BACKGROUND: Acupuncture in Chinese traditional medicine improves capacity of brain on resisting injury and accelerates injury repair in treatment of ischemic brain injury.OBJECTIVE: To observe the expressions of cerebral nerve growth factor (NGF) and choline acetyltransferase after simultaneous stimulation with electroacupuncture on Baihui (GV 20) and Dazhui (GV 14) so as to probe into the protection of electroacupuncture on hypoxia-ischemia brain injury.DESIGN: Randomized controlled experiment.SETTING: Department of Life Science in Zhengzhou Normal High Training School.MATERIALS: The experiment was performed in Human Anatomy Department of Basic Medical College of Zhengzhou University, in which, 50 cleangrade neonatal Wistar rats of 7 days old were employed and randomized into sham-operation group (10 rats), model control (20 rats) and electroacupuncture group (20 rats). Hypoxia cabin was self-made with constant pressure, 40 cm ×50 cm×60 cm in size, with two small holes of 2 cm ×2 cm for each to connect with the external. Soda lime was used to absorb moisture and CO2 in the cabin.The model was not prepared in sham-operation group. In model control and electroacupuncture group, hypoxia-ischemia model was set up. After modeling, the rats in two groups were recovered for 1 to 4 hours at room temperature; afterwards, hypoxia management was performed. The rats were placed in hypoxia cabin with constant pressure at constant temperature of 37 ℃, inputting O2 8 mL/L and mixed gas 920 mL/L, 1.5 L/minute; 2hours later, the rats were returned back to female rats for lactation continuously. In electroacupuncture group, on the 2nd day after modeling, a filiform needle of one cun was used to insert Baihui (GV 20) (midpoint of parietal bone) subcutaneously and Dazhui (GV 14) (between C7 and T1, on the midline of back). Electric stimulation was done simultaneously on two points with continuous wave, 16 Hz in frequency, 10V in intensity, retaining for 10 minutes, once per day, 10 days made 1 course, totally two courses at interval of 2 days. In model control, no any treatment was given group, 22 days after hypoxia and ischemia, the rats were anesthetized and sacrificed and brain tissue on the left side was collected to prepare paraffin slices. Immune positive cell was counted on slices of each group under optic microscope. For evaluation on the function of brain nerve cell, hippocampus was selected to count the positive cells of choline acetyltransferase. On each brain slice, 5 visual fields were randomized to calculate the average of positive cells. For evaluation on injury repair of nerve tissue, cortex and hippocampus were selected to count positive cells of cerebral NGF. The method was same as the above.MAIN OUTCOME MEASURES: Immune positive cell expressions of choline acetyltransferase and cerebral NGF in brain tissue after electric stimulation in neonatal rats.ferase in brain hippocampus: Compared with sham-operation group, that in model control was lower remarkably, but, there was no obvious change in electroacupuncture group [(24.46±8.24), (13.96±7.62), (25.54±5.05) pcs/visual field, P ＜ 0.05, P ＞ 0.05]; that in electroacupuncture group was of cerebral NGF in cerebral cortex and hippocampus: Compared with sham-operation group, that in both model control and electroacupuncture was increased remarkably [(14.14±6.11), (24.49±8.31), (31.35±9.92) pcs/visual field, P ＜ 0.05; (13.42±5.56), (21.93±5.12), (27.63±7.15) pcs/visual field, P ＜ 0.05], of which, that in electroacupuncture group was higher than model control (P ＜ 0.05).CONCLUSION: Electroacupuncture stimulates central cholinergic nerve system into positive active state in hypoxia-ischemia animals, increases cerebral nerve growth factor in quantity and enhances nerve repair of hypoxia-ischemia animals.

