Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Esophagus ; surgery ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Phonation ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Speech, Alaryngeal ; Trachea ; surgery

Objective To observe the appearances of decussation of superior cerebellar peduncle (SCP) on MR diffusion tensor imaging (DTI) with different parameters of scanning and reconstruction. Methods Twenty healthy volunteers were examined on Siemens 3.0T MR DTI (b=0, 1000 s/mm~2), post processing were made in Siemens Leonardo workstation using Siemens Standar 6 dirs software to reconstruct the white matter fibers with different fractional anisotropy (FA) threshold value (0.04-0.20), angle threshold value (20°-89°) and voxel size (1.2 mm×1.2 mm×3.0 mm-1.6 mm×1.6 mm×5.0 mm). Results Crossing fiber was presented each voxel group on diffusion tensor tractography (DTT). The types of crossing fiber in the small voxel were more than those of big voxel image obviously. Reduced along with the FA threshold value, the number of crossing fiber increased gradually. After the peak value (FA=0.08), the number of crossing fiber reduced along with the FA threshold value reduced gradually. Increased along with the angle threshold value, the number of crossing fiber increased gradually. The number of crossing fiber reduced along with the angle threshold value increased gradually after the peak value (the angle threshold value＝80°). There were 5 kinds of MR fiber tracking appearances at the level of decussation of SCP on DTT. The fiber crossed to the opposited red nucleus in anterior-posterior style, superior-inferior style and single main bundle fiber. Kissing fiber and missing fiber sign was shouw in all subjects, which mainly located in the center of the decussation. Conclusion DTT FACT can show the descussation of SCP in most health subjects with five typical appearance. The descussation of SCP has the obvious appearances, may be causing by individual difference. For the crossing fiber of SCP, voxel size 1.2 mm×1.2 mm×3.0 mm, FA 0.08 and the angle 80° are recommended.

Objective To explore the influence of middle cerebral artery blood flow on mechanical ventilation in very low birth weight premature after using Budesonide(BUD) mixed with pulmonary surfactant(PS),and to explore the protection mechanism of cerebral injury.Methods Forty premature infants (gestational age ＜ 34 weeks,birth weight ＜ 1 500 g) with respiratory distress syndrome(RDS) were randomly assigned into study group and control group in Nanjing Maternal and Child Health Hospital from Aug.2010 to Mar.2012.PS and BUD mixture was used in study group (Per 70 mg PS adding BUD 0.25 mg),PS dose of 70 mg/kg,BUD dose of 0.25 mg/kg.Control group was only administered with PS,dose 70 mg/kg.It was administered intratracheally after 30 to 60 minutes of birth in both groups.The index of blood flow rate and blood vessel elasticity of arteria cerebri media [including systolic velocity (Vs),diastolic velocity (Vd),mean velocity (Vm),resistant index (RI) and elasticity index (PI)] were monitored by using transcranial Doppler.Results The Vs increased steadily in study group,but instability in control group,and there were of statistical differences on the 4 d,5 d,6 d and 7 d (t =3.21,2.95,3.12,3.43,all P ＜ 0.05).The Vd increased steadily in study group,but unsteadily in control group,and there were statistical differences on the 4 d,5 d,6 d and 7 d (t =4.21,3.10,3.98,4.56,all P ＜0.05).The Vm of study group was higher than that in the PS group,and there were statistical differences on the 4 d,5 d,6 d and 7 d (t =2.68,2.98,3.98,3.57,all P ＜ 0.05).The RI of study group was higher than that in the control group,and there were statistical differences in the 5 d,6 d and 7 d(t =3.10,3.98,4.06,all P ＜ 0.05).PI steadily in study group,but instability in control group,and there were statistical differences in the 5 d,6 d and 7 d (t =4.18,3.23,3.02,all P ＜ 0.05).The overall incidence of periventricular/intraventricular hemorrhage showed no significant difference,but severe periventricular/intraventricular hemorrhage (grade Ⅲ,Ⅳ) of study group was less than that in the control group (x2 =4.80,P ＜ 0.05).The incidence of periventricular leukomalacia was reduced in the study group compared with that in the control group (x2 =3.31,P ＜ 0.05).Conclusion The very low birth weight infants treated with mechanical ventilation show steady cerebral blood flow and lower incidence of brain injury after using BUD mixed with pulmonary surfactant.

