Objective:To explore the clinical application value of limb remote ischemic postconditioning (LRIPC) in patients with acute cerebral infarction after recanalization.Methods:A total of 78 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Shantou University Medical College from June 2017 to March 2019 were selected. According to the random number table method, they were divided into the observation group with 39 cases (LRIPC + conventional medical treatment) and the control group with 39 cases (conventional medical treatment). The National Institutes of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment scale (MoCA) scores, the changes of cerebral blood perfusion, cerebral infarction volume and the levels of nerve function indexes before and after the treatment were compared and analyzed.Results:After the treatment, the NIHSS scores in the observation group were lower than thosein the control group, and the MoCA scores were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the mean transit time of cerebral blood flow in the observation group was shorter than that in the control group, while the regional cerebral blood flow and regional cerebral blood volume were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the volume of cerebral infarction in the observation group was lower than that in the control group ( P<0.05). After the treatment, the levels of matrix metalloproteinase 9 and S-100B protein in the observation group were lower than those in the control group: (142.45 ± 36.23) mg/L vs. (176.89 ± 42.63) mg/L, (2.52 ± 0.46) μg/L vs. (3.61 ± 0.75) μg/L; and the level of nerve growth factor was higher than that in the control group: (143.49 ± 10.58) μg/L vs. (124.96 ± 13.62) μg/L, the differences were statistically significant ( P<0.05). Conclusions:LRIPC can improve the nerve functions, cognitive functions andreduce the volume of cerebral infarction by improving cerebral blood flow. It also has a good effect on alleviating the neurological functional impairment after vascular recanalization.

Objective To explore the value of intravenous low dose furosemide on visualization of upper urinary tract during CTU. Methods 39 cases of normal upper urinary samples were examined by CTU with 5 minutes delayed,19 cases underwent intravenous injection of furosemide.The upper urinary tract was divided into 5 parts for scoring of images on a 5 score scales for opacification,the average value of ureter short axis of distention,and CT value by contrast material were measured.Results were analyzed by t test using SPSS.Results (1)30/38 segments of upper urinary tract were all or almost all opacification in furosemide group,the scores of upper urinary tract were higher than that of the control group,which had significant difference except the pelvis and left proximal ureter segments. (2)The disention of the ureter was significantly higher for all segments in furosemide group.(3)CT values in furosemide group decreased significantly for all upper urinary tract.Conclusion CTU excretory phase image acquisition with intravenous low dose furosemide is helpful on visualization of upper urinary tract.

Objective To systematically review the effect of team-based learning (TBL) versus the traditional lecture-based learning (LBL) teaching model on basic medical courses in undergraduate medical education. Methods The CNKI, VIP and Wanfang medical databases were electronically searched to retrieve randomized controlled trial studies on TBL applied in undergraduate basic medi-cal courses up to June 2014. In these studies TBL teaching model was used in experiment group with LBL teaching model as control group and course grades were adopted to evaluate the effect of learn-ing. Literature screening, data extraction, and quality assessment were performed in strict accordance with the inclusion and exclusion criteria, and then data were analyzed using RevMan 5.3 software. Results This Meta-analysis examined 12 studies, all of them with low quality at C level. Meta analysis shows that the score of the course of TBL teaching is better than the traditional LBL teaching, and the difference is statistically significant [weighed mean difference (WMD): 9.33, 95%CI (5.67, 13.00), P=0.000]. Conclusion Compared with the LBL teaching, the application of TBL teaching in medical undergraduate basic medical courses has the promotion effect, but need more rigorously randomized controlled trials to verify.

Objective To investigate the whether the cleaning effect and quality would be affected by the different condition and storage of occlusal instrument. Methods A total of 2 400 holding needle clamp and hemostatic forceps were recycled immediately, and they were randomly divided into eight groups of A1, A2, B1, B2, C1, C2, D1, D2, with 300 pieces each. A1 groups was closed and not moisturized, and cleaned in 2 hours. A2 group was fully opened and not moisturized, and cleaned in 2 hours. B1 group was closed and bathed in multi-enzyme detergent, and cleaned in 2 hours. B2 group was fully opened and bathed in multi-enzyme detergent, and cleaned in 2 hours. A1 groups was closed and not moisturized, and cleaned in 12 hours. C2 group was closed and bathed in multi-enzyme detergent, and cleaned in 12 hours. B2 group was fully opened and bathed in water, and cleaned in 12 hours. D2 group was fully opened and bathed in multi-enzyme detergent, and cleaned in 12 hours. They were cleaned by the same machine and the clean rate was compared among groups. Results The cleaning rate of A1 and A2 group, B1 and B2 group, C1 and C2, D1 and D2 group had no statistical significant difference (P > 0. 05). The occult blood positive rates of C1 (27. 33% ).

