Objective To observe the effect of microprismatic needle scalpel(MPNS) on headache induced by compression of greater occipital nerve or lesser occipital nerve.Methods 95 patients with headache induced by compression of occipital nerve were divided into the treatment group (50 cases, treated with MPNS) and control group (45 cases, treated with carbamazepine).Results In the treatment group, 42 cases were cured, 6 cases were effective, 2 cases were ineffective; while, those in the control group were 16 cases, 21 cases and 8 cases respectively. There was a significant difference between two groups ( P<0.01).Conclusion MPNS has an obvious effect on headache induced by compression of occipital nerves.

Objective To discuss the application indications of emergency thoracotomy (ET) and the surgical strategy in the treatment of chest trauma .Methods The clinical data of 35 chest trauma patients treated by ET from January 2010 to March 2014 were analyzed retrospectively .Results In 35 cases ,the injury severity score (ISS) was 12-65 ,average 31 .63 .23 cases were pene‐trating injuries and 12 cases were blunt injuries .28 cases (80 .00% ) manifest as shock on admission .Blood loss in all cases was 1 000-5 000 mL ,average 2 400 mL and 20 cases were over 3 000 mL .ET was performed in the emergency room (6 cases) and the operative room (29 cases) .The time of admission to surgery in all cases was<30 min .12 cases (34 .29% ) died ,with average ISS score of 48 .26 .The main causes of death were cardiac tamponade and hemorrhagic shock .23 cases (65 .71% ) survived .The surviv‐al rates of penetrating and blunt injury were 78 .26% (18/23) and 41 .67% (5/12) respectively .The occurrence rate of complications in the survivals was 39 .13% (9/23) .Conclusion Massive bleeding ,ventilation dysfunction and cardiac tamponade caused by severe chest trauma are the important indications of ET ;the patient with chest penetrating injury on high‐risk positions should be actively performed the exploratory thoracotomy ;race against time rapid thoracotomy is the key for successful treatment .

OBJECTIVETo explore the situation of equity in health service delivery in the experimental region of new rural cooperative medical scheme (NRCMS).

METHODSA household questionnaire survey was conducted to 2112 residents in the experimental county of NRCMS in Yuexi county with a stratified-cluster sampling on the situation of health service delivery, from July 1-15,2005. Data was analyzed with Epi Info 6.04 and SPSS 11.0 software and indices as rate, ratio, Gini coefficient, concentration index (CI) and chi-square test etc.

RESULTSThere was no significante difference of the treatment-seeking rate during two weeks among five groups economic condition residents (chi2 = 5.52, P > 0.05) and the rates were 48.14 per thousand, 82.90 per thousand, 65.88 per thousand, 48.72 per thousand and 50.66 per thousand respectively with CI = -0.026. Similarly, the hospitalization rates were 59.08 per thousand, 67.36 per thousand, 51.76 per thousand, 58.97 per thousand and 52.86 per thousand respectively in the last year and the CI = - 0.017. But there was a significante difference of rates on chronic disease among the five groups of residents with different economic conditions in the last six months (chi2 = 18.42, P < 0.01) and the rates were 295.40 per thousand, 243.52 per thousand, 230.59 per thousand, 225.64 per thousand and 176.21 per thousand and the CI = -0.055. When income reduced, the prevalence had been increasing among residents. Meanwhile, the collection funds showed unfair in residents with various income and the compensating fund of new rural cooperative medical scheme had not reduced the gap between rich and poor.

CONCLUSIONThere was an unequity of medicine expenditure and compensating fund in residents with various income in the experimental region. The low income residents had a high health service need and the government should improve NRCMS greatly to change the situation.

