Data were collected from 236 patients with advanced ClllllCerB through questionnaire survey,home visit,oncology clinics and counseling service.The data were evaluated and classified according to VAS and NCCN aduh cancer pain practice guidelines.Two hundred and eleven in 236 advancad cancer patients(89.4%)Suffered from Cancer pain,with mild pain in 31,moderate in 83 and severe in 97.One hundred and seventeen patients(49.6%)received therapy for pain relief,among whom 78(66.7%)had complete remission(CR),26(22.2%)partial remission(PR)and 13 cages(11.1%)noremission.The main reason for declining pain relief wag being scared of morphine addiction.

Aim To investigate the neuroprotective effect of picroside Ⅱ(PIC)on cyto C/caspase-9/caspase-3 signal pathway following ischemia/reperfusion(I/R)injury in rats.Methods Atractyloside(Atr)was selected as negative control,cyclosporin A(CsA)was selected as positive control,and PIC was selected as the treatment medicine.The I/R model was made by inserting a monofilament suture into internal carotid artery for 2 h,and then reperfused for 24 h.The cerebral infarction volume was detected by TTC staining,and the expression of cyto C,caspase-9 and caspase-3 were determined by immunohistochemical assay and Western blot.Results In model group,the cerebral infarct volume was obviously large;the expression of cyto C,caspase-9 and caspase-3 was increased significantly more than that in sham group(P<0.05).In PIC group,the cerebral infarct volume was significantly improved;the expression of cyto C,caspase-9 and caspase-3 was significantly decreased than that in model group(P<0.05).In Atr+PIC group,the rat infarction volume was reduced,and the expression of cyto C,caspase-9 and caspase-3 was significantly decreased than that in Atr group(P<0.05).Conclusion The mechanism of PIC inhibiting neuron apoptosis in focal cerebral I/R rats might be through down-regulating the expression of cyto C,caspase-9 and caspase-3.

Objective To evaluate the effect of ropivacaine combined with low-dose naloxone or sufentanilropivacaine mixture on brachial plexus block carried under the guidance of ultrasound.Methods A total of 100 patients of our hospital undergoing upper limb surgery was randomly divided into four groups with 25 patients in each group.Four groups are patients receiving 20 mL of 0.375％ mesylate ropivacaine (Group D),20 mL of 0.375％ mesylate ropivacaine + 10 μg sufentanil (Group S),20 mL of 0.375％ mesylate ropivacaine + 100 ng naloxone (Group N) and 20 mL of 0.375％ mesylate ropivacaine + 10 μg sufentanil +100 ng naloxone (Group N+S).All patients underwent interscalene brachial plexus block under ultrasound guidance.The sensory block,motor block and other adverse reactions were observed and recorded at 5min,6,12,18,24 h.Results The sensory and motor block time of group D was (435.5 ± 77.9) min and (350.2 ± 69.8) min,group S (831.7 ± 52.0)min and (675.8 ± 48.1)min,group N (933.0 ± 117.1) min and (499.0 ± 40.5) min,group N+S (919.3 ± 59.0) min and (534.8 ± 56.6)min.The sensory block time of group N and group N + S were significantly longer than that of group D and S (P ＜0.05).The sensory and motor block time of group D were obviously shorter than that of other groups (P ＜ 0.05).There were no significant difference in the onset time of sensory and motor block in all groups.Conclusion Low dose of naloxone combined with ropivacaine or sufentanil-ropivacaine mixture can increase the duration of sensory block on brachial plexus.

Objective To explore the effects of two kinds preoperative fasting and liquid-fasting time before caesarean section on blood glucose of puerperae with GDM before and after the operation,intra-operative complications and on blood glucose of neonates.Methods With prospective study method,162 puerperae with GDM admitted to obstetrical department of Peking University First Hospital and received cesarean section under combined spinal-epidural anesthesia between April 1st and Sep. 30th in 2015,were selected as the research object,and were divided into the control group (admitted on odd-numbered days) and the observation group (admitted on even-numbered days). Puerperae in the control group were forbidden to eat solid food for 8 h and drink transparent liquid for 6 h before the operation,while those in the observation group were forbidden to eat solid food for 6 h and drink transparent liquid for 2 h before the operation. Puererae in two groups were compared about their preoperative blood glucose,incidence of intraoperative nausea and vomiting or aspiration,intra-operative quality of bleeding,postoperative exsufflation time and blood glucose half an hour after the operation, meanwhile,neonates in two groups were compared about their Apgar scores 1 min and 5 min after birth,and their blood glucose half an hour after birth. Statistical analysis was done by independent-samplest test,Mann-WhitneyU test and χ2 test.Results Difference of preoperative blood glucose of puererae in two groups was statistically significant (P<0.01). Differences of intraoperative bleeding of puererae in two groups and blood glucose of neonates half an hour after birth in two groups were statistically significant (P<0.05). There was no statistic difference in the incidence of intraoperative nausea and vomiting or aspiration,postoperative exsufflation time of puererae,or Apgar scores 1 min and 5 min after birth of neonates in two groups(P>0.05).Conclusions The scheme of forbidding puererae from eating solid food for 6 h and drinking transparent liquid for 2 h before cesarean section can reduce the incidence of preoperative hypoglycemia,maintain a smooth post-operative blood glucose, reduce intraoperative bleeding without increasing the incidence of intraoperative complications like nausea,vomiting or aspiration,or hypoglycemia of the neonates. The new fasting and liquid-fasting scheme is safe and feasible,which makes it worth promoting in clinic.

