Objective To investigate the clinical characteristics of compression of upper trunk brachial plexus.Methods Clinical data of 27 patient with compression of upper trunk brachial plexus were retrospective analyzed.Results All cases showed sensory disturbance in radialis sides of upper extremities.13 cases accompanied by ipsilateral breast or mid-back pain.All cases showed severe tenderness at the middle point or at the juncture between center and lower third part of posterior edge of the ipsilateral sternocleidomastoid muscle.The tenderness always radiated to the involvement limb,the affected breast or the mid-back areas.Symptoms aggravated in 55.6%(15/27)cases when the suffering limbs were set in abducens and rotated externally position.25.9%(7/27)cases showed decreased nerve conduction velocities and 7.4%(2/27)showed abnormal motor unit potential.Radioactive ray studies found no abnormalities corresponding to the symptoms.Nerve blockade at the tenderness point together with physiotherapy were effective.4 weeks after treatment the total effective rate was 82.5%(23/27),ineffective rate was 14.8%(4/27).Conclusions The features of upper trunk brachial plexus entrapment neuropathy including:paraesthesia in radialis side of upper extremities and severe tenderness at the middle or center-lower part third of posterior edge of ipsilateral sternocleidomastoid muscle which radiates to the involvement limb,mid-back or breast.Local nerve blockade combined with physiotherapy was effective,and also one of the way for differential diagnosis.

Objective To establish a method for the determination of gastrodin in Tianyuan Granula. Methods The sample was refluxed with methanol, then eluted with 80 % ethanol through the alumina column(neutral). The chromato-graphic conditions were as follows: Diamonsil Cts chromatographic column(250 mm ×4.6 mm, 5 μm) with a mobile phase of acetonitrile-0. 15 % phosphoric acid (1 : 99), the detection wavelength being at 220 nm and the flow rate be-good (r=0.9999 95, n=7).The average recovery was 99.09 % and RSD=1. 50 % (n=6). Conclusion The method for determination of gastrodin in Tianyuan Granula is accurate, and with a good reproducibility.

Polyinosinic-polycytidylic acid is a synthetic analog of double-stranded RNA,which plays a vital role in the regulation of immune system.Toll-like receptor 3 ( TLR3 ),melanoma differentiation-associated gene 5 (MAD-5) and retinoic acid inducible gene - Ⅰ ( RIG- Ⅰ ) are the main three intracellular receptors binding to polyinosinic-polycytidylic acid which activates human anti-tumor immune responses including the activation of innate immunity and acquired immunity through TIR-domain-containing adapter-inducing inter feron-β (TRIF) and interferon-β.Thus,polyinosinic-polycytidylic acid plays an important role in regulating anti-tumor immune responses.The immunoregulation mechanisms ofpolyinosinic-polycytidylic acid in melanoma,breast cancer,malignant glioma and lung cancer have been clarified,which will provide new strategies for tumor immunotherapy.

AIM: To investigate the key molecular mechanism of inflammatory response in alveolar epithelial cells induced by nontypeable haemophilus influenzae(NTHi).METHODS: A549 cells were co-cultured with NTHi(multiplicity of infection,MOI: 10) and harvested 15 min and 30 min after stimulation.The phosphorylation of p38 mitogen activated protein kinase(p38 MAPK) in A549 cells was detected by Western blotting.The intracellular expression of nuclear factor-?B(NF-?B) p65 was examined by flow cytometry 4 h after stimulation.A549 cells were preincubated with p38 inhibitor(SB203580) or NF-?B inhibitor(PDTC) for 1 h and then stimulated with NTHi for 24 h.The level of interleukin 8(IL-8) in the supernatants was determined by enzyme-linked immunosorbent assay(ELISA).RESULTS: The phosphorylation of p38 MAPK was rapidly induced by NTHi stimulation.The expression of NF-?B p65 in A549 cells after NTHi stimulation was significantly up-regulated compared with control group(P

Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Humans ; Medicine, Chinese Traditional ; methods ; Neoplasms

Objective To discuss the clinical effects of treatment of femoral intertrochanteric fracture by DHS internal fixation. Methods 42 cases with femoral intertrochanteric fracture were treated by DHS internal fixation. According to AO classification, there were 16 cases of type A1,14 A2,and 12 A3. Results 36 patients were followed up for 6 to 18 months, with an average of 10 months. Their results were satisfactory. Conclusion Treatment of femoral intertrochanteric fractures with DHS internal fixation is an effective method.

