Adolescent ; Adult ; Child ; Child, Preschool ; Hepatitis B, Chronic ; diagnosis ; therapy ; Humans ; United Kingdom

Objective To investigate the synergistic effects of pirarubicin (THP) combined with hyperthermia on proliferation and invasive potential of gastrointestinal cancer cells in vitro and to discuss the underlying mechanisms. Methods Gastric cancer cell line MGC-803 was established, and they were divided into 4 groups: control group (37℃), high temperature group (43℃), drug group (37℃+THP), and drug and high temperature group (43℃+THP). After THP and hyperthermia treatment, cell proliferative ability was determined by soft agar clonogenic assay, cell nuclear antigen PCNA was detected by flow cytometry, cyclin E mRNA level was assessed by reverse transcription PCR (RT-PCR). Cell invasion assay was assessed by using transwell chamber model. Results Strong synergistic inhibitory effects on clonogenic ability of MGC-803 cells were observed after MGC-803 cells were treated with pirarubicin in combination with hyperthermia (P

Background Heparanase degrade heparan sulfate side chains of heparan sulfate proteoglycans in the extracellular matrix.Heparanase induces angiogenesis and likely promotes the vascularization of tumor.ObjectiveThe present study is to investigate the expression of heparanase and perlecan in retinas with oxygen-induced retinopathy.Methods Sixty-five clean neonatal C57BL/6J mice were raised in a hyperbaric oxygen box with a volume percentage of 75%±2% for 5 days and then returned to the normal air room.Another 65 matched mice were raised in the normal environment as controls.Evans blue was infused by the superior vena cava in all the mice on postnatal days 12,13,17,21 and 30,afterwards fluorescein angiography was performed and then the mice were sacrificed.The retinas of mice were isolated and prepared and the retinal vessels were examined under a fluorescent microscope and optical microscope.Heranase and perlecan mRNA was detected using reverse transcription PCR (RT-PCR).Heranase and perlecan proteins were detected by Western blot.The analysis of variance was used to compare the mRNA and the protein levels of heranase and perlecan between the experimental and control groups.Results The expression of heparanase mRNA in the retinas of different ages of mice and the different groups showed significant differences (F_(group)=16.303,P=0.000;F_(time)=18.614,P=0.000;F_(interaction)=11.299,P=0.000),and the expression of heparanase mRNA was significantly enhanced in mice from postnatal days 12,13,17 and 21 compared with normal control mice (P=0.001,0.000,0.000,0.001,respectively).The expression of heparanase protein in the retinas of different ages of mice and the different groups followed the same tendency(F_(group)=458.134,P=0.000;F_(time)=78.466,P=0.000;F_(interaction)=71.398,P=0.000).The expression of perlecan mRNA in the retinas of different ages of mice and the different groups showed significant differences (F_(group)=7.351,P=0.013;F_(time)=9.098,P=0.000;F_(interaction)=3.349,P=0.000),and increase in differences also were clearly seen in mice from postnatal days 13,17 and 21 compared with normal control mice (P=0.048,0.000,0.003,respectively).Conclusion The expression of heparanase and perlecan is associated with the development and progression of retinal neovascularization,and perlecan and heparanase together produce a synergistic effect.Heparanase and perlecan may participate in the angiogenesis of oxygen-induced retinopathy.

Objective To investigate the employment status of higher vocational medical col-lege graduates in Hainan province, analyze the existing employment problems, and put forward some effective suggestions. Methods A questionnaire was applied to survey the employment problems of 1 048 medical graduate in 11 medical related field of Grade 2012. A total of 989 valid questionnaires were collected. The questionnaires covered six aspects including graduates' basic information, their employment intention, access to employment information channel, service and satisfaction about school employment agencies, and employment psychology etc. SPSS 13.0 was used to analyze the statistical numbers in each option and the percentage was calculated. Results Only 22.9%(227/989) of the graduates were willing to accept the provincial employment, 49.1%(486/989) of the graduates obtained employment information channels through the school employment sector; 10.6%(105/989) of gradu-ates expressed dissatisfaction with employment services; graduates' entrepreneurial intention reached 26.9%(267/989); only 19.8% of graduates signed employment agreement, and 25.1%(248/989) of gradu-ates face the employment with anxiety and confusion. Conclusion The higher vocational medi-cal graduates in Hainan provinces need to change their employment concept and school employment guidance needs strengthening to link up the employer position requirements and expectations of grad-uates employment. Besides, the school enrollment professional settings and employment market demand also need to be linked up, to guarantee the system interface between career guidance, internship and training base.

