The design and efficacy of surgery for horizontal idiopathic nystagmus (HIN) with abnormal head posture and strabismus were investigated. Different surgical procedures were selected according to the angle of head turn in 44 cases of HIN with abnormal head posture and strabismus. For patients with a head turn of 15° or less, the Anderson procedure was used; the yoke muscles were recessed upon slow-phase. For patients with a head turn between 15° and 25°, the surgery was designed as a Kestenbaum 5-4-4-5 procedure. For patients with a head turn of 25° or more, the surgery was designed as a Parks 5-8-6-7 procedure. The surgery to correct the abnormal head posture was performed on the fixating eye while that to correct the deviation was then performed on the non-fixating eye at the same time. The amount of surgery of the horizontal rectus muscles on the non-fixating eye was sum of the angle of head turn and the degree of deviation, which was calculated as follows: recession/resection amount of medial and lateral rectis/2×5=angle of head turn±degree of deviation. The results showed as follows: (1) Visual acuity: the visual acuity in the primary ocular position increased two lines or more in 35 patients, accounting for 79.55%. Nine patients had no or only one-line improvement, accounting for 20.45% of the entire study population; (2) The degree of deviation in the primary ocular position: 37 cases had a normal primary ocular position or the degree of deviation ≤8(δ) after surgery, accounting for 84.09%. Six patients had a residual degree of deviation of 8(δ)-15(δ), accounting for 13.64%. One patient had a residual degree of deviation >20(δ), accounting for 2.27% of the patients examined; (3) Abnormal head posture: 34 patients had a normal head posture or a head turn of less than 5°, accounting for 72.27%. Eight patients had a residual head turn of 5°-15°, accounting for 18.18%. Two patients had a head turn of 15°-25°, accounting for 4.55%. It was concluded that different surgical procedures based on the angle of head turn and the relationship between deviation and null zone can eliminate anomalous head posture, correct deviation, and improve vision acuity in the primary ocular position.

Objective To explore the effect of participatory humanistic nursing on the quality of life and psychology of patients with gastric cancer. Methods From May 2015 to May 2016, 68 patients with gastric cancer were enrolled in the study. All patients were divided into the experimental group and the control group with 34 patients in each group according to the principle of double-blind randomization. Patients in the control group were given routine clinical nursing, and patients in the experimental group were given the participatory humanistic nursing care. The quality of life and psychological state were evaluated by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and Symptom Checklist 90 edited by Derogatis and compared before nursing and after 6 months of nursing. Results There was no significant difference in the quality of life before nursing between two groups (P >0.05). After nursing, the scores of physical function, role function, emotional function, cognitive function, social function of the quality of life were 57.85±4.64, 68.43±5.23, 61.43±4.97, 58.47± 6.12, 53.57±5.54 in the experimental group and 43.56±4.56, 54.67±4.67, 56.34±4.74, 51.34±4.13, 50.46± 4.27 in the control group,and there were significant differences (t=2.593-12.808,P<0.01 or 0.05). There was no significant difference in the psychological state before nursing between two groups (P>0.05). After nursing, the scores of interpersonal sensitivity, depression, anxiety, hostility, terror, paranoia, psychosis of the psychological state were 1.65 ± 0.17, 1.40 ± 0.15, 1.45 ± 0.14, 1.46 ± 0.12, 1.52 ± 0.16, 1.54 ± 0.10, 1.43 ± 0.11 in the experimental group and 1.75±0.21, 1.72±0.24, 1.63±0.21, 1.75±0.23, 1.71±0.24, 1.65±0.10, 1.56 ± 0.12 in the control group, and there were significant differences (t=2.158-6.593, P<0.05 or 0.01). Conclusions Participating humanistic care can improve the quality of life and improve the psychological state, and the clinical effect is significant, it is worthy of being popularized and applied.

Colorectal Neoplasms ; surgery ; Humans

Objective To investigate if vascular endothelial growth factor-D(VEGF-D) and endostatin(ES) promote angiogenesis in colorectal cancer(CRC). Methods One hundred and five patients undergoing CRC surgery were enrolled in this study. CRC and normal tissue microarray were produced and measured for VEGF-D and ES by immunohistochemmical staining.Results VEGF-D and ES expression were stronger in CRC tissues than in control normal mucosa. MVD was higher in cancer tissues than in normal ones. ES down-regulated expression was associated with less invasiveness, positive lymph node metastasis, distant metastasis and in cases of early Dukes′ stage, while the expression of VEGF-D in corresponding tissues was on the opposite to ES. MVD increased along with tumor invasion, lymph involvement, distant metastasis and late Dukes′ stage. Conclusions VEGF-D in accord with ES promotes the angiogenesis and progression of CRC.

