Expression and pathological diagnostic value of extracellular matrix metalloproteinase inducer,ma-trix metalloproteinase-9 and lysine demethylase 6B in invasive breast cancer / 新乡医学院学报

Objective To investigate the expressions of extracellular matrix metalloproteinase inducer(EMMPRIN),matrix metalloproteinase-9(MMP-9),lysine demethylase 6B(KDM6B)proteins and their correlation with clinicopathologic features in invasive breast cancer,and analyze the correlation among the three proteins and their value in pathological diagnosis of invasive breast cancer.Methods The surgical biopsy specimens of 124 patients with invasive breast cancer who were admitted to the Department of Pathology,the Fifth Clinical Medical College of Henan University of Chinese Medicine/People's Hospital of Zhengzhou from January 2014 to December 2017 were selected as research subjects,and 20 low-grade intraductal carcinoma tissue specimens,27 high-grade intraductal carcinoma tissue specimens,and 22 adjacent tissue specimens＞1 cm away from the invasive breast cancer were selected as controls.The expressions of EMMPRIN,MMP-9 and KDM6B proteins in cancer-adjacent tissues,low-grade intraductal carcinoma tissues,high-grade intraductal carcinoma tissues and invasive breast cancer tissues were detected by immunohistochemistry.The relationship between the relative expressions of EMMPRIN,MMP-9 and KDM6B proteins and clinicopathologic features of invasive breast cancer was analyzed,Spearman correlation analysis was used to evaluate the correlation of EMMPRIN,MMP-9 and KDM6B proteins in breast cancer tissues,and receiver operating characteristic(ROC)curve was adopted to evaluate the diagnostic value of EMMPRIN,MMP-9 and KDM6B for invasive breast cancer.Results The relative expressions of EMMPRIN and MMP-9 proteins in high-grade intraductal carcinoma and invasive breast cancer tissues were significantly higher those in cancer-adjacent tissues and low-grade intraductal carcinoma tissues,and the relative expression of KDM6B protein was significantly lower than those in cancer-adjacent tissues and low-grade intraductal carcinoma tissues(P＜0.05);the relative expressions of EMMPRIN and MMP-9 proteins in invasive breast cancer tissues were significantly higher those in high-grade intraductal carcinoma tissues,and the relative expression of KDM6B protein was significantly lower than that in high-grade intraductal carcinoma tissues(P＜0.05);there was no statistically significant difference in the relative expressions of EMMPRIN,MMP-9 and KDM6B proteins between cancer-adjacent tissues and low-grade intraductal carcinoma tissues(P＞0.05).The relative expressions of EMMPRIN and KDM6B proteins were not related to the age,tumor location and tumor diameter of patients with invasive breast cancer(P＞0.05),and the relative expression of MMP-9 protein was not related to the age and tumor location of patients with invasive breast cancer(P＞0.05).Relative expressions of EMMPRIN,MMP-9 and KDM6B proteins were correlated with WHO grading,lymph node metastasis,and tumor,node and metastasis(TNM)staging of invasive breast cancer(P＜0.05),and the relative expression of MMP-9 protein was correlated with the tumor diameter(P＜0.05).In the WHO grades Ⅰ,Ⅱ,and Ⅲ of invasive breast cancer,the relative expressions of EMMPRIN and MMP-9 proteins increased sequentially,while the relative expression of KDM6B protein decreased sequentially(P＜0.05);the relative expressions of EMMPRIN and MMP-9 proteins in the lymph node metastasis group were significantly higher than those in the non-lymph node metastasis group,and the relative expression of KDM6B protein was significantly lower than that in the non-lymph node metastasis group(P＜0.05);the relative expressions of EMMPRIN and MMP-9 proteins in TNM stages Ⅲ-Ⅳ were significantly higher than those in stages Ⅰ-Ⅱ(P＜0.05),while the relative expression of KDM6B protein was significantly lower than that in stages Ⅰ-Ⅱ(P＜0.05).In the group of invasive breast cancer with diameter≤2 cm,2 to 5 cm,and＞5 cm,the relative expression of MMP-9 protein increased sequentially(P＜0.05).Spearman correlation analysis showed that the expression of EMMPRIN was positively correlated with MMP-9 protein in invasive breast cancer tissues(r=0.990,P=0.000),the expression of EMMPRIN was negatively correlated with KDM6B protein(r=-0.606,P=0.000),and the expression of MMP-9 was negatively correlated with KDM6B protein(r=-0.612,P=0.000).ROC curve analysis showed that the area under the curve(AUC)of EMMPRIN protein for diagnosing invasive breast cancer was 0.875[95％confidence interval(CI):0.823-0.926,P＜0.05],with an optimal threshold of 10.043,sensitivity of 79.0％,and specificity of 76.8％;the AUC of MMP-9 protein in diagnosing invasive breast cancer was 0.863(95％CI:0.808-0.917,P＜0.05),with an optimal threshold of 10.070,sensitivity of 74.2％,and specificity of 76.8％;the AUC of KDM6B protein in diagnosing invasive breast cancer was 0.267(95％CI:0.196-0.338,P＜0.05),with an optimal threshold of 11.003,sensitivity of 71.0％,and specificity of 98.6％.Conclusion EMMPRIN,MMP-9 and KDM6B are related to the occurrence and development of invasive breast cancer.Detection of the expressions of EMMPRIN,MMP-9 and KDM6B is helpful to the pathological diagnosis of invasive breast cancer and clinical judgment of invasion and metastasis of breast cancer.

