OBJECTIVETo explore the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) combined with infusion of propofol in anodynia bronchoscopy.

METHODSNinety patients who received selective bronchoscopy were randomized into a group of compound TEAS with infusion of propofol (group A), a group of compound fentanyl with propofol (group B) and a group of simple propofol (group C). In group A, the plaster electrode stimulation was applied at bilateral Hegu (LI 4), Laogong (PC 8), Neiguan (PC 6) and Waiguan (TE 5). The anesthesia was induced after 20 min of stimulation till the end of examination. In group B and group C, the electric stimulation was not adopted. In group B, before anesthesia, fentanyl 1 microg/kg was injected intravenously. Afterwards, the intravenous infusion of propofol was used in the the three groups for anesthesia. The mean arterial pressure (MAP), heart rate (HR), saturation of pulse oximetry (SpO2) and respiratory rate (RR) were recorded at different time points. The induced dosage and total dosage of propofol, examination time, the awakening time and adverse reactions were observed in the patients of each group.

RESULTSThe difference in examination time was not significant among the three groups (P > 0.05). The postoperative awakening time in group A was earlier than that in group B and group C [(220.3 +/- 110.5) s vs (285.6 +/- 109.4) s, (290.1 +/- 105.1) s, both P < 0.05]. The total dosage of propofol in group C was larger than those in group A and group B [(288.5 +/- 26.7) mg vs (225.1 +/- 30.2) mg, (230.4 +/- 29.3) mg, both P < 0.05]. The induced dosage in group C was larger than those in group A and group B [(193.7 +/- 42.3) mg vs (152.3 +/- 36.1) mg, (155.4 +/- 40.5) mg, both P < 0.05]. Every life physical sign in group A during examination was more stable as compared with that in group B and group C. The incidence of hypotension and bradycardia in group A were lower than those in group C [3.3% (1/30) vs 26.7% (8/30), 0% (0/30) vs 20.0% (6/30), both P < 0.05]. The adverse incidence of oxygen supply in group A was lower than that in group B [6.7% (2/30) vs 33.3% (10/30), P < 0.05]. Intraoperative awareness and improper memory did not happen in postoperative investigation.

CONCLUSIONIn the transcutaneous electrical acupoint stimulation combined with infusion of propofol in anodynia bronchoscopy, the physical sign of patient is stable with less adverse reactions. This method reduces anesthetic dosage and shortens the postoperative awakening time, which can be effectively applied in bronchoscopy.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Analgesia ; Anesthetics, Intravenous ; administration & dosage ; Bronchoscopy ; Female ; Humans ; Male ; Middle Aged ; Pain Management ; Propofol ; administration & dosage ; Transcutaneous Electric Nerve Stimulation

Objective To explore the extent of agreement between measurements of temporal and spatial gait parameters made with portable gait analysis equipment and in the laboratory.Methods Fifteen healthy young people submitted to laboratory gait analysis using 3D motion analysis apparatus and then on the same day to analysis using the Gait Watch portable apparatus.Cadence,stride length,walking speed and step length were recorded.Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to evaluate the agreement between the two gait analyses.Results Test-retest comparisons with the Gait Watch apparatus generated ICCs for the temporal and spatial parameters ranging between 0.80 and 0.98,indicating good test-retest reliability.Bland-Altman plots comparing the two measurement systems also showed good agreement.According to paired simple t tests,the stride length,walking speed,and step length assessments with the two systems showed significant differences.All exceeded the minimum detection threshold (stride length =0.05 m,walking speed =0.12 m/s,left step length =0.03 m,right step length =0.04 m).Conclusions Measurements of cadence,stride length,walking speed and step length with the two systems yield acceptable agreement,and either can be used in clinical walking assessment.

Objective: To construct subtracted cDNA libraries of stomach tumors and normal stomach tissue using suppression subtractive hybridization(SSH).Methods: cDNA Library subtraction was performed using the protocol described in the Clontech PCR-Select cDNA Subtraction Kit. cDNA was synthesized from 2 μg of poly A+RNA from the tumor and normal tissues using AMV reverse transcriptase. The tester and driver cDNAs were digested with RsaⅠ, a four-base-cutting restriction enzyme that yields blunt ends. The tester cDNA was then subdivided into two portions, and each was ligated with different cDNA adaptor. Two hybridizations were performed. In the first, an excess of driver was added to each sample of tester. Hybridization kinetics led to equalization and enrichment of differentially expressed sequences. During the second hybridization, the two primary hybridization samples were mixed together without denaturing and thus the templates were generated from differentially expressed sequences for PCR amplification. Using suppression PCR, only differentially expressed sequences were amplified exponentially and after second PCR amplification the background was reduced and differentially expressed sequences were further enriched. The cDNAs were then directly inserted into a T/A cloning vector to generate a stomach tumor-specific subtracted cDNA library. Results: The amplified library contained 800 positive clones. Plasmid inserts were PCR amplified and showed 250－700 bp inserts. Conclusions: The successfully constructed subtracted cDNA library of gastrocarcinoma and normal tissue enables us to compare two populations of mRNA and obtain clones of genes that expressed in one population but not in the other.The characterization of these genes will allow them to be exploited for their diagnostic and therapeutic potentials.

