Objective To observation the clinical effect of anesthesia combined with epidural block for patients with COPD surgery.Methods 262 cases with COPD needed to line the chest and abdominal surgery and urology surgery patients.Patients were divided into control group and observation group according to the time sequence,underwent general anesthesia and anesthesia combined with epidural anesthesia,contrast observed in patients with operative time,postoperative extubation time,wake time and the analgesic effect of anesthesia (VAS score) was measured in patients with FVC,FEV1/FVC and FEF25％ to 27％ lung function,clinical efficacy and complication rate of two anesthesia methods.Results The patients extubation time,recovery time and VAS scores were significantly lower than those of control group,the differences were statistically significant(all P ＜0.05).Group of postoperative patients with FVC,FEV1/FVC and FEF25％ to 27％,such as lung function test results were significantly better than those of control group,and the difference was statistically significant (all P ＜0.05).Anesthesia control group total effective rate of 87.0％ observed in patients anesthesia total effective rate was 96.9％.Compared with the control group,the anesthesia clinical effect of the observation group was statistically significant (P ＜0.05).Operative time and postoperative complication rate of the two groups of patients showed no significant difference(P ＞0.05).Conclusion Anesthesia combined with epidural anesthesia used in surgery in patients with COPD can effectively improve the clinical effects of anesthesia,to enhance the safety of anesthesia,which will help the rehabilitation of patients and worth of clinical practice.

Objective To explore effect of isoorientin on gastric cancer cell autophagy.Methods Isoorientin and autophagy activator and effect of inhibitors on proliferation of human gastric cancer cell line SGC-7901 by MTT assay.Cell apoptosis was detected by flow cytometry.Production of autophagy lysosomal in gastric cancer SGC-7901 cells was obseroved by AO and MDC staining.Characteristic expression of autophagy protein was analysed by Western blot.Results MTT assay indicated that isoorientin could inhibit gastric cancer cell growth, RAP has the same effects, but 3-MA inhibition of apoptosis.Flow cytometry was used to detect the apoptosis rate of isoorientin and RAP could promote cell apoptosis , while 3-MA had the opposite effect.In AO staining, the red light appeared in the cells, and the green fluorescence appeared in the cells of MDC staining, which showed that there was an autophagy in the cells.Western blot test found the isoorientin was cell autophagy specific protein LC-3II, Beclin-1 expression increased, 3-MA suppressed the expression of the two proteins, and RAP had the opposite effect.Conclusion Isoorientin could induce apoptosis in gastric cancer SGC-7901 cells, autophagy is involved in the process of death.

Objective:To investigate the internet game addiction disorder and influential factors in the middle school students of Guangzhou.Methods:A total of 900 middle school students of Guangzhou selected by cluster sampling were investigated with unified questionnaires.Results:Of the middle school students tested,4.9%were diagnosed internet game addiction.There were remarkable differences of the addiction to network game in demography variable,such as age, educational background of father and family economic situation.Between online game addicts and non-addicts,there were significant discrepancies in social support,subjective support,use of support,self-identity,self investment today,and parent-child conflict.Gender,subjective support,parent-child conflict,self investment now,educational background of father and family economic situation entered the regression model.Conclusion:Internet game addiction is closely associated with social support,parent-child relationship,and self-identity.

Objective To compare the safety and clinical efficiency between minimally invasive percutaneous nephrolithotomy(MPCNL)in supine position and flexible ureteroscopy(FURS)in management of proximal ureteral calculi.Methods From Oct.2010 to May.2012,76 patients with single proximal ureteral calculus between 10-20 mm failed in SWL or other conservative therapy accepted MPCNL (32 cases)or FURS(44 cases).There was no significant difference between the groups in base-line parameters.Stone sizes were(15.6±2.5)mm and(14.9±2.3)mm,P＞0.05.Procedural time,post-operative hospitalization stay,complication rates(Clavien degree Ⅱ or over)and stone free rates were compared.Results In these two groups,procedural time was(49.3± 11.7)and(67.2± 17.3)min,P＜0.05,postoperative hospitalization stay were(4.2±1.1)and(1.8±0.8)days,P＜0.05,complication rates were 12.5％ and 6.8％,P＞0.05 and stone free rates(residual fragments≤3 mm)were 93.7％ and 84.1％,P＞0.05.Conclusions For patients with surgically indicated proximal ureteral calculi,both minimally invasive percutaneous nephrolithotomy in supine position and flexible ureteroscopy are effective and safe therapeutic modalities.Patients treated with flexible ureteroscopy have faster postoperative recovery.

