Clinical death of patients often results in such strong psychological stress as anxiety,fear and depression among the family members.Behavior problems incurred by such negative feelings often lead medical disputes.Early psychological intervention upon death to the families can not only protect their mental health but also effectively prevent medical disputes from happening.An analysis of the psychological response and characteristics of such families presents the principles and practice for psychological counseling.Discussions in this regard may inspire hospital administrators in how to prevent medical disputes so incurred.

Objective To investigate the short-term clinical efficacy and complication of esophageal cancer patients with two-field lymph node dissection by thoracolaparoscopic esophagectomy surgery and open surgery. Methods One hundred and fifty esophageal cancer patients with two-field lymph node dissection were selected, and they were divided into control group (using open surgery, 75 cases) and observation group (using thoracolaparoscopic esophagectomy surgery, 75 cases) by random digits table method. The operation time, bleeding amount, hospital staying time, number of lymph node dissection, reoperation rate, intensive care unit (ICU) transferring rate and postoperative complication were compared. Results There was no statistical difference in operation time between 2 groups ( P>0.05). The bleeding amount and hospital staying time in observation group were significantly lower than those in control group: (210.33 ± 30.71) ml vs. (254.59±35.28) ml and (8.45±1.52) d vs. (11.61±2.08) d, there were statistical differences (P<0.05). The number of chest lymph node dissection in observation group were significantly higher than those in control group:(17.20±4.06) pieces vs. (10.44±2.65) pieces, and there was statistical difference (P<0.05). There were no statistical differences in reoperation rate and ICU transferring rate between 2 groups ( P>0.05). There were no statistical differences in incidences of hoarseness and anastomotic stenosis between 2 groups ( P>0.05). The incidences of pulmonary infection and arrhythmia in observation group were significantly lower than those in control group:17.33%(13/75) vs. 30.67%(23/75) and 2.67%(2/75) vs. 14.67%(11/75), and there were statistical differences (P<0.05). Conclusion Compared with open surgery, thoracolaparoscopic esophagectomy surgery with two-field lymph node dissection for esophageal cancer patients can effectively reduce the degree of operative trauma, accelerate postoperative rehabilitation process, improve the effects of lymph node dissection, and reduce postoperative complication risk.

Objective To evaluate the clinical efficacy of different treatments on non-small cell lung cancer (NSCLC) patients with brain metastases and to explore the influential factors of the prognosis.Methods The NSCLC patients with brain metastases treated from Jan.2010 to Dec.2011 were follow-up.The survival time and influences resulted from the treatments were analyzed.Results The average survive time of these patients was (11.93±5.53) months,and the median survive time was 11 months.The 6-month,1-year and 2-year overall survival rates were 90.7 ％,41.1％ and 6.4 ％,respectively.Multivariate analysis showed that control of extracranial lesions,Kamofsky score,target therapy and age were independent predictive factors of survival,and the OR value were 0.358 (95 ％ CI0.217-0.593),0.302 (95 ％ CI 0.182-0.502),0.170 (95 ％ CI 0.098-0.296) and 1.635 (95 ％ CI 1.010-2.647),respectively (all P ＜ 0.01).Conclusions Radiation therapy is an effective treatment on non-small cell lung cancer with brain metastases.Biological target therapy can effectively improve survival.The survival time also is correlated with age,Karnofsky score and control of extracranial lesions.

