Objective To investigate anesthesia efficacy and safety between two drugs joint propofol intrave-nous anesthesia for colonoscopy,to provide reference for clinical treatment.Methods 120 routine colonoscopy patients were selected,they were randomly divided into control group and observation group,60 cases in each group. Patients of the control group were given ketamine and propofol before examination.Patients in the observation group were given fentanyl and propofol for intravenous anesthesia before the examination.The arterial pressure MAP,heart rate,HR,pulse oximetry SpO2 ,recovery time,time away from the hospital,anesthetic effects and adverse reactions were compared between the two groups.Results Anesthesia excellent rate in the observation group was 86.67%,that was 85.00% in the control group,the difference was not significant (χ2 =0.984,P =0.114).In the observation group,the recovery time and time away from the hospital were (7.44 ±1.24)min,(19.11 ±2.67)min,which were significantly shorter than those in the control group,the differences were statistically significant (t =5.847,P =0.004;t =6.922,P =0.001).The MAP,SpO2,HR at different time points showed statistically significant differences between the two groups(P >0.05).The incidence rate of adverse reactions in the observation group was 21.67%, that in the control group was 36.67%,the difference was not statistically significant (χ2 =5.665,P =0.007). Conclusion Fentanyl and propofol for intravenous anesthesia in colonoscopy has good anesthetic effect and good safety,which is worthy of clinical application.

OBJECTIVETo investigate the relationship between the level of di-2-ethylhexyl phthalate (DEHP) and idiopathic oligoasthenospermia by measuring the content of DEHP in the semen samples of different subjects.

METHODSWe obtained semen samples from 100 infertile men with idiopathic oligoasthenospermia, 50 working all the year round in the plastic greenhouse (group A) and the other 50 constantly dining from plastic meal boxes (group B). We also enrolled 50 normal male volunteers as controls (group C). We conducted semen analyses using a computer-assisted sperm analyzer, measured the DEHP concentration by reversed-phase high-pressure liquid chromatography, and subjected the data to statistic processing by t-test and correlation analysis.

RESULTSThe mean concentrations of DEHP in the seminal plasma were (0.72 +/- 0.48), (0.71 +/- 0.49) and (0.21 +/- 0.18) mg/L in groups A, B and C, respectively, significantly higher in A and B than in C (both P < 0.05). The DEHP concentration was negatively correlated with sperm motility (P < 0.05).

CONCLUSIONThe DEHP level in the seminal plasma is higher in infertile men frequently exposed to plastic products than in normal males and excessive DEHP may be one of the important factors of idiopathic male infertility.

Adult ; Case-Control Studies ; Diethylhexyl Phthalate ; adverse effects ; Humans ; Male ; Oligospermia ; etiology ; Plastics ; adverse effects ; Semen ; chemistry

Objective To observe the analgesic and sedative effects of dezocine injection on the medical thoracoscopy check -up.Methods 98 cases of patients with unexplained pleural effusion were randomly divided into sedation group(dezocine group,49 cases)and anesthesia group(local anesthesia by lidocaine,49 cases)by adopting digital expression method.Sedation group was intravenously injected with 5mg dezocine before the operation,and another 5mg dezocine was mixed with 100mL of 0.9% sodium chloride for intravenous drip,with 10mL of 2%lidocaine for local anesthesia during the operation;anesthesia group was only administered with 10mL of 2% lidocaine for local anesthesia.Verbal rating scales(VRS)results and visual analogue scales(VAS)results of the two group patients,as well as their hemodynamics and pleural reaction were recorded.Results The VAS scores of the sedation group and anesthesia group were (4.3 ±2.2)points and (2.1 ±1.9)points,respectively,VRS scores were (3.5 ± 1.1)points and (1.4 ±1.1 )points,there were statistically significant differences(t =0.415,P =0.019 and t =0.293,P =0.006,respectively).The two groups had basically similar operation duration,but the sedation group had more stable hemodynamic indexes such as maximum heart rate,systolic pressure,diastolic pressure and pleural reaction,including cough,dizziness,chest tightness,sweating,etc.Conclusion Dezocine injection can be used in medical thoracoscopy check -up and treatment,with significant analgesic effect and less adverse reaction,effectively alleviating the discomfort of thoracoscopy check -up,and improving patients′compliance and comfort,so as to enhance the success rate of thoracoscopy check -up.

