Adolescent ; Adult ; Aged ; Aged, 80 and over ; Electrocoagulation ; instrumentation ; methods ; Epistaxis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To explore the feasibility of DSCT dual-energy technique in pulmonary mass lesions.Methods A total of 100 patients with pulmonary masses underwent conventional plain CT scan and dual-energy enhanced CT scan.The virtual non-contrast (VNC) images were obtained at post-processing workstation.The mean CT value,enhancement value,signal to noise ratio (SNR),image quality and radiation dose of pulmonary masses were compared between the two scan techniques using F or t test and the detectability of lesions was compared using Wilcoxon test. Results There was no statistically significant difference among VNC ( A ) ( 32.89 ± 12.58 ) HU,VNC (S) ( 30.86 ± 9.60) HU and conventional plain images (35.89 ± 9.99 ) HU in mean CT value of mass ( F =2.08,P ＞ 0.05 ).There was statistically significant difference among VNC ( A ) ( 3.29 ± 1.45 ),VNC (S) ( 3.93 ± 1.49 ) and conventional plain image (4.61 ± 1.50) in SNR ( F =6.01,P ＜ 0.05 ),which of conventional plain scan was higher than that of VNC.The enhancement value of mass in conventional enhanced scan(60.74 ± 13.9)HU and distribution of iodine from VNC (A) ( 58.26 ± 31.99 ) HU was no statistically significant difference ( t =0.48,P ＞ 0.05 ),but there was a significant difference between conventional enhanced scan (56.51 ± 17.94 ) HU and distribution of iodine from VNC (S) (52.65 ± 16.78 ) HU (t =4.45,P ＜ 0.05 ).There was no statistically significant difference among conventional plain scan ( 4.69 ± 0.06 ) and VN C ( A ) ( 4.60 ± 0.09 ),VNC (S)(4.61 ±0.11 ) in image quality at mediastinal window ( F =3.014,P ＞ 0.05 ).The appearance,size,internal features of mass (such as necrosis,calcification and cavity) were showed the same in conventional plain scan,VNC (A) and VNC (S).Of 41 patients with hilar mass,18 patients were found to have lobular and segmental perfusion decrease or defect. Perfusion defect area was found in 59 patients with peripheral lung mass. The radiation dose of dual-energy enhanced scan was lower than that of conventional scan.Conclusion The virtual non-contrast,distribution of iodine and pulmonary virtual perfusion images can be obtained by DSCT dual-energy technique in one scan,which has a potential clinical value in the thorax.

Objective To explore the value of intelligent optimum tube voltage technology at dual-source CT coronary angiography.Methods One hundred and fifty patients with normal body mass index (＜25 kg/m2) with clinically suspected coronary heart disease requiring coronary artery CTA examination were collected.According to the different scanning method,patients were randomly divided into 5 groups,30 cases of each group were tested by coronary artery CTA examination.The intelligent optimum tube vohage scanning technology was set to Semi,the tube voltage of A,B,C group were 120,100 and 80 kV (Ref 120 kV,400 mAs),respectively.D and E group were set to on,the reference voltage of group D was 120 kV,and reference current was 400 mAs.The reference voltage of group E was 100 kV,reference current was 400 mAs.Using the 15 section improved segment method for evaluation of coronary artery (lumen diameter＞ 2 mm and no severe calcification).They were assessed by subjective evaluation (image quality score) and objective evaluation (including vascular CT value,signal-to-noise ratio and contrast to noise ratio).Analyses of the differences between groups were compared with image quality,objective evaluation index and radiation dose by single factor variance.Results The image quality scores in patients scanned with five groups were (3.42±0.63),(3.41±0.54),(3.49±0.33),(3.45±0.43) and (3.48±0.81),there was no statistical difference between the five groups (F=0.634,P=0.105).Each image quality was good,all could clearly show thewhole range of vessels.The CT values of the coronary artery with above groups respectively were (486±82),(554±71),(742±90),(506±81),(561±81) HU.The image noises were (25±12),(32±12),(46±14),(28± 11),(34±12) HU (F=3.430 and 4.332,P＜0.05).And the SNR and CNR was no statistic difference between the five groups (P＞0.05).The effective radiation dose of five groups are (9.3± 1.3),(6.3± 1.4),(2.8±1.5),(5.7 ± 1.2),(3.9 ± 1.3) mSv,which the difference was statistically significant (F=2.332,P＜0.05).Conclusions Intelligent optimum tube voltage technology (Ref.100 kV,400 mAs) at dual-source CT coronary angiography may be feasible in patients with normal BMI.To ensure the quality of the image at the same time,it can effectively reduce the radiation dose.

