Objective To evaluate the function of the domestic sickbeds set up by our hospital in the prevention and cure of non infectious chronic diseases. Methods A perspective study was made through offering health education, guidance and home treatment to 116 cases using domestic sickbeds and employing the method of self management. In addition, the clinical treatment results of the patients and the rate of their satisfaction towards domestic sickbeds were surveyed, analyzed and assessed. Results Through long term follow up visits, it was found that compared with the intermittently standardized group and the completely non standardized group, the control rate of chronic diseases in the standardized group with systematic management and treatment was significantly higher while the rates of complications and mortality were much lower (P

Objective To evaluate the relationship between the anesthesia factor and myocardial injury in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Eightyeight patients of both sexes,aged 42-71 yr,weighing 59-83 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective coronary artery bypass grafting with CPB,were divided into 4 groups (n =22 each) using a random number table:routine anesthesia control group (group C),dexmedetomidine-based anesthesia group (group D),sevofluranebased anesthesia group (group S) and dexmedetomidine combined with sevoflurane anesthesia group (group DS).After tracheal intubation,0.2％-2.1％ sevoflurane was inhaled until the beginning of CPB in S and DS groups.In D and DS groups,dexmedetomidine was intravenously infused as a loading dose of 1 μg/kg over 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until the end of surgery.Before induction of anesthesia,before CPB,after the end of CPB,immediately after the end of surgery and at 24 h after surgery,venous blood samples were collected for determination of plasma creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) concentrations by immunofluorescence.The restoration of spontaneous heart beat and adverse events such as hypotension,malignant arrhythmia,cardiac arrest and respiratory depression during surgery and within 24 h after surgery were recorded.Results Compared with group C,the plasma concentrations of CK-MB and cTnI were significantly decreased in the other three groups (P＜0.05).The plasma eoncentrations of CK-MB and eTnl were significantly lower in group DS than in S and D groups (P＜0.05).There were no significant differences in the rate of restoration of spontaneous heart beat among the four groups (P＞ 0.05).No adverse events were found during surgery and within 24 h after surgery in the four groups.Conclusion Dexmedetomidine combined with sevoflurane anesthesia is helpful in reducing myocardial injury and provides better efficacy than either alone in the patients undergoing cardiac surgery with CPB and is more suitable for cardiac surgery with CPB.

Objective: To assess the activity of cathepsin D (CAT-D) and alpha-1 antitrypsin (AAT) in blood in patients with hip or knee osteoarthritis, and to explore whether these two enzymes could be served as serum biomarkers for cartilage degeneration. Methods: hTe activity of CAT-D and AAT in blood serum of 44 women and 26 men with hip or knee osteoarthritis was determined by the method of ELISA before total joint replacement and on the 10th day atfer the surgery. One hundred healthy volunteers were chosen as the control. All datawere analyzed by using SPSS19.0 sotfware. Results: Compared with the controls, the activity of CAT-D in patients with osteoarthritis was decreased by 25% (P<0.05) and 50% (P<0.05) before and atfer the surgery, respectively. hTe activity of AAT in the osteoarthritis patients before the surgery was not signiifcantly changed compared with the control group (P>0.05), but it was increased by 80% after the surgery than that in the control group (P<0.05). hTere was no signiifcant difference in the activities of 2 enzymes between hip and knee osteoarthritis (P>0.05). hTe gender, hypertension, diabetes and age did not affect the activities of the 2 enzymes (P>0.05). Conclusion: AAT might be a possible inflammatory indicator in the osteoarthritis. CAT-D and AAT enzymes are not affected by gender, age, hypertension and diabetes, etc, and they might be served as potential biomarkers for cartilage degradation.

OBJECTIVETo compare the effects between mild moxibustion and specific electromagnetic spectrum therapy apparatus (TDP) for obsolete collateral ligament injury of interphalangeal joints.

METHODSSixty patients were randomly divided into a mild moxibustion group and a TDP group, 30 cases in each one. In the mild moxibustion group, pure moxa sticks were used at the affected digital joints locally for 20-30 min a time. In the TDP group, TDP was applied at the affected digital joints locally for 20-30 min a time. The treatment was given once a day for two courses, and 10-day treatment was made into a course. Visual analogue scale (VAS) for pain, swelling degree of the affected digital joints before and after treatment were observed and the clinical efficacy and safety were evaluated in the two groups.

