ObjectiveTo investigate the effect of mild hypothermia on neuron specific enolase (NSE) and superoxide dismutase (SOD) in serum of patients with large-area cerebral infarction.Methods160 cases with large-area cerebral infarction were divided into the treatment group and control group with 80 cases in each group. Patients of the control group were treated with routine therapy. Those of the treatment group were added with mild hypothermia therapy (MHT). The scores of NIHSS were assessed and NSE and SOD in serum were examined before treatment and 7, 14 and 30 days after treatment in two groups.ResultsThe NIHSS score of the treatment group was significantly lower than that of the control group ( P<0.05), and NSE level decreased, SOD vitality increased in the treatment group. Other indexes such as respiratory, pulse, serum kalium and etc of two groups were not different ( P>0.05).ConclusionMHT can improve he nerve function of patients with large-area cerebral infarction recovering and improve prognosis.

Humans ; Otitis Media ; classification ; pathology ; surgery

Cervical Intraepithelial Neoplasia ; diagnosis ; pathology ; surgery ; Colposcopy ; Conization ; Electrosurgery ; Female ; Humans ; Hysterectomy ; methods ; Neoplasm Regression, Spontaneous ; Uterine Cervical Neoplasms ; diagnosis ; pathology ; surgery ; Vaginal Smears

Objective To investigate the CT diagnostic value and CT findings of fungal sinusitis.Methods CT findings of fungal sinusitis in 25 cases proved pathologically were retrospectively analysed.Results Heterogeneous density of sinusal cavity with small calcification appeared as spots or floccose(9 cases) and sand-like or patchy(16 cases) shadows,and local bone destruction.Conclusion The fungal sinusitis has characteristic findings on CT.CT is a valuable method for diagnosing the disease.

AIM: To study the quality standard of Sanqi Capsule s. METHODS:The content of ginsenoside Rg 1 and ginsenoside Rb 1 were dertermined by HPLC-ELSD. RESULTS:Ginsenoside Rg 1 showed a good linear relationship at the range of 1.3?g ～ 6.5?g (r= 0.9994 ). The average recovery o f ginsenoside Rg 1 was 98.30% , and RSD was 1.20% (n=5). Ginseno side Rb 1 showed a good linear relationship at the range of 1.0?g ～ 5.0 ?g (r= 0.9996 ). The average re covery of ginsenoside Rb 1 was 97.12% , and RSD was 1.17% (n=5). CONCLUSION:The method is efficient and accurate wi th a good repeatability and can be used for the quality control of Sanqi Capsule s.

Objective To evaluate the implementation effect of work improvement in health services technical tool （ ） - HealthWISE developed by the International Labor Organization and the World Health Organization in a grade A tertiary Methods - hospital. A total of 14 healthcare workers who had participated in the HealthWISE teacher training in a grade A - tertiary hospital since 2016 were selected as the research subjects using a typical sampling method. Semi structured interviews ， Results ， were conducted and the interview data were collected and analyzed. Among the 14 subjects five participated in the training for more than three times. The research subjects believed that they had gained great insights through the training. The ， training had led to positive changes in both individual and team levels. In particular the hospital had established an ， ， occupational health protection system which had been significantly improved in organizational construction training and ， - ， education capacity building and so on. During the prevention and control of the COVID 19 pandemic the hospital strengthened HealthWISE application to ensure the occupational safety and health of healthcare workers. All research subjects provided opinions and suggestions on the improvement of the national comprehensive occupational health protection system for healthcare Conclusion ， workers in the future. The application of HealthWISE in this hospital has achieved remarkable results which helps to promote the establishment of a comprehensive occupational health protection system for healthcare workers on a large scale.

PurposeThe restriction of strain ratio (SR) in the diagnosis of thyroid malignant tumor are caused mainly because of disadvantages including low sensitivity, in this research the authors used different calculation methods of strain ratio based on the size of tumors, to explore the clinical application value of them on the differentiation of benign and malignant thyroid nodules.Materials and Methods Data of 336 patients with thyroid nodule (340 nodules) who underwent elasticity imaging and ultrasound-guided fine-needle aspiration were retrospective analyzed, with the pathology combined follow up acted as golden standards, fixed surface area assay and true surface area assay of strain ratio were compared on the differential diagnosis of benign and malignant thyroid nodules with various size.Results Among 340 thyroid nodules, there were 91 small nodules and 249 big nodules. Pathological results showed that 36 of 91 small nodules and 104 of 249 big nodules were malignant, while the others were benign. The true surface area assay was significantly better for the diagnosis of smaller thyroid nodules with longitudinal diameter and transverse diameter<8 mm with higher consistency with pathology (χ2=20.89,P<0.01), and fixed surface area assay is more suitable of thyroid nodules with longitudinal diameter and transverse diameter>8mm (χ2=57.08,P<0.01). The sensitivity, specificity and consistency for the diagnosis of malignant nodules of true surface area assay were 57.10%, 83.00% and 72.30% (Kappa=0.413), which were 73.60%, 85.00% and 72.30% (Kappa=0.590) in the fixed surface area assay, and 85.00%, 85.50% and 85.30% (Kappa=0.699) in the selective usage of two methods according to the tumor size, respectively.Conclusion The sensitivity is highest when using the two methods selectively according to the nodule size, with a better consistence rate with pathological results as well.