Background and purpose. Chemotherapy is a standard treatment for patients with advanced stage non-small cell lung cancer (NSCLC) However, platinum based chemotherapeutic regimen haves high toxicity profile to normal tissues. Lobaplatin (LBP) is a new third-generation antitumour platinum drug. Studies abroad have shown that Iobaplatin has an anticancer activity similar to cisplatin with better tolerance and is more effective for those who are resistant to cisplatin. This study was aimed to observe the effectiveness and toxicities of lobaplatin combined with vinorelbine (NVB) for the treatment of advanced NSCLC. Methods: Sixty-four patients pathologically diagnosed as clinical stage Ⅲ_B-Ⅳ NSCLC who did not receive treatment before, were randomly assigned to two groups. NL group (NVB+LBP): LBP at a dose of 30 mg/m~2 intravenous infusion on day 1, and NVB at a dose of 25 mg/m~2 intravenous infusion on days 1 and 8. NP group (NVB+DDP): Cisplatin (DDP) at a dose of 30 mg/m~2 intravenous infusion on day 1, 2 and 3 and NVB at a dose of 25 mg/m~2 intravenous infusion on days 1 and 8. Treatments were repeated every 21-28 days for 3 cycles. Results: For 34 patients of NL group, there were CR (1 cases), PR(13 cases), NC(15 cases), and PD(5 cases). The overall response rate (RR) was 41.2%, disease control rate (DCR) was 85.3%. In NP group: RR was 43.3%, DCR was 83.3% (X~2=0.05, P>0.05). Median overall survival time was 8.6 months and 8.9 months for NL group and NP group, respectively. The main toxicities in NL group were myelosuppression. Digestive toxicity such as anorexia, nausea,vomiting were less than those in the NP group (X~2=7.43, P<0.05), Peripheral hour,toxicity, serious liver and renal toxicity were not observed in NL group. Conclusion: Compared with cisplatin plus vinorelbine, domestic lobaplatin with vinorelbine yielded similar efficacies for NSCLC, but had less toxicity and well tolerate.

Objective To investigate the effects of repeated intrathecal cyclic AMP response elementbinding protein (CREB) antisense oligodeoxynucleotide (ODN) on the expression of NR2A in spinal cord in mice with neuropathic pain produced by chronic constrictive injury of the sciatic nerve (CCI).Methods Forty C57BL/6 male mice in which intrathecal catheter was successfully implanted were randomly divided into 4 groups ( n =10 each):normal saline group (group NS),CREB sense ODN group (group S),CREB missense ODN group (group M),and CREB antisense ODN group (group A).In groups NS,S,M and A,normal saline 5μl,sense ODN 5 μg/5 μl,missense ODN 5 μg/5 μl and antisense ODN 5 μg/5 μl were injected intrathecally once a day for 6 days,starting from the 1st day after CCI,respectively.Paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were measured on day 1 before CCI and on day 1,3,5 and 7 after CCI.Five mice from each group were sacrificed on day 7 and 14 after CCI and the lumbar segment of the spinal cord (L3-5 )was removed for determination of NR2A expression using Western blot and RT-PCR.Results Compared with the baseline value,no significant change was found in PWMT and PWTL on day 1-7 after CCI in group A ( P ＞0.05),while PWMT and PWTL were significantly decreased on day 1-7 after CCI in groups NS,S and M (P ＜0.05).Compared with groups NS,S and M,the expression of NR2A mRNA and protein was significantly downregulated on day 7 and 14 after CCI in group A ( P ＜ 0.05).The expression of NR2A mRNA and protein was significantly up-regulated on day 14 after CCI compared with that on day 7 after CCI in all the groups.Conclusion Intrathecal CREB antisense ODN during the development of neuropathic pain can attenuate neuropathic pain and inhibition of the expression of NR2A in mouse spinal cord may be involved in the mechanism.

Background and purpose:Liquid biopsy is a kind of blood, urine and other non-solid biologi-cal tissue sampling analysis, mainly for malignant tumor diagnosis, monitoring and predicting its prognosis. In this research, we optimized the extraction of miRNA in urine, established a standardized means of liquid biopsy, screened and verified the miRNA markers in patients with bladder cancer.Methods:From Jan. 2014 to Sept. 2015, we used miRNA microarray in six patients with bladder cancer and six healthy controls. Samples of 78 cases of bladder cancer and 23 healthy controls were tested by real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) to verify the relationship between miRNA markers in liquid biopsy and clinical pathological parameters. The diagnostic value of miRNA markers was also analyzed and compared.Results:We screened 10 miRNAs differential expression in urine. Combined with previous literature, we selected 20 miRNAs to verify their expression levels in bladder cancers and healthy controls. miR-509-5p/miR-124 ratio in the urine was found higher in patients with bladder cancer than in healthy controls (P<0.0001). With the rise of miR-509-5p/miR-124 ratio in urine, tumor stage and grade were also increased (P=0.003). When the cutoff was set at 0.41, the diagnostic sensitivity and specificity of miR-509-5p/miR-124 ratio were 73.1% and 82.6%, respectively. The AUC of miR-509-5p/miR-124 ratio to detect bladder cancer was 0.864, higher than that of urinary exfoliated cells (P=0.0002).Conclusion:We optimized the extraction of miRNAs in urine,established a standardized liquid biopsy of miRNA markers. The miR-509-5p/miR-124 ratio could be an ideal diagnos-tic marker for bladder cancer.

