A case of vagus nerve invasion with disseminated herpes zoster was reported. Clinical manifestation of disseminated herpes zoster and vagus nerve injury. relevant imaging examination and laboratory examination can help to establish a preliminary diagnosis. Anti-virus, anti-infection and symptomatic treatment had been performed and showed good clinical efficacy.
Aged ; Herpes Zoster ; pathology ; Humans ; Male ; Vagus Nerve ; pathology

ObjectiveTo evaluate the value of early secretory antigenic target 6 (ESAT-6) in monocytes of cerebrospinal fluid (CSF) in the early diagnosis and judgment of the tuberculous meningitis (TBM). MethodsForty cases with TBM (TBM group) and 40 patients with other meningitis patients (control group,9 cases with purulent meningitis,24 cases with viral meningitis,3 cases with cryptococcal meningitis,3 cases with cerebral cysticercosis, 1 case with neurosyphyilis) were involved in this study.Conventional examination of CSF was inspected after admission, and the ESAT-6 in monocytes of CSF was detected by immunocytochemical stain. ResultsThe positive rate of ESAT-6 was 24％ in TBM group and 0 in control group (P ＜ 0.01 ). In ROC curve, if the rate of ESAT-6 ≥8.5％ judged as positive, and ＜ 8.5％ judged as negative, 35 patients of TBM group and 4 patients of control group were ESAT-6 positive. The sensitivity of the ESAT-6 in the diagnosis of TBM was 87.5％, and the specificity of TBM was 90.0％. Thirty patients in TBM group were not given anti-tuberculosis drug treatment, and the positive rate of ESAT-6 was 93.3％ (28/30) before treatment, and was 46.7％ (14/30) after treatment of 2 weeks (P =0.000).ConclusionsESAT-6 in monocytes of CSF detected by immunocytochemical stain has higher sensitivity and specificity in the diagnosis of TBM in early stage. Observing the positive rate of ESAT-6 dynamicly has practical value in judgment the severity of TBM.