OBJECTIVETo summarize the therapeutic effect of 5 kinds of flaps for the treatment of skin and soft tissue defect in the hallex.

METHODSFrom Jan. 2008 to Jun. 2013, 24 cases with skin and soft tissue defects in the hallex were treated with 5 kinds of reversed flaps, including medial foot dorsal neurocutaneous flaps, medial foot neurocutaneous flaps, lateral tarsal flaps, anterior malleous flaps, medial cross leg and saphenous nerve flaps. The defects size ranged from 3 cm x 2 cm to 5 cm x 3 cm, with the flap size from 3. 5 cm x 2. 5 cm to 5. 5 cm x 4. 0 cm.

RESULTSPartial superficial necroisis happened at the distal end of one foot dorsal medial neurocutaneous flap. One third flap necrosis occurred in 1 foot medial neurocutaneous flap due to too tight suture at flap pedicle and resulted thrombosis. All the other 23 flaps survived completely. 15 cases were followed up for 3-36 months with normal walking function and satisfactory appearance. Among the 8 cases with nerve anastomosis, 4 cases were followed up with 2-point discrimination distance of 8-11 mm. the flaps without nerve anastomosis also had protective sense due to nerve ingrowth.

CONCLUSIONSSkin and soft tissue defects in the hallex can be treated with different appropriate flaps. The hallex length can be reserved with satisfactory function and appearance.

Foot Injuries ; surgery ; Graft Survival ; Hallux ; injuries ; surgery ; Humans ; Necrosis ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; pathology ; transplantation

Objective To explore the current situation and requirements of the health management services among the middle-aged and elderly people in Hainan province for optimizing the health management service pattern. Methods The random sampling method was adopted to perform the survey and analysis on the current situation and requirements of the health management services among 600 middle-aged and elderly people by using the mode of questionnaire combined with interview. Results Totally 575 respondents completed the questionnaire. 43.1% of respondents could correctly understand the concept of health, 40.5% of them thought that "Health is the condition without disease" ;the main ways for getting the health knowledge by these people were mainly joining the intercommunication meeting of health management (97. 2%), phone counseling (94. 4%) and brochures (90.3%) ;the requirements of the health management service mainly focused on the middle age and elderly people aged 45- 59 years old. The most needed health management service items were the mental health service (99.0 %), cultural entertainment service(97.4 %) and health care recovery(84 %). The health management requirements had no statistical difference compared with the gender (x2 = 0. 678, P= 0. 712), cultural degree (x2 = 5. 584, P = 0. 471 ) and medical insurance situation (x2 = 3. 886, P = 0. 420) ;but compared with the age, the difference was statistically significant (x2 = 9. 697, P = 0.04). Conclusion The consciousness of health management among middle age and old people needs to be increased,the health management information platform construction and propaganda promotional efforts should be strengthened, the cooperation between government and enterprise should be strengthened, the pertinence of the health management service should be enhanced and the related policy laws and regulations should be perfected.

