Objective To observe the feasibility of phase-rectified signal averaging applied for the evaluation of automatic nervous system activity in general anesthesia.Methods Forty-seven fe-males and 63 males aged 18-65 years,ASA falling into category Ⅰ or Ⅱ,scheduled for oral maxillo-facial surgery under general anesthesia were selected.The heart rate variability(HRV)signal was re-corded by Powerlab throughout the operation,and then it was sectioned into three segments with 5 minutes:pre-anesthesia(T0 ),means the waking state before the operation;intra-anesthesia(T1 ),the period of operation in 25-30 min;post-anesthesia(T2 ),the consciousness recovery state in the end of the operation.All indicators of HRV analysis was calculated in the time domain.SpO 2 ,MAP and BIS were recorded synchronously in the three periods.Results Compared with T0 ,DC, RMSSD, SDNN,SD1,SD2,logTP,logLF,logHF were significantly lower at T1 and T2 (P <0.05).In con-trast to T1 ,HR,MAP and BIS were significantly higher at T2 (P <0.05 ),DC,RMSSD,SDNN, SD1,SD2,logTP,logLF,logHF were significantly increased at T2 (P <0.05 ).There was positive relation between DC and RMSSD,SD1,logHF (r =0.905,0.909,0.932,respectively,P <0.01). Conclusion As 5 min-DC could indicate the character of PRSA,especially its specificity in showing vagus nerves activities,it is feasible that DC is used to observe the autonomic nerve activity intra op-eration.

In the article the effect of thyroid hormones was reviewed on cardiac ion channels and transports, so as to explain the changes of the action current on cardiac myocyte. Based on the molecular biology, the hormonal regulation of cardiac and transports were discussed and explained.

Objective: To compare the diagnostic value of two-dimensional time-of-flight (2D TOF) magnetic resonance venography in the sagittal plane, 2D TOF in the coronal plane, and three-dimensional contrast-enhanced magnetic resonance venography (3D CE-MRV) for intracranial venous sinus disease. Methods: Thirteen patients were suspected of having intracranial venous system abnormalities in the Neuro-surgical Outpatient Department, Xuanwu Hospital, Capital Medical University were included from July 2011 to March 2012. 2D TOF and 3D CE-MRV scan in the sagittal and coronal planes were performed at the same time. Maximum intensity projection (MIP) was used for 3D reconstruction. The diagnostic results were compared with DSA. The sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of the 8 main vein structures (superior sagittal sinus, straight sinus, bilateral transverse sinus, bilateral sigmoid sinus and bilateral transverse-sigmoid sinus junction) of the 2D TOF in the sagittal plane, 2D TOF in the coronal plane, and 2D TOF in the sagittal plane in combination with coronal plane were calculated. Results: Circled digit oneCompared to the diagnostic results of DSA, there was significant difference in using the diagnosis with TOF in the sagittal plane or coronal plane alone (all P <0.05), but there was no significant difference after combining the two methods (χu2 =1.500, P>0.05). Circled digit twoTaking DSA as a standard, the consistency of 3D CE-MRV and DSA conclusions was the highest (P<0.01, Kappa =0.933). The sensitivity, specificity, positive predictive value, and negative predicting value were 94.4%, 98.8%, 94.4%, and 98.8%, respectively. The consistency of the diagnostic results of 2D TOF in the coronal plane in combination with sagittal plane and the DSA conclusions were higher than that of 2D TOF in the coronal plane or 2D TOF in the sagittal plane alone (Kappa values were 0.815, 0.635, and 0.608, respectively). Conclusion: When it is difficult to diagnose intracranial venous sinus disease with 2D TOF in the coronal plane or 2D TOF in the sagittal plane alone, the 2D TOF sequence of other direction should be added, the collaborative diagnosis of both may improve the accuracy of diagnosis. The diagnosis of 3D CE-MRV and DSA showed a high degree of consistency. They may be used as a routine examination for the diagnosis of cerebral venous sinus disease.

Health Promotion ; Humans ; Occupational Health

Objective To analyze the use of proton pump inhibitors( PPIs) in the perioperative period of Zhoushan Hospital,thus to make appropriate management regulations for the clinical application of PPIs. Methods From September 2016 to October 2016,the use of PPIs in 614 surgical patients of Zhoushan Hospital were statistically analyzed. The rationality of the indications,drug use,drug administration,dosage,time,course of treatment,combined medication were analyzed. Results In 614 cases,there were 341 reasonable,unreasonable 273,the failure rate was 44. 46% (273/614). The main manifestations in the non indication of medication and medication course of treatment was too long. Conclusion There are many unreasonable phenomena in the course of clinical use of PPIs. Hospital and clinical pharmacists should strengthen supervision and management of the use of PPIs.