Objective To investigate the effect of various doses of dezocine on the prevention of emergence agitation after sevoflurane anesthesia in children .Methods 100 children aged from 1 to 3 years old were randomly divided into 4 groups with 25 cases each :the 0 .03 mg/kg dezocine group (group D1) ,the 0 .05 mg /kg dezocine group (group D2) ,the 0 .10 mg/kg dezocine group (group D3) and the control group .Anaesthesia was induced with 6% sevoflurane and 1 μg/kg remifentanil .Anaesthesia was maintained with 1 .5% - 2 .5% sevoflurane and remifentanil .Different doses of dezocine 0 .03 mg/kg ,0 .05 mg/kg ,0 .10 mg/kg ,and the same volume saline were administered before surgery .The incidence of emergence agitation was assessed with 5 points scale and the severity of emergence agitation was assessed with Pediatric Anesthesia Emergence Delirium (PAED) scale .The time to remove the laryngeal mask airway ,the time to be discharged from the post-anesthesia care unit (PACU) ,FLACC and Ramsey scores ,post-operative nausea and vomiting were recorded and considered .Results Compared with the control group ,the incidence of emergence agitation and PAED scales of D2 and D3 group were significantly lower than it (P < 0 .05) .Compared with the control group , FLACC scores of D2 and D3 group were lower than it(P< 0 .05) .At the same time ,Ramsey scores of D2 and D3 were higher than that of the control group(P < 0 .05) .Moreover ,Ramsey score of D3 was higher than D2(P < 0 .05) .The time span of being dis-charged from the PACU of D3 was significantly longer than that of the other groups(P< 0 .05) .Conclusion Dezocine of 0 .05 mg/kg and 0 .10 mg/kg both can reduce the incidence of emergence agitation effectively ,and there is no significant difference between the effect of the two doses .However ,the dose of 0 .05 mg/kg has a better performance in the time span for being discharged from the PACU .

Objective To explore the risk factors influencing the prognoses by analyzing clinical data of patients with acute paraquat intoxication,and provide a basis for clinical prevention and treatment of the disease. Methods The clinical data of 176 patients with acute paraquat intoxication admitted into our Hospital were retrospectively collected during the period from January 2012 to February 2013. After admission,the conventional medical treatment was given to all the patients,and according to the prognoses of 28 days after poisoning,the patients were divided into death group and survival group. The gender,age,toxic dose,time elapsed from poisoning to admission,time elapsed from poisoning to gastric lavage,number of cases treated with drug lavage,white blood cell count(WBC),alanine amino-transferase(ALT),aspartate amino-transferase(AST),blood urea nitrogen(BUN), serum creatinine(SCr),acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ)score,carbon dioxide combining power(CO2CP),number and time of cases revealing arterial blood oxygen saturation(SaO2)<0.90, and the survival rate within 28 days after admission were recorded. Multivariate logistic regression was used to analyze the factors related to the prognosis. Results ①Of the 176 cases,96 survived and 80 died in 28 days,the survival rate being 54.55%.②Univariate analysis showed the poisoning dose(ml),time elapsed from poisoning to admission (minute), WBC(×109/L), ALT(U/L),AST(U/L),BUN(mmol/L),SCr(μmol/L),APACHEⅡ scores, CO2CP (mmol/L),number of cases with SaO2<0.90 in the survival group were significantly lower than those in the death group〔38.14±39.44 vs. 88.50±58.79,41.11±30.29 vs. 90.00±59.31,11.78±3.61 vs. 16.13±5.02,84.46±42.53 vs. 156.35±76.62,76.21±38.69 vs. 184.00±86.48,5.34±2.89 vs. 10.51±6.80,84.17±77.38 vs. 199.74±162.13, 0.96±1.60 vs. 3.60±2.61,22.02±4.47 vs. 18.35±4.19,4(4.17%)vs. 80(100.00%),respectively,all P<0.01〕;there were no statistically significant differences in time elapsed from poisoning to admission(hour),number of cases treated with drug lavage and time of revealing SaO2<0.90(day)between survival group and death group〔7.96±3.39 vs. 8.05±4.26, 20(20.83%)vs. 24(30.00%), 62.25±18.45 vs. 65.70±45.10,respectively,all P>0.05〕.③Multivariate logistic regression revealed poisoning doses>30 ml〔odds ratio(OR)=6.455,95% confidence interval(95%CI)3.177-13.113,P<0.001〕,time elapsed from poisoning to admission>30 minutes(OR=8.639, 95%CI 4.043-18.461, P<0.001), WBC>12×109/L (OR=2.745,95%CI 1.388-5.426, P=0.004),BUN>8 mmol/L(OR=6.713,95%CI 2.650-17.006,P<0.001)and CO2CP≤22 mmol/L(OR=4.737,95%CI 2.389-9.394, P<0.001) were the risk factors correlated with the prognosis of patients with acute paraquat intoxicationl. Conclusion Poisoning doses,time elapsed from poisoning to admission,BUN,CO2CP and WBC are the independent risk factors for predicting prognosis of acute paraquat intoxication.

