Objective To investigate intradermal injection and subcutaneous injection of Gadodiamide MR lymphangiography (MRL) in evaluation on the central conducting lymphatics in rabbits.Methods T1 weighted three-dimendional fast low angle shot (fl3d) sequence was used before and after administration of Gadodiamide to undertake MRL.Gadodiamide was administed intrademally in the left and right footpad in 8 rabbits,and then undertake MRL in 1.5T MRI system (intradermal injection group).Three days later,Gadodiamide was administered subcutaneously in the left and right footpad in 8 rabbits,and MRL were underdone with the same sequence (subcutaneous injection group).The degree of contrast enhancement within the lumbar lymphatic trunk and thoracic duct were evaluated using a 3-point scoring system.Results Intradermal injection group showed the popliteal lymph nodes,sacral lymph node and inferior aortic lymph node enhanced obviously in all 8 rabbits,and the enhancement duration time was about 30 90 mini the lumbar lymphatic trunk and cisterna chyli were detected in 6 rabbits,and part of the thoracic duct were detected in 5 rabbits.Subcutaneous injection group showed the popliteal lymph nodes enhanced obviously in all 8 rabbits,but the lumbar lymphatic trunk and the thoracic duct were not detected.The score of contrast enhancement within the lymphatic system of intradermal injection group and subcutaneous injection group had statistical difference (t=100.00,P=0.0002).Conclusion MRL with intradermal injection Gadodiamide are better than subcutaneous injection in evaluation of the lumbar lymphatic trunk.

Objective To observe the brain tissue recovery in patients with bilateral chronic subdural hematomas after drilling and drainage treatments. Methods The clinical data of 143 patients with bilateral chronic subdural hematoma performed drilling and drainage in our hospital from January 2011 to December 2016 were collected, including gender, age, the longest and widest diameters of the skull and the longest diameter of the initial hematoma, the widest diameter of the initial hematoma, the widest diameter of the postoperative hematoma, and other clinical information. The postoperative absorption of hematoma and recovery of brain tissues were analyzed. Results In these 143 BCSDH patients, 119 were male and 24 were male; the mean age of these patients was (67.7 ±1.1) years (21-92 years old), and the mean age of male patients was (67.2 ±1.2) years and the mean age of female patients was (70.2±2.5) years. The longest diameters of the skull was 134.8 mm-177.8 mm (averaged 155.5 mm± 0.7 mm) and the widest diameters of the skull was 113.5 mm-147.0 mm (averaged 131.7 mm±0.5 mm). The longest diameters of the left and right initial hematomas were (113.4±2.5) mm and (117.6±2.1) mm,and the widest diameters of the left and right initial hematomas were (15.8±0.5) mm and (17.2±0.8) mm. There was no significant difference in the recovery rate of brain tissues between patients with different gender, age or lesion sides (P<0.05). The recovery rate of brain tissues was positively correlated with the longest and widest diameters of initial hematomas (r=0.143, P=0.018; r=0.181, P=0.002). A total of 58 patients (40.6％) presented a single-side distance<10 mm from the brain tissue to the inner edge of the skull within one week after surgery, and a total of 48 patients (33.6％) showed both sides brain recovery to<10 mm. Conclusions Drilling and drainage are the first line treatment for patients with bilateral chronic subdural hematoma and contribute to the re-location of brain tissues. The rate of brain tissue recovery is positively correlated with the size of primary hematoma.

Objective To investigate the clinical efficacy and prognosis of transcatheter arterial chemoembo-lization(TACE)combined with radiofrequency ablation(RFA)in treatment of liver cancer.Methods 64 patients of liver cancer were selected as the research subjects,and they were divided into two groups by randomized single blind method.32 cases in the control group adopted the TACE treatment,while 32 cases in the observation group were given TACE combined with RFA.The tumor shrinkage,complete necrosis rate,local recurrence rate,AFP levels and adverse reactions of the two groups were compared.The patients were followed up for 3 years to record survival.Results After treatment,the tumor shrinkage rate and complete necrosis rate of the observation group were 90.63% and 75.00%, which were significantly higher than 68.75% and 50.00% of the control group,the differences were statistically significant (χ2 =8.453,8.203,all P <0.05).The local recurrence rate of the observation group was 21.88%,which was significantly lower than 43.75% of the control group,the difference was statistically significant(χ2 =7.887,P <0.05).After treatment,the AFP level of the observation group was (70.11 ±6.45 )ng/L,which was significantly lower than (157.76 ±10.42)ng/L in the control group,the difference was statistically significant (t =7.433,P <0.05).The survival rates of 1 year,2 years and 3 years in the observation group were 84.38%,71.88%,56.25%, which were significantly higher than 65.63%,53.13%,31.25% in the control group (χ2 =8.677,8.203,8.985,all P <0.05).The incidence rate of postoperative adverse reaction had no significant difference between the two groups (χ2 =1.337,P >0.05 ).Conclusion TACE combined with RFA in treatment of liver cancer can significantly improve the effect of tumor necrosis rate,reduce the local recurrence rate and prolong the survival time of the patients, and it had less adverse reaction,higher safety,and which should be applied in clinical.

