Objective To observe the effect of restrictive transfusion in colon cancer surgery in elderly patients on postoperative VAP (ventilator-associated pneumonia). Methods Forty cases of elderly patients with colon cancer intending to undertake surgery were randomly divided into restrictive transfusion group (group R) and standard transfusion group (group S) with 20 cases in each group. In group R, patients were administered one third of accumulative fluid loss in the first 60 minute, then the infusion rate were 4 mL/(kg·h) and central venous pressure was maintained at 5 ~ 7 cmH2O. In group S, rate of fluid administration = CVE + deficit +maintenance + loss + third space. Blood gas index including lactic acid and volumes of fluid administered, blood loss, urine volume and thoracic fluid count (TFC) were recorded in the operation. Clinical pulmonary infection score(CPIS) was recorded respectively before operation, 1 day, 3 day, 7 day after operation to evaluate the risk of VAP. Results Compare with those in group S, there were significantly less TFC and intraoperative volumes of fluid administration in group R. The CPIS was significant lower at day1, day3, day7 after operation in group R. There was no significant difference in MAP, HR, CO and urine volume between two groups. Conclusions In colon cancer surgery for elderly patients, restrictive transfusion can maintain hemodynamic stability, ensure the tissue oxygenation, reduce conjunction edema, shorten the recovery and hospital stay and reduce the incidence of VAP.

Objective To investigate the effects of rapid colloid and crystalloid infusions on the plasma concentration of propofol( Cp) during target-controlled infusion.Methods Thirty-six patients were randomly assigned to three interventions(12 patients per group).At least 30 min after the start of propofol infusion,the hydroxyethyl starch solution group(HES)received HES of 24 mL/(kg· h),on the former 20 min,the sodium acetate Ringer’s injection group(AR)received AR of 24 mL/(kg· h),while HES group and AR group of later 20 min and the control group of whole course received AR of 2 mL/(kg· h).The plasma concentrations of propofol were recorded per 2 min and a half.The cardiac outputting,blood volume and clearance of indocyanine green were measured by pulsed dye density analyzer,the effective hepatic blood flow( EHBF) were obtained.Results The varying of Cp with time showed a significant treatment factor(F[2,33] =14.14,P<0.001)and time factor(F[16,528] =10.37,P<0.001)and interaction between the above factors(F[32,528] =2.82,P <0.001) by ANOVA for repeated measurement;the difference of Cp among each group,Cp in HES group was significantly lower than AR group(5-40 min)or control group(10-40 min),with significant difference(P<0.05).The varying of EHBF with time showed a significant treatment factor(F[2,28] =3.68,P=0.038)and time factor(F[2,56] =5.37,P=0.007)and interaction between the above factors(F [4,56] =3.67,P=0.010);while there was no significant difference in other groups.Conclusion Rapid HES infusion increases the effective hepatic blood flow,resulting in a decrease of propofol concentration during target-controlled infusion.Rapid HES infusion should be used cautiously as it may decrease the depth of anesthesia.

Adenocarcinoma, Mucinous ; pathology ; Breast Neoplasms ; pathology ; Carcinoma, Ductal, Breast ; pathology ; Carcinoma, Renal Cell ; pathology ; Carcinoma, Squamous Cell ; pathology ; Cystadenocarcinoma, Mucinous ; pathology ; Cystadenoma, Mucinous ; pathology ; Female ; Giant Cells ; pathology ; Humans ; Osteoclasts ; pathology ; Ovarian Neoplasms ; pathology ; Pancreatic Neoplasms ; pathology ; Thyroid Carcinoma, Anaplastic ; Thyroid Neoplasms ; pathology ; Tongue Neoplasms ; pathology ; Urologic Neoplasms ; pathology

Objective To explore the relation among the quality of the Paridis polyphylla and different species and growth conditions, and help to provide scientific foundation for introduction and cultivation of Paridis polyphylla.Methods The samples of Paridis polyphylla were collected by different varieties, different growth years, different harvest seasons and different altitude habitats. The content of saponins in Paridis polyphylla was measured by HPLC method according to the Chinese Pharmacopoeia 2015. The chromatographic column was ACQUITY UPLC? HSS T3 (3.0 mm× 100 mm, 1.8μm), the mobile phase was acetonitrile and water (gradient elution), with flow rate of 0.5 ml/min, detection wavelength was 203 nm and column temperature at 35℃.Results Total saponin content ranged from 1.35% to 3.89% among the varieties studied. The content of each components were listed as:Paris polyphylla Smith(PS) >Paris polyphylla Smith var. yunnanensis(Franch.) Hand.-Mazz. (PY) >Paris polyphylla Smith var. chinensis(Franch.) Hara (PC). From 3 to 10 years old of PC, the longer the growth years made the higher the total saponin content. Furthermore, total saponin content of PC increased gradually with the altitudes rising from 400 to 800 meters. The total saponin content of PY harvesting in spring was much higher than that of other seasons.Conclusions The Results showed the importance for introducing and cultivating of Paridis polyphylla.

