Objective To investigate the clinical application of acupuncture combined with general anesthe -sia in gynecologic laparoscopic surgery .Methods 60 ASA( the American society of anesthesiologists )Ⅰ-Ⅱpatients undergoing elective gynecologic laparoscopic surgery were randomly divided into the acupuncture group and control group.Patients in the acupuncture group were chosen Hegu (LI 4),Neiguan(PC 6) on both sides.After acupuncture, the two acupoints,electroacupuncture stimulated 20-30min,then administered general anesthesia ,electroacupuncture until surgery finished ,the control group received general anesthesia only .The drug dosages of the two groups was regu-lated,maintained anesthesia depth bispectral index ( BIS) between 40 and 60.The changes of the blood pressure ( BP) ,heart rate and BIS of the two groups at the same time points were observed;the propofol and remifentanil dos-age after the surgery ,the awaken time and extubation time ,OAA/S score and pain score after wake ,the happening of restlessness,chills,nausea and vomiting ,the usage of narcotic analgesics postoperation ,and the intraoperative aware-ness were recorded .The effect of acupuncture combined with general anesthesia was evaluated .Results Anesthetic dosage propofol of the acupuncture group [(7.44 ±1.30)μg· kg-1· h-1] was less than [(8.66 ±1.24)μg· kg-1· h-1] of the control group (t=3.720,P=0.001),remifentanil dosage was also less than the control group [acupunc-ture group (10.59 ±2.58)μg· kg-1· h-1,control group (11.93 ±2.27)μg· kg-1· h-1,t=2.168,P=0.034]. Compared with the basic value ,the BP values were higher at the time of intraoperation ,waking,extubation and 10 min after extubation (all P<0.05),the acupuncture group had more stable BP .Compared with the acupuncture group , heart rates in the control group were faster at extubation and 10min after extubation .Recovery time and extubation time of the acupuncture group were (9.05 ±2.36)min and (1.61 ±2.40)min,which were shorter than (12.50 ± 3.20)min and (15.90 ±3.37)min of the control group (P<0.05).Pain score(VAS) in the acupuncture group was lower than that of the control group .Consciousness score was higher in the acupuncture group ,the incidence rates of restlessness,chills were less.Conclusion The use of acupuncture combined with general anesthesia in gynecologic laparoscopic surgery can reduce the dosage of general anesthetics ,shorten the awaken time and extubation time ,increase the OAA/S score of the patients ,relieve pain ,and the recovery quality is higher .

Objective Porphyromonas gingivalis(Pg)is one of the main putative pathogens of periodontal disease,espcially of adult periodontitis. This in vitro study was aimed at observing the inhibition actions of 3 kinds of antimicrobial drugs on Pg. Methods 106 stains of Pg were isolated from subgingival plaques with adult periodontitis. The agar diffusion test was used to detect the inhibition actions of metronidazole,clindamycin and tinidazole on 106 stains of Pg. Results Their MIC was respectively:0. 25mg/L,0. 6rng/L. The MIC90 of tinidazole＜MIC90 of clindamycin. The results showed:all of metroidazole, tinidazole and clindamycin can be used effectively against Pg,clindarnycin and tinidazole showed more potent antibacterial activity than metronidazole. The different concentration of Pg-liquid (l05 CFU/ml, 106 CFU/ml and 108 CFU/ml) had not influenced the results. Couclusion This study is significant to antibiotical therapy of periodontal diseases.

Objective To observe the changes of zymophagy during experimental acute pancreatitis (AP) induced by caerulein.Methods Pancreatic acinar cell line AR42J cells were cultured in 6-well plates till 90％ confluent and then divided into AP group and control group.Caerulein (1 × 10-8 mol/L) was added into AP group to establish AP cell model,and 1640 cell culture medium was added into control group.After caerulein treated for one,four,six,eight,12 and 24 hours,cells and cell culture supernatant were collected.The levels of cytokine interleukin (IL)-1,tumor necrosis factor (TNF)α,trypsinogen activation (TAP) and amylase were measured with enzyme-linked immunosorbent assay (ELISA) method.The expression of LC3 and Beclin1 at mRNA of each group were detected by reverse transcription-polymerase chain reaction (RT-PCR).The LC3B protein level of each group were detected by Western blotting.The changes of autophagosome and zymophagosome were observed by transmission electron microscopy.The difference between AP group and control group was analyzed by analysis of variance.Results The level of IL-1,TNFα,amylase and TAP in cell culture supernatant of control group was (18.83±7.10) pg/mL,(14.20±3.79) pg/mL,(10.03±2.85) U/L and (39.48±8.62) pg/mL,respectively.Those of AP group significantly increased at first hour ((62.13±11.25) pg/mL,F=3.32,P＜0.01 ; (30.98±7.11) pg/mL,F=3.05,P＜0.05; (25.06±6.82) U/L,F=2.90,P＜0.05 and (128.51± 18.30) pg/mL),F=2.62,P＜0.01,at fourth or sixth hour reached peak (IL-1 at fourth hour:(71.96± 15.82) pg/mL,F=7.25,P＜0.01;TNFα at sixth hour:(39.92±8.94) pg/mL,F=4.93,P＜0.05; amylase at fourth hour:(28.83 ± 8.31) U/L,F=2.06,P＜0.05; TAP at fourth hour:(146.29± 29.36) pg/mL,F=0.14,P＜0.01) and then gradually decreased.At fourth and sixth hour,the expression of LC3 at mRNA level in AP group was 3.18±0.82,1.71±0.14,respectively,while the expression of Beclin-1 rnRNA at first,fourth hour was 2.44±0.34 and 4.13±0.30,all of them were significantly increased compared with those of control group (0.21±0.04 and 0.30±0.08,LC3 mRNA F=0.79、0.06; Beclin mRNA F=2.31、0.36,all P＜ 0.05).There were no significant differences at other time points.The numbers of autophagosome and zymophagosome of AP group were significantly higher than those of control group under transmission electron microscopy.Conclusion Zymophagy occurred during AP cell model induced by caerulein,which suggested that zymophagy might involve in the mechanism of AP.

