Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Herpes Zoster ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

Objective To evaluate the efficacy of ultrasound-guided transversus abdominis plane (TAP) block for postoperative analgesia in patients undergoing inguinal hernia repair.Methods Forty ASA Ⅰ or Ⅱ patients,aged 18-79 yr,with body mass index ＜ 30 kg/m2,scheduled for elective unilateral inguinal hernia repair combined spinal-epidural anesthesia,were randomly divided into 2 groups (n =20 each):control group (group C) and ultrasound-guided TAP block group (group B).The ultrasound-guided TAP block was performed at the end of surgery and 20 ml of 0.375 ％ ropivacaine was injected in group B,while the equal volume of normal saline was given in group C.Tramadol was injected intravenously when VAS score ≥ 4 after surgery.VAS scores at rest and during activity were recorded at 4,6,24 and 48 h after surgery.The warm block plane on the blocked side was measured at 24 and 48 h after surgery.The overall satisfaction on analgesia was scored and the time when the patients passed the flatus was recorded.TAP block-related side effects were recorded.Results Four patients required tramadol in group C,while no patients required rescue analgesic in group B.Compared with group C,VAS scores were significantly decreased,the overall satisfaction scores were increased (P ＜ 0.05 or 0.01),and no significant change was found in the time when the patients passed the flatus in group B (P ＞ 0.05).The rate of warm plane block on the blocked side was 80％ at 24 h after surgery and there was not warm block plane in patients at 48 h after surgery in group B.There was not warm block plane in patients at 24 and 48 h after surgery in group C.TAP block-related side effects were not found in group B.Conclusion The efficacy of ultrasound-guided TAP block for postoperative analgesia is better in patients undergoing inguinal hernia repair and the safety is higher.

In this paper, a new imaging method to determine the position of blood effusions or edemas in the deep position of the brain by using electric current flowing through the brain is presented. Its principle is that the existence of non-normal matters in the brain cause a disturbance to boundary potentials, while a low frenqency current flows through the brain. In terms of the measurement for the change value of boundary potentials a reconstruction for the blood effusion or the edema in the deep position of the brain can be done.

Objective To analyze the dermatology journals indexed by SCI‐E and papers published in recent 5 years ,to pro‐vide advices on periodical selection and contribution .Methods We mainly adopted the bibliometrics methods and word frequency a‐nalysis method to analyze 10 targets in 62 SCI‐E dermatology journals .Results Main publishing nationality were United States , England ,Denmark and Germany ,publishing language was English ,main publishing cycle period was bimonthly journals ,the highest impact factor was 6 .372 .The theme of published content was relatively concentrated ,reviewers′duration was fast and reasonable , 80 .7% submission of the journal was easy .Main type of literature published in recent 5 years is article ,review ,editorial and letter . 58 SCI‐E dermatology journals accept articles from China .Conclusion We suggest that the authors should firstly check the name of dermatology and cross‐disciplinary journals indexed by SCI‐E ,and evaluate the theme of published content ,rate of publishing article contributed from China ,difficulty degree for contribution ,reviewers′duration ,publishing cycle and impact factor when contribution articles .

The PBL Teaching Method has implemented in the department of gynecology and obstetrics of Fudan University since 2004.This new method cultivates the students'ability to ask and answer the questions to collaborate,to comiderate problems conpletely and the ability to consult information and solve problems quickly.Teachers and department should improve the teaching and manage level.

Objectives To investigate the effects of nerve nutrient factors and inhibitory factors on neuronal regen? eration and axonal reconstruction at ischemic neocortical penumbra after focal cerebral ischemia in rats. Methods The rat model of middle cerebral artery ischemia was established using suture-occluded method. The pathological morpholo? gy of brain tissue was examined by using HE staining. The expression levels of GAP-43 SYN, nutrient factor (BDNF VEGF Ang1) and inhibitory factor (NogoA NogoR RhoA) were determined by using Western blotting technique. Results The number of neurons in ischemic penumbra was significantly decreased in model group (P<0.01) than in sham-operat? ed group. The expression levels of GAP-43 were significantly decreased (P<0.05) while the expression levels of NogoA NgR and RhoA in the thalamus were significantly increased (P<0.05) in model group than in sham-operated group. The expression levels of SYN and nutrient factors (BDNF VEGF Ang1) were not different between the model group and sham-operated group. Conclusion The increase in nerve inhibitory factors may contribute to the down-regulation of neu?rogenesis at ischemic neocortical penumbra after focal cerebral ischemia in rats.

