Two patients were done with protective ileostomy.Postoperative gastrointestinal function recovery time was (2.5 ± 0.7) days.One postoperative intra-abdominal bleeding was successfully controlled laparoscopically.Posteperative length of hospital stay was (26.2 ± 2.9) days.The median follow-up was 12 months (5-30 months) with no cancer recurrence.Conclusions Laparoscopic radical resection of metachronous colorectal carcinoma has good curative effect,and high success rate in spite of previous history of laparotomy.