Objective To determine the independent risk factors for postoperative nausea and vomiting (PONV) after endoscopic retrograde cholangio-pancreatography (ERCP) under total intravenous anesthesia.Methods Ninety patients,47 males and 43 females,aged 18 years old or more,falling into ASA physical status Ⅰ-Ⅲ,undergoing ERCP under total intravenous anesthesia from July 18,2016 to August 31,2016 in Ruijin Hospital were included in our study.General information and intraoperative situation of patients were collected.The incidence of PONV within 24 h was recorded.A multivariate Logistic regression model was performed to analyze the independent risk factors of PONV after ERCP under total intravenous anesthesia.Results In total,90 patients were included in this study,with 33 patients (36.7%) suffering PONV.Logistic analyses showed that female (OR=3.73,95%CI 1.36-10.27),history of PONV/motion sickness(OR=4.39,95%CI 1.40-13.76),and serum-amylase greater than 3 times the normal value (OR=5.22,95%CI 1.30-20.95) were the independent risk factors for PONV after ERCP under total intravenous anesthesia.Conclusion Female,history of PONV/motion sickness,and serum-amylase greater than 3 times the normal value were the independent risk factors for PONV after ERCP under total intravenous anesthesia.

Objeetive To evaluate the effect of single-level Discover cervical artificial disc replacement on cervical sagittal alignment.Methods Retrospective analysis was conducted on patients who underwent single-level Discover cervical artificial disc replacement in our hospital from February 2012 to September 2014.Sixty-two patients (34 males,28 females) with an average age of 45.2±8.2 (31-61) who were diagnosed with single-level cervical disc herniation were included (C3-4 3 cases,C4-5 12 cases,C5-6 34 cases,C6-7 13 cases).We measured the cervical sagittal alignment parameters:index level disc angle,functional spinal unit (FSU) angle,C2-C7 angle, anterior disc height (ADH),middle disc height (MDH),posterior disc height (PDH),anterior FSU height (AFH),middle FSU height (MFH),posterior FSU height (PFH) on neutral lateral radiographs before surgery and 3 months after surgery.Results All of the patients were followed up for 3 months.The cervical sagittal alignment parameters before surgery and 3 months after surgery were as follows.Index level disc angle increased from 0.0°±4.2° to 7.3°±3.9°,FSU angle increased from 2.3°±5.0° to 6.9°±4.8°,C2-C7 angle increased from 9.5°±10.8° to 13.1°±9.1°,ADH increased from 4.3±1.0 mm to 7.9±1.1 mm,MDH increased from 5.8±0.9 mm to 8.1±0.9 mm,PDH increased from 3.7±0.9 mm to 5.5±0.9 mm,AFH increased from 34.1±3.5 mm to 36.2±3.4 mm,MFH increased from 32.3±3.5 mm to 33.6±3.3 mm,PFH increased from 33.9±3.5 mm to 34.6±3.2 mm.All changes were statistically significant (P＜0.05).Conclusion Single-level Discover cervical artificial disc replacement can improve the disk angle,FSU angle,and disk height effectively in early follow-up period,thereby improving the cervical sagittal alignment.

Meckel-Gruber syndrome is a rare,fatal disease.The rate of natal morbidity worldwide is from 1/140 000 to 1/13 250.With the development of ultrasound and molecular diagnosis technology,especially the emergence of the third generation of in vitro fertilization (IVF) and prenatal genetic diagnosis (PGD),it is possible for the genetic carriers to solve the fertility problems.In this review,the recent insight of Meckel-Gruber syndrome diagnostic criteria,possible pathogenesis and differential diagnosis of other diseases were discussed.Through the introduction of the disease,it is hoped to improve clinical understanding of the disease and remind the clinicians pay more attention to rare genetic disorders.It is helpful to improve the ability of the clinical diagnosis of the disease and other rare genetic disorders,and provide eugenic counseling and clinical guidance to the affected families.

ObjectiveTo investigate the effort of MHA-bBMP implantation combined with limited contacted titanium net duct fixation on femoral shaft bone defect of rabbit.Methods48 rabbits were divided into the experimental group (treated with bionic bone MHA-bBMP plus titanium net duck) and control group (treated with iliac autograft plus titanium net duct) with 24 animals in each group. The rabbit femoral shaft bone defect model was established by cutting 10 mm bone fragment off. After operation, bionic bone MHA-bBMP/iliac autograft was implanted into bone defect area and fixed with limited contacted titanium net duck. The general condition, serum alkaline phosphatase, X-ray, histopathologic examination and electron microscope were performed.ResultsThe fixation stability of titanium net duck in two groups was good. The bone defect of two groups was repaired. The results of phosphatase, X-ray, histopathologic examination and electron microscope of two groups were not significantly different.ConclusionBionic bone MHA-bBMP is a high bioactivity substitute, and can obtain therapeutic effect equal to iliac autograft when repairing rabbit's femoral shaft defect.

