Objective To explore the application of monitored anesthesia care (MAC) under the guidance of bispectral index in surgical treatment of chronic subdural hematoma in elderly patients.Methods Sixty patients (33 males, 27 females, aged 65-85 years, ASA physical status Ⅱ-Ⅳ) undergoing sphenotresia drainage of chronic subdural hematoma from March, 2014 to May, 2015 were randomly divided into BIS-guided monitored care anesthesia group (group M) and local anesthesia group (group C).Propofol and remifentanil were intravenously infused into patients from group M to maintain BIS index 65-75, vital signs stability and no movement.Local anesthesia was performed before skin incision for each patient.The frequency of medication, the incidence of adverse events were record.The satisfied degree of sedation and analgesia were also evaluated.Results The frequency of movement, local anesthesia drug and additional use of esmolol, were significantly less in group M than those in group C.The satisfaction degree of sedation and analgesia were significantly higher in group M than those in group C (P<0.05).There was no significant difference of respiratory depression and airway obstruction between the two groups.No nausea vomiting reflex and respiration occurred in all groups.Conclusion Bispectral index guidance can be safely applied in surgical treatment of chronic subdural hematoma in elderly patients, which can supply more sedative and analgesic satisfaction than local anesthesia.

TBX20 gene, a member of the T-box gene family, plays an important role during heart development and is required for maintaining adult heart function.TBX20 can act as both transcriptional activator and transcriptional suppressor during the development of the heart, and shows complex spatiotemporal regulation.TBX20 is an important candidate transcription factor for the pathogenesis of congenital heart disease(CHD), and its mutation or expression change can lead to the occurrence of CHD.In this paper, the latest research progress of TBX20 gene in the field of heart development is reviewed from the relationship between TBX20 and CHD, the signaling pathway involved in heart development and its interactions with other cardiac transcription factors.

Objective To study the effects of P53, PCNA, Bcl-2 protein and their relationship in salivary adenoid cystic carcinoma(SACC). Methods These proteins were examined by immunohistochemistry. Results Overexpressions of P53 and PCNA were revealed in ACC samples, they were higher than those in (polymorphous adenomas) PA, but expression of Bcl-2 protein was not different between ACC and PA. In 3 subtypes of ACC, expressions of 3 proteins were different. Conclusion Mutations of P53, Bcl-2 may be involed in the occurrence of SACC, expression of PCNA and mutation of P53 may coexist in the development of the SACC.

Objective To compare the effect and safety of rituximab plus CHOP (R-CHOP) and CHOP regimens for the treatment of newly diagnosed patients with early-stage primary gastric diffuse large B-cell lymphoma (PG-DLBCL). Methods A total of 65 patients with PG-DLBCL were retrospectively divided into two groups: 35 patients were treated with R-CHOP regimen, the others with CHOP regimen. NHL international efficacy assessment and WHO criteria were used to assess the therapeutic and the adverse reactions respectively. Results The complete remission (CR) rate of R-CHOP group was 74.3 % (26/35), which was significantly higher than that of CHOP group [50.0 % (15/30), P< 0.05], but the adverse reactions rates of two groups had no significant difference (P>0.05). The Kaplan-Meier survival analysis showed that the five-year survival rates of two groups had no significant difference (88.6%vs 75.0%, P>0.05). The PFS of R-CHOP group was better than that of CHOP group (94.4 months vs 74.9 months, P< 0.05). Conclusion Compared with CHOP regimen , R-CHOP regimen increases the therapeutic efficacy in patients with PG-DLBCL, and dose not increase the adverse reactions.

Objective:To explore differential diagnosis value of changes of brain natriuretic peptide (BNP) and N ter‐minal pro brain natriuretic peptide (NT‐proBNP) concentrations in patients with dyspnea .Methods :A total of 150 patients with dyspnea at hospitalization were enrolled and divided into cardiogenic dyspnea group (CD group ,n=51) ,pulmonary dyspnea group (PD group ,n=47) and cardiogenic plus pulmonary dyspnea group (CPD group ,n=52) .Another 40 healthy subjects were regarded as normal control group .Concentrations of BNP and NT‐proBNP were observed and compared among all groups before and after treatment .Results:Before treatment ,compared with normal control group , there were significant rise in plasma concentrations of BNP and NT‐proBNP in CD group ,CPD group and PD group ,that of CD group was significantly higher than those of PD group and CPD group , and that of CPD group was significantly higher than that of PD group , P<0.01 all .Before treatment ,the NT‐proBNP content in CD group ,CPD group , PD group were [ (3356.6 ± 321.2) pg/ml vs . (3156.9 ± 239.8) pg/ml vs .(2563.7 ± 234.20) pg/ml] respectively , comparison among three groups , P<0.01 all .Compared with before treatment ,one week after discharge ,plasma concentrations of BNP and NT‐proBNP significantly reduced in CD group ,CPD group and PD group ,the plasma BNP and NT‐proBNP concentrations of CD group were the highest , those of PD group were the lowest ,and those of CPD group were the middle , P<0.01 all .Conclusion:Plasma BNP and NT‐proBNP concentrations are helpful to differential diagnose whether dyspnea belongs to cardiogenic or pul‐monary diseases .