Andrgrapholide-mediated c-SKI inhibits myocardial fibroblast transdif-ferentiation and myocardial fibrosis / 中国病理生理杂志

AIM:To investigate the effect of cellular Sloan-Kettering Institute(c-SKI)protein expression on myocardial fibrosis in mice treated with andrgrapholide(Andr).METHODS:Male C57 mice were randomly divided into control group,model group[isoprenaline(ISO)group]and ISO+Andr group,with 6 mice per group.The mice in ISO and ISO+Andr groups were subcutaneously injected with ISO,while those in control group were injected with normal sa-line.The mice in ISO+Andr group was intragastrically given Andr,while those in ISO and control groups were given nor-mal saline.The histopathological characteristics of the heart tissue were detected by HE and Masson staining after 8 weeks of administration.The expression levels of c-SKI and extracellular matrix(ECM)-related proteins were detected by immu-nohistochemistry or Western blot.The c-SKI mRNA level was detected by qPCR.Human cardiac fibroblasts(HCFBs)were treated with different concentrations of Andr for 48 h.The cell viability was detected by CCK-8 assay,and the c-SKI and ECM-related protein levels were detected by Western blot.The transdifferentiated cell model was treated with the lowest effective dose of Andr.The cell morphology was observed under a microscope,the levels of c-SKI and ECM-related pro-teins were assessed by Western blot,and the c-SKI mRNA level was detected by qPCR.The transforming growth factor-β1(TGF-β1)-treated HCFBs were treated with the combination of c-SKI knockdown and Andr.The cell viability was detected by CCK-8 assay,and the levels of c-SKI and ECM-related proteins were detected by Western blot.RESULTS:After the intervention of Andr,the myocardial fibers in mice were neatly arranged,the morphology of myocardial cells was basically normal,the cell membrane was intact,and the collagen volume fraction was significantly reduced(P＜0.01).The mRNA and protein levels of c-SKI were significantly up-regulated(P＜0.05 or P＜0.01),and the protein levels of fibronectin 1(FN1),α-smooth muscle actin(α-SMA),vimentin and collagen type I(Col I)were significantly down-regulated(P＜0.01).After 50 μmol/L Andr treatment for 48 h,the viability of HCFBs was significantly decreased(P＜0.01),the pro-tein levels of Col I,α-SMA,vimentin and FN1 were significantly down-regulated(P＜0.01),and c-SKI expression was significantly up-regulated(P＜0.01).Compared with PBS group,the number of the HCFBs in TGF-β1 group increased with flattened and irregular morphological change,and the FN1,α-SMA,Col I and vimentin levels were significantly in-creased(P＜0.01),while c-SKI expression was significantly decreased(P＜0.01).After Andr intervention,the induction effect of TGF-β1 on HCFBs was reversed.Knockdown of c-SKI combined with Andr treatment in HCFBs significantly down-regulated c-SKI expression(P＜0.01),significantly up-regulated FN1,α-SMA,vimentin and Col I levels(P＜0.05),and significantly increased the cell viability.CONCLUSION:Andrgrapholide may affect the TGF-β1 signaling pathway by regulating c-SKI expression,and inhibit the proliferation of myocardial fibroblasts and ECM deposition,thus inhibiting myocardial fibrosis.

