Objective To summarize the experience of nursing cancer patients with Wernicke encephalopathy (WE) after gastrointestinal surgery. Method The clinical data of 6 patients with WE after gastrointestinal surgery in our hospital from January 2005 to June 2015 were retrospectively analyzed to summarize the nursing strategies. Results All the 6 patients showed mental changes of different types, 5 patients developed with ocular manifestations and one patient with ataxia. Only one patient showed the classic triad of the disease at clinical presentation. All the 6 patients had characteristic manifestations on cranial MRI and received thiamine (vitamin B1) at diagnosis. Four patients were completely recovered and 2 were partially recovered. Conclusion Timely sufficient thiamine supplementation during the perioperative period is the key to prevent and treat WE in the patients with gastrointestinal cancer. Careful observation of the patients′ mental state and the effective nursing for the special classic triad of the disease are critical for a better prognosis.

Objective To evaluate the diagnostic value of hysteroscopy in comparison with hysteros- alpingography(HSG) in the detection of intrauterine abnormalities in infertile patients.Methods 52 patients(ob- serving group) with filling defects under HSG received hysteroscopy,and the remaining 22 patients (contrasting group) with normal hysterosalpingographic findings also received hysteroscopy with their consent.Results In- trauterine abnormalities in observing group and contrasting group confirmed by hysteroscopy were 78.8 % and 9.1% respectively,and there was statistical significance(P

BACKGROUND:According to the theory of Traditional Chinese Medicine, stimulating certain acupoints of the body after exercise may improve its antioxidant capacity, but different acupoints have different effects. OBJECTIVE:To compare the effect of different acupuncture combinations on the antioxidant capacity of myocardial and liver tissues in rats after exhausted swimming exercise, and screen out the optimal acupoint combination for exercise-induced fatigue. METHODS:Seventy Sprague-Dawley male rats were divided into five groups: control group (n=10), model group (n=15),Sanyinjiao +Zusanli group (n=15),Shenshu +Zusanli group (n=15),Dazhui+Zusanli group (n=15). Except the control group, rats in the other four groups were subject to exhausted swimming. In the three acupuncture groups, rats were given acupuncture at corresponding acupint combinations at 15 minutes after exercise. RESULTS AND CONCLUSION:Compared with the control group, the activities of superoxide dismutase and glutathione peroxidase in the myocardial and liver tissues were significantly reduced in the model group, while the malonaldehyde content in cardiac muscle was significantly increased. Compared with the model group, the activities of superoxide dismutase and glutathione peroxidase in the cardiac muscle were significantly increased inSanyinjiao +Zusanli group, the superoxide dismutase in liver tissue was significantly increased inShenshu+Zusanli group, the malonaldehyde content in the myocardial tissue was significantly decreased in Sanyinjiao +Zusanli group and Dazhui +Zusanligroup, the malonaldehyde content in the liver tissue was significantly decreased in Sanyinjiao +Zusanligroup. Different acupuncture combinations have different effects on the activities of superoxide dismutase and glutathione peroxidase, as wel as the malonaldehyde content in the myocardial and liver tissues of fatigued rats. Acupunture could increase the antioxidant ability in cardiac muscle of rats and the best combination might beDazhui+Zusanli; acupoint combinations ofShenshu +Zusanli andSanyinjiao +Zusanli are specific for liver tissue.

Objective To analyze the characteristics and hepatotropism of this negative element HBVnt453-250 sequence.Methods pHBv453-250,pHBV250-453.plucHBV453-250 and plucHBV250-453 were constructed,with luciferase and enhanced green fluorecence protein(EGFP)gene as the reporter gene,respectively.After transfection of HepG2 cells with these plasmids,luciferase assays,real-time PCR and western blot assays were used to detect the gene transcription and expression level.The SV40 promoter of pGL3 control and pHBV453-250 were replaced by the cytomegalovirus early promoter,resulting in plasmids pCMVcontrol(luc)and pCMV453-250(luc).Results Compared with pHBV453-250,the mutant plasmids.with the inhibitory element inserted in difierent site or inverted orientation.exerted similar downregulation of Juciferase gene transcription and expression.Western blot analysis demonstrated the similar repression when EGFP was used as the reporter gene.By transfeeted to HepG2 cell line,the plasmid pCMV453-250(1UC)could reduce lneiferase activity(36.56%)compared with pCMLcontrol(luc).When the plasmids plueHBV453-250 and plucHBV250-453 were transfected to non-liver cell lines(A549,HeLa),luciferase gene was expressed weakly,compared with that of pGL3control(P＜0.05).Conclusion The inhibitory effect of HBVnt453-250 sequence acted in both orientation-and position-independent manners,and had no promoter selectivity and funotioned in hepatocyte-independent manner.