Objective To compare the analgesic efficacy and safety of the sole local anesthetic ropivacaine with the combination of both local anesthetic ropivacaine and opioidergic analgesic sufen-tanil given epidurally on the labor pain control.Methods After institutional review board approval and patient consent,a total of 481 nulliparas requesting epidural labor analgesia were randomized into two groups:a sole local anesthetic group (0.125% ropivacaine,group R)and a combination of local anesthetic and opioidergic analgesic group (0.125% ropivacaine+0.3 μg/ml sufentanil,group RS). Analgesic efficacy was measured using numerical rating scale (NRS)of pain and maternal visual ana-logue scale (VAS)analgesia satisfaction with regard to the first and the second stage of labor.Anal-gesic safety was measured with the Bromage scale of maternal safety and epidural labor analgesia re-lated side effects,as well as fetal safety including Apgar scoring and umbilical cord artery blood gas a-nalysis.Results A total of 346 participants completed the study,with 1 64 and 182 women in each group R and RS,respectively.The median NRS pain score during the first stage of labor was signifi-cantly lower in the combination group (2.2,IQR:1.8-2.7 )comparing to the sole local analgesic group (2.4,IQR:2-2.8)(P <0.001).No significant difference was observed in NRS pain score dur-ing the second stage of labor.Patients in both groups were rated the same VAS satisfaction of analge-sia.Patients in the sole local analgesic group experienced fewer side effects than those in the combina-tion group (37.7% versus 47.2%,P =0.082).The incidence of 1-min Apgar≤7 was lower in the sole local analgesic group 2 (1.2%) than the combination group 10 (5.5%) (P < 0.05 ). Conclusion The sole local anesthetic ropivacaine produces a comparable labor analgesic effect as the combination of both local anesthetic ropivacaine and opioidergic analgesic sufentanil but the former has less maternal side effects,and less incidence of lower 1-min Apgar scoring.

Objective: To carry out the native assessment of International Affective Picture System(IAPS) among Chinese older adults.Methods:Altogether 116 Chinese older adults,including 51 male and 65 female,from three communities in Dalian City,aged from 60 to 80 years,rated 60 pictures(positive:25,neutral:12,negative:23) selected from the IAPS in terms of valence,arousal and dominance with Self-Assessment Manikin(SAM).The mean affective ratings were compared to the normative ratings of USA National Institute of Mental Health(NIMH).Result: Reliability analysis indicated that the affective ratings of our sample were stable and highly internally consistent.The affective ratings of Chinese older participants were strongly correlated with the normative ratings of NIMH(r=0.92,0.54 and 0.88 respectively for valence,arousal and dominance,P0.05).Conclusion: IAPS is highly internationally accessible just as the expectation of its designers.However,considering about great differences in many aspects such as culture,social living and age between Chinese aged and NIMH sample,they may have different affective experiences to the same emotional stimuli.Therefore it is necessary to do some revisal before the IAPS is applied to Chinese aged.

Objective To investigate the effects of levator ani muscle exposure in abdominal periueal resection for rectal cancer.Methods The clinical data of 109 patients with rectal cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2001 to January 2008 were retrospectively analyzed.There were 55 patients received traditional procedure (conventional method group) and 54 patients received modified procedure with levator ani muscle exposure (levator ani muscle exposure group).The mesorectum was sharply dissected according to the total mesorectal excision principle.It is essential to remove the rectum along with the mesorectum up to the level of the levators.Preoperative bowel preparation,anesthesia,body position,abdominal incision,perineal incision and suture of the 2 groups were the same as Miles procedure.In the conventional method group,the superficial dissection was carried out with electrocautery or ultracision harmonic scalpel.The presacral space was entered by dividing the rectococcygeus muscle,commencing at the level of the tip of the coccygeus.The levators were then divided near the pelvic wall attachments and next procedures were performed without levator ani muscle exposure.In levator ani muscle exposure group,once the ischiorectal fat was cleared by electrocautery,the planes of levator ani muscle were identified and exposed after dividing the rectococcygeus muscle and next procedures were performed.The patients in stage Ⅰ only needed to follow-up; the patients in stage Ⅱ had to receive chemotherapy with following situation:poor differentiation,T4 stage,blood vessel or lymphatic invasion,number of lymph nodcs detected ＜ 12.Patients in stage Ⅲ or Ⅳ needed adjuvant chemotherapy.The follow-up evaluation included blood routine examination,hepatic and renal function examination,chest radiography,hepatobiliary ultrasonographic evaluation and determination of CEA levels (once every 3 months in the first year after operation,and once every 6 months after one year).Abdominal CT scan and colonoscopy should be employed every year.All the patients were followed up till December of 2012.All data were analyzed using the chi-square test or t test.The survival curve was drawn using the Kaplan-Meier method,and the prognosis was analyzed using the Log-rank test.Results The operation time were (60 ± 15)minutes and (30 ± 10) minutes in the conventional method group and the levator ani muscle exposure group,with significant difference between the 2 groups (t =3.936,P ＜ 0.05).The intraoperative blood loss were (300 ± 60) mL and (30±20) mL in the conventional method group and the levator ani muscle exposure group,with significant difference between the 2 groups (t =5.687,P ＜ 0.05).Three patients were with rectal injury,1 with urethral injury,1 with vaginal injury,and 10 with incision infection in the conventional method group.There were 9 patients with incision infection in the levator ani muscle exposure group.The course of chemotherapy was under 12 in 30 patients,and above 6 in 41 patients.The median time of follow-up of the patients was 56 months (range,15-95 months).Of the 109 patients,10 missed the follow-up,15 patients had local recurrence,30 had distal metastasis,and 35 patients died.The 1-,3-,5-year cumulative survival rates were 93.4％,76.0％ and 65.6％.The 5-year survival rates were 65.2％ and 66.3％ for patients in the conventional method group and the levator ani muscle exposure group,with no significant difference between the 2 groups (x2=4.210,P ＞0.05).Conclusion Levator ani muscle exposure method provides clearer vision of operational field,shorter operation time,less blood loss and less injury to the rectum or urinary tract (vagina).

