To analyze the correlation between fragmented QRS complexes( fQRS) and inflammation in 136 patients with acute coronary syndromes(ACS). Patients with fQRS had increased hs-CRP levels (P<0.01) in comparison to patients with non-fragmented QRS. The higher hs-CRP levels was,the more the number of leads in the fQRS on ECG was(P<0.01). When we performed multiple logistic regression analysis, fQRS was found to be related to in-creased hs-CRP levels [ OR:1.507 , 95% CI:1.172~1.936 , P<0.01 ] . fQRS was independently related to in-creased hs-CRP. fQRS that may result as an end effect of inflammation at cellular level can represent increased car-diac risk in patients with ACS.

Arthrogryposis multiplex congenita (AMC) is a rare disorder characterized by non-progressive,multiple contractures.In addition to affected extremities,patients may also present microstomia,decreased temporomandibular joint mobility.Although the etiology of AMC is unclear,any factor that decreases fetal movement is responsible for AMC.Thus,accurate diagnosis and classification are crucial to the appropriate treatment of AMC.The development of ultrasound technology has enabled prenatal diagnosis.Very early treatment is favorable,and multidisciplinary treatment is necessary to improve the function of AMC patients.Most patients require surgery to release contracture and reconstruct joints.However,perioperative care is challenging,and difficult airway is the first concern of anesthesiologists.Postoperative pulmonary complications are common and regional anesthesia is recommended for postoperative analgesia.This review on AMC is intended for anesthesiologists.Thus,we discuss the treatment and perioperative management of patients undergoing surgery,as well as the diagnosis and classification of AMC.

Objective To observe the clinical efficacy of acupuncture plus contralateral needling in treating post-stoke myodystonia. Method Totally 120 patients with post-stroke myodystonia were randomized into group A, B, C and D, 30 in each group. Group A was intervened by yin-reducing and yang-tonifying needling method plus contralateral needling; group B was by ordinary acupuncture plus contralateral needling, group C was by yin-reducing and yang-tonifying needling alone, while group D by ordinary acupuncture. Clinical Spasticity Index (CSI) was observed before and after intervention. Result After treatment, the CSI scores (tendon reflex, muscle tension, episodic spasm scores and total score) were significantly changed in the four groups (P<0.01, P<0.05). The tendon reflex score, muscle tension score and total score in group A were significantly different from that in the other three groups after intervention (P<0.01,P<0.05). There was a significant difference in comparing the episodic spasm score between group A and D after intervention (P<0.01). There were significant differences in comparing the tendon reflex score, muscle tension score and total score between group B and D after intervention (P<0.05). The total score in group C was markedly different from that in group D after intervention (P<0.05). Conclusion Yin-reducing and yang-tonifying needling method plus contralateral needling is an effective method in treating post-stroke myodystonia.

The paper analyzes the overall evolutionary context of the situations of anti-diabetic drug patent applicants at home and abroad and conducts comparative analysis of the main patent applicants,etc.by making use of the patent analysis method and combining pharmaceutical knowledge.Relevant research results can be taken as the references for domestic pharmaceutical enterprises to make patent strategies and evaluate competitors.

Objective To investigate the sonographic characteristic of hepatic lymphoma. Methods Fifteen patients with pathological proven hepatic lymphomas (4 primary and 11 secondary hepatic lymphomas) were included in this retrospective study. All the 15 patients underwent conventional B-mode ultrasound examinations. Two patients (one with primary lymphoma and another with secondary lymphoma) underwent contrast enhanced ultrasonography (CEUS). Results In the conventional ultrasonography, hepatic masses were detected in 9 patients (4 primary and 5 secondary lymphomas). No hepatic mass was detected in the remaining 6 patients with pathological proven secondary lymphomas. For the 4 patients with detectable primary masses, 2 had a single mass and 2 had multiple masses. All primary hepatic lymphomas were hypoechoic. For the 5 patients with detectable secondary masses, 2 had a single mass and 3 had multiple masses. The hypoechoic lymphomas were found in 3 patients, while hyperechoic and isoechoic lymphomas were found in the other 2 patients. In the 4 patients with primary hepatic lymphomas, 3 had hepatomegaly, while none of the 4 patients had splenomegaly. In the 5 patients with detectable secondary masses, hepatomegaly was found in 3 patients in whom 2 had splenomegaly and 1 had a plate-shaped hypoechoic region within spleen. For the 6 patients without detectable secondary masses, splenomegaly was found in all 6 patients and hepatomegaly was found in 4 patients. In the spleen of one patient, a plate-shaped hypoechoic region was detected in the B-mode ultrasonography. In the CEUS, the primary lymphoma presented a thick ring region with slight enhancement peripheral to the mass during the hepatic artery phase;while the secondary lymphoma presented the uneven enhancement pattern with a small plate-shaped region unenhanced in its center during the hepatic artery phase. Conclusions In ultrasonography, the patients with hepatic lymphomas commonly present a single or multiple hypoechoic well-deifned hepatic masses, poor blood lfow and uneven enhancement peripheral to the mass during the hepatic artery phase of CEUS. Other sonographic characteristic include hepatomegaly and splenomegaly. No mass is detected in ultrasonography can not exclude the diagnosis of hepatic lymphoma.

