China ; Esophageal Diseases ; surgery ; Humans ; Lung Diseases ; surgery ; Thoracic Injuries ; surgery ; Thoracic Neoplasms ; surgery ; Thoracic Surgery ; Trachea ; surgery

Objective To investigate the effects of goal‐directed volume therapy (GDVT )on the intracranial pressure(ICP) and the balance of cerebral oxygen consumption and supply in selective neurosurgery. Methods Twenty‐four patients sched‐uled for intracranial tumor resection were randomly divided into 2 groups:conventional fluid management group (group C ,n=12) and GDVT group(group G ,n=12). Patients in group C received introperative fluid transfusion according to classical fluid management strategies while those in group G received GDT according to stroke volume variation (SVV) ,guided by Flotrac‐Vigileo system.Mean arterial pressure(MAP) ,heart rate(HR) ,cardiac index(CI) ,ICP ,SVV and jugular bulb oxygen saturation (SjvO2 )were recorded before the anesthesia induction(T1 ) ,at the moment of intubation(T2 ) ,at the moment of opening the hard meninges(T3),1hafteropeningthehardmeninges(T4),andattheendofthesurgery(T5).Thecerebraloxygenextractionra‐tio(CERO2 )was calculated. The duration of surgery ,crystalloid volume ,colloid volume ,blood transfusion volume ,urinary output and bleeding volume were recorded as well.Results The colloid transfusion volume ,the total fluid transfusion volume and uri‐nary output were significantly increased in group G when compared with those in group C (P<0.05).MAP ,CI ,and SjvO2 were much higher and CERO2 were much lower at T4 and T5 in group G than in group C(P<0.05). There was no significant differ‐ence in the ICP at each time point between groups G and C (P>0.05).Conclusion Goal‐directed fluid therapy optimizes the cardiac preload without increasing the ICP in selective neurosurgery ,and it also improves the balance of cerebral oxygen con‐sumption and supply.

Medicare work runs throughout the whole process of military training and directly affects the quality of military training. Good preparation,medical service and preventive health care work were done to reduce the injury rate during military training from recognizing significances ,char-acteristics,rules and methods of medicare. Additional health-related military programs,targeted tech-nical and tactical training and optimization and integration of teachers are effective ways to expand the military direction,improve and enrich the content o military training.

The conception of evidence-based medicine (EMB) has a strong influence on the medical world since it built up.This concept has been widely used in all sorts of clinic and basic medical research,however,it is little reported to be practised in our fundamental medical education.As for it,this article will briefly analyze the importance of introducing the idea into fundamental medical education,and for one thing,suggest some more reform measures for medical teaching staff.

Apelin is a polypeptide consisting of 77 amino acids. Apelin receptors are found to be the angiotensin-like G protein coupled receptor (APJ). Apelin/APJ system is widely distributed in the peripheral and central nervous system. Apelin-13 is one of the subtypes of Apelin, which has strong biological activity. This study reviewed the new research prog?ress of Apelin-13 on physiological and pathological processes involved in the cardiovascular system, respiratory system, ner?vous system, digestive system and endocrine system.

Acupuncture Points ; Adult ; Aged ; Female ; Gout ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome

Acupuncture Therapy ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Gastritis, Atrophic ; therapy ; Humans ; Male ; Middle Aged

Abundant experiences have already been accumulated in treatment of stroke with acupuncture. Development of rehabilitation theory also brings unprecedented opportunity and challenge to acupuncture. Combined with the modern rehabilitation theory and practice, it is very helpful to deepen the understanding on treatment of acupuncture for cerebral apoplexy and enhance the therapeutic effect in clinic by studying the mechanism of acupuncture treatment, opportunity of intervention, selection of acupoints, needling manipulations and quantity of stimulations etc. Through analysis on the necessity and the way of combination of acupuncture and modern rehabilitation, it is concluded that rehabilitation evaluation, rehabilitation phases and obstacle analysis should be taken as references by acupuncturists to reinforce the therapeutic effect and creditability of acupuncture treatment on cerebral apoplexy.
Acupuncture Therapy ; methods ; Hemiplegia ; rehabilitation ; therapy ; Humans ; Stroke ; therapy ; Stroke Rehabilitation

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Female ; Gout ; therapy ; Humans ; Male ; Middle Aged

OBJECTIVETo study clinical efficacy of smoothing Gan reinforcing Shen (SGRS) method in treating poor response of diminished ovarian reserve (DOR) patients in in vitro fertilization and embryo, transfer (IVF-ET).

METHODSTotally 84 DOR patients undergoing IVF-ET were assigned to the experimental group (SGRS Chinese herbs as adjuvant therapy) and the control group according to random digit table, 42 in each group. Patients in the control group received controlled ovarian hyperstimulation (COH) and IVF-ET. Those in the experimental group additionally received basic formula of SGRS method, one dose per day. The dose and use time of recombinant follicle-stimulating hormone (r-FSH) were recorded during ovarian stimulation process. On the injection day of human chorionic gonadotropin (HCG) and serum levels of estradiol (E2) on the oocyte retrieval day were determined using chemiluminescent method. E2 contents in the follicular fluid on the oocyte retrieval day were detected using ELISA. The total number of retrieved oocytes, the number of mature oocytes in metaphase II (M II), the number of normal fertilization [with two pronucleus (2PN)], the number of portable embryos, and the number of good quality embryos were recorded. The correlation between Chinese medical adjuvant therapy and the aforesaid indices were observed. The clinical pregnancy rate and the abortion rate were finally compared between the two groups.

RESULTSThe total dose of r-FSH, the E2 level on HCG injection day, the serum E2 level on the oocyte retrieval day, the number of retrieved oocyte, the number of oocytes in M II the number of oocytes with 2PN, the number of portable embryos, and the number of good quality embryos were all positively correlated with Chinese medical adjuvant therapy (P < 0.05, P < 0.01). Compared with the control group, serum E2 levels on the HCG injection day and the oocyte retrieval day obviously increased, the number of retrieved oocytes, the number of oocytes in M II, and the number of portable embryos were increased more in the experimental group with statistical difference (P < 0.05, P < 0.01). There was no statistical significance in the clinical pregnancy rate or the abortion rate between the two groups (P > 0.05).

CONCLUSIONSGRS Chinese herbs as adjuvant therapy could improve ovarian responsiveness of DOR patients undergoing IVF-ET, increase the number of retrieved oocytes, elevate the quality of oocytes and the number of embryos.

Adjuvants, Pharmaceutic ; therapeutic use ; Chorionic Gonadotropin ; Drugs, Chinese Herbal ; therapeutic use ; Embryo Transfer ; methods ; Estradiol ; Female ; Fertilization in Vitro ; methods ; Follicle Stimulating Hormone ; metabolism ; therapeutic use ; Follicular Fluid ; Humans ; Medicine, Chinese Traditional ; Oocyte Retrieval ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Pregnancy ; Pregnancy Rate