Objective:To investigate the feasibility of marrow stromal cells/ceramic bovine bone/hydrogel in the repair of autogenous calvarial defects. Methods:The complex of ceramic bovine bone,hydrogel,rhBMP-2,TGF-? and marrow stromal cells(MSCs) induced by minerlization inducing medium was prepared and applied in the repair of autogenous calvarial defects in 8 SD rats(group A).Ceramic bovine bone /MSCs was used as control in another 8 SD rats(group B). 4 and 8 weeks after operation 4 rats in each group were sacrificed, the osteogenesis was examined by HE staining,modified Mallory's trichrome staining and image analysis.Results:4 weeks after operation, osseous plerosis can be seen in both groups, the quantity of bone-like tissues formation(?m~2) in group A and group B was 6 813.09?96.32 and 3 839.25?104.52(P

Objective To investigate the effect of different concentrations of sevoflurane inhalation combined with pro?pofol anesthesia on rocuronium pharmacodynamics. Methods Sixty-seven patients, who underwent elective abdominal op?eration in Tianjin Medical University General Hospital from Nov. 2014 to Feb. 2015, were randomly allocated to three groups:propofol combined 0.5 minimum alveolar concentration (MAC) end-tidal concentration of sevoflurane (group Ⅰ, 24 cases), propofol combined 0.75 MAC end-tidal concentration of sevoflurane (group Ⅱ, 20 cases) and propofol combined 1 MAC end-tidal concentration of sevoflurane (groupⅢ, 23 cases). All those patients were given midazolam 0.05 mg/kg, sufen? tanil 0.3μg/kg, etomidate 0.3 mg/kg for anesthesia induction. Rocuronium was given through the T1 mode of Closed-loop muscle relaxant infusion system and infused by 2ED95(0.6 mg/kg). The following variables were recorded:average consump?tion dosage of rocuronium, recovery index, averaged consumption dosage of propofol and remifentanil. Results The aver?aged consumption dosage of rocuronium was decreased in the three groups in turn[(9.71 ± 2.38 vs 7.50 ± 0.98 vs 6.90 ± 1.14)μg·kg-1·min-1,F=18.562,P<0.05]. There was no significant difference in recovery index between the three groups [(8.92± 2.62 vs 8.95 ± 2.58 vs 10.30 ± 3.65)min,F=1.577, P>0.05]. The average consumption dosage of propofol and remifentanil were lower in groupⅢthan those of groupⅠand groupⅡ(P<0.05). Conclusion High concentration of sevoflurane can enhance neuromuscular blockage effect of rocuronium, and decrease the consumption dosage of propofol and remifentanil.

Massage prescriptions for treating infantile anorexia in Chinese Academic Journal Full-Text Database (CNKI, 1979-2012), Chinese Scientific and Technological Journal Full-Text Database (VIP, 1989-2012) and Wanfang Database (1990-2012) were collected. By using Chinese Medicine Inheritance Auxiliary Platform (Version 2.0) Software, 286 massage prescriptions for treatment of infantile anorexia were screened involved 76 acupoints, 20 commonly used acupoints, and 57 core acupoint combinations. Infantile Tuina specific points were used as main acupoints in massage therapy for infantile anorexia, and core acupoints covered Jizhu, Pi meridian, abdomen, Nei-Bagua, Zusanli (ST36), and Ban-men.
Acupuncture Points ; Acupuncture Therapy ; Anorexia ; therapy ; Data Mining ; Databases, Factual ; Humans ; Infant ; Massage ; Meridians ; Physical Therapy Modalities ; Software

Objective: In order to reveal the mechanisms of rh-endostatin and its suppression effect on HUVECs at different activating levels. Methods: Three types of HUVEC were prepared. We detected the ex-pression of CD105 and CD62E on the surface of adhering HUVEC, HUVEC of exponential phase of growth, and HUVEC activated with TNF-alpha. The effect of endostatin on these three types of HUVEC was indicated by the variation in the expression of CD105 and CD62E on the cells. The relationship of the changes in cell markers with the time and the concentration of endostatin was analyzed by SPSS 11.5. Results: The expres-sion of CD105 was correlated with time and dose of endostar in all groups. The expression of CD62E was cor-related with the dose of endostar in HUVEC treated with TNF-α for 24h. Conclusion: Endostatin of a certain dose can inhibit the activation of endothelial cells but it cannot induce cell apoptosis.

Objective To investigate the feasibility of laparoscopic repair for ingunal hernia after peritoneal dialysis. Methods Laparoscopic repair of inguinal hernia was conducted in 26 patients with chronic renal insufficiency who had received peritoneal dialysis for a long time. For indirect inguinal hernia, a piece of mesh was placed in the abdominal cavity and the internal ring was sutured and ligated under laparoscope. For direct inguinal hernia, the hernia sac was high suspended and then the mesh onlay was placed under laparoscope. Results The laparoscopy was successfully performed in all the 26 patients, without conversions to open surgery. No postoperative hematoma of scrotum or refractory neuralgia was observed. Follow-up examinations for 6~12 months (mean, 9 months) showed no recurrence. Conclusions Laparoscopic herniorrhaphy for inguinal hernia after peritoneal dialysis is feasible, effective, and safe.

Objective To stuey effects of coloprotectomy under colonoscopy combined with laparoscope on exfoliated tumor cells in abdominal cavity.Methods 42 cases of colorectal cancer proved by pathologic histology were devided into two groups randomly: Laparoscope Group(laparoscopic surgery) and Combined Group(colonoscopy combined with laparoscope surgery).Operation time,the positive rate of exfoliated tumor cells in abdominal cavity after and before operation,the positive rate of residual tumor cells in resection of operation specimen and postoperative complications between 2 groups were compared.Results Operation time of the Combined Group was shorter than that of the Laparoscope Group [(160.5?12.6) min vs.(201.2?18.4) min,t=-8.363,P=0.000].The positive rate of exfoliated cells in abdominal cavity before operation had no significant difference between the 2 groups[9.5%(2/21) vs.19.0%(4/21),?2=0.194,P=0.659],but the postoperative positive rate of exfoliated cells in the Combined Group was significantly lower than that in the Laparoscope Group[14.3%(3/21) vs.42.9%(9/21),?2=4.200,P=0.040].There were no residual tumor cells in resection of operation specimen of 2 groups.No infection of incisional wound and lung occurred.A follow-up for 6-24 months in the Laparoscope Group showed abdominal metastasis in 1 case.Conclusions Coloprotectomy for colorectal cancer under colonoscopy combined with laparoscope can decrease exfoliated tumor cells in abdominal cavity and shorten operation time.