ObjectiveTo investigate the significance of hearing screening combined with gene screening for neonates with high-risk of hearing impairment.MethodsNeonates admitted to the Neonatal Department of Guangdong Women and Children Hospital between July 2013 and June 2014 were enrolled in this study. They were divided into high-risk group (with high-risk for hearing impairment) (n=3 129), and control group (n=5 106). Neonate hearing screening was carried out using otoacoustic emission and automated auditory brainstem response. Blood samples were collected using a standard protocol for detecting the mutations of four common deafness genes, includingGJB2,GJB3,SLC26A4 and mitochondrial 12s rRNA.Chi-square test was used to compare the differences of the pass rate of hearing screening and positive rate of gene mutations between the two groups.ResultsThe rates of failure on otoacoustic emission, automated auditory brainstem response or both in the high-risk group were 11.92% (373/3 129), 10.32% (323/3 129) and 4.83% (151/3 129), respectively, higher than those in the control group [5.03%(257/5 106), 6.56%(335/5 106) and 2.02% (103/5 106)] (χ2=130.265, 37.354 and 51.196, allP=0.000). In the high-risk group, the overall positive rate of gene mutations was 5.63% (176/3 129), and theGJB2 andSLC26A4 gene mutation rates were 3.04% (95/3 129) and 2.40% (75/3 129)], all higher than the control group [3.15% (161/5 106), 2.04% (104/5 106) and 1.06% (54/5106)] (χ2=30.301, 8.216 and 22.517, allP<0.01). But the mitochondria 12S rRNA gene andGJB3 gene mutation rates were the same in high-risk group and control group [0.19% (6/3 129) vs 0.06% (3/5 106); 0.03% (1/3 129) vs 0.00%(0/5 106), bothP>0.05]. The rates of failure on otoacoustic emission and automated auditory brainstem response of the neonates with deafness gene mutations were 9.50% (32/337) and 10.39% (35/337), respectively, higher than the neonates without [1.14% (90/7 898) and 1.29% (102/7 898)] (χ2=154.621 and 163.399, both P=0.000).ConclusionCombined hearing screening is of clinical significance for neonates with high-risk of hearing impairment.

OBJECTIVEThis study aims to determine the effect of fluoride concentration on the corrosion behavior of cobalt-chromium alloy fabricated by two different technology processes in a simulated oral environment.

METHODSA total of 15 specimens were employed with selective laser melting (SLM) and another 15 for traditional casting (Cast) in cobalt-chromium alloy powders and blocks with the same material composition. The corrosion behavior of the specimens was studied by potentiodynamic polarization test under different oral environments with varying solubilities of fluorine (0, 0.05%, and 0.20% for each) in acid artificial saliva (pH = 5.0). The specimens were soaked in fluorine for 24 h, and the surface microstructure was observed under a field emission scanning electron microscope after immersing the specimens in the test solution at constant temperature.

RESULTSThe corrosion potential (Ecorr) value of the cobalt-chromium alloy cast decreased with increasing fluoride concentration in acidic artificial saliva. The Ecorr, Icorr, and Rp values of the cobalt-chromium alloy fabricated by two different technology processes changed significantly when the fluoride concentration was 0.20% (P < 0.05). The Ecorr, Icorr, and Rp values of the cobalt-chromium alloy fabricated by two different technology processes exhibited a statistically significant difference. The Icorr value of the cobalt-chromium alloy cast was higher than that in the SLM group cobalt-chromium alloy when the fluoride concentration was 0.20% (P < 0.05). The Ecorr, tRp alues of the cobalt-chromium alloy cast were lower htan those of the SLM group cobalt-chromium alloy when the fluoride concentration was 0.20% (P< 0 .05).

CONCLUSIONFluoride ions adversely affected the corrosion resistance of the cobalt-chromium alloy fabricated by two different technology processes. The corrosion resistance of the cobalt-chromium alloy cast was worse than that of the SLM group cobalt-chromium alloy when the fluoride concentration was 0.20%.

