OBJECTIVETo explore the impacts on EC50 in the remifentanil inhibition of tracheal intubation response by the transcutaneous electrical acupoint stimulation (TEAS) at Hegu (LI 4) and Neiguan (PC 6).

METHODSForty patients with selective surgery undergoing endotracheal intubation with intravenous general anesthesia were divided into I to II degree by the American Society of Anesthesiologists (ASA) and were randomized into an observation group and a control group, 20 cases in each one. Before general anesthesia induction, in the observation group, the transcutaneous electric stimulation was applied to bilateral Hegu (LI 4) and Neiguan (PC 6) for 30 min, with dense-disperse wave, 2 Hz/100 Hz in frequency; in the control group, the sham-stimulation was applied to the acupoints, with the lamp on, but without electric current output. Afterwards, the general anesthesia induction started. When the target concentration of propofol and remifentanil was stabilized at the preset value, the endotracheal intubation was conducted. Dixon sequential method was applied for the determination of ECs in remifentanil inhibition of tracheal intubation response.

RESULTSThe level of EC50 in remifentanil inhibition of tracheal intubation response was 3. 46 ng/mL, 95% confidence interval was 2. 80 ng/ml to 4. 27ng/mL in the observation group; those were 4. 18 ng/mL and 3. 30 ng/mL to 5. 29 ng/mL in the control group separately. The differences were significant in comparison of the two groups (P<0. 01).

CONCLUSIONTEAS apparently reduces EChe in the remifentanil inhibition of tracheal intubation response by around 17%as.

Acupuncture Points ; Adult ; Aged ; Anesthetics, Intravenous ; administration & dosage ; Female ; Humans ; Intubation, Intratracheal ; adverse effects ; Male ; Middle Aged ; Pain ; etiology ; Pain Management ; Piperidines ; administration & dosage ; Transcutaneous Electric Nerve Stimulation

Oxygen free radical, an important risk factor for cerebral infarction, plays an important role in the formation of atherosclerosis, and it is one of the major factors of cerebral isehemia-reperfusion injury after cerebral infarction. Glutathione peroxidase (GPx) is a crucial antioxidant enzyme, its main role is to scavenge the excessive oxygen free radicals produced from metabolism or during the oxidative stress. The deficiency of GPx will increase the risk of cerebral infarction. This article reviews the biological characteristics of GPx and its correlation with cerebral infarction.

Objective To study the change and its correlation between plasma concentration of glutathione peroxidase and polymorphisms of the glutathione peroxidase(GPx-3) promoter gene in patients with acute cerebral infarction(ACI).Methods 94 patients with ACI and 80 normal controls were detected the concentration of plasma glutathione peroxidas.The patients with ACI were undertaken neural function deficient scale(NDS) after 1 d onset.GPx-3 gene polymorphism were detected using polymerase chain reaction and ligase detection reaction(PCR-LDR) in patients with ACI.Results Plasma glutathione peroxidase concentration in ACI group were lower than that in the normal control group in first day onset(P0.05).The plasma concentration of glutathione peroxidase and NDS in patients with mutation of GPx-3 promoter gene were obviously lower than those in the patients without mutation(P

To explore the clinical application and value of small incisions in the treatment of benign thyroid diseases with endoscopic assistance.A total of 57 cases with thyroid nodules were operated under the assistance of ultrasonic scalpel and endoscope with the lifting-up of special instrument and small neck incisions.However one malignant case was converted iuto open surgery according to frozen sections.The other 56 cases were successfully operated.The mean operative duration was 42 min and postoperative stay 2 -3 days.All incisions achieved primary healing and the length range was 1.5 - 3.5 cm.Except for transient hoarseness in 1 case,there was no such complications as choking,lip paralysis or hemorrhage,etc.All were discharged uneventfully.This surgical approach shall be recommended for its merits of miniinvasiveness,less hemorrhage,fewer complications and wider applications.

Objective To compare postoperative adjuvant chemoradiotherapy with adjuvant chemotherapy in patients with gastric cancer by a meta-analysis.Methods PubMed,EMbase,Cochrane Library,Wanfang,CNKI,VIP,and CBM databases were searched to identify the controlled clinical trials of postoperative adjuvant chemoradiotherapy versus adjuvant chemotherapy for gastric cancer.The obtained data were analyzed using RevMan 5.2.5 and Stata 12.0.The difference between two groups was estimated by calculating the odds ratio (OR) with 95％ confidence interval (CI).Results A total of 12 controlled clinical trials involving 1674 gastric cancer patients,which were selected according to inclusion and exclusion criteria,were included in this meta-analysis.The meta-analysis showed that the 3-and 5-year survival rates were significantly higher in the adjuvant chemoradiotherapy group than in the adjuvant chemotherapy group (OR=2.96,95％ CI=1.75-5.03,P=0.000; OR=1.45,95％ CI=1.06-1.99,P =0.020);the local recurrence rate was significantly lower in the adjuvant chemoradiotherapy group than in the adjuvant chemotherapy group (OR =0.50,95％ CI =0.34-0.72,P =0.000) ; there was no significant difference in distant metastasis rate between the two groups (OR =0.79,95％ CI =0.58 -1.07,P =0.130).Conclusions The meta-analysis of existing study results shows that compared with adjuvant chemotherapy alone,adjuvant chemoradiotherapy is a relatively safe and effective postoperative treatment for gastric cancer.