LncRNA MALAT1 promoted myocardial cell damage in oxidative stress models by regulating miR-181a / 安徽医科大学学报

Objective @#To investigate the expression and mechanism of long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) and microRNA 181 a ( miR 181 a ) in a myocardial cell oxidative stress model. @*Methods @#The expression of MALAT1 and miR 181 a in peripheral blood of 30 patients with acute myocardial infarction ( AMI group) and 30 healthy controls ( Normal group) was detected by qRT PCR. Pearson correlation analysis was performed to determine the correlation between MALAT1 and miR 181 a in AMI . The binding sites between MALAT1 and miR-181a were predicted using the lncBase online prediction database and validated by dual luciferase reporter assay. An oxidative stress model of myocardial cells was established by hydro gen peroxide (H2O2 ) treatment in AC16 human myocardial cell line . siRNA targeting MALAT1 ( si-MALAT) and negative control siRNA ( si-NC) were transfected into AC16 cells , and the cells were divided into H2O2 treatment (H2O2 ) group , H2 O2 + si NC group , and H2O2 + si-MALAT group . Cell proliferation activity was detected by CCK-8 assay , cell apoptosis was assessed by TUNEL assay , and the expression levels of cleaved caspase-3 , Bcl-2 associated X protein (Bax ) , and B cell lymphoma-2 ( Bcl-2) were determined by Western blot. @*Results @#Compared to the Normal group , the expression of MALAT1 was upregulated and the expression of miR-181a was down regulated in the AMI group (P < 0.05) , and there was a negative correlation between MALAT1 and miR-181a expression. The lncBase online prediction database and dual-luciferase reporter assay results had proven that MAL AT1 could target and regulate the expression of miR 181 a. Compared to the H2O2 group, the H2O2 + si MALAT group showed increased cell viability (P < 0.05) , decreased TUNEL positive rate (P < 0.05) , decreased expres sion levels of cleaved caspase-3 and Bax (P < 0.05) , and increased expression level of Bcl-2 (P < 0.05) , while the H2O2 + si NC group showed no significant changes (P > 0.05) .@*Conclusion @# LncRNA MALAT1 expression is elevated in AMI patients , which could promote oxidative stress induced myocardial cell damage through targeted inhibition of miR-181a.

The study on indocyanine green excretion test to predict mild hepatic encephalopathy / 中国实用护理杂志

Objective:To explore whether the 15-minute retention rate (R15) of indocyanine green (ICG) in the indocyanine green excretion test and the effective hepatic blood flow (EHBF) can predict the occurrence of mild hepatic encephalopathy (MHE).Methods:Using the convenience sampling method, we collected clinic data from 153 patients diagnosed with liver cirrhosis or liver failure from June 2019 to December 2019 in the Third Affiliated Hospital of Sun Yet-sen University in Guangzhou. We screened the MHE patients with the number connect test-A and the digital symbol test, and analyzed the clinical data. By taking different values for R15 and EHBF as cut-off points, the significance of the two factors in predicting MHE is explored respectively.Results:The incidence of MHE was 38.56% (59/153). Single factor analysis showed that the difference of Child-Pugh grade between the MHE group and the non-MHE group was statistically significant ( χ2 value was 7.606, P<0.05), while the differences between cirrhosis and liver failure diagnosis, fasting blood glucose, and serum creatinine were not statistically significant ( P>0.05). When most points between 0.11 and 0.61 were selected as normal and abnormal cut-off points of R15, R15 had statistical significance ( P<0.05) and when R15 selected 0.18, it was most significant (Fisher exact test P=0.00024). When most points between 0.08 and 0.76 were selected as normal abnormal cut-off points of EHBF, EHBF had statistical significance ( P<0.05) and when EHBF selected 0.25, it was most significant (Fisher exact test P=0.00022). Through Logistic stepwise regression analysis, the risk factors for MHE were R15 and EHBF. The ROC curve was used to illustrate the predictive effects of two factors on MHE. Conclusions:The incidence of MHE in patients with cirrhosis or liver failure is high. When R15≥0.18 or EHBF≤0.25 L/min, R15 and EHBF in indocyanine green excretion test can better predict the occurrence of MHE than Child-Pugh classification, and can be help to evaluate and manage patients in time.

