Objective To compare the effects of methylprednisolone and dexamethasone individually combined with tropisetron on the prevention of postoperative nausea and vomiting (PONV) of high risk in patients with thyroid surgery.Methods One hundred and sixty patients of high risk of postoperative nausea and vomiting scheduled for radical operation of thyroid with general anesthesia were randomly divided into four groups with 40 cases each.Four groups of the patients were intravenously injected methylprednisolone 40 mg plus tropisetron 5 mg at the end of the operations (group MT),dexamethasone 7.5 mg before anesthesia induction,and tropisetron 5 mg at the end of the operations (group DT),tropisetron 5 mg at the end of the operations (group T),and normal saline (group C).Incidence and severity of nausea,vomiting and adverse reactions were recorded during 24 hours after end of the operations.Results Compared to group DT,the incidences of PONV during the 0 ～ 2 h and 2 ～ 6 h,and the visual analogue scale (VAS) of PONV at 2 h after the operations in group MT were significantly lower (P ＜ 0.05).Compared to group C,the incidences of PONV and VAS score during the 0 ～ 24 h after the operations in group MT and group DT were significantly lower (P ＜0.05),the incidences of PONV during the 2 ～6 h and 6 ～ 12 h after the operations,and VAS score of PONV at 6 h and 12 h after the operations in group T were significantly lower (P ＜0.05).Compared to group C,incidences of headache in group MT and group DT were significantly lower (P ＜ 0.05),and incidence of swim in group T was also significantly lower (P ＜ 0.05).Incidence of adverse reactions in group MT and group DT were no significant difference.Conclusions Preventive effect of methylprednisolone combined with tropisetron for PONV in high-risk patients within 6 hours after thyroid surgery was significantly better than that of dexamethasone combined with tropisetron.

Objective To discuss the clinical manifestation and pathology of papillary renal cell carcinoma (PRCC).Methods From January 2007 to January 2012,the clinical and pathologic data of 25 patients (17 males and 8 females with average age of 54 years ranging from 24-76 years) with PRCC were retrospectively analyzed in combination with review of literature.The clinical stages of the tumor were as follows,Ⅰ in 16 cases,Ⅱ in 5 cases,Ⅲ in 4 cases.And the radiographic inspections of PRCC were compared with that of 100 randomly selected clear renal cell carcinoma (CRCC).Results All the PRCC cases had different imaging presentations compared with CRCC.CT attenuation of CRCC was higher than that of PRCC in corticomedullary,nephrographic and excretory phase (P＜0.05).Heterogeneous enhancement was most commonly seen in CRCC than PRCC (P＜0.05).There were 21 patients underwent radical nephrectomy,and 4 patients underwent laparoscopic nephron sparing surgery.The pTNM stages of the tumor were as follows,pT1N0M0 in 16 cases,pT2N0M0 in 5 cases,pT3aN0M0 in 2 cases,pT1N1M0 in 1 case,,pT2N1M0 in 1 case.Of these 25 patients,8 (32％) and 17 (68％) were diagnosed as type Ⅰ and type Ⅱ PRCC,respectively.All the 25 cases of patients were followed up from 6 to 60 months.One case died of metastasis,1 case died of cerebrovascular disease and the other 23 patients survived with tumor-free.Conclusions PRCC is a special type of RCC with low morbidity.Radiological examination can be used in the differential diagnosis of CRCC and PRCC before surgery.The prognosis after surgical treatment is good,but the adjuvant systemic treatment is to be study.

Objective To observe the role of the health education model in pain self- efficacy for patients with cancer pain. Methods Sixty- four patients suffering from cancer pain were enrolled into the study and self- contrast experiment was made on each patient. The health education model was set up and health education for each patient with cancer pain was implemented. The pain, self- efficacy, cancer pain knowledge before and after the intervention were observed by Numerical Rating Scale (NRS),Chronic Pain Self- efficacy Scale(CPSS) and Cancer Pain Knowledge Questionnaire. Results NRS score were (5.38 ±0.19) points and (1.05 ± 0.11) points before and after the intervention, and there was significant difference (t =25.288, P = 0.000). Before intervention, pain management self- efficacy, physical function self- efficacy, symptom coping self- efficacy of CPSS scores were (10.38 ±0.37) , (20.97±0.81) , (16.86 ± 0.49) points, while after the intervention, the scores were (19.31± 0.30) , (33.25 ± 0.60) , (29.75 ±0.51) points, there were significant differences ( t = -33.225, -18.236, -18.235, all P = 0.000). Before and after the intervention, the answer rate of Cancer Pain Knowledge Questionnaire was 50.00%(32/64) and 87.50%(56/64), there was significant difference( χ2=20.51, P < 0.01). Conclusions To set up the health education model and implement health education for each patient with cancer pain can improve the patient′s pain management and enhance self-efficacy.

Objective To approach a semi-quantitative diagnostic criteria of neonatal hypoxic-ischemic encephalopathy(HIE) by comprehensive scoring, including history, clinical manifestation and laboratory data,which can be used for early diagnosis,severity grading and the institution of therapy.Methods We analyzed history, clinical manifestation and some parameters of laboratory data,and established criteria for scoring and grading,and compared this grading with the grading determined by clinical data and follow-up,which brought forward a semi-quantitative diagnostic criteria, and applied this criteria to other 41 patients with HIE to test its reliability.Results The grading criteria were established as the following:if total score ≥20.0,the patient was graded as severe one;total score between 10.5-19.5, moderate one; between 5.5-10.0,mild one;≤5.0,non-HIE one. The scoring system was used in other 41 patients with HIE,the specificity and sensitivity were 100% and 96 .9%,97.2% and 100%,100% and 100%, respectively.Conclusions For severe HIE cases who are not permitted to receive compated tomography(CT) examination or no CT can be used, this scoring system can be used to diagnoze HIE and grade the severity. This method is simple and easy to perform.Both specificity and sensitivity are high for diagnosis and severity judgment of HIE.

