10.3969/j.issn.1000-3606.2013.06.001

The author analyzed how toelaborate narrative contents using structured standard with electronical -ly structured medical record information model and the relation of the two .Astructured medical record data entry way was worked outcompatible with standard terminology based on ways of expressing narrative contents using structured standard.It provided a theoretical basis for clinical use .

Objective To investigate the analgesic efficacy of intravenous administration of lidocaine in patients following laparoscopic cholecystectomy. Methods Twenty-five ASA Ⅰ or Ⅱ patients, aged 30-55 yr,weighing 50-70 kg, scheduled for laparoscopic cholecystectomy, were enrolled in this study. Lidocaine 1.5 mg/kg was injected intravenously immediately before anesthesia. Anesthesia was induced with intravenous fentanyl 2 μg/kg, propofol 2 mg/kg and rocuronium 1 mg/kg and maintained with inhalation of isoflurane (end-tidal concentration 1.5%-2.0%) and intermittent iv boluses of rocuronium after tracheal intubation. Lidocaine was infused abdominal intravenously at a rate of 1.5mg·kg-1·h-1 form the end of ofperation to 24 h after operation. The degree of abdominal pain and shoulder pain was assessed with VAS score at 1, 6, 12 and 24 h after operation. The effective analgesia was defined as VAS score of ≤ 3. The adverse reactions were recorded. Results The effective analgesia rate was 100% within 24 h after operation. No adverse reactions occurred. Conclusion Intravenous administration of lidocaine exerts satisfactory analgesia in patients after laparoscopic cholecystectomy.

Objective To raise diagnostic rate of protruded lesion of gastrointestinal mucosa and to judge the precise differentiation to the depth of malignant lesion.Methods 12 cases of gastrointestinal diseases were examined by MPS combined with endoscopic examination.Results To the patients suffering protruded lesion of gastrointestinal mucosa with negative biopsy,the MPS provided a sound basis for diagnosis;To the cases of malignant lesion,findings of MPS with regard to the depth were in total concordance with that of surgical biopsy.Conclusion MPS is significanfly superior to conventional endoscopy with pathological biopsy in the differentation of protruded lesion of gastrointestinal mucosa.But in the case of malignant lesion,only the depth of infiltration of gastrointestinal wall can be correctly assessed by MPS.The value is limited in showing whole Picture for larger focus and in the identification of around lymphnodes and whether or no distal metastases in the near organs.

Objective To evaluate the similarities and differences between four-dimensional radiotherapy (4D-CT ) and active breathing control techniques(ABC) in respiratory management in lung radiotherapy ,and investigate the indications and feasibility of different breathing control techniques for different patients .Methods Twenty-one patients treated with lung radiotherapy received respiratory management .4D-CT technology was used in 11 patients ,while ABC technology was adopted in the rest 10 .The ratios of planning target volume(PGTV) to gross tumor volume(GTV)[(PGTV/GTV)] were calculated .The differences between these two respiratory management technologies were compared in terms of the PGTV ,positioning time ,planning time and treatment time to investigate the indications .Results 4D-CT technology had higher PGTV/GTV ratio ,and shorter positioning time and irradiation time than ABC technology(P<0 .05) ,but there was no significant difference in the planning time(P>0 .05) .In patients with ABC and 4D-CT technology ,objective response rates were 50 .0% ,45 .5% ,respectively ,and the radiation pneumonitis rates were 30 .0% ,27 .3% ,respectively .There was no significant difference in both groups (P>0 .05) .Conclusion In lung tumor radiothera-py ,ABC can reduce irradiation volume ,suitable for patients with good performance status .4D-CT is time-saving and well tolerated , suitable for patients with smaller tumors .

Objective To track superparamagnetic iron oxide (SPIO)-labeled pancreatic islet cells in rats using 3.0T magnetic resonance imaging (MRI), and to detect the survival and rejection of grafts after transplantation. Methods Twenty male Wistar rats and 5 male Lewis rats were included in the study. SPIO-labeled pancreatic islet cells were tracked using a GE 3.0T Signa Excite MRI scanner with an animal coil. The images of SPIO-labeled islet cells in rats after transplantation were compared with those of the unlabeled ones. FSE T2WI sequence and GRE T2*WI sequence were used for the detection. The sensitivity of images for detection of grafts was also compared. SPIO-labeled pancreatic islet cells isolated from Wistar and Lewis rats were transplanted into the liver of Wistar rats. Afterwards, the survival and rejection of islet cells were observed sequentially in these two growps. The rats in the syngeneic group were sacrificed 3 months post-transplantation, while the rats in the allogeneic group were sacrificed 3 weeks post-transplantation. MRI of the grafts were correlated with the pathological results. Results SPIO-labeled pancreatic islet cells were seen on MRI as distinct homogenous, hypointense spots in the liver. GRE T2*WI were more sensitive to the detection of SPIO-labeled islet cells than FSE T2WI. The relative count of hypointense spots in the syngeneic group were (90.03±9.52)%, (92.87±18.21)% and (86.25±24.81)%, respectively at 1 week, 2 weeks and 3 weeks after transplantation, while the relative count in the allogeneic group were (41.40±15.41)%, (33.41±14.01)% and (23.58±16.78)%, respectively. The difference between these counts was statistically significant (P<0.01). Iron particles were detected only in the SPIO-labeled cells. Three months post-transplantation, the grafts were found well-preserved in the liver of the rats of the syngeneic group, while only a few grafts were found in that of the allogeneic group. Conclusions MRI can be used to track SPIO-labeled islet cells in vivo, and has significant value in detecting the survival and rejection of grafts after transplantation in rats.