Research progress on the relationship between TET1 and tumor invasion and metastasis / 国际外科学杂志

TET1 has been discovered capable of promoting DNA demethylation by mediating 5-methylcytosine to inhibit the genesis and development of cancer.Epithelial-Mesenchymal transition is a complex cellular program in cancer progression and metastasis,whose hallmark is loss of cell polarity and cell adhesion and acquirement of migration and invasion abilities,leading tumor cells into blood vessel and lymphatic vessels to form new metastatic lesions.Epigenetics plays a vital role in epithelial-mesenchymal transition.This review focuses on the relationship of TET1,epigenetics and epithelial-mesenchymall transition,and the research progression of TET1's role in cancer invasion and metastasis.

Qualitative research on experiential teaching in the core midwifery curriculum / 中国实用护理杂志

Objective To understand the practice of experiential teaching in the core midwifery curriculum. Methods Phenomenology as a qualitative research method was utilized and fifteen students participated in the non-structured interviews. Results Four themes were found: comprehension of knowledge;professional thought; teacher- student relationship;gratitude. Conclusions Experiential teaching can increase the teaching effect of core midwifery curriculum, and develop good ideological and professional qualities.

The effect of flupentixol and melitracen tablets combined with Yueju pills in the treatment of functional gas-trointestinal disorders / 中国基层医药

Objective To observe the effect of flupentixol and melitracen tablets combined with Yueju pills in the treatment of functional gastrointestinal disorders ( FGID) .Methods According to the digital table ,308 patients with FGID were selected and randomly divided into 4 groups,77 cases in each group.The control group were given conventional treatment .The treatment group was divided into 3 groups:group 1:flupentixol and melitracen tablets was added on the basis of routine therapy;group 2:Yueju pills was added on the basis of routine therapy;group 3:patients in this group used conventional treatment combined with flupentixol and melitracen tablets and Yueju pills .The period of treatment was 6 week,then their clinical symptoms were compared .Results The effective rate in group 1,2,3 was 79.2%,62.3%,94.8%,respectively,which was significantly higher than 19.4% in the control group(χ2 =54.96, 29.24,89.18,all P<0.05);while compared each treatment group ,the total effective rate in group 3 was obviously higher than that in group 1 ang group 2(χ2 =8.27,24.08,all P<0.05),and the total effective rate in group 1 was higher than that in group 1(χ2 =4.09,P<0.05).Conclusion Flupentixol and melitracen tablets combined with Yueju pills are more effective for treating functional gastrointestinal disorders than that of single drugusing .

Correlation between the level of Ca2+/calmodulin-dependent protein kinases IV and essential hypertension in Shihezi community / 实用医学杂志

Objective To study the correlation between the level of CaMKIV and essential hypertension (EH) in Shihezi community. Methods One hundred and forty-six patients with EH and 142 with normal blood pressure are enrolled from 15 communities in shihezi. We collected the clinical data, including blood pressure, body mass index, waist circumference, blood lipids. The serum level of CaMKIV was detected using an enzyme linked immunosorbent assay. Results The serum level of CaMKIV in the EH group was significantly lower than that in the normal blood pressure group (P < 0.05). The serum CaMKIV was negatively correlated with systolic BP and diastolic BP (r = -0.304, -0.452, all P < 0.05), with more obvious correlation with patients whose diastolic blood pressure was over 100 mmHg (r = -0.571, P < 0.05). Conclusions The serum level of CaMKIV is negatively correlated with EH, which is an independent factor of EH.

