ObjectiveTo observe the effcacy of isoflurane supplemented with ropivacaine for sacral block in indirect inguinal hernia.Methods120 cases of children who were going to be operated in inguinal hernia repairs were randomly divided into isoflurane group( A),ropivacaine group( B ),and isoflurane supplemented with ropivacaine group(C).Sacral block was performed after induction with different anesthetics.Haemodynamics( MAP、HR 、SpO2 ) in three groups were compared,and anesthesia effect,waking time,drug dosage and adverse reactions were analyzed.ResultsHaemodynamics in isoflurane supplemented with ropivacaine group were more stable than the other two groups,and anesthesia effect was better than isoflurane group and ropivacaine group( all P ＜0.05).Moreover,waking time,drug dosage and adverse reactions in group C were statistical differently conpared with controls( all P ＜ 0.05 ).ConclusionIsoflurane supplemented with ropivacaine for sacral block was helpful for respiration and circulation management applied in indirect inguinal hernia and could be a perfect anesthetic methods.

With the development of medical technology,methods for treatment of lung cancer gradually diversified.Radiotherapy and chemotherapy have gradually become the main methods of treatment.Clinical study have found that simply adopting one kind of treatment,cannot achieve ideal control,with the result of low 5 year survival rate,and high recurrence rate and metastasis.Combining chemotherapy and radiotherapy,can achieve better effect than that by using single method of treatment,as non-small cell lung cancer (NSCLC) is particularly sensitive to the chemotherapy.Recent clinical findings indicate that treating late NSCLC patients with combined therapy methods could achieve significant clinical effect.

Since the 1990s,models of genetically modified mice(gene knockout,mutation or transgene overexpression) have been increasingly used in heart research.The findings from this class of murine models have contributed significantly to a number of research breakthroughs achieved in the last 15 years.Currently,the number of genetically modified mouse strains has been increasing steadily.These models that targeted a family or a functionally relevant group of proteins have formed systemic tools for research use.The database of mouse cardiac phenotype has been established.Meanwhile,the research methodology and strategic approach exploring mouse cardiac phentypes at molecular to in vivo levels have been mature.It is expected that the use of this class of genetically targeted mouse models will become increasingly important in future research.

The dada of 987 out-patients aged 60 or over,who visited Bajiao Community Health Center of Beijing Shijingshan District from January 2006 to December 2009,were retrospectively analyzed.The results revealed that there was no gender difference in the prevalence of low vision and blindness ( χ2 =2.719,P = 0.606); the severity of low vision and blindness was correlated with the age of patients ( χ2 =138.389,P = 0.000); cataract was the main cause of low vision and blindness,accounting for 49.6%(62/125) of low vision and 64.3% (36/56) of blindness.

Eye and nervous system are anatomically and physiologically very close.About 40% of the nerve fibers in brain are correlated with visual function.Seven of twelve cranial nerves are straightly correlated with visual afferent or eye movement.Neurological diseases can affect eye in many different ways.Furthermore,systemic disorders can cause secondary neurological lesions or even primary neurological disorders,which sequentially show ocular symptoms and signs.Better understanding of the close relationship between eye and brain,together with intimate cooperation between ophthalmologists,neurologists,neurosurgeons and other specialties,are the key point to improve our neuro-ophthalmology service in China.

Objective To investigate the feasibility and safety of combined coronary and renal angiographies through transradial approch.Methods Three hundred and twenty patients in hospital from August 2007 to April 2009 who underwent combined coronary and renal angiographies through transradial approach were included in this study.Renal artery angiography of 300 cases was done by 5 FMP-A1 catheter (MP-A1 group),and 20 cases was done by TIG catheter (TIG group).Control group had 625 patients in hospital from January 2004 to April 2009 who underwent combined coronary and renal angiographies through transfemoral approach.The achievement ratio,operating time,dosage of contrast agent and complication of angiography were observed.Results The achievement ratio was higher in MP-A1 group [97.0%(291/300) ]and control group [98.4%(615/625)]than that in TIG group [40.0%(8/20)](P< 0.01).The operating time was (32.21 ± 3.37) min and the dosage of contrast agent was (52.72 ± 7.91) ml in MP-A1 group,and it was (30.78 ± 3.23) min and (51.88 ± 7.22) ml in control group respectively.There was no significant difference between two groups(P>0.05).The operating time was (26.42 ±4.31) min and the dosage of contrast agent was(51.72 ± 10.11) ml in TIG group.There was significant difference in the operating time between TIG group and the others groups (P < 0.05).The complications of angiography through transradial approach (0.9%,3/320) were less than those through transfemoral approach (3.0%,19/625) (P <0.05).Conclusions Renal artery angiography through transradial approach by 5 F MP-A1 catheter(125 centimeter) is safe and has minor complication.The achievement ratio of transradial approach for renal artery angiography by 5F MP-A1 catheter is higher than that by TIG catheter.

