Objective] The article explores and analyses the clinical dialectical experience of my postgraduate tutor in the treatment on chronic abdominal pain of children. [Methods]From following professor Sang Gao clinical studies,summarize the experience and thoughts of treating chronic abdominal pain of children,and with a case. [Results]My tutor believes that the pathogenesis of chronic abdominal pain of children caused by weakness of middle energizer, disorder of Qi, which lead to the spleen deficiency and qi stagnation, to cure the disease must treat with liver and spleen together, with activating the spleen and regulating the liver, harmonizing stomach and relieving pain as a rule which can achieve good effect. [Conclusion] Activating the spleen and regulating the liver is an effective treatment, it is worthy of in-depth study and promotion.

Objective: This trial was designed to study the profile of the pharmacokinetics of desflurane in balance anesthesia. Method:Forty ASA physical status Ⅰ and Ⅱ patients undergoing abdominal surgery were admitted to this study. All patients were anesthetized with balance anesthesia technique,which received delivered concentration(FD)of 6% desflurane in a fresh gas(O_2: N_2O=1:2)inflow of 3L/min until end-tidal target concentration(FA)of 3% des flurane was obtained, then the FD was adjusted to maintain the target concentration, 30 min later the inflow was decreased to 1.5L/min. As well as nitrous oxide,oxygen and carbon dioxide concentrations were measured at the common gas outlet and the endotracheal tube connector respectively. At same time fentanyl and atracurium were given as necessary. The SpO_2,BP,and HR were also measured. We observed the time of target concentration reached during wash-in period, and also the time of FA: FAO = 1/2 during wash-out period at the end of operation. Result: During the first 30 min of 3L/min flow administration,the target concentration was obtained at 2.9 min,and was kept stable during the whole procedure,even during low flow(1.5L/min)it was not required to increase the FD to maintain FA at the target concentration. The wash-out time of FA:FAO= 1/2 was 2.0 min from stopping adminstration. The time of spontaneous breath recovery, open eye, extubation.reciting of name and birthday and discharge from recovery room was 6, 5.8.6,9.0,12.0 and 30 min respectively. The parameters of cardiac function were stable during operation. Con clusion: During the balance anesthesia with desflurane.even at relative low flow.the FD of desflurane provides a reasortable surrogate of FI and FA. The lower solubility of desflurane favors its safe use in low-flow technique.and the anesthesia depth can be controlled more easy.

To compare the effects of desflurane, sevoflurane, isoflurane and enflurane on cardiovascular response to surgical procedures and recovery from anesthesia. Method: The 40 patients scheduled for abdominal hysterectomy under balanced anesthesia were randomly divided into desflurane (D), sevoflurane (S), isofluane(I)and enflurane(E)groups. After induction of anesthesia and endotracheal intubation, 6% of desflurane, 2% of sevoflurane,1. 15% of isoflurane and 1.7% of enflurane in oxygen and nitrous oxide(1:2) were inhaled in D,S,I and Egroups, respectively. The fractional end tidal alveolar concentration of inhaled anesthetics(Fa) was adjusted to 1MAC during the maintenance of anesthesia. 2?g?kg~(-1)?h~(-1) of fentanyl was infused simultaneously, and the rate of infusion was decreased by 50 percent after infusion for half an hour. Heart rate(HR), systolic pressure(SP), diastolic pressure(DP), SpO_2, and P_(ET)CO_2 were monitored continuously. Volume of minute ventilation(Ve)was observed before induction of anesthesia and 5, 15, 30, 45min after extubation. The recovery parameters of conciousness were also observed. Result: There was no significant difference among the four groups in hemodynamics. Within 30rain after extubation, Ve in I and E groups were lower than that before inductoin of anesthesia and that in D and S groups. The recovery time in D and S groups were significantly shorter thanthat in E and I groups. Conclusion: In balanced anesthesia,desflurane can effectively inhibit the cadiovascular response to surgical procedures and the recovery from anesthsia is faster than any other vaporized anesthetics.