RESULTSThe excellent rate was 56.7% (17/30) and the excellent and, good rate was 83.4% (25/30) in the mild moxibustion group,which were better than 36.7% (11/30) and 76.7% (23/30) in the TDP group respectively (both P < 0.01). After treatment the score of VAS and digital joints swelling degree were improved than those before treatment in the two groups (P < 0.01, P < 0.05), and the improvements of the mild moxibustion group were better than those of the TDP group (P < 0.01, P < 0.05).

CONCLUSIONMild moxibustion can apparently relieve the painful and swelling degree of obsolete collateral ligament injury of interphalangeal joints, which is superior to TDP.

Acupuncture Points ; Adolescent ; Adult ; Collateral Ligaments ; injuries ; Electromagnetic Radiation ; Female ; Humans ; Joint Diseases ; therapy ; Magnetic Field Therapy ; Male ; Moxibustion ; Pain Measurement ; Young Adult

Objective To investigate the risk factors for influencing recrudescence after endovascular embolization of posterior communicating artery aneurysms.Methods From January 2014 to December 2014,71 consecutive patients (a total of 74 aneurysms) with posterior communicating artery aneurysm treated with endovascular treatment at the Department of Neurosurgery,Yijishan Hosptial of Wannan Medical College were enrolled retrospectively.The aneurysms were calculated as the number of cases (n=74).The aneurysms were divided into two groups according to whether they had recrudescence or not,including recurrent group (n=18) and non-recurrent group (n=56).The differences of the clinical data and aneurysm characteristics between the two groups were compared.Multivariate logistic regression was used to analyze the risk factors for recrudescence after endovascular embolization of posterior communicating artery aneurysms.Results Of the 74 patients with aneurysm,51 were treated with simple coil embolization and 23 were treated with stent-assisted coil embolization.All the coils were released satisfactorily.There were significant difference in the size of aneurysms and Raymond grade between the two groups (all P<0.01).The incidence of aneurysms with daughter cysts (55.6% [10/18] and the rate of non-stent-assisted coil embolization (88.9% [16/18]) in the recurrent group were significantly higher than those in the non-recurrent group (23.2% [13/56],62.5% [35/56]).The difference between the two groups was statistically significant (all P<0.05).There was no significant difference in other aneurysm features between the two groups (all P>0.05).After variable selection,the Raymond grade was referred to Raymond gradeⅠ.Multivariate logistic regression analysis showed that the non-stent-assisted coil embolization (OR,4.789,95%CI 1.207-19.009,P=0.026),Raymond grade Ⅱ (OR,12.326,95%CI 3.838-39.592,P<0.01),Raymond grade Ⅲ (OR,36.884,95%CI 2.892-470.454,P=0.005) were the independent risk factors for recrudescence after embolization of posterior communicating artery aneurysms.Conclusion Non-stent-assisted coil embolization,Raymond Ⅱ and Ⅲ may cause recrudescence of posterior communicating artery aneurysms.

Objective To investigate the feasibility and effectiveness of endovascular treatment of posterior communicating artery aneurysm (PcoAA)in keeping the fetal posterior cerebral artery (FPCA) patency. Methods Form January 2014 to December 2015,14 patients with ruptured PcoAA enrolled retrospectively were treated with endovascular embolization. Six of them were treated with simple coil embolization,3 with stent-assisted coil embolization,3 with double catheter-assisted coil embolization,1 with stent-assisted coil embolization + double catheter technique,and 1 with Y-stent in Yijishan Hospital, Wannan Medical College. The immediate embolization rate of PcoAA (using Raymond grade),prognosis of the patients (the modified Rankin scale score at 6 months after procedure),complications,and imaging follow-up results were analyzed. Results The success rate of coil and stenting was 100% . All the stents were accurately released in place without displacement. The immediate Raymond grading of the aneurysms displayed that Raymond grade Ⅰ was in 8 cases,Raymond grade Ⅱ was in 4 cases,and Raymond grade Ⅲ was in 2 cases. All FPCA were kept patent. A coil protruded into internal carotid artery in one case during the procedure. Others did not have any complications,such as intraoperative cerebral vasospasm,in-stent thrombosis,and rupture. All 14 patients were followed up for 3 -24 months after procedure. Two had recurrence. Both were aneurysms embolized with coils only. No rebleeding and ischemic
complications were observed. The modified Rankin scale scores in 13 cases were 0 -2 at 6 months after procedure,1 was 4. Conclusions Endovascular embolization for the treatment of PcoAA and keeping FPCA patency are safe and feasible. A variety of endovascular treatment modalities are necessary in order to keep FPCA patency.