Objective To discuss the etiology,clinical features,diagnosis and treatment measures of female pseudohermaphroditism.Methods Five Cases,of female pseudohermaphroditism were collected.The etiology,clinical features,diagnosis and treatment measures were discussed.Results One case induced by exogenous androgenic hormones,4 cases induced by congenital adrenal hyperplasia.All the 5 cases presented with abnormal development of vulva and the sex chromosomes karyotype of 46XX.The combined treatment ofreconstructive surgery (5 cases)and supplementary glucocorticoid (4 cases)wefe performed.After 3months,the levels of adrenocorticotrophic hormone and virosterone were normal.Followed up for 1-10 years,The postoperative appearance of external genitalia was similar to the normal.The secondary sex characters were improved obviously,3 cases were mainly feminilism,2 cases existed different degree of psychologic obstacle.Conclusions The diagnosis and treatment in the early stage are very important.The combination treatment of surgery and medicine for the patients with female pseudohermaphroditism is satisfied.

BACKGROUND:Biliary tract stents comprise two types:expanding metallic stents and plastic stents,the patency time of the former is shorter than the latter,but the cost is higher.Thus,it is dispute which kinds of stent should be selected.Accordingly,it becomes a research topic how to improve patency rate and prolong patency time using cheap stents.OBJECTIVE:To explain the progress of biliary tract stents and to explore the effects of materials and types of biliary tract stents on patency rates and patency times.METHODS:The Chinese Journal Full-text Database and Medline were retrieved by the first author using search terms of "biliary stent,metallic stent,plastic stent,occlusion and stricture" both in Chinese and English.Meta analysis or repetitive studies were excluded.After that,20 documents concerning the effects of materials and types of biliary tract stents on patency rates and patency times were analyzed.RESULTS AND CONCLUSION:Biliary stent implantation is the preferred way for alleviative treatment of malignant obstruction of bile duct with few complications.Biliary tract stents comprise two types comprise metallic stents and plastic stents,the biocompatibility of both stents need to be improved.The metallic stents exhibited advantages in preventing bacteria,maintaining stent patency and reducing complications,but the high cost limited its application.Though plastic stents easily lead to stent occlusion due to bacteria adhesion and biliary siltation,however,it has merits of easy change and cheap cost.The combination of biliary stent implantation and radiotherapy can prolong effective patency period and prevent stent occlusion.The results demonstrated that biliary stent implantation is best methods for treating malignant obstruction of bile duct,and combined biliary stent implantation with radiotherapy can prevent stent obstruction.

Objective To investigate the clinical characteristics of methylmalonic acidemia.Methods Methylmalonic acidemia diagnosis and treatment of 12 cases of clinical data were collected,the clinical manifestations,laboratory examinations,gas chromatography/tandem mass spectrometry analysis of the measurement results of urine organic acids,blood gas analysis,glucose,lactic acid,ammonia and other characteristics were sumarized,and the clinical features and outcome of the situation were also sumarized.Results 1 year old first visit eight cases,12 cases,8 cases from rural areas;12 cases of major treatment complained of anorexia,poor spirit hospitalized one case;respiratory infection hospitalized five cases; seizure hospitalized three cases;weight gain admission,one case;vomiting admitted three cases,three cases of drowsiness,coma admitted one case,the movement behind the main complaint admitted two cases.After hospitalization check urine organic acid analysis found significantly increased methylmalonic acid,respectively,while ammonia,lactic acid increased,high blood sugar,high uric acid,low albumin,urine protein abnormalities,abnormal urine ketone bodies,abnormal increased anion gap,video science and abnormal electrophysiological examination.Diagnosed with methylmalonic acidemia,according to the case were given VitB12,betaine,folic acid,L-carnitine,limiting protein intake and other treatment.Symptomatic treatment improved in seven patients,two patients were lost;automatically discharged one case,two cases of death.Conclusion Methylmalonic acidemia based on clinical characteristics,so early detection,early diagnosis,early treatment will help to improve prognosis.

OBJECTIVETo observe the effect of conical atone needle on foot combined with Nan anvil at Yintang (CV 29) for insomnia.

METHODSSeventy patients were randomly divided into a ibian technique group and an acupuncture group,35 cases in each one. In the Sian technique group, conical stone needle on foot combined with bias anvil at Yintang(GV 29) were used,and the therapy was applied at Yongquan(KI 1), Taichong(LR 3) and Gongsun(SP 4), etc. In the acupuncture group, common acupuncture was implemented at Sanyinjiao(SP 6), Shenmen (HT 7) and Sishencong(EX-HN 1), etc. In the two groups, treatment was given for 2 weeks,once a day. There were two days to have a rest between 5-time treatment. The change of Pittsburgh sleep quality index(PSQI) before and after treatment was recorded and the clinical effect was observed after 10-time treatment and in two weeks aftet treatment.

RESULTSAfter treatment,the total scores of PSQI were declined significantly compared with those before treatment in the two groups(both P<0. 01). The total PSQI scores after treatment,the curative and effective rates and total effective rates when followed up bad no statistical significance(all P>0. 05).

CONCLUSIONConical stone needle on foot combined with Sian anvil at Yintang(GV 29) treating insomnia is safe and effective,and this treatment acquires similar efficacy with less suffering.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Female ; Humans ; Male ; Middle Aged ; Needles ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy ; Treatment Outcome