OBJECTIVE To investigate the effect of furanodiene(FDE),a diterpene derived from the medicinal plant Zedoary,on apoptosis of human gastric cancer MGC-803 cells induced in vitro. METHODS MGC-803 cells were treated with FDE 46.29~740.74μmol·L-1 for 24,48 and 72 h,and the cell viability was detected with MTT assay. Cell morphology was observed by light microscopy and Hoechst33342 staining. Flow cytometry was used to detect cell apoptotic rate and cell cycle. Rh123 staining and fluorescence probe DCFH-DA were employed to detect the changes in mitochondrial membrane potential (MMP) and reactive oxygen species(ROS). RESULTS MTT Results showed that FDE 46.29-740.74μmol · L-1 exhibited significantly higher cytotoxicity to gastric cancer MGC-803 cells. IC50 for MGC-803 of 24,48 and 72 h treatment was 347.91,257.41 and 101.01μmol·L-1,respectively. Treatment with FDE 92.58-370.32μmol·L-1 for 24 h also caused significant morphological changes in MGC-803 cells. AnnexinⅤ-FITC/PI double staining showed that the apoptotic rate increased after FDE 92.58-370.32μmol·L-1 treatment for 24 h(P<0.05). FDE enabled MGC-803 cell cycle arrest in S phase. DCFH-DA staining showed that FDE resulted in an increase in intracellular ROS levels(P<0.05) when PDE concentration was 370.37μmol·L-1(P<0.05). MMP decreased after FDE treatment when PDE concen?tration was 370.37μmol·L-1(P<0.05). CONCLUSION FDE Possesses potent tumor selected toxicity and can induce apoptosis of MGC-803 cells through cell cycle arresting,which is related to inhibition of DNA biosynthesis.

Objective:To study the clinical features, experiences of diagnosis and treatment, and treatment process of ovarian nonspecific steroid cell tumor. Methods:The clinical materials of one case of ovarian nonspecific steroid cell tumor were retrospectively analyzed,and the related literaturels were reviewed. Results:The patient displayed amenorrhea and masculine characteristics.Preoperative ultrasonography demonstrated the solid tumor of 53 mm ×39 mm on the right ovary,consideration for the right side of ovarian malignant tumor,and laparotomy was performed.The pathologic results showed that the tumor cells were arranged in nests,and the cytoplasm was bright or eosinophilic, and the nucleus were round or oval with nucleolus.The immunohistochemical staining results revealed that calretinin,vimentin and inhibin were positive in the tumor cells.The patient was diagnosed with ovarian nonspecific steroid cell tumor.The postoperative follow-up of 3 months was performed,and there was no recurrence.Conclusion:The diagnosis of ovarian nonspecific steroid cell tumor should be combined with the clinical manifestation and pathologic results,and operion is the main treatment method.

Objective To explore the effect on walking ability of the orthotic insole produced by the International College of Biomechanics (ICB) when it is combined with an ankle foot orthosis (AFO).Methods A total of 40 stroke survivors with hemiplegia were randomly divided into an observation group and a control group,each of 20.In addition to conventional medical treatment and rehabilitation,the control group received AFOs and walking rehabilitation training.The observation group accepted walking training with an ICB orthotic insole combined with an AFO.The experiment lasted 4 weeks.Timed up and go test (TUGT) times,10 m maximum walking speed (10 m MWS) and Berg balance scale (BBS) ratings were recorded before and after the treatment.Results Before the treatment there was no significant difference between the group averages in terms of any of the measures.After the treatment,significant improvement was observed in all of the measurements,with the improvements in the observation group significantly better than those in the control group,on average.Conclusion An ICB orthotic insole combined with an AFO results in better improvements in the walking ability of hemiplegic subjects than an AFO alone.

