Objective To explore the risk factors of shivering after intraspinal anesthesia.Methods 640 anesthesia recovery patients after intraspinal anesthesia from February 2011 to May 2015 were selected as the research subjects.According to whether patients appeared shivering,they were divided into research group and control group.The research group had 328 cases of appearing shivering,the control group had 312 cases without shivering. Basic clinical data of patients,operation time and blood loss,tympanic membrane temperature,anesthesia,anesthesia blocks plane indicators were compared to explore the risk factors of shivering after intraspinal anesthesia.Results This study included 640 cases,including 328 cases with chills reaction,the incidence rate was 51.25%.Single factor results showed that the low age,male,central cooler,surgery for a long time,the bleeding of more lumbar hemp,choice of anesthetic methods and anesthetic plane above T8 indicators, there were close relationship with shivering after intraspinal anesthesia,the differences between the two groups were statistically significant (χ2 =40.661,17.208, 32.369,32.931,36.624,14.844,26.84,all P<0.05).Multivariable logistic regression analysis results showed that age,gender,core body temperature,operation time,blood loss,spinal canal anesthesia methods and indexes of anes-thetic plane were important risk factors of chills reaction after anesthesia in patients with spinal canal anesthesia (OR=1.843,1.925,2.183,0.548,0.497,0.529,0.743,all P<0.05).Conclusion Male,younger age,operation for a long time,big intraoperative blood loss,tympanic membrane temperature low mode selection subarachnoid block anesthesia,and the anesthesia plane factor are the main risk factors of spinal canal anesthesia patients to appear chills response,the above factors are needed for close monitoring of patients with intraspinal anesthesia in the preoperative period.

It was generally considered that patients with chronic HBV infection and normal alanine aminotransferase (ALT) level had no or mild liver pathological changes,but in recent years,a large number of studies have found that such patients may also have marked inflammation and fibrosis in the liver.This article discusses the association between clinical features and liver pathological features in patients with chronic HBV infection and normal ALT level and points out that age,sex,HBeAg status,HBV DNA load,ALT level,and liver stiffness measurement are associated with liver pathological changes.Monitoring of these clinical indices helps with early detection of liver pathological changes in patients with chronic HBV infection and normal ALT level.

Objective To investigate the dynamic changes of serum interleukin (IL)-1β,tumor necrosis factor (TNF)-α,cyclooxygenase (COX)-2 levels in patients with acute gouty arthritis with various severityes and to provide evidence for the course of anti-inflammatory drug used in patients with acute gouty arthritis.Methods Ninety patients with gouty arthritis were randomly selected including sixty acute gouty arthritis patients and thirty gout patients in remission (observation group 3).Sixty acute gouty arthritis patients were divided into severe (observation group 1) and mild (observation group 2) subgroups according to the chief complaints and pain score points (VRS-4 method).All acute gouty arthritis patients were given the same dose and duration of etoricoxib and colchicine (14 days in all).Serum IL-1β,TNF-α,COX-2 levels were detected by enzyme-linked immunosorbent assay (ELISA) after the 1,3,7,10 and 14 days after onset.The 2-tailed independent samples t test was used for the analysis of measurement data.ANOVA were adapted for the comparison between groups.Results The serum levels of IL-1β,TNF-α in the observation group 1,2 were significantly higher than those in the control group in day 1 and 7 (P＜0.01),and almost completely returned to normal at day 10 to 14 day anti-inflammatory therapy.The serum COX-2 levels in observation group 1,2 were significantly higher than those in the control group (P＜0.01) in day 1 to 3,and returned to normal at day 7 to 10 after anti-inflammatory therapy.There were no significant differences between observation group3 and the control group (t=-0.880,-1.201,-0.548; P=0.383,0.235,0.586).② The serum levels of IL-1β,TNF-α were significantly higher in observation group 1 than those in observation group 2 [(24±5) pg/ml and(19±3) pg/ml,(323±84) ng/ml and (234±29) ng/ml; P=0.001,0.002],while there was no significant differences between observation group 2 and the control group (P=0.357).The serum COX-2 levels in observation group 1 were significantly higher than those in observation group 2 at day 7 [(12.9±2.0) pg/ml and (9.1±1.6) pg/ml],while there was no significant difference between observation group 2 and the control group (P=0.941).Conclusion Inflammatory factor can return to normal completely after anti-inflammatory therapy for acute gouty arthritis for 10 to 14 days.This study provides evidence for the course of anti-inflammatory drug used in patients with acute gouty arthritis.

Objective To investigate the effect of electroacupuncture on hypothalamic and hippocampal expressions of ghrelin and ghrelin receptor (GHS-R) mRNA in functional dyspepsia (FD) rats. Methods Eighty SD rats were randomly allocated to normal control, model control, medication and electroacupuncture groups, 20 rats each. A rat model of FD was made by tail clamp modeling method. The medication group received an oral gavage of cisapride solution and the electroacupuncture group, electroacupuncture treatment. The expressions of ghrelin protein and GHS-R mRNA in the hypothalamus and hippocampus were examined by Western blot and real-time PCR, respectively, in all the four groups. Results Compared with the model control group of rats, the expression of ghrelin protein in the hypothalamus and the expression of GHS-R mRNA in the hypothalamus and hippocampus increased in the medication group (P<0.05) and the expressions of ghrelin protein and GHS-R mRNA in the hypothalamus and hippocampus were up-regulated in the electroacupuncture group (P<0.05). Compared with the medication group of rats, the expressions of ghrelin protein and GHS-R mRNA in the hippocampus were up-regulated in the electroacupuncture group (P<0.05). Conclusions Electroacupuncture and medication can improve gastrointestinal functions and correct an imbalance in the brain-gut axis through the hippocampus-hypothalamic pathway by regulating hypothalamic and hippocampal ghrelin protein and GHS-R mRNA contents and activating hypothalamic neurons and hippocampal excitatory synapses.

