Objective To analyze the application effect and safety of streamlined liner of the pharynx airway (SLIPA) anesthesia in painless fiberoptic bronchoscopy (FB).Methods Two hundred and eighty-two patients who undorwent FB examination in Kaifeng Second People's Hospital from January 2015 to January 2017 were selected and divided into observation group and control group,with 141 patients in each group.The patients in observation group were given SLIPA assisted anesthesia;the patients in control group were given endoscopic mask assisted anesthesia.The oxygen saturation (SpO2),systolic blood pressure (SBP),diastolic pressure (DBP) and heart rate (HR) of patients in the two groups were monitored.The changes of SBP,DBP and HR,the incidence of adverse reactions and the satisfaction of patient to the anesthesia were compared between the two groups.Results The fluctuation of HR,SBP and DBP of patients in the observation group was (3.52 ± 2.92) times · min-1,(7.04 ±5.30) mmHg(1 mmHg =0.133 kPa),(1.52 ± 1.63) mmHg respectively and in the control group was (5.52 ± 1.89) times · min-1,(30.12 ± 8.88) mmHg,(4.06 ± 5.78) mmHg respectively;the fluctuations of HR,SBP and DBP of patients in the observation group were significantly less than those in the control group(P ＜ 0.05).In the observation group,12 patients with cough,8 patients with abdominal distension,6 patients with pharyngeal pain,2 patients with SpO2 ≤90％,4 patients with SpO2 ＜ 85％;in the control group,57 patients with cough,32 patients with abdominal distension,47 patients with pharyngeal pain,28 patients with SpO2 ≤90％,19 patients with SpO2 ＜ 85％.The incidence of adverse reactions of patients in the observation group was significantly lower than that in the control group (x2 =27.10,61.82,41.59,72.46,87.75;P ＜0.05).The anesthesia satisfaction of patients in the observation group(97.87％) was significantly higher than that in the control group(82.98％) (x2 =29.97,P ＜ 0.05).Conclusion SLIPA assisted anesthesia has good clinical effect and safety in patients with painless FB.

Objective To evaluate the clinical usefulness of MR imaging(MRI) and MR tomography angiography(MRTA) in demonstrating the presence and degree of neurovascular contact of the rostral ventrolateral medulla oblongata(RVLM) in root entry zone of the 9th and 10th cranial nerves in patients with essential hypertension(EHT) and normotensive health volunteers(NTHV).Methods(Patients with) EHT(group 1,n=100) and NTHV(group 2,n=88) underwent high-resolution(axial and coronal) brain stem MRI and MRTA.Images were interpreted consensually by tow radiologists who were blinded to the patients hypertensive status.Neurovascular contact was graded as vessel contact without RVLM deformity(gradeⅠ),clear vessel contact in continuity with the brain stem but without apparent associated deformity(graded Ⅱ), and displacement contact of the RVLM(graded Ⅲ).Results(Neurovascular) contact of RVLM was found in 52.0%(52/100) of EHT and in 43.2%(38/88) of NTHV(?~2=1.459,P=0.230).The compression rate(gradeⅠ—Ⅲ) and affected side(left or right) showed no statistically significant differences between the EHT and NTHV(?~2=0.879,P=0.350;?~2=0.238,(P=0.628);?~2=0.733,P=0.390).Conclusion Neurovascular contact is not more frequently seen in patients with EHT than in normotensive contact subject.This result does no support the hypothesis that neurovascular contact at the RVLM is an etiology of EHT.Furthermore,thin-slice(3 mm) MRI may not be a reliable good screening method for detecting patients with neurovascular contact.Therefore,MRI cannot aid patient selection among hypertension patients lacking symptomatic cranial neuralgias.

OBJECTIVETo explore the distribution features of Chinese medical constitutions in different ages population, thus providing scientific evidence of constitution process theory.

METHODSRecruited were 21 948 cases from a survey of Chinese medical constitutions and health conditions in 9 provinces or municipalities across China (including Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi, and Henan) from Dec 2005 to Jan 2007. The body constitution type of individual was diagnosed using discriminant analysis on the basis of Chinese medical constitution questionnaire. By using correspondence analysis, the correlation between the general population, genders, ages, and Chinese medical constitution types was studied.

