Acupuncture Points ; Acupuncture Therapy ; Child ; Dermatomyositis ; therapy ; Humans ; Male

The article summarizes the questions of clinical practicing in obstetrics and gynecology through clinical teaching in person,and find out some measures to improve teaching quality of clinical practicing.

Objective To explore the clinical characteristics and drug sensitivity of newborn pneumonia of klebsiella pneumoniae,and investigate the positive rate of extended-spectrum ? lactamases(ESBLs)in klebsiella pneumoniae.Method Sixty-seven cases of sputum samples newborn pneumonia of klebsiella pneumoniae from Jan.2003 to Dec.2005 were collected.Bacteria identification and drug sensitivity test were performed.At the same time,ESBLs were detected.Results The clinical characteristics of newborn pneumonia of klebsiella pneumoniae were non special,and the positive rate of ESBLs in klebsiella pneumoniae was 17.91%.The klebsiella pneumoniae was 100%sensitivie to carbopenems,but resistant to commonly used ?-antibiotics such as penicillin and cephalosporin.ESBLs negative strains had higher drug sensitivity than ESBLs strains.Conclusions Partial klebsiella pneumoniae are ESBLs strains and insensitive to commonly used antibiotics.In order to decrease ESBLs strains,the antibiotics treatment shall be used appropriately and the selection of antibiotics shall be guided by the results of drug sensitivity tests.

Drug discovery and development is an expensive process with a high attrition rate. Cytochrome P450 (CYP) induction and inhibition mediated drug-drug interaction of drug candidates serves as one of the reasons for such attrition. Consequently a great effort is paid to identify those compounds that influence pharmacokinetic parameters of other drugs, which may lead to drug-drug interactions. CYP plays a central role in metabolism and biosynthesis of a wide range of exogenous and endogenous compounds. CYP induction mediated drug-drug interactions may result in an increased metabolic clearance for coadministrated drugs, and subsequently affect their effectiveness and safety. Assessment of CYP induction potential for drug candidates has become an integral part of new drug discovery and development. This article reviews the current understanding on CYP induction mediated drug-drug interaction and its clinical implications, along with the in vitro and in vivo methodologies for assessment of the induction potential of new drug candidates.

Objective: To explore the expression of survivin in endometrial cancer and its roles in regulating apoptosis of endometrial cancer cells. Methods: Imnumohistochemistry was used to examine the expression of survivin in endometrial cancer specimens. RNA interference (RNAi) was applied to knock down survivin expression. The effect of RNAi was examined by RT-PCR and Western blotting. Cell apoptosis was detected by the FCM before and after RNAi. Western blotting was used to detect the expressions of caspase-3, caspase-8 and Bcl-2, which were closely associated with apoptosis. Results: The positive rate of survivin protein in endometrial cancer was obviously higher than those in atypical endometrium and normal endometrium (P < 0.05 and P < 0.01, respectively). RNAi effectively inhibited the expressions of survivin mRNA and survivin protein (P < 0.01). RNAi also induced cell apoptosis. Cell apoptosis rates in the two groups of RNAi were obviously higher than those in control groups (P < 0.01). Survivin RNAi also up-regulated the cleavage of caspase-3 and caspase-8. Conclusion: The aberrant expression of survivin may be closely related to the carcinogenesis of endometrial cancer, and inhibition of its expression may induce apoptosis of endometrial cancer cells.

ObjectiveTo deter mine the sustained attention function of the patients with mild Alzheimer's disease(AD) and mild cognitive impairment(MCI).Methods10 patients with MCI, 10 with mild AD and other 10 healthy elderly controls were tested with Continuous Performance Task(CPT) aimed to assess sustained attention. ResultsCompared with the normal controls, the mild AD patients reacted very more slowly(P<0.001), missed more targets(P<0.05), while that the MCI patients did was as well as the control group. ConclusionThe mild AD patients shows impairment in sustained attention function, but the MCI patients shows a preserved ability of sustained attention function.

Objective To explore the diagnosis value of ultrasound real-time elastography in thyroid diffuse diseases.Methods Eleven elastic quantitative parameters of 123 patients with thyroid diffuse diseases and 42 healthy volunteers obtained from the ultrasound real-time elastography were analyzed with principal components analysis to attain a comprehensive evaluation value which was named stiffness index(SI),reflecting the organization elastic information of different thyroid diffuse diseases.SI among each group was compared by ANOVA.Results Chronic lymphocytic thyroiditis SI was 86.37±20.45,subacute thyroiditis SI was 86.14±19.95,primary hyperthyroidism SI was 54.68±21.69,normal control group SI was 41.34±15.59,respectively.The SI between chronic lymphocytic thyroiditis,subacute thyroiditis,primary hyperthyroidism and normal controls had significant statistical differences (P<0.05),the SI between primary hyperthyroidism and chronic lymphocytic thyroiditis,subacute thyroiditis had significant statistical differences (P<0.05),the SI between chronic lymphocytic thyroiditis and subacute thyroiditis had no significant statistical difference (P>0.05).Conclusions Ultrasound real-time elastography could indirectly reflect the stiffness information of thyroid lension tissue and have a certain degree of diagnosis value in thyroid diffuse disease.