Objective To explore the relationship between adenoid vegetation children with different types of tympanograms and secretory otitis media in children and diagnosis of secretory otitis media .Methods A retrospec-tive study was carried out among 328 cases with adenoid vegetation in children ,including simple adenoid vegetation and associated with chronic tonsillitis and tonsillar hypertrophy ,from August 2010 to May 2012 .The incidence of secretory otitis media and outcomes of tympanometry for the diagnosis were analyzed .Results 104 cases were diag-nosed with secretory otitis media by tympanic membrane puncture or tympanostomy tube in 328 cases with adenoid vegetation (32 .31% );86 cases (147 ears) were finally diagnosed as secretory otitis media among 89 cases (152 ears) with type B tympanogram (147/152 ,96 .63% );16 cases (20 ears) were finally diagnosed secretory otitis media among 33 cases (49 ears) with type C tympanogram (20/49 ,40 .82% );2 cases (2 ears) with type As tympa-nogram were finally diagnosed .Conclusion With or without complaint of hearing loss ,children with adenoid vegeta-tion should be checked by routine tympanometry .Careful physical examinations and electric otoscope or ear endosco-py combined tympanometry can greatly reduce the rate of misdiagnosis of secretory otitis media .

Objective To evaluate the characteristics of quantitative monitoring of brain function during the perioperative period in elderly patients and its relationship with postoperative cognitive dysfunction (POCD).Methods Seventy ASA physical status Ⅰ or Ⅱ patients,aged ≥ 60 yr,scheduled for elective lumbar spine decompression and fusion surgery under general anesthesia,having an expected postoperative length of hospital stay ≥ 7 days,were enrolled in the study.The cognitive function was assessed by using Mini-Mental State Examination before operation and the results were normal.Fifty healthy elderly volunteers were chosen and served as control group.Cognitive function was assessed at l day before operation (D0) and 3 (D3) and 7 days after operation (D7).Z score was used to identify POCD.All the patients were then divided into POCD group or control group (group C) according to the results of diagnosis.Quantitative monitoring of brain function was carried out using a traction system,and the wavelet index (WLI),i_22 and i_20 were recorded.Results A total of 67 patients completed the study and were enrolled in the analysis,there were 9 cases in group C,and 58 cases in group POCD.The WLI was significantly decreased at D7,and no significant change was found in WLI at D3 as compared with the value at D0.The WLI was significantly lower at D7 than at D3.There was no significant difference in i_22 and i_20 between the three time points.Compared with group C,i_22 was significantly decreased at D0,and no significant change was found in i_22 at the other time points and in WLI at each time point in POCD group.Conclusion During quantitative monitoring of brain function during the perioperative period in the elderly patients,WLI is significantly decreased on 7th day postoperatively,and no significant change is found in i_20 and i_22,however,the pre-operative low i_22 value can predict the development of POCD.

Objective To investigate the risk factors for venous thromboembolism in elderly patients with lung cancer,in order to provide theoretical basis for clinical prevention and treatment.Methods A retrospective analysis was carried out in 869 elderly patients who were treated in our hospital from Mar.2010 to Mar.2014.And the venous thromboembolism and its related risk factors in elderly lung cancer patients were analyzed.Results 35 cases (4.35％) complicated with venous tbromboembolism.Multivariate logistic regression analysis showed that adenocarcinoma,basic diseases,and D-dipolymer≥300 μg/L belonged to the independent risk factors for the complication of venous thromboembolism in elderly patients with lung cancer (OR=2.839,1.586 and 10.514,respectively,P=0.007,0.022 and 0.000).Conclusions The risk factors for the complication of venous thromboembolism should be monitored in the treatment of elderly patients with lung cancer.Early anticoagulation therapy should be performed to improve clinical effect and reduce the incidence of complications.

BACKGROUND:The influence of Tol-like receptor 2 (TLR2), Tol-like receptor 4 (TLR4), Tol-like receptor 6 (TLR6) signal transduction pathway and active Treg in children with Henoch-Schonlein purpura has been unknown.
OBJECTIVE:To investigate the expression of TLR2, TLR4 and TLR6 in peripheral blood mononuclear cells and Treg immune response in patients with Henoch-Schonlein purpura, and to explore the role of TLR2, TLR4, TLR6 and Treg activation in the pathogenesis of Henoch-Schonlein purpura.
METHODForty-two hospitalized children with Henoch-Schonlein purpura were enrol ed in this study. Another 15 healthy children were selected as controls. TLR2, TLR4 and TLR6 at protein level in peripheral blood mononuclear cells were detected by flow cytometey;reverse-transcription PCR and real-time PCR were used to evaluate the level of MyD88;the levels of transforming growth factor-βand interleukin-10 were measured by enzyme-linked immunosorbent assay. t-test or t’-test was used to compare the levels of these genes and proteins. Pearson’s correlation test was done for correlation analysis.
RESULTS AND CONCLUSION:Compared with the control group, the protein levels of TLR2, TLR4, TLR6 and the relative expression level of MyD88 mRNA were significantly up-regulated (P<0.01). The serum levels of transforming growth factor-βand interleukin-10 were higher in the Henoch-Schonlein purpura children than the healthy children (P<0.05). There was a significant correlation between the protein levels of TLR2, TLR4, TLR6 and mRNA level of MyD88 (P<0.01), but no relationship was found between TLRs and interleukin-10, transforming growth factor-β(P>0.05). The excessive activation of TLR2, TLR4, TLR6 may be involved in the process of Henoch-Schonlein purpura via MyD88-dependent pathway, and the compensatory activation of Treg may participate in protective immunity.