RESULTSConstitutions of yin-deficiency type, wetness-heat type, qi-depression type, and special diathesis type often occurred in the population ranging 15 -24 years old. Gentleness type mostly occurred in the population ranging 25 -44 years old. During this time period, phlegm-wetness type and wetness-heat type were liable to occur in males, while blood-stasis type was liable to occur in females. Qi-deficiency type and yang-deficiency type were most often seen in those older than 45 years. Phlegm-wetness type and blood-stasis type body constitution were also liable to occur in those older than 45 years.

CONCLUSIONSThe distribution features were different in different Chinese medical constitutions. Different constitution types exist in different genders. Different constitution types exist different ages population.

Asian Continental Ancestry Group ; Body Constitution ; China ; Discriminant Analysis ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Qi ; Surveys and Questionnaires ; Yang Deficiency ; Yin Deficiency

Objective The study was conducted to investigate the acute phase of convulsion related problem on the clinical manifestations,imaging and electroencephalograph (EEG) examination of purulent meningitis.Methods Cluster sampling method was employed to select children in our hospital,a total of 301 cases with purulent meningitis was analyzed retrospectively.Among them,62 cases had convulsion.The incidence of convulsion in the acute phase of the purulent meningitis,risk factors,and prognosis were analyzed.Results The convulsion incidence rate of acute purulent meningitis was 20.60％.The partial seizure was eight cases (12.90％).The secondarily generalized seizure following partial seizure was 15 cases (24.19％).The generalized seizure was 32 cases (51.61％).The convulsive status was 7 cases (11.29％).The EEG abnormality was significantly different between the convulsion group and the no convulsion group (P ＜ 0.05).The incidence of brain organic damage was significantly different between two groups (P ＜0.05).The multivariate unconditional logistic regression analysis showed,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the relevant factors (P ＜ 0.01).Conclusions The most common seizure of purulent meningitis was the generalized seizure.Brain organic damage easily resulted in convulsion of purulent meningitis.The days of hospitalization,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the positively relevant factors.Those positively relevant factors in combination of the clinical manifestations,imaging,and EEG examination in children would play an important role in diagnosis,treatment,and prognosis evaluation of convulsion derived from purulent meningitis.Moreover,convulsion affects the disease recovery in children with purulent meningitis.

Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.

BACKGROUND: Recently, Chinese herb and comprehensive therapy are widely adopted for the treatment of chronic atrophic gastritis (CAG), while infrared ray is widely used in the fields of physical therapy and scientific research. Therefore, some scholars suggest whether the physical characteristics of infrared ray have effects on the treatment of chronic atrophic gastritis.OBJECTIVE: To observe the effect of infrared ray on the changes of gastric mucosa tissue in rat models with chronic atrophic gastritis.DESIGN: Randomized controlled observation.SETTING: Hebei North University.MATERIALS: Thirty-five adult Wistar male rats weighing from 180 to 230 g were purchased from Hebei Experimental Animal Center [SCXK (ji) 2003-1-003]. The experiment was disposed with the ethical standard. Sodium salicylate powder produced by Beijing Fangcao Chemical Company (batch number: 890720). The drug was prepared with distilled water. Infrared lamp (220 V, 200 W) was bought by Equipment Division of our college.METHODS: The experiment was carried out in the Experimental Center of Hebei Beifang College from June 2005 to January 2006. ① Experimental intervention: Rats were fed with conventional standard granules for one week. Among them, 8 rats were selected as the normal control group, and other rats underwent model establishment. Rats were perfused with sodium salicylate and alcohol to stimulate gastric mucosa, and then chronic CAG models were established for 8 weeks based on exertion, irregular diet and other factors. Five rats were randomly selected for the check of histopathology before the end of model confirmedly making, and then the model rats were randomly divided into model group and infrared group with 11 in each group. Infrared lamp (220 V, 200 W, 0.76–1.5 μm in wavelength) was used to vertically radiate at the gastric projective area of rats in the infrared group, once a day, ten minutes once for twenty days. The rats in normal group and model group were regularly breed. ② Experimental evaluation: The body mass was weighed every week in 1, 4, 9 and 12 weeks after modeling. The infiltration of inflammatory cells and thickness of gastric mucosa were observed under optic microscope.MAIN OUTCOME MEASURES: ① Changes of body mass; ② pathohistological changes of gastric mucosa.RESULTS: All 30 rats were involved in the final analysis. ① Changes of body mass: From the end of the 4th week, increasing percentage of body mass in the model group and infrared group was decreased gradually as compared with that in the normal group, and there was significant difference (P < 0.05). ② Pathohistological changes of gastric mucosa: Gastric mucosa of rats in the model group was thinner, and atrophic glands, notable inflammatory infiltration and partial intestinal metaplasia were observed under optic microscope. The thickness of gastric mucosa in the infrared group was significantly thicker than that in model control group, and there was significant difference (P < 0.01); the inflammatory cells in the infrared group were less than those in the model group, and there was significant difference (P < 0.05). Morphologic structure and volume of the parietal cells were all recuperated or closed to normal.CONCLUSION: Infrared ray can decrease thickness of gastric mucosa and reduce inflammatory cells of rats with chronic atrophic gastritis, and it has greatly therapeutic achievements.

