Intravenous immunoglobulin (IVIG) is safe and effective concentration formulation which is obtained from the plasma of health adults.Domestic IVIG was used in clinical since 1979 by Liao Qingkui,who are pediatric doctor form West China Second Hospital.Researches on clinical applications of IVIG are quickly developed at home and abroad,which now become the indispcnsable treatment for primary and secondary immunodeficiency diseases,autoimmune diseases,infectious disease(especially for virus),stem cell or organ transplantation and ICU areas.Treatment dose and course are administered accordding to individuals and pharmacokinetic characteristics of IVIG,immunoglobulin rose to peak of drug concentration quickly,and recovery to the original level of plasma after 3-4 weeks.Common therapeutic dose of IVIG recommended by the literature were 400mg/(kg·per time),3-5 d,or 1000 mg/(kg·per time),2d,or 2000 mg/(kg·per time),1d,which were usually used for idiopathic thrombocytopenic purpura,Kawasaki disease patients.Treatment perscription of 200-600 mg/(kg·per time),1 d,and once every 2-6 weeks are used for immunodeficiency diseases and infections.Now,the clinical application of IVIG was reviewed.

Transsphenoidal microsurgery has become a major approach for removal of pituitary adenomas. Due to the anatomic differences of skull base between Chinese and foreigners and the different experience of surgeons, the pre- and post-operation managements of the operation are different. From 1982 to 2002, a total of 1 047 patients received transsphenoidal removal of pituitary adenomas in our hospital and gained satisfactory outcomes. This article summarizes our experience on 1 047 patients and discusses some relevant problems, including the diagnostic standards of adenoma size, surgery indications, the apoplexy operation, the re-operation for recurrent cases, management of complications, post-operation radiotherapy, and the anatomy of sphenoidal sinus and sellar area, hoping to improve the successful rate of the operation.

OBJECTIVE:Taking metoprolol succinate sustained-release tablets as an example,to explore the value of speckle tracking imaging in therapeutic efficacy evaluation of CHF drugs. METHODS:68 CHF patients who had never underwent regular treatment were given Metoprolol succinate sustained-release tablets and anti-heart failure agents for 3 months. NYHA classification, resting heart rate(RHR),6 min walk distance(6MWD)and conventional echocardiographic measurements were tested before and 1 and 3 months after treatment. Dynamic image were collected in the apical 2-chamber view,apical 4-chamber view and left ven-tricular long axis plane for speckle tracking imaging offline analysis. The left ventricular global longitudinal strain (LVGLS) were measured. After 3 months of treatment,CHF patients were divided into standard group(group A,RHR 55-60 times/min)and non-standard group (group B,RHR>60 times/min) according to resting heart rate. The improvement of above indicators were com-pared between 2 groups,and that of LVGLS was also compared. RESULTS:After 1 month of treatment,RHR,LVEDd,LVEF and LVGLS of group A were improved significantly,compared with group B,with statistical significance (P<0.05). After 3 months of treatment,there was statistical significance in above indicators between 2 groups(P<0.05). In group A,RHR,6MWD and LVGLS improved significantly after 1 month of treatment,there was statistical significance,compared with before treatment (P<0.05);there was statistical significance in above indicators after 3 months of treatment,compared with before treatment and after 1 month of treatment (P<0.05). In group B,RHR and 6MWD improved significantly after one month of treatment;there was statistical significance,compared with before treatment(P<0.05);there was statistical significance in significant improvement of each indicator between after 3 months of treatment and before treatment (P<0.05);only there were statistical significance in RHR and NYHA grading,compared with after one month of treatment(P<0.05). CONCLUSIONS:Speckle tracking imaging can early reflect the left ventricular function improvement of CHF patients after anti-heart failure treatment,especially in patients with RHR control standard earlier and more significant. Speckle tracking had good clinical application value in the follow-up treatment of heart failure as routine evaluation index.

Objective To compare the influences of combined spinal-epidural anesthesia(CSEA)and general anesthesia(GA)on patients who underwent laparoscopic gynecological operation.Methods A total of 60 patients of ASA Ⅰ～Ⅱ,were divided into two groups:the CSEA group and the general anesthesia group.Each group consisted of 30 patients.Glucose and cortisol levels were determined before anesthesia,10 minutes after anesthesia,10 minutes after pneumoperironeum and 10 minutes after abdominal deflation.Results No significant differences existed between the two groups on age,weight,operation time,pneumoperitoneum time,time to regain consciousness after operation,HR,SpO2,ECG and MABP(P＞0.05)No significant difference was found in cortisol level between two groups at various time points(P＞0.05).In the general anesthesia group,glucose level at 10 minutes after pneumoperitoneum was significantly lower than that before anesthesia(P＜0.05),but no significant difference was found in glucose level between the two groups at other time points(P＞0 05).At the same time,significant difference was found in postoperative complication rate between two groups(P＜0.01).Conclusion Both CSEA and general anesthesia can effectively inhibit the patients'stress response in laparoscopic gynecological operation.