Objective To investigate the effect of acupuncture combined with human amniotic mesenchymal stem cells ( HAMCs ) transplantation on the osteoporosis in ovariectomized rats.Methods Forty-five healthy female non-pregnant Wistar rats were randomly divided into sham operated group, model group and experimental group ( acupuncture+HAMC transplantation), 15 rats in each group.At 7 days after the surgical wound healing, the rats received acupuncture every day and intravenous injection of HAMCs suspension ( except the sham operated group) once a week for consecutive 12 weeks.The body weight was measured every week.24 hours after the last intervention, the rats were killed and specimens were collected.Specimens of the mid-, proximal-and distal femur were taken to measure the bone mineral density using a dual energy X-ray absorptiometer.At 12 weeks after the intervention, changes of the expression of serum 25-hydroxy-vitamin D (25-HVD), C-terminal peptide of type I collagen (CTX-I), bone specific alkaline phosphatase ( BAP) and human tartrate-resistant acid phosphatase 5b ( TRACP 5b) were determined by ELISA, the biomechanical properties of the removed femur was measured, and the expression of transforming growth factor-β( TGF-β) in the vertebrae was assessed by RT-PCR assay.Results Body weight of rats in the sham operation group was increased gradually in accordance with the natural growth of animals, that of the model group was significantly higher than that of the sham operated group since two months after modeling, and the body weight of the experimental group was similar to that of the sham operated group.The bone mineral density and calcium content of the model group were significantly decreased compared with that of the sham operated group ( P<0.05) , and the bone mineral density and bone calcium content of the experimental group were significantly higher than that of the model group ( P <0.05 ) .The ELISA showed that the expressions of serum 25-HVD, CTX I, BAP, and TRAP5b in the model group were significantly lower than that of the sham operated group, and those of the experimental group were significantly higher than that of the model group ( P<0.05 ) . Measurement of biomechanical properties showed that the limit load, limit stress and elastic modulus of the femur of the sham operated group were significantly higher than that of the model group ( P<0.05 ) , and the limit load and elastic modulus of the experimental group were significantly higher than that of the sham operated group ( P <0.05 ) .T-PCR showed that the expression of TGF-β1 m-RNA in the experimental group was significantly up-regulated than that of the sham operated and model groups ( P<0.05) .Conclusions Acupuncture combined with human amniotic mesenchymal stem cell ( HAMCs) transplantation has a synergistic effect on the treatment of osteoporosis, and can improve the conditions in ovariectomized rats.

AIM: To observe the effects of sera containing Kang xian ling (a traditional Chinese medicine) on c-Met and its downstream MAPK signal molecules in HK-2 cells treated with transforming growth factor-β_1(TGF-β_1), so as to further explore the effective mechanism of anti-renal fibrosis of the traditional Chinese medicine. METHODS: Rat sera containing herbs were collected after rats were intragastrically administered with the herbs. HK-2 cells activated by TGF-β_1 were incubated with different heat-inactivated sera. The proliferation and expression of MAPK and the phosphorylation of MAPK in HK-2 cells were detected by Alarm blue and immunoblotting. RESULTS: No significant difference of cell proliferation between any two groups was observed. C-Met and the phosphorylation of its downstream molecules were also observed after incubated with different sera. CONCLUSION: The receptor c-Met of hepatocyte growth factor, and the phosphorylation of its downstream MAPK molecules can be regulated by the sera containing Kang xian ling.

Objective To investigate the chromosomal aberrations in seven medical staffs suspected with exposure to ionizing radiation and to speculate its possible causation.Methods The hospital staffs,including 6 females and 1 male,worked in a clinical laboratory where a CT room was located downstairs.The thickness of precast slab between these two rooms was 6 cm.Peripheral blood lymphocytes of seven staffs were examined for conventional chromosomal aberrations.Results The frequencies of dicentrics in the peripheral lymphocytes of 4 females were from 0.40％ to 1.60％ that was significantly higher than the spontaneous frequency of dicentrics (0.03％,x2 =36.79,P ＜ 0.05).The translocation was observed in the lymphocytes from all subjects with frequencies from 0.33％ to 1.20％,obviously higher than its spontaneous frequency of 0.01％ (x2 =42.90,P ＜ 0.05).Conclusion These staffs suffer from ionizing radiation.

Objective To evaluate characteristics of CT and 18F-FDG PET/CT in pulmonary sclerosing hemangioma (PSH).Methods A retrospective study involving 12 patients (2 males,10 females;24-80 years old) confirmed as PSH by pathology from May 2012 to July 2014 was investigated.All patients underwent chest CT scan,including enhanced CT;and 5 cases underwent whole-body 18F-FDG PET/CT.All imaging data were collected and analyzed to find out a more effective diagnostic method.Results In 12 PSH patients,9 had single lesion,of which 4 involved left lung and 5 right lung.The rest 3 patients including 1 with two nodules located in the right lower lobe,and 2 with multiple nodules scattered in several lobes.Plain CT showed all lesions had uniformly isodensity,4 with calcification,3 with air meniscus sign.Contrast-enhanced CT examinations showed that the majority lesions were prominent enhancement and few moderate enhancement,all lesions showed vessel marginating sign and 6 with cystic and necrosis area.18F-FDG PET/CT examinations showed that the lesions displayed patchy pattern of mild to moderate uptake with SUVmax 2.2--4.0.Conclusions The characteristic CT features of PSH,especially the contrast-enhanced CT imaging,are important for diagnosis.18F-FDG PET/CT findings are extremely helpful in differentiating PSH from malignant lesions.

