Objective To investigate the expression of pro-apoptotic factor (Smac) and Survivin in gastric ulcer tissue.Methods Selected the 80 cases of gastric ulcer patients as the research object in the first people′s hospital of neijiang,in which no precancerous lesions of 40 cases of gastric ulcer (N group),40 cases of precancerous lesions of gastric ulcer(Y group),two groups of patients were Smac mRNA and Survivin mRNA were detected by using PCR method,immunohistochemical SP method of Smac and Survivin in specimens of table detect.Gastric ulcer patients were treated by triple therapy,and the apoptosis index was detected by TUNEL.Results Smac in N group(++) and (+++) in the expression accounted for 82.5％ was higher than that in Y group accounted for 47.5％,Survivin in group N (++) and (+++) in the expression accounted for 15.0％ was significantly lower than Y group accounted for 35.0％;And Smac mRNA in the N group relative expression the amount was significantly higher than that of Y group,while the expression of Survivin mRNA in the N group were significantly lower than Y group;N group the apoptosis index of the triple therapy after treatment than before treatment significantly decreased,the difference was statistically significant(P<0.05).Conclusion The clinical application of Smac and Survivin can be used as an auxiliary diagnostic index for the diagnosis of precancerous lesions in patients with gastric ulcer.Patients with gastric ulcer without precancerous lesion treated by triple therapy which can effectively control the apoptosis index of patients,improve the survival rate of patients.

Radio frequency identification sensor network, a technique integrating radio frequency identification (RFID) with wireless sensor network (WSN), is introduced. The basic structure of RFID sensor network is analyzed at first. Then components of RFID sensor and relevant supporting techniques including thin film battery, quartz crystal microbalance (QCM) and surface acoustic wave (SAW) are discussed. Research status and foregrounds of both domestic and international researches are introduced as well as applications in different fields.

The present advantage and disadvantage or problems of basic medical sciences elective courses in college and university are analyzed and indicated.Meanwhile,the experience of teaching optional course of the clinical applied anatomy of heart has been presented,including reforming teaching method,combining the anatomical theory with the clinical specialty,especially boosting the interesting in the course and medical research,encouraging students to do more dissection and culturing their competence in learning and following closely the trends of medical science and technology development.The new teaching style received a better teaching effect and improved the teaching quality. The significance that the teachers should pay more attention to practice training in their teaching students of optional courses has been positively emphasized.

ObJective To study the effects of flurbiprofen axetil preemptive analgesia on T cell immune functions in postoperative patients with upper abdominal.Methods Seventy-six patients with upper abdominal operation were divided into observation group (40 cases) and control group (36 cases) by random digits table,observation group and control group were given intravenous injection of 100 mg flurbiprofen axetil or 10 ml 0.9％ sodium chloride 10 min before skin incision respectively.Peripheral venous blood samples were collected for the determination of CD4+,CD8+,natural killer cell (NK cell) and CD4+/CD8+ by flow cytometry 1 day preoperative,2 and 48 h postoperative.Results In two groups,the CD8+ and NK cell of 2 h postoperative were lower significantly than those of preoperative (observation group:0.1850 ±0.0550 vs.0.2430 ±0.0856,0.1197 ±0.0673 vs.0.1598 ±0.0775；control group:0.1219 ±0.0571 vs.0.2385 ±0.0847,0.0778 ± 0.0311 vs.0.1621 ± 0.0806,P ＜ 0.05),however,the observation group was significantly higher than the control group (P ＜ 0.05).There was no significant difference in CD4+,CD8+ and NK cell of 48 h postoperative between two groups.Conclusion There are disorders on the T cell immune functions in postoperative patients with upper abdominal,but flurbiprofen axetil preemptive analgesia can improve the T cell immune function.

ObjectiveTo determine the depth of sedation induced by target-controlled infusion (TCI) of propofol required to inhibit the swallowing reflex.MethodsThirty-five ASA Ⅰ or Ⅱ healthy volunteers,aged 20-60 yr,with body mass index ＜ 30 kg/m2,were enrolled in the study.Sedation was performed with TCI of propofol.The initial target plasma concentration (Cp) of propofol was set at 2.4 μg/ml and the Cp increased or decreased by 0.2 μg/ml every 5 min until the BIS value reached the predetermined level.The initial Cp of propofol was increased or decreased by 0.3 μg/ml in the next subject according to the BIS value in the previous one.The up-and-down sequential experiment was pedormed.The BIS value was set at 65 in the first subject and the ratio of the BIS value between the two consecutive subjects was 1.1.The BIS value was increased or decreased depending on the occurrence of the swallowing reflex in the previous subject.The half-effective BIS value (BIS50) and 95％confidence interval (CI) of propofol inhibiting the swallowing reflex were calculated by up-and-down sequential method.ResultsThe BIS50 of propofol required to inhibit the swallowing reflex was 64.4 (95％ CI 59.3-69.8).ConclusionThe BIS50 and 95％ CI of propofol administered by TCI and required to inhibit the swallowing reflex is 64,4 (59.3-69.8).