Background. There has been an increasing awareness of the importance of acute pain management particularly multiple studies revealing the frequent undertreatment of acute pain and establishment of JCAHO pain management standard. Methodology. Current acute pain practices and patient satisfaction were assessed at St. Luke's Medical Center from May to September 2008 involving patients who underwent elective abdominal surgical procedures using a modified questionnaire based on the 2005 American Pain Society Quality Improvement Guidelines and Recommendations. Results: The study revealed predominant use of a multimodal approach to pain treatment which resulted in mean and median worst VAS scores of 4-5 and 5-6 respectively. Patient satisfaction was high and reasons for dissatisfaction include lack of empathy and indifference of healthcare providers, patients, and their families and a regular ongoing process of quality improvement. Conclusion. Recommendations are made on the institutionalization of efforts of the Acute Pain Service with emphasis on structural setup, multidisciplinary approach, education of health care providers, patients, and their families, and a regular ongoing process of quality improvement.
Human ; Aged ; Middle Aged ; Adult ; Young Adult ; PAIN MANAGEMENT ; PAIN CLINICS

Objective To investigate the effects of different doses of gabapentin on streptozotocin (STZ)-induced diabetic neuropathic pain in rats.Methods Male SD rats aged 6 weeks weighing 180-200 g were used in this study. Diabetes ntellitus ( DM) was induced by intraperitoneal STZ 60 mg/kg and confirmed one week later by blood glucose =16.7 mmol/L before breakfast. The DM rats were randomly divided into 4 groups ( n = 6 each) : gabapentin groups received intraperitoneal gabapentin 30, 60 and 120 mg/kg twice a day (at 9:00 am and 3:00 pm) for 3 weeks respectively and control group received intraperitoneal normal saline 0.6 ml instead of gabapentin. The paw withdrawal threshold to von Frey filament stimulation was measured before and at 30, 60, 120, 180, 240 min after first gabapentin injection and once a week for 3 weeks. Results After gabapentin 60 and 120 mg/kg, the paw withdrawal threshold to mechanical stimuli was significantly increased and lasted for about 4 h. The analgesic effect peaked at 60 min after IP gabapentin injection. Normal saline and gabapentin 30 mg/kg had no significant analgesic effect. The degree of analgesia was significantly decreased at day 14 and 21 of treatment with gabapentin 60 and 120 mg/kg as compared with that at 60 min after gabapentin injection. Conclusion The hyperalgesia and allodynia in rats with diabetes mellitus can be effectively reversed by gabapentin 60 and 120 mg/kg,while long-term use of gabapentin can induce drug tolerance.

Objective To study the effects of Panax Notoginseng Saponins (PNS) on the damaged expression of ZO-1 of brain microvascular endothelial cells caused by Aβ42.MethodsBrain microvascular endothelial cells were divided into normal control group, model group, PNS low-, medium- and high concentration groups. They were incubated for 24h in 5% CO2 incubator at 37℃ . Then cell vitality was detected by MTT colorimetric method and ZO-1 protein expression was tested by Western blot.Results Stimulation of Aβ42 reduced the activity of microvascular endothelial cells (P<0.01) and suppressed the expression of ZO-1 protein (P<0.01). Compared with the model group, the activity of microvascular endothelial cells of PNS groups, especially the high and medium dose groups (P<0.05), and increased the ZO-1 protein expression. Conclusion PNS can partly recover the barrier function of blood brain barrier through inhibiting the decrease of the activity of microvascular endothelial cells caused by Aβ42.

Objective:To explore the gene frequencies of HLA-Cw and to analyze the recognition characteristic between HLA-Cw and KIR in Guangdong Han population.Methods:An auto semi-quantitative PCR-RSSO method was adopted to detect the HLA-Cw genotypes of a sample of 122 bone marrow donors.Results:The gene frequencies of HLA-CW 03,07,01,08,04,14,15,12,06,05,16 were 0.237 1 , 0.215 9 , 0.175 2 , 0.112 9 , 0.050 5 , 0.041 9 , 0.041 9 , 0.037 6 , 0.033 3 , 0.008 2 , 0.004 1 respectively.HLA-Cw 02,04,05,06 belong to “group 1” recognizing KIR-2DL1/2DS1.HLA-Cw 01,03,07,08 belong to “group 2” recognizing KIR-2DL2/2DL3;2DS2/2DS3.There was a significant difference between the two groups in total HLA-Cw gene frequencies in Guangdong Han population( P

Purpose: During the major shift in China's policies on coronavirus disease 2019 (COVID-19), many residents will be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) over a short period, including a few patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Moreover, it is unknown whether this comorbidity affects the efficacy of NAC for breast cancer and the patient's psychological state and quality of life (QOL). This study aims to answer these questions. Methods: The clinical data of 2,793 patients with breast cancer who received NAC at The Affiliated Hospital of Qingdao University were retrospectively collected. The infected and non-infected groups were divided according to whether they were infected with COVID-19 during NAC. Propensity score matching was used to reduce patient selection bias. The effectiveness, psychological well-being, and QOL of the two groups were compared. Results: No discernible differences were observed in the pathological complete response rates (p = 0.307) and major histological responses rate (p = 0.398) between the infected and non-infected groups. Following the full course of NAC, the Functional Assessment of Cancer Treatment General (p < 0.001) and Functional Assessment of Cancer Therapy for Breast Cancer (p < 0.001) were lower in the infected group than the non-infected group, the Hospital Anxiety and Depression Scale (HADS) anxiety scale (p < 0.001) and HADS depression scale (p < 0.001) were considerably higher in the infected group than the non-infected group. Conclusion With timely treatment and effective medical management, SARS-CoV-2 does not appear to affect the efficacy of NAC; however, it can significantly affect the QOL of patients and increase their psychological distress. Therefore, in addition to a timely assessment of the efficacy of NAC, it is necessary to dynamically understand the patient's psychological state and QOL.