To observe the analgesic effects of morphine and bupivacaine for the patient controlled epidural analgesia (PCEA) after prostatectomy. Methods: 21 patients after receiving prostatectomy were treated with PCEA including morphine and bupivacaine, and 24 patients were treated with routine analgesia as control. The effects of analgesia with visual analogue scale (VAS) were evaluated indirectly, and episodes of bl adder spasm were recoreded. Results: The effects of PCEA on postoperative analgesia and controlling bladder spasm were much better than that of routine analgesia. Conclusion: Effects of morphine and bupivacaine used in PCEA for post-prostatectomy analgesia are confirmed adm inistration is slimple. Because of their dosage is smalller and side effects are fewer, this treating protocol is beneficial for the recovery of the patients re ceiving prostatectomy.

Bacteremia ; etiology ; Female ; Humans ; Infant, Newborn ; Listeria monocytogenes ; isolation & purification ; Male

Head ; surgery ; Humans ; Neck ; surgery ; United States

Objective:To discuss the clinical feature, diagnosis, and treatment course of pancreatic acinar cell carcinoma (ACC) to guide clinical practice and improve prognosis of patients. Methods:Clinical data of 15 patients with pathologically confirmed pancreatic acinar cell carcinoma between December 1994 and March 2014 in Tianjin Medical University Cancer Institute and Hospital were retro-spectively studied. Results:The patients include eight males and seven females with a median age of 44. Tumors in these patients appeared in different parts of the pancreas. Eight patients had tumor in the head, six in the body and tail, and one in the uncinate process. The tumor size ranged from 3 cm to 18 cm, with an average diameter of 6.67 cm. The patients presented less jaundice and the tumor markers remained constant, specifically, no increase was reported. Six patients had metastasis before their operation. Twelve patients received radical resection, while the other three received palliative treatment. The preoperative and intraoperative diagnoses were not exact. The final diagnosis depended on pathologic confirmation after surgery or puncture. The immunohistochemical results of trypsin and chymotrypsin were positive in the patients who were examined. The postoperative chemotherapy was usually based on gemcitabine. The average survival time was 20.6 months. Conclusion:Pancreatic acinar cell carcinoma has special clinical features, and clinicians tend to regard it as low-grade malignancy. The attitude towards ACC should be positive.

Objective:To investigate the clinical characteristics and electroencephalogram (EEG) of epilepsy patients with breach rhythm, improve clinical understanding of breach rhythm and avoid over-interpretation.Methods:Twelve epilepsy patients with breach rhythm who visited the Department of Neurology, Xijing Hospital, the Air Force Military Medical University from January 2016 to January 2017 were collected retrospectively. The clinical data, including etiology, clinical manifestations, EEG features and prognosis were summarized, and outpatient and telephone follow-up was performed for at least three years.Results:The clinical data of 12 patients with epilepsy with breach rhythm were collected, including eight males and four females, aged 36-78 years. After analysis, it was found that brain trauma was the most common cause of breach rhythm. Among them, two cases of skull defect were not repaired, eight cases were repaired with skull titanium mesh, one case was repaired with skull polymethylmethacrylate, and one case was repaired with skull polyetheretherketone. The distribution of the breach rhythm in 12 patients was consistent with the abnormal area of the skull. The breach rhythm can be expressed as high amplitude and fast frequency, or low amplitude and slow frequency and appear individually (similar to sharp waves, spikes). On the basis of pleomorphic slow waves, 10 patients were mixed with sharp waves and spike waves, and imaging confirmed that they had brain damage in corresponding parts. All of the 12 patients had a history of seizures, with tonic-clonic seizures and (or) focal seizures being the most common. Three patients with breach rhythm had no clinical seizures for more than five years, and had been taking antiepileptic drugs for epileptic spikes on EEG, and they were given reduction and discontinuation of the drugs and were seizure-free for three years during follow up.Conclusions:Skull repair is a common cause of breach rhythm, and repair materials with different resistances cause different waveforms and frequencies. Breach rhythm, epileptiform discharge and other pathological slow-wave activities can exist at the same time. Breach rhythm is a benign variant phenomenon which needs no special treatment.