Objective To analyze the composing experience of Menghe physician Ma Peizhi for cough by TCM inheritance support system. Methods The prescriptions for cough of Ma Peizhi were collected, frequency and association of drugs were analyzed by using data mining methods such as revised mutual information, complex system entropy cluster and unsupervised hierarchical cluster. Results Based on the analysis of 57 prescriptions, the frequency of each herb and association rules among the herbs were computed, 18 core combinations and 9 new prescriptions were mined from the database. Conclusion Menghe physicians Ma Peizhi is well experienced in expelling wind and opening the inhibited lung, dissolving phlegm and relieving cough. TCM inheritance support system can be used to analyze clinical experience of old TCM doctor.

Objective To investigate the distribution of carbapenemase-resistant genes carried by multi-drug resistant Acineto-bacter baumannii .Methods 80 strains of multi-drug resistant Acinetobacter baumannii were collected .Polymerase chain reaction (PCR)wasusedtodetectcarbapenemase-resistantgenes,suchasOXA-23,OXA-24,OXA-51,OXA-58,SIM,IMP,VIM ,GIMand SPM ,in multi-drug resistant Acinetobacter baumannii .Results Drug resistant gene OXA-23 [49 (61 .3% )] ,OXA-51 [73 (91 .3% )] ,OXA-58[7(8 .8% )] ,OXA-24[1(1 .3% )] ,IMP[17(21 .3% )] and VIM[2(2 .5% )] were found in 80 strains of multi-drug resistant Acinetobacter baumannii ,while GIM ,SIM and SPM gene were not found .Conclusion IMP ,OXA ,VIM is the main genotypes carried by multi-drug resistant Acinetobacter baumannii .

Objective To investigate the correlation between autophagy related gene(ATG) locus polymorphism and the pulmonary tuberculosis(PTB) susceptibility according to the frequency distribution characteristics of autophagy related gene in the patients with PTB.Methods Eighteen single nucleotide polymorphism (SNP) loci of autophagy related genes in 202 patients with PTB as the case group and 222 healthy controls were genotyped by SequenomMassArray mass spectrometry array technology.The correlation between the each locus genotype and the PTB susceptibility was statistically analyzed.Results In the PTB patients group and healthy control group,after correcting the factors of sex and age,the binary Logistic regression analysis found that the frequency distribution of genotype and allele had statistical difference between rs5973822 and rs807185 sites in ATG4A gene (P＜0.05).The stratified analysis by body mass index (BMI) found that this difference was more significant in the high BMI population,moreover the distribution frequency in the patient group was lower than that in the control group,and the other 16 SNP loci had no statistical difference.Conclusion ATG4A gene rs5973822 and rs807185 loci polymorphism may be negatively correlated with PTB susceptibility,moreover which is more significant in the high BMI group.

Objeetive To analyze the experiences for impediment syndrome of Ma Peizhi of Menghe Medical Genre by using traditional Chinese medicine (TCM) inheritance support system.Method The prescriptions for impediment syndrome of Ma Peizhi were collected and inputted to TCM inheritance support system,from which we can get the frequency of drug usage and the relationship between drugs based on the association rules and clustering algorithm.Results In the 61 prescriptions,the drugs that used most frequently were Chinese Angelica,Largeleaf Gentian Root,and Twotoothed Aehyranthes Root,and the drug combinations that used most frequently were Largeleaf Gentian Root-Chinese Angelica,Chinese Angelica-Largeleaf Gentian Root,Chinese Angelica-Mulberry Twig.And there were also 26 core combinations and 13 new prescriptions mined from the database.Conclusion Ma Peizhi of Menghe Medical Genre was well experienced impediment syndrome by dispelling wind and removing dampness,and promoting blood circulation by removing blood stasis,from which we can make a conclusion that TCM inheritance support system can be used to analyze the doctors' clinical experiences.

Objective To analyze the principle of the drug use ofMenghe PhysiciansMa-Peizhi by using the Traditional Chinese Medicine(TCM)inheritance support system.Methods The prescriptions for the commonly encountered diseases that used byMa-Peizhi were collected to build a database, and analyze by the unsupervised data mining methods, such as apriori algorithm, entropy clustering complex systems, from which we could get the frequency of the drugs, the association rules between drugs, the core drug combinations, and so on.Results Based on the analysis of 745 prescriptions, the most frequently used drugs were tuckahoe, chiretta, paenoiae alba, dried orangepeel and dioscoreae. The core drug combinations were “radix rehmanniae recen- salivia chinensis-ophiopogon root”, “teasel root-viscum album-achyranthes”, “menispermaceae-heracleum hemsleyanum michaux-gentiana macrophylla”, and “mulberry leaf-periostracum cicadae-the root of balloon flower”. The new prescriptions were “mulberry leaf-viter rotundifolia-batryticated silkworm-periostracum cicadae-the root of balloon flower”, “teasel root-viscum album- achyranthes- ramulus mori- periplocae”, and so on.ConclusionMenghe PhysiciansMa-Peizhi was well experienced in treating the commonly encountered diseases by agile diagnosis and treatment, and addition or subtraction of changes based on the classical prescriptions.