Objective To study the availability of escharectomy in shock phase and its role in preventing complications.Methods To make an analysis between the escharectomies and skin grafting of 79 cases in or beyond shock phase in the incidence of sepsis,visceral complications,MODS,mortality,healing time and the expenditure.Result The cases of the early operations revealed much better consequences than those performed beyond shock phase.Conclusion The escharectomy in shock phase proves to be available and significant in reducing post burn complications.

This study examined endogenous cannabinoid (ECB)-anandamide (AEA) and its cannabinoid receptors (CBR) in mice liver with the development of schistosoma japonicum. Mice were infected with schistosoma by means of pasting the cercaria onto their abdomens. Liver fibrosis was pathologically confirmed nine weeks after the infection. High performance liquid chromatography (HPLC) was employed to determine the concentration of AEA in the plasma of mice. Immunofluorescence was used to detect the expression of CBR1 and CBR2 in liver tissue. Morphological examination showed typical pathological changes, with worm tubercles of schistosoma deposited in the liver tissue, fibrosis around the worm tubercles and infiltration or soakage of inflammatory cells. Also, CBR1 and CBR2 were present in hepatocytes and hepatic sinusoids of the two groups, but they were obviously enhanced in the schistosoma-infected mice. However, the average optical density of CBR1 in the negative control and fibrosis group was 13.28+/-7.32 and 30.55+/-7.78, and CBR2 were 28.13+/-6.42 and 52.29+/-4.24 (P<0.05). The levels of AEA in the fibrosis group were significantly increased as compared with those of the control group. The concentrations of AEA were (0.37+/-0.07) and (5.67+/-1.34) ng/mL (P<0.05). It is concluded that the expression of endocannabinoids AEA and its cannabinoid receptor CBR were significantly increased in schistosoma-infected mice. Endogenous endocannabinoids may be involved in the development of schistosoma-induced liver fibrosis.
Arachidonic Acids/*metabolism ; Endocannabinoids/*metabolism ; Liver Cirrhosis/etiology ; Liver Cirrhosis/*metabolism ; Liver Cirrhosis/parasitology ; Polyunsaturated Alkamides/*metabolism ; Random Allocation ; Receptor, Cannabinoid, CB1/*metabolism ; Receptor, Cannabinoid, CB2/*metabolism ; Schistosomiasis japonica/*complications ; Schistosomiasis japonica/metabolism

Objective To explore the application of MR diffusion weighted imaging (DWI)in the prognosis evaluation of liver cancer after treatment of transcatheter arterial chemoembolization(TACE).Methods Forty-five patients with primary hepatocellular carcinoma and treated with TACE were included in the study.Digital subtraction angiography(DSA)was used as the gold standard to evaluate the value of DWI in the prognosis evaluation.Results The average apparent diffusion coefficient (ADC)value of tumor necrosis tissue was (1.89±0.22)×10-3mm2/s,which was significantly different from that of tumor residual tissue of (1.39±0.27)×10-3mm2/s (P<0.05).Receiver operating characteristic curve showed that the sensitivity and specificity of diagnosing the necrotic tissue were 82.6% and 85.3% respectively with the ADC threshold of 1.68×10-3mm2/s.The sensitivity,specificity and positive likelihood ratio of traditional MRI enhancement were 86.9%,87.8% and 7.12,respectively.The sensitivity,specificity and positive likelihood ratio of MRI enhancement combined with DWI were 95.7%,82.9% and 5.59,respectively.Conclusion DWI can distinguish tumor necrosis from tumor residual in the prognosis evaluation of liver cancer treated with TACE.Traditional MRI enhancement combined with DWI are better in detecting tumor residual and recurrence of liver cancer treated with TACE.

The construction of hospital administration talent echelon has become a " bottleneck" problem in the core competence construction of county-level public hospitals in ethnic regions. West China-Mabian Medical Alliance has made a preliminary exploration on the cultivation of hospital management talents in county-level public hospitals. The hospital carried out the working principle of " setting up a talent pool by post" , and gradually established a reserve talent pool with suitable scale and dynamic adjustment by providing part-time project management positions for young employees in the hospital. There were three kinds of part-time project management positions: part-time assistant to president, part-time project supervisor and part-time department management assistant. In addition, the hospital strengthened the ideological and political education, medical management theory training and practical training of the reserve talents in a planned way. The practical experience of hospital reserve management personnel training based on West China-Mabian Medical Alliance can be used for reference by other county-level hospitals.

