Objective: To observe the effect and safety of application of combined spinal and epidural anesthesia to hip surgery on the elderly.Methods: 47 patients aged over 70 years underwent hip surgery;All patients were given combined spinal and epidural anesthesia with 7.5mg~10mg of 0.5% bupivacaine(1~1.4ml of 0.75% bupivacaine was attenuated with 0.5~1ml of cerebrospinal fluid;density: 1.010).The time to anesthesia?sensory block levels and the effect of analgesia and muscle relaxation were recorded;BP?HR and SPO2 were monitored.Results: Foot febrile and lower limb numbness appeared in 40 patients immediately after drug administration;foot febrile appeared in 7 patients 3min after drug administration.There were 3 patients at the highest sensory block levels(T6)?40 patients at T10~12 and 7 patients at T7~9.Combined spinal and epidural anesthesia could provide 100% satisfactory analgesia and muscle relaxation during operation.BP and HR had no obvious variation after anesthesia.Conclusion: The application of combined spinal and epidural anesthesia has the advantage of low-dosage?fast-acting?consummate analgesia?satisfactory muscle relaxation and small interference with recirculating and respiratory system;etc,and so it is safe and effective for hip surgery on the elderly.

Objective To investigate the effect of pretreatment with penehychidine hydrochloride(PHCD) on NF-κB activity in the lung tissue following acute lung injury(ALI)induced by hemorrhagic shock in rats.Methods Twenty-four Wistar rats of both sexes weighing 200-250 g were randomly divided into 3 groups (n=8 each):group Ⅰ sham operation (group S);group Ⅱ ALI and group Ⅲ PHCD.The animals were anesthetized with intraperitoneal chloral hydrate 350 mg/kg.Hemorrhagic shock was produced in group Ⅱ and Ⅲ.Right carotid artery was cannulated for BP monitoring.Left femoral artery was cannulated for blood letting.MAP was reduced to 35-45 mm Hg within 10 min and maintained for 1 h in group ALI and PHCD(group Ⅱ andⅢ).The animals were then resuscitated with blood and normal saline.PHCD 2 mg/kg was given iv immediately before blood-letting in group PHCD.Blood samples were obtained from artery at 6 h after hemorrhagic shock wag induced for blood gas analysis and from right auricle for determination of plasma TNF-α concentration by ELISA.The lungs were then harvested for microscopic examination and determination of the expression of NF-κB p65 by immuno-histochemistry and W/D lung weight ratio.Results The plasma TNF-α concentration and expression of NF-κB p65 in the lung tissue were significantly increased in group ALI and PHCD as compared with group S and were significantly lower in group PHCD than in group ALI.There was less damage to the lung tissue in group PHCD than in group ALI.Conclusion PHCD pretreatment can attenuate ALl induced by hemorrhagic shock by inhibiting NF-κB activity.

Survivin is the strongest member of the inhibitor of apoptosis protein(IAP)family. Smac is the second mitochondria-derived activator of cysteine proteases,which can promote apoptosis by combining with IAP. Abnormal expression of them is closely related with occurrence,development,treatment tolerance and prognosis of ovarian cancer. It is prompted that Survivin and Smac are expected to play important roles in the early diagnosis and targeted therapy of ovarian cancer.

Compared with the traditional teaching methods,multimedia teaching has specific advantages and has been widely used. Meanwhile,the defects in multimedia teaching must be attached great importance to. This paper focuses on some problems widely existing in the multimedia teaching and sets forth several proposals of promotion in the use of multimedia teaching.

AIM: To compare the efficacy of different locations scleral tunnel incision in phacoemulsification cataract on preoperative corneal astigmatism.
METHODS:Totally 90 patients (94 eyes) in our hospital who had undergone the phaco-surgery from March 2013 to October 2014 were divided into two groups. The group A was those with 3. 2mm scleral tunnel incision at the direction of 10:00 ~11:00 points. The group B was those with 3.2mm scleral tunnel incision at the steepest corneal meridian. Incision was not sutured. Corneal astigmatism status of preoperative and postoperative at different times were detected by corneal refractive. The impact of different surgical incision on postoperative corneal astigmatism was compared. In the two groups, patients with preoperative corneal astigmatism<1. 00D, 1. 00 ~2.00D and > 2. 00D were compared respectively. The changes of the uncorrected visual acuity and corneal astigmatism at postoperative 1wk, 1 and 3mo were observed.
RESULTS:The uncorrected visual acuity of the patients who were in the group B preoperative corneal astigmatism <1. 00D and 1. 00 ~ 2. 00D was better than that in the group A. The postoperative corneal astigmatism of the patients who were in the group B preoperative corneal astigmatism <1. 00D was lower than that in the group A.
CONCLUSION: On the basis of preoperative corneal astigmatism, 3. 2mm scleral tunnel incision at the steepest corneal meridian to some extent can correct preoperative corneal astigmatism < 1. 00D, and accordingly improve the uncorrected visual acuity.