Effective budget management is crucial for the internal control of procurements in public hospitals.This paper investigates challenges such as unscientific budget preparation,insufficient market analysis,and inadequate procurement internal control in a tertiary hospital in Shenzhen.In addition,based on a budget inquiry mechanism,the study explores strategies to en-hance internal control management within procurements in public hospitals,focusing on the pilot implementation of budget price review mechanisms in the hospital.The paper proposes such rules as"whoever applies is responsible and conducts research,"departmental checks and balances,continuous feedback,and pre-budget inquiry.These measures are used to improve procure-ment cost control,enhance hospital operational efficiency,and increase economic benefits.

Objective To investigate the impact of prescribed adaptive statistical iterative reconstruction V (Pre-ASiR-V) on imaging quality and radiation dosage of pure ground glass nodules (pGGN) in chest phantom,in order to obtain the optimal level of Pre-ASiR-V.Methods CT scanning for a chest phantom containing 4 artificial pGGNs was performed with Revolution CT,and the Pre-ASiR-V level was set as 0,20％,40％,60％,80％ and 100％ group,respectively.The mean noise,effective dose (ED) and the subjective scores of pGGN imaging were recorded and compared.Results The mean noise of groups (Pre-ASiR-V 0,20％,40％,60％,80％ and 100％) was (17.93±2.20)HU,(17.30±3.68)HU,(18.20± 3.44)HU,(18.80±0.20)HU,(19.87±2.56)HU and (15.90±4.56)HU,respectively (F=0.568,P=0.723).ED of these groups was 7.40 mSv,5.16 mSv,3.36 mSv,1.97 mSv,0.97 mSv and 0.33 mSv,respectively.Compared with imaging of PreASiR-V 0,the reduction percentage of ED was 30.27％,54.59％,73.38％,86.89％ and 95.54％,respectively.The subjective score of the image quality evaluated by the 2 observers had high agreement (Kappa=0.778,P=0.003),and all the scores were greater than 3.The subjective score of Pre-ASiR-V 80％ and 100％ group was slightly lower than those in other groups.Conclusion Different Pre-ASiR-V level slightly impacts the noise of high-resolution CT images of chest phantom,while reduces radiation dosage significantly.Pre-ASiR-V level of 60％ is the optimal protocol.

Objective To investigate the distribution and characteristics of iodine excess areas in Liaocheng City of Shandong Province, and to provide data evidence for taking intervention measures. Methods From 2011 to 2013, 1 - 3 samples of drinking water were collected from all administrative villages in 8 counties (cities and districts) of Liaocheng.At the same time,1 sample of edible salt was collected from the household where water samples were collected. Arsenic and cerium spectrophotometry was used for the detection of water iodine and salt iodine was detected by semi-quantitative method. The region were divide according to the definition of "Water Source Excess Iodine Area and Excess Iodine Disease Area"(GB/T 19380-2016)and"Division of Iodine Deficiency Disorders Area"(GB 16005-2009).Results A total of 7 794 water samples were collected in 5 865 villages of 134 towns and the iodine median was 158.2 μg/L. The median of water iodine of 57 samples was less than 10 μg/L in drinking water and the ratio was 0.7%;2 286 samples were 10- 100 μg/L and the ratio was 29.3%; 5 451 samples were over 100 μg/L and the ratio was 69.9%. The towns with suitable water iodine (10 - 100 μg/L) and high water iodine ( > 100 μg/L) were 24.6%(33/134)and 75.4%(101/134), respectively, and no iodine deficiency town was found. The areas with high water iodine were distributed in patchy or foci. A total of 3 300 salt samples were collected,among them,iodized salt was 1 183(35.58%,1 183/3 300)and non-iodized salt was 2 117(64.15%,2 117/3 300). Among them, there were 36 towns with high iodine content and 20 towns with suitable iodine content, and the iodized salt coverage rates were 10.72% (225/2 099) and 79.77% (958/1 201),respectively.Conclusions The population of Liaocheng City is at risk of iodine excess.The high iodine areas coexists with suitable iodine areas.