Objective To investigate the value of detecting plasma microRNA‐125a‐3p(miRNA‐125a‐3p) ,IGF‐2 on monitoring invasion and metastasis in NSCLC ,and to study the correlation between miR‐125a‐3p and IGF‐2 .Methods miR‐125a‐3p transcripts of 20 controls ,73 NSCLC were performed in plasma by quantitative reverse transcription‐polymerase chain reaction(qRT‐PCR) and PCR data was analyzed by the 2‐ΔΔCT method .The expression of IGF‐2 in plasma was detected by ELISA .Results The expression of miR‐125a‐3p in stage Ⅲ /Ⅳ was lower than stage Ⅰ/Ⅱ and the controls(P=0 .001 ,P=0 .005) .There was no statistical differ‐ence between the stage Ⅰ /Ⅱ patients and the controls(P=0 .776) .The expression of miR‐125a‐3p was related with lymph node metastas ,lower expression in positive lymph node metastasis (P=0 .003) .The expression of IGF‐2 in stage Ⅰ /Ⅱ 、stage Ⅲ /Ⅳ was higher than the controls(P=0 .036 ,P=0 .011) .There was no statistical difference between the stageⅠ/Ⅱ and stage Ⅲ/Ⅳ (P=0 .451) . The expression of IGF‐2 was related with lymph node metastas ,higher expression in positive lymph node metastasis (P=0 .037) .The re‐sults showed a negative correlation between miR‐125a‐3p expression and IGF‐2 in plasma(r= -0 .280 ,P=0 .007) .Conclusion Low ex‐pression of miR‐125a‐3p and high expression of IGF‐2 in plasma may play a role in invasion and metastasis of NSCLC .miR‐125a‐3p may play a negative regulatory role on IGF‐2 .

ABSTRACT:Strongyloides stercoralis is an opportunistic parasitic nematode ,whose larvae can invade the lung ,brain ,liv‐er ,kidney and other organs of hosts and cause strongyloidiasis .The infection opportunity of strongyloidiasis increased with raised living standard ,changed lifestyle and family pets .So far ,the relevant domestic researches of strongyloidiasis are limited in case reports and epidemiological investigation ,but researches involving biological characteristics ,immune phenomenon and protective immune response in humans are still very little .Based on the references ,this review summarizes recent findings in morphology ,life cycle ,pathogenicity ,epidemiology ,immunology ,diagnosis and prevention of S .stercoralis for raising the awareness of strongyloidiasis .

Objective To investigate the expressions and clinical pathological significance of EpCAM and the β-catenin pathway in colon cancer,and the correlation between EpCAM andβ-catenin.Methods Immunohistochemistry was used to detecte the expressions of EpCAM and β-catenin proteins in colon cancer tissues and corresponding adjacent tissues of 70 cases of colon cancer patients,the clinical and pathological features of colon cancer and their relationship were retrospective analyzed.Results ①EpCAM and β-catenin protein expressions in colon cancer tissue was 52 cases (74.3％) and 55 (78.6％) positive respectively; EpCAM and β-catenin proteins in cancer adjacent tissues in 13 cases( 15.7％ ) and 9 cases ( 12.9％ ) were positive,the differences were statistically significant.②the EpCAM expression is positively correlated with the β-catenin expression ( r =0.616,P ＜ 0.01 ).③The expressions of EpCAM and β-catenin correlated with the tumor differentiation,invasion depth,lymph node metastasis and TNM staging related ( P ＜ 0.05).Conclusion EpCAM and β-catenin pathways in colon cancer positively correlate,and closely correlate with colon cancer.The expression level of EpCAM and β-catenin can be used as a reference for the colon disease course and healing.

Objective To investigate the diagnosis and treatment of the blunt pancreatic injury.Methods The clinical data of 21 blunt pancreatic trauma patients admitted to our hospital in the past 5 years were analyzed retrospectively.Results 3 of 21 patients were simple blunt pancreatic injury, while the other 18 patients were complicated with other abdominal organs injuries.According to the grading criteria, the number of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ grade injury were 4, 7, 5, 3 and 2 cases, respectively, and only 9 patients were diagnosed by CT before operation, and the diagnosis was confirmed during the operation in 11 patients, and 1 was miediagnosed in the first operation.Single drainage or debridement and drainage were performed in 8 cases and distal pancreatectomy with and without spleen were performed in 5 and 3 cases, respectively, and 3patients received pancreaticojejunostomy, 1 received Whipple operation, the other 1 case underwent duodenorrhahy and diverticulation.The mortality rate was 9.5% (2/21), and the complications of pancreatic pseudocyst and fistula developed in 2 (9.5%, 2/21 ) and 5 (23.8%, 5/21 ) cases respectively, and they were cured by drainage, while the other 12 were cured completely.Conclusions The preoperative misdiagnosis rate of pancreatic trauma is high;CT scan should be used to confirm the diagnosis.Careful pancreatic exploration is mandatory and simple and effective surgical procedures with effective drainage is important for treatment success.