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.

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 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.

BACKGROUND:Stromal cel-derived factor-1 (SDF-1) is one of the most powerful chemokines in myocardial infarction region and plays a particularly pivotal role in the homing of stem cels to an injured myocardium and promoting angiogenesis. On the other hand the microbubble and acoustics active substances carrying targetable ligands can be prepared into targeted ultrasound contrast agents that can be combined with living cels used for molecular imaging. The key of ultrasonic molecular imaging is to find imaging targets, and to successfuly prepare targeted ultrasound contrast agent which can be combined with the imaging target specificaly and efficiently. OBJECTIVE:To prepare and evaluate targeted microbubble contrast agents with SDF-1 monoclonal antibody. METHODS:Targeted microbubble contrast agent with SDF-1 monoclonal antibody was prepared using the biotin-streptavidin method. The physiochemical properties of targeted microbubble contrast agent were evaluated by appearance, pH, particle diameter, optical and fluorescence microscope and flow cytometry test. Four minipigs underwent ligation of the left anterior descending coronary artery to complete the establishment of acute myocardial infarction model, and another two minipigs were subject to thoracotomy but no ligation of the coronary artery. Then, al animals were injected with microbubble contrast agents. The stability of microbubbles was assessed by immunofluorescence testin vivo. RESULTS AND CONCLUSION:SDF-1 and microbubbles were combined by biotin-streptavidin method.In vitro appearance of the contrast agent was translucent yelow or green, and stratified after standing. pH vaule was 7.02±0.12 for non-targeted contrast agent and 6.10±0.19 for targeted microbubble contrast agent. Under the fluorescence microscope, the distribution and size of targeted microbubbles were uniform, and the microbubbles were surrounded by bright and ring shaped green fluorescence that had no changes after highly shaking. The diameter of microbubbles was (2 422.62±238.82) nm after carrying the SDF-1 antibody. Flow cytometry results showed that the carrying rate of targeted contrast agents was stable in different periods.In vivo test showed that targeted microbubbles gathered in vascular endothelial cel surface after acute myocardial infarction. These findings indicate that the targeted microbubble contrast agent carrying SDF-1 monoclonal antibody prepared by biotin-streptavidin method can be combined with vascular endothelial cels, and the binding rate is high and stablein vitro.

Objective: To observe the effect of preoperative effect on peri-operative pain in patients following a thoracotomy. Methods: 120 cases following lung-cancer thoracotomy were randomly allocated into four groups, 30 in each group. Cases in group A and B were treated with acupuncture analgesia 3 d before operation; cases in group A and C were treated with acupuncture analgesia after operation; and cases in group D were treated with general anesthesia. The pain management indexes in four groups were all controlled below 3. After that, analgesia-related β-endorphin and stress-related cortisol were observed before and after operation. In addition, the specific doses of postoperative analgesic-Fentanyl in four groups were compared. Results: The comparison of β-endorphin between group A, C and D showed P<0.05 one day before operation, so did group B, C and D 1 day before operation. The intra-group comparison of cortisol between the day of admission and 1 day after extubation and between 1 day before operation and one day after extubation in group A, B and D showed P<0.05, so did group C between the day of admission and 1 day after extubation. In addition, the contents of Fentanyl in postoperative analgesic pump in four groups showed P<0.05 through one-factor analysis of variance, showing a significant difference. Conclusion: Preemptive analgesia could increase the β-endorphin in patients following a thoracotomy and showed remarkable advantage when compared with the conventional postoperative analgesia. It did not cause significant difference regarding stress index cortisol. Acupuncture has no remarkable advantage when compared with operation and extubation for the major immediate stress. Additionally, postoperative acupuncture could be a substitute for the dose of pain killers and the match can be reduced by 20%.

BACKGROUND:Due to the different transplantation time after myocardial infarction, the homing ability of bone marrow mesenchymal stem cels to damaged tissues as wel as the repairing role wil be very different. OBJECTIVE:To explore the optimal window time for the homing of bone marrow mesenchymal stem cels to the myocardial tissue after myocardial infarction. METHODS: Eighteen Chinese miniature pigs were modeled by the ligation of left anterior descending coronary artery. BrdU-labeled bone marrow mesenchymal stem cels were injectedvia the coronary artery at 1 day, 3 days, 1 week, 2 weeks, 3 weeks, 4 weeks after modeling, respectively. Then, the animals were kiled at 3 days after cel transplantation to detect the home of bone marrow mesenchymal stem cels in the infarct zone. RESULTS AND CONCLUSION:BrdU-labeled positive cels with brown nuclei were visible at 1 day, 3 days, 1 week, 2 weeks, 3 weeks, and 4 weeks after myocardial infarction, especialy at 1 week after myocardial infarction (P < 0.05). It indicates that the best homing window for bone marrow mesenchymal stem cels was at week after myocardial infarction, when the stem cel transplantation is given to be able to promote myocardial repair.

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 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.