Objective To compare the accuracy of blood volume perfusion imaging (perfusion CT)with contrast enhanced 64-slice spiral computed tomography (CECT) in the evaluation of gross tumor volume (GTV) and clinical target volume (CTV) using rabbits with VX2 brain tumor. Methods Perfusion CT and CECT were performed in 20 rabbits with VX2 brain tumor. The GTV and CTV calculated with the maximal and minimal diameter of each tumor in the blood volume (BV) maps and CECT were measured and compared to those in pathological specimens. Results The mean value of the maximal and minimal diameter of GTV was (8.19 ± 2. 29) mm and (4.83 ± 1.31) mm in pathological specimens, (11.98 ±3.29) mmand (7.03±1.82) mm in BV maps, while (6.36±3.85) mm and (3.17±1.93) mm in CECT images, which were significantly different (pathological specimen vs. BV map, t = 7. 17,P =0. 000;pathological specimen vs. CECT, t = 8.37, P = 0. 000, respectively). The mean value of the maximal and minimal diameter of CTV in pathologic specimens was (12.87 ± 3.74) mm and (7.71 ± 2. 15) mm, which was significantly different from that of GTV and CTV in CECT (t = - 3. 18, P = 0. 005 and t = - 4. 24, P =0. 000;t= -11.59,P=0.000 and t= -9.39,P=0.000), while similar with that of GTV in BV maps (t = - 1.95,P = 0. 067; t = - 2. 06, P = 0. 054). For CECT, the margin from GTV to CTV was 81.83% ±40.33% for the maximal diameter and 276.73% ± 131.46% for the minimal. While for BV maps, the margin was 7.93% ± 17. 84% and 12.52% ± 27. 83%, which was significant different from that for CECT images (t=7.36,P=0. 000 and t= -8.78,P=0.000). Conclusions Compared with CECT, the BV map from 64-slice spiral CT peffusion imaging might have higher accuracy in target volume delineation for brain tumor.

OBJECTIVETo measure the stability of Evans procedure and Chrisman-Snook technique in the treatment of II degree lateral collateral ligament of ankle joint, and provide basis for treatment and prognosis.

METHODSFrom July 2008 to June 2009,18 frozen corpes were collected, including 10 males and 8 females, with an average age of fresh 39.3 +/- 11.2 years. The frozen corpes were randomly divided into three group, including normal controls(group A), Evans procedure (group B) and Chrisman-Snook technique ( group C), 6 specimens in each group. Anterior talofibular ligament and calcaneofibular ligament were cut off to cause II degree lateral collateral ligament in group B and C. Evans procedure or Chrisman-Snook technique were applied to restore lateral collateral ligament, and measure biomechnics. The displacement of tibiotalar joint and subtalar joint were observed.

RESULTS(1) The lateral stress results of tibiotalar joint showed the displacement by Evans procedure (group B) was greater than other groups (P < 0.0001). There were no significant differences between group A and C (P > 0.05). (2) The lateral stress results of subtalar joint showed the displacement by Evans procedure (group B) was greater than other groups (P< 0.0001). There were no significant differences between group A and C (P > 0.05).

CONCLUSIONAnkle instability is caused by ankle joint lateral collateral ligament injury. Chrisman-Snook technique is better than Evans procedure in stability on the early stage of ankle joint restoration, and conform to principle of biomechanics.

Adult ; Ankle Joint ; Biomechanical Phenomena ; Female ; Humans ; Lateral Ligament, Ankle ; diagnostic imaging ; injuries ; surgery ; Male ; Mechanical Phenomena ; Prognosis ; Radiography ; Reconstructive Surgical Procedures ; methods

