Objective To explore the narcotic effect of three inhalation induced methods of sevoflurane.Methods According to the different inhalation methods of sevoflurane,60 patients with elective upper abdominal surgery under intubation general anesthesia were divided into group A (vital capacity breathing),group B (tidal volume breathing),and group C (gradually increasing the concentration of sevoflurane),each group 20 cases.The sevoflurane concentration of A group and B group was 9％,which of group C was 4％,and oxygen pipeline was prefilled by oxygen flow(3L/min).The heart rate(HR),mean blood pressure(MAP),diastolic blood pressure(DBP) and systolic blood pressure(SBP) values and the effect of muscle relaxants were observed and recorded at T1 (basic indicators),T2 (eyelash reflex),T3 (before intubation),T4 (intubation time 2 min),T5 (intubation time 4 min),T6 (intubation time 6 min).Results The SBP,DBP,and MAP of group A,B and C at different time points were all inhibited(all P ＜0.05),and the significant inhibitory effect was at time point T3 (all P ＜0.01).There was no close correlation between HR changes and the muscle relaxant effect of group A,B and C at different point(all P ＞ 0.05).Conclusion Three kinds of sevoflurane inhalation induction can lower blood pressure,and they are safe,reliable,and able to be accepted by the patients.

Objective To determine the expression of metastasis-associated gene 2 ( MTA2 ) and p53 in colorectal cancer and non-cancerous mucosa, analyze their relationship with clinicopathological parameters, and discuss the clinical significance. Methods 120 colorectal neoplasm patients' cancer tissues and clinical information were col-lected from the first affiliated hospital of Anhui medical university. 30 patients of them were chosen to collect non-cancerous mucosa which was 5 cm away from the tumor. Immunohistochemistry staining was used to detect the ex-pression of MTA2 and p53. According to the clinicopathological parameters, the positive and negative expression of MTA2, p53 were counted each group, discussed the relationship between positive expression and clinicopathologi-cal parameters by SPSS 19.0 . Results The immunohistochemistry showed that the positive expression rate of MTA2 was 59.16%, and the positive expression rate of p53 was 61.67%. The expression of MTA2 and p53 in colorectal cancer were significantly higher than non-cancerous mucosa ( P<0.05 ) . The MTA2 expression was positively cor-related with the depth of invasion, lymphatic metastasis, distant metastasis and TNM stages (P<0.05). The p53 protein expression was positively correlated with depth of invasion and lymphatic metastasis ( P<0.05 ) . Conclu-sion MTA2 could be used as a new clinical biomarker and therapeutic target for colorectal cancer probably, which might be more effective than p53 .

PURPOSE: To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. MATERIALS AND METHODS: Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. RESULTS: The mean radial displacements were 2.26 (+/-1.03) mm in the control group and 3.05 (+/-1.97) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. CONCLUSION: This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.
Consensus ; Displacement (Psychology) ; Head ; Head and Neck Neoplasms ; Humans ; Lymph Nodes ; Masks ; Neck ; Skull Base ; Spine