Objective:To evaluate the effect of sevoflurane-dexmedetomidine combined anesthesia on inflammatory responses in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).Methods:A total of 96 American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 45-60 yr, weighing 60-75 kg, with New York Heart Association Ⅱ or Ⅲ, scheduled for elective CABG with CPB, were divided into 4 groups ( n=24 each) using a random number table method: routine general anesthesia (group C), sevoflurane-based general anesthesia group (group S), dexmedetomidine-based general anesthesia group (group D) and sevoflurane combined with dexmedetomidine-based general anesthesia group (group SD). In D and SD groups, dexmedetomidine was intravenously infused in a loading dose of 1μg/kg over 10 min at the beginning of induction anesthesia, followed by an infusion at 0.4 μg·kg -1·h -1 until the end of the surgery.After tracheal intubation, 1%-2% sevofluran was inhaled in S and SD group.Before anesthesia induction, before the CPB, immediately at the end of CPB, at 6 h after the end of CPB and 24 h after surgery, central venous blood samples were collected for determination of plasma interleukin-6 (IL-6), IL-10 and tumor necrosis factor-alpha (TNF-α) concentrations by enzyme linked immunosorbent assay.The restoration of spontaneous heart beat, the occurrence of serious adverse events during surgery and within 24 h after surgery, the retention time of intubation and duration of intensive care unit (ICU) stay after surgery were recorded. Results:Compared with group C, the plasma concentrations of IL-6, IL-10 and TNF-α were significantly decreased in the other 3 groups, and the postoperative retention time of tracheal intubation was shortened in group SD ( P<0.05). Compared with group S or group D, the plasma concentrations of IL-6, IL-10 and TNF-α were significantly decreased ( P<0.05), and no significant change was found in the postoperative retention time of tracheal intubation in group SD ( P>0.05). There was no significant difference in the duration of ICU and restoration of spontaneous heart beat ( P>0.05), and no serious adverse events occurred during surgery and within 24 h after surgery among the groups. Conclusion:Sevoflurane combined with dexmedetomidine anesthesia is helpful in reducing the inflammatory responses in patients undergoing CABG with CPB, but provides no value in clinical outcomes.

Objective:To evaluate the effect of esmolol on the expression of phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2) during cerebral ischemia-reperfusion (I/R) in rats.Methods:Forty-eight clean-grade healthy adult male Sprague-Dawley rats, were allocated into 3 groups ( n=16 each) using a random number table method: sham operation group (Sham group), cerebral I/R group (I/R group) and esmolol group (E group). Cerebral I/R was induced by 3 cycles of 20-min occlusion of bilateral common carotid arteries followed by 10-min reperfusion in anesthetized rats.Esmolol 200 g·kg -1·min -1 was intravenously infused for 1 h starting from 30 min before ischemia, and the model was established after 30-min infusion in E group.The equal volume of normal saline was given at 30 min before ischemia in I/R group.Bilateral common carotid arteries were only isolated but not clamped, and the equal volume of normal saline was given after isolating bilateral common carotid arteries in Sham group.Learning and memory function was tested by Morris water maze test before ischemia and at 1, 3 and 7 days of reperfusion.Rats were sacrificed after Morris water maze test, and the hippocampus was excised for determination of wet to dry weight ratio (W/D ratio), permeability of blood-brain barrier (using Evans blue method), expression of ERK1/2 mRNA (by real-time polymerase chain reaction ), and expression of p-ERK1/2 (by Western blot). Results:Compared with Sham group, the escape latency and swimming distance were significantly prolonged at 1, 3 and 7 days of reperfusion, the W/D ratio and EB content in brain tissues were increased, and the expression of ERK1/2 mRNA and p-ERK1/2 was up-regulated in I/R and E groups ( P<0.05). Compared with I/R group, the escape latency and swimming distance were significantly shortened at 1, 3 and 7 days of reperfusion, the W/D ratio and EB content in brain tissues were decreased, and the expression of ERK1/2 mRNA and p-ERK1/2 was down-regulated in E group ( P<0.05). Conclusion:The mechanism by which esmolol alleviates cerebral I/R injury and improves cognitive function is related to inhibiting the up-regulated expression of ERK1/2 in rats.