BACKGROUND: Foreign scholars use thermotherapy, a new pathway for synthetic therapy of tumor, to perform hyperpyrexia combined with chemical drug radiotherapy of intraperitoneal infiltration and metastasis or to study on the therapeutic effect of metaphase and advanced stage tumor. Especially, establishing thermal biology and thermal dosiology is a scientific and quantified track for synthetic therapy of thermal radiotherapy, thermal chemotherapy and hyperthermal perfusion of tumor.OBJECTIVE: To analyze the thermal dose effect of regional radiofrequency (RF) hyperthemia combined with radiotherapy, chemotherapy and thermal perfusion on metaphase and advanced stage tumor.DESIGN: Controlled observation.SETTING: Key Department of Traditional Chinese and Western Medicine for Tumor, the 107 Hospital of Chinese PLA (General Center for Non-traumatic Treatment and Diagnosis of Tumor).PARTICIPANTS: Totally 1 455 patients with metaphase and advanced-stage tumor admitted to the General Center for Non-traumatic Treatment and Diagnosis of Tumor, the 107 Hospital of Chinese PLA between June and September 2006 who received conservative palliative treatment in the Department of Internal Medicine were recruited in this study. They were all confirmed by pathology and imageology. ECOG was scored 2 to 4 points. Informed consents of detection and treatment were obtained from all the involved patients. The study was approved by the Hospital Ethics Committee.According to the therapeutic regimen, the patients were assigned into thermal perfusion group (n =53), thermal radiotherapy group (n =874), thermal chemotherapy group (n =458) and simple hyperthemia group (n =70).METHODS: After admission, patients in each group were performed peritoneal and pelvic cavity perfusion,intensity-modulated radiation therapy, routine chemotherapy and integrated traditional and western medicine palliative therapy, respectively. Meanwhile, they received RF hyperthemia using in vitro endogenic magnetic field hyperthermia system. A thermocouple was placed in the abdominal cavity. Temperature at 3 different sites in the abdominal cavity was collected, and meanwhile two different sites for measuring temperature at rectum and external acoustic meatus were monitored. The maximal temperature (Tmax), minimal temperature (Tmin) and the average temperature (Tave) of therapeutic target were recorded. 40 ℃/min was used as thermal dose, thermal perfusion was performed once a week, and RF hyperthemia was conducted twice a week, 60 minutes once. Target temperature was 39.5 to 43 ℃, and the thermal dose of 40 ℃/min was calculated out. Intensity-modulated radiation therapy was conducted within 1 hour before heating at (3-5)Gy/time, 3 to 4 times a week. Total dose was DT 30 to 50Gy. Thermal perfusion was conducted 2 to 3 times a week, and intensity-modulated radiation therapy was conducted once to twice a week and 6 to 8 times a course of treatment. The thermal effect of each patient was analyzed at different temperature and different diseases.MAIN OUTCOME MEASURES: ① To analyze the effect of effective thermal dose. ② To evaluate the therapeutic effect and the improvement of quality of life according to World Health Organization (WHO) objective therapeutic effect evaluation criteria and Zubrod-ECOG-WHO scores. ③To observe the changes in abdominal dropsy.RESULTS: Altogether 1 455 patients with metaphase and advanced stage participated in the final analysis. ①After perfusion, body temperature was over 39.5 ℃ in most cases after 15-minute warming, over 40.0 ℃ after another 25-minute warming, over 41.0 ℃ after additional 35-minute arming, and even to 43.0 ℃ after frequent such a thermal therapy. Temperature over 41 ℃ was found in 91 cases, at 40 ℃-40.9 ℃ in 414 cases and at 39.5 ℃-39.9 ℃ in 950 cases. ② The thermal effect of 40 ℃/min could obviously improve the therapeutic effects of graded intensity-modulated radiation therapy, low-dose chemotherapy and thermal perfusion group. The total effective rate of thermal perfusion group, thermal radiotherapy group, thermal chemotherapy group and simple hyperthemia group was 81.6%, 81.9%, 80% and 50%, respectively. The clinical therapeutic effect of 40 ℃-40.9 ℃ and 39.5 ℃-39.9 ℃ in the thermal perfusion group, thermal radiotherapy group and thermal chemotherapy group was significantly better than that in the simple hyperthemia group (P ＜ 0.05). ③ Comparison of Zubrod-ECOG-WHO score of patients before and after therapy: After therapy, Zubrod-ECOG-WHO score was enhanced in 76.3% patients. ④The changes in abdominal dropsy of patients before and after therapy: After therapy, abdominal dropsy changed in 75% patients.⑤The therapeutic effects of different diseases at different temperature: For the same disease, the therapeutic effects over 41 ℃ and at 40 ℃-40.9 ℃ were significantly different from those at 39.5 ℃-39.9 ℃(P ＜ 0.05); However, the therapeutic effects over 41 ℃ were not significantly different from those at 40 ℃-40.9 ℃ (P ＞ 0.05).CONCLUSION: ①The effects of regional RF hyperthemia combined with intensity-modulated radiation therapy are confirmed in the treatment of metaphase and advanced-stage of tumor. ② The therapeutic effects strengthen correspondingly with 40 ℃/min thermal dose increase or temperature increase.

Objective: To explore the effect of atorvastatin (Atv) on high glucose-induced oxidative stress injury in human umbilical vein endothelial cells (HUVECs) by SIRT1/NADPH oxidase pathway with the possible mechanisms.
Methods: HUVECs were cultured in low glucose medium and then divided into 6 experimental groups:①Normal group,②Osmotic pressure control group,③High glucose (HG) group,④HG+Atv (0.1, 1.0, 10.0)μmol/L group,⑤HG+sirtinol (SIRT1 inhibitor) group,⑥HG+apocynin (NOX4 inhibitor) group, and HUVECs were further cultured for 24 hours. The cell proliferation was examined by CCK-8 kit, ROS level was detected by lfow cytometry method, protein expressions of SIRT1 and NOX4 were measured by Western blot analysis.
Results: ① Compared with Normal group, HG group had decreased HUVECs proliferation, Atv improved the HG inhibited proliferation in a does dependent manner. ② HG group had the higher level of ROS, increased NOX4 protein expression and decreased SIRT1 protein expression. ③ In HG condition, Atv up-regulated SIRT1 expression and down-regulated ROS and NOX4 expressions in a does dependent manner.④In HG condition, sirtinol decreased SIRT1 expression, increased NOX4 expression, and apocynin decreased NOX4 expression, while it had no inlfuence on SIRT1 expression.
Conclusion: Atorvastatin could resist HG-induced oxidative stress injury in HUVECs, which might be related to up-regulated SIRT1 expression, and SIRTI plays the role in NADPH oxidase at upstream.