China ; Data Collection ; Delivery of Health Care ; Health Expenditures ; Health Services Needs and Demand ; Healthcare Disparities ; Humans ; Income ; Rural Health Services ; economics ; utilization

Objective To investigate the efficacy of Ilizarov technique in treatment of Gustilo type Ⅲ B and C of large tibia bone defect combined with soft tissue defect. Methods Thirty cases with large tibia bone defect combined with soft tissue defect in our hospital from January 2016 to December 2018 were selected including 25 cases with type Ⅲ B and 5 cases with type Ⅲ C,who were all open tibia fractures and treated with Ilizarov technique. Results All patients were followed up for 10 to 18 months with an average of 15 months. The bone defects were reconstructed, the difference between the length of the affected limb and the healthy side was less than 2 cm. The fracture was healed and the wound was closed. One case was with paralysis of common peroneal nerve and recoveried after 3 months. Twenty-two cases recovered without extra surgery, five cases restored with skin graft and three cases covered the wound by rotating skin flap. Conclusion Ilizarov technique is one of effective ways to treat Gustilo Ⅲ type B and type C of large defect combined with soft tissue defect.

OBJECTIVETo investigate perioperative patterns of melatonin and cortisol secretion rhyme in patients undergoing coronary artery bypass grafting surgery.

METHODSEleven male patients scheduled for elective coronary artery bypass grafting surgery (CABG) under hypothermic cardiopulmonary bypass (CPB) were enrolled in the study. Anesthesia was induced and maintained with propofol (3 mg.kg-1.h-1) and supplemented with fentanyl (15 micrograms/kg). Blood samples were taken during surgery at specific time-points and every 3 h in the immediate postoperative period and postoperative day 2 and day 3. Plasma melatonin and cortisol levels were measured by radioimmunoassay and enzyme-linked immunosorbent assay respectively.

RESULTSDuring surgery, plasma melatonin levels were below the minimum sensitivity level but low levels, without circadian variation, were measured during the immediate postoperative period. During postoperative day 2 and day 3, circadian secretion patterns of melatonin were present in 10 patients and showed an inverse correlation with light intensity exposed (r = -0.480, P = 0.01). Plasma cortisol levels in the immediate postoperative period were significantly higher than those before induction of anesthesia (P < 0.01). During postoperative day 2 and day 3, only 3 patients regained circadian secretion of cortisol.

CONCLUSIONSIt is concluded that melatonin and cortisol secretion are disrupted during cardiac surgery and in the immediate postoperative period.

Cardiopulmonary Bypass ; Circadian Rhythm ; Coronary Artery Bypass ; Coronary Disease ; physiopathology ; surgery ; Humans ; Hydrocortisone ; secretion ; Intraoperative Period ; Male ; Melatonin ; secretion ; Middle Aged ; Monitoring, Intraoperative ; Postoperative Period

OBJECTIVETo study the expression of lung Krüppel-like transcription factor (KLF2/LKLF) in lung tissues of rats with chronic obstructive pulmonary disease (COPD) and the relationship between KLF2 and NF-E2-related factor 2 (Nrf2), and make further explore the effects of KLF2 on the expression of gamma-glutamylcysteine synthetase (gamma-GCS).

METHODSTwenty-two male SD rats were randomly divided into a COPD group (n = 10) and a normal control group (n = 11). The rat model of COPD established by cigarette smoking and intratracheal instillation of lipopolysaccharide (LPS), and lung tissues were obtained. The expressions of KLF2, Nrf2, gamma-GCS mRNA and protein in lung tissues were measured by immunohistochemistry (IHC), Western blot, in situ hybridization (ISH) and reverse transcription-polymerase chain reaction (RT-PCR). To explore the relationship between KLF2 and Nrf2 protein,we utilize the method of co-immunoprecipitation (CO-IP).

RESULTSIHC and Western blot showed that protein expressions of KLF2, Nrf2, gamma-GCS were higher in the lung tissues from rats with COPD than those in the control groups (all P < 0.05). The levels of KLF2, gamma-GCS mRNA were markedly increased in the COPD group (all P < 0.01) while Nrf2 mRNA expression in COPD group had no significant difference with that in control group ( P > 0.05). CO-IP result showed that KLF2 were obviously present in immunoprecipitates of Nrf2 (P < 0.01) . Linear correlation analysis showed that the level of KLF2 protein was positively correlated with the level of Nrf2 protein (P < 0.05), and KLF2, Nrf2 proteins were positively correlated with gamma-GCS mRNA and protein (all P < 0.05).

CONCLUSIONThe expression of KLF2 is significantly up-regulated in COPD, which maybe up-regulate gamma-GCS mRNA expression by increasing Nrf2 expression and nuclear translocation against oxidative stress.