[ABSTRACT]AIM:Tostudytherelationshipbetweenhuman8-oxoguanineglycosylase1(hOGG1)gene Ser326Cys polymorphism and severity of coronary artery lesions in the patients with diabetes mellitus .METHODS: We retrospectively analyzed 323 patients with diabetic mellitus receiving coronary angiography .These patients underwent the test of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and were divided into Cys/Cys genotype (n=85), Ser/Ser genotype (n=121) and Ser/Cys genotype (n=117) according to the results of PCR-RFLP. All clinical data including history of diseases , complications and biochemical markers , such as blood glucose , blood lipids and so on, were recorded.hOGG1 mRNA and 8-hydroxydeoxyguanosine (8-OHdG) were measured by RT-PCR and ELISA, respectively.The results of coronary angiography such as number and severity of coronary artery with lesions were analyzed by 2 cardiovascular physicians .Gensini score and SYNTAX score were also detected by the unitary criteria .RE-SULTS:(1)8-OHdG in Cys/Cys genotype was higher than that in Ser /Ser genotype and Ser/Cys genotype (P<0.05), but there was no statistical difference between Ser /Ser genotype and Ser/Cys genotype (P>0.05).(2)hOGG1 mRNA ex-pression in Cys/Cys genotype was lower than that in Ser/Ser genotype and Ser/Cys genotype (P<0.05), and no statistical difference between Ser/Ser genotype and Ser/Cys genotype (P>0.05) was observed.(3)The probability of triple vessel lesions in Cys/Cys genotype was high and the probability of single vessel lesions in Ser /Cys genotype was low , but the difference among 3 genotypes was not statistically significant (P>0.05).(4)Gensini score and SYNTAX score in Cys/Cys genotype were 48.7 ±15.3 and 39.5 ±17.2, respectively, and the ratio of complex lesions in Cys/Cys genotype was 73.0%.These scores and the ratio of complex lesions were higher than the other 2 genotypes (P<0.05), and no statisti-cal difference between Ser/Ser genotype and Ser/Cys genotype was observed (P>0.05).CONCLUSION:hOGG1 gene Ser326Cys polymorphism has relationship with coronary artery lesions in the patients with diabetes mellitus and Cys /Cys genotype might have some impacts on the severity of lesions .The mRNA expression of hOGG1 in the patients with diabetes mellitus carrying Cys/Cys genotype is lower than that in the patients carrying the other 2 genotypes , then decreases the abil-ity of identification and removal of 8-OHdG and the capacity of repairing DNA oxidative damage , and accelerates the devel-opment of atherosclerosis .

Objective To evaluate roles of color doppler echocardiography(CDE)and angiocardiography(ANGI)in diagnosis of children's combined with congenital heart diseases(CHD).Methods From Jan.2006 to Jun.2008,31 children with combined with CHD underwent not only CDE but also ANGI.Of those,18 cases were subjected to surgical operation.Main diagnosis and concomitant cardiovascular malformations derived from CDE and ANGI,operative findings as well,were compared.Results In 18 cases undergoing surgery,diagnosis of 15(83.33%)cases from CDE and 17(94.44%)cases from ANGI were in line with the operative findings.Of intracardiac malformations,diffe-rences between CDE and ANGI were:CDE diagnosed 1 case with pulmonary atresia /ventricular septal defect(PA/VSD)as persistent truncus arteriosus(PTA),2 cases with tetralogy of Fallot(TOF)as PA/VSD by mistake,and 1 case with partial anomalous pulmonary venous connection(PAPVC)was suspected by CDE but missed by ANGI,all above mentioned confirmed by sugery;except main diagnosis,CDE missed atrial septal defect(ASD),anomalous origin of right coronary artery and single left coronary for 1 case,respectively.In diagnosing extracardiac abnormal structures:1 case of interrupted aortic arch(IAA)was suspected by CDE but diagnosed and classified by ANGI;for double aortic arch(DAA),pulmonary arteriovenous fistula(PAVF),patent ductus arteriosus(PDA)and absence of right pulmonary artery,1 case of each was missed by CDE;furthermore PDA reported by CDE but not found by ANGI in 4 cases with PA/VSD.Conclusions The diagnostic difference between CDE and ANGI mainly lies in extracardiac malformations including coronary arteries.In diagnosing combined CHD,combination of CDE and ANGI can improve accurate rate.J Appl Clin Pediatr,2009,24(1):44-45