Objeetive To explore the analgesic and hemostatic effect of lidocaine gelatin fiber used after endoscopic sinus surgery.Methods 86 patients underwent endoscopic sinus surgery were randomly divided into A and B groups.In A group,20％ lidocaine gelatin fiber and expansion hemostatic sponge was packed into 43 patients' nasalcavity,while in B group,only expansion hemostatic sponge was packed.Nasal bleeding in patients while packed material within 24 hours and when extracted the material were observed.The analgesic effects were evaluated after packing material 1,6,12,and 24 hours after surgery.Results In A group,the amount of bleeding was (16.30 ± 5.19)ml,while the amount was(32.30 ± 12.09) ml in group B.Statistical analysis showed significant difference(t =7.97,P ＜0.05).There were no significant differences in nasal bleeding when extracted the stuffing and in analgesic efficiency 1hour after surgery.But the analgesic efficiency of lidocaine gelatin fiber was 20％,which was better than expansion hemostatic sponge 6 ～24 hours after surgery (t =27.163,29.091,16.241,all P ＜ 0.05).Conclusion Lidocaine gelatin fiber not only had better hemostasis,but also had better analgesia than expansion hemostatic sponge after endoscopic sinus surgery.

Objective To evaluate the diagnostic value of 18F-FDG PET-CT in looking for tumor primary lesion with multiple bone metastasis.Methods 84 patients with suspected bone metastases were detected by routine imaging (X -ray,CT,MRI)in our hospital from May 2012 to September 2014 were selected,18F -FDG PET/CT were used to find the primary lesion.The final diagnosis were confirmed by tissue pathology or by clinical imaging follow -up.The diagnostic sensitivity,specificity and accuracy on tumor bone metastasis of 18F -FDG PET/CT were recorded.Results In 84 patients,primary tumor was found in 49 cases,of which 46 cases (54.8%)confirmed pri-mary tumor by operation or pathology,the other 3 cases were false positive;35 patients were diagnosed as non meta-static bone tumor by PET/CT,in which 34 cases were finally confirmed as non metastatic bone tumor by pathology and follow -up;accuracy,sensitivity,specificity of 18F -FDG PET/CT were 54.8%(46 /84),93.9% (46 /49)and 95.2%(80 /84);18 cases of lung cancer,9 cases of prostate cancer,7 cases of breast cancer,5 cases of lymphoma, 4 cases of renal cell carcinoma,2 cases of liver cancer,1 cases of Uterine sarcoma were included in 46 primary tumors.Conclusion 18F -FDG PET/CT has a higher specificity,accuracy as well as higher detection rate in search of multiple bone metastases,thus it is beneficial to the clinical therapy.

