Emodin is the main effective monomer of Rhubarb, which has a variety of pharmacological actions and valuable clinical applications.Recently, there are many reports about molecular mechanisms of emodin pharmacological actions,and they givehighly attention on the dephlogisticating and antineoplastic effects. These effects are achieved through affecting the concentration and transportation of ions, resisting of oxidation and free radical, and affecting the secretion of inflammatory factor and the enzyme activity and apoptosis and so on. This article summarizes the reports and hopes to provide theoretical basis for the practical application.

Objective To use a simple bedside technique to verify the pathophysiological mechanism of pulmonary hypertension (PH) in different races. Method The Valsalva maneuver (VM) was performed in patients referred to a specialty PH clinic. The blood pressure response of patients to VM was in different fashions. The blood pressure (BP) was measured by using cuff and stethoscope. When the cuff was inflated to 15 mmHg above the systolic pressure, sound could be heard by auscultation during VM and when the cuff was deflated the sound disappeared over 3 heart beats which was considered as abnormal BP response, and less than 3 heart beats defined as normal BP response. The right heart catheterization in patients with PH as a part of the standard evaluation. Results This study included 84 patients with a mean age of (63 ± 16) years. Those with abnormal BP response to VM had higher pulmonary artery wedge pressure (PAWP) [(22.5±6.6) vs. (11.9±4.3) mmHg, P ＜0.0001] and lower pulmonary vascular resistance [(5.8 ± 4.0) vs. (8.1 ± 4.6 ) WU, P = 0.01]. Blood pressure response to VM did not correlate with mean pulmonary artery (PA) pressure [(46.2 ± 9.9) vs. (43.4 ±10.4) mmHg, P =0.20] or cardiac index (both 2.4 ± 0.6 L/min/m2). The abnormal BP response to VM had high sensitivity (89.4%), specificity (86.1%) and accuracy (86.9%) for determining PAWP＞ 15 mmHg.Conclusions BP response to Valsalva maneuver provides important information about left heart filling pressures in patients with PH.

Objective To investigate the impact of compliance and quality of life of psychological intervention for cancer patients and their primary caregivers,as well as the correlation between the psychological issues of patients and their primary caregivers.Methods The enrolled patients were randomly divided into intervention group and control group.The patients in intervention group were given to standardize anti-tumor therapy,while the patients and their primary caregivers were given psychological intervention once a week.The patients in the control group only received standard anti-tumor therapy.By TDL determination of quality of life,anxiety rating scale (SAS) and self-rating depression scale (SDS),in front of the psychological intervention after 8 weeks of intervention,the two groups of patients and their primary caregivers were questionnaired,and recorded the completion of the treatment plan.By SPSS 12.0 software,the statistics were completed.Results 51 cases in intervention group and 38 cases in control group were able to complete the number of people expected to treat there was a statistically significant (P ＜ 0.05).TDL determination and quality of life scores in intervention group patients and their primary caregivers were significantly higher (P ＜ 0.05).SAS and SDS score in intervention group patients and their primary caregivers were significantly lower than control group (P ＜ 0.05).Conclusion The effective psychological intervention to cancer patients and their primary caregivers during the treatment of patients could improve the compliance of cancer patients,the quality of life of cancer patients and their primary caregivers.The psychological problems between the patients and primary caregivers are positive correlation.

OBJECTIVETo compare the therapeutic effects between anatomical locked plate combined with coracoclavicular ligament reconstruction and clavicular hook plate for treatment of distal clavicle fracture of Neer type II b.

METHODSFrom August 2010 to August 2013, 42 patients with Neer II b distal clavicle fractures were randomly divided into two groups as group A and group B. In group A, there were 22 cases including 14 males and 8 females with an average age of (44.2±11.6) years old. In group B, there were 20 cases including 11 males and 9 females with an average of (45.6±12.4) years old. The patients of group A were treated with anatomical locked plate combined with coracoclavicular ligament reconstruction,the patients of group B were treated with hook plate. All fractures were fresh, the time between injuries and operation was 24 hours to 7 days (mean,72 h). General information between the two groups was comparable before operation(P>0.05). Postoperative radiographic were followed up to observe the fracture healing,internal fixation and to measure coracoclavicular distance of two groups. Shoulder function after operation was evaluated by Constant-Murley score system.

RESULTSAll patients were followed up with an average of 16.8 months (ranging 12 to 24 months). There was no nonunion,infection and other complications between two groups. The clavicular stress fracture occurred in 1 clavicular hook patient at 6 months after the operation. According to the Constant-Murley score system, that the scores of group A were 90.6±6.2, 91.8±4.8, 94.7±3.6 and 97.8±1.2 at 1st, 3rd, 6 month and last follow-up after operation were higher than those of group B 74.8±3.4, 78.4±4.4, 82.2±2.8 and 94.6±3.6 (P 0.05). The fracture healing time of group A (21.6±2.2) weeks was shorter than that of group B (25.8±2.5) weeks (P 0.05). There were no statistically significant differences between two groups in coracoclavicular distance at last follow-up (P>0.05).

CONCLUSIONThe anatomical locked plate combined with coracoclavicular ligament reconstruction need not expose shoulder and can reduce the incidence of postoperative pain and limited activity of shoulder, with fewer complication, it is advantageous to the shoulder joint function early recovery.