It is reported by current investigations,that BNP can suppress heart hypertrophy but it can also depress compensatory hypertrophic response.BNP is an useful marker in the early diagnosis,prognosis,therapy guiding of heart failure and coronary heart disease,but comorbid conditions should be considered in the diagnosis of heart failure.The polymorphism in the 5'-flanking region of the NPPB gene is found to be related with essential hypertension.On the basis of some investigation,it is supposed that the instillation of BNP at the early stage of hypertension will contribute to therapy of hypertension.

Objective To determine the association between homocysteine and severity of large cerebral artery atherosclerosis.Methods Total 152 ischemic stroke patients were evaluated using transcranial Doppler(TCD),magnetic resonance angiography(MRA) or digital substraction angiography(DSA).Severity of cerebral artery atherosclerosis was scaled by number of stenosed or occluded artery.Results There were 83 patients in low level homocysteine group with mean Hcy level(15.31?3.08)?mol/L,while 69 patients in high level homocysteine group with mean Hcy(34.47?21.38)?mol/L.Number of abnormal intra-and extra-artery was 1.86?1.51 and 1.52?1.46 respectively.No significant difference was demonstrated in the number of abnormal artery between two groups.No correlation was noted between Hcy and number of abnormal artery.Conclusion There is no relationship between high homocysteine and severity of large cerebral artery atherosclerosis in ischemic stroke patients.Homocysteine might be the marker of the disease.

Objective To discuss combined detection of pleural biopsy under medical thoracoscopy and pulmonary serum tumor markers in diagnosis of pleural effusion with unknown reason.Methods 76 patients with pleural effusion caused by unknown reason from January 2014 to March 2016 were retrospectively analyzed. Pleural biopsy was conducted under medical thoracoscopy and sent for pathological examination, and 10 ml venous blood was collected from these patients upon admission for testing serum tumor markers (CEA, SCC-AG, ProGRP and CYFRA21-1).Results Among the 76 patients, there were 32 cases with benign lesions (14 with pulmonary tuberculosis, 9 with inlfammatory lesions, 6 with granulomatous inlfammation, 2 with empyema and 1 with hamartoma) and 44 cases with malignant lesions (18 with adenocarcinoma, 13 with squamous carcinoma, 6 with small cell lung cancer, 3 with adeno-squamous carcinoma, 2 with mesothelioma, 1 with large cell carcinoma and 1 with thymoma). The detection of serum tumor markers showed statistically significant differences in the levels of CEA, SCC-AG, ProGRP and CYFRA21-1 in serum between the malignant pleural effusion group and benign pleural effusion group (P = 0.021,P = 0.006,P = 0.003 andP = 0.010). The levels of various serum tumor markers in the malignant pleural effusion group were obviously higher than those in the benign pleural effusion group. According to the pathological results, patients with pleural effusions not caused by lung cancer (2 with mesothelioma and 1 with thymoma) were eliminated from 44 patients with malignant pleural effusions. The rest 41 patients with pleural effusions caused by lung cancer were divided into non-small cell lung cancer and small cell lung cancer according to the pathological types. The results showed that there were statistically signiifcant differences in the levels of CEA, ProGRP and CYFRA21-1 between non-small cell lung cancer and small cell lung cancer (P = 0.036,P = 0.005 andP = 0.008), while there was no statistically signiifcant difference in the level of SCC-AG (P = 0.811).Conclusions Due to high detection rate and high accuracy in detecting pleural effusions caused by unknown reason, medical thoracoscopy is of great signiifcance, especially for the diagnosis of malignant pleural effusions of pleural metastases. However, serum indicators may provide important reference values for us before the pathological results are available. Thus, it is an important means of diagnosing malignant pleural effusions caused by lung cancer and should be promoted in clinic.