Background:Damage of intestinal mucosal barrier is a key factor in the development and progress of acute pancreatitis(AP),and is closely related with the prognosis of the disease. Aims:To investigate the protective effect and possible mechanism of mucoprotective agent teprenone on intestinal mucosal barrier in rats with experimental AP. Methods:Forty-five adult male Sprague-Dawley rats were randomly divided into normal control group(n = 5),AP model group(n = 20)and teprenone treated group(n = 20). AP model was established by subcutaneous injection of cerulein at abdominal wall. Rats in treated group were intervened with teprenone intragastrically before and after model establishment. ELISA was used for measurement of serum interleukin-1(IL-1),IL-6,tumor necrosis factor-α(TNF-α)and amylase;histopathological and ultrastructural changes of small intestinal mucosa were observed by light microscope and transmission electron microscope;Western blotting was used to detect the expressions of tight junction protein occludin and ZO-1. Results:Serum levels of IL-1,IL-6,TNF-α and amylase in AP model group were significantly higher than those in normal control group(P < 0. 05),accompanied by necrosis and exfoliation of small intestinal villus,widening of intercellular tight junctions and downregulation of occludin and ZO-1 expression. While in teprenone treated group,serum levels of proinflammatory cytokines and amylase were significantly decreased as compared with AP model group(P < 0. 05),the villus of small intestine remained intact,and dense tight junctions were observed. Expressions of occludin and ZO-1 in teprenone treated group were upregulated. Conclusions:Teprenone may protect against intestinal mucosal barrier injury in AP model rats by upregulating tight junction protein expression.

Objective To investigate the effect of Amikacin and prulifloxacin alternate application in the treatment of Lung infections in ICU resistant Acinetobacter Bauman.Methods 82 cases of Lung infections in ICU resistant Acinetobacter Bauman from August 2014 to August 2016 in our hospital were selected and randomLy divided into two groups, 41 cases in control group were given routine treatment, 41 cases in the experimental group were treated with Amikacin and prulifloxacin alternate application, and patients were treated continuous for two weeks.Levels of serum CRP, PCT, WBC, N%, SCR, BUN, AST, ALT, scores of APACHE II and CPIS and clinical efficacy were observed pre-and post-treatment.Results After two weeks, levels of serum CRP, PCT, WBC and N% in experimental group were significantly lower than control group, scores of APACHE II and CPIS were significantly lower than the control group, the total clinical efficiency was higher than the control group(P<0.05), and the levels of serum SCR, BUN, ALT, AST were lower, but had no statistically difference.Conclusion Amikacin and prulifloxacin alternate application in the treatment of Lung infections in ICU resistant Acinetobacter Bauman can reduce the patient's inflammatory reaction and the degree of infection.

Objective:To investigate the effect of the ceramometal b ridge on the local gingival groove flora.Methods: Classi cal bacterial incubation and identification were used to study the changes of th e local gingival groove flora in 6 patients wearing ceramometal bridge for 1 wee k to 3 months. Results: 3 months after the prosthetic procedure the CFU o f P.melaninogenica, Gram-positive bacilli cmainly Actinomyces and the t otal bacteria were significantly increased (P

OBJECTIVEThe purpose of this study was to evaluate the effects of squamous cell carcinoma on oral bacteria.

METHODSThis study investigated the microbial contents of the plaque on the surfaces of oral squamous cell carcinomas. Samples were obtained from the central surface of lesions, contiguous healthy mucosa and saliva of 42 patients with oral squamous carcinoma before and after operation.

RESULTSThe median of bacterial colony forming units per milliliter (CFUs/ml) of saliva before operation was 8.10 x 10(8) CFUs/ml. The median of CFUs per square centimeter of the tumor surface was 5.21 x 10(5) CFUs/cm2 which was significantly higher than that of the healthy (the control) mucosa (1.77 x 10(4) CFUs/cm2, P = 0.0001). The CFUs per square centimeter of mucosa surface at the operative zone was 4.34 x 10(5) CFUs/cm2 which was also significantly higher than that of the healthy (control) mucosa(7.24 x 10(4) CFUs/cm2, P = 0.0001).