We integrate the precision medicine into the training process of breast surgery postgraduates. Besides the traditional training, we emphasize the idea of precision medicine and provide precision medicine lessons. We also carry out multidisciplinary precision-medicine teaching ward-rounds, and take use of AI system to assist clinical decision making, so as to stimulate the subjective initiative of the postgraduates, and strengthen the training of clinical practical capabilities. Our experience has showed that applying the precision medicine mode to the training of breast surgery postgraduates is more conducive to strengthening their clinical capabilities and overall quality.

Objective To evaluate efficacy and safety of glucocorticoids for community-acquired pneumonia (CAP).Methods We searched relevant randomized controlled trials (RCT) from Pubmed,EMBASE,Cochrane Library,Chinese Journal Full-text Database,Chinese Biomedical Literature Database and traced the related reference to obtain the information that had not been found by using key words of steroids,glucocorticoids,cortisol,corticosteroids,community acquired pneumonia and CAP.The quality of RCT included was evaluated.Meta-analysis was performed with RevMan 5.0 provided by the Cochrance Collaboration.Results Seven RCTs involving 944 patients were included in the meta-analysis.Mean length of hospital stay in glucocorticoids treatment group was significant shorter than that in conventional treatment group (WMD =-1.70,95％ CI:-2.01-1.39,Z =10.81,P ＜0.01).No significant differences were found regarding mortality (RR =0.77,95％ CI 0.46-1.27,Z =1.03,P =0.30),mean length of ICU stay (WMD =1.17,95％ CI:-1.68-4.02,Z =0.81,P =0.42),the risk of double infection (RR =1.32,95％ CI 0.66-2.63,Z=0.79,P=0.43),the incidence of hyperglycemia (RR=1.84,95％ CI0.76-4.41,,Z=1.36,P=0.17),the incidence of upper gastrointestinal bleeding (RR =1.98,95％ CI O.37-10.59,Z =0.80,P =0.42) between conventional treatment group and glucocorticoids treatment group.Conclusions Glucocorticoids treatment used in patients with community-acquired pneumonia may shorten the course of illness and possess better safety,but could not reduce the mortality.

Objective To study the feasibility and curative effect of transumbilical single-incision (TSIL) vs multiple-incision (MIL) laparoscopic splenectomy.Methods Ten cases (2 cases of idiopathic thrombocytopenia purpura,1 case of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of cirrhotic splenomegaly) underwent TSIL from Jan 2010 to Ju12011,and 12 cases (3 cases of ITP,2 cases of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of splenomegaly) underwent MIL.Clinical data were compared with each other.Results No severe complications occurred in either group.The mean operation time of single-incision group and multiple-incision group was ( 182 ± 23 ) min and ( 169 ± 19) min,and blood loss was( 160 ± 13 ) ml and ( 155 ± 16) ml ( P ＞ 0.05 ).The post-operative pain score in TSIL and in MIL group was respectively [ ( 1.60 ± 0.20) vs (3.60 ± 0.90) on day 1,P ＜ 0.05 ; (0.50 ±0.10) vs (2.00 ±0.45) on day 2,P ＜0.05].There was no significant difference between the two groups in the recovery of the gastrointestinal function,the length of hospital stay and the cost of hospitalization, all P ＞ 0.05.The umbilical incision in TSIL cases is more cosmetic.Conclusions Transumbilical single-incision laparoscopic splenectomy is feasible and safe in experienced hands.

OBJECTIVE:To determine serum concentrations of western medicines in patients treated with "traditional Chinese antiepileptic medicine" alone and to evaluate the curative effects.METHODS:A total of 60 epileptic patients who visited our hospital between Feb.1997 and June 2006 were subjected to plasma drug level monitoring and during which the patients were treated with "traditional Chinese antiepileptic drugs" alone.Plasma concentrations of 4 kinds of western medicin-es were determined by FPIA.RESULTS:Of the 60 cases,valproic acid,carbamazepine,phenytoin and phenobarbitone were detected in 18,40,41,and 47 cases/times,respectively.On average,more than two kinds of western medicines were detected in every patient,and the blood concentrations were mostly beyond effective plasma drug concentration.The total curative effects were unsatisfactory.CONCLUSION:The fact that western medicine ingredients detected in these traditional Chinese antiepileptic medicines is inconformity with medication principle of epilepsy.Traditional Chinese antiepileptic medicines should be used with caution in the clinic in the treatment of epileptic patients.