Objective To investigate the movement and its influencing factors of the space-occup ying pancreatic lesions and provide a reference for the safe margin between CTV and PTV in accurate radio therapy.Methods Gold fiducials were implanted into the lesions of 16 pancreatic carcinoma patients by percutaneous punctures under B-uhrasonographic guidance.The movements of these markers were measured under the X-ray simulator system in the x,y and z axial directions,respectively.The relevant influencing fac tors were analyzed.Results The motion amplitudes of pancreatic lesions were 0.1-0.3 (mean 0.16 ± 0.06) cm,0.1-0.4 (mean 0.25 ±0.12) em and 0.5-1.6 (mean 0.88±0.24) cm in the x,y and z axi al directions,respectively.The movements were not associated with the height,weight,age,tumor location or tumor size.Conclusions The motion of the space-occupying pancreatic lesions is mainly influenced by the respiration,especially with the maximal amplitude in the z axial direction.Therefore,the motion in the z axial direction should be given more consideration when determining the PTV margin.

Objective To investigate the changes of phosphorylated CREB in spinal cord dorsal horn of rats underwent chronic compression of dorsal root ganglia (CCD) and effects of intrathecally administer NOS inhibitor L-NAME,AG or 7-NI and cGMP analogue 8-Br-cGMP on the expression of pCREB in dorsal horn and the changes in thermal hyperalgesia of rats.Methods 90 male adult Wistar rats were randomly divided into L-NAME,AG,8-Br-cGMP,7-NI,Cremophor and PBS groups.Different NOS inhibitors were injected intrathecally by microsyringe at the 5th day after CCD,the thermal paw withdrawal latencies were measured before injection and 0.5,2.0,6.0,12.0,24.0 h after treatment,the anti-nociceptive effects of agents were compared.The expression of pCREB was detected by immunohistochemical analysis 2 h after intrathecal injection.Results CCD significantly increased the expression of pCREB and pCREB positive neurons located in all laminae of bilateral spinal cord.The expression of pCREB in ispilateral and contralateral spinal cord showed no significant difference.Compared with PBS group,there was significant decreasing in number of pCREB positive neurons in L-NAME,AG and 7-NI groups(P

Objective To evaluate the effects of nasal non-Hodgkin′s lymphoma(N-NHL) treated with chemotherapy alone, radiotherapy alone, chemotherapy plus radiotherapy and autologous peripheral blood stem cell transplantation(APBSCT) combined with total body irradiation(TBI);and to analyze the impact factors of prognosis. Methods 135 patients were treated between 1980 and 2000. All were confirmed by histopathology as N-NHL, including 122 T cell in origin, 12 B cell and 1 NK cell in origin. The main radiotherapy portal was set in front of the nose with a spade-like protrusion, supplement with a portal next to the ear on one side or both sides. Combined portal in facial cervical area was first used when there was invasion of the oropharynx. The median dose to the nasal cavity was 56.0Gy with a range of 35.2 to 75.5Gy, with added 30Gy to the primary lesion in two patients. Six patients received TBI combined with APBSCT, with 8Gy in the TBI group. Chemotherapy, given before or during after radiotherapy or alone, consisted of 2-6 cycles of COP, COPP, COMP, CHOP or COBDP. Prognostic factors were analyzed with Cox model. Results The local control rate was 12%,69%,76% and 83% in chemotherapy alone, radiotherapy alone, chemotherapy plus radiotherapy and APBSCT combined with TBI, respectively(P=0.057).The 5-year survival rate was 9%,52%,63% and 83%,respectively(P=0.032). Multi-factor analysis showed that tumor extension and treatment methods were the most important prognostic factors besides Ann-Arbor stage, but gender, pathology, age and symptoms had little effect on prognosis .Conclusions Chemotherapy plus radiotherapy group achieves a better survival rate than radiotherapy alone. It is helpful to evaluate prognosis to make more detail subareas on basis of local extensions in Ann Arbor staging system.For some N-NHL patients with good financial condition, APBSCT combined with TBI is a good choice.