Animals ; Dipeptides ; metabolism ; Kruppel-Like Transcription Factors ; metabolism ; Lung ; pathology ; physiopathology ; Male ; NF-E2-Related Factor 2 ; metabolism ; Pulmonary Disease, Chronic Obstructive ; metabolism ; pathology ; physiopathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate whether murine soluble Fas gene transfected marrow graft could block the immune escape of leukemia cells, so as to eliminate the residual leukemia cells and reduce relapse after bone marrow transplantation (BMT).

METHODSThe murine leukemia/lymphoma models were established by inoculating female C57BL/6 mice (H-2b) with 10(5) EL4 cells/mouse through caudal vein. Donors of BM grafts were C57BL/6 male mice. Bone marrow mononuclear cells (BMMCs) were transfected with sFas or EGFP by adenovirus (adsFas or adEGFP) 24 hours before BMT (group D or E). The following three groups were set simultaneously: group A, no BMMCs transplanted; group B, BMMCs transplanted with no adenoviruses transfection; group C, EL4 cells transfusion only. Hematopoietic reconstitution, generation of leukemia/lymphoma and the survival rate were observed in all the groups after BMT.

RESULTSThe spleen indices examined 11 days after BMT were not obviously different among group B, D and E (P > 0.05), but in group A were significantly lower than those in the groups B, D, E (P < 0.01). The leukocyte and platelet counts on day 30 after BMT were recovered in group B and D, but were very low in group C and E. The Y-chromosomes appeared 2 months after BMT. Bone marrow pictures in group B and D were almost normal, but in group C and E had plenty of lymphoblast-like tumor cells. Tumors were obviously revealed in the mice of group C and E by histopathology examination, but did not in group B and D. The survival rate was 0 in group A, 100% in group B and D, 12.5% in group C and 6.25% in group E. Compared with that in group E, the survival was significantly increased in the sFas group (P < 0.01).

CONCLUSIONSGraft transfected with sFas gene prolonged the post-BMT survival of leukemia/lymphoma mice. The transfection of sFas might block the effect of the immune escape of EL4 cells through FasL.

Animals ; Bone Marrow Transplantation ; immunology ; Combined Modality Therapy ; Female ; Genetic Therapy ; methods ; Leukemia, Experimental ; immunology ; therapy ; Male ; Mice ; Mice, Inbred C57BL ; Transduction, Genetic ; Transfection ; Transplantation, Homologous ; Tumor Escape ; fas Receptor ; genetics

To ascertain whether connective tissue growth factor (CTGF) participates in the remodeling of pulmonary artery at the early-stage of bleomycin (BLM)-induced pulmonary fibrosis, mean pulmonary arterial pressure, the expression of type I and type III collagens, and the expression and location of CTGF in pulmonary artery and arteriole were investigated in the present study. Sprague-Dawley rats received instillation of BLM [5 mg/kg body weight, in 0.5 mL of normal saline (NS)] or instillation of the same amount of NS as control. Mean pulmonary arterial pressure was detected via a catheter in the pulmonary artery. Type I and type III collagens were examined with Sirius red staining under polarized light. CTGF expression was investigated by using immunohistochemistry, and was represented as average optical density and percentage of positive area of CTGF. The mean pulmonary arterial pressure was higher in rats on day 14 after BLM instillation [(19.5+/-2.9) mmHg] than that in the control rats [(14.8+/-1.2) mmHg] (P<0.05). The type I and type III collagens were increased both in pulmonary artery and arteriole of rats on day 14 after BLM instillation, compared with those in the control rats (P<0.05, P<0.01, respectively). The ratio of type I/III collagens in pulmonary artery was also higher in BLM-treated rats than that in the control rats (P<0.05). The values of average optical density of positive CTGF staining were increased both in pulmonary artery (0.37+/-0.02) and arteriole (0.40+/-0.03) of rats on day 14 after BLM instillation, compared with those in the control rats (artery, 0.34+/-0.01; arteriole, 0.29+/-0.01) (both P<0.05). The percentages of positive area of CTGF were higher in pulmonary artery (8.40+/-1.13) and arteriole (12.4+/-2.0) of rats on day 14 after BLM instillation than those in the control rats (artery: 1.42+/-0.63; arteriole: 1.16+/-0.34), respectively (both P<0.05). The increased positive CTGF staining areas were mainly located in the endothelium and smooth muscle layer. It is therefore concluded that CTGF expression increases in the endothelium and smooth muscle layer of pulmonary artery and arterioles during high pulmonary arterial pressure and remodeling of pulmonary artery at the early-stage of BLM-induced pulmonary fibrosis, and that the increased CTGF might be one of the mechanisms of maintenance and development of pulmonary hypertension.
Animals ; Bleomycin ; Collagen Type I ; metabolism ; Collagen Type III ; metabolism ; Connective Tissue Growth Factor ; metabolism ; Hypertension, Pulmonary ; Pulmonary Artery ; metabolism ; Pulmonary Fibrosis ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo compare the efficacy and safety of remifentanil with fentanyl used for intraoperative anesthesia.