In this paper the causes of deficiency of public welfare were analyzed in medical research,and some strategies were proposed to enhance the public welfare of public health care services according to the cardinal principles of new healthcare reform package in 2009.These were benefit to maintain the public welfare of public medical and health care services,and to reach the goal of medical research served as the clinic and the patients.

Objective:To explore the imaging manifestation of elastofibroma dorsi in18F-FDG PET-CT.Methods: The back soft tissue mass of abnormal metabolism was found by18F-FDG PET-CT scan, and then delayed imaging for the mass was performed.Results: Surgical pathology confirmed it was elastofibroma. The tumor showed clear boundary, there was no damage to adjacent ribs, and this method was mild radioactivity uptake, besides, metabolism was decreased at delayed imaging in18F-FDG PET-CT; the patient had no correlated clinical symptomatic and apparent positive physical signs.Conclusion: Tumor detection rate of18F-FDG PET-CT for elastofibroma dorsi is higher than normal CT detection. And the delayed manifestation for metabolism were decrease. Therefore, these situation accordance to benign tumor metabolism changes.

Objective To investigate the role of retroperitoneal lymph node dissection (RPLND) in the treatment of testicular cancer. Methods The clinical data of 39 cases (age range,20-58 years;median age,29 years) of germ cell tumor who underwent RPLND were retrospectively analyzed.Of the 39 cases,17 had the tumors on the left side and 22,on the right.One case was of seminoma,and the other 38 were of non-seminomatous germ cell tumor (NSGCT).According to the clinical examinations and radiology, 20 cases were of stage Ⅰ,15 of stage Ⅱ,and the rest 4 could not be staged. Results Of the 39 cases,10 with stage I tumors underwent nerve-sparing modified RPLND and the other 29 underwent bilateral RPLND.No metastasis was found in the dissected tissues in 22 cases,while metastasis,in 17 (including 4 of clinical stage I).All the patients with pathological metastases or elevation of blood tumor markers received postoperative chemotherapy.Follow-up was carried out for 1-149 months.The disease-free survival rate was 97.4%(38/39).Of the 10 cases receiving modified RPLND,8 regained their ejaculation function. Conclusions The probability of presence of the non-seminomatous components must be considered in the diagnosis and follow-up of seminoma cases,and the RPLND should be done if necessary.Nerve-sparing modified RPLND should be performed for clinical stage Ⅰ patients;while postoperative chemotherapy should be chosen for pathological stage Ⅱ patients.

Objective:To investigate the possible roles of the negative co-stimulation molecule PD-L(ligand) in the T-cell mediated immune response against tumor.Methods:Flow cytometric analysis was used to examine murine tumor cell line L929 expresses PD-L(L1 and L2).Anti-PD-L blocking monoclonal antibodies combined with injection i.p.of irradiated L929 into C57BL/6 mice was employed to sensitize the T cells of the animals.2 weeks after sensitization,mice were sacrificed,and splenocytes were prepared to perform the examinations of T cell proliferation,cytotoxic T cells(CTL) activity,and apoptosis through in vitro coculture with L929 in the presence of blocking PD-L antibodies.Results:The expression of PD-L1 by L929 was detectable,whereas there was no expression of PD-L2 on these cells.Application of blocking antibody against PD-L1 or PD-L2 together with irradiated L929 cells in the process of in vivo sensitization as well as in vitro stimulation,it was shown that blockade of PD-L1 significantly enhanced the T cell proliferation induced by L929 cells and the CTL activity against L929,evidenced by the increased apoptosis and death rate of L929 cells.In control,blockade of PD-L2 had small effects on these terms.Conclusion:The negative co-stimulation molecule PD-L1 plays a role in the escape of tumor cells from host T-cell mediated tumor immunity.Therefore,blockade of PD-L1 has potential significance for tumor immunotherapy.

Objective To discuss the clinical applied value of MSCT MPR in displaying the relation between periampullary diverticula(PAD) and pancreaticobiliary duct.Methods There were 32 patients with PAD found through the volume scans by MSCT, and proved by endosope or GI. The axial source images after being reconstructed were transmitted to Vitrea workstation for observation, and the images which were valid to show the relation between PAD and pancreaticobiliary duct were get.Results In 32 patient,34 PADs were found,22PADs located above the papilla , 7 located in the neck edge of diverticula , 4 were papilla in diverticula and 1 located below papilla .Conclusion MPR can clearly display PAD and pancreaticobiliary duct, their relation and pancreaticobiliary disease.