Acute Disease ; Cardiomyopathies ; chemically induced ; Chemical and Drug Induced Liver Injury ; Critical Illness ; Ethylene Oxide ; poisoning ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; chemically induced ; Occupational Diseases ; chemically induced ; Respiratory Tract Diseases ; chemically induced

OBJECTIVE: To determine the content of dracorhodin in Diedaqili Tablets by HPLC. METHODS: The separation was performed on Diamonsil TM C18 column. The mobile phase consisted of acetonitril-0. 05mol? L-1 sodium biphosphate solution ( 45∶ 55) with detection wavelength at 440nm and flow rate at 1. 0mL? min-1. RESULTS: The calibration curve of dracorhodin was linear within the range of 0. 122～ 0. 854? g ( r=0. 999 9) , with average recovery at 101. 4% ( RSD=0. 91% ) . CONCLUSION: This method is simple, reliable and reproducible, and suitable for the quality control of Diedaqili Tablets.

Objective To explore therapeutic effects and indications of stereotatic puncture and drainage under multi-parameter orientation in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods A total of 56 patients with HICH underwent stereotatic puncture and drainage from October 2003 to May 2005.The entrance position,the puncture plane,the puncture angle and depth,and the length of side hole of drainage tube were accurately designed before operation,and,if necessary,multiple drainage tubes were introduced via one hole.Results According to the Glasgow Outcome Scale(GOS) scores,12 patients recovered well(21.4%),29 patients were moderate disability(51.8%),and 12 patients were severe disability(21.4%).No longstanding coma was noted.Three patients died(5.4%). Conclusions Stereotatic puncture and drainage under multi-parameter orientation has better therapeutic effects and less damages than open operation.The procedure is suitable for 10~60 ml hematoma,especially in elderly patients and deep-located hematoma.The best operation timing is 3~6 hours after the onset of hemorrhage.

Objective To explore the clinical value of CT-guided selective radiofrequency thermocoagulation of the semilunar ganglion for the treatment of primary trigeminal neuralgia(PTN).Methods A total of 24 patients with PTN were included.Under local anesthesia and CT guidance,the semilunar ganglion was punctured by way of the oval foramen via the anterior approach using the Hartel's technique.Selective radiofrequency thermocoagulation was performed after the targets were confirmed by electrical stimulation. Results The pain was completely relieved in 18 patients,partially relieved in 5 patients,and unchanged in 1 patient,the total effective rate being 95.8%(23/24).Follow-up observations for 3~18 months(mean,12 months) in the 24 patients showed recurrence in 2 patients(8.3%).Conclusions CT-guided selective radiofrequency thermocoagulation is a safe,simple,and effective option for the treatment of PTN,especially suitable for the elderly and high-risk patients.

Nasal polyps is a common disease in clinical, with nasal mucosal inflammatory hyperplasia. However, the molecular mechanism of it is largely unknown. Tumor suppressor genes, proliferation and apoptosis related genes and cytokines play an important role in the formation and pathological development of nasal polyps. The expression level of tumor suppressor related proteins and receptors is not constant, high level of these expression can stimulate nasal mucosal proliferation, while low or lacking expression may facilitate nasal polyps cells apoptosis. Both proliferation and apoptosis make a big difference in nasal polyps formation and development. This article concludes the relationships between new progressions in nasal polyps pathogenesis and tumor suppressor genes and proliferation apoptosis genes, which not only helps practitioners deeply and comprehensively understand nasall polyps pathogenesis but promotes explorations to effective therapeutics.
Apoptosis ; Apoptosis Regulatory Proteins ; genetics ; Cytokines ; Disease Progression ; Genes, Tumor Suppressor ; Humans ; Nasal Mucosa ; Nasal Polyps ; genetics