This paper points out that sunshine purchase, reasonable utilization and scientific management be involved in the management of medical equipment.

Objective To study changes of AMPA receptors expression in nucleus accumbens and hypothalamus of methamphetamine dependent rats,and the therapeutical effect of rhynchophylline.Methods SPF male rata were randomly divided into normal control group,model group of methamphetamine,low dose of rhynchophylline group and high dose of rhynchophylline group(n=8 in each group).Experiment of conditioned place preference(CPP)was used to build the model of methamphetamine dependent rata.Western blotting was used to examine the changes of GluR2/3 subunits expression.The time of staying in drug-paired compartment of rats was used independent-samples t test to gather statistics,and the photodensity of proteinum strap was used One-Way ANOVA to gather statistics.Results Compare with rats in normal control group(the time of staying in drug-paired compartment of rats was(383.00±38.20)s),the rats produced CPP after treated with methamphetamine(the time of staying in drug-paired compartment of rats was(536.20±57.49)s),and low(30mg/kg) and high (60 ms/kg)dose of rhynchophylline(the time of staying in drug-paired compartment of rats were(299.80±15.96)s and(189.40±59.02)s)both could eliminate CPP effect.Compare with rats in normal control group (the ratio of value of average gray scale were(0.54±0.04)INT·mm~2 and (0.70±0.04)INT·mm~2),GluR2/3 subunits expression in nucleus aecumbens increased significantly in model group(the ratio of value of average gray seale was(0.89±0.03)INT·mm~2)and low dose of rhynchophylline group(the ratio of value of average gray seale was (0.93±0.03)INT·mm~2,P<0.01),which decreased significantly in hypothalamus(the ratio of value of average gray scale were (0.53±0.03)INT·mm~2 and (0.52±0.02)INT·mm~2,P<0.01).But GluR2/3 subunits expression in nucleus accumbens and hypothalamus of rats in high dose of rhynchophylline group(the ratio of value of average gray scale were (0.57±0.06)INT·mm~2 and (0.65±0.01)INT·mm~2) just liked the expression of normal control group(P>0.05).Conclusion GluR2/3 subunits expression of methamphetamine-induced CPP rats increased in nucleus accumbens but decreased in hypothalamus.High dose of rhynchophylline can reverse such changes and rebound the expression to normal level.

AIM:To observe the expression of hypoxia-inducible factor 1 (HIF-1) and neuroglobin (NGB) in piglet cortex during deep hypothermic circulatory arrest.METHODS:Wuzhishan piglets were randomly assigned to car-diopulmonary bypass group ( CPB group) , 40 min of circulatory arrest ( CA) at 18 ℃ without cerebral perfusion ( DHCA group) or with selective antegrade cerebral perfusion ( SACP group) .After 180 min of reperfusion, cortical tissue was har-vested for determining HIF-1αand NGB expression by HE staining, Western blot and real-time PCR.RESULTS:Severer cerebral injury was observed in DHCA group than that in SACP group.After 180 min of reperfusion, HIF-1αprotein and mRNA levels were significantly higher in DHCA group than those in CPB group (P<0.05).Accordingly, SACP animal had higher levels of HIF-1αprotein and mRNA than those in DHCA group (P<0.05).Simultaneously, higher NGB pro-tein and mRNA levels were found in DHCA group than those in CPB group after 180 min of reperfusion ( P<0.05) .The SACP animal had higher levels of NGB protein and mRNA than those in DHCA group (P<0.05).CONCLUSION:Up-regulation of HIF-1 and NGB are involved in the mechanism against cerebral injury resulting from DHCA in the cortex and possibly a part of cerebral protective effect of SACP.

Objective To evaluate the efficacy of intraopèrative ultrasonography (IOUS) on primary and repeated hepatectomies for hepatocellular carcinoma (HCC).Methods 430 patients underwent 555 operations for HCC.New tumors detected by IOUS at the primary and repeated hepatectomies were retrospectively analyzed.The long-term outcomes were also studied.Results IOUS had the highest sensitivity in the routinely used imaging examinations.The detection rate by each imaging modality decreased slightly but uniformly at the second hepatectomy.IOUS detected 56 new tumors in 30 patients (7.1％) at the primary hepatectomy and 13 new tumors in 8 (7.3％) at the second.The average size of tumor detected was 8.7±3.8 and 9.0±5.2 mm at the primary and second resections,respectively.The preoperative surgical plan was changed due to the IOUS findings alone in 24 patients (5.6％) at the primary hepatectomy,and in 7 (6.4％) at the second.Although recurrence was frequent in patients with new tumors detected at the primary hepatectomy,long-term survival after appropriate treatment for recurrence was similar to those patients without new tumors detected.Conlusions Despite recent progress in imaging modalities,IOUS is still the most sensitive examination.The same degree of precaution is necessary to detect new tumors using IOUS in repeated hepatectomy.Patients with new tumors detected by IOUS are at high risk for recurrence so that regular check-up is important to improve patient survival.