METHODSFifty-four patients undergoing modified radical mastectomy or total hysterectomy were randomly assigned to remifentanil group or fentanyl group with 27 cases in each group. Anesthesia was induced with propofol (2 mg/kg) and either remifentanil (2 micrograms/kg) or fentanyl (2.5 micrograms/kg), and was maintained with inhalation of nitrous oxide in oxygen (2:1) and a continuous infusion of either remifentanil (0.2 microgram.kg-1.min-1) or fentanyl (0.03 microgram.kg-1.min-1). Depth of anesthesia, hemodynamic changes, recovery profile of anesthesia, postoperative analgesia and adverse reactions were observed.

RESULTSThe number of patients exhibited light depth of anesthesia during tracheal intubation and maintenance in the remifentanil group was significantly fewer than that in the fentanyl group (P < 0.05). Hemodynamic changes during intubation, skin incision, maintenance of anesthesia and extubation in the remifentanil group were significantly smaller than those in the fentanyl group (P < 0.05, P < 0.01). The time to opening eyes on command and the time for extubation after surgery were comparable between the two groups. More patients in the remifentanil group required bolus injection of morphine for postoperative pain relief than those in the fentanyl group (P < 0.05). There was no significant difference between the two groups in the aspect of adverse reactions.

CONCLUSIONThe anesthetic and analgesic effects of remifentanil are more potent than those of fentanyl. Remifentanil can offer superior intraoperative hemodynamic stability compared with fentanyl without compromising recovery from anesthesia.

Adolescent ; Adult ; Anesthetics, Intravenous ; therapeutic use ; Breast Neoplasms ; physiopathology ; surgery ; Female ; Fentanyl ; therapeutic use ; Hemodynamics ; drug effects ; Humans ; Hysterectomy ; Mastectomy, Modified Radical ; Middle Aged ; Pain, Postoperative ; prevention & control ; Piperidines ; therapeutic use

OBJECTIVETo explore the quality of life and related social support among people living with HIV/AIDS with related factors.

METHODS331 people living with HIV/AIDS and 148 of their family members were selected using a typical sampling method. Questionnaires on general conditions, tables on history of infection, generic quality of life inventory-74 (GQOLI-74) and social support scale (SSS) were used.

RESULTSData from one-way analysis suggested that people living with HIV/AIDS and their family members with the different sexs, different villages and different cultural backgrounds had differences in GQOLI-74 scores (P < 0.05) while people living with HIV/AIDS with the different villages had differences in SSS scores (P < 0.05). Results from Multiple linear regression analysis revealed that being elderly and negative life events were negatively associated with social support (P < 0.05), while factors as more advanced educational background, harmonious neighborhood relationship and having bother pouring nature were the predictive factors (P < 0.05).

CONCLUSIONMany factors might affect dimensions of quality of life among people living with HIV/AIDS and their family members in rural areas of northern Anhui. Community care and social support of HIV/AIDS should still be greatly enhanced in the countryside of China. A community care mode based on family and neighborhood was expected to be developed.

Acquired Immunodeficiency Syndrome ; complications ; ethnology ; psychology ; China ; Cultural Characteristics ; Family Relations ; Female ; Humans ; Male ; Quality of Life ; Social Support