Objective:To evaluate the efficacy and safety of docetaxel+ prednisone in the treatment of castrated resistant prostate cancer in patients over 75 years old.Methods:In this study, 118 metastatic castration resistant prostate cancer (mCRPC) patients over 60 years old treated in Beijing Hospital from February 2013 to December 2019 were retrospectively analyzed. The median age of the patients was 72 (65, 77)years, ECOG scores ≤2. All 118 cases had bone metastasis, 5 cases had visceral metastasis. A total of 40 patients chose docetaxel as the first-line treatment of mCRPC, and the remaining 78 patients chose docetaxel as second-line or third-line treatment. The study included 53 patients >75 years old and 65 patients aged 60-75 years. The age of patients in the two groups were 67 (63, 71) years old and 78 (76, 83) years old, the difference was statistically significant ( P<0.05). Among them, there were 24 cases with Gleason score ≤7 and 41 cases with Gleason score >7 in 60-75 years old group, and 30 cases with Gleason score ≤7 and 23 cases with Gleason score >7 in the group of >75 years old, with significant difference between the two groups ( P = 0.034). Sixty-one patients received endocrine therapy and 4 received orchiectomy in the 60-75 years old group; 43 patients received endocrine therapy and 10 received orchiectomy in the group of >75 years old, the difference was statistically significant ( P=0.035). There were 37 cases with ECOG 0 score, 25 cases with 1 scores and 3 cases with 2 scores in the group of 60-75 years old; there were 5 cases with ECOG 0 score, 38 cases with 1 score and 10 cases with 2 score in the group of >75 years old, with significant difference between the two groups ( P<0.05). There was no significant difference in PSA level[ 90 (35.5, 258) ng/ml vs. 115 (60, 296) ng/ml], G8 scale score [(14.3±2.1 vs. 13.6±1.1)], Mini-Cog score[3(2, 3) vs. 3(1, 3)], and visceral metastasis [2 cases (3.1%) vs. 3 cases (5.7%)]( P>0.05). The efficacy and safety of docetaxel in the two groups were further observed. Results:The median follow-up time was 21.5 (6, 62) months. There was no significant difference in chemotherapy cycle [(6.1±1.3) vs. (6.8±1.7)] and chemotherapy dose [(70.3±4.3) mg/m 2 vs. (66.3±5.2) mg/m 2] between the 60-75 years old group and the >75 year old group ( P> 0.05). The PSA response rate [72.3%(47/65)vs.66.0%(35/53)], pain relief rate [45.0% (9/20) vs. 54.5% (6/11)], and median progression-free survival[6.1 (1.4, 11.2) months vs. 5.9 (2.0, 12.0) months] had no statistical significance ( P>0.05). There were no deaths in the two groups during chemotherapy. The median overall survival(OS) of patients aged 60-75 years and those >75 years old who received docetaxel as first-line treatment were 26.5 (16.1, 31.3) months and 24.8 (17.5, 28.4) months, respectively ( P=0.223). The median OS of the two groups were 17.3 (13.2, 20.5) months and 15.4 (12.3, 20.0) months with docetaxel treatment as second or third line treatment ( P=0.331). There were 3 cases (4.6%) and 5 cases (9.4%) of grade 3 adverse reactions in 60-75 years group and >75 years old group, respectively. Grade 3 leukopenia occurred in 1 case time (1.5%) and 2 cases (3.8%) respectively. Grade 3 neutropenia fever occurred in 1 case time in both groups. There was no significant difference in the incidence of above complications between the two groups ( P > 0.05). Conclusions:The efficacy and safety of docetaxel + prednisone chemotherapy for mCRPC patients >75 years old were similar to those of 60-75 years old. Age should not be the absolute contraindication of docetaxel for prostate cancer chemotherapy.

