Acupuncture Therapy ; Diaphragm ; pathology ; Humans ; Male ; Middle Aged ; Respiratory Paralysis ; pathology ; therapy

Acupuncture Therapy ; Female ; Humans ; Pruritus Ani ; therapy ; Young Adult

Usually the survival period of patients with duodenal obstruction caused by inoperable advanced pancreatic cancer is rather short. For such patients, minimally invasive treatment should be employed as the first choice. This paper reported a case with advanced pancreatic cancer complicated by biliary and duodenal obstruction. After implantation of biliary stent, the obstructive jaundice was relieved. Because of the insufficient cardiac function, the patient was not able to tolerate gastrojejuostomy; besides, as both DSA-guided stent implantation and endoscopic nutrition tube placement failed to success, implantation of nutrition tube via the trans-hepatic and biliary route, as a novel tube placement technique, had to be carried out, and the result in this case was satisfactory.

Objective To investigate the mammographic,galactographic,pneumographic features and their pathological basis.Methods Mammography(n=26),galactography(n=13),pneumography(n=5)and specimen radiography(n=12) in 26 cases pathologically proved,and mammographic-pathologic correlation were analyzed.Results The breast hamartomas in 26 cases were all benign,they were circumscribed and surrounded by a true capsule.The mammographic appearances could be divided into three types acording to different amount of fibroglandular and adipose tissue in tumors:prominantly fatty,prominantly fibrous(fibroglandular)and mixed fibrofatty.Conclusion A clearly containing areas of fat and fibroglandular density and a characteristic"slice of sausage"appearance can be showed on mammograms.Galactography and pneumography is of a great help to differential diagnosis of breast hamartomas.

Objective To explore the effect of postural reduction and balloon dilation on the correction of vertebral height following balloon percutaneous kyphoplasty (PKP) for osteoporotic vertebral coinpressive fracture (OVCF).Methods From June 2012 to December 2013,47 OVCF patients involving 57 fractured thoracolumbar vertebrae with intact posterior wall underwent PKP.In all patients postural reduction was performed under general anesthesia.The percentages of vertebral height loss before and after balloon dilation were compared.The curative effects were evaluated by comparing preoperative and postoperative visual analogue scale(VAS) scores and cobb angles.Results Compared with preoperation,the vertebral heights of anterior and middle columns were significantly improved after postural reduction,balloon dilation and PKP (P ＜ 0.05),but there was no significant improvement before and after balloon dilation (P ＞0.05).The postoperative average cobb angle (22.8°± 8.1°) was significantly decreased compared with the preoperative one (22.8° ± 8.1°) (P ＜ 0.05).The VAS scores at preoperation,one day postoperation and the final follow-up were respectively 8.5 ± 0.4,3.4 ± 0.2 and 3.1 ± 0.3.The postoperative ones were significantly lower than the preoperative one (F =7.518,P =0.006).Conclusions In PKP,postural reduction under general anesthesia plays an important role,but balloon dilation may exert an insignificant effect on restoration of vertebral height.

The paper uses computer multimedia technology to collect and switch audio and video signals, constructs the remote High Definition ( HD) surgery demonstration system which supports live broadcast, recorded broadcast, rebroadcast and video-on-demand depending on the network communication routing technology.It introduces functions, design scheme and composition of the system and points out that the system can realize HD video transmission and video talkback between the surgery scene and the classroom.Thus, tech-nical level of clinical surgery teaching can be enhanced.

