Objective A 23-year-old female patient who had a past history of sexual - precocity and fracture developed hyperhyroidism 8 months ago. Radiological examination revealed enlargement of sella turcica and a adrenal gland nodule. The patient was diagnosed to have McCune -Albright syndrome and scheduled for resection of left subtotal adrenalectomy under general anesthesia. The patient was taking (1) thiamazole 5 mg t. i. d. and propranolol 10 mg q. d. for hyperthyroidism; (2) adalat 10 mg t. i. d. and potassium citrate 20 ml t. i. d. for Cushing syndrome and (3) calcium tablets for osteoporosis. Anesthesia was induced with intravenous midazolam 1 mg, fentanyl 50 ?g and vecuronium 1 mg followed by propofol 150 mg and succinyl choline 100 mg. The patient was intubated and mechanically ventilated (VT = 500 ml, RR =10 bpm, I: E = 1 :2) . PET CO2 was maintained between 35 - 45 mm Hg. Anesthesia was maintained with inhalation of isoflurane and N2O - O2 (1:2) and intermittent i.v. boluses of fentanyl and vecuronium. The BP was increased to 180/110 mm Hg after induction of anesthesia. Urapidil 10 mg was given intermittently i.v. During the exploration of adrenal gland BP was again increased to 200/140 mm Hg. Nitroglycerin was infused i.v. and BP was decreased to 120-130/80-90 mm Hg and was kept at this level till the end of operation. Hydrocortisone succinate 100 mg was infused i.v. slowly after operation. The operation went smoothly. The patient was extubated and the postoperative course was uneventful.

Object To develop a method for the determination of palmatine hydrochloride and berberine hydrochloride in Chinese Mahonia Stem from different habitats Methods HPLC method was set up, using Intersil ODS 3 C 18 column, the mobile phase was acetontrile water sodium laurylsulfonate (470∶ 530∶1 g), the UV detection wavelength was 265 nm, with a flow rate of 1 0 mL/min at 40 ℃ Results A good linearity was obtained in the range of 4 368 52 416 ?g/mL(r=0 999 9) for palmatine hydrochloride and 4 532 54 384 ?g/mL (r=0 999 9) for berberine hydrochloride The average recovery of palmatine hydrochloride and berberine hydrochloride was 98 97% and 98 98%, respectively Conclusion The method is simple, rapid and with better reproducibility for the determination of palmatine hydrochloride and berberine hydrochloride in Chinese Mahonia Stem

Objective To study the epidemiological characteristics of Hand-Foot-Mouth Disease of chil-dren in Zhongshancity from 2011 to 2015 and provide etiological evident for the prevention and control of Hand -Foot -Mouth Disease of children in Zhongshan city. Methods We analyzed the data of children with Hand-Foot-Mouth Disease in Zhongshan Boai 's Hospital from 2011 to 2015. The enterovirus nucleic acid of Hand-Foot-Mouth Diseaseof children were detected. Results Atotal of 31164 cases of Hand-Foot-Mouth Disease were diagnosed in Zhongshan Boai′s Hospital during 2011-2015,the ratio of male to female was 1.62:1. Every year,the peak inci-dence of the disease is not the same. During 2011-2015,there were 10147 cases of Hand-Foot-Mouth Diseaseof children,among which,through viral nucleic acid EV71and CoxA16testing,2062 cases were positive and the positve rate was 20.32%. Pathogen of Hand-Foot-Mouth Diseasewas mainly based on EV71 in 2011,2012, 2013and2015,accounting for the total positive rate of 79.04%,72.46%,81.60%,73.73%respectively;Pathogen of Hand -Foot -Mouth Diseasewas mainly based on Cox16 in 2014,accounted for 54.47% of the total positive. In different years EV71 and CoxA16 positive rate was significant different.There were 1982 cases repeated Hand-Foot-MouthDiseaseinfectioins .Conclusion The incidence of Hand-Foot-Mouth Disease of children is related to age , sex and season in Zhongshan city. It is mainly based on clinical diagnosis ,the preventive measures and the clinical recognition in time to provide help for the treatment and control of Hand-Foot-Mouth Disease of children.