Objective To analyze the incidence of stress hyperglycemia and its influential factors in patients with acute myocardial infarction and cerebral infarction. Methods The case data of 1630 consecutive patients with incipient myocardial infarction without cerebrovascular disease admitted in the department of cardiology and 1338 patients with atherosclerotic acute cerebral infarction without cardiovascular disease admitted in the department of neurology,Xuanwu Hospital,Capital Medical University from January 2009 to December 2012 were analyzed retrospectively. A total of 2048 patients without diabetes mellitus were selected from them,among them 1165 patients were in an acute myocardial infarction group and 883 were in a cerebral infarction group. The fasting blood glucose >7. 8 mmol/L in the next morning after admission was defined as hyperglycemia. Single factor and multifactor logistic regression analyses were used to compare the incidence of stress hyperglycemia and its influential factors of both groups. Results ( 1 ) Of the 1165 patients with myocardial infarction,the incidence of stress hyperglycemia was 17. 2% (n=201);of the 883 patients with cerebral infarction,the incidence of stress hyperglycemia was 5.4% (n=48). There was significant difference between the 2 group (χ2= 65.677;P < 0. 01). (2) Comparing the general information of the patients with stress hyperglycemia (n=249) and those without stress hyperglycemia ( n=1799) of the cardio-cerebrovascular diseases showed that there were significant differences in hyperlipidemia, drinking history, family history of cardio-cerebrovascular diseases, age, heart rate, total cholesterol, low density lipoprotein cholesterol,leukocyte count,blood urea nitrogen,and triacylglycerols between the 2 groups (P<0. 05). (3) Multivariate Logistic analysis showed that heart rate ( OR,1. 013,95%CI 1.002-1.024),leukocyte count (OR,1.109,95%CI 1.508-1.163),and triacylglycerols(OR,1.174, 95%CI 1. 042-1. 322) were the independent risk factors for stress hyperglycemia in myocardial infarction. (4) Systolic blood pressure (OR,1. 019,95% CI 1. 006-1.033) and leukocyte count (OR,1. 132,95%CI 1. 009-1. 268) were the independent risk factors for stress hyperg lycemia in cerebral infarction. Conclusion The incidence of stress hyperglycemia in patients with myocardial infarction is higher than that in patients with cerebral infarction,and the increased leukocyte count is a common independent risk factor for both.

Humans ; Indocyanine Green ; Liver Cirrhosis ; Liver Failure

Objective To investigate hemorrhagic transformation (HT) and outcomes in acute ischemic stroke.Methods The demographics,vascular risk factors,imaging and other clinical data in patients with acute ischemic acute were collected retrospectively and compared.Using the susceptibility weighted imaging (SWI) to diagnose HT,and the patients were divided into either a HT group or a non-HT group.The modified Rankin scale was used to evaluate the clinical outcomes.Multivariate logistic regression analysis was used to determine the independent risk factors for HT and poor outcome in HT patients.Results A total of 96 patients with acute ischemic stroke were enrolled and 34 of them had HT (35.4％).The age (66.21 ± 7.04 years vs.61.21 ±13.42 years; t =2.020,P=0.046) and infarct volume (3.88 ±2.20 cm3 vs.1.96 ± 1.37 cm3; t =5.67,P=0.001) in the HT group were significantly older or larger than those in the non-HT group.The proportions of hypertension (58.8％ vs.30.6％;x2 =7.228,P=0.007),diabetes (29.4％ vs.6.5％;x2 =9.293,P=0.002),atrial fibrillation (35.3％ vs.3.2％;x2=18.128,P=0.000),and cardiogenic cerebral embolism (35.3％ vs.3.2％ ; P =0.000) were significantly higher than those in the non-HT group,while the proportion of small arterial occlusive stroke was significantly lower than that in the non-HT group (38.2％ vs.62.9％ ;P =0.032).Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.168,95％ confidence interval [CI] 1.059-3.412; P =0.021),infarct volume (OR 3.461,95 ％ CI 1.317-6.270; P =0.044) and atrial fibrillation (OR 1.284,95％ CI 1.117-2.903; P =0.015) were the independent risk factors for HT.In the HT patients,age (69.46 ±7.17 years vs.64.19 ±6.31 years; t =2.248,P =0.032) in the poor outcome group was significantly older than that in the good outcome group.The proportions of hypertension (84.6％ vs.42.9％ ;x2 =781,P =0.016),diabetes (50.0％ vs.14.3％ ;x2 =6.053,P =0.014),cardiogenic cerebral embolism (61.5％ vs.19.0％ ; P =0.025) and hematoma HT (76.9％ vs.19.0％ ;x2 =11.104,P =0.001) were significantly higher than those in the good outcome group.Multivariate logistic regression analysis showed that the diabetes (OR 2.151,95％ CI 1.179-3.218; P =0.023),atrial fibrillation (OR 4.136,95％ CI1.010 to 8.413; P =0.046) and hernatoma HT (OR 2.134,95％ CI 1.219-4.452; P =0.039) were the independent risk factors for the poor outcomes of HT patients at 3 months after symptom onset.Conelusions The incidence of HT in patients with acute ischemic stroke was 35.4％.Age,infarct volume and atrial fibrillation were the independent risk factors for HT,and diabetes,atrial fibrillation and hematoma HT were the independent risk factors for the poor outcomes in HT patients at 3 months after symptom onset.