OBJECTIVETo explore the value of color doppler ultrasound examination of thyroid in occupational health care of radiation-exposed physicians.

METHODSOne hundred and thirty-four radiation-exposed physicians (observation group) and sixty-eight non-radiation-exposed physicians (control group) received color doppler ultrasound examination of thyroid using ALOKA SSD-4000 color doppler ultrasonic diagnostic apparatus, and the results were compared between the two groups.

RESULTSThe anteroposterior diameters of the left lobe, right lobe, and isthmus of the thyroid in the observation group were significantly larger than those in the control group (P < 0.01). Compared with the control group, the observation group had significantly larger internal diameters and peak blood flow velocities during systole of the right superior thyroid artery (P < 0.05, P < 0.05). There were no significant differences in detection rates of thyroid nodules and lymph nodes between the observation group and the control group (18.7% vs 13.2%, P > 0.05; 6.7% vs 1.5%, P > 0.05). The radiation-exposed physicians were exposed to low-dose ionizing radiation with a dose between 0.14 and 1.67 mSv/a.

CONCLUSIONThe color doppler ultrasound examination of the thyroid can detect early changes in the thyroid of radiation-exposed physicians exposed to long-term and low-dose ionizing radiation.

Humans ; Lymph Nodes ; Occupational Exposure ; analysis ; Occupational Health ; Physicians ; Radiation Exposure ; analysis ; Radiation, Ionizing ; Thyroid Gland ; diagnostic imaging ; radiation effects ; Ultrasonography, Doppler, Color

Objective To explore the efficacy and adverse effects of nimotuzumab combined with chemotherapy and radiotherapy in the treatment of locally advanced cervical cancer.Methods Sixty patients with stage Ⅲ cervical cancer by the histopathologic diagnosis were collected,and they were randomly divided into two groups using the random number table method.The control group (n =30)using intensity-modulated radiotherapy,intracavitary afterloading therapy and periodic chemotherapy,the observation group (n =30)in addition to the intensity-modulated radiotherapy,intracavitary afterloading therapy and periodic chemotherapy, the nimotuzumab (200 mg)was given to the patients before weekly radiotherapy.All patients were received 6 to 7 times of treatment.Results The curative effects of all the patients were evaluated after radiotherapy 3 months.In the observation group,there were 20 cases of CR,5 cases of PR,4 cases of SD,1 case of PD,the total effective rate (CR +PR)was 83.3%.In the control group,there were 1 8 cases of CR,3 cases of PR,6 cases of SD,3 cases of PD,the total effective rate was 70.0%.The difference was statistically significant (χ2 =8.356,P <0.05).The main adverse reactions in the observation group and control group included slight radioactive proctitis (1 6.7% vs 1 3.3%),radioactive cystitis (1 0.0% vs 1 0.0%),nausea and vomiting (50.0% vs 46.7%),reduction of white blood cells (40.0% vs 43.3%),with no significant differences (χ2 =3.357,P =0.71 9;χ2 =2.71 7,P =0.925;χ2 =5.882,P =0.623;χ2 =4.728,P =0.687).There were no skin rashes and allergic reactions.Conclusion Nimotuzumab can enhance the locally stage cervical cancer patients′sensitivity on radiotherapy,which can increase the efficacy and doesn′t increase adverse
reaction obviously.

Objective To investigate the effect of group cognitive behavioral therapy on anxiety and depression in patients with chronic heart failure ( CHF ) .Methods One hundred patients with CHF were recruited from January 2012 to December 2013 in cardiovascular department , and were divided into the intervention group and the control group , with 50 patients each .Comprehensive intervention including routine heart failure care and group cognitive behavioral therapy combined with other therapies was adopted on the patients in the intervention group .The Self-rating Anxiety Scale ( SAS ) and the Self-rating Depression Scale ( SDS) were used to compare the difference of anxiety and depression between groups .Results At the baseline, the incidence of anxiety was 25%, within which 11 patients had mild anxiety , and 10 patients had moderate anxiety, and 4 patients had severe anxiety.The incidence of depression was 39%, within which 19 patients had mild depression , and 14 patients had moderate depression , and 6 patients had severe depression .The score of SAS and SDS in the intervention group after intervention were (36.90 ±8.465) and (27.53 ±7.162), respectively, which were significantly lower than (40.91 ±8.019) and (36.78 ±10.562) in the control group (t=9.244,10.335, respectively;P<0.01).Conclusions Group cognitive behavioral therapy can effectively relieve the anxiety and depression in patients with chronic heart failure .