Objective:To investigate the use of proton pump inhibitors ( PPIs) in the patients with cirrhosis or hepatitis in one hospital and evaluate the use rationality .Methods:A retrospective study was carried out on 211 patients with the diagnosis of hepatitis or cirrhosis in the infectious disease ward between 2013 and 2014 , and the use rationality of PPIs was evaluated .Results: A total of 211 cases were inspected, and among them, 192 ones were treated with PPIs (91%) with 62 ones treated with PPIs irrationally, which accounted for 29.3%of the total cases.The main irrational use of PPIs was long treatment course (24.5%), inadequate prophylaxis indications (5.7%) and purposeless use (2.6%).Conclusion: Irrational use of PPI is common in hepatitis or cirrhosis patients . Clinical pharmacists should strengthen pharmaceutical care to improve the rational drug use .

Background and purpose:P38 mitogen-activated protein kinase (P38MAPK) signal transduction pathway is involved in occurrence, development and transfer process in a wide variety of tumors. Urokinase-type plasminogen activator (uPA) plays an important role in tumor invasion and metastasis. This study aimed to explore the clinical signiifcance of the P38MAPK signaling pathway and the expression of uPA in ovarian cancer.Methods:The expressions of uPA, P38MAPK, ERK and AKT were detected in 49 cases of cervical adenocarcinoma by immunohistochemistry. The expressions of uPA and P38MAPK were detected by Western blot in ovarian cancer cell lines HO8910, HO-8910PM, SKOV3 and CAOV3. The changes of uPA and P38MAPK were detected by SB203580, a speciifc inhibitor of P38MAPK signal transduction pathway.Results:The result of immunohistochemical method showed that positive expression rates for uPA, P38MAPK, ERK and AKT were 61.22%, 57.14%, 53.06% and 55.10%, respectively. The expression of the uPA was positively correlated with the P38MAPK (r=0.865,P=0.001), and related with clinicopathologic stage, differentiated degree, lymph node metastasis, but not related with age and histologic type (P>0.05). The expressions of AKT and ERK were related with the lymph node metastasis and greater omentum metastasis(P<0.05), but not related with age and histologic type (P>0.05). The expression of uPA in HO-8910PM was higher than that in ovarian cancer cell lines HO8910, SKOV3 and CAOV3, and the expression of uPA reduced when the P38MAPK signal transduction pathway was cut off by the SB203580. The expressions of P38MAPK and uPA were negatively correlated with the prognosis of ovarian cancer (Log-rank=3.897 and 11.044,P=0.048 and 0.001). Conclusion:The P38MAPK signal transduction pathway was activated in ovarian cancer. The activated P38MAPK signal transduction pathway can raise the expression of uPA, which may contribute to the development of ovarian cancer. The result indicates that the P38MAPK signal transduction pathway and uPA might play an important role in the invasion and metastasis of ovarian cancer. P38MAPK and uPA might be useful markers for evaluating prognosis of ovarian cancer.

Objective To investigate the feasibility and value of CT perfusion imaging in combination of CTA 320-slice CT with dual-low-dose in detection of acute cerebral ischemia.Methods Forty patients with acute stroke underwent perfusion imaging and CTA using a single scan with 320-slice CT with dual-low-dose schedule.CTA,4D-CTA,4D-perfusion imaging and fusion images were generated at a post-processing workstation.All patients also underwent a 3.0T magnetic resonance imaging with DWI for a comparison.Quality of the images,degree of vascular stenosis,and location of ischemic lesions were evaluated.Results The vascu-lar stenosis or occlusion was found in 33 patients,8 of whom were confirmed by the DSA.The ratio of better images of CTA was 82.5%.CTP showed 297 lesions with abnormal perfusion.202 lesions were confirmed as infarct by DWI,while 95 ones were nor-mal on DWI but with increased DLY and TTP and slightly decreased CBF and CBV in 49,increased DLY and TTP and normal CBF and CBV in 21,and increased DLY and TTP and slightly increased CBF and CBV in 25.Conclusion CT perfusion in combination with CTA by 320-slice CT with dual-low-dose is feasible and useful to observe accurately the vascular structures and the ischemic status of the whole brain at early stage.