As the major part of mesencephalic locomotion region, pedunculopontine tegmental nucleus (PPN) participates in motor initiation, rhythmic and speed regulation. In addition, PPN is regarded as a novel deep brain stimulation target for patients with Parkinson′s disease due to its dramatic effect on the gait disturbance and postural instability. However, PPN also has an important role in muscle tone control and dystonia. This review is aimed at summarizing the involvement of PPN in dystonia, providing fundamental for targeting PPN for treatment of dystonia in the future.

Objective:To explore the clinical mechanism of PD-1 and VEGFR2 inhibitors combined in intervening the progression of colon cancer liver metastasis.Methods:120 patients with colon cancer liver metastasis from Feb. 2021 to Dec. 2022 were selected as research subjects. According to the treatment plan, patients were divided into control group ( n=60) and observation group ( n=60). The control group received PD-1 inhibitor treatment, while the observation group received combination of PD-1 inhibitor and VEGFR2 inhibitor treatment. Tumor vascular density and permeability were evaluated by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). The expression of PD-1 and VEGFR2 proteins were analyzed through protein blot. The levels of serum inflammatory factors IFN - γ, TNF - α, and IL-12 in patients before and after intervention were detected using ELISA. The tumor control effects between the two groups of patients were compared. The average overall survival and average progression free survival between the two groups of patients were compared. Results:Before intervention, there was no statistically significant difference in vascular permeability or density between the observation group and the control group patients; After 6 weeks of intervention, the vascular permeability and density of patients in the observation group decreased compared to the control group. There were no significant changes in vascular permeability or density in the control group before and after intervention. Before intervention, there was no statistically significant difference in the expression of PD-1 or VEGFR2 proteins between the observation group and the control group; P>0.05; After 6 weeks of intervention, the expression of PD-1 and VEGFR2 proteins in both groups of patients decreased compared to that before intervention. The expression of PD-1 and VEGFR2 proteins in the observation group decreased compared to that of the control group (PD-1: 1.04±0.02 vs. 1.30±0.04; VEGFR2: 1.12±0.01 vs. 1.57±0.16) ; P<0.05. Before intervention, there was no statistically significant difference in serum levels of IFN - γ, TNF - α, or IL-12 between the observation group and the control group; After 6 weeks of intervention, the serum levels of IFN - γ, TNF - α, and IL-12 in both groups of patients increased compared to those before intervention. However, the observation group showed a more significant increase in IFN - γ, TNF - α, and IL-12 levels compared to the control group (IFN - γ: 38.44±3.28 pg/mL vs. 27.55±2.63 pg/mL; TNF - α: 44.62±2.15 pg/mL vs. 30.57±2.09 pg/mL) ; IL-12: 33.49±2.51 pg/mL vs. 20.75±1.86 pg/mL; P<0.05). In the control group, there were 8 cases of partial tumor remission, 14 cases of stable tumor phase, and 22 cases of effective tumor control. In the observation group, there were 17 cases of partial tumor remission, 24 cases of stable tumor phase, and 41 cases of effective tumor control. PR, SD, and DCR in the observation group were higher than those in the control group, and the difference was statistically significant ( P<0.05). The average overall survival and mean progression free survival of the observation group were longer than those of the control group. Conclusions:Combined treatment with PD-1 and VEGFR2 inhibitors significantly improves tumor control and survival in patients with colon cancer liver metastases. By reducing tumor vessel density and permeability, enhancing immune responses, and reducing immune evasion of tumor cells, the combined intervention provides a more effective clinical strategy for the treatment of colon cancer liver metastases.