Application of fiberoptic bronchoscopic-assisted nasotracheal intubation under awake induction with dexmedetomidine in ankylosing spondylitis patients / 中华全科医师杂志

A total of 60 ankylosing spondylitis patients scheduled for elective surgery with anticipated difficult airway were enrolled and randomly assigned into either dexmedetomidine (D) or midazolam plus sufentanil (MF) group.Group D:topical nasal anesthesia and a loading dose of dexmedetomidine at 1.0 μg/kg in 10 min; group MF:intravenous infusion of 0.05 mg/kg midazolam plus 3 μg/kg sufentanil.Fiberoptic bronchoscopic (FOB)-assisted awake nasotracheal intubation was performed.Mean arterial pressure (MAP),heart rate (HR),Pulse oxygen saturation (SpO2),Ramsay score and success rate of intubation were recorded and compared between two groups.The intubation conditions and level of comfort were also evaluated.MAP and HR of group D at FOB through postnaris (T1),peep the epiglottis(T2),intubation success immediately(T3)and 1 min after intubation(T4) were significantly lower (P ＜ 0.05 or P ＜ 0.01) than those of group MF while Ramsay sedation scores were obviously higher (P ＜ 0.05) than those of group MF.Group D with endotracheal intubation comfort level 5 score of grade 1-2 were 8 and 14 cases and were significantly higher than 4 and 10 cases of group MF.Immediately after intubation,level 3 scores in grade 1 of group D (n =21) were significantly higher than group MF (n =12) ; initial success rate of intubation in group D was obviously higher than that in group MF (70％,n =21 vs.47％,n =14).And the incidence of unpleasant intubation memory in group D was lower than that in group MF (37％,n =11 vs.67％,n =20).Fiberoptic bronchoscopic-assisted nasotracheal intubation offers better conditions for intubation and reduces the incidence rate of intraoperative awareness.

Correlation of serum cyclophilin A level with occurance of essential hypertension in Xinjiang Xibo and Mongolia populations and its clinical significance / 天津医药

Objective To investigate the correlation of cyclophilin A (CyPA) level in patients with essential hyperten?sion(EH)in Xinjiang Xibo and Mongolia populations and to investigate its clinical significance. Methods EH patients (n=76) and healthy control subjects (n=62) were selected from Xinjiang Xibo populations. On the other hand, EH patients (n=66)and healthy control subjects (n=57) were selected from Xinjiang Mongolia populations. Serum cyclophilin A was measured using enzyme-linked immunosorbent assay(ELISA). Parameters such as age, body mass index(BMI), waist, waist hip ratio, blood pressure were measured in each group. The correlation of cyclophilin A with each parameter was analyzed. Results The levels of serum cyclophilin A in EH patients in Xinjiang Xibo and Xinjiang Mongolia populations were significantly high?er than those in their corresponding healthy control groups(P<0.05). Serum cyclophilin A in patients with essential hyperten?sion(EH)in Xinjiang Mongolia population was signifantly higher than that in EH patients from Xinjiang Xibo population (P<0.05). There was a positive correlation between serum cyclophilin A level and occurance of EH in both Xinjiang Xibo and Xinjiang Mongolia populations. Conclusion The serum cyclophilin A is significant higher in EH patients in both Xinji?ang Xibo and Xinjiang Mongolia populations so it is positively correlated with occurance of EH (P<0.05). Cyclophilin A lev?el is a risk factor of essential hypertension in both Xinjiang Xibo and Xinjiang Mongolia populations.

Discussion on management of medical equipment measuring instruments / 中国医学装备

Objective:To enhance hospital equipment information management standards for the purpose of measurement instruments.Methods:Using solutions based on Web technology, database technology, database through the establishment of measurement devices, implement life cycle management method.Results: To solve the many hospital only attach importance to the management of medical equipment, ignore the metering device management, lead to measuring instruments record disorder, query the inconvenience problem.Conclusion: Medical device measurement equipment management system improves the ability of the hospital information management, strengthens the efficiency of communication and exchanges of various departments and produces good economic and social benefits.