This paper analyzed the moral construction in the prenatal diagnosis of surgical nursing and nursing features, including:strictness and complexity , professional and comprehensive , collaborative, and independence , carry out from the patients with preoperative evaluation , operation and postoperative effect evaluation every link and detail, with the theory of nursing ethics to guide and standardize nursing , dealing with the relation between various ethic, improve patient satisfaction , based on the premise of mutual modern relationship between nurses and pa-tients.

Objective To discuss the influence of the progress and result in gastic cancer operation through application of neo-adjuvant chemotherapy in multi-disciplinary team (MDT).Methods Clinical data of the patients treated in MDT model 45 cases and non-MDT model(78 cases) were respectively analyzed,and the index about pathologic change,histologic transform and operative result between the two groups were compared.Results In the index of pathologic change,the incidence of abdominal adherence and ascites and pyloric obstruction in MDT model group were obviously less than non-MDT model group( P ＜0.05 ).In the index of histologic transform,texture of mesentery in MDT model group was more fragile than non-MDT model group( P ＜0.05).In the index of operative results,the operative duration and intra-operative bleeding in MDT model group were less than non-MDT model group (P ＜0.05).Conclusion Neo-adjuvant chemotherapy has certain influence in gastric caneer operation,but the successful operations were performed by standard and correct procedures.Therefore,optimizing combined therapy in MDT model and constructing preoperative evaluation system with neo-adjuvant chemotherapy.

Aim To investigate the effects of chronic morphine treatment and withdrawal on the level of SNAPs in different brain regions of rats,including nucleus accumbens(NAc),caudate putamen(CPu) and hippocampus(Hip).Methods Adult male Wistar rats were randomly assigned into control,morphine and spontaneous withdrawal group.The morphine dependent rat model was established by subcutaneous morphine injection with increasing doses for 8 d,three times a day(8:00,12:00,and 18:00).The control group was injected with the same volume of normal saline.Rats in morphine group were killed 4 h after the last injection,and rats in withdrawl group were killed at indicated time.Control groups were paralleled with all treatment groups.The brains were removed and the NAc,CPu and Hip were separated.The expression of SNAPs mRNA and protein were determined by RT-PCR and Western blot.Results The expression of ?SNAP in CPu of morphine dependent rats was up-regulated by about 25%(P

OBJECTIVE:To compare the contents of loganic acid,swertiamarin,6′-O-β-D-glucosyl gentiopicroside,gentiopi-croside,sweroside,isoorientin and isovitexin in wild and cultivated Gentiana officinalis,and to provide basis for rational use of G. officinalis. METHODS:UPLC method was adopted. The separation was performed on ACQUITY UPLC? BEH C18 column (50 mm × 2.1 mm,1.7 μm) with mobile phase consisted of methanol-0.04% phosphoric acid (gradient elution) at the flow rate of 0.3 ml/min. The detection wavelength was set at 242 nm,and column temperature was 30 ℃. RESULTS:For loganic acid,swertiama-rin,6′-O-β- D-glucosyl gentiopicroside,gentiopicroside,sweroside,isoorientin and isovitexin,a good linearity was obtained in the range of 2.1-537.1 μg,1.05-270 μg,0.92-236 μg,11.1-2 830 μg,0.75-192 μg,0.167-102 μg,0.216-52.80 μg(r≥0.999 5), respectively. Their average recoveries were 97.72%-99.84%(RSD≤3.39%,n=6). The contents of loganic acid,swertiamarin, 6′-O-β-D-glucosyl gentiopicroside,gentiopicroside,sweroside and isoorientin in the wild sample were higher than in the cultivat-ed;the content of isovitexin was lower than the cultivated,but there was no statistical significance(P>0.05). The sum of gentiopi-croside and loganin acid content were all higher than 2.5% in both wild and cultivated samples,and met the requirements of 2015 edition of Chinese Pharmacopoeia(first part). CONCLUSIONS:The content difference of 7 indicative constituents in wild and cul-tivated G. officinalis is not statistically significant,and the indicative constituents of the pharmacopoeia is qualified.

Objective To investigate the circulation and use of Akebiae Caulis and Clematidis Armandii Caulis;To provide references for clinical safe medication. Methods Literature review, field survey and telephone interview were used to conduct the investigation. Results ① The market currency of the Akebiae Caulis and Clematidis Armandii Caulis was very confused, and the mainly medicinal materials on the market were Clematidis Armandii Caulis. ② The majority used medicinal materials were Clematidis Armandii Caulis, and Akebiae Caulis was rarely used. ③ The Chinese Pharmacopoeia collected Akebiae Caulis and Clematidis Armandii Caulis separately, but there was phenomenon of using Clematidis Armandii Caulis replacing of Akebiae Caulis. Conclusion Market of Akebiae Caulis is shrinking; the phenomenon of using Clematidis Armandii Caulis to replace Akebiae Caulis widespread in clinic. There are differences in the efficacy of Akebiae Caulis and Clematidis Armandii Caulis, so they should be distinguished and cannot be used to mix or substitute.