OBJECTIVE: To compare the effects of bupivacaine, lidocaine and saline injections in alleviating post tonsillectomy pain. METHOD: We recruited 60 patients into the study. All subjects were randomly allocated into 3 groups. Group 1 received 0.9% sodium chloride (saline group), group 2 received 0.25% bupivacaine (bupivacaine group) and group 3 received 2% lidocaine (lidocaine group), infiltrated around each tonsil. Pain was evaluated with McGrath's face scale. RESULT: The postoperative pain scores at 2 and 6 hours were similar among the groups (P>0.05). The pain scores in the bupivacaine group were lower than those in the saline group at 12 h (P<0.05). The pain scores in the bupivacaine and lidocaine groups were significantly lower than those in the saline group from 18 to 24 hours until day 7 (P<0.05). There was no difference between the bupivacaine and lidocaine groups (P> 0.05). CONCLUSION Local infiltration of bupivacaine is a relatively and safe effective method and is equivalent to use of lidocaine for post tonsillectomy pain.
Analgesia ; methods ; Bupivacaine ; Child ; Child, Preschool ; Female ; Humans ; Lidocaine ; Male ; Pain Measurement ; Pain, Postoperative ; prevention & control ; Snoring ; surgery ; Tonsillectomy

OBJECTIVE: To explore the related factors of tonsil postoperative pain. METHOD: After founding databank a statistic analysis was performed on 90 cases with tonsillectomy who admitted in our hospital. Chi-square test were used to investigate the related factors for postoperative pain in those patients. RESULT: After Chi-square test, the important effect factors in the postoperative pain were gender, age, surgical methods, preemptive analgesia, physical analgesia and preoperative anxiety level. CONCLUSION The pain after tonsillectomy is influenced by not only surgery itself, but also by preemptive analgesia, preoperative anxiety level and so on.
Humans ; Pain Measurement ; Pain, Postoperative ; Palatine Tonsil ; surgery ; Tonsillectomy

OBJECTIVE: To observe the effects of sleeping body posture on sleeping structure and respiratory events in patients with OSAHS. METHOD: We assessed the sleeping body position, the sleeping structure, position specific AHI and the Epworth Sleepiness Scale (ESS) in a total of 80 patients with Positional OSAHS. The patients were grouped according to AHI: mild OSAHS (5 < or = AHI <15), moderate (15 < or = AHI < 30) and severe (AHI > or = 30). The polysomnography data and clinical characteristics were compared between each group. RESULT: The severe OSAHS group, when compared with the mild and the moderate ones, had a significant different in REM%, NREM%, NREM LSaO2, RDI, S-AHI and L-AHI due to posture (P < 0.05). The severe and the mild OSAHS groups had significant different in MSaO2, LSaO2 due to posture (P < 0.05). The moderate and the mild OSAHS group had significant different in LSaO2, REM LSaO2 and RDI (P < 0.05). In all mild, moderate and severe groups, the LT% were higher than ST%, but the difference was not significant (P > 0.05). For mild-to-moderate groups, there was no correlation between the ESS and the AHI for any position different (P > 0.05). For severe group, the ESS was significantly correlated with L-AHI (r = 0.551; P < 0.01); the REM L-AHI and NREM L-AHI was also significantly correlated with ESS of severe group (r were 0.516 and 0.528, P < 0.01). CONCLUSION The L-AHI, NREM L-AHI, REM L-AHI and NREM LSaO2 were considered to monitor the stability of OS-AHS, while REM LSaO2 were consider to clarify the severity of OSAHS.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Posture ; Sleep Apnea, Obstructive ; Sleep Stages ; Young Adult