Objective To investigate the relationship between the C161T polymorphisms in peroxisome proliferators-activated receptor γ (PPARγ) gene and atherothrombotic infarction (ATI) in a Chinese Han population.Methods The patients with atherothrombotic infarction and controls,who without histories of stroke,transient ischemic attack and myocardial infarction were enrolled.Genotypes of the PPARγ C161T polymorphisms were determined using the polymerase chain reaction-restriction fragment length polymorphism.The frequencies of genotype and allele in patients with ATI and controls were compared.Results A total of 112 ATI patients and 112 controls were enrolled.There were no significant differences in the age (67.9± 11.73 years vs.66.5 ± 10.35 years; t =0.386,P =0.701) and the proportion of male (61.61％ vs.58.04％ ;x2 =0.297,P =0.586) in the ATI group and the control group.The proportions of hypertension (59.82％ vs.44.62％ ;x2 =5.171,P =0.023),type 2 diabetes mellitus (26.79％ vs.9.82％;x2 =10.778,P =0.001) in the ATI group were significantly higher than those in the control group.Body mass index (25.13±1.86 kg/m2 vs.24.11 ± 1.81 kg/m2; t =3.543,P=0.001),systolic pressure (158.84 ± 20.15 mm Hg vs.135.82 ± 19.58 mm Hg; t =7.350,P =0.000),diastolic pressure (76.90 ± 13.64 mm Hg vs.68.90 ± 8.52 mm Hg; t =4.374,P =0.000) and the level of fasting blood glucose (6.523 ± 2.831 mmol/L vs.5.706 ± 2.177 mmol/L; t =2.026,P =0.044) in the ATI group were significantly higher than those in the control group.The genotype frequencies of CC,CT and TT in the ATI group were 77.7％,17.0％ and 5.4％,respectively,and in the control group were 69.6％,22.3％ and 8.0％,respectively.There were no significant difference between the two groups (x2 =1.909,P =0.385).The allele frequencies of C and T in the ATI group were 86.2％ and 13.8％,respectively,and in the control group were 80.8％ and 19.2％,respectively.There were no significant difference between the two groups (x2 =2.331,P =0.127).Conclusions PPARγ C161T polymorphisms may be not associated with the onset of ATI in a Chinese Han population.

Objective To investigate the predictive values of the pulsatility index detected by transcranial Doppler (TCD) and serum neuron-specific enolase (NES) in patients achieved return of spontaneous circulation after cardiopulmonary resuscitation (CPR). Methods The patients with CPR restoration of spontaneous circulation who were still in coma were divided into survival group and death group. TCD monitoring and serum NSE detection were performed at 48 hours after CPR restoration of spontaneous circulation. Receiver operating characteristic (ROC) curves were used to evaluate the predictive values of the pulsatility index detected by TCD and serum NES in patients after successful CPR. Results Seventy patients were collected, 32 patients (19 males and 13 females) in the survival group, age 54. 63 ± 13. 28 years; 38 patients (22 males and 16 females) in the death group, age 58. 00 ± 13. 15 years. There were no significant differences in age and gender between the survival and death groups. The pulsatility index was 1. 217 + 0. 352 in the death group, and it was significantly higher than 0.841 +0. 163 in the survival group; the serum NSE content was 130. 968±59.634 ng/ml in the death group, and it was signiflcantly higher than 49. 465 ± 26. 864 ng/ml in the survival gronp (P＜0. 01). When the pulsatility index was used to predict the death of patients, the ROC area under the curve was 0. 794 (P=0. 000,95% confidence interval [CI] O. 679-0. 908);when the cutoff value was 1. 110, the sensitivity was 68.4%, the specificity was 100%,positive predictive value was 100%, and negative predictive value was 72. 7%. When serum NSE level was used to predict the death of the patients, the ROC area under the curve was 0. 756 (P= 0. 000, 95% CI 0. 672-0. 885); when the cutoff value was 56. 502 ng/ml, the sensitivity was 80. 8%, the specificity was 65. 4%, positive predictive value was 82. 5%, and negative predictive value was 76. 6%. Conclusions The pulsatility index detected by TCD and serum NSE content can be used as predictors in patients achieved return of spontaneous circulation after CPR.

Objective Candidas rank as the second factor of deep fungal infection .This study aimed to investigate the rela-tionship between Candidas and melanin by screening clinically isolated melanin -producing Candidas . Methods We incubated 360 strains of clinically isolated Candidas with caffeic acid , DOPA agar , and minimal medium at a temperature of 35℃, with Cryptococcus neoformans as the positive control .We observed the changes in the culture media using transmission electron microscopy (TEM) and electron spin resonance ( ESR) spectroscopy . Results Cryptococcus neoforman produced pigmentation in all the three types of medi -um.At 5 days, a standard strain of Candida albicans SC 5314 turned dark brown in the DOPA agar and minimal medium and , at 10 days, 12 and 15 of the 360 Candida strains turned dark brown in the DOPA agar and minimal medium , respectively, which were not shown to be melanin by TEM and ESR spectroscopy . Conclusion Culture media are not reliable enough for the identification of mel-anin-producing Candidas , and the observations need to be further verified by TEM and ESR spectroscopy .