Objective To investigate the characteristics and relevant factors of overweight and obesity in adults of the Shandong coastal area in 2009,as well as to estimate the epidemiological trends by comparing with results found in 2004.Methods A random and stratified cluster sampling of adults aged 20 years or older was conducted,and 5060 inhabitants in the cities of Qingdao,Yantai,Weihai,Rizhao,and Dongying were included.Results The standardized prevalence rates of overweight,obesity,and abdominal obesity were 33.5％,16.1％,and 40.0％respectively in 2009,with respective increase of 0.6％ (P＜0.05),2.9％ (P＜0.01),and 6.8％ (P＜0.05)compared with those in 2004; the rates for male were 37.9％,17.1％,and 44.6％ respectively in 2009,with increase of 3.7％ (P＜0.01),3.7％ (P＜0.0l),and 10.2％ (P＜0.01) respectively compared with those in 2004 ;the prevalence of abdominal obesity for female was 38.6％,with an increase of 6.6％ (P＜0.01) compared with that in 2004.The prevalence of obesity increased consistently with age,reached a peak within 50-69 years old.There was a trend of developing obesity in younger,males,while obesity became more common in postmenopausal women.In contrast with the findings in 2004,the average age,body mass index,waist circumference,triglyceride,total cholesterol,uric acid,and blood glucose levels increased significantly (P＜0.01) in 2009.Logistic regression analysis showed that aging,dyslipidemia,hypertension,hyperglycemia,hyperuricemia were positively related with obesity,and smoking was negatively related with it.Consumption of meat was related to male obesity,while carbohydrate consumption was related to female obesity.Conclusions A remarkable increase in the prevalence of obesity was found in 2009 compared with 2004,especially for the young and middle-aged men and postmenopausal women.Aging,hypertension,hyperglycemia,hyperuricemia,dyslipidaemia,and incorrect components of diet contributed to obesity.Although smoking is a negative factor for body weight,it is not suggested.

Objective To evaluate the effect of pregnancy and delivery after renal transplantation (RT)on recipients,graft and offspring.Methods Clinical data of 6 pregnancies in 5 recipients were retrospectively studied and literature was reviewed.Results Among them,6 pregnancies and 4 deliveries occurred in 5 female RT recipients.The mean age at pregnancy was 31.1 years,with a mean interval between RT and pregnancy being 3.6 years.Preeclampsia developed in two pregnancies and hyperlipemia in one pregnancy.One RT recipient who discontinued immunosuppressant following pregnancy on her own exhibited subsequent renal failure.She underwent a second RT and delivered a healthy baby two years following the second RT.One RT recipient decreased the immunosuppressant dose to half after the pregnancy on her own and developed renal failure thereafter.Four patients underwent a Cesarean section at 38 th,35 th,35 th,and 38 th week,respectively.The mean birth weight was 3262.5 g with all Apgar scores of 10.Conclusion Our data coupled with prior reports suggest that for the recipients with normal renal function,successful pregnancy is achievable if immunosuppressant was taken correctly,but the pregnancy is at high risk,and careful monitoring is needed.

Objective To observe the relationship between serum lipid concentration profiles and thyroid function after thyroid hormone withdrawal( THW) in patients with differentiated thyroid carcinoma( DTC) .Methods Sixty-five post-operative DTC patients who prepared to receive radioiodine ablation were included in this study.Serum thyroid hormones ( TSH, FT4 , FT3 ) and lipid profile [ total cholesterol ( TC ) , triglycerides ( TG ) , low-density lipoprotein-cholesterol(LDL-C), and high-density lipoprotein-cholesterol(HDL-C)] levels were measured before and 3 weeks after THW.The relationship between serum lipid profile concentrations and thyroid hormone levels were measured.Results Before surgery, HDL-C level showed a significant positive correlation with TSH level(r=0.273, P=0.041), whereas other lipid profile did not show any significant correlation with thyroid hormones levels.Before THW, no correlation was observed between thyroid hormones and lipid profile.After 3 weeks′THW, the TC level was correlated with FT4 and FT3 levels(r were-0.321 and-0.415, respectively, both P<0.01).The LDL-C level was correlated with FT4 level(r=-0.347, P=0.005).The HDL-C level was significantly correlated with TSH, FT3, and FT4 levels (r were 0.342,-0.452, and-0.478, all P<0.01).The serum LDL-C level in patients with TSH above 50 mU/L(n=50) was higher than that in patients with TSH below 50 mU/L(n=15, P=0.001), while serum TC, TG and HDL-C levels were not significantly different between those two groups(P>0.05).Conclusion The serum lipid profile varies with the change of serum thyroid hormones after THW in postoperative DTC patients.