Role of p21 and p27 in carcinogenesis and drug resistance / 国际外科学杂志

Human cancers arise from an imbalance of cell growth and cell death.Critical factors that control the balance are those regulate the cell cycle.Several molecular effectors have been identified to be able to regulate specific phases of the cell cycle,including cyclins,cyclin-dependent kinases (CDKs) and CDK inhibitors.Notably,deficiency of two G1-checkpoint CDK inhibitors-p21 (CDKN1A) and p27 (CDKN1B)-has been implicated to be correlated with initiation or progression of many human malignancies or cancer cells drug-resistance.However,contradict reports also suggested that p21 and p27 could promote tumor progression.Here,we summarized the historic and recent studies on these two CDK inhibitors,including their identification as well as their roles in carcinogenesis and drug resistance.

Progress in the development of metabolic and breast cancer / 国际外科学杂志

With the social development,the number of obese people is increasing.Recent studies have shown that obese women to have breast cancer disease's risk is higher than normal body weight,and etabolic disorders growing threat to human health.Estrogen,aromatase have contributed to the occurrence and development of breast cancer after menopause.AMPK is a negative regulator of aromatase,it can inhibit proliferation of cancer cells by metabolic pathways.What's more metformin,resveratrol inhibited proliferation by this route has been confirmed in breast cancer cells.Here,the author do an overview of the role of obesity-related factor for postmenopausal breast tissue estrogen synthesis and metabolic abnormalities affect aromatase expression in breast.

Research on epidermal growth factor receptor in breast cancer / 国际外科学杂志

Decades researches of molecular oncology have found some moleculars which can promote tumor growth and help cancer surrive.This brings new hope for the treatment of tumors.Epidermal growth factor receptor (EGFR) is the first important molecular to inhibit tumor growth.Fifty percent triple negative breast cancer (TNBC) and inflammatory breast cancer (IBC) overexpress EGFR.EGFR and its downstream pathway can regulate epithelial-mesenchymal transition,promote tumor cell migration.EGFR therapy can improve the chemosensitivity of TNBC cells,apoptotic signal transduction occur.These studies suggest that the EGFR targeted therapy may have an important role in the treatment of TNBC and IBC.

Progress of versican in the occurrence and development of neoplasms / 国际外科学杂志

Versican comes from fibroblasts and belongs to chondroitin sulfate proteoglycan.It distributes in various tissues.The versican have functions including regulate cell growth and differentiation,promote cell proliferation,invasion and metastasis,and stimulate angiogenesis.Experiments have confirmed that the expression of versican is involved in various cancers.Here,the author do an overview of versican in the occurrence and development of breast cancer,liver cancer and chondrosarcoma aimed to further explore the pathogenesis of tumors.

Feasibility of induction with sevoflurane-midazolam-remifentanil for tracheal intubation without muscle relaxants in patients with huge mediastinal tumor / 中华麻醉学杂志

Objective To evaluate the feasibility of induction with sevoflurane-midaaolam-remifentanil for tracheal intubation without muscle relaxants in patients with huge mediastinal tumor.Methods Twenty-two ASA Ⅰ-Ⅲ patients with huge mediastinal tumor,aged 22-64 yr,weighing 48-76 kg,scheduled for surgery under general anesthesia,were enrolled in this study.Anesthesia was induced with iv injection of midaaolam 0.03 mg/kg and inhalation of 8％ sevoflurane through a mask.Sevoflurane was inhaled at the initial concentration of 8％,followed by decrement of 2％ every 30 s until 4％.When the eyelash reflex disappeared,remifentani1 2 μ g/kg was injected slowly over I min and sevoflurane inhalation was stopped 30 s later.The patients were mechanically ventilated after tracheal intubation.MAP and HR were recorded before induction and immediately before and 1 min after inlubation.The time of disappearance of eyelash reflex was recorded.The inlubation condition was evaluated using VibyMogensen score.Results The time period from sevoflurane inhalation to disappearance of eyelash reflex was(110 ± 14)s.The success rate of tracheal intubation at the first attempt was 86％.The position of the glottis was higher in 2 patients,and tracheal intubation was successfully performed under the guide of fiberoptic bronchoscope.The satisfactory intubation conditions were found in 86％ of cases.Compared with that before anesthesia induclion,MAP and HR were significantly decreased immediately after intubation and at 1 min after intubation(P ＜ 0.05).SpO2 ＞ 95％ in all patients.BIS was maintained at 45-55 during the period(before intubation until 1 min after intubation).Conclusion Induction with sevoflurane-midazolam-remifenlail is rapid and smooth,provides good conditions for intubation and can be applied to tracheal intubation without muscle relaxants in patients with huge mediastinal tumor.

