Acupuncture Therapy ; Adult ; Dysmenorrhea ; complications ; Female ; Humans ; Syncope ; etiology ; therapy

Objective To analyze the reasons of early complications in anterior cervical spine surgery and its management. Methods Between Jan 1992 and Dec. 2003, 412 patients underwent anterior cervical surgery. There were 308 males and 104 females with an average age of 45.6 years (18-76). The di-agnosis of these patients included 258 of cervical spondylosis, 138 of cervical injury, 8 of cervical spinal tu-mor and 8 of tuberculosis of cervical spine. The medical history was from 4 hours to 20 years with an aver-age duration of 548 days. Among 412 patients, there were 58 cases (14.1%) with complete paraplegia, 192 cases (46.6%) with incomplete paraplegia and 162 cases without neurological deficits. Anesthesia used in this group of patients were local in 35, cervical plexus block in 52, local associated with cervical plexus block in 6, general in 318 and general associated with cervical plexus block in 1. Three surgical procedures were performed: 1) anterior decompression and interbody fusion with autogenous iliac crest in 33 cases; 2) anterior decompression and interbody fusion with threaded fusion cage in 32 cases; 3) anterior decompres-sion, interbody fusion with autogenous iliac crest and plate fixation in 347 cases. Results Fifty-one early complications occurred in 42 patients and the incidence was 12.37%. 28 patients (6.8%) had complications directly related to the procedure which included superior laryngeal nerve injury in 5, recurrent laryngeal nerve injury in 4, migration of bone graft in 2, infection or haematoma in 4, deterioration of neurological function in 5,nerve root injury in 2, loosening of screw or plate fixation in 2 and esophageal fistula in 1. 23 cases (5.08%) had early complications indirectly related to the procedure. Conclusion In order to reduce the incidence of early complications in anterior cervical spine surgery, make familiarization with anatomy, improvement of surgical skill as well as appropriate perioperative management are essential in anterior cer-vical spine surgery.

Objective:To investigate the short-term efficacy of thoracoscopic radical surgery in the treatment of esophageal cancer and its influence on the expression of trigger receptor-1 (TRE-1) and tumor necrosis factor receptor-associated protein 1 (TRAP1).Methods:A total of 68 patients with esophageal cancer who were admitted to First People′s Hospital of Ningyang from June 2016 to June 2019 were selected and divided into thoracoscope radical surgery group and raditional surgery group by stratified sampling method, with 34 cases in each group. The thoracoscopic radical surgery group was treated with thoracoscopic radical surgery, and the traditional surgery group was treated with traditional open radical esophageal cancer surgery with neck, chest, and abdominal incisions. The levels of inflammatory factors, immune function, lung function indexes, TREM-1, TRAP1 expression and complications of the two groups were observed and compared.Results:Before operation, the levels of inflammatory factors tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10 in two groups had no significant differences ( P>0.05). At 2 d after operation, the levels of TNF-α, IL-6, IL-10 in two groups were increased and the levels of above index in the thoracoscopic radical surgery group were lower than those in the traditional surgery group: (23.21 ± 0.32) mg/L vs. (29.69 ± 0.48) mg/L, (232.15 ± 23.64) ng/L vs. (246.73 ± 25.89) ng/L, (0.64 ± 0.19) ng/L vs. (0.89 ± 0.21) ng/L, and there were statistical differences ( P<0.05). Before operation, the levels of CD 3+, CD 4+, CD 8+, and CD 4+/CD 8+ in two groups had no significant differences ( P>0.05). At 2 d after operation, the levels of CD 3+, CD 4+, CD 8+ decreased and the level of CD 4+/CD 8+ increased, and the levels of CD 3+, CD 4+, CD 8+, CD 4+/CD 8+ in the thoracoscopic radical surgery group were higher than those in the traditional surgery group: (46.78 ± 1a2.43)% vs. (41.32 ± 9.36)%, (46.12 ± 9.68)% vs. (41.59 ± 7.98)%, (27.42 ± 4.27)% vs. (21.38 ± 3.16)%, 1.47 ± 0.46 vs. 1.25 ± 0.27, and there were statistical differences ( P<0.05). Before operation, the levels of forced expiratory volume in one second (FEV 1), forced vital capacity (FVC), FEV 1/FVC in two groups had no significant differences ( P>0.05). At 2 day after operation, the levels of FEV 1, FVC, FEV 1/FVC in two groups decreased, and the levels of FEV 1, FVC, FEV 1/FVC in the thoracoscopic radical surgery group were higher than those in the traditional surgery group: (2.37 ± 0.72) L vs. (1.82 ± 0.53) L, (3.34 ± 1.06) L vs. (2.43 ± 0.82) L, (62.47 ± 15.26)% vs. (53.67 ± 12.28)%, and there were statistical differences ( P<0.05).Before operation, the expression of TREM-1 and TRAP1 in two groups had no significant differences ( P>0.05). At 2 d after operation, the expression of TREM-1in the thoracoscopic radical surgery group was higher than that of traditional surgery group: (141.56 ± 34.69 vs. 121.54 ± 22.75); the expression of TRAP1 was lower than that of the traditional surgery group: (1.63 ± 0.51 vs. 2.11 ± 0.64), and there were statistical differences ( P<0.05). The postoperative complication rate of the thoracoscopic radical surgery group was lower than that of the traditional surgery group:5.88%(2/34) vs. 23.53%(8/34), and there was statistical difference ( χ2=4.221, P=0.040). Conclusions:The short-term efficacy of thoracoscopic radical surgery in the treatment of esophageal cancer is better than that of the traditional surgery group, which can increase the expression of TREM-1, reduce the expression of TRAP1, and reduce the inflammatory response and the impact on the immune function.