Objective To study the relationship between velocities of ductus venosus(DV),inferior vena cava(IVC) and right hepatic vein(RHV) of fetus,and abnormal perinatal outcome in high-risk pregnancy so as to find out which venous velocity can predict abnormal perinatal outcome and which velocity is the best for predicting abnormal perinatal outcome. Methods Velocities of DV,IVC and RHV in 67 cases of high-risk pregnancy were examined through color Doppler and their relationship with perinatal outcome was analyzed respectively. Results RHV-pulsatility index(PI) ,DV-pre-load index(PLl) ,DV-S/A and IVC-peak velocity index(PVI) could all predict abnormal perinatal outcome in high-risk pregnancy. But RHV-PI had the best prediction, and when its positive cutoff value was taken as 2. 89,the sensitivity for abnormal outcome was 75. 0% ,the specificity was 76. 7% ,and the correct index (Youden index) was 0. 52. Conclusions RHV-PI can best predict abnormal perinatal outcome in high-risk pregnancy,which can help a lot for prompt clinical treatment.

Objective To evaluate the efficacy of remifentanil combined with propofol in children of different age undergoing short-term ophthalmologic operation.Methods Forty-eight children aged 4-12 yr undergoing elective short-term ophthalmologic operation were divided into 4 groups(n=12 each)according to age and anesthetics:group ⅠPK aged 4-7 yr and group ⅡPK aged 8-12 yr received ketamine and propofol combined anesthesia;group ⅠPR aged 4-7 yr and group ⅡPR aged 8-12 yr received remifentanil and propefol combined anesthesia.In group ⅠPK and ⅡPK the anesthesia was induced with intravenous bolus of ketamine 2 ms/kg and ketamine 1-2 ms/kg.In group ⅠPR and ⅡPR the anesthesia was induced with intravenous remifentanil 1 μg/kg and respiratory rate(RR),cerebral state index(CSI)and SpO2 were recorded before anesthesia induction(baseline),2 min after induction,at the initiation of the operation,15 min after the initiation of operation and at emergence from anesthesia.Adverse effects during and after the operation,induction time,analepsia time,conscious recovery time and total sedation time were recorded.The mean infusion rate of remifentanil was calculated.Results Compared with the baesline,SP,DP,HR,RR and CSI were significantly decreased in 4 groups(P＜0.05).RR,CSI and incidence rates of adverse effects were significantly lower,and the emergence time and the recovery time of consciousness were significantly shorter in group ⅠPR and ⅡPR than in group ⅠPK and ⅡPK(P＜0.05).The average infusion rate of remifentanil was lower in group ⅡPR than in group ⅠPR(P＜0.05).Conclusion Remifentanil combined with propofol can produce good anesthetic effect in children undergoing short-term ophthalmologic operation,with less adverse effects,stable hemodynamics and rapid emergence from anesthesia.The dosage of remifentanil is difierent in children at different ages.

Objective To investigate the feasibility,safety and clinical efficacy of transvaginal myomectomy.Methods A total of 92 patients with uterine leiomyoma were given either vaginal myomectomy(Study Group,n=46) or abdominal myomectomy(Control Group,n=46).Clinical outcomes between the two groups were compared.Results Both vaginal and abdominal myomectomy were performed successfully.The operation time between the two groups was not statistically significant(t=-0.734,P=0.465).There were significant differences between the Study Group and the Control Group in the intraoperative blood loss(60.4(?5.6 ml) vs 82.5?50.2 ml;t=-2.210,P=0.000),the time to first passing flatus(15.3?3.2 h vs 27.5?4.8 h;(t=-14.343,)P=0.030),the incidence of postoperative pain (?~2=29.447,P=0.000),the rate of postoperative pyrexia(?~2=3.903,P=0.048),and the hospital stay(3.1?0.4 d vs 5.2?1.1 d;t=-12.169,P=0.000).Conclusions Transvaginal myomectomy has advantages of little invasion,quick recovery of bowel movement,slight postoperative pain,low rate of postoperative pyrexia,and short hospital stay,being a safe and feasible minimally invasive option for uterine leiomyoma.