Objective To explore the regulatory roles of butorphanol on isolated rabbit pulmonary arteries by lipopolysaccharide(LPS)pre-incubation and assay the protective effect of ketamine on clinic sep tic shock patients.Methods Vascular ring tension detection technique was applied to observe the effect of butorphanol on the normal or lipopolysaccharide incubated pulmonaryvascular.Results In normal group, the final concentration of butorphanol(0.1 μmol,1μmol,10μmol,100μmol)were used to make pretreat ment- phenylephrine(PE)pulmonary artery relaxation.In LPS group,the effect of vasodilation of butor phanol was enhanced.Conclusions LPS can enhance the effect of butorphanol on pulmonary artery relaxa tion reaction.And the direct effect of butorphanol on pulmonary arteries was vasodilation.

Objective To investigate the effect and mechanism of low-dose remifentanil(RF)on systemic artery tension of baby rabbit with septic shock.Methods Thirty-six systemic artery strips were prepared from 12 baby rabbits and randomly divided into 6 groups:control group,lipopoly-saccharide(LPS)group,RF group,LPS + RF group,NG-nitro-L-arginine(L-NNA)pretreated group,LPS + L-NNA pretreated group.Each group had six rings(n =6).The effect of low-dose RF on the systemic artery tension of baby rabbit with septic shock was observed with isolated vascular ring technique.The change was also obversed after L-NNA pretreatment.Results In control group:the relaxant rates after low-dose RF at the time point of 5 min,10 min,20 min were(18.48±3.96)％,(23.63±4.42)％,(28.33±3.73)％(P＜0.05),compared with NS group.After pretreatment with L-NNA,RF-related relaxant rates of systemic arteries decreased significantly to(8.15 ± 1.01)％,(13.08 ± 1.46)％,(18.54 ±2.94)％(P ＜ 0.05).In LPS group,low dose RF(4 μg/L)did not bring out any response to systemic arteries(P ＞0.05).The tension was not affected with pretreatment of L-NNA(P ＞ 0.05).Conclusion These results suggest that low dose RF has relaxant effect on systemic arteries of baby rabbits,and NO may be involved.Low dose RF has no relaxant effect on LPS-pretreated systemic arteries of baby rabbits,and it has no association with NO.

Objective To explore the operative cooperation of the intra-extra cranial bypass operation of the intracranial giant aneurysms. Methods A retrospective analysis of 7 patients who had intracranial giant aneurysm and received the intra-extra cranial bypass operation from October 2014 to June 2016. All preoperative and intraoperative nursing points of operative cooperation were analyzed. Results The post-operative digital subtraction angiographies of 7 patients without any perioperative nursing complications showed enough flow in the bypass arteries. Conclusions Operative multi-incision managing, positive temperature intervening, special instruments using and thrombosis preventing play very important roles in the nursing points of the successful operative cooperation.

Objective To compare the efficacy of weight loss,metformin and rosiglitazone in women with polycystic ovary syndrome(PCOS).Methods A randomized controlled trial(RCT)was carried out in Peking Union Medical College Hospital(PUMCH),one hundred and six women with PCOS were assigned to three intervention groups:weight loss,weight loss and metformin,weight loss and rosiglitazone group.Patients were treated with weight loss(diet and exercise),weight loss and mefformin (500 mg three times daily),weight loss and rosiglitazone(4 mg once daily)for three months.Sixty patients completed treatments.Basal body temperature(BBT),total testosterone as well as fasting serum insulin levels and lipid were measured and compared in all patients before and after weight loss.Results No significant differences were found in the baseline characteristics among three groups.In weight loss group 51%(22/43)patients completed treatment,and 23%(5/22)patients resumed ovulation.In weight loss and mefformin group 58%(21/36)patients completed treatment,and 43%(9/21)patients resumed ovulation.In weight loss and rosiglitazone group 63%(17/27)patients completed treatment,and 59% (10/17)patients resumed ovulation.Ovulation rate was significantly higher in weight loss and rosiglitazone group than in weight loss group.There was no significant difference among three groups in body mass index (BMI),waist circumference,waist-hip ratio(WHR),sex hormone,serum fasting insulin and lipid level after treatment.Conclusion Weight loss,metformin and rosiglitazone all can improve ovulation each.

Objective To compare the safety and clinical efficiency between minimally invasive percutaneous nephrolithotomy(MPCNL)in supine position and flexible ureteroscopy(FURS)in management of proximal ureteral calculi.Methods From Oct.2010 to May.2012,76 patients with single proximal ureteral calculus between 10-20 mm failed in SWL or other conservative therapy accepted MPCNL (32 cases)or FURS(44 cases).There was no significant difference between the groups in base-line parameters.Stone sizes were(15.6±2.5)mm and(14.9±2.3)mm,P＞0.05.Procedural time,post-operative hospitalization stay,complication rates(Clavien degree Ⅱ or over)and stone free rates were compared.Results In these two groups,procedural time was(49.3± 11.7)and(67.2± 17.3)min,P＜0.05,postoperative hospitalization stay were(4.2±1.1)and(1.8±0.8)days,P＜0.05,complication rates were 12.5％ and 6.8％,P＞0.05 and stone free rates(residual fragments≤3 mm)were 93.7％ and 84.1％,P＞0.05.Conclusions For patients with surgically indicated proximal ureteral calculi,both minimally invasive percutaneous nephrolithotomy in supine position and flexible ureteroscopy are effective and safe therapeutic modalities.Patients treated with flexible ureteroscopy have faster postoperative recovery.

