[ABSTRACT]OBJECTIVE To summarize the clinical related factors and prognostic influence factors of perioperative pulmonary embolism of head and neck malignant tumor.METHODSFrom 2010-2014, our hospital carried out a total of 2736 cases of head and neck malignant tumor surgical operations, of which, 10 cases were clinically diagnosed as postoperative pulmonary embolism, retrospectively analyzed the process of clinical treatment of the patients of pulmonary embolism with head and neck malignant tumors, and summarized their etiological factors, clinical manifestations, diagnosis and treatment. RESULTS The preoperative period incidence of pulmonary embolism in patients with head and neck malignant tumor was 0.37%(10/2736). Their clinical manifestations were mainly of asthma and breathing difficulty, and 3 cases of asymptomatic hypoxemia. 8 cases of patients showed pulmonary artery and branch filling defects after pulmonary artery angiography (CTA), 7 cases of patients got cured and were discharged from the hospital after comprehensive treatment such as anticoagulation etc; 3 cases of patients died after emergency treatment. 2 cases of patients suffered cavity bleeding, and there was no anticoagulant drug adjustment.CONCLUSIONThe mortality of head and neck cancer patients with perioperative pulmonary embolism is high, and therefore, preventive measures and timely treatments are important to reduce the incidence of pulmonary embolism.

[Objective]Porous collagen type Ⅱ matrices crosslinked by 1-ethyl-3-(3-dimethyl aminopropyl)carbodⅡmide(EDC) and N-hydroxysucinimide(NHS) were developed as scaffolds for cartilage tissue engineering.[Method]Collagen type Ⅱ matrix was crosslinked by EDC/NHS,and then freeze-dried to achieve collagen scaffolds.The porous characteristics of the prepared scaffolds were tested by using diffenent methods,including laser scanning confocal microscopy (LSCM),scanning electron microscopy (SEM) and mechanical testing machine.The chondrocytes labeled by GFP were planted in crosslinked collagen type Ⅱ,and observed by LSCM.[Result](1) The mechanical properties of cross-linked matrices increased significantly,reaching 2.18?0.47MPa.(2)The degradation of cross-linked matrices decreased by 8.28% after 4 hours.The pore size was about 90?m,and their average porosity and water capacity reached 93.39% and 97.78%,respectively.3.Chondrocytes were in good condition in the crosslinked collagen.[Conclusion]The present work indicates that EDC/NHS-crosslinked collagen type Ⅱ could keep the properties and biocompatibility of collagen,besides,the mechanical strength increased and the degradation was decreased.It will be suitable for cartilage tissue engineering purposes.

Objective To investigate the influence of iodine on apoptosis of thyrocytes and to study the effect of iodine on the pathogenesis of thyroid diseases. Methods Normal human thyrocytes were cultured in the absence or presence of 10 -8 ～10 -4 mol/L NaI. Apoptosis, Fas expression, Bcl-2 and Bak expression and Fas and soluble Fas (sFas) mRNA levels in thyrocytes were detected by flowcytometry, Western blot and semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) respectively, sFas was detected in supernatant of cultured thyrocytes by ELISA. Results (1) Low concentration of iodine (10 -8 mol/L) could inhibit apoptosis, while high concentrations of iodine (10 -6 ～10 -4 mol/L) increased apoptosis (P

OBJECTIVEThis research aims to study the changes in pain threshold and glial cell line-derived neurotrophic factor (GDNF) in a Sprague Dawley (SD) rat model oftrigeminal neuralgia.

METHODSA total of 36 male SD rats were randomly divided into three groups: operative, sham-operative, and control. In the operative group, a chronic constriction injury (CCI) was caused by placing loose chromic gut ligatures around the right infraorbital nerve (ION). In the sham-operative group, the right ION was subjected to the same procedure, but without ligation. In the control group, the right ION was not subjected to any treatment. The pain thresholds of the three groups were recorded at different times after the operation. The GDNF expression in each group was analyzed via immunohistochemical staining.

RESULTSAn allodynia to mechanical stimulation in the region of the ligated ION was observed starting on the 2nd week after operation. Pain thresholds started to increase gradually from the 6th week and returned to the original level at the 10th to 12th week after operation. Cells that expressed the GDNF markedly increased in number in the operative group with changes observed at different times.

CONCLUSIONWe use chronic constriction injury to the infraorbital nerve (CCI-ION) to establish a trigeminal neuralgia-like animal model in SD rats. GDNF may play a role in regulating pain by promoting the restoration and regeneration of nerve fibers.