Objective To investigate the effects of total nutrient admixture (TNA) on the recovery of patients with gastric cancer after radical gastrectomy.Methods The clinical data of 50 patients with gastric cancer who were admitted to the Affiliated Hospital of Luzhou Medical College between March 2013 and March 2014 were retrospectively analyzed.Among 50 patients receiving radical gastrectomy,26 patients receiving TNA were allocated to the experimental group and 24 patients receiving conventional fluid infusion were allocated to the control group.Patients in the experimental group received the nutritional support therapy using TNA at preoperative day 5 and at postoperative days 1-5,and patients in the control group received the postoperative intravenous rehydration including water,glucose,electrolyte,vitamins and micro elements.The nutritional indexes [albumin (Alb),prealbumin,transferrin and hemoglobin (Hb)],time to anal exsufflation,incidence of complications (wound infection,anastomotic leakage,blooding and intestinal obstruction) and duration of hospital stay were observed before nutritional support therapy and at postoperative day 8.The count data were analyzed using the chi-square test.The chi-square value of correction for continuity was used when 1 ≤ minimum theoretical frequency ≤ 5.The measurement data with normal distribution were presented as (x) ±s and analyzed using the t test or repeated measures ANOVA.The ordinal data were analyzed by the analysis of variance.Results The Alb,prealbumin,transferrin and Hb in the experimental group were (38.6 ± 2.0) g/L,(281 ± 33) mg/L,(2.5 ± 0.9) g/L and (111 ± 20) g/L before nutritional support therapy and (38.2 ± 1.9) g/L,(277 ± 16) mg/L,(2.3 ± 1.1) g/L and (112 ± 37) g/L at postoperative day 8,respectivley.The Alb,prealbumin,transferrin and Hb in the control group were (38.3 ±2.4) g/L,(287 ± 34) mg/L,(2.4 ± 1.1) g/L and (107 ± 21) g/L before nutritional support therapy and (30.3 ±2.3) g/L,(190 ± 41) mg/L,(1.6 ± 0.3) g/L and (93 ± 22) g/L at postoperative day 8,respectivley.There were significant differences in the nutritional indexes at postoperative day 8 between the 2 groups (F =174.042,95.637,9.529,4.919,P ＜ 0.05).The time to anal exsufflation in the experimental group were (52 ± 11) hours,which was significantly different from (70 ± 12) hours in the control group (t =-5.176,P ＜ 0.05).The incidence of complications was 15.4％ (4/26) in the experimental group,which was significantly different from 58.3％ (14/24) in the control group (x2=6.460,P ＜0.05).Patients with complications in the 2 groups were cured by anti-infective or symptomatic treatment.The duration of hospital stay was (9 ± 3) days in the experimental group and (12 ± 4) days in the control group,with a significant difference between the 2 groups (t =-2.912,P ＜ 0.05).Conclusion TNA can improve the nutritional status of patients after radical gastrectomy in a short time.It could help patients to get through the perioperative period smoothly,and enhance the postoperative recovery.