Objective To investigate the hemodynamic changes of contralateral vertebral arteries with transcranial Doppler (TCD)in patients with subclavian artery steal syndrome. Methods Forty-five outpatients or inpatients with subclavian artery stenosis or occlusion confirmed by TCD and color Doppler flow imaging (CDFI)and treated at Baoan District Center Hospital of Shenzhen from March 2012 to April 2015 were analyzed retrospectively. According to the TCD detection,the degrees of intracranial arterial steal were divided into 4 groups:non-blood steal (n=8 ),blood steal phase Ⅰ(n=21 ),phase Ⅱ(n=11 ), and phase Ⅲ(n =5 );45 healthy subjects from Baoan District Central Hospital were used as a control group. The contralateral vertebral artery hemodynamic indexes of each blood steal group were detected respectively,and they were compared with the control group. Results Of the patients without blood steal,6 patients had mild subclavian artery stenosis,2 had moderate stenosis;of the patients with phase I blood steal,12 had mild subclavian artery stenosis,9 had moderate stenosis;of the patients with phaseⅡblood steal,3 had moderate subclavian artery stenosis,7 had severe stenosis,and 1 had occlusion;of the patients with phase Ⅲ blood steal,3 had severe subclavian artery stenosis,2 had occlusion. The degree of blood steal was positively correlated with the lesion degree of subclavian artery stenosis (r=0. 78, P<0. 05). TCD findings revealed that the contralateral vertebral artery systolic blood flow velocities in patients with phase Ⅰ,Ⅱ,andⅢsteal groups were 70 ± 23,85 ± 30,and 104 ± 32 cm/s,respectively;their mean flow velocities were 39 ± 10,46 ± 16,and 54 ± 17 cm/s,respectively;their pulsatility indexes were 1. 17 ± 0. 20,1. 27 ± 0. 31,and 1. 43 ± 0. 36,respectively,and they were all significantly higher than 49 ± 9,34 ± 7,and 0. 66 ± 0. 08 cm/s of the control group (all P<0. 01),and 50 ± 11,34 ± 10,and0.68±0.12cm/s of the non-blood steal group (all P<0.01),and there were significant differences among the steal blood groups in each phase (all P <0. 01 ). Conclusion Detecting the hemodynamic indexes of contralateral vertebral arteries using TCD can preliminaryly assess the subclavian artery lesions and their steal degree.

Objective To explore the effectiveness and safety of vaginal paravaginal repair(VPVR) plus vaginal bridge repair in the treatment of female pelvic organ prolapse (POP). Methods Sixty-five patients with different defects of pelvic floor underwent VPVR or plus vaginal bridge repair for posterior vaginal wall. Patients were followed up after operation. The cure rate was estimated subjectively and objectively. The patients' quality of life was evaluated by the pelvic floor distress inventory short form 20 (PFDI-20). Results All 65 cases were treated by vaginal hysterectomy and anterior vaginal repair, in which there were 33 cases underwent VPVR while 32 cases underwent VPVR plus middle area repair. Forty concomitant procedures for vaginal bridge repair were also performed. The average operative time was (110.00±20.12) min and blood loss was (119.52±45.33) ml. The symptom of stress urinary incontinence of 25 cases significantly released after operation. Four incision recovery delayed and there were no other complicatious occurred. Patients were followed up for 6-29 months,the objective cure rate was 100.00% (65/65) and subjective cure rate was 92.31%(60/65), and 58 cases (89.23%)improved significantly with the quality of life comparing with that of pre-operation by completing PFDI-20 (P<0.01). Conclusions It is an effective and safe procedure for VPVR plus vaginal bridge repair to correct median to severe anterior vaginal prolapse and posterior vaginal wall prolapse. More clinical trials are needed to evaluate their long-term outcome.

Objective: To analyze the relationship between inflammatory factors and relevant risk factors in patients of essential hypertension (EH) combining acute coronary syndrome (ACS) with its clinical significance. Methods: Our research included 3 groups: EH group, n=79 patients with standard criteria, EH+ACS group, n=85 and Control group, n=48 normal subjects. Blood levels of lipoprotein-associated phospholipase A2 (Lp-PLA2), tryptase (TPS) and relevant clinical, biochemical parameters were measured; risk factors for cardiovascular disease were examined and the relationship between above parameters, risk factors and ACS occurrence in EH patients was studied by Logistic regression analysis. Results: The OR values were all greater than 1 in fibrinogen (Fbg), high-sensitivity C-reactive protein (hs-CRP), TPS, atherosclerotic plaque, Lp-PLA2 and EH grading. Fbg was the most significant independent risk factor (OR=22.242, 95% CI 6.458-76.609, P<0.0001), the standardized partial regression coefficient b'as absolute value (b') was 1.079 which was the highestone in above 6 variables with the strongest impact for ACS occurrence in EH patients. Conclusion: Fbg, hs-CRP, TPS, atherosclerotic plaque and EH grading were the independent risk factors for ACS occurrence in EH patients; Fbg was the highest risk factor for ACS occurrence with the strongest impact, which provided a new direction for ACS prevention and treatment.