Animals ; Constriction ; Disease Models, Animal ; Glial Cell Line-Derived Neurotrophic Factor ; Glial Cell Line-Derived Neurotrophic Factors ; Hyperalgesia ; Male ; Pain Threshold ; Rats ; Rats, Sprague-Dawley ; Trigeminal Neuralgia

Purpose To investigate the clinicopathologic features of cervical adenoid basal cell carcinoma. Methods Clinical and pathological data were analyzed in 12 cases of cervical adenoid basal cell carcinoma and the relevant literatures were reviewed. Results The age of 12 cases of with cervical adenoid basal cell cancer patients ranged from 36~70 years ( mean:53. 3 years) , with a medi-an age of 51. 5 years. Amongst 12 patients who contained no gross definite lesion, 5 patients (41. 7%) had the symptoms of vaginal bleeding. 8 cases of patients underwent hysterectomy, while the other four received cervical conization. Cervical intraepithelial neopla-sia ( CIN) lesions were observed in all 12 cases. The tumor cells were small and uniform, with dark oval nuclei without conspicuous nucleoli and scanty cytoplasm. Tumor infiltrated into the stroma in nests and cords. Glandular differentiation within tumor nests were seen in 12 cases, including two cases of squamous cell differentiation accompanied by partial and minor interstitial edema. Peripheral palisading cells around tumor nests were also found. The infiltrating depth of tumor ranged from 0. 5~10 mm with the average 4. 12 mm. Cancer embolis were available in 2 cases with no lymph node metastasis. 10 cases followed up for 3~78 months with no recur-rence and metastasis, but 2 cases were lost. Conclusion Adenoid basal cell carcinoma is a rare uterine cervical tumor found in post-menopausal women, which are often accompanied with CIN. This tumor has a favorable prognosis and should be clearly separated from adenoid cystic carcinoma and other tumors which also have infiltrative growth pattern.

Objective To compare the effects of fluoxetine and transcuataneous electrical nerve stimulation (TENS) on central pain after spinal cord injury (SCI) using a sham-controlled crossover method.Methods Ele-ven patients with central pain after SCI were randomly divided into two groups which were then subject to 2 phases of treatment.Patients in group 1 were treated by oral intake of fluoexetine for 4 weeks followed by TENS treatment for 4 weeks.Those in group 2 were treated in the reverse sequence.A fifteen day washout period was arranged between the two phases of treatment.The short-form McGill pain questionnaire (SF-MPQ) and the Beck depression inventory (BDI) were used to assess all patients pre-and post-treatment.Results SF-MPQ scores were reduced significantly after either fluoexetine or TENS treatment.After each phase of treatment there was no significant difference between the two groups.Significant improvement in terms of BDI scores was found with fluoxetin treatment in both phases of the trial,but not with TENS treatment.Conclusions Both fluoxetine and TENS can alleviate central pain after SCI,and fluoxetine can relief patients' depression at the same time.

ObjectiveThe purpose of the present study was to discuss the method to avoid spillage by means of adding chemotherapeutic drugs into sealed transfusion bottles.Methods90 penicillin sealed bottles of the same batch number were randomly divided into the test group and the control group,each with 45 bottles.Standard method according to Basic Nursing was used to add chemotherapeutic drugs into transfusion bottles in the control group.Drugs were added into transfusion bottles under negative pressure in the test group.The operating time was measured,the spillage volume of puncture site was calculated and microbial detection of syringe was observed in the two groups.ResultsThere was a significant difference in the spillage volume of puncture site between the two groups (P<0.01),but no difference was seen in the operating time and microbial detection of syringe (P>0.05),ConclusionsThe spillage volume of puncture site was reduced significantly by means of adding chemotherapeutic drugs into transfusion bottles under negative pressure.This can decrease chemotherapeutic professional exposing risks and drug wastage.

