Objective The aim of this study was to evaluate the clinical value and the possibilities of measuring the serum levels of pepsinogen I (PG I ) and careineembryonic antigen (CEA) in 402 patients with gastric ulcer.Methods The patients with gastric ulcer were all confirmed by either operation or gastrofiberscope,and divided into two groups,benign and malignant gastric ulcer.After comparing the relationship between the patients'clinical appearance and the Radioimmunoaasay(RIA) results,(CEA and PG I ).Results There were 73 patients were onfirmed malignant gastric ulee in 402 patients.The positive rate of PG was 52.05% (38/73).The positive rate of CEA was 64.38% (47/73).Both were 30.14% (22/73).Then there were 63(63/73) patients who was positive in the combined determination.Solo determination's positive rate of CEA and PG were significantly different from the combined determination.(P＜0.05 and 0.01) Conclusions Feasibility and the necessity of combined determination were evaluated.Compared with solo determination,for patients with malignant gastric ulcer,it was more sensitive to determine and analysis the serum levels of PG I and CEA sYnthetically.So it is recommended to popularize the combined determination of serum PG I and CEA in clinical distinctive diagnosis of benign and malignant gastric ulcer.

Objective To investigate the clinical efficacy of the self-retaining laryngeal microsurgical operation in the treatment of Reinke ’ s edema of vocal cords . Methods There were 24 cases of Reinke ’ s edema who were treated with self-retaining laryngoscope mucosal stripping surgery of vocal cords from January 2004 to December 2009 ( traditional group ) , while another group of 32 cases of Reinke ’ s edema were treated with self-retaining laryngoscopic microsurgery lateral submucosal incision micro-flap operation of vocal cords from January 2010 to December 2015 ( laryngeal microsurgery group ) .The two groups were executed with electronic laryngoscopy and subjective voice evaluation GRBAS ( The Speech and Language Institute of Japanese in 1979, G: Grade, R:Roughness, B:Breathness, A:Asthenia, S:Strain) in pre-operation and post-operation (1 week, 3 weeks, 8 weeks).The wound healing time of vocal cords , hoarseness improved time and voice improvement were retrospectively compared between the two groups . Results The patients in laryngeal microsurgery group had earlier voice hoarse improvement and more rapid mucosal epithelial of vocal cords recovery time in post-operation as compared with the patients in the traditional group [voice improving time, (7.3 ±1.9) d vs. (11.3 ±2.7) d, t=-6.481, P=0.000;mucosal epithelial of vocal cords recovery time , (12.2 ±3.1) d vs.(20.1 ±3.4) d, t=-9.062, P=0.000].The results of pre-operative voice evaluation with GRBAS showed no significant differences between the two groups, but the results of post-operative evaluation of each session (1 week, 3 weeks, 8 weeks) showed that the main data were statistically different.The GRBAS score of laryngeal microsurgery group was lower than that of traditional group in post -operation, especially after 8 weeks (8 weeks after post-operation, G:1.0 ±0.8 vs.1.6 ±0.2, t=-3.584, P=0.000; R:1.0 ±0.9 vs. 1.5 ±0.4, t=-2.536, P=0.014;B:1.0 ±0.6 vs.1.4 ±0.5, t=-2.647, P=0.011).In laryngeal microsurgery group, 24 cases were cured , 5 cases were effective and 3 cases were invalid , contrasting in the traditional group with 11 cases of cured , 7 cases of effective and 6 cases of invalid respectively, with a significant difference (Z=-2.239, P=0.025).No significant difference in effective rate between the two groups [90.6%(29/32) vs.75.0%(18/24),χ2 =1.459, P=0.227]. Conclusion The clinical efficacy of self-retaining laryngoscope microsurgery in the treatment of Reinke ’ s edema of vocal cords is faster and better comparing traditional operation , with a more significant pronunciation quality improvement .