Objective To investigate tumor lymphatic and mircovascular densities as prognostic markers in 69 cases of invasive breast cancer treated with partial or total mastectomy and lymph node dissection.Methods 69 cases of untreated primary unilateral invasive ductal breast carcinomas were selected.All cases were immunostained with D2-40 and CD31.Positively stained microvessels were counted in densely vascular/lymphatic foci (hot spots).The relationship between lymphatic vessel density (LVD),microvessel density(MVD) and prognosis was analyzed.Results The mean ± SD peritumoral lymphatic vessel density (P-LVD) was significantly higher than intratumoral LVD(I-LVD) (P ＜ 0.01).There was a positive correlation of D2-40 LVD(peritumoral) counts with lymph node metastasis (P =0.003) and clinical stage (P =0.026),and CD31 microvessel density was found significantly associated with clinical stage(P =0.038).No significant association was found between above variants with I-LVD (P ＞ 0.05).Univariate analysis showed that survival time was impaired by higher MVD and higher peritumoral LVD(P =0.007,P =0.008,P =0.014,P =0.024,log-rank test),but not I-LVD.Multivariate survival analysis showed that MVD,peritumoral LVD,TNM stage and lymph node metastasis were independent prognostic factors for overall survival.Conclusions Peritumoral LVD and MVD were significantly correlated with survival status of patients with breast cancer.This is the first attempt to predict prognosis of breast cancer patients by quantifying the peritumoral LVD and MVD.

BACKGROUND:Hyperbaric oxygen as a wel-recognized therapy for ischemic and hypoxic diseases has to be combined with other treatments. OBJECTIVE:To study the effects of hyperbaric oxygen combined with neural stem cel transplantation via tail vein in chronic stress depression rats. METHODS:Of 60 Sprague-Dawley rats, 15 rats randomly selected were given no treatment as normal group, and the rest 45 ones were used to establish a rat model of depression and randomly divided into three groups:model group (n=15, without giving any treatment), neural stem cel group (n=15, injection of 1 mL neural stem cel suspension (3×106) via the tail vein) and combined group (n=15, hyperbaric oxygen treatment plus neural stem cel injection). Hyperbaric oxygen treatments were carried out four times per day, for 1 week, and al the treatments were given 24 hours after modeling. Rats in each group were subjected to body mass measurement and sugar water consumption test 1 and 2 weeks after treatment, and open field test within 5 minutes after treatment to observe rat behavior changes. The survival and distribution of CM-Dil labeled neural stem cel s were observed by fluorescence microscopy. The changes in the size, morphology and number of hippocampus neurons in rat were detected by the method of nylon staining. TUNEL method was used to measure the apoptosis of nerve cel s. RESULTS AND CONCLUSION:Compared with the normal group, in the model group, rat’s body weight, sucrose water preference and open field test scores were significantly lower, reduced number of hippocampal neurons with intact structure was found and TUNEL results showed more apoptosis (P<0.05). Compared with the model group, the body weight, sucrose preference and open field test score increased significantly (P<0.05), the number of hippocampal neurons was increased, while the number of apoptotic cel s was reduced significantly in the neural stem cel and combined groups (P<0.05). Compared with the neural stem cel group, these indexes were improved more significantly in the combined group (P<0.05). More CM-Dil positive cel s were found in the combined group than the neural stem cel group (P<0.05). Additional y, the number of hippocampal neurons was higher in the combined group than the neural stem cel group, but lower than the normal group. To conclude, transplantation of neural stem cel s combined with hyperbaric oxygen can improve the depression behavior and apoptosis in the hippocampal neurons in chronic stress depression rats.

Adolescent ; Adult ; Aged ; Electrodes ; Epistaxis ; surgery ; Female ; Hemostasis, Endoscopic ; methods ; Humans ; Male ; Middle Aged ; Young Adult

Objective To explore the pathological changes by CT scan on localized thermochemotherapy dur- ing and after the operation of human gliomas.Methods Retrospective analysis was given to the CT scan of 37 pa- tients receiving thermochemotherapy during and after the operation,and the relation of the tumorous cells and mi- crovessels and CT density by EM were analyzed.Changes of tumorous cells and microvessels after localized ther- mochemotherapy on C_6 gliomas in rat were analyzed.Results When the tumor was low dense on CT pattern,less cellular number with increasing the amount of fluid between the cells was demonstrated pathologically.On EM,a lower cellular electron density was observed.The amount of fluid in cytoplasm was increased,the cytoplasm was porous,swelling denaturation was chiefly seen in organelle.If the tumor had mixed density on CT,cellular number was more,the amount of fluid was less.On EM,cellular electron density increased correspondingly,the fluid in cyto- plasm decreased,organdie was aggregated.After thermochemotherapy,the tumor reduced,liquefied,and vanished by CT scan.It could be observed that the tumorous cell become smaller,concentrated and cataclased,finally formed apoprotic bodies and separated from the cell in C_6 gliomas in EM.The tumorous vessels was less,smaller and thinker. Some vessels only could see the base membrane and no endothelioid cells.Conclusion The remaining tumors is van- ished by CT scan.The mechanisms of tumors disappearance proposes to explain that thermochemotherapy can dam- age C_6 glioma cells and microvessels,decrease microvessels density and induce tumor ceils apoptosis.That inhibits tu- morous angiogenesis and proliferation.

