ObjectiveTo observe the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy, and to furtherexplore its clinical and theoretical significance.MethodSixty patients who were going to receive laparoscopic cholecystectomy were enrolled and randomized into an observation group (combined acupuncture-medication anesthesia) and a control group (conventional general anesthesia) by the random number table, 30 subjects in each group. The total bilirubin (TBIL), alanine aminotransferase (ALT), aspertate aminotransferase (AST), urea nitrogen, creatinine, and Mini-Mental State Examination (MMSE) were observed to evaluate the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy.ResultBefore operation, there were no significant differences in TBIL, ALT, urea nitrogen, creatinine, and MMSE between the observation group and the control group (P>0.05), while the AST level of the observation group was significantly higher than that of the control group before operation(P<0.05). On post-operation day 1, there were no significant differencesin comparing ALT and AST levels between the two groups (P>0.05); the TBIL level in the observation group was significantly lower than that in the control group (P<0.01); there were no significant differences in comparing the urea nitrogen and creatinine levels between the two groups (P>0.05). The MMSE score of the observation group was significantly higher than that of the control group 6 h after the operation (P<0.01). on post-operation day 1, there was no significant difference in comparing MMSE score between the two groups (P>0.05).ConclusionThe combined acupuncture-medication anesthesia and conventional general anesthesia play equal effects on liver and kidney functions in laparoscopic cholecystectomy, thus the two anesthesia methods are both safe andeffective. The combined acupuncture-medication anesthesia has certain protective effects on brain function in early stage, and possibly produces certain protective effectson liver function.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hepatitis B ; epidemiology ; immunology ; prevention & control ; Humans ; Infant ; Infant, Newborn ; Male

BACKGROUND: There are few reports addressing the differentiation of bone marrow mesenchymal stem cells (BMSCs) into neurons, and the uncertainties mainly focused on the differentiated neurons had neuron morphology, but did not have neuron function. OBJECTIVE: To investigate the feasibility of rat bone marrow mesenchyma stem cells (BMSCs) differentiation into neuron-like cells and glial-like cells under rat hippocampal neuron's conditional medium. METHODS: Rat BMSCs at passage 5 were divided into 4 groups. The medium of hippocampal neurons and glial cells was added in the conditioned medium group. The Dulbecco's modified Eagle's medium containing bFGF was added in the basic fibroblast growth factor (bFGF) group. The serum-free medium containing Neurobasal and B27 was added in the serum-free medium group. The DMEM supplemented with fetal bovine serum was added in the negative control group. 12 and 24 hours following induction, neuron specific enolase (NSE), microtubule-associated protein-2 (MAP-2) and glial fibrillary acidic protein (GFAP) were detected using immunocytochemical staining in each group. NSE, MAP-2 and GFAP expression was determined using Western-blot assay. RESULTS AND CONCLUSION: 12 and 24 hours following induction, BMSCs were positive for MAP-2, GFAP and NSE in the conditioned medium, bFGF and serum-free medium groups, but negative in the negative control group. Compared with the negative control group, MAP-2 expression was significantly enhanced in the conditioned medium, bFGF and serum-free medium groups 24 hours following induction (P < 0.05), and the increased range was significantly greater in the conditioned medium group compared with other two groups (P < 0.05). No significant difference in NSE and GFAP expression was detected in the conditioned medium, bFGF and serum-free medium groups. Results suggested that hippocampal neuron conditioned medium can in vitro induce the differentiation of rat BMSCs into neuron-like cells and glial cell-like cells. Compared with the bFGF medium and serum-free medium, positive rate was greatest in the hippocampal neuron conditioned medium-induced neurons and glial cells.

