Surgery is the main treatment for Cushing's syndrome.The disturbed metabolic consequences such as prolonged exposure to excessive glucocorticoid,high glucose and hypertension will add the risks and difficulties to surgery.This paper reviews the perioperative glucocorticoid replacement,correction of the hypercotisolaemia before operation,and prevention of complications after operation.

Objective To evaluate the effect of crisis prediction score nursing in reducing complication and nursing deficiencies in patients with myasthenia gravis complicated with thymoma.Methods 46 patients were randomly divided into the study group and the control group,the study group was given with crisis prediction score nursing,the control group was given with individual nursing.The postoperative complications incidence,hospitalization time,nursing defect rate,patient satisfaction were compared between two groups,and Osserman efficacy evaluation was implemented.Results Compared with the control group,postoperative complications (hemorrhage,pneumothorax,respiratory tract infections and myasthenia gravis crisis)rates and nursing defect rate in the study group were lower,hospitalization time shortened,and patients' satisfaction degree increased.Conclusions The crisis prediction score care can significantly reduce postoperative complications and nursing defect rate,which is important for patients' health.

0.05).But only 23 lesions(38.3%)showed high signal on T1WI.Conclusion:This research confirmed the MRI-guided HIFU equipment is useful to monitor the HIFU treatment and evaluate the curative effect accurately,which provids a basis for the latter treatment of liver tumors.

Child ; Humans ; Urolithiasis ; diagnosis ; therapy

Tamoxifen has shown definitive effect when used as the adjuvant hormonal treatment in women with estrogen-receptor-positive breast cancer. However, long-term use of Tamoxifen can induce fatty liver disease. It has been proposed that tamoxifen may act throught mechanisms such as inducing triacylglycerol accumulation in mitochondria, abnormal fatty acid oxidation, and antagonizing actions of estrogen on hepatic lipid metabolism. Therefore, it is necessary to monitor lipid profile and liver function, conduct regular ultrasonography and CT examination in patients receiving tamoxifen treatment. Replacing tamoxifen with toremifene oraromatase inhibitors, or using lipid-lowering medicines may help prevent tamoxifen-induced fatty liver disease.

Eisenmenger syndrome (ES) was considered as a surgical contraindication in the past time. Only a few patients got lung transplantations or heart-lung transplantations due to lack of donors. Most of the patients had to choose conservative treatment to prolong their survival time. Recently, some clinical trials indicated targeted therapies in pulmonary arterial hypertension (PAH) were effective for the treatment of ES. This article reviewed the recent advances in this area.

Objective To investigate the role of platelet-derived growth factor-β receptor (PDGFR-β) in self-renewal of neural stem cells (NSCs).Methods In this study,NSCs of subventricular zone were isolated and cultured from PDGFR-β knockout (PDGFR-β-/-) mice of postnatal day 1 (P1) and P28;the number and diameters of secondary neurospheres were calculated;using 5-bromo-2-deoxyuridine (BrdU) incorporation assay and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay,cell proliferation and survival rates were analyzed;gene expression profiles were determined by PCR-array analyses;the effect of brain-derived neurotrophic factor (BDNF) on secondary neurospheres formation was examined in these cells.Results In PDGFR-β-/-NSCs,stem cell activities,such as number (/well;P1:25.9±1.3vs117.6±3.6,t=4.236,P＜0.01;P28:13.8± 0.7vs 19.8±0.6,t=2.116,P＜0.01)and diameters (μm;P1:67.7±1.9 vs 69.1 ±2.0,t=3.211,P＜0.01;P28:33.4±0.8vs37.8±0.8,t=2.354,P ＜0.01) of secondary neurospheres,cell proliferation (％;P1:73.3 ± 2.7 vs 88.7 ± 3.6,t =2.773,P ＜ 0.05;P28:28.6 ± 9.6 vs 68.2 ± 4.5,t =6.302,P ＜ 0.05) and survival rates (％;P1:14.5 ±2.1 vs 9.3 ± 1.3,t =7.222,P ＜ 0.05),were significantly lower as compared with age-matched controls.In comparison of the same genotypic NSCs,the decrease of secondary neurosphere formation was more striking in P28 NSCs than in P1 NSCs.PCR Array analyses demonstrated that expressions of fibroblast growth factor2 and BDNF were decreased (-2.04 ± 0.25,t =2.653,P ＜ 0.05;-3.24 ± 0.37,t =1.324,P ＜ 0.05),and Noggin (2.31 ± 0.37,t =2.749,P ＜ 0.05) was increased in P1 PDGFR-β-/-NSCs as compared with P1 controls.Addition of BDNF rescued the number and diameter of secondary neurospheres in P1 PDGFR-β-/-NSCs to similar levels as controls.Conclusions PDGFR-β signaling may play a role in the selfrenewal and proliferation of NSCs.BDNF may be involved in the effects of PDGFR-β signaling in these cells.

