Objective To observe the effects of controlled hypotension induced with remifentanil nitroglycer -in in endoscopic sinus surgery .Methods 60 ASAⅠ-Ⅱpatients treated with endoscopic sinus surgery were random-ly divided into 3 groups:general anesthesia(group A),nitroglycerin(group B),remifentanil nitroglycerin group(group C).The blood pressure,heart rate,the quality of the surgical field,surgical time,extubation time,blood loss and sur-geon satisfaction of the surgical field were observed during anesthesia .Results The operative time showed statistic significance between the groups (F=4.792,P<0.05).In terms of the extubation time,there was a statistically sig-nificant difference between the groups (F=37.507,P<0.01).The blood loss and the quality of the surgical field were statistically significant between the groups respectively ( F =16.011, P <0.01;F =71.050, P <0.01 ). Conclusion Controlled hypotension induced with remifentanil nitroglycerin in endoscopic sinus surgery can lower blood pressure effectively ,improve the quality of surgical field ,and shorten the operation time and the extubation time .

ObjectiveTo investigate the influence on negative emotion of ICU patient's relatives by comprehensive needs intervention.Methods 100 ICU patient's relatives were randomly divided into intervention group and control group,50 cases per group.Patients in intervention group were given comprehensive needs interventions for two weeks,then were tested by self-rating anxiety scale(SAS),self-rating depression scale(SDS) and symptom checklist 90 (SCL-90),and their negative emotion were compared.ResultsExcept for interpersonal relationship factor (P＞ 0.05 ),the other SCL-90 factorial scores of ICU patient's relative were all significantly higher than the national norm before intervention(P ＜ 0.01 ～0.05 ).Anxiety and depression rates in two groups were 64％ and 53％ respectively,SDS standard scores were 49.62 ± 9.18 and 49.70 ± 9.73,SAS scores were 40.08± 11.93 and 40.04 ± 11.76,and they were all significantly higher than normal norm.After intervention,SAS,SDS standard scores and SCL-90 factors of intervention group were significantly decreased,and were superior than control group,and there were statistical difference (P＜ 0.01 ～ 0.05 ).ConclusionThere are so much psychological diseases with the relatives of ICU patients,especially anxiety and depression.

Chronic hepatitis C virus ( HCV) infection has been reported in association with several extrahepatic complications, among which mixed cryoglobulinemia is the most documented. Clinical manifestations of HCV related cryoglobulinemia include skin lesions, glomerulonephritis, peripheral neuropathy, and widespread vasculitis.The therapy may be directed to eradicate HCV infections, suppress B-cell clonal expansion and cryoglobulin production, and ameliorate symptoms.This paper reviews the research progress on pathogenesis, clinical manifestations, diagnosis and treatment of HCV related cryoglobulinemia.

Objective To study the efficacy of voice therapy combined with Jinsangsanjie pill in patients with vocal nodule .Methods A total of 146 patients with vocal nodes were randomly divided into three groups :45 cases in group A(single Jinsangsanjie pill therapy) ,47 cases in group B(single voice therapy) and 54 cases in group C(voice therapy combined with Jinsangsanjie pill therapy) ,30 healthy adults were as a normal control group .The treatment lasted 1 month .The results were evaluated by voice handicap index ,voice acoustic analysis and electronic laryngo‐scope which were collected before and after 1 month treatments .Results The VHI ,jitter ,shimmer and NNE of all patients were reduced while the MPT was increased after the treatment .The differences were significant (P<0 .05) .VHI 3 .64 ± 2 .12 ,jitter 0 .30% ± 0 .08% ,shimmer 1 .41% ± 0 .31% ,NNE -16 .83 ± 5 .84 dB of group C were significantly lower while MPT 18 .87 ± 3 .38 s and cure rate(93 .5% ) were significantly higher than those of in groupA(7.39±2.56,0.38% ±0.12% ,1.78% ±0.41% ,-13.38±4.42dB,16.38±3.11s,80.5% )andgroupB (23.6±12.5,0.48% ±0.18% ,1.98% ±0.42% ,-9.42±3.82dB,14.98±3.28s,52.4% )(P< 0.05).The VHI ,,jitter shimmer ,NNE of group A were significantly lower .MPT and cure rate were significantly higher than those of in group B .There were no statistical differences in each vocal indicators between group C and the normal control group (P>0 .05) .Conclusion The voice therapy combined with Jinsangsanjie pill in the treatment of vocal nodules is more efficiently ,and can improve patient’s pronunciation features .