OBJECTIVETo study the protective effect of lidocaine against lung injury after hemorrhagic shock in rabbits.

METHODSEighteen healthy rabbits were randomly divided into 3 groups (n=6), namely lidocaine group (group L), hemorrhagic shock group (group H) and control group (group C). Hemorrhagic shock model was established in rabbits in groups L and H, and the venous blood samples were collected for measurement of plasma malondialdehyde (MDA) and superoxidedismutase (SOD) before phlebotomy (T0), 2 h after hemorrhagic shock (T1) and 2 h after resuscitation (T2). Blood samples were also taken for measurement of MDA and SOD at the same time points in group C. The wet to dry weight ratio of the lung (W/D) was measured at T2.

RESULTSMDA level was significantly lower while SOD level significantly higher in group L than in group H (P<0.05). The W/D ratio in group L was reduced significantly as compared with that in group H (P<0.05).

CONCLUSIONLidocaine can remarkably alleviate lung injury after hemorrhagic shock by inhibiting MDA production and increasing SOD content.

Animals ; Disease Models, Animal ; Lidocaine ; pharmacology ; Lung ; drug effects ; metabolism ; Lung Injury ; prevention & control ; Malondialdehyde ; blood ; Rabbits ; Shock, Hemorrhagic ; drug therapy ; Superoxide Dismutase ; blood

AIM:To explore the changes and significance of Kupffer cells in the process of tree shrew chroni -cally infected with hepatitis B virus (HBV).METHODS:The animals were divided into 3 groups.Group A consists of 6 tree shrews that were identified as persistently infected with HBV;group B consists of 3 tree shrews that were suspected as persistently infected with HBV;group C consists of 4 tree shrews that were not inoculated with HBV and were applied as normal controls.Liver biopsies were collected regularly from all animals , and the Kupffer cells were isolated , purified and primarily cultured.The techniques of flow cytometry , immunohistochemistry, lysosomal fluorescent probe staining and real-time RT-PCR were applied to determine the number and function of these Kupffer cells .RESULTS: The result showed that the count and proportion of CD 163+cells in group A were significantly higher than those in group B and group C ( P<0.05).Meanwhile, the fluorescence intensity levels of lysosomal , the number of lysozyme-positive cells and the mRNA ex-pression level of TNF-αin the Kupffer cells in group A were significantly lower than those in group B and group C ( P<0.05).CONCLUSION:Kupffer cells may play a regulatory role during host’s chronic HBV infection.

OBJECTIVETo evaluate the clinical efficacy of sufentanil and fentanyl at equivalent dose for patient-controlled intravenous analgesia (PCIA) after thoracotomy.

METHODSSixty ASA I-II patients (20-60 years of age) undergoing radical operation for lung or esophageal cancer were randomly divided into sufentanil intravenous analgesia group (group S, with sufentanil 1 microg/ml) and fentanyl intravenous analgesia group (group F, fentanyl 10 microg/ml). PCIA was administered with background infusion of 2.5 ml/h, bolus injection of 2.5 ml and lockout time of 15 min. The pain intensity according to visual analogue scale (VAS), cumulative analgesic consumption (CAC), sedative scores and side effects at 24 and 48 h after administration were recorded. SpO(2), respiratory rate (RR), blood pressure (BP) and ECG were continuously monitored.

RESULTSThere were no significant differences in CAC between the two groups, but he VAS was lower in group S than in group F (P<0.05) and the sedative efficacy was superior in group S (P<0.05). The incidence of nausea and vomiting in group S was lower than that in group F (P<0.05). No significant differences were observed in SpO(2), RR, heart rate and mean arterial pressure between the two groups.

CONCLUSIONPCIA with sufentanil provides better efficacy of analgesia and sedation with lower incidence of nausea and vomiting than with fentanyl in postoperative patients with thoracotomy.

Adult ; Analgesia, Patient-Controlled ; Esophageal Neoplasms ; surgery ; Female ; Fentanyl ; administration & dosage ; adverse effects ; Humans ; Infusions, Intravenous ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Nausea ; chemically induced ; Pain, Postoperative ; drug therapy ; Sufentanil ; administration & dosage ; adverse effects ; Thoracotomy ; Vomiting ; chemically induced

The construction of teaching faculty is not only a core element to carry out medical education in municipal general hospitals, but also a weak link. Constructing a performance evaluation system of teaching faculty has important significance in promoting teaching reform and innovation, and improving teachers' enthusiasm for teaching as well as their teaching quality in municipal general hospitals. Taking the Affiliated Dongguan People's Hospital of Southern Medical University as an example, this paper focused on the construction of teaching faculty and aimed to provide references for municipal general hospitals to build a performance evaluation system through the promotion of a series of measures such as teaching ability assessment, quantitative assessment of teaching work, teaching quality evaluation, and teaching contribution assessment.