Objective·To establish a cell-based screening system for identification of compounds with activity in regulating retinoic acid receptor (RARα) stability. Methods·The modified pMSCV plasmid constructs, named as RARα-EGFP-IRES-DsRed, consists of enhanced green fluorescent protein (EGFP) fusing to RARα and red fluorescent protein (DsRed) as internal references incorporating the internal ribosome entry site (IRES) as interval sequence. The RARα-EGFP-IRES-DsRed plasmid was stably transfected into NB4 cells which were named as NB4-pMGIR-RARα. Fluorescence signals of EGFP and DsRed indirectly reflecting the expression of RARα, were detected by flow cytometry in cells that were treated with all-trans retinoic acid, sodium valproate, cytarabine, lenalidomide, etoposide, montelukast and gambogic acid, respectively. Effects of these compounds on the expression of RARα protein were further examined by Western blotting. Results·A double fluorescence reporter system for screening compounds that can increase the stability of RARα protein was successfully established, and sodium valproate was identified as a potent compound to promote the stability of RARα. Conclusion·The double fluorescence reporter system can be used to screen compounds regulating the stability of RARα protein, which can be further used to identify compounds regulating the stability of other proteins.

No abstract available.
Eosinophilia*

BACKGROUND:For patients in intensive care unit (ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physical activity can result in side effects. This study aimed to investigate the feasibility of early rehabilitation therapy in patients with mechanical ventilation. METHODS:A randomized controlled trial was carried out. Sixty patients, with tracheal intubation or tracheostomy more than 48 hours and less than 72 hours, were admitted to the ICU of the Affiliated Hospital of Medical College, Qingdao University, from May 2010 to May 2012. These patients were randomly divided into a rehabilitation group and a control group. In the rehabilitation group, rehabilitation therapy was performed twice daily, and the training time and intensity were adjusted according to the condition of the patients. Early rehabilitation therapy included heading up actively, transferring from the supine position to sitting position, sitting at the edge of the bed, sitting in chair, transferring from sitting to standing, and ambulating bedside. The patient's body mass index, days to first out of bed, duration of mechanical ventilation, length of ICU stay, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality of patients were all compared between the rehabilitation group and the control group. The differences between the two groups were compared using Student's t test. RESULTS:There was no significant difference in body mass index, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality between the rehabilitation group and the control group (P>0.05). Patients in the rehabilitation group had shorter days to first out of bed (3.8±1.2 d vs. 7.3±2.8 d; P=0.00), duration of mechanical ventilation (5.6±2.1 d vs. 12.7±4.1 d; P=0.005) and length of ICU stay (12.7±4.1 d vs. 15.2±4.5 d; P=0.01) compared with the control group. CONCLUSION:Early rehabilitation therapy was feasible and effective in improving the outcomes of patients with mechanical ventilation.

Objective: To investigate the pharmacokinetics, tissue distribution and excretion characteristics of Fc- G- CSF (the fusion protein of Fc and granulocyte colony stimulating factor)in rats. Methods: Fc-G-CSF was labeled with 125I by the chloramine T method, and the content of 125I-Fc-G-CSF in each biological sample was determined by the trichloroacetic acid(TCA)precipitation method. Results: After a single subcutaneous injection of 125I-Fc-G-CSF 30 μg/kg, the AUC was(362.1±48.1)μg•h/L and the Cmax was(27.0±3.0)μg/L. Up to 36 hours of the drug administration, the drug exposure was highest in serum but lowest in brain. Up to 96 hours of the drug administration, the cumulative excretion rate through urine was about 57.5%, and the cumulative excretion rate through feces was about 23.5%. Conclusion: The blood concentration of 125I-Fc-G-CSF reached a peak after 12 h of the subcutaneous injection in rats, and the serum concentration was continuously higher than the concentrations in other tissues. The 125I-Fc-G-CSF excretion mainly adopted the urinary excretion.

Objective To investigate the expression of phosphatase and tension homolog (PTEN) in adipose tissue of KKAy diabetic mice, a mouse model of type 2 diabetes.
Methods KKAy diabetic mice were fed with high fat diet for 4 weeks. After blood glucose met the criteria of diabetes (over 16.7 mmol/L), mice were randomly divided into 3 groups:a control group (without any treatment), a rosiglitazone group (treated with rosiglitazone 12.5 mg/kg·d once per day), and a metformin group (treated with metformin 3 g/kg·d twice daily). After 4 weeks, we then determined the expression of PTEN and phosphoserine 473-Akt (pS473-Akt) in the epididymal adipose tissue with Western blots. The mice in each group were further divided into the insulin (-) subgroup and insulin (+) subgroup, which were intraperitoneally injected with saline and insulin (5 mU/g body weight), respectively.
Results The expression of PTEN was elevated in the epididymal adipose tissue obtained from KKAy diabetic mice compared with that from the C57BL/6J mice (P<0.001). In accordance with the enhanced expression of PTEN, the level of pS473-Akt stimulated by insulin was decreased in the adipose tissue of KKAy mice compared to the C57BL/6J mice (P<0.001). Treatment with the insulin-sensitizing agents, rosiglitazone and metformin did not inhibit the elevated expression of PTEN in adipose tissue of KKAy diabetic mice.
Conclusion PTEN may play an important role in the development of insulin resistance in adipose tissue of type 2 diabetes mice model.

No abstract available.
Female ; Fetomaternal Transfusion* ; Pregnancy