Objective To discuss the agreement between pulse pressure variation of radial artery and pulse pressure variation of dorsal pedalartery in neurosurgery.Methods Twenty-five patients undergoing selective craniotomy under general anesthesia were enrolled.The following data were monitored and recorded respectively after tracheal intubation general anesthesia under different time:radial artery pulse pressure variability (PPV1) and dorsalis pedis pulse pressure variation (PPV2).Tidal volume was set to 8 ml/kg.Bland-Altman plots were created to assess agreement between PPV1 and PPV2.Results The mean differences and the limits of agreement between PPV1 and PPV2 are 20 min after induction of anesthesia 0.5% (-1.9%-2.8%), boneless flap instantly-0.5% (-3.8%-2.9%), Cut the dura mater instantly-0.1% (-3.2%-3.0%), and bone flap 0.1% (-2.4%-2.6%).Conclusion Dorsal pedal artery pulse pressure variation in neurosurgery craniotomy has certain guiding significance to the monitoring and management.

The academic orientation determines the development direction of the subject, and also puts forward the corresponding requirements for the professional teaching. The deep development of anes-thesiology, perfect preoperative evaluation, refined management of clinical anesthesia and ultimately improv-ing the prognosis of patients are the total development directions of anesthesiology. Perioperative patient home (PSH) advocates taking patients as the center, dominated by anesthesia, based on evidence-based medicine in the perioperative period, solidarity and cooperation of multiple disciplines, the integration of a variety of medical resources, and providing continuous and efficient medical services for patients. PSH is required to ensure the safety of clinical anesthesia, reduce the incidence of anesthesia mortality and serious
complications, and improve the long-term survival rate and quality of life by improving the clinical work of the department of anesthesia. Practicing PSH, the anesthetic doctors should have the academic idea of the treatment of anesthesia. The concept requires making comprehensive use of a variety of teaching methods, putting emphasis on the training of basic knowledge, and in the teaching of basic knowledge, infiltrating the overall and local thinking and using lecture method in cooperation with the case teaching. To make solid promotion of PSH concept, we should use CBL teaching, strengthening the management of clinical anesthesia, and striving to promote the clinical practice of PSH.

The global and local,goal and destination,treatment and reinjury are three common critical thinking,which has the vital significance to the teaching of anesthesiology.Through the classroom interpretation of the pathogenesis,we preliminarily cultivate the students' global and local thinking by guiding students to find the primary problem in the global and local and finding out the breakthrough point of disease treatment.Through the case teaching,we promote students to constantly strengthen their goal and destination thinking by guiding students to select target,determine the endpoint,and solve the problem in stages to make the treatment of the critically ill patient which students simulate has good operability.Through adoption of problem based learning,we make students know how to achieve the optimal treatment effect by guiding them to have extensive discussions and have access to information so as to cultivate students' treatment and reinjury thinking and enhance their global and local thinking at the same time.

It described the status quo of the healthcare system in South Korea, and the milestones of the country to achieve universal coverage of social medical insurance. The paper presented in focus the development from multiple social medical insurance funds to a universal social medical insurance system in South Korea, and analyzed those serious setbacks including monopolizing private medical organizations, lack of first-visit and referral system, and excessive percentage of personal payment, as a result of unparallel progress of the reform of medical insurance and that of healthcare system. Authors hope to be inspirational for the ongoing reforms in the social medical insurance system and healthcare system, in an effort to avoid likewise mistakes.

Objective To assess language function in children with benign epilepsy with centrotemporal spikes in children(BECTS) and its association with the age of epilepsy onset.Methods We assessed language function in 63 children with BECTS and 30 age and sex matched controls by the subtest of CWISC.Results Children with BECTS performed significantly worse on all language tasks as compared to controls and overall better language function was positively correlated with older age of the child.Early age at seizure onset demonstrated significant negative correlation with language dysfunction,age below 6 years being related to the lowest performance scores(P ＜ 0.05).There was no relationship between the language function and the laterality of epileptic focus,seizure treatment status,or the duration of epilepsy(P ＞ 0.05).There was significant relationship between the language dysfunction and onset age of epilepsy (P ＜ 0.05).Conclusion Children with BECTS have language difficulties that are more pronounced in younger age group.Despite better language functioning in older children with BECTS,their verbal abilities remain inferior to those of children without epilepsy.Early age at seizure onset is a significant factor predicting worse language functioning in children with BECTS.

Objective:This study aimed to compare the efficacy and adverse reactions of two different chemotherapeutic regi-mens. In particular, chemotherapy with paclitaxel liposome was administered in combination with either S-1 or oxaliplatin as the first-line therapy of advanced gastric cancer. Methods:A total of 118 patients with advanced gastric cancer were randomly divided into groups A (61 cases) and B (57 cases). In group A, paclitaxel liposome combined with S-1 was administered;in group B, paclitaxel lipo-some combined with oxaliplatin was applied. The short-term efficacy, adverse reactions, Karnofsky performance status score, median time to progression (mTTP), and median overall survival (mOS) of the two groups were observed and compared. Results:No signifi-cant differences were observed in the objective response rate, disease control rate, and mTTP between groups A and B (31.1% vs. 29.8%, 75.4%vs. 71.9%, 4.2 months vs. 3.8 months;P>0.05). The mOS rates were 10.5 and 8.9 months in groups A and B, respectively, with statistically significant differences (P=0.006). The incidence of degreesⅢtoⅣdiarrhea and peripheral nerve toxicity was signifi-cantly higher in group B than in group A (P<0.05). No statistical differences were found between the two groups in terms of other side effects. Conclusion:The two paclitaxel liposome-based regimens showed similar therapeutic effect in patients with advanced gastric cancer. S-1/paclitaxel liposome treatment could be more effective in terms of mOS and had a tendency of lower toxicity.