Objective:To review the development and progress of geriatric research in China from the perspective of funding from the National Natural Science Foundation of China, and to provide supporting data for further development of the field.Methods:Based on project funding data of the National Natural Science Foundation of China for geriatric medicine from 2008 to 2017, the number and composition of projects, funding amount and funded institutions were statistically analyzed, and the overall trend of change was examined.The research hotspots in recent years were summarized by using word frequency analysis.Results:From 2008 to 2017, a total of 446 projects were approved in the field of geriatric medicine.Both the number of projects and the amount of funding showed an increasing trend.Project types were gradually expanded and the composition was constantly optimized.Since 2014, the fund types each year included 6 or more and breakthroughs in major projects were achieved.East China remained the leading region in the number of projects and amount of funding, with Beijing, Shanghai and Zhejiang receiving the highest numbers of project approvals and accounting for more than 10% of the national total in the number of project approvals and the amount of funding.During this period, 114 institutions received funding, with 74 winning 2 or more projects.In word frequency analysis, senescence(229 times), cell(161 times)and protein(120 times)were the three most frequently used keywords.Conclusions:In the field of geriatric medicine, the project approval level from the National Natural Science Foundation of China has significantly improved in quantity and quality, but it has always been under-represented in the branch of medical sciences.The regional and institutional distribution of projects is unbalanced and tends to skew in favor of institutions with prominent academic disciplines.Basic research is the main type of funded projects.Geriatric research is centered on the mechanisms of aging.

Objective To analyze the application of modified abdomen pathway for excising the adrenal huge pheoehromocytoma.Methods One patient(male,42-year-old)had adrenal huge pheochromocytoma.The pheochromocytoma was about 15.0 cm×8.0 cm×7.0 cm.After 3 weeks' preparations,the patient was operated.The operation was made through the modified abdomen pathway for excision,without excising the transverse on peritoneal,and the interference to organs of peritoneal was reduced.The tumor on adrenal gland adhered kidney very tightly.Expanded radical excision including tumor,kidney,adrenal gland was applied.Results The operative time was 300 rain and the volume of bleeding was about 1000 ml.In the operation process,blood pressure of the patient was stable,the visual field of operation was satisfactory.Blood pressure of the patient returned normal 6 months postoperatively.And there was no indication of tumour relapse or matastasis.Conclusion The modified abdomen pathway can expose the satisfactory visual field,and is safe and effective for adrenal gland tumor operation.

Chemical investigatation of Drosera peltata var. multisepala led to the isolation of eleven compounds using various chromatographic techniques. The structures of these compounds were elucidated as isoshinanolone-4-O-beta-D-glucoside (1), isoshinanolone (2), epi-isoshinanolone (3), plumbagin (4), droserone (5), droserone-5-O-glucoside (6), quercetin (7), kaempferol (8) , gossypetin-8-O-glucoside (9), 3,3'-dimethoxy ellagic acid (10), and ellagic acid (11) by their physicochemical properties and spectral data analysis. Compound 1 was a new compound. Compounds 3, 8, 10, and 11 were isolated from this plant for the first time.
Chromatography, Liquid ; methods ; Drosera ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Ellagic Acid ; analogs & derivatives ; analysis ; isolation & purification ; Glucosides ; analysis ; isolation & purification ; Kaempferols ; analysis ; isolation & purification ; Magnetic Resonance Spectroscopy ; methods ; Molecular Structure ; Naphthoquinones ; analysis ; isolation & purification ; Plant Extracts ; analysis ; isolation & purification ; Quercetin ; analysis ; isolation & purification ; Spectrometry, Mass, Electrospray Ionization ; methods ; Tetrahydronaphthalenes ; analysis ; isolation & purification

To investigate the chemical constituents of the aerial part of Piper wallichii. Nine compounds were isolated by various chromatographic techniques and the structures were elucidated by their physicochemical properties and the spectral data analysis. Nine compounds were identified as one lignan (-)-galbelgin (1) and eight neolignans: denudatin B (2), hancinone D (3), (+)-licarin A (4), kadsurenone (5), wallichinine (6), hancinone C (7), hancinone B (8), (+)-burchellin (9). Compounds 1, 3, 4, 8, 9 were isolated from this plant for the first time.
Lignans ; analysis ; isolation & purification ; Piper ; chemistry ; Plant Extracts ; analysis ; isolation & purification

BACKGROUNDAlthough cytological methods for breast oncology have been used in recent decades, intra-operative frozen section has been playing a vital role in making therapeutic decisions. We analyzed a large series of frozen section diagnoses for Chinese cases of breast lesion within the last 15 years. The experience was expected to increase the diagnostic accuracy of cases with breast lesions.