Practice abilityoriented professional quality training is an important part of thethree orientation talent training mode in Qiqihar Medical School, and it is the key link of the reform and inno-vation of talent training mode. This article mainly expounds the connotation of training mode in the three orientation under the guidance of medical personnel and medical research ability, and the training objec-tives cover innovative thinking ability and scientific research ability, including five aspects of training strat-egy such as reforming the teaching mode of the traditional theory course, setting up scientific research related courses, carrying out academic lecture, reforming the teaching mode of experiment course and con-structing the scientific research team of teachers and students by the scientific research project as well as seven aspects of the evaluation system, such as the literature review, the title of the report, academic report and research application writing, scientific research (comprehensive) experiment report, thesis writing and comprehensive performance, and deeply analyzes the close relationship between the practice ability and the medical research ability of medical students.

Objective To investigate the effects of intrathecally cyclic AMP response element-binding protein(CREB) antisense oligodeoxynucleotide (ODN) on neuropathic pain behaviors.Methods Using mouse model of neuropathic pain induced by chronic constriction injury of sciatic nerve (CCI),24 male C57BL/6 mice successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into 4groups(n=6):Saline group(NS),CREB sense ODN group(S),CREB missense ODN group(M),CREB antisense ODN group(A).Mice in NS,S,M and A were intrathecally treated with Saline 5μ l,Sense ODN 5μg/5μl,Missense ODN 5μg/5μl and Antisense ODN 5μg/Sμl once daily on day 1 ～6 after CCI respectively.Paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency(PWTL) were tested on day 1 before CCI and day 1,3,5,7,10,14,17,21 after CC(I).Results Mice in A group maintained the pain thresholds in the baseline and lasted at least 7 days after CCI ( 7 d,PWMT:( 0.81 ± 0.20 ) g vs ( 1.00 ± 0.19 ) g,P ＞ 0.05 ;PWTL:(5.96 ± 0.69) s vs (6.93 ± 1.08 ) s,P ＞ 0.05 ).The withdrawal thresholds in the ipsilateral hind paws of the mouse were significantly lower than baseline in A group on day 10 after CCI( 10 d,PWMT:(0.56 ±0.19)g vs (1.00±0.19)g,P＜0.05; PWTL:(3.93 ±0.28)s vs (6.93 ± 1.08)s,P＜0.05).Compared with NS group ( 10 d,PWMT:(0.56 ±0.19)g vs (0.37 ±0.08)g,P＜0.05; PWTL:(3.93 ±0.28)s vs (3.14 ±0.45)s,P＜0.05),S group,M group,the withdrawal thresholds of A group was significantly elevated on day 10 after CCI.These effects lasted up to at least day 21 after CCI.Conclusion Intrathecally treated with CREB antisense ODN in the development of neuropathic pain induced by CCI completely improved pain behaviors during the course of injection,and the effects of relief pain lasted at least 15d after no injection.

In March 2017, a severely burned male patient aged 36 years with hypovolemic shock was admitted to our hospital. The patient received large quantities of antibiotics and blood products and repeated skin graft after admission, and then he suffered wound errhysis and throat congestion. The patient was healthy before without family history of bleeding or thrombosis disease. Laboratory tests showed that prothrombin time and activated partial coagulation time were remarkably prolonged, blood coagulation factor Ⅴ activity was extremely low, and the result of qualitative test of coagulation factor inhibitor was positive. Acquired blood coagulation factor Ⅴ deficiency was diagnosed. After application of dexamethasone (5 mg, twice per day) and infusion of fresh frozen plasma, blood coagulation indicators of patients recovered in 4 days, the result of qualitative test of coagulation factor inhibitor was negative, and bleeding symptoms were improved.

Objective:To explore the curative effect of laparoscopic surgery for hepatic cysticercosis.Methods:Search the literature from February 2010 to February 2020 on literature platforms such as Wanfang Data, VIP, CNKI, Pubmed, ScienceDirect, Web of Science, etc. the key words were "肝囊型包虫病" , "细粒棘球蚴" , "手术" , "开腹手术" , "腹腔镜" , "微创手术" , " echinococcosis " , " liver or hepatic " , " laparoscopic or minimal invasive " . Data on intraoperative indicators (e.g., operation time, bleeding volume), postoperative complications, hospital stay, recurrence rate, etc. in the literature included in the study were extracted and meta-analyzed.Results:A total of 9 articles were included, including 2 prospective studies and 7 retrospective case-control studies. A total of 1031 patients were enrolled, including 272 in the laparoscopic group and 759 in the laparotomy group. The results of the meta-analysis showed that the total postoperative complication rate in the laparoscopic group was lower than that in the laparotomy group ( OR=1.64, 95% CI: 1.10-2.45, P<0.05). Incision-related complications in the laparoscopy group and laparotomy group the difference was statistically significant ( OR=2.81, 95% CI: 1.03-7.70, P<0.05), and the hospital stay in the laparoscopic group was shorter ( SMD=1.21, 95% CI: 0.47-1.96, P<0.05). There was no significant difference between the two groups in operation time, postoperative bile leakage, residual cavity infection and effusion, and postoperative recurrence rate ( P>0.05). Conclusions:Under the premise of strictly grasping the indication of laparoscopic surgery, the incidence of complications after laparoscopic surgery is low, the hospitalization time is short.