Adult ; Aged ; Hospitals, General ; Humans ; Male ; Medical Staff ; Middle Aged ; Occupational Exposure ; Radiation Protection ; Young Adult

Objective To determine the median effective target plasma concentration (EC50) of propofol inhibiting the response to laryngeal mask airway (LMA) insertion when combined with dexmedetomidine.Methods ASA Ⅰ or Ⅱ patients of both sexes,aged 20-60 yr,with body mass index 20-25 kg/m2,scheduled for surgeries under general anesthesia,were studied.EC50 of propofol was determined by modified Dixon' s up-and-down sequential experiment.After dexmedetomidine 1.0 μg/kg was infused over 10 min,propofol was infused by targetcontrolled infusion.The initial target plasma concentration of propofol was set at 3.0 μg/ml.LMA was inserted when the target effect-site concentration of propofol and target plasma concentration of propofol reached the balance and BIS value was 50-60.Each time the target concentration increased/decreased by 0.2 μg/ml according to the occurrence of the response to LMA insertion.The response to LMA insertion was defined as the occurrence of coughing,body movement,laryngospasm or systemic voluntary movement.EC50 and 95 ％ confidence interval (CI)of propofol for inhibition of the response to LMA insertion were calculated.Results The EC50 of propofol required for inhibition of the response to LMA insertion was 2.351 (95％ Cl 1.737-2.600) μg/ml when combined with dexmedetomidine 1.0 μg/kg.Conclusion The EC50 of propofol inhibiting the response to LMA insertion is 2.351 μg/ml when combined with dexmedetomidine.

ObjectiveTo study the expressions of p75NTR,Bax and Bcl-2 and cell apoptosis in rat cortical neurons following mechanical injury and discuss the mechanism and mutual action way during the apoptosis of rat neurons after mechanical injury.Methods Cortical neuron cultures were prepared from the brain tissues of day 17 rat embryos and were exposed to mechanical injury seven days after seeding.After the traumatic neuron injury models were created,the apoptosis ratio of neurons was tested at several time points.The models were divided into the minor,moderate,severe injury groups according to the injury severity and the control group.The expressions of Bax and Bcl-2 in each group were detected by immunohistochemistry method and that of p75NTR by Western-blot.Combining with cellular apoptosis ratio in each group shown after FCM analysis,the correlation between the expressions of p75NTR,Bax and Bcl-2 and the apoptosis in rat neurons after mechanical injury could be analyzed.ResultsThe apoptosis ratio of the neurons in all the injury groups was obviously higher than that in the control group,with significantly higher apoptosis ratio of the neurons in the severe injury group than the minor and moderate injury groups (P ＜0.05).P75NTR,Bax and Bcl-2 were all expressed in all the injury groups,with statistical differences between groups.The expression of Bax in the severe injury group was significantly higher than that in the minor and moderate injury groups(P ＜ 0.05 ). Conclusions p75NTR expression and Bax/Bcl-2 ratio are closely correlated with neuron apoptosis.The early expression of p75NTR may be one of mechnisms for neuronal apoptosis after neuron injury,when Bax and Bcl-2 may be involved.

Objective To discuss the advantage of hispectral index(BIS) monitoring used in gastrointestinal endoscopy,and to observe elinical effects of target-controlled infusion(TCI) propofol combined with remifentanyl in elderly patients.Methods 120 patients aged from 65 to 78 with ASA physical status Ⅰ ～ Ⅱ were randomly divided into two groups,i,e.Group A (propofol with fentanyl ),Group B ( TCI propofol and remifentanyl with BIS).The amount of propofol was adjusted by consciousness and hemodynamics in Group A,while by BIS value in Group B.BIS was controlled at 55 ～60.The total amount of propofol and the time of wake-up,the incidence of complicatiors in each group were recorded.Results Compared with Group A,the changes of MAP and HR at T1 and T2 were smaller in Group B(P ＜ 0.05 ) ; Compared with Group A,the total amount of propofol and the time of wake-up were less in Group B ( P ＜ 0.05 ) ;Compared with Group A,the incidence of intraoperative respiratory depression and bradycardia were increased in Group B( P ＜ 0.05 ),there were no differences in the rest between the two groups.Conclusion Under BIS monitoring,TCl propofol and remifentanyl in elderly patients undewent gastrointestinal endoscopy may reduce propofol,and reach rapid recovery from anesthesia,but it needs additional management of respiration and circulation.