Feasibility of induction with sevoflurane-midazolam-remifentanil for tracheal intubation without muscle relaxants in neck brake patients / 中华麻醉学杂志

Objective To evaluate the feasibility of induction with sevoflurane-midazolam-remifentail for tracheal intubation without muscle relaxants in neck brake patients.Methods Forty ASA Ⅰ or Ⅱ patients with cervical spine fracture with dislocation,aged 13-68 yr,scheduled for surgery under general anesthesia,were enrolled in this study.Anesthesia was induced with iv injection of midazolam 0.03 mg/kg and inhalation of 5%sevoflurane through a mask.Sevoflurane was inhaled at the initial concentration of 5%,followed by decrement of 1% every 30 s until 3%.When the eyelash reflex disappeared,remifentanil 2 μg/kg was injected slowly over 45s and 30 s later sevoflurane inhalation was stopped.The patients were mechanically ventilated after tracheal intubation.The time of disappearance of eyelash reflex was recorded.The intubation condition was evaluated using VibyMogensen score.Results All patients were successfully intubated at the first attempt.The time period from sevoflurane inhalation to disappearance of eyslash reflex was(69 ± 4)s.Coughing occurred in 3 cases during intubation.The satisfactory intubation conditions were found in 100% of cases.SpO2 ＞ 95% in all patients.BlS was maintained at 45-55 during the period(before intubation until 3 min after intubation).Conclusion Induction with sevoflurane-midazolam-remifentail is rapid and smooth,provides good conditions for intubation and can be applied to tracheal intubation without muscle relaxants in neck brake patients.

Algorithm of non-standard video transformation based on FPGA / 医疗卫生装备

Objective To study a kind of video transformation algorithm based on FPGA in view of the present situation that the video output of X-ray equipment can not be connected to common video adapter.Methods Through the control of non-standard video signal AD sampling data read-write succession in FIFO,800 digital sampling data was output(output resolution:800?600,refresh rate:60Hz)in the period of every line of effective signal.The output module combined these data with line and field synchronized signal and transform them into standard VGA signal.Results Non-standard medical video signal could be transformed into standard medical video signal by using VHDL in normal FPGA.Conclusion The speed of this algorithm is high,and the transformation effect is clear and smooth.

Clinical and pathological analysis in one case of antiepileptic drug hypersensitivity syndrome / 重庆医科大学学报

Objective: To discuss the clinical features,diagnosis,pathogenesis and treatment of antiepileptic drug hypersensitivity syndrome(AHS).Methods: A retrospective analysis of one case of AHS was focused on his clinical data.Results: About six weeks after carbamazepine treatment the patient presented fever firstly.The highest temperature is up to 39.6℃.Subsequently he developed diffusible red maculopapular rash and swollen superficial lymph nodes.Physical examination found internal organs involvement(mainly liver and lung).Laboratory examinations showed that the leucocyte increased to 54.21?109/L,and the percentage and absolute count of eosinophil rose,while IgG and IgM decreased.The CT of thoracic part showed the lymph nodes of hilum of lung and mediastina swelled together with pleural effusion.A biopsy study of lymph node suggested the reactive hyperplasia which was not equal to lymphoma.The bone marrow smear showed granulocytic cell line hyperplasia and abnormal lymphocyte were observed.After discontinuing carbamazepine in time and applying corticosteroids,the temperature descended rapidly and the swollen lymph nodes recovered soon.Conclusion: AHS is an idiosyncratic reaction.It usually occurs within 2 to 8 weeks after initiation of antiepileptic drug therapy,and typically manifests itself as fever,eruption and internal organ involvements.Pathogenesis is still not definite.Important basis for diagnosis and differential diagnosis depends on clinical manifestations and laboratory examinations.Early recognition of AHS and timely discontinuing of the suspected drugs are the essential therapy.