METHODSThe data from consecutive 13243 cases of breast lesions diagnosed with intra-operative frozen sections between 1988 to 2002 were compared with paraffin sections in a case by case manner. The causes of false negative and positive diagnoses as well as delayed diagnoses were analyzed.

RESULTSOne hundred and seventeen cases (0.9%) were falsely diagnosed, with one false positive case and 116 false negative cases. The diagnosis of 47 cases (0.4%) was delayed. The proportion of several lesions had the features of the patients' ages. Six types (false invasion, peri-papilloma, adenoma of nipple duct, florid adenosis, sclerosing adenosis, and granulose cell tumor) of lesions may lead to false positive, and four types (morphological changes responding chemotherapy, well differentiated papillary carcinoma, invasive lobular carcinoma, and tubular carcinoma) to a false negative. Gross and microscopic findings may be inconsistent in two types of lesions (radial scar and florid adenosis) microscopic and clinical findings in three types (ganulomatous mastitis mammary, duct ectasia, and fat necrosis), and three types (abundant fat or sclerous tissues; borderline lesions and changes of post-chemotherapy) were likely wrongly classified.

CONCLUSIONSIntra-operative frozen section can accurately identify breast lesions in many instances, leading to fewer errors on account of more diagnostic experience and understanding of diagnostic limitations.

Adolescent ; Adult ; Age Factors ; Aged ; Biopsy ; methods ; Breast ; pathology ; Breast Diseases ; diagnosis ; pathology ; Breast Neoplasms ; diagnosis ; pathology ; Child ; China ; Female ; Frozen Sections ; methods ; Humans ; Intraoperative Care ; methods ; Male ; Middle Aged ; Paraffin Embedding ; methods ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity

Objective:To build a comprehensive medical, teaching, and research discipline indicators system that is objective and easily accessible in data, and to develop a comprehensive evaluation method, at the same time provide references for discipline evaluation and orientation.Methods:Literature review was used in referring to the evaluation indicators of different ranking systems in China, Delphi method and Analytic Hierarchy Process(AHP) were applied to identify the indicators and their weight.Results:A comprehensive discipline evaluation indicator system, including 3 first-level indicators, 12 second-level indicators, and 41 third-level indicators, were constructed. The Cartesian coordinates allows for specifying the location of the medical, teaching, research level of certain discipline, and the distribution of relevant discipline groups in three-dimensional space.Conclusions:The indicators system for discipline evaluation in this study has the characteristics of refinedness, comprehensiveness, operability, and applicability, providing references for the future evaluation of disciplines.

Objective To explore the role of an artificial intelligence(AI)model based on real-time object detection network in fetal facial ultrasound examination.Methods With the normal fetal facial ultrasound standard plane(FFUSP)at 20-24 weeks of gestation as the research object,a FFUSP recognition model based on real-time object detection network was constructed.The recognition accuracy of the model for FFUSP and the anatomical structures were analyzed,and the clinical value was evaluated by analyzing its performance in identifying FFUSP in 119 cases of fetal ultrasound images.Results The overall precision,recall rate,mAP@.5 and mAP@.5:.95 of the AI model were 97.8%,98.5%,98.1%and 61.0%,respectively.The clinical validation showed that the AI model had a sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 100.0%,98.5%,87.4%,100.0%and 98.7%for facial anatomy recognition,and the results were highly consistent with the classification of fetal ultrasound experts(k=0.925,P<0.001).The recognition accuracy of the model for 3 types of standard planes reached 100%;and the average speed of dynamic video detection was 33.93 frames per second.Conclusion The FFUSP recognition model based on real-time object detection network exhibits excellent performance,and it can be applied to real-time ultrasound diagnosis,teaching and intelligent quality evaluation.