OBJECTIVE:To analyze the characteristics and rules of new and serious ADR induced by Chinese patent medicine in Wuhan during 2012-2013,and to improve the monitoring levels of Chinese patent medicine-induced ADR and clinical rational drug use. METHODS:New and serious Chinese patent medicine-induced ADR cases reported by 16 districts of Wuhan during 2012-2013 were classified and analyzed statistically. RESULTS:A total of 245 cases of new and serious TCM ADR were reported in 2012-2013,accounting for 13.61% of all reports;the incidence of ADR in patients above 51 years old was the highest,account-ing for 55.51%;42.04%of new and serious ADR induced by Chinese patent medicine occurred within 30 minutes after using medi-cine;among suspected drugs,intravenous dripping was the main way to cause new and serious ADR induced by Chinese patent medicine (50.39%);blood-regulating formula was the main cause of new and serious ADR induced by Chinese patent medicine (40.80%);new and serious ADR induced by Chinese patent medicine mainly manifested as systemic damage(25.97%),followed by lesion of skin and its appendants(18.81%). CONCLUSIONS:It is needed to strengthen the rational use of Chinese patent medi-cine and the supervision of TCM injection for activating blood circulation to dissipate blood stasis,strengthen the supervision and improvement of instruction content of Chinese patent medicine. TCM Pharmacists should carry out the clinical pharmaceutical care.

Objective To investigate the association between drainage volume and removal of chest tube after video-as?sisted thoracoscopic surgery(VATS) lobectomy. Methods Patients with VATS were randomly divided into three groups:the drainage volume was less than 100 mL/24 h (group A), the drainage volume was more than 100 mL/24 h but less than 200 mL/24 h(group B) and the drainage volume was more than 200 mL/24 h but less than 300 mL/24 h (group C). According to in?clusion criteria and exclusion criteria, finally there were 90 patients in group A, 87 patients in group B and 83 patients in group C. The duration of chest-tube drainage, the occurrence of pulmonary infection, pulmonary atelectasis, pneumothorax, hydrothorax, seepage or delayed union after removal of chest tube, the dosage of analgesic and the length of hospital stay af?ter surgery were recorded. Data were analyzed statistically. Results The average durations of chest-tube drainage were (91.76±15.59)h, (84.17±18.33)h and (56.14±12.25)h, the average morphine consumptions were (236.82±67.20)mg, (187.36± 76.64)mg and (139.29±52.74)mg, and the average lengths of hospital stay after surgery were (11.47±1.90)d, (10.68±2.50)d and (10.23 ± 2.14)d for three groups of patients, respectively. And the indexes in group C were distinctly lower than those in group A and group B (P<0.05). There were no significant differences in pulmonary atelectasis, the occurrence of postopera?tive pulmonary infection, pneumothorax, hydrothorax, seepage or delayed union after removal of chest tubes between three groups of patients (P > 0.05). Conclusion It is safe and acceptable that the removal of chest tube after VATS when the drainage volume reaches 300 mL within 24 h.

0.05). There was statistically significant difference in morbidity rate between the groups (2.1% vs 9.3%, P=0.037). Conclusions: Percutaneous and surgical treatment of pyogenic liver abscesses are both effective, nevertheless percutaneous drainage carries lower morbidity and should be the first-line treatment.