In recent years, the number of outpatients in stomatological hospital is in increasing year by year and being accompanied by the corresponding medical risks. One of the risks which may endanger the patient life is medical emergency which need emergency treatment by the dentists in dental clinical practice. The most common emergency type is syncope, followed by hyperventilation, drug overdose, adrenaline reaction and hypertension, etc. Unexpected events mainly occurred at the end of the treatment and before leaving the dental clinic, during or immediately after the local anesthesia, in the treatment process. Tooth extraction related emergency is the most frequently occurring emergency, followed by the local anesthesia related ones. It's strongly suggested that dentists should pay more attention to outpatient clinical emergency treatment, and related knowledge and skills training should be offered to improve the ability to handle medical emergencies.
Dental Care ; Dental Clinics ; Dentists ; Emergencies ; Emergency Treatment ; Humans

Adrenocorticotropic Hormone ; therapeutic use ; Brain-Derived Neurotrophic Factor ; physiology ; Child, Preschool ; Female ; Humans ; Methyl-CpG-Binding Protein 2 ; genetics ; Mutation ; Rett Syndrome ; drug therapy ; genetics

Child ; Diabetes Mellitus, Type 1 ; genetics ; Female ; Humans ; Infant ; Male ; Siblings

Objective To discuss the levels of inhibitory protein Ga-2 (Gαi2) in hippocampus of brain and the effects of Gαi2 on neuronal intracellular Ca2+ level in cerebral ischemia reperfusion injury model of rats.Methods Ninety SD rats were randomly (random number) assigned to sham group (n =30),ischemic-reperfusion (IR) group (n =30),Pertussis toxin (PT) group (n =30).The blood flow of right common carotid artery of rat was blocked for 90 min to make ischemia reperfusion model.The levels of Gαi2 in hippocampus was assayed by immunohistochemistry and Western blotting after ischemia reperfusion for 6,12,24 h in each group.The average fluorescence values of intracellular Ca2+ levels in hippocampus of rats in three groups were detected by using Flow CytoMeter (FCM).Neuronal cell apoptosis was measured by TUNEL.Results After restoration of middle cerebral artery blood flow for different lengths of time,the levels of hippocampus Gαi2 and Ca2+ levels in IR group were significantly higher than those in Sham group (P ＜0.01).The hippocampus Ca2+ levels in PT group were higher than those in IR group (P ＜ 0.01).The apoptotic rates of neurons in PT group were lower than those in IR group (P ＜0.05).Conclusions The level of Gαi2 in cerebral ischemia reperfusion injury model was increased.Gαi2 might reduce the calcium ion concentration of neurons after cerebral ischemia and rcduce the neuronal cell apoptosis in this model.Gαi2 might play a role in protecting neuron from cerebral ischemia reperfusion injury.

Objective To compare the therapeutic efficacy between laparoscopic peritoneal vaginoplasty and sigmoid loop vaginoplasty. Methods A total of 29 cases of congenital absence of vagina received either laparoscopic peritoneal vaginoplasty (Peritoneal Group, 14 cases) or sigmoid loop vaginoplasty (Sigmoid Group, 15 cases) from March 1998 to April 2003. Results The operation failed in 1 case in the Peritoneal Group, requiring a conversion to open sigmoid loop vaginoplasty. Both groups had no surgical complications or postoperative pyrexia. The operating time of the Peritoneal Group (118 9?19 0 min) was significantly shorter than that of the Sigmoid Group (202 0?18 6 min) ( t =-11 674, P =0 000). And the intraoperative blood loss of the former (36 2?12 6 ml) was significantly less than that of the latter (105 3?46 3 ml) ( t =-5 205, P =0 000). The conditions of reconstructed vagina of both groups were basically the same, but the vagina length of the Sigmoid Group (10 8?1 1 cm) was significantly greater than that of the Peritoneal Group (9 0?0 8 cm) ( t =-4 882, P =0 000). Among the Sigmoid Group, 3 cases had somewhat more amount of vaginal secretion and 4 cases had abnormal-smelling secretion. Patients in both groups reported the same satisfactory degree of sexual life. Conclusions Laparoscopic peritoneal vaginoplasty and sigmoid loop vaginoplasty present a similar therapeutic efficacy, but the former gives less surgical invasion than the latter.

Objective To evaluate the effect of ureteroscopic treatment for upper urinary tract obstruction. Methods A total of 56 cases of upper urinary tract obstruction were treated under ureteroscope by using direct-vision dilatation, electrocauterization or balloon dilatation. Results A successful dilatation was achieved in 49 cases (87.5%, 49/56) whereas a failure was encountered in 7 cases. There were no complications such as ureteral perforation, rapture or heavy bleeding. A follow-up for 0.5~3 years (mean, 2.5 years) in 43 cases was carried out. The obstruction disappeared in 33 cases, remained in 6 cases, and relapsed in 4. The hydronephrosis disappeared in 30 cases, subsided in 5 cases, and had no changes in 8. Conclusions The treatment of the upper urinary tract obstruction under ureteroscope offers advantages of minimal trauma and satisfactory outcomes.