Blood Flow Velocity ; Coronary Angiography ; Coronary Vessels

Objective To compare the efficacy of different volume of ropivacaine and lidocaine for ultrasound-guided infraclavicular brachial block.Methods Sixty patients scheduled for distal upper limb surgery were divided into group A and group B by random digits table method with 30 cases each.The patients were given ultrasound-guided infraclavicular brachial block,but the patients in group A using 0.3％ ropivacaine mixed with 1％ lidocaine 20 ml,the patients in group B using the same mixture 30 ml.Sensory block was assessed every 5 min after the block.Motor block was evaluated at 30 min after the block.The onset time of anesthesia,surgical success rate,complications and duration of anesthesia were recorded.Results There was no significant difference in the surgical success rate [93.3％(28/30) vs.96.7％(29/30),P＞0.05],onset time of sensory block [10 (5) min vs.5 (5) min,P＞0.05] and degree of motor block between the 2 groups.The duration of anesthesia in group A was shorter than that in group B (P ＜ 0.05).Conclusion The efficacy of ultrasound-guided infraclavicular brachial block with the mixture of 0.3％ ropivacaine and 1％ lidocaine 20 ml and 30 ml is similar in surgical success rate and onset time of anesthesia.

OBJECTIVETo evaluate the efficacy and safety of etanercept plus Tripterygium wilfordii polyglycoside (TWP) in elderly patients with active rheumatoid arthritis (RA).

METHODSTotally 46 elderly patients with active RA were randomly assigned to the treatment group (22 cases) and the control group (24 cases). All patients received subcutaneous injection of etanercept, 25 mg each time, twice per week. The dosage was reduced to once per week 3 months later. Patients in the treatment group took TWP Tablet (10 mg each time, three times per day), while those in the control group took methotrexate (MTX), 10 mg each time, once per week. The whole course lasted for 24 weeks. Patients' rest pain, tender joint number, swollen joint number, health assessment questionnaire (HAQ), patients' global assessment, physicians' global assessment, erythrocyte sediment rate (ESR), C reactive protein (CRP), rheumatic factor were assessed at week 0, 4, 8, 12, and 24. The curative effect was statistically evaluated by the United States Institute of Rheumatology ACR20, ACR50, and ACR70 improvement criteria. Meanwhile, any adverse event was recorded and evaluated.

RESULTSTotally 41 completed the trial, and 5 dropped off (3 in the treatment group and 2 in the control group). Compared with the control group, there was no statistical difference in ACR20, ACR50, or ACR70 in the treatment group (P > 0.05). Compared with before treatment in the same group, there was some improvement in tender joint number, swollen joint number, visual analogue scale (VAS) for patients' global assessment, VAS for physicians' global assessment, ESR, CRP, and HAQ between the two groups, showing statistical difference (P < 0.05). Compared with the control group in the same phase, there was no statistical difference in the treatment group (P > 0.05). There was no statistical difference in the occurrence of adverse events between the two groups.

CONCLUSIONSEtanercept plus TWP could achieve equivalent therapeutic effect to that of Etanercept plus MTX. The two regimens could improve clinical signs, symptoms, and QOL related to RA. They were well tolerated in the treatment of elderly patients with active RA.

Aged ; Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Drug Therapy, Combination ; Etanercept ; Female ; Glycosides ; therapeutic use ; Humans ; Immunoglobulin G ; therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Treatment Outcome ; Tripterygium ; chemistry

Craniopharyngioma ; surgery ; Endoscopy ; Female ; Humans ; Middle Aged ; Pituitary Neoplasms ; surgery ; Skull Base ; Sphenoid Sinus ; surgery

Medical science has both the characteristics of natural science and humanities.Modem medical education pays more attention to the close association between professional education and humanistic education.How to handle the relationship between infectious disease and humanistic education has become more and more important.In current study,integrating humanistic education in clinical infectious disease teaching not only improved infectious disease teaching effect but also established good medical ethics and increased the comprehensively quality.