Background Proliferative diabetic retinopathy (PDR) is a serious complication of diabetes mellitus,and vitrectomy is a main treatment.Exploring the influential factors of blood glucose fluctuation during perioperative duration is helpful for surgery.Objective The aim of this study was to explore glycolic fluctuation and its influential factors in PDR patients.Methods A retrospective cases-observational study was carried out.The clinical data of 100 PDR patients who received vitrectomy in Peking University People's Hospital from March to August in 2013 were collected,including 8 cases with type 1 diabetes mellitus and 92 cases with type 2 diabetes mellitus.The PDR patients were staged as Ⅳ,Ⅴ,Ⅵ based on the criteria of The First National Fudus Conference.The body height,weight,history of hypertension,PDR stage,previous usage of insulin,glycosylated hemoglobin (HbA1c) level,admission blood pressure,blood glucose level in different time points and postoperative body positions were recorded,and perioperative anxiety was scored according to the Hamilton Anxiety Scale (HAMA).Repeated ANOVA was used to analyze blood glucose and anxiety at different time points.Results The linear regression analysis showed that the preoperative blood glucose level was lower in the patients who used insulin during perioperative period(r =-1.64,P＜0.05).HbA1 c level showed the positive correlations with the blood glucose level at different time points(all at P＜0.05).The waiting time for surgery had a positive correlation with the fasting blood glucose in the morning of operative day(r=0.54,P＜0.05),and the postoperative position primarily caused the raise of postoperative right blood glucose(r =1.10,P＜0.05).The anxiety score on admission presented with the positive correlations with the blood glucose levels at admission and 2 hours after breakfast,lunch and dinner on the first postoperative day (r=0.13,0.07,0.05,0.10,all at P ＜ 0.05),and the high anxiety scores at preoperation and postoperation induced the high blood glucose levels at the corresponding time points (r =0.14,0.16,both at P＜0.05).A positive correlation was found between the anxiety score and blood glucose fluctuation values (ρ=0.47,P＜0.01).The blood glucose values were significantly lower in the patients with normal HbA1c than those with high HbA1c (all at P ＜ 0.05).Conclusions Remaining an ideal HbA1c level,establishing a good doctor-patient relationship and administering appropriate sedative drugs can ease the anxiety and improve the glycolic of PDR patients during preoperative duration.

Objective To evaluate the effect of dexmnedetomidine pretreatment on apoptosis in hippocampal neurons of rats undergoing one-lung ventilation (OLV).Methods Ninety adult male SpragueDawley rats,aged 10-11 months,weighing 260-300 g,were divided into 3 groups (n=30 each) using a random number table:two-lung ventilation (TLV) group,group OLV and dexmedetomidine pretreatment group (group D).Dexmedetomidine 25 μg/kg was injected intraperitoneally at 45 min before OLV in group D.After tracheal intubation,the animals were ventilated in volume-controlled mode.OLV was performed for 90 mnin followed by 30 min of TLV in OLV and D groups.TLV was performed for 120 min in group TLV.On 1,3 and 7 days after ventilation,6 rats in each group were selected,and Morris water maze test was carried out to evaluate the cognitive function.The swimming speed,time of staying at the target quadrant,and frequency of crossing the platform quadrant were recorded.Six rats in each group were selected immediately after ventilation and sacrificed,the hippocampi were removed for detection of cell apoptosis,and the apoptosis index was calculated.Immediately after ventilation and on 1,3 and 7 days after ventilation,6 rats in each group were selected and sacrificed,and the hippocampi were removed for determination of phosphorylated extracellular signal-regulated kinase 1/2 (pERK1/2),phosphorylated cyclic adenosine monophosphate response element-binding protein (pCREB),Bcl-2 and Bax expression.The ratio of Bcl-2 expression to Bax expression (Bcl-2/Bax ratio) was calculated.Results Compared with group TLV,the time of staying at the target quadrant was significantly shortened,the frequency of crossing the platform quadrant was decreased,the apoptosis index was increased,the expression of pERK1,pERK2,pCREB and Bcl-2 was down-regulated,the expression of Bax was up-regulated,and Bcl-2/Bax ratio was decreased in group OLV (P＜0.05 or 0.01).Compared with group OLV,the time of staying at the target quadrant was significantly prolonged,the frequency of crossing the platform quadrant was increased,the apoptosis index was decreased,the expression of pERK1,pERK2,pCREB and Bcl-2 was up-regulated,the expression of Bax was down-regulated,and Bcl-2/Bax ratio was increased in group D (P＜0.05 or 0.01).Conclusion Dexmedetomidine pretreatment decreases apoptosis in hippocampal neurons through activating ERK/CREB signaling pathway,thus reducing cognitive dysfunction of rats undergoing OLV.