Objective To study the clinical significance of reticulocyte parameters change before and after chemotheraphy in acute leukemia.Methods Thirty-two chemotherapeutic patients suffered from acute leukemia were improved after chemotherapy.The percentage of reticulocyte(RET%),reticulocyte absolute value(RET#),low fluorescent reticulocyte percentage(LFR),middle fluorescent reticulocyte percentage(MRF),high fluorescent reticulocyte percentage(HFR),white blood cells(WBC) and absolute neutrophils count (ANC) and immature reticulocyte fraction(IRF) were detected by using the Sysmex 2000 automatic blood cell analyzer.Results IRF,MFR and HFR after chemotherapy in the patients with leukemia were always declined,reached the lowest on 7 d of chemotherapy,began to recover on 14 d after chemotherapy,and recovered to the level before chemotherapy on 21 d of chemotherapy.LFR began to increase on 7 d of chemotherapy,and began to decrease on 14 d of chemotherapy.WBC and RET# were always decreased on 7,14 d of chemotherapy,and began to recover on 21 d of chemotherapy.Conclusion IRF,MFR,HFR and LFR are the sensitive indicators reflecting the bone marrow recovery and are earlier than WBC and RET# by 7 d.

Objective To investigate the relationship between high-density lipoprotein cholesterol (HDL-C) and idiopathic pulmonary embolism.Methods Clinical data of 34 patients with idiopathic pulmonary embolism from January 2005 to March 2011 were enrolled and healthy people with gender,age and basic diseasematched at the same period were selected as control.The venous blood samples of all the subjects were taken at 7:00 am after 10 hours of fasting and analyzed for total cholesterol (TC),lower-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C).Results Compared with healthy people,patients had reduced HDL-C level with a statistical significance ( ( 1.10 ± 0.28 ) mmol/L vs ( 1.49 ± 0.35 ) mmol/L,t =- 5.427,P ＜ 0.05 ).However,no statistically significant differences were found in the levels of TC and LDL- C (P ＞ 0.05 ).HDL-C was correlated with idiopathic pulmonary embolism( r =0.284,P ＜ 0.05 ).Conclusion The levels of HDL-C,but not TC or LDL-C,might be associated with the idiopathic pulmonary embolism.

Objective To investigate the numbers and distribution of dendritic cells and the expressive intensity of CD1c,S-100,HLA-DR and its relation with T cell in human breast cancer tissues,and to discuss the relationship between dendritic cell(DCs) and developing of breast cancer.The study can provide the experimental data in the further biological therapy of breast cancer. Methods The human breast cancer tissues and relatively normal breast tissues were collected from surgical operation and the samples of 20 patients with breast cancer were analyzed by immunocytochemistry and computer imaging techniques. Results The result showed that the expressive intensity of CD1c,S-100,HLA-DR was dramatically weaker in breast cancer tissues than in those of relatively normal breast tissues(P

Objective To study the effect of TanshinoneⅡA(TSN) on vascular smooth muscle cells(VSMCs) induced by high glucose and its relationship with MAPK signal pathway.Methods After the establishment of the model of diabetic rats,the aortic of rats was isolated and cultured.DNA synthesis was analyzed by ELISA of BrdU.The activity of MAPK was measured by liquid scintillation counting.Results TSN inhibited the proliferation and DNA synthesis of vascular smooth muscle cells from diabetic rats in dose-dependent manner.TSN at the dosage of 0.5 mg/L significantly decreased the activity of MAPK as well as of U0126.Conclusion The effect of TSN on the proliferation and DNA synthesis of vascular smooth muscle cells from diabetic rats is potentially mediated by inhibition of MAPK.

Objective To explore the expression of estrogen receptor(ER) and progesterone receptor(PR) in gestational trophoblastic tumor(GTT) and their significance.Methods The expression of ER and PR in 34 cases of GTT was detected by immunohistochemical method;20 cases of normal villi and 30 cases of hydatiform mole served as controls.Results The positive expression rate of ER in normal villi,hydatiform mole and GTT was 85.00%,83.33% and 44.12%,respectively,and had positive correlation with the malignance degree of GTT.The positive expression rate of PR in normal villi,hydatiform mole and GTT was little.The expression of ER was closely related to these clinicopathological features of GTT(P

Acute ST-elevation myocardial infarction is a common clinical acute and severe disease, and it has a high fatality rate. At present, thrombolysis is still the most applicable and effective treatment method at the primary hospital. In the thrombolysis therapy, the best anticoagulation therapy can improve the patency of infarct-related coronary artery and lower the rate of reinfarction. For acute ST-elevation myocardial infarction, studies on thrombolysis anticoagulation mechanism, common anticoagulant, bleeding complications and prospect of research are necessary.