Objective To explore the application value of minimally invasive surgery in the treatment of lumbar spinal tuberculosis, and to provide reference for clinical treatment of spinal tuberculosis. Methods Data of 252 cases of patients with lumbar spinal tuberculosis treated by conservative treatment in our hospital from January 2005 to December 2014 were retrospectively analyzed. Patients were divided into four groups on the basis of systemic application of antituberculosis chemotherapy. A total of 154 patients were given simple local chemotherapy of percutaneous placement of focus catheter (group A), 48 patients were received percutaneous perfusion drainage and local chemotherapy (group B), 32 patients underwent percutaneous puncture catheter debridement combined with local chemotherapy (group C), and 18 patients were given percutaneous debridement and internal fixation combined with local chemotherapy catheter (group D). Data of erythrocyte sedimentation rate (ESR), visual analogue scale (VAS), Oswestry disability index (ODI) score and the modified MacNab criteria were recorded before operation and at the end of the follow-up in four groups of patients. Results Of the 252 patients, 228 were followed up and 214 patients achieved clinical cure. The lost access were15 cases in group A, 5 cases in group B, 2 cases in group C and 2 cases in group D. The total rate of lost visit was 9.52%. The follow up duration ranged from 25-126 months. The mean duration of follow-up was 68(60, 76) months. A total 214 cases reached the standard of clinical cure. No complications (retrograde infection and cross infection) were found in all patients during treatment. ESR was statistically decreased to (7.26 ± 3.43) mm/1 h at the last follow-up (t=35.06, P=0.023) compared with that (44.96 ± 12.42) mm/1 h before operation. The VAS and ODI were 1.5(1, 3) and 30(25, 35)% at the last follow-up, which were significantly improved than those [7.5(7.0, 8.0) and 60(55, 65)%] before operation (Z=13.641 and 6.806, P<0.05). According to the improved MacNab criteria, the overall excellent and good rates for patients were 86.4%(197/228) at the last follow-up. Conclusion According to the stepped care and personalized treatment, patients of lumbar tuberculosis are preoperative comprehensive evaluated, and most patients can achieve long-term stability and a better clinical efficacy after interventional and minimally invasive treatment.

Objective To explore the relationship between case mix index ( CMI ) and the bed allocation in clinical departments, and to evaluate the performance of bed scale of departments at tertiary hospitals based on CMI. Methods Based on the HIS system of a tertiary hospital, the authors collected the disease treatment information and bed allocation information of each clinical department in 2015. The CMI value was calculated by means of diagnosis-related group( DRG) , while the proportion of cases and average daily beds occupancy corresponding to the quartile of the CMI value of each department was also counted. Then the bed occupancy and distribution of various patients were analyzed. Results The hospital′s overall CMI value, DRG groups, DRG cases at the departments, days of stay, DRGs, CMI values and its quartiles were calculated. It was found that the medical and surgical CMIs had a linear relationship with the critical proportion (r=0. 998, 0. 996, P<0. 001). The main influencing factors of average daily bed occupancy were ranged from high to low as followed: the number of cases that were allocated in the group, employee numbers and CMI (F=87. 656, P<0. 001). Conclusions CMI is an ideal indicator for the difficulty of medical services at different departments and for evaluating the bed scale performance. Hence it can be used as an important reference for bed number adjustment in hospitals.

Objective To investigate the changed brain areas of functional connectivity ( FC ) patterns of subthalamic nucleus ( STN) between different subtypes of Parkinson′s disease ( PD) and healthy controls and their clinical significance .Methods Twenty-three PD patients and 12 health controls were enrolled, and PD patients were divided into 11 tremor dominant PD patients and 12 postural instability and gait disorder (PIGD) dominant PD patients.The difference of whole-brain resting-state FC with STN among the three groups was investigated and the relationship between the changed areas and clinical symptoms was calculated.Results Compared with healthy controls , PIGD dominant group showed increased FC between STN and right calcarine and decreased FC between STN and right precuneus , and tremor dominant PD patients showed decreased FC between STN and precuneus , right angular gyrus and left middle frontal gyrus , while the FC strength between the STN and left middle frontal gyrus showed positive relationship with MMSE scores ( r=0.64, P=0.034 ) .Compared with tremor dominant PD patients , PIGD dominant patients showed increased FC in the area of left calcarine .Conclusions Decreased FC between STN and precuneus was gained in different subtypes of PD , and PIGD dominant patients showed increased FC between STN and calcarine.Changed areas based on the FC of STN in different subtypes of PD were found related with cognition and mood control .

Objective To study term selecting principles and methods of subject terms in the class ofPharmaceutical Zoology and Botanyfor the new edition of TCM Materia Medica Subject Headings;To provide references for the revision.Methods Based on the compiling principles, word frequency of subject headings in TCM database were used as references. MeSH was referred to establish detail rules and regulations for revision of TB class.Results In TB class, 226 subject headings were planned to delete, such as Apocynum Linn, Piper betle Linn, cetacean anddolphins;42 subject headings were planned to add, such as Kalimerisindica, Actinidiaceae and Squamata.Conclusion This revision formulated individual revision principles, proposed solutions for common problems, and basically completed adding and deleting of TB class and frame adjustment.