Objective To explore the effect, safety and value of propofol combined with fentanyl in painless gastrointestinal endoscopy.Methods 1 200 patients were collected and divided into normal group and painless group,600 cases in each group.Normal gastrointestinal endoscopy was performed on unanesthetic patients,while painless gastrointestinal endoscopy was operated on anesthetic patients with Propofol and Fentanyl.The safety and clinical effect were compared between the two groups.Results 1 200 cases of patients were able to complete the gastrointestinal endoscopy examination successfully with no serious side effects.Compared with normal gastrointestinal endoscopy,the patients undergoing painless gastrointestinal endoscopy examination guaranteed more comfortable experiences,suffering less pain and side effects.The differences were significant between the two groups (all P < 0.05 ).Conclusion Propofol combined with fentanyl in painless gastrointestinal endoscopy was a safe,effective and painless process and was worthy of promoting widely.

Objective To study the flurbiprofen axetil (FA) for postoperative analgesia of gynecological laparoscopic surgery and the changes of interleukin-6 in blood.Methods80 cases were selected for gynecologic laparoscopic surgery,the patients were randomly divided into 4 groups with 20 cases each group.Group A was given FA 50 mg and tramadol 1 mg/kg 30 minutes before the end of surgery.Group B was given FA 50 mg 5 minutes before induction of anesthesia and given tramadol 1 mg/kg 30 minutes before the end of surgery,and group C was given FA 50 mg five minutes before induction of anesthesia.Group D was given tramadol 2 mg/kg 30 minutes before the end of surgery.After the surgery,the VAS was observed in real-time of wake up (T1),and 2 hours (T2),6 hours (T6) and 24 hours (T24) after operating.The blood of each group was taken at the different time points including arriving in the room (T0),waking up (T1) and 6 hours (T6) after operating.The blood samples were hold for 30 minutes and centrifuged (3000 r/min,10 min),and IL-6 was detected using double-antibody sandwich ABC-ELISA.ResultsThe experiments showed that VAS in T1 time point of group A,B,C were lower than that of group D(1.40±0.26,1.67±0.37,1.60±0.42 vs 3.13±2.32).In T24 time point,VAS of group A,B were also lower than that of group D(2.13±1.24,2.00±1.25 vs 3.53±1.87),the differences were significant (P＜0.05).The experiments showed that concentration of IL-6 in group D was higher than that in group A,B,C at the T1 time point (12.26±6.56 vs 2.94±2.55,3.37±2.43 vs 2.93±1.16,P＜0.05).ConclusionsThe postoperative analgesic effect of Flurbiprofen axetil combined with tramadol on the ogynecological laparoscopic was superior to using any of the drug alone.Flurbiprofen axetil could inhibit increasing of IL-6 and have an effect against the inflammatory response induced by surgical trauma,and it has a good analgesic effect.

Objective To investigate the effect of isoflurane preconditioning on Bcl-2 and Bax mRNA expression and the signaling pathway of nitric oxide against brain ischemia-reperfusion(I/R).Methods Seventy-five male gerbils were randomly divided into 5 groups(n=15):SHAM,I/R,ISO,AG+ISO and AG group.Global cerebral I/R was produced by occlusion of bilateral common carotid arteries for 5 minutes and confirmed by isoelectric potential on EEG.In ISO group,the animals inhaled 1.2%-1.5% isoflurane for 30 minutes followed by 30 minutes wash-out period before I/R.In AG+ISO group,30 minutes after aminoguanidine,200 mg/kg i.p.isoflurane was inhaled as ISO group,and aminoguanidine was injected 30 min before I/R in AG group.After 24 hours,the forebrains were collected,and the expression of Bcl-2 and Bax mRNA was determined by reverse transcriptase polymerase chain reaction.Results Bcl-2 mRNA expression in ISO group(1.22±0.12) was significantly higher than that in sham(0.83±0.16),I/R(0.83±0.11) and AG+ISO group(0.82±0.12)(P<0.05).Bax mRNA expression in I/R and AG group was significantly higher than that in sham group(P<0.05),and the expression in ISO group was higher than that in AG+ISO group.Conclusion Nitric oxide is involved in the signaling pathway of isoflurane preconditioning and has the protection effect on gerbil brain against I/R.