Aneurysm of the internal carotid artery is a rare disease and is known to be associated with congenital arterial anomalies such as neurofibromatosis type I (NF-I). NF-I is an autosomal dominant neurocutaneous disorder characterized by a variety of manifestations that involve the central and peripheral nervous systems, skin, vascular system, and skeleton. In particular, the involvement of vascular abnormalities in NF-I is well known. Any vessel may be affected by this condition, although the renal artery is most frequently involved. The vascular abnormality can be occlusive or an aneurysmal degenerative change. Therefore, symptomatic presentations might assume an indolent pathophysiologic course such as hypertension, or manifest as a catastrophic event such as arterial rupture that could result in sudden death. We report a rare autopsy case of an aneurysmal rupture of the internal carotid artery in a woman with suspected NF-I, who collapsed in her home.
Aneurysm ; Autopsy ; Carotid Artery, Internal ; Death, Sudden ; Female ; Glycosaminoglycans ; Humans ; Hypertension ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Peripheral Nervous System ; Rare Diseases ; Renal Artery ; Rupture ; Skeleton ; Skin

Primary signet ring cell carcinoma of the prostate is extremely rare and about 18 cases have been reported in the literature. We report two cases of primary signet ring cell carcinoma of the prostate, arising in 79-year-old and 65-year-old men. Both cases were the poorly differentiated adenocarcinoma of the prostate with many signet ring cells. Signet ring cells were positive for prostatic specific antigen and prostatic acid phosphatase but negative for neutral and acid mucins. In summary, the signet ring cell carcinoma of the prostate is a rare variant of poorly differentiated adenocarcinoma of the prostate. The orgin of the prostate should be considered in cases of metastatic signet ring cell carcinoma, particularly when the signet ring cells are negative for neutral and acid mucins. Prostatic specific antigen and prostatic acid phosphatase should also be performed to confirm the primary signet ring cell carcinoma of the prostate.
Acid Phosphatase ; Adenocarcinoma ; Aged ; Carcinoma, Signet Ring Cell* ; Humans ; Male ; Mucins ; Prostate*

In Western countries, more and more people select acupuncture and moxibustion as medical ways, and more and more acupuncture and moxibustion research organizations are set up. Britain TCM foundation is such one center for acupuncture research. This center is aimed at promoting acupuncture research. Since 1991, a series of clinical trials and several big research tasks have been completed. The clinical designs in the center are very careful and scientific, being worth to be learnt. In the paper, clinical studies in the center are introduced for increasing levels of acupuncture and moxibustion research at home.
Acupuncture ; Acupuncture Therapy ; Biomedical Research ; History, 20th Century ; Humans ; Moxibustion ; United Kingdom

Objective To evaluate the effect of pregnancy and delivery after renal transplantation (RT)on recipients,graft and offspring.Methods Clinical data of 6 pregnancies in 5 recipients were retrospectively studied and literature was reviewed.Results Among them,6 pregnancies and 4 deliveries occurred in 5 female RT recipients.The mean age at pregnancy was 31.1 years,with a mean interval between RT and pregnancy being 3.6 years.Preeclampsia developed in two pregnancies and hyperlipemia in one pregnancy.One RT recipient who discontinued immunosuppressant following pregnancy on her own exhibited subsequent renal failure.She underwent a second RT and delivered a healthy baby two years following the second RT.One RT recipient decreased the immunosuppressant dose to half after the pregnancy on her own and developed renal failure thereafter.Four patients underwent a Cesarean section at 38 th,35 th,35 th,and 38 th week,respectively.The mean birth weight was 3262.5 g with all Apgar scores of 10.Conclusion Our data coupled with prior reports suggest that for the recipients with normal renal function,successful pregnancy is achievable if immunosuppressant was taken correctly,but the pregnancy is at high risk,and careful monitoring is needed.

Objective To evaluate the value of low-density lipoprotein-cholesterol (LDL-C) and non-high-density lipoprotein-cholesterol (non-HDL-C) in differential diagnosis of familial hypertriglyceridemia (FHTG) and familial combined hyperlipidemia (FCHL).Methods We recruited 9 FHTG pedigrees (94 subjects) and 24 FCHL pedigrees (94 subjects) and then divided them into affected groups and non-affected groups according to lipid abnormality.Another 10 normal control pedigrees (57 subjects) served as controls.We compared the routine lipid levels such as triglyceride (TAG),total cholesterol (TC),HDL-C and LDL-C and non-HDL-C between the groups.After stratification based on TAG level,we observed the relationship between LDL-C and non-HDL-C.Last we confirmed and analyzed the cut-off value of differential diagnosis between FHTG and FCHL with receiver operating characteristic (ROC) curve.Results The levels of TAG,TC,and non-HDL-C were significantly higher in the affected group of FHTG than in the non-affected group of FHTG and the normal group (P＜0.01 or P＜0.05).The levels of TAG,TC,HDL-C,LDL-C and non-tHDL-C wcrc significantly higher in the affected group of FCHL than in the non-affected group of FCHL and the normal group (P＜0.01 or P＜0.05).The levels of TAG were significantly higher (P＜0.01) while TC,HDL-C,LDL-C and non-HDL-C levels were significantly lower (P＜ 0.01 or P＜0.05) in the affected group of FHTG than in the affected group of FCHL.The association between LDL-C and non-HDL-C was positive both in FHTG and FCHL,but the relationship became weaker as TAG level increased.The cut-off value of LDL-C and non-HDL-C was 3.575 mmol/L and 4.525 mmol/L,respectively.Conclusion In addition to the routinely used lipid indexes,non-HDL-C may be a new index for differential diagnosis of FHTG and FCHL,and may be superior to LDL-C in this regard.