Objective:To access the feasibility and safety of application of flexible laryngeal mask air-way ( FLMA) in oral&maxillofacial day surgery. Methods:Retrospective study was conducted of 40 oral& maxillofacial day surgery patients (3 to 61 years of age) using FLMA under general anaesthesia in De-partment of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology. All the patients were with American Society of Anesthesiologists ( ASA ) physical status Ⅰ -Ⅱ, including 19 males and 21 females. The patients' vital signs were recorded at five different time points:baseline before anesthesia ( T0 ) , time right after the FLMA insertion ( T1 ) , time at incision ( T2 ) , 15 min after incision ( T3 ) and time at the end of the operation ( T4 ) . The first attempted FLMA insertion successful rate and the number of timed of changing to endotracheal intubation were recorded. During operation, frequencies of movement, hypoxia and obstruction of airway were noted and the operation time, anesthesia time, time from the end of the operation to extubation, movement and coughing following extubation and sore throat within 24 h were taken down. Operation-related complications of bleeding, hematoma and injury of local nerves were recorded within 24 h as well. Results:The operations of all the 40 patients were successfully done under general anaesthesia. The 36 ( 90%, 36/40 ) patients using FLMA successfully were under steady process, including 16 males and 20 females. The first attempted successful rate of FLMA insertion was 80% (32/40), and the second 50% (4/8). Three out of the 4 failed FLMA patients were changed to endotracheal intubation after the second attempt failed. The other patient was changed to endotracheal intubation before operation because of leak. The average operation time was (46. 58 ± 22. 57) min, the anesthesia time was ( 77 . 97 ± 26 . 82 ) min and the time from the end of operation to extubation was (8. 31 ± 3. 33) min. All the patients were recorded without obvious body movement during the operation procedure. There were 4 patients (11. 11%, 4/36) with slight body movement during extubation. The incidence of sore throat was 13. 89% (5/36) within 24 h postoperatively. There were no complications of bleeding, hematoma and injury of local nerves. The vital signs of baseline T0 were significantly different from those at other time points T1, T2, T3, and T4 (P<0. 01). As to the hearts rate after anesthesia, the values at T1, T2, T3 and T4 for two-two comparison, there was no statistical difference (P>0. 05). As to the values of systolic blood pressure and diastolic blood pressure after anesthesia at T1 and T4 , T2 and T3, for two-two comparison, there was no statistical difference (P>0. 05). As to the respiratory rate from the start of the surgery, the values at T2, T3 and T4 showed no statistical difference (P>0. 05). Conclusion:Flexible laryngeal mask airway is a supraglottic airway management method. It is suitable and safe for securing the airway in oral & maxillofacial day surgery. The advantages of fewer haemody-namic changes and postoperative complications are confirmed.

Objective To compare the whole-body equivalent doses from volumetric modulated arc therapy (VMAT) and static intensity-modulated radiotherapy (IMRT) for patients with cervical cancer.Methods Nine patients with cervical cancer admitted to our hospital in 2014 were included in this study.Both VMAT and IMRT were planned for each patient.Each patient's personal dose equivalent (Hp (10)) was measured using thermoluminescent dosimeters placed at the xiphoid process and glabella during IMRT and VMAT.The whole-body equivalent doses were estimated based on the results measured at the xiphoid process and compared between the VMAT and IMRT techniques.The paired t test was used for difference analysis.Results The Hp (10) values measured at the xiphoid process and glabella of every patient were lower for VMAT than for IMRT.At a prescribed dose of 50 Gy,if the mean Hp (10) values measured at the xiphoid process were considered to represent the whole-body equivalent doses,the whole-body equivalent doses for VMAT and IMRT were 364 mSv and 538 mSv,respectively.Conclusions VMAT results in a lower whole-body equivalent dose to patients compared with IMRT.The decreased whole-body equivalent dose delivered by VMAT may reduce the likelihood of a radiation-induced secondary malignancy.