Objective Through investigating the clinical and laboratory characteristics of Kawasaki disease (KD) in infants younger than 12 months in order to improve the accuracy of early diagnosis of KD and decrease the risk of coronary artery lesion (CAL).Methods Clinical manifestations,diagnosis and treatment of total 106 patients younger than 12 months with KD hospitalized in Chengdu Women and Children's Central Hospital from Jan.2006 to Jan.2014 were reviewed.Results (1) Among 106 cases,72 cases were male and 34 cases were female,the ratio of male to female was 2.1:1.0.The age varied from 2 months to 12 months,and the average age was (8.4 ± 2.7) months.Twenty-eight cases were younger than 6 months,78 cases were within 6 months to 12 months.(2)KD scattered the whole year and occurred more frequently in spring and summer.The average duration of fever before final diagnosis was (8.0 ±3.5) days.The major clinical manifestation were erythema and cracking of lips (77.4％,82/106 cases),rash (73.6％,78/106 cases),eye conjunctival hyperemia (70.8％,75/106 cases),changes in extremities (59.4％,63/ 106 cases),strawberry tongue (48.1％,51/106 cases),cervical lymphadenopathy (40.6％,43/106 cases),respectively.Among 106 cases,33 cases (31.1％) were diagnosed as incomplete KD (IKD),86 cases (78.9％) accompanied with one or more than one systematic or organic lesion,33 cases (31.1％) were misdiagnosed before the final diagnosis of KD,32 cases (30.2％) accompanied with CAL.Ninety-five point nine percent(94/98 cases) were sensitive to the first dose of intravenous immunogloblin (IVIG) therapy.(3)Compared with the infants of KD older than 6 months,the infants younger than 6 months had longer fever duration before the final diagnosis,higher prevalence of IKD,higher incidence of gastrointestinal involvement and anemia,higher white blood count,lower haemoglobin and albumin values,higher incidence of CAL and coronary artery aneurysms (CAA) (all P ＜ 0.05).IVIG treatment response for both groups was sensitive (P ＞ 0.05).Conclusions (1) Infants KD,especially younger than 6 months old had higher rate of IKD,often accompanied with other organic lesion,and were easily to be misdiagnosed and missed diagnosis.Most infants KD were sensitive to the first dose of IVIG therapy.(2) Infants of KD younger than 6 months old were more prone to suffer from CAL and CAA.(3) To avoid misdiagnosis and missed diagnosis of infants KD,cardiac ultrasonography is important for those who have unexplained fever over 5 days and were not sensitive to the treatment,especially the male.

Background:Irritable bowel syndrome( IBS)patients are often accompanied by anxiety,depression and other psychological abnormalities,but the effects of psychological abnormalities on daily life have not yet been fully clarified. Aims:To investigate the effects of psychological abnormalities on life quality,sleep quality and symptom severity in IBS patients. Methods:A total of 101 IBS patients admitted from Nov. 2014 to May 2015 at Anhui Provincial Hospital Affiliated to Anhui Medical University were enrolled in this study. Zung self-rating anxiety scale(SAS)and Zung self-rating depression scale(SDS)were used to evaluate the mental state;IBS-quality of life(IBS-QOL)was used to evaluate the life quality;Pittsburgh sleep quality index(PSQI)was used to evaluate the sleep quality;IBS symptom severity score (IBS-SSS)was used to evaluate the symptom severity. Correlations between psychological factors,life quality,sleep quality and symptom severity were analyzed. Results:57. 4%(58 / 101)of IBS patients were accompanied by varying degrees of anxiety and/ or depression. The IBS-QOL score of 101 patients was 73. 28 ± 12. 79,in which anxiety,loss of appetite and health concerns were the most severely affected. 73. 3%(74 / 101)of IBS patients were accompanied by varying degrees of sleep disorders,in which daytime dysfunction,sleep quality and sleep efficiency were the most severely affected. Of the 101 IBS patients,the symptom of 13 cases was mild,63 cases was moderate and 25 cases was severe. IBS-SSS score was 253. 00 ± 72. 58. Correlation analysis showed that anxiety,depression were negatively correlated with life quality(r = - 0. 426,P < 0. 001;r = - 0. 501,P < 0. 001)and positively correlated with sleep quality(r = 0. 556, P = 0. 000;r = 0. 513,P = 0. 000)and symptom severity(r = 0. 231,P = 0. 020;r = 0. 357,P < 0. 001). Life quality was negatively correlated with symptom severity(r = - 0. 417,P < 0. 001). Conclusions:IBS patients have psychological abnormalities and their life and sleep qualities are decreased,the more serious the psychological abnormalities,the more damage on life and sleep qualities and the more severe the IBS symptoms.

