Objective To compare the effect of the conventional teaching programs and logical thinking ability training program of ultrasound medical profession. Methods 85 ultrasound medical junior students were randomly divided into control group (n=40) and experimental group (n=45) re-spectively. Experimental group was provided with logical thinking ability cultivation to develop logical thinking of students, and the key was to enable students to find the key problems of ultrasound in the diagnosis of the disease and put forward measures to solve them and control group carried on the con-ventional teaching. Teaching effect, the medical record analysis test scores, clinical skills examination and questionnaire score were compared between the two groups, using SPSS 18.0 software for statisti-cal analysis of the data. Results (1)Students in the experimental group thought that compared with the control group, their interest in learning improved, the ability of clinical analysis enhanced, inter-action between teachers and students and learning efficiency and self-study ability increased and the difference has statistical significance. (2)The experimental group's scores of medical records analysis, the assessment scores of clinical skills and the student questionnaire score were higher than those of the control group and the two groups' score difference was statistically significant. Conclusion To strengthen the training of medical ultrasound medical imaging direction students' logical thinking ability can significantly improve the quality of teaching, and it is worthy to be promoted and applied.

MicroRNAs( miRNAs)are a family of endogenous noncoding small RNA molecules that are approximately 20 nucleotides in length. Aberrant expression or dysfunction of miRNAs and subsequent dysregulation of their target genes might be involved in the occurrence and development of various cancers. Gastric cancer is a leading malignant disease worldwide. Recent studies have shown that some miRNAs are closely associated with the proliferation,migration,invasion, apoptosis and chemosensitivity of gastric cancer cells by regulating their target genes. Advances in study on gastric cancer-related miRNAs,their target genes,and the use of miRNAs-targeted therapy in gastric cancer were reviewed in this article.

Objective Repair of aortic arch aneurysm is technically demanding and usually requiring complex circulatory management. Operative morbidity and mortality may be prohibitive with traditional surgical intervention. We described our experience with 5 hybrid endovascular procedure for aorta repair with different kinds of bypass followed by concomitant placement of stent graft in the aorta. Methods We retrospectively reviewed the clinical data of 5 consecutive patients presenting with aortic aneurysm or dissection from 2007 to 2008 treated by the hybrid aorta repair. Complete surgical rerouting of the supra-aortic vessels was followed by endovascular repair of aortic arch aneurysm with a Zenith TX2 stent graft. Hybrid left carotid-subclavian bypass with Zenith stent graft deployment covering the ostium of the LSA was performed in a Debakey type Ⅲ aortic dissection case. Procedures were successfully completed with exclusion of the aortic aneurysm. All stent grafts were deployed retrograde from the femoral artery in these patients. Results Technical success with complete aneurysmal exclusion was achieved in all patients (100%). At a follow-up period of 2-10 months, there was no incidence of endoleak. Documented perioperative neurelogic events did not occurred in all patients. Postoperatively one patient suffered from ARDS and cardiac failure and recovered. One patient died of myocardial infarction. Conclusions Hybrid arch repair provides an alternative to patients otherwise considered prohibitively high risk for traditional open arch and thoracoabdominal aorta repair.

Objective To observe the relationship between plasma level of homocysteine(HCY) and ischemic stroke in young and middle-aged adults,explore the clinical signficance concerning the occurrence and development of ischemic stroke in young and middle-aged adults.Methods The plasma homocysteine level of 132 young and middle-aged adults patients with ischemic and 86 control peoples were measured by means of enzymatic cycling assay.Results The plasma homocysteine level in ischemic stroke was higher than that in control group( P ＜ 0.01 ).The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group of young and middleaged adults.The plasma homocysteine level and the infarcted focus was positively linearly correlated.Conclusion Hyperhomocysteinemia is a risk factor of ischemic stroke among young and middle-aged adults.The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group.The plasma homocysteine level can reflect the size of the infarcted focus and the degree of disease,and the plasma homocysteine level should serve as a kind of regular examination or as an index intervention can be taken,all of which are great importance to prevent ischemic stroke and reduce its morbilily.