To analyze the clinical characteristics and combined use of chemical and traditional Chinese medicine (TCM) medicine of hospitalized patients with psoriasis base on real world database, 2 991 cases of hospitalized patients with psoriasis in hospital information system (HIS) database from 16 hospitals in China were analyzed for general hospitalization information, combined diseases and combined use of drugs et al. The results showed that half of inpatients aged 18-45 years old. The most common syndrome of TCM was intrinsic blood heat. More than 1/3 inpatients' hospitalization time was 18-25 days, and the average expense of hospitalization was 6 989. 20 RMB. The top five combined diseases were hypertension, non-alcoholic fatty liver disease, diabetes, upper respiratory tract infection and lipoprotein disorders. Medicine information analysis showed 599 chemical medicines and 341 TCMs were used and combined use of drugs was common in clinical practice. Licorice extract medicine was the most common combined TCM with western medicine; in the next two places were compound Qingdai capsule and tripterygium glycosides. The most common combined use of chemical medicines were Vitamin C, calcium gluconate, ketotifen, cetirizine, retinoic acid and external use glucocorticoid. Anti-inflammatory and liver protection, clearing heat and toxic materials, activating blood and dissolving stasis were the most common combined TCM medicine with western medicine, while the most common combined chemical medicine with TCM were anti-allergic, anti-infection, glucocorticoid and retinoic acid. In conclusion, half of hospitalized patients of psoriasis were young adults. The main type of combined diseases was metabolic disorders and upper respiratory infections. Combined use of chemical medicine and TCM was common in clinical practice. Licorice extract medicine was the most common combined TCM with western medicine.
Adolescent ; Adult ; Aged ; Ascorbic Acid ; therapeutic use ; Calcium Gluconate ; therapeutic use ; Cetirizine ; therapeutic use ; China ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Ketotifen ; therapeutic use ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Psoriasis ; drug therapy ; Tretinoin ; therapeutic use ; Young Adult

Objective To analyze the complications of lower cervical pedicle screw fixation in treatment of the cervical spine disorders and discuss the operative technique. Methods A retrospective study was made in 104 patients with different cervical injuries treated by C3-7 pedicle screw fixation (total use of 624 screws) from July 2004 to March 2008. One stage posterior reduction and fixation using lower cervical pedicle screw-rod system or screw-plat system were performed in 66 traumatic patients and the nerve condition was evaluated by Frankel criteria system. For 46 non-traumatic patients, laminoplasty or laminectomy was performed for decompression, and cervical pedicle screw-rod system or screw-plat system were used in deformity correction and stability reconstruction. Based on exploration to quadric walls of vertebral pedicle during operation, postoperative thin-slice CT scan along operative vertebra segments' pedicle and bilateral oblique position X-ray of cervical spine in all patients, we evaluated screw location, screw angle as well as the distance and the relation between the screws and the internal pedicle wall or lateral wall. Results In this study, the lower cervical pedicles of 104 patients were fixated with 624 screws including 77 screws (12.34% ) for pedicle wall damage, 68 screws (10.8% ) for the lateral wall injury, 56 screws (8.97% ) for grade Ⅰ violation of pedicles, 12 screws (1.92% ) for grade II violation of pedicles Ⅱ violation of pedicles and 9 screws (1.44% ) for inferior wall injury of cervical pedicle. The follow-up lasted for 3-24 months (average 9. 8 months), which showed breakage of two screws (0.32% ) and loosening of one screw (0.16% ). Conclusions Lower cervical pedicle screw fixation has relatively low incidence of complications and is a safe operation. The complications can be minimized by sufficient preoperative imaging studies of the pedicles, familiar with the feature of opography and reasonable surgery technique.

Bronchopulmonary Sequestration ; classification ; pathology ; surgery ; Humans ; Infant ; Lung ; diagnostic imaging ; Male ; Radiography ; Respiratory System Abnormalities ; diagnosis ; surgery

Objective To observe the changes of soluble L-selectin(sL-selectin) concentrations in children with viral encephalitis(VE) and probe its significance in pathogenesy and clinic.Methods Selecting 30 children with VE,including 14 mild case and 16 severe case.Collecting their venous blood and cerebrospinal fluid(CSF) in acute and recovery stage.Using double antibody sandwich enzyme-linked immunosorbent assay(ELISA) method to measure sL-selectin concentrations of serum and CSF and comparing with control group,respectively.Results SL-selectin concentrations from serum and CSF in the acute stage were significantly higher than those of control group(all P0.05).Conclusions L-selectin may participate in the pathologic course in VE.The concentrations of sL-selectin from serum and CSF are related with the patients′ condition and it has important reference value in judging patients′ condition,assessing their prognose and guiding clinical treatment.

Objective To investigate the effect of leukotriene receptor antagonist montelukast on inflammatory factors in children with asthma.Methods Eighty children with moderate asthma who aged 6-14 years old were randomly assigned to 3 treatment groups:5 mg once daily montelukast,or inhaled 100 ?g twice daily budesonide and 5 mg montelukast with inhaled budesonide 100 ?g per day.Each dose group received medicine for 12 weeks.Before starting therapy and 12 months later,clinical effects were observed,and pulmonary function was measured in patients simultaneously;concentrations of serum and sputum eosinophil cationic protein(ECP), IL-5 and TNF-? were measured respectively;also the peripheral blood eosinophil (Eos)was counted.Results Following treatment,clinical evaluation was improved and there were significant increases in pulmonary function in asthmatic children.Compared with control group,the levels of serum ECP,IL-5,TNF-? and blood Eos counting increased significantly in asthmatic children.The blood Eos counting was significantly correlated with ECP concentration in serum of children with asthma(P