Objective To evaluate the effects of different sequences of intravenous administration on fentanyl-induced cough during induction of general anesthesia.Methods One hundred patients of both sexes,aged 18-70 yr,weighing 42-88 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were equally randomized to 2 groups using a random number table:fentanyl-propofol group (group FP) and propofol-fentanyl group (group PF).In FP group,fentanyl 3 μg/kg was injected intravenously over 3 s,and then propofol 1.5 mg/kg was injected intravenously.In PF group,propofol 1.5 mg/kg was injected intravenously,and then fentanyl 3μg/kg was injected intravenously over 3 s.The development,intensity and onset time of cough were recorded within 1 min after fentanyl injection.Results Compared with FP group,the incidence of cough was significantly decreased,and no significant change was found in the intensity and onset time of cough in PF group.Conclusion Administration in the propofol-fentanyl sequence can reduce the development of fentanyl-induced cough as compared with that in the fentanyl-propofol sequence during induction of general anesthesia.

Objective Little is known about the role of low oxygen concentration in the formation of the capsule of Cryptococ -cus neoformans .This study was to investigate the effect of hypoxic condition on the capsule size of Cryptococcus neoformans . Methods We cultured 39 Cryptococcus neoformans strains in liquid Sabouraud medium and then incubated them at the normoxic (21%) and hypoxic concentration (1%), respectively.After 72 hours of incubation, we observed the capsules formed at different ox-ygen conditions under the Olympus microscope and the measured their sizes using the Axiovision software . Results Of the total number of Cryptococcus neoformans strains , 30 showed larger capsules in the normoxic than in the hypoxic condition , 17 with statisti-cally significant differences in their diameters (P<0.05), while the other 9 strains exhibited just the opposite results , 4 with statisti-cally significant differences in their diameters ( P<0.05). Conclusion Hypoxia might inhibit the growth of the Cryptococcus neoformans capsule.However, further studies are needed on its correlation with the serum or gene types of the Cryptococcus neofor-mans strain.

Objective To evaluate the topical anesthetic effects of compound lidocaine cream ( CLC) coated endo-tracheal tube on the prevention of cough/agitation during extubation in thyroidectomy under general anesthesia . Methods 42 patients scheduled for thyroidectomy in Peking Union Medical College Hospital were continuously en -rolled in this prospective double-blinded randomized controlled trial .Patients were randomized into two groups . Group L were intubated with endotracheal tube coated with CLC , while the control group , group C with liquid par-affin .The end point of study was spontaneous or induced cough /agitation during extubation .Hemodynamic parame-ters and the consumption of opioids were recorded .Patients were followed for major complications during their stay in hospital .Results Spontaneous cough/agitation rate was lower in group L than group C ( 15% vs 65%, P<0.01 );so was induced cough/agitation (35%vs 90%, P<0.001 );the value of SBP ×HR was lower in group L at 1 min after extubation ( P<0.05 ) .Conclusions The topical anesthetic effects of CLC coated endotracheal tube could prevent cough and agitation during extubation in thyroidectomy under general anesthesia .

Objective To investigate the relationship of radiation dose with the volume and late toxicity of the sternocleidomastoid muscle ( SM) in patients with nasopharyngeal carcinoma. Methods SM was divided into upper part and lower part based on the lower edge of cricoid cartilage. Patients were divided into three groups according to the prescribed dose for clinical target volume at the lower neck ( CTV2 ) ( 0, 54,60 Gy) . The dosimetric parameters included Dmean , V66 , and V60 for the upper, lower, and whole SM. SM was delineated and the volume was calculated on computed tomography images in the treatment planning system before and at 6, 12, and 18 months after treatment. The anteroposterior and transversal diameters of SM at C3?C4 , C4?C5 , C5?C6 , and C6?C7 levels were measured and recorded. Late toxicity of neck skin and SM was evaluated according to the Common Terminology Criteria for Adverse Events V4 .0 criteria. Between?group comparison was made by t?test or Kruskal?Wallis non?parametric test. Between?group comparison of the sample rate was made by one?way analysis of variance. The correlation analysis was made by Spearman correlation. Results There were significant difference in SM volume between the three time points after treatment ( P=0. 000) . At 12 or 18 months after treatment, the volume of SM wasignificantly reduced ( P=0. 000,0. 000);the reduction in SM volume was significantly correlated with V66 of the SM and the upper SM ( P=0. 015,0. 020) . At 18 months after treatment, SM fibrosis was significantly correlated with V60 of the upper SM ( P=0. 030);the fibrosis of neck skin was significantly correlated with the Dmean and V60 of the upper SM ( P=0. 029,0. 005) . Conclusions In order to prevent the incidence of the fibrosis of neck skin and SM, the dose homogeneity should be as high as possible, while the number of hot spots should be as small as possible.