Objective To investigate the causes of peripheral cytopenia in patients with posthepatitic cirrhosis and portal hypertensive splenomegaly.Methods The clinical data of 183 patients with hepatitic cirrhosis and portal hypertensive splenomegaly complicated by peripheral cytopenia who were operated in our hospital in the past 17 years were retrospectively studied.Results All these patients underwent splenectomy.Before operation,all these patients had one or more types of peripheral cytopenia (cumulative cytopenia:390 patient-times).After splenectomy,blood counts in 79.2％ returned to normal;in 15.9％ increased but failed to reach normal levels;and in 4.9％ became lower than before operation.5 patients died soon after operation.Conclusion Hypersplenism is the main cause for the peripheral cytopenia most cirrhotic portal hypertension patients.Splenectormy is an effective method to treat hypersplenism.

Objective To analyze the efficacy and safety of nalbuphine in patients with sedative analgesia in intensive care unit (ICU). Methods A prospective observation was conducted. The adult patients with mild and moderate analgesia in general ICU of the First Affiliated Hospital of Zhengzhou University from January to November in 2017 were enrolled, and they were divided into nalbuphine group and sufentanil group in proper order. The nabobrown group was given 40 mg nabobrown, the sufentanil group was given 0.1 mg sufentanil, both of which were injected with 50 mL normal saline for continuous intravenous infusion in micro-pump. Infusion speed was checked according to pain level. The analgesic target was critical-care pain observation tool (CPOT) score < 2. The change in hemodynamics of patients in both groups were observed, and CPOT score and Richmond agitation-sedation scale (RASS) score were recorded before and l, 3, 5, 12, 24 hours after administration. The analgesic and sedative effects of two drugs were evaluated. Results A total of 141 patients were enrolled, including 71 patients in nalbuphine group and 70 in sufentanil group. There was no significant difference in general data including gender, age, body weight, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) or pain source, as well as baseline hemodynamics parameter between the two groups. At 1 hour and 3 hours after administration, nalbuphine had no effect on blood pressure, but the heart rate was decreased slightly, while the heart rate and blood pressure of the sufentanil group were decreased obviously. The two drugs could make the heart rate and blood pressure fluctuate obviously with the time of medication, but there was no statistical difference between the two drugs. The two drugs had no significant effect on pulse oxygen saturation (SpO2) during analgesia. The average dosage of nalbuphine was 0.03 (0.02, 0.05) mg·kg-1·h-1in the nalbuphine group, and the patient was satisfied with the analgesic effect until 3 hours after the use of the drug, and CPOT score was significantly decreased as compared with that before administration [1.0 (1.0, 2.0) vs. 3.0 (2.0, 4.0), P < 0.01], and the sedative effect was increased, RASS score was significantly lower than that before administration [0 (0, 1.0) vs. 1.0 (1.0, 2.0), P < 0.01]. No patients in naporphine group were treated with sufentanil due to unsatisfactory analgesia. The average dosage was 0.11 (0.06, 0.14) μg·kg-1·h-1in the sufentanil group, the patient was satisfied with the analgesic effect until 5 hours after administration, and the CPOT score was significantly lower than that before administration [1.0 (1.0, 2.0) vs. 4.0 (3.0, 6.0), P < 0.01], and the sedative effect was significantly increased, RASS score was significantly lower than that before administration [0 (-1.0, 0) vs. 2.0 (1.0, 2.0), P < 0.01]. The scores of CPOT and RASS in the sufentanil group were significantly higher than those of the naporphine group before use, so the decrease in the CPOT and RASS scores of the two drugs was further analyzed, which indicated the decrease in CPOT score of naporphine group was significantly lower than that in sufentanil group from 3 hours on [1.0 (0, 2.0) vs. 2.0 (1.0, 3.0), P < 0.05], and the decrease in RASS score of naporphine group was significantly lower than that in sufentanil group from 1 hour on [0 (0, 1.0) vs. 1.0 (0, 2.0), P < 0.01]. It suggested that naporphine could achieve sustained and stable analgesic effect and avoid excessive sedation caused by sufentanil. Conclusions Naporphine had a sustained and stable analgesic effect on patients with mild and moderate ICU analgesia. The onset time of naporphine was equivalent to sufentanil, and it had a certain sedative effect and less influence on hemodynamics.