Objective: To analyze Chinese elderly health policy documents from 2018 to 2022 based on policy tools, so as to provide insights into improving elderly health policies and promoting healthy aging. Methods: Elderly health policy documents were retrieved from “the magic weapon of Peking University”, the policy document database of the State Council and portal websites of relevant ministries and commissions using keywords “elderly”, “aging” and “elderly health”. The documents were encoded using content analysis and keywords were extracted. A two-dimensional analysis framework was constructed based on Rothwell and Zegveld's classification framework and dimension theory, and the use of policy tools was analyzed. Results: Totally 57 Chinese elderly health policy documents were collected from 2018 to 2022, including 44 notices, 7 opinions, one rule, one regulation, one law, one announcement, one letter and one joint declaration. There were 37 documents (64.91%) issued by National Health Commission and its departments and offices. The high-frequency keywords in the documents included “medical and healthcare institutions”, “elderly health”, “rehabilitation/nursing”, “community/grassroots/rural”, “pilot”, “traditional Chinese medicine”, “propaganda” and “standardization”. There were 413 document codes, and the supply-, environment- and demand-side policy tools accounted for 52.54%, 31.72% and 15.74%, respectively. Public health and medical services (19.61%) and science popularization (7.99%) were the most commonly used supply-side policy tools, law/regulations and administration systems (7.99%) was the most commonly used environment-side policy tools, while pilot/demonstration projects (5.33%) was the most commonly used demand-side policy tools. The external and internal indicators of the system dimensions accounted for 48.18% and 51.82%, and political system (17.19%) and technical system (16.46%) were the two most commonly used external indicators, while service system (35.60%) was the most commonly used internal indicator. Conclusions Chinese elderly health policies focused on supply-side policies from 2018 to 2022, such as public health and medical services. The use of demand-side policy tools is recommended to be increased and the internal composition of supply- and environment-side policy tools are recommended to be optimized.

Objective To detect the expressions of HuR and COX-2 in epithelial ovarian carcinoma,and investigate the correlation of HuR and COX-2 expression. In addition, we attempt to seek the pathway to prevent the occurrence and development of epithelial ovarian cancer by combined analysis of various clinicopathologic characteristics. Methods The expressions of HuR and COX-2 in 68 epithelial ovarian carcinoma, 10 borderline ovarian tumors and 5 normal ovarian tissues were examined by S-P immunohistochemical method. The relationship of HuR and COX-2 expressions with clinicopathologic parameterwere evaluated by correlation analysis. Results(1) The expression of HuR in epithelial ovarian cancer tissue (76. 47% ,52/68) was significantly higher than that in borderline epithelial ovarian tumor tissues (30. 00% ,3/10) and normal ovarian tissues (0, x2 = 18. 873, Ps ＜ 0. 05), but there were no significant differences betweenthe expressions of HuR in borderline epithelial ovarian tumor and normal ovarian tissue(P ＞ 0. 05).(2) The positive expression rate of cytoplasmic HuR in epithelial ovarian carcinoma and borderline epithelial ovarian tumor were 45.60% (31/68) and 10. 00% (1/10) respectively,but normal ovarian tissues showed no staining of HuR. We found no significant differences between the expression of cytoplasmic HuR in epithelial ovarian carcinoma and borderline epithelial ovarian tumor or normal ovarian tissue(x2 = 7. 999 ,P =0. 018).(3) The positive expression rate of cytoplasmic HuR in epithelial ovarian carcinoma of FIGO stage Ⅲ - Ⅳ was significantly higher than that of stage Ⅰ - Ⅱ(56. 09% vs. 29. 63%, x2 = 4. 598, P = 0. 032). The positive expression rates of cytoplasmic HuR in epithelial ovarian carcinoma of histological grade 1,2,3 were 10. 00%,46. 67% ,57. 14% respectively, which showed significant difference in the comparison among the three groups (x2 =6. 627 ,P =0. 036). (4) The positive expression rates of COX-2 in epithelial ovarian cancer (67. 64%)and borderline epithelial ovarian tumor tissues (60. 00%) were significantly higher than that in normal ovarian tissues (0, Ps ＜ 0. 05), but we found no significant difference in the comparison between the expression of malignant and borderline ovarian tumors. Statistical analysis showed that the positive expression rate of COX-2 in epithelial ovarian carcinoma was correlated with FIGO stage and lymph node metastasis. (5)There was a significantly positive correlation between cytoplasmic HuR and COX-2 expressions in epithelial ovarian carcinoma. Conclusion The expressions of HuR and COX-2 increased in the epithelial ovarian carcinoma, and the cytoplasmic expression of HuR was significantly correlated with the expression of COX-2. These results suggested that increased cytoplasmic expression of HuR and COX-2 expression might play important roles in the initiation and development of epithelial ovarian carcinoma.