Adult ; Bone Plates ; Clavicle ; injuries ; surgery ; Female ; Fractures, Bone ; surgery ; Humans ; Ligaments, Articular ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods

Objective To explore the effect of application of hospital-school combined three-dimensional teaching mode in the operation nursing practice teaching.Methods 129 students were collected by cluster sampling,then based on class unit,they were randomized into the experimental group (69 students) and the control group (60 students).The experimental group used hospital-school combined threedimensional teaching mode and the control group used traditional teaching mode.Then,both groups had finished an operation nursing comprehensive theoretical examination and a self-report questionnaire for mastery of basic knowledge of operation nursing.Besides,the experimental group had a questionnaire survey of cognitive evaluation for the new teaching mode.Results The average score of operation nursing comprehensive theoretical examination of the experimental group was (77.81 ±9.87),higher than the control group (70.35±12.37); The self-report score for mastery of basic knowledge of operation nursing of the experimental group was (3.94±0.45),higher than the control group (3.68±0.46).The students of the experimental group also considered that the new teaching mode improved their comprehensive knowledge and innovative abilities,critical thinking ability,humanistic care spirit,communication ability,team cooperation ability and innovation ability,etc.Conclusions The effect of application of hospital-school combined three-dimensional teaching mode in the operation nursing practice teaching was good,but it still had some limitations which needed us to pay attention to and to perfect.

Objective To evaluate the clinical value of 131 Ⅰ SPECT/CT in the differentiation of indeterminate 131Ⅰ uptake on planer whole body scan (WBS) for patients with DTC after 131Ⅰ treatment. Methods Fifty-six DTC patients ( male: 19, female: 37, mean age: 45 ± 15 years, ranging from 20 to 85 years) underwent 131Ⅰ treatment. 131Ⅰ WBS was performed five days after 131 Ⅰ treatment, followed by regional 131Ⅰ SPECT/CT for the indeterminate foci with abnormal uptake on 131Ⅰ WBS. The diagnostic difference of the two imaging modalities was compared by x2 test. Results There were 288 foci with abnormal uptake on 131 Ⅰ WBS, including 108 indeterminate foci (37.5%). Subsequent 131Ⅰ SPECT/CT identified 27 foci as DTC metastases (25.0%) and 71 foci as non-metastases such as benign lesions at nose, oral cavity, salivary gland, maxillary cyst, thyroid remnant, thymus, gallbladder, gastrointestinal tract, and uterus, or non-specific uptake of body contaminations (65.7%). However, the remaining 10 foci (9.3%) remained indeterminate on 131 Ⅰ SPECT/CT imaging. The diagnostic accuracy of 131 Ⅰ SPECT/CT was significantly higher than that of 131Ⅰ WBS (x2 = 102.35, P＜0. 01). Conclusion 131Ⅰ SPECT/CT could significantly improve the diagnostic accuracy for the differentiation of indeterminate foci with abnormal uptake on 131Ⅰ WBS.

Objective To investigate the expression and significance of tumor necorisis factor related apoptosis induled ligand receptor(TRAILR) in human craniopharyngioma.Methods The expression of TRAILR was determined by immunohistochemistry and in situ hybridization in 24 samples of craniopharyngioma and 16 samples of normal brain tissue.Results With low decoy receptor(DcR) expression in partial craniopharyngioma cells and low death receptor(DR) expression in partial normal brain cells,DR was expressed highly in all craniopharyngioma samples while DcR in most normal brain tissue. High DR expression and low DcR expression in craniopharyngioma tissue differed from low DR expression and high DcR expression in normal brain tissue(P

Objective To investigate the expression and significance of death receptor 4(DR4) and DR5 in human craniopharyngioma.Methods The expression of DR4 and DR5 was determined by immunohistochemistry and in situ hybridization in 28 samples of craniopharyngioma and 25 samples of normal brain tissue.Results With low expression in partial normal brain tissue,DR was expressed highly in all of the craniopharyngioma samples.High DR expression in craniopharyngioma tissue differed from low DR expression in normal brain tissue(P0.05).Conclusions High DR expression is prevalent in craniopharyngioma tissue.This may contribute to the apoptosis-induced therapy of craniopharyngioma.The control of DR expression lays in protein level.This may contribute to the selective induced-apoptosis of tumor necrosis factor-related apoptosis-induced ligand.

Gymnastics ; physiology ; Humans ; Workload

Objective To study the safety measures during perioperative period in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) , to minimize uvulopalatopharyngoplasty (UPPP) major complications. Methods The complications and other relative information of 1446 OSAHS patients treated with UPPP were analyzed. Complications of 1004 OSAHS patients adopted standardized management measures after 2004 and 442 OSAHS patients who performed UPPP before 2003 were compared. Results Among the 1446 cases of OSAHS surgery, there were 49 cases (3. 39% ) of difficult intubation; 8 cases (0.55%) intraoperative mild arrhythmia; 13 cases (0. 90%) of surgery dangerous situations after extubation; 19 cases (1. 31%) of intraoperative primary hemorrhage; 11 cases (0. 76%) of mild arrhythmia during the postoperative observation period; 21 cases (1.45%) of uncontrolled hypertension immediately after surgery; 32 cases of secondary hemorrhage a week after surgery. All complications were cured and no death occured. Compared with those operations before 2003, complications were significantly reduced with enforcement of standardized management of perioperative measures since 2004. The data had significant difference by χ2 test( P <0.05). Conclusions There are five key points during the periperative period of OSAHS surgery: preoperative examination, intubation, surgery, postoperative extubation, and postoperative care. Risk factors and complications could be prevented effectively in the above five important processes.