Objective To observe the infiltration situation of Langerhans cells(LC)in laryngeal squamous cell carcinoma tissue and to investigate its clinical significance.Methods Seventy-two cases of laryngeal squamous cell carcinoma were selected and the tumor tissue in all cases was operatively resected.The immunohistochemical SP method was adopted to detect the infiltration situation of LC in laryngeal squamous cell carcinoma tissue.Then the relationship between the LC infiltration degree with tumor stage,relapse,metastasis and prognosis was analyzed.Results Among 72 cases of laryngeal squamous cell carcinoma,27 cases(37.5％)were LC infiltration degree of +,37 cases(37.5％)were ++ and 18 cases(25.0％)were +++.The LC infiltration degree in laryngeal carcinoma tissue was correlated with the cervical lymph node metastasis,recurrence,disease free survival,3-year survival and 5-year survival(P＜0.05),and had no correlation with the age,classification,TNM stage and postoperative radiotherapy(P>0.05).Conclusion LC infiltration can be seen in the tumor tissue of the patients with laryngeal squamous cell carcinoma.The LC infiltration degree is higher,indicating that the prognosis would be better.

OBJECTIVE: To analysis the acoustic characteristics in patients with unilateral arytenoid dislocation and unilateral vocal fold paralysis, and evaluate the application value of acoustic analysis technique in these two diseases. METHOD: The voice signals of sustained vowel /a/ were measured using the software MDVP in 50 healthy adults and 67 patients with unilateral vocal cord movement disorders. The acoustic parameters (jitter, shimmer, NHR and F₀) were analyzed. All patients were divided into arytenoid dislocation group (36 cases) and vocal fold paralysis group (31 cases) through the laryngeal electromyography. All groups were divided into male and female group again. The acoustic characteristics between the two experimental groups and normal control groups were observed and compared. Results were analyzed using Rank sum test. RESULT: (1) In both male or female groups, there were significant differences in jitter and shimmer between two experimental group and control group. In both male or female groups, there were significant differences in NHR between arytenoid dislocation group and control group. There were no significant differences in NHR between vocal fold paralysis group and control group. Except for the male vocal fold paralysis group, there were significant differences in F between the other experimental groups and control groups. (2) In both male or female groups, there were no significant differences in jitter and shimmer between vocal fold paralysis group and arytenoid dislocation group. There were significant differences in NHR. CONCLUSION The acoustic parameters are effective parameters to measure the voice quality of patients with unilateral arytenoid dislocation and unilateral vocal fold paralysis. NHR is the most sensitive parameter in the distinction of vocal cord paralysis and arytenoid dislocation.
Acoustics ; Adult ; Arytenoid Cartilage ; physiopathology ; Case-Control Studies ; Electromyography ; Female ; Humans ; Male ; Software ; Vocal Cord Paralysis ; diagnosis ; Vocal Cords ; physiopathology ; Voice Quality

OBJECTIVE:To study the correlation between antibacterials amount and drug resistance of Echerichia coli,and to provide reference for clinical use of antibacterials. METHODS:Retrospective review was used to calculate DDDs of antibacterials and resistance rate of Escherichia coli to 11 kinds of antibacterials each quarter. The correlation analysis was carried out using the SPSS 13.0 statistical software. RESULTS:The resistance rates of E. coli to piperacillin/tazobactam,cefoperazone/sulbactam and le-vofloxacin were with upward trends,and the others showed downward trends. The resistance rates of E. coli to meropenem and imi-penem/cilastatin appeared in 2014,increasing from 0 to 8.8% and 9.4%,respectively. DDDs of them were significantly correlated to drug resistance of E. coli,showing positive correlation(r=0.915,0.793,P<0.01). DDDs of piperacillin/tazobactam was signif-icantly correlated to resistance rate of E. coli(r=0.807,P<0.01),while that of ceftazidime was negatively correlated to resistance rate of E. coli(r=-0.672,P<0.05). There was no statistical significance in resistance rate of E. coli to other 7 kinds of antibacte-rials. CONCLUSIONS:There are some correlations between the DDDs and resistance rates. We should strengthen the monitoring of bacterial resistance and the management of rational application of antibacterials.

Objective To investigate the correlation between methylation status and death-associated protein kinase 1 (DAPK1) in SiHa and Hela cell line of cervical carcinoma and intervention of DNA methyltransferase inhibitor 5-azacytidine on the expression of DAPK1 and the proliferation of the cells. Methods DAPK1 methylation status was analyzed using methylation-specific PCR methods. The expression of mRNA and protein of DAPK1 were analyzed by RT-PCR and SABC methods after the treatment with 5-azacytidine. MTT assay was used to observe the changes of proliferation activity of the cells after 5-azacytidine treatment. Results DAPK1 genes were methylated and did not express in SiHa cells in the cervical carcinoma. Its expression could be restored by 5-azacytidine. MTT assay showed 5-azacytidine could weaken the proliferation of cancerous cells. Conclusion DAPK1 methylation plays an important role in the carcinogenesis of cervical cells and can reexpress after the treatment with 5-azacytidine which also restored its inhibitory function on carcinoma.