BACKGROUND:Study confirmed that the de-epidermized dermis(DED)can be used as dermal substitute and may form epidermal structure after incubating keratinocytes.However,the cell biological activity,tissue structure characteristics and the basement membrane component analysis of dermal substitute have been reported less.OBJECTIVE:To investigate the cell activity and the tissue structure characteristics of DED.METHODS:Skin flap was treated with 56℃ phosphate buffered solution to remove the epidermis,and the dermal cell components were deleted by freezing and thawing with liquid nitrogen to obtain DED.The DED cell activity was detected with tissue culture method,hematoxylin nuclear staining was used to determine the DED cell nuclei,and vimentin immunohistochemistry was applied for fibroblast determinations.The basement membrane and its components were detected using Periodic Acid-Schiff staining and collagen type Ⅳ immunohistochemistry.Van Gieson stain,Weigart stain and those double staining were respectively used to determine DED collagen fibers and elastic fibers.The DED ultrastructure was observed under transmission and scanning electron microscope.RESULTS AND CONCLUSlON:Using tissue culture method,the cultured DED did not exhibit cell growth at 2 weeks.Hematoxylin-eosin staining showed no nuclear in DED,vimentin immunohistochemistry showed no vimentin expressed in DED.Van Gieson staining showed DED collagen fibers were stained as rose red,Weigert staining showed DED elastic fibers were stained as pu rplish black double staining further demonstrated uniform arrangement of collagen fibers and elastic fibers.DED surface and the remaining appendages were strongly positive for Periodic Acid-Schiff staining,and type Ⅳ collagen expression was significant.Transmission and scanning electron microscope results showed that,the DED elastic fibers and collagen overlap arranged with pore intervals,they intercrossed into a network.There is no living cell component in DED,dermal matrix surface and appending organ luminal wall still retain glycogen,type Ⅳ collagen and other basement membrane components,dermal matrix is rich in collagen and elastic fibers.it is a three-dimensional collagen matrix similar to in vivo dermis.

[ABSTRACT]AIM:Toexplorethedevelopmentofhepaticsinusoidalcapillarizationintheearlystageofliverfi-brosis induced by carbon tetrachloride (CCl4) in rats.METHODS:Clean SD rats were randomly divided into normal con-trol group (group N, n=6) and liver fibrotic model group (group M, n=32).The rats in group N were intraperitoneal in-jected with saline and the rats in group M were intraperitoneal injected with CCl 4(2 mL/kg, twice a week for 4 weeks).At the end of the 3rd day and the 1st, 2nd and 4th weeks, all rats were killed and then the samples were collected .The patho-logical changes in the livers were observed by HE staining and Masson straining .The development of hepatic sinusoidal capillarization was observed by transmission electron microscopy (TEM) and immunohistochemical staining .The cell sur-face expression of vascular endothelium-associated marker CD31, collagen type Ⅳ(Col IV) and laminin (LN) was deter-mined.RESULTS:HE and Masson staining showed the formation of liver fibrosis after treatment with CCl 4 for 4 weeks. TEM showed that the fenestrate diameter of liver sinusoidal endothelial cells (LSECs) grew down, the fenestrate numbers of LSECs were decreased along with the development of liver fibrosis , and the consecutive basement membrane was formed at the end of the experiment .The expression of CD31 was significantly increased along with the development of defenestration , and the expression of Col IV and LN was significantly increased after the treatment with CCl 4 for 2 weeks and 4 weeks , re-spectively .CONCLUSION:The typical hepatic sinusoidal capillarization was detected in the early stage of liver fibrosis , and the deposition of LN in the liver sinusoidal walls was the mainly factor of formation of the consecutive basement mem -brane .

OBJECTIVETo study tetrahydropalmatine's permeative properties of acupoint and non-adupoint transdermal administration of baijiezi tufang in vitro and in vivo.

METHODTaking tetrahydropalmatine as an evaluative component to assess the permeative of baijiezi tufang in acupoint skin and non-acupoint skin with the modified Franz diffusion cell method and in vivo penetration studies. The content of tetrahydropalmatine was determined by a HPLC method.

RESULTThe 24 hours cumulative permeation amount through acupoint skin was (13.53 +/- 3.92) microg x cm(-2), about 4 times higher than non-acupoint skin. The steady-state infiltration rates of tetrahydropalmatine in acupoint skin was (0.659 1 microg x cm(-2) x h(-1)), 4.5 times higher than non-acupoint skin. The content in acupoint skin was signally higher than that in non-acupoint skin (P < 0.05). An accumulation of fluorescence can be clearly seen in the four layers: stratum corneum > viable epidermis > dermis > subcutaneous.

CONCLUSIONIn vitro and in vivo studies show that the permeation of baijiezi tufang in acupoint skin was better than in non-acupoint skin, following a higher cumulative amount and skin content.

Acupuncture Points ; Administration, Cutaneous ; Animals ; Berberine Alkaloids ; administration & dosage ; pharmacokinetics ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; administration & dosage ; metabolism ; Guinea Pigs ; Skin ; metabolism