Objective:To explore the value of combined detection of PCT and IL-6 in differential diagnosis SIRSin ICU patients.Methods:100 patients with ICU admitted to our hospital from 2013 to 2016 were choosen,including 61 cases with non septic SIRS and 39 cases with sepsis,and 50 healthy persons over the same period were selected as control,and they were divided into non-septic group,sepsis group and control group.The levels of serum PCT and IL-6 were detected by electrochemiluminescence assay,and took PCT of 2 g/L and IL-6 of 50 ng/L for the critical value to identify non infectious SIRS and sepsis,to evaluate the clinical diagnostic value of combined detection.Results:The maximum values of PCT and IL-6in the non-septic group respectively were 0.91 ± 0.54 μg/L and 62.77± 11.75 ng/L,in the septic group respectively were 24.49± 5.00 μg/L and 1542.69± 361.66 ng/L,in the control group respectively were 0.08± 0.06 tμg/L and 3.68± 1.11 ng/L,the maximum values of PCT and IL-6 in the non-sepsis group and the sepsis group were significantly higher than control group (P＜0.05).Compared with the non-septic group,the maximum valuesin sepsis group were significantly increased (P＜0.05).The proportions of PCT ＞ 2 g/L and IL-6 ＜ 50ng/L in the non-septic group respectively were 21.31％ and 65.57％,in the septic group respectively were 92.31％ and 87.18％,the proportions of PCT＞2 g/L,IL-6＜50 ng/L in the sepsis groupwere significantly higher chan those in the non-septic group (P＜0.05).The positive predictive values,sensitivity and specificity of PCT were higher than IL-6,the positive value,specificity of combined detection was higher than IL-6 and PCT,while the sensitivity of combined detection was higher than IL-6,P＜0.05.Conclusions:Combined detection of PCT and IL-6 is helpful for differential diagnosis of sepsis and non-septic SIRS.

BACKGROUND:The low oxygen environment after femoral fracture and cerebral trauma wil induce series of related cytokines expression, including hypoxia-inducible factor 1αand core binding factorα1, which play key roles in regulating bone healing. However, whether the accelerated bone healing is correlated with the expression of hypoxia-inducible factor 1αand core binding factorα1 is stil unknown.
OBJECTIVE:To construct rat models of brain injury, to compare the expression level of hypoxia-inducible factor 1αand core binding factorα1 in femoral fracture combined with cerebral trauma rats and simple femoral fracture rats, and to assess the influence of cerebral trauma on bone healing.
METHODS:Rats were randomly divided into blank group, simple femoral fracture group and femoral fracture combined with cerebral trauma group. At 1, 2, 3 and 5 weeks after modeling, rats were executed. Bone healing was evaluated using femoral fracture end X-ray score and hematoxylin and eosin staining at cal us tissues. Besides, the expression levels of hypoxia-inducible factor 1αand core binding factorα1 of three groups were determined with immunohistochemistry.
RESULTS AND CONCLUSION:Bone healing in the femoral fracture combined with cerebral trauma group was better than that of simple femoral fracture group. There was significant difference in the expression level of hypoxia-inducible factor 1αand core binding factorα1 between the simple femoral fracture group and femoral fracture combined with cerebral trauma group (P<0.05). At the same time, the level of simple femoral fracture group and femoral fracture combined with cerebral trauma group was significantly higher than that of blank group, and that in femoral fracture combined with cerebral trauma group was significantly higher than that of simple femoral fracture group (P<0.05). Results verified that the expression levels of hypoxia-inducible factor 1αand core binding factorα1 of rats with femoral fracture combined with cerebral trauma were significantly high, which may be the major reason why the bone healing was accelerated after fracture combined with brain injury.

This experiment was aimed to mainly observe the effect of Anshen navel plaster on autonomic activities and to compare neurotransmitter gamma-aminobutyric acid (GABA) and monoamine neurotransmitter (5-HT) contents change of insomnia rats.The rats were treated by P-chlorophenylalanine (PCPA),which can make healthy rats lose sleep.The rat model of insomnia was prepared by intraperitoneal injection of PCPA.The healthy SD rats were randomly divided into the blank control group,model control group,low dosage of Anshen navel plaster group,high dosage of Anshen navel plaster group and Tongren Anshen pill group according to the random number table.EthoVision were used to record the rat's autonomic activities.Content changes of 5-HT and GABA of rats in each group were measured by enzyme-linked immunosorbent assay (ELISA).The results showed that rat's autonomic activities were decreased in the Anshen navel plaster group and Tongren Anshen pill group,which indicated that the Anshen navel plaster had a good sedative effect.Intraperitoneal injection of PCPA can remarkably change rat's serum neurotransmitter expression levels,especially GABA and 5-HT.After the intervention of experimental drugs,compared with the model group,the expression levels of GABA and 5-HT were increased significantly.It was concluded that Anshen navel plaster has obvious sedative effect.It can regulate the contents of sleep factors such as GABA and 5-HT.

Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury. Methods 113 cases were randomly assigned to 3 groups: control group(n=37), computer-assisted training group(n=38) and face-to-face training group(n=38). The control group just received cognitive dysfunction evaluation. The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks. And 33 patients were selected to prolong for 12 weeks. They were evaluated with Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR) at the beginning, the 6th week point and the 12th week point respectively. Results 6-week after treatment, The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001); It showed that computer-assisted group>face-to-face group>control group(P<0.001) both 6 weeks and 12 weeks latter. Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training; The first 6 weeks of training is the best period for rehabilitation; The younger the patient is, the better results are.