Objective To explore the effects of penehyclidine hydrochloride (PHC) on the withdrawal syndrome and conditioned place preference(CPP) of morphine dependent rats. Methods ( 1 ) Forty-eight male SD rats were randomly assigned to 6 groups with one of 8 rats:morphine dependent group (MOR group) ,naloxone precipitated withdrawal group ( NAL group) ,PHC treatment groups ( PHC1,2,3 ) ,normal saline control group ( NS group). Subcutaneous injection of morphine in gradually increasing doses for 5 days (from 10 to 50 mg/kg ,two times daily) to establish the model of morphine physical dependent rats. The withdrawal syndrome was precipitated by naloxone (5 mg/kg,sc) and treated with PHC in various doses (0.5,1.0,1.5 mg/kg ,ip ) 30 min before haloxone-precipitated withdrawal. The body weight loss and withdrawal syndrome were observed respectively in 20 minutes. (2) 40 male SD rats were randomly assigned to 5 groups with one of 8 rats: morphine dependent group (MOR group) ,PHC treatment groups (PHC1 ,2,3 ) ,normal saline control group (NS group). The morphine conditioned place preference was induced by alternate subcutaneous injection of morphine for 7 days in rats ( 10mg/kg,once daily,8:00 AM) and saline( 16:00 PM). At d8,the rats were received the CPP test. The rats of PHC groups were treated with PHC (0.5,1.0,1.5 mg/kg , ip) prior to the CPP test, whereas the rats were treated with saline in MOR and NS group. Results (1) Theweight loss((8.53 ±l.20)g,(7.36±l.06)g,(5.40±1.79 ) g vs ( 12.63 ± 2.22 ) g, F = 83.16, P ＜ 0.01 ) and score precipitated withdrawal symptoms ( 25.36 ± 3.11,21.38±3.50,17.06±1.78 vs 31.69 ±2.76, F=256.56, P＜0.01)of morphine withdrawal rats was obviously alleviated by ip PHC in dose-related manner before naloxone-precipitated withdrawal. (2) There were significant differences in the times spent in the drug-paired side (gray area) between MOR and PHC groups( (529 ± 83 )s,(460 ± 107 ) s, (418 ± 97 ) s vs ( 643 ± 111 ) s, F = 13.22, P ＜ 0.01 ), and also in dose-related manner. Conclusion PHC could significantly inhibit the withdrawal syndrome and the expression of CPP on morphine dependent rats in a dose-dependent manner.

Objective To observe the influence of different level of hyperhomocysteinemia on mRNA and protein expressions of KV1 .3 ,CaN,NFAT,IL-6 and TNF-αin lymphocytes of patients with acute ST-segment elevation myocardial infarction (STEMI).Methods We selected 90 STEMI patients and divided them into three groups according to the level of plasma homocysteine:the first experimental group (STEMI group,Hcy<1 5μmol/L, n=30),the second experimental group (STEMI with mild Hhcy group,Hcy 15~30μmol/L,n=30)and the third experimental group (STEMI with intermediate Hhcy group,Hcy>30 μmol/L,n=30 ).Another 30 healthy examined people were selected as control group (n=3 0 ).Peripheral lymphocytes were isolated by Ficoll density gradient centrifugation.The Hcy in the plasma was measured with the IMX assays.Real-time quantitative PCR (RT-PCR)was used to detect mRNA expressions of KV1.3,CnAα,NFAT1,IL-6 and TNF-αand Western blot technique was used to detect the expressions of KV1.3,CnAαand NFAT1.Results The mRNA and protein expression levels of KV1.3,CnAαand NFAT1 in each experimental group were significantly higher than those in control group (P<0 .0 5 or P<0 .0 1 ).Multiple comparison in each experimental group showed that compared with that in the first experimental group,the expression level of the second experimental group increased (P<0.05 or P<0.01)and compared with first and second experimental groups,the expression level of the third experimental group increased (P<0.05 or P<0.01).The mRNA expression levels of IL-6 and TNF-αin each experimental group were significantly higher than those in control group (P<0.05 or P<0.01 ).Multiple comparison in each experimental group showed that compared with that in the first experimental group,the expression level of the second experimental group increased (P<0 .0 5 or P<0 .0 1 )and compared with first and second experimental groups,the expression level of the third experimental group increased (P<0.01).Plasma total Hcy levels were positively correlated with mRNA and protein expressions of KV1.3 in all observed groups (r=0.503 P=0.000,r=0.726 P=0.000).Conclusion The higher level of Hcy in plasma,the higher mRNA and protein expression levels of KV1.3,CnAα,NFAT1 and the higher mRNA expression levels of IL-6,TNF-αin the lymphocyte of STEMI patients,which may be one mechanism for Hcy exacerbating the inflammatory reaction of STEMI.