This study examined endogenous cannabinoid (ECB)-anandamide (AEA) and its can-nabinoid receptors (CBR) in mice liver with the development of schistosomajaponicum.Mice were infected with schistosoma by means of pasting the cercaria onto their abdomens.Liver fibrosis was pathologically confirmed nine weeks after the infection.High performance liquid chromatography (HPLC) was employed to determine the concentration of AEA in the plasma of mice.Immunofluorescence was used to detect the expression of CBR 1 and CBR2 in liver tissue.Morphological examination showed typical pathological changes,with worm tubercles of schistosoma deposited in the liver tissue,fibrosis around the worm tubercles and infiltration or soakage ofinfiammatory cells.Also,CBRI and CBR2 were present in hepatocytes and hepatic sinusoids of the two groups,but they were obviously enhanced in the schistosoma-infected mice.However,the average optical density of CBR1 in the negative control and fibrosis group was 13.28±7.32 and 30.55±7.78,and CBR2 were 28.13±6.42 and 52.29±4.24 (P<0.05).The levels of AEA in the fibrosis group were significantly increased as compared with those of the control group.The concentrations of AEA were (0.37±0.07) and (5.67±1.34) ng/mL (P<0.05).It is concluded that the expression of endocannabinoids AEA and its cannabinoid receptor CBR were significantly increased in schistosoma-infected mice.Endogenous endocannabinoids may be involved in the development of schistosoma-induced liver fibrosis.

Objective To systematically review the correlation between birth weight and blood pressure of child and adolescent, and provide a theoretical basis for the etiologic research and the prevention for hypertension of child and adolescent.Methods Comprehensive electronic searches of Chinese Web of Knowledge (CNKI), Wang Fang, Wei Pu (VIP), PubMed and Web of Science were conducted to identify any study reporting the correlation of birth weight and blood pressure of child and adolescent.SPSS 13.0 software was used to convert the data.Meta-analysis was conducted with STATA 12.0 software.Results Thirty four researches were included in this study.The results of meta-analysis showed that low birth weight children or adolescents had a higher risk of hypertension with a significant difference compared to the group which birth weight greater than 2 500 g (OR =1.20;95％ CI:1.09-1.33;P ＜ 0.01).Its systolic blood pressure and diastolic blood pressure was on the high side.In addition, it showed that no significant differences were found between hypertension and high birth weight (OR =1.03;95％ CI:0.89-1.18;P ＞ 0.05).But its systolic blood pressure and diastolic blood pressure was on the high side too.Conclusions Abnormal birth weight is probably a risk factor of child and adolescent high blood pressure.Low birth weight has greater influence on blood pressure of children and adolescents.It can be detected early to prevent abnormal birth weight and child hypertension.

Objective:To observe the maximum tongue pressure and study the oropharyngeal activity during swallowing of patients with nasopharyngeal carcinoma (NPC) after radiotherapy so as to correlate the maximum tongue pressure with swallowing function.Methods:The mean maximum tongue pressure of nineteen NPC patients with dysphagia was measured at the anterior (TA), middle (TM) and posterior (TP) positions, followed by video fluoroscopy. Oral transit time (OTT), upper esophageal sphincter(UES)opening time (UOT) and UES opening range (UOR) were correlated with the mean maximum tongue pressures.Results:The maximum pressure at the TM and TP positions was significantly negatively correlated with OTT, but there was no significant correlation with the anterior readings. The maximum pressures at all three tongue positions were, however, positively correlated with UOT and UOR.Conclusion:The maximum pressure at the TA, TM and TP positions is strongly correlated with the swallowing function of NPC patients.

Objective:To explore the change in cerebral blood flow when healthy subjects swallow hot and ice water, and to verify the sensitivity of functional near-infrared spectroscopy (fNIRS) in identifying liquid temperatures while swallowing as a basis for applying it in diagnosis and intervention.Methods:Sixteen healthy subjects swallowed hot and ice water in randomized order while the process was recorded using fNIRS. The activation at rest and when swallowing hot and ice water was compared pairwise.Results:Compared with the resting state, 19 channels were activated during the swallowing of the hot and ice water. The common activated areas were S1, M1, PMC, SMA, Wernicke′s area, the somatosensory association cortex, the visual association cortex and the frontal eye field. However, the dorsal lateral prefrontal cortex was activated only when swallowing hot water, and the subcentral area was activated only when swallowing ice water. The SMA and PMC were significantly more activated when swallowing hot water than ice water.Conclusions:Multiple brain regions are activated and participate in regulating swallowing. The PMC and SMA areas can distinguish hot water from ice water swallowing.