ObjectiveTo study echovirus 11 ( ECHO11 ) sequences genetic variability of the VP1 gene of 82 isolates from 15 countries and 2 provinces in China.MethodsThe VP1 sequences of 82 strains of echovirus 11 were downloaded from the GenBank,and their nucleotide and amino acid diversity were calculated and phylogenetic tree was constructed using Mega software.Results82 echovirus 11 strains were divided into 4 genotypes( A-D),Genotype A is further divided into 7 subgenotyps and genotype D into 7 subgenotyps.The prototype strain Gregory is the sole member of genotype B.Genotype C is divided into 3 genotypes.The sequence diversity between echovirus 11 strains is 21.7%-24.1% (AA diversity:6.0%-12.1% ).ConclusionOur results show that most genotypes contain isolates that have circulated over a wide geographical(several countries from different continents) and temporal range.Several genotypes were also shown to co-circulate in a region during the same period of time,showing that the epidemic of echovirus 11 has typical time and geographical characters.

Objective To explore the expression of TLR4/NF-κB pathway in cerebral injury resulting from DHCA ( deep hypothermia circulatory arrest ) as well as the effect of SACP ( selective antegrade cerebral perfusion). Methods Twelve pigs were randomly assigned to DHCA group (n = 6) or SACP group (n = 6) at 18 ℃ for 80 min. IL-6 was assayed by ELISA. Apoptosis and NF-κB proteins were detected by fluorescence TUNEL and Western blot, respectively. The level of TLR4 was determined through qRT-PCR and Western blot. Results Serum IL-6 level of SACP group was significantly lower at the end of circulation arrest and experiment and apoptotic index and NF-κB protein were apparently lower in SACP group (P < 0.05). The level of TLR4 protein and mRNA from SACP group decreased significantly (P < 0.05). Conclusions TLR4/NF-κB pathway plays a critical role in pathogenesis of DHCA cerebral injury and attenuating TLR4/NF-κB cytokines probably contributes to neuroprotection of SACP. TLR4/NF-κB pathway may be a novel target for DHCA.

OBJECTIVETo investigate a method in repairing pulp defects of thumb and finger.

METHODSTo examine and analyze 19 case of pulp defect of thumb and finger repaired with free pulp flap of toe since 1987.

RESULTSAll the transplanted pulp flaps in 19 cases are survived and are followed up from 3 months to 12 years. All the digits recovered good out appearance with normal skin creases and ridges. The two-point discriminations are 6-8 mm. The repaired thumb or finger are free of paint during pinching and grasping. The split thickness skin grafts on the donor toes yield no hypertrophic scar and no callousity occurred on the donor feet. No detrimental influence occurred on the donor feet.

CONCLUSIONThe free pulp flap transfer has obvious advantages than any other methods in repairing pulp defects of single finger by, first, good outward appearance, second, quality of the skin over donor flap is almost as rub resistant as recipient finger, third, anastomosis of the digital nerves give functional influence, finally, short rehabilitation period however, the operation requires microsurgical technique and has a risk of failure.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Fingers ; surgery ; Humans ; Male ; Surgical Flaps

Objective:To analyze the clinical application effect of psychological intervention based on narrative medicine in geriatric inpatients.Methods:Using the convenient sampling method, a total of 120 inpatients who were admitted to Department of Geriatrics in Shaoxing Seventh People's Hospital from January 2018 to December 2020 were selected as the research objects. According to the block random method, the patients were divided into the control group and the observation group, with 60 cases in each group. The patients in the control group were given routine nursing, while patients in the observation group were given psychological intervention based on narrative medicine on the basis of the control group. The Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) and Exercise of Self-Care Agency (ESCA) were used to investigate the patients, and the nursing satisfaction of the two groups was calculated.Results:Before nursing, there were no statistically significant differences in SAS, SDS and ESCA scores between two groups ( P>0.05) . After nursing, the SAS and SDS scores of the observation group were lower than those of the control group, and scores of self-concept, self-care responsibility and the total score of ESCA were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The nursing satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Psychological intervention based on narrative medicine can improve the self-care ability and nursing satisfaction of inpatients in the geriatric department and improve the adverse emotional state of patients, which is worthy of clinical application.

Objective To investigate the role of TLR4/NF-κB signal pathway in pathogenesis of brain inju-ry during deep hypothermia circulatory arrest(DHCA). Methods BV2 microglia cells were subjected to oxygen-glucose deprivation/reoxygenation(OGD/R),in vitro model for DHCA. The BV2 were randomly divided into the control group(C group)and the experimental group(O group). BV2 viability was determined by CCK-8 assay. TLR4 and its downstream signaling molecules ,MyD88 and phosphorylated NF-κB (p-p65) expressions were detected by Western blotting. TLR4 mRNA expression in BV2 microglial cells were determined by RT-PCR. Level of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in culture medium was detected by ELASA. Results Compared with the group C,BV2 microglia cell viability in experiment group was obviously weaker(P<0.05). Expressions of TLR4,MyD88 and phosphorylated NF-κB(p-p65)from the experiment group increased remarkedly than those from the group C (P < 0.05). TLR4 mRNA level was higher significantly in the group O than in the group C (P < 0.01). Production of IL-6 and TNF-α in the group O were up-regulated apparently compared to the group C(P<0.01). Conclusion TLR4/NF-κB signaling pathway contributed to activation of BV2 microglia cells treated by OGD/Reoxygenation ,which was probably the exactly way that involved in pathogenesis of brain injury during deep hypothermia circulatory arrest.

Hemorrhage/etiology* ; Humans ; Image-Guided Biopsy ; Lung/diagnostic imaging* ; Lung Diseases/etiology* ; Lung Neoplasms ; Retrospective Studies ; Risk Factors ; Ultrasonography, Interventional