OBJECTIVETo observe the therapeutic efficacy of Qianggu Granule (QGG), Diacerein Capsule (DC), and QGG + DC in treating knee osteoarthritis (KOA, belonging to Gan-Shen insufficiency induced vein stasis syndrome), and to explore the clinical advantages of QGG + DC.

METHODSNinety patients in line with the diagnosis standard were randomly assigned to three groups, i. e., the QGG group (30 case, treated by QGG), the Western medicine treatment group (30 case, treated by DC), and the combination therapy group (30 case, treated by QGG +DC). Then the patients' symptoms and signs were scored. Meanwhile, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), tumor necrosis factor alpha (TNF-alpha), comprehensive efficacy, and adverse reactions, etc. were assessed.

RESULTSThe ache could be obviously alleviated, the patients' joint function could be improved, and their quality of daily activities could be elevated in all the 3 groups. There was statistical difference in the symptoms and signs scores, CRP, ESR, and TNF-alpha before and after treatment (P < 0.05). Better effects were obtained in the combination therapy group (P < 0.05). As for the comprehensive efficacy, it was better in the QGG + DC group than in the QGG group and the DC group, showing statistical difference (P < 0.01).

CONCLUSIONSThe comprehensive therapeutic efficacy of applying QGG + DC in treating KOA (belonging to Gan-Shen insufficiency induced vein stasis syndrome) was superior to using QGG or DC alone. Besides, no obvious adverse reaction occurred.

Adult ; Anthraquinones ; therapeutic use ; Blood Sedimentation ; C-Reactive Protein ; analysis ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; Phytotherapy ; Tumor Necrosis Factor-alpha ; analysis

OBJECTIVETo examine the protective effect of Ginkgo biloba leaf extract (GbE) on learning and memory deficit induced by aluminum chloride (AlCl(3)), and explore its mechanisms.

METHODSThe rat models with learning and memory deficit were induced by administering via gastrogavage and drinking of AlCl(3) solution. And the model rats were treated with GbE at the dose of 50, 100, 200 mg/kg every day for 2 months accompanied with drinking of AlCl(3) solution, respectively. Their abilities of spatial learning and memory were tested by Morris water maze, and the acetylcholinesterase (AChE) activity in serum was assayed with chemical method, the AChE expression in hippocampus was observed by immunohistochemistry assay, and then quantitative analysis was done by BI 2000 image analysis system.

RESULTSLearning and memory deficit of rats could be induced by AlCl(3) solution (P < 0.01), and AChE expressions in rats hippocampus were increased (P < 0.01); GbE ameliorated learning and memory deficit and reduced AChE expression in rats hippocampus in a dose-dependent manner, while GbE significantly increased serum AChE activity at the dose of 200 mg/kg each day (P < 0.05).

CONCLUSIONGbE can ameliorate learning and memory deficit induced by AlCl(3), which may be due to its inhibition of the AChE expression in hippocampus.

Acetylcholinesterase ; metabolism ; Aluminum Compounds ; toxicity ; Animals ; Chlorides ; toxicity ; Dose-Response Relationship, Drug ; Ginkgo biloba ; Hippocampus ; enzymology ; Immunohistochemistry ; Male ; Maze Learning ; drug effects ; Memory Disorders ; chemically induced ; prevention & control ; Neuroprotective Agents ; therapeutic use ; Phytotherapy ; Plant Extracts ; therapeutic use ; Plant Leaves ; Plant Structures ; Rats ; Rats, Wistar ; Reaction Time