Objective To evaluate the effect of sevoflurane postconditioning on autophagy during focal cerebral ischemia-reperfusion (I/R) in rats.Methods Forty-five clean-grade healthy male SpragueDawley rats,weighing 280-350 g,were divided into 3 groups (n=15 each) using a random number table method:sham operation group (S group),cerebral I/R group (I/R group) and sevoflurane postconditioning group (SP group).Focal cerebral I/R injury model was established by Zea-Longa method in chloral hydrate-anesthetized rats.The animals in SP group inhaled 2.4％ sevoflurane for 30 min starting from onset of reperfusion.The expression of autophagy-related proteins LC3 and beclin-1 was detected by Western blot at 2 h of reperfusion.The cerebral cortex was removed for examination of the morphology and number of autophagosomes with an electron microscope.Neurological deficit was assessed and scored at 24 h of reperfusion.Rats were sacrificed at 72 h of reperfusion for determination of the cerebral infarct size.Results Compared with S group,the neurological deficit score was significantly increased,the percentage of cerebral infarct size was increased,LC3Ⅱ/LC3Ⅰ ratio in cerebral cortex was increased,the expression of beclin-1 was up-regulated,and the number of autophagosomes was increased in I/R and SP groups (P＜0.05).Compared with I/R group,the neurological deficit score was significantly decreased,the percentage of cerebral infarct size was decreased,LC3Ⅱ/LC3Ⅰ ratio in cerebral cortex was decreased,the expression of beclin-1 was down-regulated,and the number of autophagosomes was reduced in SP group (P＜0.05).Conclusion Sevoflurane postconditioning mitigates focal cerebral I/R injury through inhibiting autophagy in rats.

Objective To investigate the gastric contents reflux occurred in the patients in Neurosurgery Intensive Care Unit ( NICU) , and to analyze the risk factors of gastric contents reflux and provide basis for timely and effective nursing intervention measures of clinical practice. Methods A total of 47 patients with mechanical ventilation in NICU of some grade A class three hospitals were collected the data such as age, gender, body posture, state of consciousness, gastric retention, diameter of nasogastric tube, the ballonet pressure of artifical airway and also included samples of throat secretion to test pepsin and pH. Results A total of 235 times watched among 47 patients that the incidence rate of gastric contents reflux was 48. 1%. The single factor analysis showed that there were significant differences of gastric contents reflux between subgroups of different tube diameter, nasal feeding pump rate, gastric retention, Glasgow score and ballonet pressure (χ2 =6. 641, 56. 615, 142. 846, 17. 784, 8. 620;P<0. 05). Further logistic regression analysis indicated that the factors affected gastric contents reflux was nasal feeding pumping rate and gastric retention. Conclusions Gastric contents reflux is a common complication in EN patients in the NICU. According to the Influencing factors, monitoring gastric retention and set proper nasal feeding pump rate is important for continuous nasal feeding patients to reduce gastric contents reflux rate.

[Abstact] Objective To investigate the characteristics of heart rate variability (HRV) of ambulatory electrocardiogram in patients with acute stroke, and evaluate the predictive value of HRV in stroke prognosis. Methods Eighty-three patients acute stroke (study group) and 83 cases of healthy subjects (control group) from October 2016 to October 2017 in Dalian Municipal Central Hospital Affiliated of Dalian Medical University were selected. The 24 h ambulatory electrocardiogram was performed to determine HRV in 2 groups, including standard deviation of NN intervals (SDNN), standard deviation of the 5 min mean cycle lengths (SDANN), root-mean-square successive difference (RMSSD) and percentage value of NN50 count (PNN50). Results The SDNN, SDANN, RMSSD and PNN50 in study group were significantly lower than those in control group: (80.83 ± 10.52) ms vs. (148.11 ± 22.59) ms, (79.98 ± 8.89) ms vs. (129.35 ± 5.34) ms, (19.28 ± 4.25) ms vs. (39.57 ± 2.38) ms and (5.91 ± 2.12) % vs. (19.35 ± 12.15) %, and there were statistical differences (P＜0.05). Among the 83 patients with acute stroke, there were no statistical differences in SDNN, SDANN, RMSSD and PNN50 between ischemic stroke (54 cases) and hemorrhagic stroke (29 cases) (P＞0.05). The SDNN, SDANN, RMSSD and PNN50 in right stroke (43 cases) were significantly lower than those in left stroke (40 cases): (75.18 ± 2.32) ms vs. (88.12 ± 3.58) ms, (73.36 ± 2.18) ms vs. (85.69 ± 7.29) ms, (17.57 ± 1.67) ms vs. (20.58 ± 4.23) ms and (4.39 ± 1.57) % vs. (8.61 ± 1.12) %, and there were statistical differences (P＜0.05). Patients were followed up for 1 year, 24 died and 59 survived. The SDNN, SDANN, RMSSD and PNN50 in dead patients were significantly lower than those in survived patients: (92.35 ± 4.58) ms vs. (154.37 ± 4.65) ms, (76.23 ± 4.03) ms vs. (143.95 ± 4.34) ms, (7.43 ± 2.12) ms vs. (31.65 ± 1.52) ms and (2.35 ± 0.46) % vs. (11.65 ± 0.48) % , and there were statistical differences (P＜0.05). Conclusions The autonomic nervous function of patients with acute stroke is seriously unbalanced, with increased sympathetic excitability and decreased vagus excitability. The decrease of HRV can easily induce cardiac events and seriously affect the prognosis.