Objective To investigate the correlation of interaction between polymorphisms of prothrombin gene G20210A in 3' untranslated region and tissue factor pathway inhibitor (TFPI) gene C399T in 5' untranslated region with thrombin activity in plasma and the pathological stages of esophageal carcinoma.Methods Based on TNM method,we selected 198 patients with stage Ⅰ esophageal carcinoma,198 with stage Ⅱ,198 with stage Ⅲ,and 198 with stage Ⅳ from the First Affiliated Hospital of Xinxiang Medical College from May 2011 to August 2015 for this study;198 patients with esophageal carcinoma of stage 0 served as the control group.The thrombin activity in plasma were determined by chromogenic substrate assay.The genetic polymorphisms of prothrombin gene G20210A in 3' untranslated region and TFPI gene C399T in 5' untranslated region in peripheral blood leukocytes of the above-mentioned patients were analyzed by PCR-RFLP technique.Unconditional logistic regression model and single factor analysis were performed to calculate the adjusted odds ratios (OR) and 95％ confidence intervals (95％ CI) of polymorphisms prothrombin gene G20210A and TFPI gene C399T polymorphisms and to analyze the interaction of nucleotide polymorphisms with thrombin activity in plasma and the pathological stages of esophageal carcinoma.Results The frequencies of G20210A (GA),G20210A (AA),C399T (CT) and C399T (TT) were 24.24％,26.77％,24.24％ and 25.76％ in stage Ⅰ group;34.34％,37.37％,34.85％ and 36.36％ in stage Ⅱ group;39.90％,42.93％,40.41％ and 41.92％ in stage Ⅲ group;45.45％,46.97％,45.35％ and 46.46 in stage Ⅳ group;and 13.64％,14.14％,13.13％ and 13.64％ in stage 0 group,respectively.Statistical tests showed significant difference in the frequencies among each group (all P＜0.01).The risks of invasion and metastasis of esophageal carcinoma significantly increased in the subjects with G20210A,in those with G20210A(AA) genotype,in those with C399T (CT) genotype and in those with C399T (TT) genotype.Combined analysis of the polymorphisms showed that percentage of G20210A (AA)/C399T (TT) in stage Ⅰ group,stage Ⅱ group,stage Ⅲ group,stage Ⅳ group and stage 0 group was 7.07％,14.14％,18.18％,21.71％ and 1.52％,respectively,and statistical tests showed significant difference in the frequency among each group (all P＜0.01).People who carried G20210A(AA)/C399T(TT) had higher risks of invasion and metastasis of esophageal carcinoma,and statistical analysis suggested a positive interaction between G20210A (AA) and C399T (TT) in increasing the risks of invasion and metastasis of esophageal carcinoma (All γ＞ 1).Likewise,there were also positive interactions in the pathogenesis of invasion and metastasis of esophageal carcinoma between G20210A (GA) and C399T (TT),G20210A (GA) and C399T(CT),G20210A (AA) and C399T (CT) (All γ＞1).The thrombin activities in plasma in stage Ⅰ,Ⅱ,Ⅲ and Ⅳ groups were all significantly higher than those in stage 0 group,and there were significant differences among stage Ⅰ,stage Ⅱ,stage Ⅲ and stage Ⅳ in thrombin activities (all P＜0.01).Patients with mutation genotype had significantly higher thrombin activities than those with wild homozygous in the same TNM stage.Conclusion G20210A and C399T gene mutations are the risk factors in the invasion and metastasis of esophageal carcinoma.Significant interactions between G20210A and C399T mutations increase the risk of invasion and metastasis of esophageal carcinoma,which may be closely related to their increased thrombin activities in plasma.

Objective:To investigate the clinical value of the changes of serum complement,immunoglobulin and inflammatory cytokines in children with mycoplasma pneumonia (MP).Methods:60 cases of children with MP infection were collected as MPP group,60 cases of healthy children as control group.The serum levels of complement (C3,C4) and immunoglobulin (IgA,IgG,IgM) were detected by INA,the serum levels of inflammatory cytokines (IL-8,IL-10,IL-13,TNF-α) were detected by ELISA.Results:①The serum levels of IgM,C3,C4,IL-8,TNF-et and IL-13 in MPP group in acute stage were significantly higher than those in the recovery stage and control group (P＜0.05),the levels of IL-8,TNF-et,IL-13 in the recovery stage were significantly higher than those in control group (P＜0.05);the serum levels of IgA,IL-10 in MPP group in acute stage were significantly lower than those in the recovery stage and control group,and these were still significantly lower than the control group (P＜0.05);the IgG in MPP group in acute stage was not significant difference with control group (P＞0.05),but it in recovery stage was significantly higher than the acute stage and the control group (P＜0.05).②The serum levels of IgM,IgG,C3,C4,IL-8,TNF-et and IL-I 3 in MPP group in severe were significantly higher than those in the mild stage and control group (P＜0.05),and the levels of IgM,IL-8,TNF-αt,IL-13 in the severe stage were significantly higher than those in control group (P＜0.05);the serum levels of IgA,IL-10 in MPP group in severe stage were significantly lower than those in the mild stage and control group,and these in mild stage were still significantly lower than the control group (P＜ 0.05).Conclusion:Children with MP infection have a significant cellular and humoral immune dysfunction,the detection of the changes of serum complement,immunoglobulin and inflammatory cytokines is valuable to assessing the disease staging and degree.