Objective To study the clinical efficacy of amiodarone combined with metoprolol in the treatment of arrhythmia.Methods100 cases of patients with coronary heart disease arrhythmia treated in our hospital from August 2015 to September 2016 were selected as the research object in this study.They were randomly divided into the control group and the experimental group, each group had a total of 50 cases.Patients in the control group were treated with conventional arrhythmia treatment, and the experimental group was treated with amiodarone combined with metoprolol on the basis of conventional treatment.Comparative analysis of the experimental group and the control group of patients with clinical therapeutic effect index.ResultsAfter the corresponding treatment, the experimental group of 50 patients, the therapeutic effect of 18 cases were invalid, 12 cases were effective, 20 cases were markedly effective, the total effective number of cases to 32 cases, the effective rate was 64.0%.In the control group of 50 patients, 29 patients were invalid, and the effective rate was effective in all of the 8 patients.The effective rate of the treatment was effective in all of the 13 patients, with a total effective rate of 42.0%.Therefore, the effective rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05).The diastolic blood pressure, systolic blood pressure and heart rate in the experimental group were significantly better than those in the control group (P<0.05).There was no significant difference between the experimental group and the control group in the incidence of adverse reactions, which was not statistically significant.ConclusionAmiodarone Combined with metoprolol for treatment of arrhythmia is better, more widely used, can improve the treatment efficiency to a great extent, the treatment of high safety, with further clinical promotion and application.

Objective To evaluate the variations of effective doges with the preset scanning parameters from linac-integrated kV cone beam CT( CBCT). Methods Weighted CT dose index(CTDIW) were measured with PTW TM30009 CT ion chamber in head phantom and body phantom, respectively, for different combinations of tube voltage, mAs, collimator and gantry rotation range. Dose length products(DLP) were derived from CTDIW and effective doses(E) were calculated by the DLP and EDLP. Results CTDIW and effective dose had the quadratical relationship with tube voltage, depending linearly on product of tube current and exposure time. Effective dose had close relationship with the collimator and the gantry rotation range. Both the DLP and ED for CBCT were lower than the reference dose level recommended for conventional CT. Conclusions Effective dose from CBCT has a close relationship with the scanning parameters. Optimal imaging parameters should be chosen according to the patient's anatomy to reduce patient dose.

Objective To study activation effect of a natural compound baicalein on cystic fibrosis transmembrane conductance regulator(CFTR) chloride channel.Methods A cell-based fluorescence assay was used to determine CFTR-mediate iodide influx rate/dt(mmol?L-1?s-1)] activated by baicalein(the concentrations were 0.18,0.55,1.65,5,15,44,133 and 400 ?mol?L-1).Results The Ka of flavonoid baicalein stimulating CFTR was about 16 ?mol?L-1.The half of maximal activity was reached in ten minutes and the activation disappeared in 20 min after baicalein was washed out.The activation of baicalein was not affected obviously under different concentrations of Forsklin(0,20,50 and 100 nmol?L-1)and the activation could be totally inhibited by CFTRinh-172.Conclusion Baicalein can stimulate CFTR-mediated iodide influx in a dose-dependent way and its activity manifests a rapid and reversible characteristic.It might work in both elevating CFTR protein phosphorylation and direct binding way.

Animals ; Carnitine ; pharmacology ; H(+)-K(+)-Exchanging ATPase ; metabolism ; Mitochondria, Muscle ; enzymology ; Muscle, Skeletal ; drug effects ; Physical Conditioning, Animal ; Rats