OBJECTIVETo observe the acupuncture effect on urinary retention after spinal anesthesia.

METHODSOne hundred and fifty-four patients with spinal anesthesia were randomized into an observation group (80 cases) and a control group (74 cases). In the observation group, the electroacupuncture was applied to bilateral Fushe (SP 13) and Shuidao (ST 28); 2 Hz/50 Hz, retaining for 30 min. One treatment was required. In the control group, no any intervention was applied after operation. The incidence of the postoperative urinary retention, the time of the first automatic micturition since 30 min after spinal anesthesia, the volume of the first micturition, the postoperative urine condition, the lower abdominal distention, incomplete urination and the others were observed.

RESULTSThe incidence of urinary retention in the observation group was lower than that in the control group; the first automatic micturition in 30 min after spinal anesthesia was earlier than that in the control group; the comfortable urination rate was higher than that in the control group; the incidence of incomplete urination and lower abdominal distention were lower than those in the control group. The differences were significant in comparison of the two groups (all P<0.05).

CONCLUSIONAcupuncture apparently shortens the time of first automatic micturition after spinal anesthesia and promotes the recovery of bladder urinary reflection. This therapy acts on promoting urination and reducing postoperative urinary retention.

Acupuncture Points ; Adult ; Aged ; Anesthesia, Spinal ; adverse effects ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; physiopathology ; therapy ; Urinary Retention ; etiology ; physiopathology ; therapy ; Urination ; Young Adult

Objective To investigate the relationship between electrocardiogram and serum alanine ami-notransferase and electrolytes in patients with primary liver cancer .Methods Clinical data of 241 patients with primary liver cancer treated in our hospital were retrospectively studied .Single factor analysis was used to analyze the risk factors of abnormal electrocardiogram in patients with primary liver cancer .The multivariate logistic re-gression analysis was performed to analyze the factors that were statistically significant .Results Single factor a-nalysis showed that age,gamma glutamyl transferase(GGT),electrolyte is associated with ECG abnormalities in the patients with primary hepatocellular carcinoma (P<0.05).Multivariate logistic regression analysis showed that,the GGT and electrolyte anomaly led to primary hepatocellular carcinoma in the patients with abnormal ECG independent risk factors .Conclusion The level of electrolyte ,age≥60 and GGT anomaly and primary electro-cardiogram in patients with hepatocellular carcinoma ( HCC ) is a close relationship for active hepatoprotective , maintain electrolyte balance therapeutic intervention for patients with hepatocellular carcinoma ( HCC) .

Objective:To establish an evaluation index system for training effect of order-oriented clinical medical students in Xinjiang by employers, so as to lay a foundation for training effect evaluation.Methods:On the basis of questionnaires and interviews with the training requirements of employers, Delphi method was used to determine the index system and weight.Results:The training requirements of employing units for the ability of free and directional medical students in autonomous regions were in turn competent for work, knowledge and practical ability, and good moral quality. The cultivation requirements for students' personal qualities of free and directional medical students were good interpersonal communication and moral quality. After three rounds of Delphi expert consultation, the evaluation index system was established, and three dimensions (knowledge, professional ability, professional ethics literacy), nine secondary indicators and 33 tertiary indicators were screened out, and the weights were determined.Conclusion:The evaluation index of training effect of directional clinical medical students established by Delphi expert consultation method needs further validation. Through the follow-up empirical application in directional clinical students, the evaluation index system can be constantly improved, which can also provide reference for the establishment of evaluation index system for other positions.

Objective: To optimize and evaluate the modified RNA-tailing and primer-extension RT-PCR method in relative quantification of microRNAs (miRNAs) in several kinds of tissues. Methods: Small-sized RNAs (

Plasma cell gingivitis is a rare form of gingival hyperplasia,mostly located in mucous membrane and characterized by swollen gums.Pathological examination showed dense plate shaped gathering of plasma cells in the connective tissue.Diagnosis relies on pathological examination.The cause of the disease is unknown,may be associated with allergic reactions.Expectant treatment is often use for the disease. Relapse of the lesion is commot,but canceration is rare.One case of plasma cell gingivitis followed for 2 years is presented,and the clinical manifestation and treatment are discussed in this paper.

Objective To observe the change of early postoperative cognition in the elderly under low central venous pressure (LCVP) after lobe resection to investigate the safety and feasibility of LCVP in Geriatrics.Methods A total of 45 ASA class Ⅰ ～ Ⅱ old patients (60 ～ 75 y)with elective liver resection were divided into L group and C group.In the LCVP group (L group),CVP was maintained below 5 cmH2O during liver resection until the lobe was done.The patients in the control group (C group) received standard care (The CVP was controlled between 6 cmH2O to 12 cmH2O).To compare the anesthesia recovery after surgery,all patients were tested with a battery of neuropsychologic assessment of cognitive function preoperatively and on the 7th day postoperatively.Results During liver resection,the MAP [(75.8 ±7.9)mmHg] and CVP [(3.1 ±0.4)cmH2O] of experimental group were lower than the control group [MAP (92.3 ± 10.6)mmHg,CVP(9.3 ± 1.4)cmH2O].The difference was statistically significant (t' =20.08,P ＜0.05,t =5.89,P ＜0.01) ;There was no statistically significant difference in postoperative recovery of spontaneous breathing,respiratory,eye opening time,extubation time and leave the operating room time between two groups[(18.1 ±6.7)min,(25.4±8.3)min,(31.9±11.7)min,(42.8±17.8)minvs (15.3 ± 7.0)min,(22.6 ±9.4)min,(30.2 ± 10.8) min,(45.4 ± 13.6) min,P ＞ 0.05].The incidence of POCD was 30.0％ in the experimental group and 27.3％ in the control group.The difference was no statistical significance between two groups(P ＞0.05).Conclusious There was no significant influence of low central venous pressure on anesthesia recovery time and early postoperative cognition in the elderly under hepatic resections.