Objectives To explore the clinical features and pathological types of childhood Henoch-Sch?nlein purpura ne-phritis (HSPN)with proteinuria. Methods Clinical and pathological data of 180 children with HSPN presenting with proteinuria were retrospectively analyzed in groups according to 24-hour urinary protein levels. Results The moderate proteinuria (57 cases, 31.7%) was the most common clinical type, followed by high-grade proteinuria (51 cases, 28.3%), mild proteinuria (46 cases, 25.6%) and microalbuminuria (26 cases, 14.4%). According to the International Study of Kidney Disease of Children , the major pathological type of HSPN are grade II (92 cases, 51.1%) and grade III (73 cases, 40.6%). The main pathological changes of moderate proteinuria were grade II (31 cases, 54.4%), and the main pathological changes of high-grade proteinuria were grade III (33 case, 64.7%). The pathological grade was progressively increased along with severity of proteinuria. The difference was statistically significant (χ2=39.54, P=0.002). The main immunopathological type was IgA+IgM (84 cases, 46.7%), followed by IgA+IgM+IgG (55 cases, 30.6%). No correlation was found among immunopathological typing, pathological typing and clinical typing (P>0.05). Conclusions The HSPN children with massive proteinuria show more severe pathological changes, but the se-verity of clinical symptoms is not completely consistent with the pathological damages.

OBJECTIVETo compare therapeutic effects between surgical and conservative treatment for postoperative lumbar discitis.

METHODSFrom January 2004 to January 2009, 41 patients (17 males and 24 females ranging the age from 37 to 68 years with an average of 53.6 years) with postoperative lumbar discitis were retrospectively studied and divided into two groups. There were 19 patients in operation group, 22 patients in conservative group. Clinical data and features,image data, laboratory examinations, antibiotics utilization, hospital stays and sequelae were recorded and analyzed. Visual analogue scales system (VAS) and Oswestry disability index (ODI) were applied to evaluate therapeutic effects.

RESULTSAll patients were followed up over 2 years. Imaging revealed good bone fusion and no occurrence of discitis. VAS score and ODI at 1 month, 1 year and 2 years were significantly improved after treatment (P < 0.01). While VAS and ODI in operation group at 1 month were improved more than that of conservative group (P < 0.01), and there was no significant difference between two groups at 1 year and 2 years (P > 0.01).

CONCLUSIONSurgical and conservative treatment for postoperative lumbar discitis is effective. Surgical treatment is superior to conservative treatment in a short time, while conservative treatment can achieve long-term satisfactory curative effects.

Adult ; Aged ; Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Discitis ; drug therapy ; surgery ; Female ; Humans ; Lumbar Vertebrae ; drug effects ; surgery ; Male ; Middle Aged ; Postoperative Complications ; drug therapy ; surgery ; Retrospective Studies ; Treatment Outcome