Objective To investigate the protective effect and mechanism of active vitamin D3 on podocyte injury in type 1 diabetic rats.Methods Animals were randomly divided into normal control group (NC group),diabetic nephropathy group (DN group),diabetes nephropathy plus active vitamin D3 group (DN + VD group).Random tail vein blood glucose was measured and 24 hours of urine was collected every 3 weeks to observe the dynamic changes of blood glucose and 24-hour urine volume and urinary albumin.Rats were sacrificed at the end of 18th week,the kidney weight to body weight ratio,serum creatinine,blood urea nitrogen,serum calcium,and serum phosphorus levels were measured.Pathological in glomeruli were observed by PAS staining.Immunohistochemistry and Western blotting were used to observe the expression of slit diaphragms proteins including Nephrin,Podocin,and vitamin D receptor protein VDR.The mRNA level of autophagy-related protein P62 was detected by realtime quantitative PCR,and expression of autophagy-related protein including LC3B/A,Beclin1,and P62 were detected by Western blotting.Ultrastructure of podocytes and autopbagosomes in podocytes were observed by electron microscopy.Results Levels of serum creatinine,blood urea nitrogen,and blood glucose in diabetic rats were higher than those in NC group (P＜0.05),but without significant difference between DN and DN+VD groups (P＞0.05).Compared with the DN group,the urinary protein and kidney weight to body weight ratio in the DN +VD group were significantly lower (P＜ 0.05).Mesangial matrix hyperplasia and basement membrane thickening were improved,and podocyte fusion and shedding were partially reversed.The expressions of Nephrin,Podocin,VDR,LC3B/A and Beclin1 were increased,and P62 mRNA and protein were down-regulated (P ＜ 0.05).The number of autophagosomes in podocytes increased.Besides,positive correlations were found between Nephrin and Beclin 1 (r =0.939 8,P＜0.05),as well as Nephrin and VDR (r=0.948 3,P＜0.05),and Beclin1 andVDR (r=0.9093,P＜0.05).Conclusion Active vitamin D3 inhibits the injury of diabetic nephropathy podocytes by up-regulating VDR expression and enhancing autophagy activity,thereby reducing proteinuria and delaying the development of diabetic nephropathy.

OBJECTIVETo measure the 96h-LC50 values of 32 substituted benzenes to the carp and to study the relationship between quantitative structure-activity and structural parameters of chemicals.

METHODSThe acute toxicity values of 32 substituted benzenes to the carp were determined in a semistatic test. The energy of the lowest unoccupied molecular orbital, and the highest occupied molecular orbital, the dipole moment and the molecular weight of substituted benzenes were calculated by the quantum chemical method MOPAC6.0.

RESULTSThe range of the toxicity of studied compounds was broad, and the most toxic compound was pentachlorophenol, while the least toxic compound was 4-methylaniline. By the stepwise regression analyses, a series of Quantitative structure-activity relationships (QSAR) equations were derived from all compounds and subclasses. The equation log1/LC5o=0.759logP + 2.222 (R2 (adj)=0.818) was found to fit well and the average predicted percentage error was 6.16%.

CONCLUSIONThe toxicity of anilines and phenols to the carp could be modeled well by logP alone, whereas the toxicity of the halogenated benzenes and nitrobenznes not containing hydroxyl or amino group can be controlled by hydrophobic and electronic factors.

1-Octanol ; chemistry ; Aniline Compounds ; toxicity ; Animals ; Benzene Derivatives ; toxicity ; Carps ; Hydrophobic and Hydrophilic Interactions ; Lethal Dose 50 ; Models, Chemical ; Molecular Weight ; Phenols ; toxicity ; Quantitative Structure-Activity Relationship ; Water ; chemistry ; Water Pollutants, Chemical ; toxicity

OBJECTIVETo preliminarily research the formular about the Traditional Chinese Medicine (TCM) syndrome of adolescent neck pain.

METHODSAn observation table of adolescent neck pain syndromes was formulated,and 1 397 patients with adolescent neck pain were investigated to establish a database of adolescent neck pain. The Descriptive Statistical Analysis and Hierarchical Cluster Analysis were performed by statistical software.

RESULTSTotally 60 TCM symptoms was clustered into 4 TCM syndromes by Hierarchical Cluster Analysis. The expert panel of TCM syndromes preliminarily formulate 4 TCM syndromes of adolescent neck pain by analyzing the result of Cluster Analysis and discussing their clinical experience.

CONCLUSIONAdolescent neck pain is a category of Tendon Trauma's Bi-syndrome of TCM. Ying, Wei, Qi and blood block caused by exopathy, strains, and internal injury is considered as the main pathogenesis of adolescent neck pain. Base on statistical result and expert's opinions, 4 TCM syndromes about adolescent neck pain were formulated: cold-dampness syndrome, dampness-heat blockage syndrome, liver-stagnation and spleen-deficiency syndrome, Qi and Yin deficiency of both heart and kidney syndrome.

Adolescent ; Adult ; China ; epidemiology ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Neck Pain ; diagnosis ; epidemiology ; Young Adult