Objective To investigate the relationship between psychological quality and performance capacity of the crew in armored equipment so as to provide scientific evidence for the training of crew .Methods The psychological quality of 82 crew members of armored cavalry was tested and analyzed by neurobehavioral testers and questionnaires .Results and Conclusion The education level and age had no significant effect on the performance capacity among the armored crew . The test results of psychological quality parameters showed the same trend as the performance capacity of the crew , but their psychological health status had obvious effect on the performance capacity .The psychological quality of the crew had great influence on their performance capacity ,so we should pay attention to mental intervention ,enhance psychological protection ability of the crew , and improve their combat effectiveness continuously .

Objective To investigate the relationship between the steroid-sensitive nephrotic syndrome(SSNS) and interleukin-18(IL-18) and to approach the inhibitive role of dexamethasone(DEX) on expression of IL-18 of peripheral blood mononuclear cells(PBMC) in children with SSNS in vitro.Methods IL-18 levels of serum, urine and supernatants of PBMC cultured in vitro were measured by enzyme linked immunosorbent assay(ELISA) in 23 children with SSNS who were either before or after treatment. Fifteen age-matched healthy children served as normal control group, and another 18 children with respiratory infections as infectious control group.Results There were signi-ficant differences of IL-18 in serum and urine before and after treatment in children with SSNS (t=15.072,16.149 Pa

Abstract: Objective　To evaluate the completion and final effect of key parasitic disease prevention and control planning tasks in Hubei Province from 2016 to 2019, summarize the experience, find out the problems, and provide the basis for the next stage of prevention and control. Methods　According to the requirements of the Final Evaluation Plan of the National Plan for the Prevention and Control of Hydatid Disease and Other Major Parasitic Diseases (2016-2020), a retrospective survey method was adopted to collect relevant data on the implementation and safeguard measures of the prevention and control of major parasitic diseases, and population infection status in Hubei Province in 2016-2019. Results From 2016 to 2019, We carried out 2 920 992 person times of publicity and education, 209 times of prevention and control technology training, 7 680 person times of business training, with an average of 52 sessions and 1 920 person times per year. We have allocated 3.445 2 million yuan for the prevention and control of parasitic diseases, including 1.722 2 million Yuan froom provincial government, to achieved full coverage of safe drinking water in rural areas under the current national standards, and 7.687 9 million harmless toilets have been built in rural areas. From 2016 to 2019, we carried out 39 658 person times of monitoring and disease investigation, the infection rate of human liver fluke was 0, and the infection rate of soil transmitted nematode was 0.42%. While the annual infection rates varied, there was no statistically significant difference in infection rate between years (χ2＝2.276, P>0.05), but there were statistically significant differences in the infection rates between various soil nematodes (χ2=112.807, P<0.01). From 2016 to 2019, a total of 5 393 people were detected at 17 monitoring points, with the serum positive rate of 3.93% for paragonimiasis, there was a statistically significant difference in serological positive rate between years (χ2=146.011, P<0.01); a total of 738 stream crabs were collected, and the infection rate of intermediate host was 16.26%, wtih a statistically significant difference in the infection rate of stream crabs between years (χ2=49.731, P<0.01). Conclusions　From 2016 to 2019, we adhered to the prevention and control strategy of "prevention first, prevention and control combined", implemented comprehensively various prevention and control measures, and achieved remarkable results in Hubei Province. The key parasitic diseases have been in a low epidemic situation, meeting the requirements of the prevention and control objectives. But the transmission risk still exists, the next step is to continue to strengthen security and monitoring and consolidate the achievements of prevention and control.