AIM: To explore the feasibility of using vector-based small interfereing RNA(siRNA) to inhibit the expression of MDR1 mRNA and P-glycoprotein and to reverse the multidrug resistance of drug-resistant ovarian cancer cell line.METHODS: An adriamycin-resistant human ovarian cancer cell subline OVCAR/AR was established by stepwise inducement.Another mutidrug-resistant human ovarian cancer cell subline OVCAR/MDR was established by transfecting multidrug resistant gene 1(MDR1) into ovarian carcinoma cell line OVCAR-3.Transfection of MDR1 mRNA specific siRNA expressing plasmids(pSN/mdr1a and pSN/mdr1b) into OVCAR/AR and OVCAR/MDR cells was performed using liposome transfection reagents.MDR1 mRNA expression level was quantified using real time reverse transcription polymerase chain reaction(real time RT-PCR).Flow cytometry(FCM) was performed to assess the expression of p-glycoprotein(P-gp).Multidrug resistant to anticancer agents was evaluated by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide(MTT) assay.RESULTS: Basal MDR1 mRNA expression level in drug-resistant cell line OVCAR/MDR was higher than that in OVCAR/AR cell line,and was both higher than that in its parent cell line OVCAR-3.The expression of MDR1 mRNA and P-gp protein in both OVCAR/AR and OVCAR/MDR cells was inhibited dramatically by transfecting with pSN/mdr1a and pSN/mdr1b.The reversal rate of chemoresistance to adriamycin in OVCAR/AR and OVCAR/MDR transfected with pSN/mdr1a and pSN/mdr1b was 79.5% and 93.9%,compared with control group.CONCLUSION: MDR1 expression in the drug-resistant cell lines is partially inhibited by treatment with vector-based MDR1 specific small interference RNAs at the mRNA and protein level,which increases the chemotherapy sensitivity of these drug resistant ovarian carcinoma cell sublines.

ObjectiveTo guide fluid management and evaluate the clinical index through monitoring extravascular lung water index(EVLWI) of patients with pulmonary contusion.MethodsThirtyone severe chest trauma patients with pulmonary contusion were selected,performed with central venous catheterization or femoral artery catheterization,and connected to pulse index continuous cardiac output (PICCO).EVLWI after pulmonary contusion were measured by using thermal dilution.The intake and output of patients were recorded in detail,fluid intake was controlled,furosemide was prescribed,and the changes and correlations of oxygenation index,EVLWI and liquid balance difference at different time points were evaluated.ResultsEVLWI after pulmonary contusion at 1st to 7th d after hospitalization was respectively (9.25 ±0.71),(8.98 ±0.61),(8.61 ±0.59),(7.75±0.53),(6.64 ±0.49),(6.22±0.36),(5.59 ±0.39) ml/kg.Comparing with 1st d after hospitalization,EVLWI declined from 3rd d (P ＜ 0.05).Oxygenation index at Ist to 7th d after hospitallzation was respectively( 145.76±23.61 ),( 144.19±20.24),( 146.67±19.25 ),(159.33±15.42),(177.38±14.25),(199.33±19.04),(213.71±18.51) mm Hg(1 mm Hg =0.133 kPa).Comparing with 1st d,oxygenation index from 4th to 7th d had significant difference (P ＜ 0.05 ).The fluid volume at 1st d to 7th d were all negative balance,that of 3rd d to 6th d had significant difference comparing with 1st d [(-431.43±121.17),(-601.43±127.09),(-629.52±140.69),(-320.01 ±93.71) ml vs.(-213.81±63.91 ) ml](P ＜ 0.05 ).Oxygenation index and EVLWI had negative correlation(r =-0.824,P＜0.01).Liquid balance difference and the changes of oxygenation index and EVLWI had no correlation.ConclusionEVLWI effectively monitoring after pulmonary contusion can not only evaluate the changes of pulmonary vascular permeability of patients with pulmonary contusion,but also have important significance to guide fluid management.

It is to difficult to diagnose and treat hepatobiliary surgical diseases since its diverse clinical manifestations,which increases the difficulty of clinical internship.Taking clinical cases as teaching material,case-based learning was combined with teaching theme and was conducted by means of discussion and question and answer between teachers and students.Students can know about concepts or theories related to teaching theme.Case-based learning in internship can consolidate basic knowledge of hepatobiliary surgery,cultivate clinical scientific thinking and is helpful in analyzing and resolving problems of hepatobiliary surgical diseases.