Objective To explore the middle cerebral artery (MCA) blood flow changes in healthy adults before and after carotid artery compression test by transcranial Doppler ultrasound (TCD).Methods Ninety-nine normal healthy adults,including 62 male and 37 female,were chosen in our study;they were divided into young group (＜40 years,n=35) and elderly group (＞40 years,n=64).The differences of peak level of MCA systolic blood flow velocity (Vp),mean blood flow velocity (Vm) and end diastolic blood flow velocity (Vd),and their compensation rates before and after oppression of the ipsilateral carotid artery were compared between patients of different ages and gender by TCD.Results The Vp,Vm and Vd,and the Vm and Vd compensation rates in the young group before and after oppression were significantly higher than those in the elderly group (PP＜0.05).The Vp,Vm and Vd,and their compensation rates before and after oppression showed no significant differences between male and female subjects (P＞0.05).Conclusion TCD can evaluate the effect of MCA blood flow on the collateral artery after compression carotid artery test;the compensatory effect of Vm and Vd in the young group is significantly higher than that in the elderly group.

OBJECTIVE: To ascertain the feasibility of using shear wave velocity (SWV) in assessing the stiffness of carotid plaque by supersonic shear imaging (SSI) and explore preliminary clinical value for such evaluation. MATERIALS AND METHODS: Supersonic shear imaging was performed in 142 patients with ischemic stroke, including 76 males and 66 females with mean age of 66 years (range, 45–80 years). The maximum, minimum, and mean values of SWV were measured for 129 carotid plaques. SWVs were compared between echolucent and echogenic plaques. Correlations between SWVs and serum homocysteine levels were investigated. Based on neurological symptom, the surrogate marker of vulnerable plaque (VP), binary logistic regression was performed and area under curve (AUC) of homocysteine only and homocysteine combing SWVmean was calculated respectively. RESULTS: Echogenic plaques (n = 51) had higher SWVs than echolucent ones (n = 78) (SWVmin 3.91 [3.24–4.17] m/s vs. 1.51 [1.04–1.94] m/s; SWVmean, 4.29 [3.98–4.57] m/s vs. 2.09 [1.69–2.41] m/s; SWVmax, 4.67 [4.33–4.86] m/s vs. 2.62 [2.32–3.31] m/s all p values < 0.01). Pearson correlation analysis showed that stiffness of plaques was negatively correlated with homocysteine level. R values for SWVmin, SWVmean, and SWVmax were −0.205, −0.213, and −0.199, respectively. Binary logistic regression analysis showed that sex (p = 0.008), low-density lipoprotein (p = 0.015), triglycerides (p = 0.011), SWVmean (p = 0.004), and hyper-homocysteinemia (p = 0.010) were significantly associated with symptomatic ischemic stroke. Receiver operating characteristic curves revealed that SWVmean combing serum homocysteine level (AUC = 0.67) presented better diagnostic value than serum homocysteine only (AUC = 0.60) for symptomatic ischemic stroke. CONCLUSION: Supersonic shear imaging could be used to quantitatively evaluate stiffness of both echolucent and echogenic carotid plaques. More importantly, SWVs of plaques were not only correlated to serum homocysteine level, but also associated with symptomatic ischemic stroke, suggesting that SSI might be useful for understanding more about VP.
Area Under Curve ; Biomarkers ; Female ; Homocysteine ; Humans ; Lipoproteins ; Logistic Models ; Male ; ROC Curve ; Stroke ; Triglycerides

Traditional Chinese medicine has a long-standing understanding of the brain;however,the theoretical foundation and treatment approach for diseases related to the brain have not been systematically organized and studied. The three treasures of essence,qi,and spirit are closely associated with the brain in humans. Based on this theory,this study explored the relationship between essence,qi,spirit,and the brain,with the intention that "the brain is the official position of gathering essence,qi,spirit,and in charge of mental activity". It investigated the theoretical implications of the brain,stating that "essence" forms the material basis of the brain's structure,"qi" is fundamental for brain function,and the "conscious spirit" corresponds to the state of the brain,residing in the heart,serving as the external manifestation of the brain,governing aspects like thoughts,consciousness,and emotions. The "primordial spirit" is the axis of the brain,which is rooted in the brain and serves as the internal core of the brain,thereby governing and regulating the central activities of human life. Essence,qi,mental activity,and primordial spirit mutually support and depend on each other,collectively maintaining the function of the brain governing the mental activity. The primordial spirit,which the brain governs,regulating and controlling the essence,qi,and couscious spirit is a specific manifestation of physiological and psychological activities in the human body. This study provides treatment strategies for clinical brainrelated disorders under the theoretical guidance that "the brain is the official position for gathering essence,qi,and spirit,and is in charge of mental activity". These strategies include " nourishing essence and marrow,supplementing qi to ascend clear,and nurturing nourishment and enriching the spirit". This study aims to contribute to the innovation and development of traditional Chinese medicine theories.