Objective To observe the degree of joint flexion and extension of elbow and knee joints of moderate skeletal fluorosis patients before and after treatment and to assess the effects of Gun's MaQian decoction in treating moderate skeletal fluorosis. Methods 54 moderate skeletal fluorosis patients were randomly recruited into a treatment group and a control group. The treatment group was treated with Gun's MaQian decoction initially, and changed to be treated with GuKangNing capsule after 8 weeks' treatment. The control group was treated with placebo at first, and also changed to be treated with GuKangNing capsule after 8 weeks. Results Joint flexion and extension of elbow was improved greatly in both groups after the treatment, while the treatment group showing better effects than the control group (P<0.05). The improvement of joint flexion and extension of knee had not showed a statistical significance after the treatment. A 24 weeks follow-up to the joint flexion and extension of both elbow and knee revealed obvious improvement and the difference between the two groups were significance (P<0.05). Conclusion Gun's MaQian decoction can improve the flexion and extension of elbow and knee in moderate skeletal fluorosis patients.

Objective To study the pathological alterations,such as oxidative stress,cell proliferation and insulin resistance,especially autophagy,in Alzheimer' s disease (AD) complicated with type 2 diabetes (AD + T2DM).Methods The mouse models of T2DM,AD and AD + T2DM were used in the study,and totally 80 mice were divided into four groups:control group,T2DM group,AD group and AD + T2DM group.Morris water maze was applied to test the ability of learning and memory among the above mentioned groups.In the meantime,insulin resistance index,the expression of insulin receptor substrate 2,oxidative stress,cell proliferation and autophagy were observed with chemical analysis,immunofluorescent labeling,transmission electron microscopy and Western blotting.Results On day 4,the difference of time to find Morris water maze in control group,T2DM group,AD group and AD + T2DM group ((26.08 ±4.93) s,(38.46 ± 4.07) s,(47.32 ± 5.86) s,(53.01 ± 6.12) s,F =2.454,P =0.025) was statistically significant,and the time in AD + T2DM group was longer than that in AD group (t =-3.624,P =0.033).Compared with control group,insulin resistance occurred in T2DM group,AD group and AD + T2DM group (4.35 ± 0.48,16.12 ± 3.57,7.03 ± 3.11,18.78 ± 5.06,F =5.602,P =0.009),and the reduction of insulin receptor substrate 2 expression,the oxidative stress reaction,neural proliferative suppression and autophagy (F =418.344,222.514,436.250,113.934,23.772,35.469,all P ＜ 0.05) were induced in T2DM group,AD group and AD + T2DM group,which were more serious in AD + T2DM group than in AD group (t =-2.796,21.723,-8.041,9.037,-4.403,-32.011,-26.593,all P ＜0.05).Conclusion AD + T2DM mice suffered more serious cognitive impairment than AD and T2DM mice.The oxidative stress levels of AD + T2DM mice were upregulated,and thus led to the inhibition of cell proliferation,eventually leading to promotion of autophagy.

Objective The efficacy and safety of off-pump coronary artery bypass grafting (OPCAB) as comparing with conventional coronary artery bypass grafting(CCABG) remain inconclusive in randomized, controlled trials and retrospective studies. We tried to assess the incidence of myocardial infarction (MI) after OPCAB and CCABG. with a meta analysis based on published data in randomized ,controlled trials. Methods Relevant randomized controlled trials, published in English and Chinese before January 2009, were searched in Medline, the Science Citation Index Expanded, the Cochrane Central Register of Controlled Trials (CENTRAL) and CBMdisc. Manual searching of bibliographies were performed, with key words "oronary artery bypass graft", "off-pump" and "myocardial infarction". Two reviewers selected eligible trials independently, performed quality assessment and collected relevant data. Meta-analysis was performed with software RevMan 5. Results 22 trials were considered to be eligible for the meta analysis. The incidence of MI was 2.81% (42/1494) in the OPCAB group as compared with 3.57% (54/1512) in the CCABG group. No significant difference was present between the two groups (OR =0.80,95% CI =0.54 - 1.20, P =0.28). Conclusion Our meta analysis of current available randomized controlled trials involving OPCAB and CCABG in patients with coronary artery diseases suggests that the difference in the incidence of postoperative MI between CCABG and OPCAB groups is not significant.