Objective:To investigate the early auditory discrimination of vowels, consonants and lexical tones in prelingually-deafened children with cochlear implants (CI) using auditory event-related potentials.Methods:Nineteen prelingually-deafened CI children and 19 normal hearing (NH) children were recruited in this study. A multi-deviant oddball paradigm was constructed using the monosyllable/ta1/as the standard stimulus and monosyllables/tu1/,/te1/, /da1/,/ra1/,/ta4/and/ta2/as the deviant stimuli. The event-related potentials evoked by vowel, consonant and lexical tone contrasts were recorded and analyzed in the two groups.Results:NH children showed robust mismatch negativities (MMNs) to vowel, consonant and lexical tone contrasts ( P<0.05), whereas CI children only showed positive mismatch responses (pMMRs) and P3a responses to the vowel ( P<0.05) and consonant contrasts ( P<0.05) and no significant event-related potential to the lexical tone contrasts ( P>0.05). The longer pMMR and P3a peak latencies ( P<0.01) but similar amplitudes ( P>0.05) were found in CI children than in NH children. CI children showed weaker phase synchronization of θ oscillations than NH children ( P<0.05). The duration of CI use was positively correlated with the scores of Categories of Auditory Performance (CAP) ( P=0.004), Speech Intelligibility Rate (SIR) ( P=0.044) and Meaningful Auditory Integration Scale (MAIS) ( P=0.001) in CI children. Conclusions:Prelingually-deafened CI children can process vowels and consonants at an early stage. However, their ability of processing speech, especially lexical tones, is still more immature compared with their NH peers. The event-related potentials could be objective electrophysiological indicators reflecting the maturity of CI children′s auditory speech functions. Long-term CI use is beneficial for prelingually-deafened children to improve auditory and speech performance.

Objective:To investigate the relationship between the mechanism of clonidine preventing sevoflurane-induced neurotoxicity and Tau phosphorylation in neonatal mice.Methods:Seventy-two SPF healthy newborn C57BL/6 wild-type mice, aged 6 days, were divided into 4 groups ( n=18 each) using a random number table method: normal control group (C group), clonidine control group (CC group), sevoflurane-induced neurotoxicity group (S group) and prevention with clonidine group (SC group). Mice inhaled 3% sevoflurane for 2 h daily on postnatal days 6, 9 and 12, and normal saline or clonidine 1 mg/kg was intraperitoneally injected before anesthesia in S group and SC group. Six mice were randomly selected from each group after the end of anesthesia on postnatal day 12, and the hippocampal tissues were removed for determination of the expression of the phosphorylated Tau protein (AT8) and total Tau protein (Tau46) at Tau-PS202 and Tau-PT205 sites by Western blot. The ratio of AT8 expression to Tau 46 expression (AT8/Tau46 ratio) was calculated. Another 12 mice in each group underwent novel object recognition test on postnatal days 29-30 (the discrimination ratio of novel objects was observed), and the Morris water maze test was performed on postnatal days 31-37 (the escape latency and the times of crossing the platform were observed). After the end of the behavioral testing, the hippocampal tissues were harvested under anesthesia to detect the expression of postsynaptic density-95 (PSD-95) by Western blot. Results:Compared with group C, the expression of AT8 was significantly up-regulated, the ratio of AT8/Tau46 was increased, the expression of PSD-95 was down-regulated, and the number of crossing platforms and novel object discrimination ratio were decreased in group S ( P<0.05). Compared with group S, the expression of AT8 was significantly down-regulated, the ratio of AT8/Tau46 was decreased, the expression of PSD-95 was up-regulated, and the number of crossing platforms and novel object discrimination ratio were significantly increased in group SC ( P<0.05). There was no significant difference in the expression of Tau46 and escape latency among the four groups ( P>0.05). Conclusions:The mechanism by which clonidine prevents sevoflurane-induced neurotoxicity in neonatal mice is related to the inhibition of Tau phosphorylation.