OBJECTIVE: To study the correlation between dosage and curative effect of blood coagulation factor VIII in the prevention and treatment of haemophilia A in children and to determine the suitable dose for prevention of hemophilia in developing countries. METHODS: For different body weights of child patient, every time we used the same dosage of blood coagulation factor VIII (250 U each time, 3 times a week) and observed and recorded the number of hemorrhages in child patients. Then we compared the number of hemorrhages with children without treatment to determine the curative effect. According to the different body weights, we calculated the dosage of VIII factor of blood coagulation per kilogram (hereinafter referred to as the dose), and used Spearman correlation coefficient to study the correlation between dose and curative effect. RESULTS: The number of hemorrhages in 58 child patients before the treatment was 4.36 ± 1.78, while after the treatment was 2.22 ± 1.04 (t=7.91, P<0.001). The Spearman correlation coefficient of child patients of 5-10 U/kg was -0.421 (P=0.005); the Spearman correlation coefficient of child patients of 10-15 U/kg was -0.331 (P=0.030); the Spearman correlation coefficient of child patients over 15 U/kg was -0.16 (P=0.325). CONCLUSION Prevention and treatment can significantly reduce the times of hemorrhage in hemophilia patients.
Blood Coagulation ; Child ; Factor VIII ; administration & dosage ; therapeutic use ; Hemophilia A ; therapy ; Hemorrhage ; prevention & control ; Humans

Objective:To evaluate the strategy and skills of reoperation for recurrent carcinoma at the stoma of esophagojejunostomy after total gastrectomy.Methods:The management experience in 18 patients at the Department of General Surgery, Tumor Hospital of Zhengzhou University from Oct 2016 to Jul 2021 were analyzed retrospectively.Results:Thirteen patients underwent left thoracoabdominal combined incision to completely remove the tumor.One patient developed anastomotic leakage, two patients developed pulmonary infection, one patient developed costochondritis, all were cured and discharged after conservative treatment; Nine patients had no postoperative complications. Two patients abandoned surgery due to high position of the tumor, 3 patients due to poor cardiopulmonary function, and were given radiotherapy and chemotherapy.The postoperative follow-up period was 4.6 to 42.9 months. Four patients died of tumor recurrence, and the remaining patients survived until the end of the follow-up. The overall 1-and 3-year recurrence-free survival rates were 100% and 20%, respectively.Conclusion:Surgery on recurrent carcinoma at esophagojejunostomy stoma after total gastrectomy, although difficult and challenging,could still benefit most patients when at the hands of expertise.

Objective To observe the effects of Gegen Qinlian Decoction on pancreatic endoplasmic reticulum stress in mice with type 2 diabetes mellitus(T2DM);To explore its mechanism of action in the treatment of T2DM.Methods Totally 75 SPF male db/db mice were randomly divided into model group,metformin group,and Gegen Qinlian Decoction high-,medium-,low-dosage groups,with 15 mice in each group.15 db/m mice were set as the blank group.The administration groups received corresponding medicine for gavage for 12 weeks.Body mass,fasting blood glucose(FBG)and glycated hemoglobin(HbA1c)in mice were detected,HE staining was used to observe the pathological changes of pancreatic tissue,the apoptosis of islet cells was determined by TUNEL staining,Western blot was used to detect pancreatic tissue glucose regulatory protein 78(GRP78),protein kinase R-like endoplasmic reticulum kinase(PERK),p-PERK,activated transcription factor 4(ATF4)and C/EBP homologous protein(CHOP)protein expression,RT-PCR was used to detect pancreatic tissue PERK,ATF4,CHOP mRNA expressions.Results Compared with the blank group,the body mass,FBG and HbA1c contents in the model group significantly increased(P<0.01);the pancreatic tissue structure was incomplete,with blurry boundaries and vacuoles inside,leading to a significant increase in pancreatic islet cells apoptosis(P<0.01);the expressions of GRP78,p-PERK,ATF4,and CHOP proteins in pancreatic tissue significantly increased(P<0.01),and the mRNA expressions of PERK,ATF4 and CHOP significantly increased(P<0.01).Compared with the model group,the body mass,FBG and HbA1c contents of mice in each administration group significantly decreased(P<0.05,P<0.01);pathological changes in pancreatic tissue was reduced,and islet cells apoptosis decreased to varying degrees(P<0.05,P<0.01);the expressions of GRP78,p-PERK,ATF4 and CHOP proteins in pancreatic tissue significantly decreased(P<0.01)in Gegen Qinlian Decoction high-and medium-dosage groups and the metformin group,and the expressions of PERK,ATF4 and CHOP mRNA significantly decreased(P<0.05,P<0.01).Conclusion Gegen Qinlian Decoction may decreased pancreatic islet cells apoptosis,protect pancreatic cell function,and delay the progression of T2DM by inhibiting the endoplasmic reticulum stress PERK/ATF4/CHOP signaling pathway,and down-regulating the expressions of related genes and proteins.