Objective To assess the value of primary resection and anastomosis with intraoperative colonic defecation in the patients with obstructive left colonic cancer. Methods From January 2000 to January 2008, 39 patients undergoing emergency laparotomy for left colonic cancers with complete obstruction were analyzed retrospectively. Results The patients were 25 males and 14 females, with a median age of 68.5 years (range: 57～78 years). The primary tumors were located at splenic flexure (3/7.7%), descending colon (8/20.5%), sigmoid colon (15/38.5%), boundary of sigmoid colon and rectum (8/20.5%), and superior segment of rectum (5/12.8%). Primary resection and anastomosis with intraoperative colonic de-fection were performed in 18 patients with left hemicolectomy, 13 patients with sigmoid colectomy and 8 pa-tients with anterior resection. Early complications included wound infection in 4 patients (wound disruption in 1 patient) and pulmonary infection in 5 patients. One patient complicated with anastomotic leakage and intra-abdominal abscess died of tumor metastasis after reoperation. Another one died of respiratory failure secondary to pulmonary infection. Morbidity and mortality was 25.6% and 5.1% respectively. Conclusion Primary resection with intraoperative colonic defecation can be applied to patients with malignant colonic complete obstruction with good operative results.

Objective To assess the value of primary resection and anastomosis without intraoperative irrigation in the patients with obstructive left colonic cancer. Method Between January 2000 and January 2008, 93patients underwent primary resection and anastomosis for colonic cancers were analyzed retrospectively. Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) was performed in 43 patients with obstructive left colonic caner and traditional left-sided colectomy in 50 cases without obstruction. Both groups of patients were comparable in terms of gender, nutritional status, underlaying disease, tumor location and stage, etc ( P = 0.83,0.13,0.29,0.51,0.38). The average age of the patients with colonic obstruction was significant older than that of the cases without obstruction (61.2 ± 8.6 vs. 58.1 ±7.8, P =0.010).The operative results were compared between patients with obstructive colonic cancer and cases without obstruction.Results The mean hospital stay of the primary anastomosis group and traditional left-sided colectomy group were (16.6±7.8) d and (12.4±5.4) d respectively, and the former was significant longer than the latter (P =0.002). The costs of hospitalization in the two groups were (50192.8 ± 39727.4) RMB and (46489.3 ±29543.1)RMB respectively (P = 0.04) . The morbidity and mortality in the two groups were 25.6% (11/43) vs. 18%(9/50) (P =0.375) and 2.3% (1/43) vs. 2.0% (1/50) (P =0.714) respectively, and there were no significant difference between the two groups. Conclusions Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) compares favorably with traditional left-sided colectomy in safety and efficiency for left colonic cancer with obstruction.

Objective: To investigate the effect of mitoxantrone (MIT) on calreticulin (CRT) expression in B16 cells, and to observe the immune effect of B16-membrane antigen vaccine highly expressing CRT on B16 tumor-bearing mice. Methods: The expression of CRT on membrane of B16 cells was detected by immunofluorescence after treatment with different concentrations of MIT. B16-implanted mouse model was established, and the growth of B16-implanted tumors and CRT expression in B16-implanted tumor tissues were observed after treatment with different concentrations of MIT. Membrane antigen vaccines from both normal B16 cells and MIT-treated B16 cells were prepared, and mice were immunized before B16 cell implantation. The infiltration of immune cells into B16 tumor tissues and the ratios of CD4~+ and CD8~+ T cells in the spleen of B16 tumor-bearing mice were examined by immunohistochemistry and flow cytometry, respectively. Results: Flow cytometry results showed that MIT dose-dependently increased CRT expression on B16 cell membrane, with CRT expression in control and high dosage MIT groups being (29.40±3.57)% and (72.20±2.94)% (P<0.05), respectively. MIT also increased CRT expression in B16 tumor tissues, with those in the control and high dosage MIT groups being 3.21±1.37 and 9.17±1.06 (P<0.05), respectively. MIT effectively inhibited the growth of B16 tumors (P<0.05). Compared with normal B16 cell membrane antigen vaccine, the vaccine highly expressing CRT increased the numbers of DCs and T cells in B16 tumors tissues and the ratios of CD4~+ and CD8(+) T cells in the spleen (P<0.05). Conclusion: MIT can increase CRT expression on membrane of B16 cells. B16-membrane antigen vaccine highly expressing CRT can enhance the infiltration of DCs and T cells in melanoma, thus improving the immune effect of B16-membrane antigen vaccine.

The standardized training of resident physicians of Chinese medicine specialized graduate students (standardized training) is a great reform of clinical postgraduate education and a major initiative to improve professional degree graduates education. It contributes to higher professional qualities of clinicians in China. At this stage, the standardized training in our school just started and some problems existed such as department arrangement, training and checking system, curriculum and tutors instruction. Here, taking the standardized training in our school as an example, this paper discussed some issues on the training and put forward suggestion. This will help standardize our training, improve the training quality of our graduate students and develope medical professional talents.