Objective To evaluate left ventricular (LV) remodeling and function after acute myocardial infarction (MI) in rats using speckle tracking imaging (STI). Methods The left anterior descending coronary was ligated to induce MI in twenty normal rats. One day after creation of MI, fifty survivals based on the diagnostic criteria of MI were divided into 4 groups as follows:pre-infarction, 1 day,4weeks,and 8 weeks after MI. Echocardiography was performed to evaluate the changes of left ventricularfunction in rats. M-mode and two-dimensional cross-sectional echocardiography data were acquired at the papillary muscle level and digitally stored for further analysis. Circumferential strain rate(SRcir) and radial strain rate(SRrad) indexes were measured by STI software for each animal. Results One day after MI,indexes of SRcir and SRrad in anterior and lateral segments were significantly decreased (P ＜0.01, for both). Four weeks after MI,compared with baseline,SRrad and SRcir were decreased in all segments ( P ＜0.01). Eight weeks after MI, however, SRrad and SRcir showed no significant difference compared with 4weeks group. Conclusions STI can correctly identify LV dysfunction in rats and can be used for serial assessment of cardiac remodeling in rats models.

Objective To analyze the features of supraclinoid internal carotid aneurysms. The experience and mistakes in the microsurgery of supraclinoid internal carotid aneurysms were summarized to improve the results. Methods The data of 24 cases of supraclinoid internal carotid aneurysms that were operated from May 2004 to March 2009 were reviewed. There were 6 cases of small or middle aneurysms, 18 cases of large or giant aneurysms. The operative methods included direct clipping, partial excision of aneurysm with reconstruction of the parent artery, aneurysm trapping with extracerebral/intracerebral (EC-IC) bypass, etc. Results Among the 24 cases, 8 cases had good results. Ten cases occurred hemiplegja post operation immediately, with 5 cases recovered to grade IV ,3 cases had aphasia,5 cases with vision acuity fall,4 cases had abnormal eyeball movement,2 cases had continued coma and died finally. Second operations were performed in 3 cases. The total operation rate of well results was 66.7% (16/24). Mortality rate was 8.3% (2/24). Conclusions The operative technique of the supraclinoid internal carotid aneurysms is difficult because of the location and the large size of the aneurysms. The temporary obstruction' of the parent artery is often needed, so the aneurysm can be partially resected and clipped. The results of clipping of large or giant aneurysms are better than the other methods. But in large or giant aneurysms that had thrombus, the EC-IC bypass is needed to prevent large infarction. The bypass procedure may induce some severe complications that result in some poor outcome.

Nuclear factor κB (NF-κB) is an important cellular transcription factor. The important role of NF-κB-mediated cell signal transduction pathway in apoptosis is a hot topic at home and abroad. In order to discover new regulators in NF-κB signaling pathway, a high-throughput cell-based screening model based on dual luciferase reporters system was established, a number of genes that can activate NF-κB signal pathway were obtained by screening of 439 novel function genes. Among them, TMEM9B can obviously activate NF-κB signaling pathway. Further experiments showed that TMEM9B activated NF-κB signaling pathway in a dose-dependent pattern. Western blotting and EMSA experiments confirmed that TMEM9B can promote the degradation of IκBα (a cytoplasm inhibitor of NF-κB), and cause NF-κB shift from the cytoplasm to nucleus. At the same time, flow cytometry result demonstrated TMEM9B can induce apoptosis in HEK293T and HeLa cells. In short, a stable and effective screening system for NF-κB has been established, through which TMEM9B was identified to be able to significantly activate NF-κB signal transduction pathway and thus cause cells apoptosis.

OBJECTIVETo explore the feasibility and safety on lung resection surgery with the combined method of microinjection acupuncture (MIA) and intravenous anesthesia instead of compound traditional acupuncture and drug anesthesia (ADA).