Objective To compare the dose distribution of the three-dimensional conformal radiotherapy(3D-CRT)and 5-field or 7-field intensity modulated radiation therapy(IMRT), and to explore the value of IMRT in preoperative radiotherapy for rectal cancer.Methods Ten rectal cancer patients treated with preoperative combination radiotherapy and chemotherapy were enrolled in this study. 3D-CRT plan and the 5.field or 7-field IMRT plans were performed for each patient.The conformal index (CI),heterogeneity index(HI)of the planning target volume(PTV)and the dose of normal organs of 3D-CRT plan(3D-CRTp)and the 5-field or 7-field IMRT plans(IMRT5fp or IMRT7fp)were analyzed with the dose-volume histogram.Results The CI values of PTV were 0.91,0.87 and 0.78 in IMRT7fpIMRT5fp and 3D- CRT but with IMRT7fp>IMRT5fp>3D-CRTp(t=-5.69、-8.91,P<0.01),respectively.The HI values of PrV were 1.09,1.08 and 1.05 in IMRT5fp,IMRT7fp and 3D- CRTp but with IMRT5fp >IMRT7fp>3D- CRTp(t=3.41、-6.89,P<0.01),respectively.The ratio of dose volume were 0.08,0.10 and 0.19(t=2.79、3.52,P<0.05)in IMRT7fp,IMRT5fp and 3D- CRTp on the small intestine V50,with 0.07,0.10 and 0.19(t=2.58、3.40,P<0.05)in IMRT7fp,IMRT5fp and 3D-CRTp on the bladder V50 and 0.01,0.01 and 0.05(t=3.00、3.17,P<0.01)in IMRT7fp,IMRT5fp and 3D- CRTp on the fomoral head V45.The ratio of dose volume were 0.31 and 0.38(t=3.91,P<0.01)in IMRT7fp and IMRT5fp on the bone marrow V50,with 0.07 and 0.10 in IMRT7fp and IMRT5fp on bladder V45.Conclusions IMRT plan is superior to 3 D- CRT plan in dose conformal degrees of PTV with preoperative radiotherapy of rectal cancer and can significantly protect the normal tissues.The 7-field IMRT plan might be the optimal plan for dose conformal degree and dose uniformity compared with 5-field IMRT.