BACKGROUND:The degradable poly-L-lactic acid (PLLA) biliary-enteric composite stent has been developed. OBJECTIVE:To analyze the solubility and biocompatibility of the degradable PLLA biliary-enteric composite stent. METHODS:Solubility:the PLLA composite stent was implanted into artificial gastric acid to detect the dissolution rate within 12 weeks. Pyrogen test:the PLLA composite stent extracts were injected into the rabbits via ear vein to detect the changes of body temperature. Hemolysis test:the PLLA composite stent extracts, normal saline and distil ed water were added into the rabbit anticoagulant, respectively, to detect the hemolysis ratio. Cytocompatibility test:Caco-2 cel s were respectively cultured in the DMEM medium containing 10%fetal bovine serum, rubber material extracts and the PLLA composite stent extracts, and the cel proliferation was detected at 12, 24, 36 and 48 hours;the lactic dehydrogenase release was detected at 2 days. RESULTS AND CONCLUSION:The PLLA composite stent showed a long stability in vivo, and approximately 80%was dissolved at about 20 weeks. No reactions of pyrogen and henolysis were observed in the pyrogen and hemolysis tests. The PLLA composite stent made no effects on the Caco-2 cel proliferation and lactic dehydrogenase release. In conclusion, the PLLA composite material holds a good solubility and cytocompatibility.

Objective:To survey the awareness of common primary care clinical guidelines among primary care providers in Qingdao city.Methods:A questionnaire survey on the awareness of common clinical guidelines in primary care was conducted in August 2020 among 659 providers (293 males and 366 females) from 81 primary medical institutions in Qingdao city. The contents of the questionnaire included the general information of primary physicians, the frequency of using the guidelines, the level of understanding of the guidelines, the effect of guidelines in clinical work, the attitudes towards promoting the guidelines, and the interest in learning the guidelines and the way of learning.Results:A total of 659 valid questionnaires were recovered with a recovery rate of 100.0%. The results showed that 14.7% (97/659) practitioners applied the guidelines in most cases, and 31.6% (208/659) frequently used. There were significant differences in use frequency among providers with different practice types, professional titles, education background, practice locations and institutions ( P<0.01). Among participants, 15.2% (100/659) did not know about primary care guidelines, 63.3% (417/659) knew but did not learned guidelines, 21.5% (142/659) knew and studied guidelines carefully. The top five of the learned guidelines (114, 80.3%) were bronchial asthma (113, 79.6%), type 2 diabetes (108, 76.1%), chronic obstructive pulmonary disease (101, 71.1%), and chronic cor pulmonale (83, 58.5%). Most participants who learnt the guidelines viewed the guidelines as quite helpful or very helpful, the score of usefulness for professional knowledge was the highest (4.44±0.60). Most of participants (94.2%, 621/659) thought it was necessary to develop primary care guidelines; and the major factors affecting the promotion were lack of training (79.8%, 526/659), difficulties in access (46.7%, 308/659) and ignorance or neglect (23.2%, 153/659).Most practitioners (93.8%, 618/659) were interested in learning primary care clinical guidelines, and the expected ways of training were online teaching (70.0%, 420/618), training courses(58.3%, 360/618) and special lectures (55.2%, 341/618). Conclusion:The current situation of learning clinical guidelines among primary care providers in Qingdao is not satisfactory, but they are willing to learn the guidelines for improving clinical practice. We should strengthen the training and promotion of primary care guidelines among primary care providers in the future.