Background Recent studies indicated that human amnion mesenchymal stem cells (hAMSCs) can be induced to differentiate into multiple types of cells in vitro,but whether the hAMSCs can differentiate into ocular surface cells has not been reported yet.Objective This study was to investigate the feasibility of inducing differentiation of hAMSCs into ocular surface cells by co-culturing with human bulbar conjunctiva fibroblasts (hBCFs).Methods This study was approved by Ethic Committee of Affiliated Second Hospital of Guangzhou Medical University.HAMSCs were isolated from placenta under the informed consent of healthy delivery women.hAMSCs were cultured,passaged and identified by detecting the expressions of CD44,CD45,CD73,CD90 in the cells with flow cytometer,osteogenesis and adipogenic differentiation experiments.Human conjunctival tissue was obtained during the eye operation under the informed consent of patients and hBCFs were isolated and cultured with explant culture.The cells were divided into the hAMSCs culture group and the hAMSCs and hBCFs co-culture group and cultivated in Transwell chambers for 7 days.The expressions of cytokeratin 19 (CK19) and α-smooth muscle actin (α-SMA) in the cells were assayed by immnofluorescence technique.Results Cultured hAMSCs showed the slender shape and cell body enlarged with passage.CD44,CD73 and CD90 were expressed in the cells,and the expression of CD45 was absent.After 3-4 weeks of osteogenesis and adipogenic induce,the cells showed red staining for alizarin and oil red O.In the co-culture group of hAMSCs and hBCFs,hAMSCs presented the epithelioid cell-like in shape and showed the positive response for CK19 and weaker response for α-SMA.However,in the hAMSCs culture group,the cells showed the positive response for α-SMA and absent response for CK19.Conclusions The hAMSCs can differentiate into ocular surface cells after being induced by hBCFs.And the differentiation mechanism is possibly relevant to mesenchymal cells epithelium.

Objective To investigate clinical features and antifungal therapeutic effect of chronic severe hepatitis (CSH) patients with invasive fungal infection (IFI), and to improve the diagnosis and treatment.Methods Clinical manifestation, blood routine, imageology and mycetology characteristic, antifungal treatment perscription and therapeutic effect of 79 CSH patients with IFI were retrospectively analyzed. Antifungal therapeutic effect was compared between fluconazole and voriconazole. Results Thirteen (16.5%) patients received glucocorticoid or other immunodepressants for a relatively long time, 40 (50.6%) patients had invasive operation, and 61 (77.2 %) patients were administered 1-6 kinds of broad-spectrum antibiotics. Seventy-three patients had fever. Leucocytes and neutrophilic granulocyte increased in 96.2% of the patients. Lung (31.6%), intestinal tract (26.2%) and oral cavity (14%) infections were common. Fungus was found in 70.9% of the patients. Candida albicans (40.9%) and aspergillus (21.1%) were often seen. Halo signs and crescent signs on lung CT were relatively specific in 40% of the patients with fungal pneumonia. Voriconazole was more effective than fluconazole(71.4% vs. 39.0%, P<0.05). Twelve patients with lung aspergillus infection were administered voriconazole, 8 (66.7%) patients of whom was effective, and the other 4 (33.3%) patients died. Conclusion There are high risk factors in major CSH patients with IFI. The most common clinical manifestations of CSH patients with IFI are fever, leukocytosis, lung and intestinal tract infection. Candida albicans and aspergillus infection are common. Voriconazole is more effective than fluconazole, and can increase the survival rate of CSH patients with IFI.

measured by OCT 1 and 3mo after surgery. Chi-square test was used to compare preoperative and postoperative BCVA. Pearsion’s correlation was used to evaluate relationship between postoperative BCVA and central foveal thickness.RESULTS:The ratio of BCVA<0. 05 was 30%,14%, 11%and 7% respectively for per-operation, 1wk, 1 and 3mo post - operation. After surgery, the central foveal thickness was significantly increased in group with BCVA<0. 3 comparing to group with BCVA≥0. 3. Three month post-operation, central foveal thickness was significantly decreased in both groups comparing to that in 1mo post-operation (P<0. 01). There has significant correlation between 3mo postoperative BCVA and central foveal thickness (r=-0.716, P<0.05).CONCLUSlON: ln this study, BCVA is improved after 3mo follow up. There has significant correlation between postoperative BCVA and central foveal thickness.