Objective To investigate effect of applying nursing flowchart in the post-anesthesia care unit(PACU).Method The nursing flowchart in PACU are as follous,including a ventilator connection,monitoring instrument connection,handover of pipeline and skin and training for PACU nurses.Results After application of the nursing flowchart,the nursing time for postoperative patients was reduced from 7.0 min to 4.0 min.No nursing risks and adverse events occurred.Conclusion Application of nursing flowchart in PACU can improve the quality of nursing and enhance patients safety.

Objective To explore the mechanism of blood-stage treatment in patients with psoriasis vulgaris through studying the level change of IFN-?, IL-4, IL-10 and IL-17 in patients with blood-stage treatment during activity and quiescence period separately. Methods 20 patients with psoriasis vulgaris in active stage(blood heat syndrome)and 20 patients with psoriasis vulgaris in resting stage(blood stasis syndrome) were recruitedto observe the treatment effects by the PASI score,and to observe thechange of IFN-?, IL-4, IL-10, IL-17 before and after treatment in the serum by ELISA. Results The PASI scores of two groups were both significantly decreased after treatment (blood heat syndrome group t=6.685, P<0.01;blood stasis syndrome group t=4.959, P<0.01). The levels of cytokines were significantly different between patients in the periods of activity and quiescence. Onvarying degrees, the levels of cytokines of two groups were improved after treatment. The levels of cytokines IFN-?, IL-17 in blood heat group significantly decreased(t=3.024, P<0.01;t=2.543, P<0.05). The levels of cytokines IL-17 drop but the levels of cytokines IL-4 raised in blood stasis group,that were significantly differentwith the levels before treatment(t=2.417, P<0.05; t=2.547, P<0.05). Conclusion The levels of INF-?, IL-4, IL-10 and IL-17 could be effectively modulated with blood-stage treatment in treating psoriasis vulgaris.

Objective To conduct a systematic review on the safety and efficacy of enhanced recov -ery after surgery ( ERAS) in perioperative management of hepatectomy .Methods A literature search was conducted on databases which included the PubMed , Embase, Cochrane Library, Sinomed, Wangfang, VIP and CNKI for randomized controlled trials ( RCTs) on application of ERAS in patients after hepatectomy . The data collection ended in August 2015.A meta-analysis was performed using RevMan 5.3 software.Re-sults Eleven RCTs which included 1074 patients were selected into this study .There were 530 patients in the ERAS group and 544 patients in the control group .On Meta-analysis, when compared with the control group, the ERAS group had significantly shorter length of hospital day (WMD=-2.36, 95%CI: -3.19~-1.54 , P<0.05 ) , shorter time for functional recovery ( WMD=-2.30 , 95%CI: -3.77 ~-0.83 , P<0.05), lower total complication rate (RR=0.65, 95%CI:0.52~0.80, P<0.05), and significantly decreased rates of postoperative pulmonary infection (RR=0.36, 95%CI:0.14~0.91, P<0.05) and nausea and vomiting (RR=0.48, 95%CI:0.26~0.89, P<0.05).There were no significant differences between the two groups on the rates of postoperative bleeding , biliary fistula, abdominal infection, delayed incisional healing, wound infection and urinary tract infection (P>0.05).The ERAS group had significant-ly lower hospitalization cost (SMD=-1.61, 95%CI:-2.42~-0.80, P<0.05), but the differences between the two groups on mortality and re-admission rates were not significant (P>0.05).When compared with the control group , the drainage tube removal time ( WMD=-2.83 , 95% CI:-3.92~-1.76 , P<0.05), time to first mobilization (SMD=-2.34, 95%CI:-2.98~-1.70, P<0.05), time to first feeding ( SMD=-5.08 , 95%CI: -9.33~-0.83 , P<0.05) , time to passage of first flatus ( SMD=-3.60, 95%CI:-4.85~-2.34, P<0.05) in the ERAS group were significantly shorter , but there was no significant difference on the time to the first bowel motion ( P>0.05 ) .Conclusions ERAS in the peri-operative management of hepatectomy was safe and beneficial .

Objective To compare everolimus (EVR) with calcineurin inhibitor (CNI) minimization or withdrawal on renal function of liver transplant patients with standard CNI therapy.Methods A search was conducted on databases which included the PubMed,Embase and Cochrane library for randomized controlled trials (RCTs) comparing EVR with CNI with minimization or withdrawal (the EVR group) with standard CNI therapy (the standard CNIs group) on renal function of liver transplant patients.A metaanalysis was performed using RevMan 5.3 software.Results Five RCTs which included 1 264 patients were selected into this study.There were 790 patients in the EVR group and 474 patients in the standard CNIs group.On meta-analysis,the EVR group had significantly better renal function (SMD =0.36,95％ CI 0.09 ～ 0.64,P ＜ 0.05),but higher rates of infection (RR =1.37,95％ CI 1.08 ～ 1.74,P ＜ 0.05),dyslipidemia (RR =2.46,95％ CI 1.79 ～ 3.38) and leukopenia (RR =2.37,95％ CI 1.32 ～ 4.26).No significant differences were found on the mortality and the acute rejection rates between the two groups (all P ＜ 0.05).Conclusions EVR with CNI minimization or withdrawal after liver transplantation provided effective immunosuppression and improved patients' renal function.The treatment increased the rates of infection,dyslipidemia and leukopenia.