METHODSNinety cases of lung resection surgery were randomized into a general anesthesia group, a MIA group and a ADA group, 30 cases in each one. In the general anesthesia group, before surgery, the intramuscular injection of atropine 0. 5 mg was used; during surgery, the anesthesia induction was followed with intravenous injection of fentanyl citrate, propofol and rocuronium bromide and the dosage was increased accordingly; after surgery, the analgesia pump was applied. In the MIA group, on the basis of general anesthesia, before anesthesia induction, the acupoint catgut embedding was applied to Jiaji (EX-B 2) of T4 , T6 and T, , Feishui (BL 13), Xinshu (BL 15) and Geshu (BL 17) on the affected side and bilateral Quchi (LI 11) and Zusanli (ST 36); after surgery, the analgesia pump was applied. In the ADA group, on the basis of general anesthesia, before! anesthesia induction, electroacupuncture (EA) was applied to Hegu (LI 4), Neiguan (PC 6) , Houxi (SI 3) and Zhigou (TE 6) for 30 min; during surgery, EA and intravenous medication were combined at the same acupoints as those before surgery; after surgery, moxibustion and the analgesia pump were applied in combination for analgesia. In each group, the biological indices were monitored during surgery at 11 time points named T. (before anesthesia I induction), T1 (intubation in general anesthesia induction), T2 (skin incision), T3 (rib exposure in muscular incision) T. (chest open), T, (lung removal), T6 (drainage tube implantation), T7 (chest closure), T (muscular stitching), T, (skin stitching) and T0 (extubation). The actual dosage of anesthetics during surgery and the, dosage of fentanyl citrate in analgesia pump were quantified after surgery. Results (1) In the MIA group and ADA group, the increased dosage of fentanyl citrate was less than that in the general anesthesia group [(1. 23±0. 28) µg . kg-1 . h-1 vs (2. 4±0. 54µg. kg-1 . h-1, (1. 1±0. 38µg . kg-1 . h-1 vs (2. 4±0. 54µg. kg-1 . h-1 , both P<0. 05]. The increased dosage of propofol and rocuronium bromide was not different during surgery among the groups (all P>0. 05). (2) In the MIA group and ADA group, after surgery, the increased dosage of fentanyl citrate was less than that in the general anesthesia group [(11. 0±1. 04)µg/kg vs (15. 4±1. 52µg/kg, (11. 5±1. 38µg/kg vs (15. 4±1. 52µg/kg, both P<0. 05], reducing by 25% in comparison. (3) The differences in heart rate and blood pressure at 11 time points during surgery were not significant among the three groups (all P>0. 05).

CONCLUSIONn The combined method of MIA and intravenous anesthesia significantly reduces the dosage of intravenous anesthetics during and after lung resection surgery as compared with ADA, presenting the similar analgesic effect as simple intravenous medication and the good safety. The combined method of MIA and intravenous anesthesia is much

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Aged ; Anesthetics, Intravenous ; administration & dosage ; Blood Pressure ; Female ; Heart Rate ; Humans ; Lung ; surgery ; Lung Diseases ; physiopathology ; surgery ; Male ; Microinjections ; Middle Aged ; Propofol ; administration & dosage ; Young Adult

Objective To evaluate left atrial (LA) function by real-time three-dimensional echocardiography (RT-3D) and speckle tracking imaging (STI) after circumferential ablation of pulmonay vein ostia for atrial fibrillation guided by carto mapping system. Methods Thirty patients who had ablation procedure for paroxysmal atrial fibillation were accepted echocardiography to estimate the LA function at pre-operation,3 days and 3 months of post-operation. The LA maximal, minimal and pre-systolic volume (LAVmax, LAVmin and LAVp), LA passive ejection fraction (LAPEF), LA active ejection fraction (LAAEF) were measured by RT-3DE respectively. The strain rate curve was acquired in each LA segment (anterior, posterior, lateral, inferior and septal) by STI. Systolic strain rate (SRs), early diastolic strain (SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured. Results Comparing with preoperative,3 days post-ablation SRs,SRe and SRa decreased significantly in each wall of LA. After 3 months,SRa and SRe in anterior, inferior and septal were significantly improved, however, SRs showed no significant difference. LAVmax and LAVpre were significantly decreased. LAPEF and LAAEF were significantly improved. Conclusions The patients with circumferential pulmonary vein ablation were in a deterioration after three days. The pump function and conduit functions of left atrial were increased after 3 months.

Objective To investigate the relationship between the content of stromal cell-derived factor-1 (SDF-1) in myocardium in different period of myocardial infarction and left ventricular function.Methods Twenty three Chinese miniature pigs were randomly divided into the experimental group and the control group.The swines in experimental group were prepared as acute myocardial infarction model by ligating anterior descending coronary artery and were randomly divided into 6 subgroups according to the different time points after infarction.The left ventricular end-diastolic diameter (LVDd),left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were measured respectively.Global circumferential strain (GCS) and global radial strain (GRS) of left ventricle were measured.The content of SDF-1 were also measured by real-time quantitative PCR.Results Compared with the control group,SDF-1 levels were significantly elevated,and LVEF,LVFS,GCS and GRS were reduced.However,LVDd were significantly increased.The content of SDF-1 and GCS has a negative correlation (r =-0.580,P =0.000).Conclusions The content of SDF-1 in myocardial tissue have a certain relationship with GCS of left ventricular myocardium.