Objective To introduce the microsurgical experience of total removal in large and middle sized recurrent sphenoid ridge meningiomas and discuss the recurrent reasons Methods A series of 24 cases large and middle sized recurrent sphenoid ridge meningiomas operated microsurgically by combined frontotemporal orbitozygomatic approach were analysed retrospectively Result Totol removal(Grade Ⅱ of Simpson system)were achieved in 14 of the 24 patients,and subtotal in 6,partial in 4 There were isolative tumor nodi near main tumor in 5 cases Conclusion Combined frontotemporal orbitozygomatic approach and microsurgical technique are helpful to totally remove the tumor Resection uncompletely and tumor implantation within operation were recurrent reasons of sphenoid ridge meningiomas

Objective To evaluate the clinical effect of cerebellomedullary fissure approach to resect the fourth ventricle tumors. Methods Eightten cases of the fourth ventricle tumors that have been operated on through the posterior fossa craniotomy and cerebellomedullary fissure approach were analyzed retrospectively. Results Total turmor resection was achieved in 13 patients and subtotal in 5 patients. All patients were conscious after surgery. None of them presented mutism. Three cases suffered from postoperative hydrocephalus, ventriculoperi-toneal hunts were applied in 2 cases, another case died of acute obstructive hydrocephalus. Conclusion The cerebellomedullary fissure approach can provide a sufficent exposure to resect the fourth ventricle tumor without incision of the inferior vermis.

Objective:To investigate the therapeutic effect of continuous blood purification (CBP) on acute pancreatitis (AP) and its influence on prognosis.Methods:200 patients with AP in our hospital from January 2010 to December 2016 were selected as the subjects,and they were divided into conventional treatment group and CBP treatment group according to the random number table method,600 cases in each group.The conventional treatment group was received conventional drug therapy,and the CBP treatment group was treated with CBP on the basis of commonly used drugs.The disappeared time of clinical symptoms after treatment and the changes of inflammatory factors and the changes of intestinal function before and 72 h after treatment were compared between the two groups,the mortality rate was compared between the two groups at 7 d after treatment.Results:Abdominal pain disappeared time,abdominal distension disappeared time and abdominal tenderness disappeared time in CBP treatment group after treatment were lower than the conventional treatment group (P＜0.05).There was no significant difference in the levels of endotoxin,C reactive protein (CRP),amylase (AMS),two amine oxidase and malondialdehyde before treatment in the two groups (P＞0.05).At 72 h after treatment,endotoxin,CRP,AMS,two amine oxidase and malondialdehyde levels were lower than those before treatment,and the CBP treatment group was lower than the conventional treatment group (P＜0.05).The mortality rate of CBP treatment group was lower than that of conventional treatment group at 7 d after treatment,the difference was statistically significant (P＜0.05).Conclusion:CBP can effectively improve the clinical therapeutic effect of AP,and improve the clinical prognosis of patients.

Objective:To evaluate the quality of the current foreign clinical practice guidelines (CPG) on obstetric venous thromboembolism (VTE), providing reference for standardizing the prevention and treatment of domestic VTE clinical practice.Methods:The GPGs for the management of obstetric VTE published abroad from inception to July 2020 were electronically searched. Two researchers independently evaluated the quality of the included guidelines in accordance with the internationally recognized guideline evaluation tool, AGREE Ⅱ.Results:A total of 12 guidelines, 2 recommendations and 1 consensus for obstetric VTE were included, covering 3 continents and 9 countries, and the published time span was 2009-2020. The standardized scores of the six domain (scope & purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability and editorial independence) included in the guidelines were: 99.44%, 62.78%, 70.35%, 95.74%, 68.80% and 76.94% respectively, and the scores in each domain were ≥ 50.00%, indicating that the included CPGs were of good quality. Except for the domain scope & purpose, the ranges of the other five domains were ≥ 50.00%, suggesting that the quality of the CPGs differed significantly. Among the 15 included CPGs, 4 CPGs were level A (recommended), 11 CPGs were level B (recommended after being revised), and there was no CPG in level C (not recommended). The difference in the recommended content of obstetric VTE management mainly focused on the risk assessment, drug type, dosage and period.Conclusions:The overall quality of the CPGs for obstetric VTE management is high, while the quality of the CPGs varies greatly. In addition, there are differences in the recommended content of obstetric VTE management. More high-quality researches are required to provide evidence-based support for the improvement of the CPGs.

Objective To study the effects of dexmedetomidine on the swallowing reflex. Methods Sixty adult volunteers (ASAⅠ-Ⅱ) were randomly divided into two groups, dexmedetomidine sedation group and propofol sedation group respectively. The BIS value was maintained between 60-65 in both groups. Swallowing reflex was induced by water injection in the pharynx at different depths of sedation, and the swallowing movements were observed. Meanwhile, the RR, SpO2 and OAA/S scores were recorded. Results The swallowing reflex existed in dexmedetomidine sedation group when BIS values was maintained at 60, which had significant difference compared with that in propofol sedation group. The RR, SpO2, OAA/S score in dexmedetomidine sedation group also had statistical difference compared with that in propofol sedation group during swallowing reflex test. Conclusions Slow infusion of dexmedetomidine to maintain the BIS value above 60 will not affect swallowing reflex, and can obtain satisfactory hemodynamic stability. It′clinical safety is high.