CONCLUSIONOral carcinoma can break the balance of oral microflora, which may be one of the reasons leading to the high susceptivity of these compromised patients to systemic infection.

Adult ; Aged ; Bacteria, Aerobic ; isolation & purification ; Bacteria, Anaerobic ; isolation & purification ; Bacterial Infections ; etiology ; prevention & control ; Carcinoma, Squamous Cell ; microbiology ; Female ; Humans ; Male ; Middle Aged ; Mouth Mucosa ; microbiology ; Mouth Neoplasms ; microbiology ; Saliva ; microbiology ; Streptococcal Infections ; prevention & control ; Streptococcus ; isolation & purification

Bacterium is dominant microflora population in human oral cavity, and the novel species and novel genus were discovered and named one after another. This article reviewed the major biological characteristics of 5 novel genus and 16 novel species isolated from the human oral cavity from 2009 to 2012.
Bacteria ; classification ; isolation & purification ; Humans ; Mouth

Objective To study the changes in serum adiponectin level in children with severe sepsis,and to explore its clinical significance.Methods A prospective study was conducted,and 39 cases of critically ill children with severe sepsis and 47 cases of sepsis were enrolled into the Pediatric Intensive Care Unit(PICU),Children's Hospital of Nanjing Medical University from July 2012 to July 2014.Thirty cases of critically ill children without sepsis were enrolled as a control group.The plasma adiponectin,procalcitonin(PCT),and C-reactive protein(CRP)were determined with enzyme linked immunosorbent assay(ELISA)within 24 hours after PICU admission.The pediatric critical illness score(PCIS)was recorded.Results Among severe sepsis group,sepsis group and control group,there was no statistical significance in body temperature,heart rate,body mass index,PCIS,white blood cell count,platelet count,bilirubin,creatinine,pH value and activated partial thromboplastin time(APTT)(all P>0.05).Plasma adiponectin in the severe sepsis group[(0.102±0.041)mg/L] significantly decreased compared with that in the sepsis group[(0.125±0.046)mg/L] and the control group[(0.147±0.047)mg/L](F=8.456,P=0.000).The level of CRP in the severe sepsis group[(60.68±59.43)mg/L] significantly increased compared with that in the sepsis group[(52.76±26.67)mg/L] and the control group[(33.89±6.87)mg/L](F=17.416,P=0.000).There was a statistical significance in PCT level in the severe sepsis group,the sepsis group and the control group(x2=27.269,P=0.000).Further comparison showed that there was a significant difference in PCT level between the severe sepsis group and the sepsis group(Z=-4.679,P=0.000),which was also statistically significant between the severe sepsis group and the control group(Z=-4.244,P=0.000);there was no significant difference between the sepsis group and the control group(Z=-0.340,P=0.733).Negative correlation was found between plasma adiponectin and CRP(r=-0.219,P=0.042),PCT(r=-0.303,P=0.005).The correlation between plasma adiponectin and PCIS was positively correlated(r=0.332,P=0.002).Conclusions Plasma adiponectin decreased in severe sepsis children and was significantly associated with the severity of the disease.Detection of plasma adiponectin levels in children with sepsis has an important clinical significance in evaluating the severity of sepsis.Plasma adiponectin is negatively correlated with CRP and PCT,and plays a role in diagnosis of infection.

OBJECTIVETo investigate the safe and effective treatment for painful venous malformation (VM) in limbs.

METHOD(1) 97 cases with painful VM underwent MRI to detect the location of VM, as well as its size and structure, its relationship with the surrounding tissue. Statistical analysis was also performed. (2) The embolic agent (ethanol) was first injected to embolize the draining vessels of VM, then the Polidocanol plus Methotrexate (MTX) was followed to keep the embolization effect on VM. The therapeutic effect was observed and analyzed.

RESULTSFrom January 2010 to January 2012, 97 patients with painful VM were treated. A Spearman correlation analysis showed no significant correlation between symptoms of pain and lesion growth, volume, or MRI grades (P > 0.05). The lesions in the muscle space are more likely to have the symptoms of pain (P < 0.01), followed by the lesions in the muscle, then the lesions in the joint and subcutaneous tissue. The pain relieve percentage was 95.9% (93/97) after one time embolic sclerotherapy. No severe complication, such as distant embolization, nerve damage, or muscle atrophy happened. No pain reoccurrence happened after 0.5-1.5 years of follow-up period.

CONCLUSIONSThe treatment of embolic scleratherapy is minimal invasive, safe and effective for painful VM with stable results.

Ethanol ; therapeutic use ; Extremities ; blood supply ; Humans ; Methotrexate ; therapeutic use ; Pain ; etiology ; Pain Management ; methods ; Polyethylene Glycols ; therapeutic use ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; methods ; Statistics, Nonparametric ; Vascular Malformations ; complications ; pathology ; therapy ; Veins ; abnormalities