Objective To study the clinical therapeutic effect of arthroscopic debridement cooperated with injecting chuanxiongqin in treating knee osteoarthritis. Methods Sixty cases of knee osteoarthritis were randomly divided into 2 groups: treating group and control group, 30 cases in each group. The treating group were treated by arthroscopic debridement cooperated with injecting chuanxiongqin;the control group were given hyaluronate-Na after received arthroscopic debridement. The operation evaluation criteria of JOA was taken to value the therapeutic effect at 1 week, 3 months, 6 months and 12 months postoperation. At the same time, nitric oxide (NO) content in joint fluid were measured at preoperation, 1 week, 4 weeks, 3 months postoperation. Results At 1 week postoperation, there were no statistically significant differenced > 0.05) between the two groups,at 3, 6 and 12 months postoperation, the therapeutic effect of the treating group were much better than those of the control group (P < 0.01);NO content in joint fluid of preoperative treatment group [(90.32 ± 22.24) μmol/L]and control group [(90.31 ±22.20) μ mol/L]was similar, there was no significant difference (P >0.05). At 3 months postoperation, NO content in joint fluid of the treating group [(85.63 ± 30.63) μ mol/L]decreased significantly compared with preoperative (P < 0.05 ) , and the content was much lower than that of the control group [(89.66 ± 20.63 ) μ mol/L], there was significant difference between the two groups (P < 0.05). Although NO content in joint fluid of the control group was decreased, but the difference was not statistically significant (P >0.05). Conclusions Arthroscopic debridement with injecting chuanxiongqin in treating knee osteoarthritis can control inflammatory reaction of cartilage and synovia]in effect, improve the therapeutic effect. Therefore, it should be avalid method in treating knee osteoarthritis.

AlM: To explore the judgment of pattern reversal visual evoked potential on visual function and injured part of children with spastic cerebral palsy.METHODS: There were two groups in this study. 30 children with spastic cerebral palsy ( quadriplegia: 15, diplegia:15) were selected as observation group, while 30 normal children were selected as control group with randomized controlled trial. The changes of half-view and full- view incubation period and amplitude were observed by pattern reversal visual evoked potential.RESULTS: Full-view pattern reversal visual evoked potential: the P100 incubation period of the observation group was 113. 55 ± 8. 14ms, and the P100 amplitude was 23. 08±15. 41μV. The P100 incubation period of the control group was 105. 05 ± 5. 58ms, and the P100 amplitude was 31. 65±7. 37μV. From the comparison on P100 incubation and P100 amplitude between two groups, the difference was statistically significant ( P<0. 05 ) . P100 incubation period of the spastic diplegia of full-view pattern reversal visual evoked potential was 112. 73±7. 22ms, and the P100 amplitude was 21. 03±12. 17μV. P100 incubation period of the spastic quadriplegia was 114. 37 ± 9. 02ms, and the P100 amplitude was 25. 14 ± 18. 06μV. From the comparison on P100 incubation and P100 amplitude between two groups, the difference had no statistically significance (P>0. 05). Compared to the control group, each eye and each view latency of observation group were higher, the difference was statistically significant ( P<0. 05). The change of the incubation period of the full-view and half - view pattern reversal visual evoked potential took place in the lesion of the visual pathway:including optic neuropathy, some optic nerve lesion, lesion after optic chiasma, and optic chiasma lesion. Among them, the lesion after the optic chiasma was the most common.CONCLUSlON:Pattern reversal visual evoked potential can help people to understand the visual impairment and injury of children with spastic cerebral palsy in order to identify the abnormal children and early intervention.

Objective To study the effect of leaf movement speed on the setup error of multileaf collimator (MLC) in RapidArc mode,and to improve quality assurance and verify the reliability of RapidArc.Methods Referring to the PicketFenceStatic_M120.dcm and PicketFenceRA_Ml20.dcm files,the Tilt tests with different adjacent leaf speed were designed and setup errors of MLC were obtained by analyzing electronic portal imaging device images.Results In the Tilt tests,the setup errors gradually increased from gapl 1 to gapS0 in both static gantry mode and RapidArc mode.With a gantry angle of 270°,gap41 had the maximum setup error of-0.55 mm.In the RapidArc mode,gap46 had the maximum setup error of-0.67 mm.The deviation of gap width was no greater than 15％ in any mode.There was no significant difference in deviation pattern of gap width between four modes with different gantry angles.The same gaps in different stripes showed a consistent trend in gap width.The RapidArc mode had a larger variation in percentage deviation of gap width than the static gantry mode.Conclusions The setup error increases with the increase in the speed of MLC leaf.The variation in the leaf speed has no significant impact on the gap width.There is no correlation between the leaf speed and the deviation of gap width.Four different gantry angles give similar deviation patterns of gap width,suggesting that the deviation of gap width is related to the leaf rather than the gantry angle.The RapidArc mode has a greater impact on the gap width than the fixed gantry mode.