Objective To explore the effectiveness and safety of tiotropium bromide inhalation agent with tulobuterol patch in the treatment of C and D level of COPD in stable period .Methods According to the digital table,255 cases of C and D level in patients with stable COPD were randomly divided into the study group and control group,the patients in study group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day,and give tulobuterol patch(2mg/paste),one time every day.The control group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day.The changes of lung function were observed before and after treatment,the clinical symptom score and inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation condition.Results The patients in the two groups after treatment ,pulmonary function ,clinical symptoms score,inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation compared with statistical significance(all P<0.05).Subgroup analysis in study group ,emphysema phenotype visible persistent effect ,chronic bronchitis phenotype ,ACOS phenotype early effective treatment ,decreased efficacy after half a year .The adverse reac-tion of two groups of drugs were respectively 19.7%and 21.0%,there was no significant difference in the incidence of adverse reaction between the two groups (χ2 =0.071,P>0.05).Conclusion Tiotropium bromide inhalation agent with tulobuterol patch can improve clinical symptoms and pulmonary function in patients with C and D level part of the stable phase of COPD .

Objective To study the change of miR-146a in the development and progression of papillary thyroid carcinoma(PTC).Methods Real-time fluorescence quantitative polymerase chain reaction was used to detect the change of miR-146a in tumor tissues of 43 cases of PTC and 36 cases of nodular goiter,also in peripheral blood of 32 cases of PTC and 23 cases of nodular goiter.The correlation of miR-146a change and the clinicopathological parameters of patients with PTC was analyzed.Results ① The relative content of miR-146a in the 43 patients with PTC and 36 patients with nodular goiter was 0.0280 ± 0.0131 and 0.0212 ± 0.0111 respectively.The difference had statistical significance (P ＜ 0.05).miR-146a in PTC tissues was significantly correlated to clinicopathological parameters such as lymph node metastasis,tumor stage (P ＜ 0.05),and it was unrelated to age or tumor size(P ＞0.05).② The relative content of miR-146a in peripheral blood of 32 patients with PTC and 23 patients with nodular goiter was 0.0891 ±0.0419 and 0.0922 ±0.0456 respectively.The difference had no statistical significance(P ＞ 0.05).There was no significant correlation between miR-146a in peripheral blood of patients with PTC and age,tumor stage,lymph node metastasis,or tumor size of patients (P ＞ 0.05).Conclusions MiR-146a expression is upregulated in patients with PTC,and there is a significant correlation between miR-146a content and clinicopathological parameters such as lymph node metastasis,tumor stage,especially in advanced stage.It suggests that miR-146a may play a role in carcinogenesis and development of PTC.

Objective To define the diagnostic criteria of cardiovascular magnetic resonance imaging in distinguishing isolated left ventricular noncompaction (LVNC) from lesser degrees of hypertrabeculation. Methods Twenty-five patients with LVNC, 39 with dilated cardiomyopathy ( DCM), 16 with aortic stenosis(AS), 15 with aortic regurgitation(AR) , 19 with hypertension (HT) and 22 normal subjects were enrolled in this study. Cardiac magnetic resonance imaging was performed to evaluate the left chamber diameter, functional parameters and noncompaction or hypertrabeculation of the left ventricle in diastole with one-way ANOVA. The left ventricle was divided into 17 segments for localizing all involved segments in this present study. Results The LVNC patients had the commonest myocardial segments involved (10±2)in all subjects. Each patient with LVNC was unexceptionally associated with apical noncompaction (17th segment) , which was seldom found in the other subjects. The lateral walls including 16th, 12th and 11th segments were the most vulnerable segments in all subjects, but nobody was found to involve the basal and mid septum including 2nd, 3rd, 8th and 9th segments. The end-diastolic NC/C (noncompaction/compaction) ratio was, on average, the greatest in patients with LVNC (3.3±0.6), compared with all other subjects(AS:1.0 ±0.3, AR:1.0 ±0.3,HT:0.8 ±0.1,healthy volunteers:0.9 ±0. 2) (F = 169. 62,P <0.05). Receiver operating characteristics analysis identified the end-diastolic NC/C ratio of>2.5 as a valuable parameter to distinguish LVNC from DCM.with values for sensitivity of 96.O%(24/25)and specificity of 94.9%(37/39),respectively.The mean number of NC/C ratio>2.5 segments in the LVNC patients was 4.0 ±2.0.while 8 of 39 patients with DCM had only one segment of NC/C ratio >2.5.Conclusions MRI is all exceUent imaging modality to diagnose LVNC and distinguish LIVNC from hypertrabeeulation.The criteria of LVNC is the NC/C ratio>2.5 in two or more than two segments of free ventricular walls associated with the left ventrieular apex involved.