Objectives The study aims were to analyze the clinical features and to explore the management of intrapancreatic pseudocysts after acute pancreatitis.Methods A retrospective study was conducted on 151 patients who received surgical treatment from Dec,2008 to Feb,2012 after acute pancreatitis.Based on CT/MRI findings and clinical data,there were 17 patients with intrapancreatic pseudocysts (11.3％).The clinical manifestations,diagnoses and treatments for these 17 patients were retrospectively analyzed,and the outcome after operations were followed.Results For the 17 patients,obstructive jaundice was present in 3 patients,pancreatic portal hypertension (PPH) in 7,pseudoaneurysm in 2.All 17 patients underwent operation.The surgical procedures included internal drainage (n=8),external drainage (n=5),distal pancreatic resection with splenectomy (n=3),and local resection (n=1).All patients recovered after the operations.Conclusions Intrapancreatic pseudocysts after acute pancreatitis had a high incidence of local complication.The diagnosis of these pseudocysts was difficult.The treatment should be performed early for those patients who had developed complications.

Objective To evaluate the predicting value of the marker of endothelial injury: plasma matrix metalloproteinase-9( MMP-9) and high sensitivity C-reactive protein( hsCRP) level on the progression of acute anterior circulating territory infarction progressing to malignant middle cerebral artery infarction (m-MCAI). Methods 90 patients with acute anterior circulating territory infarction, in which 46 patients progressed to m-MCAI, were collected and sampled consecutively. The plasma MMP-9 and hsCRP of all patients were determined by ELISA and immunotur-bidimetry,respectively,at admission. And the clinical characters and cranial CT features of the patients were analyzed. Results At admission,the plasma MMP-9 level in the patients with m-MCAI(242.0 ±58.0)ng/ml was significantly higher than that in the patients with non m-MCAI( 169.0 ± 50.0) ng/ml( P < 0. 01) ,the plasma hsCRP level in the patients with m-MCAI(6.25 ±1.2) ng/ml was significantly higher than that in the patients with non m-MCAI( 1.55 ± 0.9) mg/ml( P <0. 01).Conclusion The increased level of plasma MMP-9 and hsCRP could be predictors for the m-MCAI proceeding.

Relapse may occur in about 75% of patients who experienced the resection of hepatic metas-tases from coloreetal cancer. Perioperative chemotherapy with 5-fluorouraeil, leucovorin and oxaliplatin (FOLFOX) can reduce the risk of disease progression in eligible and reseeted patients compared with surgery a-lone. Pre-operative chemotherapy may cause vascular changes and steatohepatitis, which has the potential to in-crease the risks of surgery. A pooled analysis shows a trend of a longer median progression-free survival dura-tion among pest-operative patients who received adjuvant chemotherapy with 5-fluorouraeil and leueovorin-based regimen. Bevaeizumab in either pre-or pest-operative chemotherapy does not increase surgical complications.How to choose the best time and duration of the ebemotherapy needs to be further studied.

Background and purpose: Renal-cell carcinoma (RCC) is susceptible to immune therapy including the use of the nonmyeloablative allogeneic transplantation(NAT). However, NST can produce severe toxicity, so it might not be appropriate for many patients with metastatic RCC. Other novel allogeneic immunotherapies have been designed to induce an autologous immune response directed against the malignancy. This study evaluated the efficacy and safety of infusions of partially HLA-matched irradiated allogeneic blood mononuclear cells for advanced renal-cell carcinoma. Methods: Patients with histologically proven diagnosis of advanced RCC received infusions of partially HLA-matched allogeneic blood mononuclear cells. Repeat infusions were given every 8 weeks. Treatment was continued until disease progressed, unacceptable toxicity, or patient (or donor) choice. Results: Eight patients were enrolled. After every infusion, 6 patients received an oral administration of thalidomide daily with 100-300 mg/d for 2 months. One patient had durable complete response. Five stable diseases and two progress diseases were observed. In eight patients, time to progression and survival were 320 and 879+days, respectively. Severe toxicity was not observed. Conclusion: Infusions of partially HLA-matcbed irradiated allogeneic blood mononuclear cells for advanced RCC may induce some antitumor effects and deserves further study.

Single-agent gemcitabine, the standard chemotherapy for pancreatic cancer, has only mod-est effect. Gemcitabine has been combined with a variety of cytotoxic agents and targeted agents. Most phase Ⅲ studies, however, have failed to show improved survival compared with gemcitabine alone. One phase Ⅲ study has shown improved survival in advanced pancreatic cancer by adding erlotinib to gemcitabine. Studies evalua-ting non-gemcitabine-based regimens have showed considerable promise.

Carcinosarcoma(CS)of the uterus is a rare class of malignant female pelvic neoplasms.The primary modality of therapy for uterine CS is surgery.Postoperative adjuvant radiation therapy may only improve loco-regional control.Standard adiuvant treatment of uterine CS has shifted from primarily loco-regional radiotherapy to chemotherapy.Potentially more effective adjuvant chemotherapy regimens will be investigated.Chemotherapy can extend life for patients with advanced,persistent,or recurrent uterine CS.However,effect of chemotherapy remains to be further enhanced.