?Dry eye is a multi-factorial disease of tear film and ocular surface, and it can result in discomfort, visual disturbance and tear film instability and potential damage of ocular surface, accompanied by hyper osmolarity of tears and ocular surface inflammation. lnflammation is the key factor to dry eye. Many kinds of immune cells and inflammatory factors are involved in the occurrence and development of dry eye syndrome. Cell apoptosis, nerve dysregulation, disorders of sex hormones also play an important role in pathologic process of dry eye. Recently, while illustrating the pathophysiology and pathogenesis of dry eye has been made some progress, there is still no single standard. The possible mechanisms of ocular surface inflammation and tear dysfunction of dry eye were reviewed in this article.

Objective To analyze the X -ray, CT, and MR imaging findings in osteoid osteoma. Methods Forty-eight cases of osteoid osteoma proved by surgical pathology were collected, including 33 males and 15 females. Among the 48 cases, all patients had plane films, 32 were imaged with CT scanning, 10 with MR imaging, and 8 with all three techniques. The imaging findings of osteoid osteoma and the ability of X-ray, CT, and MRI in demonstrating the nidus and the surrounding reaction were analyzed. Results The imaging manifestations of osteoid osteoma revealed a circular or oval nidus with different bone sclerosis around the nidus. The diameters ranged from 0.4 cm to 1.7 cm, with the average of 9.7 cm. There were also soft tissue and bone morrow edema around the nidus or distinct effusion of joint on MR imaging in all 10 cases. Among 48 cases, only 37 cases showed nidus on plane film. All 32 cases with CT scanning showed nidus. The display ratios of nidus were 77% for X-ray and 100% for CT, respectively. 10 cases with MR imaging could be diagnosed correctly. But the nidus could be affirmed in only 8 cases, and the nidus was affirmed by comparing with plane film or CT in the other 2 cases. Conclusion Nidus is the key in diagnosing the osteoid osteoma correctly. Plane film is still an important checking method for osteoid osteoma. CT scan is the best method to demonstrate the nidus. MRI can demonstrate the soft tissue and bone morrow edema around the nidus sensitively, but probably lead to an incorrect diagnosis. Combining with X-ray or CT, MRI can make an accurate diagnosis.

OBJECTIVE:To explore the comprehensive model for the prevention and treatment of community hypertension.METHODS:By questionnaire survey,the community hypertension target population was screened and the drug use in hypertensive patients was analyzed statistically.RESULTS:Of the 65 000 community residents investigated,1 250 were found to be hypertensive patients,with a total treatment rate of 80.0%;only 32.8% were treated with at least 2 kinds of drugs,and the overall blood pressure control efficacy was poor.CONCLUSION:The program of prevention and treatment for community hypertensive patients is conducive to patients' long term adherence to medication,scientific and rational drug use and effective and stable control of blood pressure.

ObjectiveTo detect specific antigens of neural cells in amniotic epithelial cells(AECs) in rats. MethodsAECs were dissociated and purified from the amnion of pregnancy 12—14 d rats. The expression of specific markers of neural stem cells (Nestin, Musashi) and differentiated cells (MAP-2,NSE,GFAP) and ChAT, NT-3 in the AECs were detected by immunocytochemistry. ResultsThe cultured AECs displayed positive immunoreactivity to MAP-2, NSE, GFAP, Nestin and Musashi. In addition, the cells also demonstrated immunoreactivity to ChAT and NT-3. ConclusionAECs are similar with neural cells and it may be useful as a sustained source to improve outcome of neural stem cells transplantation.

ObjectiveTo investigate an effective method to isolate neural stem cells(NSCs).MethodsNSCs were dissociated by digestion with trypsin, EDTA and different doses of Dispase,and serum-free culture techniques and immunohistochemistry techniques were used to verifying the dissociated.ResultsA lot of single neural stem cells were obtained by using Dispase to digest neurosphere, and the cells could keep its structure and morphology.ConclusionIt is an ideal method by using Dispase to digest neurosphere for isolating NSCs.

Objective:To explore the application and effect of team-based learning (TBL) combined with flipped classroom in the teaching of physiology.Methods:A total of 70 medical students were selected and randomly divided into two groups, experimental group ( n=34) and control group ( n=36). Both groups studied digestion physiology by different method. In the experimental group, the students were taught by TBL combined with flipped classroom. The control group was given traditional teaching. The students studied and discussed problems in a team, and shared the answers in the flipped classroom. The effects of teaching were evaluated by the final test scores and the self-made questionnaire. SPSS 17.0 was used for t test on data comparison between the two groups. Results:The test scores of digestion physiology in the experimental group were (5.47±1.02) points, which were significantly higher than those of the control group (4.42±1.63) points, with significant differences ( P=0.020). A total of 34 questionnaires were issued and 34 valid questionnaires were collected, with an effective rate of 100%. The questionnaire results showed that TBL combined with flipped classroom was accepted and approved by about 82% of students in the experimental group who agreed that the teaching model helps enhance students' initiative and interest in learning, develop their sense of cooperation and comprehensive application ability. Conclusion:TBL combined with flipped classroom is feasible and effective in the physiological teaching, and it can be popularized in medical courses.