Objective To investigate the effect of CCAAT/enhancer-binding protein homologeus protein (CHOP) in Tan Ⅱ A treated acute promyelocytic leukemia (APL) cells.Methods APL cell differentiation was monitored by morphology and membrane differentiation antigens; expression of CHOP was inhibited by siCHOP; mRNA and protein expression of CHOP in Tan Ⅱ A-intervened APL cells were examined by RT-PCR and Western blot.Results Expression of CHOP was increased in Tan Ⅱ A induced differentiated APL cells (proteins levels 1.933±0.987 vs 0.537±0.110,F =114.852,P ＜ 0.01,mNRA levels 1.587±0.815 vs 0.713±0.090,F =52.256,P ＜ 0.01),combination of CHOP gene silencing with Tan Ⅱ A treatment induced strong APL cell differentiation [(50.767±1.241) ％ vs (16.167±2.122) ％,F =989.431,P ＜ 0.05] and apoptosis [(89.233±5.581) ％ vs (27.433±2.957) ％,F =308.961,P ＜ 0.05].Conclusion CHOP acts as a negative regulator in Tan Ⅱ A induced differentiation.Inhibition of CHOP may be a promising therapeutic strategy.

Objective To investigate the risk factors of thrombopenia(TP)in septic patients complicated with acute kidney injury (AKI).Methods Two hundred and sixty five septic patients complicated with AKI admitted in Intensive Care Unit ICU of Zhejiang Provincial People''s Hospital during January 2012 and December 2016 were enrolled in the study.The clinical data, results of laboratory tests, Acute Physiology and Chronic Health Evaluation (APACHEII) scores, Sequential Organ Failure Assessment (SOFA) scores, therapeutic intervention, and 28-day mortality were documented.Among 265 patients, TP occurred within 7 days in 112 cases (TP group) and did not occur in 153 cases (non-TP group).Multivariable Logistic regression analysis was performed to analyze the risk factors of TP.Results The 28-day mortality rate in TP group was higher in TP group than that in non-TP group (47.3% vs.33.3%, χ2=5.307,P<0.05).Univariate analysis showed that age, C-reactive protein (CRP), procalcitonin (PCT) and APACHEII score, SOFA score, continuous renal replacement therapy (CRRT), heparin anticoagulation, shock, usage of linezolid and bloodstream infections were associated with TP in septic patients with AKI(all P<0.05).Multivariable Logistic regression analysis showed that age≥65 (OR=4.53, 95%CI 1.23-9.24,P<0.05), CRRT(OR=5.24,95%CI 2.14-14.56,P<0.01), heparin anticoagulation(OR=4.56,95%CI 2.13-8.46,P<0.01), usage of linezolid(OR=2.35,95%CI 1.25-5.24,P<0.01), shock(OR=2.15,95%CI 1.03-4.96,P<0.01)and bloodstream infections(OR=4.26,95%CI 1.36-12.48,P<0.01)were independent risk factors for septic patients with TP.Conclusion For septic patients with AKI having these risk factors, the platelet counts should be closely monitored, and intervention measures should be given to reduce the occurrence of TP.

Objective To evaluate the efficacy and safety of Qingpeng ointment for the treatment of localized dermatitis and eczema in children.Methods Sixty-eight outpatient children with localized dermatitis or eczema were included in this study.All the patients were topically treated by Qingpeng ointment twice daily for a week,which was agreed by their patients.The efficacy was evaluated after the end of the treatment by lesion scores,and adverse reactions during the treatment were recorded.Results Of the 68 patients,61 completed the trial,7 withdrew from the trial because of worsened lesions,unfavorable effects and distrust of this drug.The total response rate was 81.4％ (31/51) in patients treated with Qingpeng ointment alone.Irritant reaction occured in only one case,but did not influence the treatment.Conclusion Qingpeng ointment displays a favorable efficacy and safety in the treatment of localized dermatitis and eczema in children.

2.83 cm(left-right).The density of lymphocele was homogeneous ,with 0~15 HU(mean value,5.7HU).Adjacent organs were displaced by compression of lymphocele.Conclusion It should be diagnosed as a lymphocele if a pelvic cyst is found in postoperation of pelvic malignant tumor.