Objective To compare the cuffed renal vein technique and the classical techniques in kidney transplantation.Method The classical techniques of mouse renal transplantation required clamping both vena cava and aorta simultaneously and carried out suture anastomoses of the renal artery and vein in a heterotopic position.In our laboratory,we have successfully developed mouse orthotopic kidney transplantation for the first time,using a rapid cuffed renal vein technique for vessel anastomosis,wherein the donor's renal vein was inserted through an intravenous catheter,folded back and tied.During grafting,the cuffed renal vein was directly inserted into the recipient's renal vein without the need for clamping vena cava and suturing renal vein.Result This technique allowed for the exact transplantation of the kidney into the original position,compared to the classical technique,and had significantly shortened the clamping time due to a quicker and more precise anastomosis of renal vein as described.The renal vein anastomoses time was dramatically shortened in cuffed renal vein technique (4 min) as compared with the classical technique (9 min,P＜0.001).This also allowed for a quicker recovery of the lower extremity activity,reduction in myoglobinuria with resultant kidney graft survival of 88.9％.Conclusion The cuffed renal vein technique simplifies microvascular anastomoses and affords important additional benefits.

Objective To synthesize poly asparagine derivatives and to evaluate its safety at the cellular level, which provide research platform for its potential application as drug carrier. Methods Polysuccinimide was synthesized by ther?mal polymerization of L-polyaspartic acid, and the target product of PSI-Phe-EA was obtained by the ring-opening reaction of polysuccinimide using L-phenylalanine methyl ester hydrochloride and ethanol amine. The structure of PSI-Phe-EA were characterized by 1H NMR. The rate of ring-opening of PSI was calculated by internal standard method of 1H NMR. The change of hydrophilicity was studied by the comparison of solubility. The cytotoxicity and morphology modification by PSI-Phe-EA at designate concentrations was investigated by MTT method and inverted microscopy respectively. The effects on cell cycles were analyzed by flow cytometry after propidium iodide (PI) staining. Results 1H NMR results confirmed the structure of PSI-Phe-EA and the ring-openning rate of PSI was 40%. The hydrophilicity of PSI-Phe-EA was greatly in?creased upon ring opening using ethanol amine. MTT test showed that the cell survival rates of NIH 3T3 and HepG2 cells were higher than 80%under the examined concentration (<100 mg/L). Inverted microscopy showed that 50 mg/L of PSI-Phe-EA treatment had no adverse effects on cell morphology. Cell cycle analysis indicated that PSI-Phe-EA treatment had no in?fluence on cell cycles of NIH 3T3 and HepG2 cell lines. Conclusion PSI-Phe-EA showed high hydrophilicity without sig?nificant effects on the cells survival, cells morphology and cell cycles. It is a kind of safe polymer material.

Objective To observe the preventive effects of puerarinon development of deep vein thrombosis (DVT) in elderly women with osteoporosis after hip replacement. Methods 100 elderly women with osteoporosis who scheduled for femoral head arthrolastybetween January 2012 and January 2014 in Cangzhou Central Hospital were selected and then randomly divided into a study group (n=50) and a control group (n=50). The control group received routine anti?inflammatory and anticoagulant therapy ,while the study group received intravenous drip of puerarinof 400 mg mixed with 5%glucose liquid 500 ml daily for 15 days as a treatment course. After the treatment, DVT incidence rate ,change of early diagnostic indexes and hemorheology were compared with their baselines. Results DVT incidence rate was significantly lowerin the study group than in the control group (8.0%vs. 24.0%, P<0.05). Ascompare with the control group,thromboxane A2/prostacyclin,plasma homocysteine and hemorheology?were significantly reduced (P < 0.05). Conclusions Puerarin has a preventive effect for deep vein thrombosis in elderly women with osteoporosis after hip replacement.