Objective:To investigate the effect of enteral nutrition support by CT-guided percutaneous gastrostomyon the nutritional status of patients with esophageal cancer complicated with dysphagia during radiotherapy.Methods:Therewere46 cases of esophageal cancer patients with dysphagia treated with CT-guided percutaneousgastrostomy.Others 43 cases of esophageal cancer by oral feeding in patients with dysphagia as control groupduringthe sametimein our hospital radiotherapy center.Patients in the observation group were ingested daily through the gastrostomy,and the nutritional intake of the control group included oral ingestion and intravenous infusion.All patients were measuredthe body height,body weight (BW).body mass index (BMI),Serum levels of serum albumin (ALB),pre-albumin (PA) and hemoglobin (HB) before and after radiotherapy.We also observed the incidence of acute radiation esophagitis and the completion of the treatment plan during radiotherapy in both groups,and to observe the two groups of patients the incidence rate of radiotherapy and treatment plan during the completion of acute radiation esophagitis.Results:There was no significant difference in BW,BMI,ALB,PA,HB before radiotherapy between the two groups (t =0.84,0.63,-1.07,-0.81,1.48,P ＞ 0.05).The BW,BMI,ALB,PA and HB of the observation group were significantly higher than those of the control group at the end of radiotherapy,which werestatistically significant (t=3.30,4.65,6.82,43.56,31.91,P ＜ 0.01).During the radiotherapy,the total incidence of acute radiation esophagitis in the observation group was significantly lower than that in the control group,(x2=3.971,P＜ 0.05).In addition,the completion rate of the observationgroup was significantly higher than that of the control group (x2 =6.811,P ＜ 0.01).Conclusion:To the Patients with dysphagia of esophageal cancer,enteral nutrition byCT guided percutaneous gastrostomy,can improve the malnutrition,the immune function of the patients and reduce the acute radiation esophagitis during radiotherapy and ensure the successful completion of the treatment plan.

Objective To evaluate the role of transient receptor potential channel 8 (TRPM8) in the development and maintenance of neuropathic pain and the relationship with nuclear factor kappa B (NF-κB) in the dorsal root ganglion of rats.Methods Thirty-six pathogen-free healthy adult male SpragueDawley rats,weighing 180-200 g,aged 6-8 weeks,were divided into 3 groups (n=12 each) using a random number table:sham opeation group (group S),neuropathic pain group (group NP) and TRPM8 bocker BCTC group (group BCTC).Neuropathic pain was induced by ligation of the right sciatic nerve in anesthetized rats.BCTC 20 nmol was intrathecally injected once a day on preoperative day 1 and postoperative days 1,3,7 and 10 in group BCTC.The thermal,mechanical and cold pain thresholds were measured on preoperative day 1 and postoperative days 1,3,7,10 and 14.The dorsal root ganglions of the lumbar segment (L4-6) were removed on postoperative days 7 and 14 for determination of the expression of TRPM8 and NF-κB p65 by Western blot.Results Compared with group S,the thermal and mechanical thresholds were significantly decreased on postoperative days 1-14,and the cold pain threshold was decreased on postoperative days 3-14 in NP and BCTC groups,the expression of TRPM8 and NF-κB p65 in dorsal root ganglions was up-regulated on postoperative days 7 and 14 in group NP (P＜0.05),and no significant change was found in the expression of TRPM8 and NF-κB p65 in dorsal root ganglions in group BCTC (P＞0.05).Compared with group NP,the thermal pain threshold was significantly decreased and the cold pain threshold was increased on postoperative days 3-14,the expression of TRPM8 and NF-κB p65 in dorsal root ganglions was up-regulated on postoperative days 7 and 14,and no significant change was found in the mechanical pain threshold in group BCTC (P＞0.05).Conclusion NF-κB activation after opening of TR-PM8 in dorsal root ganglion neurons is involved in the development and maintenance of neuropathie pain in rats.

Objective To investigate the situation of admission nursing evaluation on elderly patients of geriatrics departments in several Shanghai comprehensive hospitals, and the results will be the base for designing elderly patient′s comprehensive admission nursing evaluation form. Methods 41 nurse managers of geriatrics department in Shanghai comprehensive hospitals were selected as research object. Self-designed questionnaire included general data, elderly patient admission nursing evaluation content and the importance of each item. Results The effective recovery rate was 97.56%(40/41). 98%(39/40) hospitals considered that elderly patients need to have a comprehensive assessment according to the elderly characteristics, only 18%(7/40) hospitals used the special nursing evaluation form for elderly patients. The score of importance of five dimensions were as follows: geriatric syndromes or problems scored (4.64 ± 0.38), physical function assessment scored (4.60 ± 0.46), physiological function assessment scored (4.53 ± 0.45), mental and psychological assessment scored (4.10 ± 0.57) and social assessment scored (4.07±0.52). The score of importance of 29 items were as follows:fall assessment scored (4.90±0.30), pressure ulcer assessment scored (4.85 ± 0.36), activities of daily living scored (4.75 ± 0.44), urinary incontinence assessment scored (4.70 ± 0.52), pain assessment scored (4.70 ± 0.46). Conclusions It is of great significance to carry on the comprehensive admission nursing evaluation for the elderly patients, which needs to be valued and strengthened.