Objective to determine predictive factors of intestinal obstruction in acute myocardial infraction (AMI) patients after primary percutaneous coronary intervention (PCI) and to establish predictive model.Methods A total of 1220 AMI patients underwent primary PCI in Jiangxi provincial people's hospitalfrom June2004 toJune 2014were retrospectively analyzed.And 1025 cases of them whichall met the inclusion and exclusion criteriawere randomlydivided by using random number generated by SPSS 17.0 into two cohorts:model derivation cohort (MDC) and model validation cohort (MVC).MDC was divided into intestinal obstruction group and control group.predictive factors were identified using univariable andmultivariable logistic regression analysis in MDC.Interger point values were assigned to each predictor based upon their coefficient in multivariable logistic regression model to establish scoring model.The summed scores of each case in MVC were calculated to test predictive ability of the model by ROC cure.Results Total of 1 025 patients,103 patients were diagnosed with different types of intestinal obstruction and the incidence of intestinal obstruction was 10.0％.Low position intestinal obstruction,incomplete intestinal obstruction and simple intestinal obstructionwere main characteristics in these patients.logistic regression analysis identified ten risk factorscan predict the appearance of intestinal obstruction:age ＞ 65years old (OR =1.44,95％ CI:1.26-4.63,P =0.000),diabetes mellitus (OR =3.37,95％ CI:2.39-9.47,P =0.000),habitual constipation (OR =4.75,95 ％ CI:3.58-11.24,P =0.024),inferior and extensive anterior wall myocardial infarction (OR =2.16,95％ CI:1.94-4.79,P =0.017),cardiac functiongrade≥3 class (Killip classification) (OR=2.86,95％CI:1.98-5.67,P=0.002),femoral approach (OR=2.76,95％CI:1.38-6.12,P=0.002),K+ ＜3.5 mmol/L (OR=1.86,95％CI:1.11-5.47,P =0.005),taking laxative (OR =3.59,95％ CI:2.99-10.21,P =0.000),using morphine (OR =1.98,95％ CI:1.07-3.12,P =0.021) and estimated glomerular filtration rate (eGFR) ＜60 mL · min-1 · 1.73m-2 (OR =1.19,95％ CI:1.10-3.22,P =0.031).and areas under the ROC cure was 0.815 (95％ CI:0.802-0.883,P =0.000) and indicating the accuracy of predicting intestinal obstruction.Conclusions age ＞ 65 years old,diabetes mellitus,habitual constipation,inferior and extensive anterior parts of myocardial infarction,cardiac functiongrade ≥3class (Killip classification),femoral approach,K + ＜3.5mmol/L,taking laxative,using morphine and eGFR ＜ 60 ml.min-1.1.73m2 were important predictive factors for intestinal obstruction in AMI patients after underwent 0 and the scoring model can predict accurately intestinal obstruction in such patients.

Computed tomography (CT) is considered the most sensitive method for the detection of intraocular foreign bodies (IOFBs).The purpose of this study was to evaluate a new method of 3-dimentional (3D) localization of IOFBs that takes advantage of the anatomical structure of the optic nerve and to assess the clinical outcomes using this new method.Twenty-two trauma patients with IOFBs or suspected IOFBs admitted to our hospital were scanned with multislice CT (MSCT) between July and December 2003.All scanning was performed with a 16-row spiral CT in axial plane using a sequential scanning protocol.During the scanning,the eyeball of the patient was kept stable and was not allowed to rotate internally or externally.Section collimation was set at 16 mm × 0.75 mm.Table feed was 12 mm.Reconstruction index was 0.75 mm.After scanning,the reconstructed images were loaded into a workstation to create the multiplanar reconstruction images with the aid of the 3D software.We compared the localization results with the operative findings.Multiplanar reconstruction images showed IOFBs in all 22 patients.IOFBs occurred in the eyeball of 14 patients,in the wall of the eyeball of 5 patients and in the posterior orbits of 3 patients.Different surgical procedures were designed according to the localization by this new method and all IOFBs were successfully removed.All of these foreign bodies were metallic and the localization of IOFB using MSCT was consistent with that found by operative findings.It was suggested that MSCT is a simple and effective imaging modality for the localization of IOFBs.In our study,we localized the IOFBs more quickly and accurately by taking advantage of the fixed position of the intraocular segment of the optic nerve,and determined the necessary surgical parameters.

Hepatolenticular degeneration was one of the rare several genetic metabolic diseases in clinic that could be cured by liver transplantation method, developing slowly and being irreversible. Metabolic disorders of copper lead to abnormal copper accumulation in various of tissues and organs. So that, the disease′s clinical manifestations were lacking in specificity and many patients missed the best opportunity of drug treatment. With the maturity of technologies and innovation of theory of liver transplantation, there were more and more methods that will be applied to personalized treatment. In this paper, a review of the research progress in the treatment of hepatolenticular degeneration with liver transplantation was made with reference to the relevant literature at home and abroad.