Objective To compare the efficacy and side-effects of combined spinal-epidural anesthesia(CSEA)and epidural anesthesia(EA)for ureteroscopic pneumatic lithotripsy.Methods A total of 60 patients with ureteral calculi(ASA gradeⅠ-Ⅱ)were divided into A and B groups randomly(30 in each).CSEA was performed in group A,and EA was carried out in group B.Anesthetic effects and side-effects were observed in both the groups.Results Anesthetic effects were satisfying in both the groups,no patient had headache after the operation.The onset time of anesthesia in group A was shorter than that in group B [(7.2?4.1)min vs(17.4?3.3)min,t=-10.615,P=0.000].The level of motor block of CSEA was stronger than that of EA(?2=40.000,P=0.000).No significant differences were found between the two groups in the number of patients who developed hypotension(6 in group A and 3 in group B,?2=0.523,P=0.470)or shivering(9 in group A and 6 in group B,?2=0.800,P=0.371).Conclusions Both CSEA and EA are applicable to ureteroscopic pneumatic lithotripsy.CSEA is more efficient than EA.

Objective To observe the effect of electroacupuncture of Siguan on contents of hippocampal monoamine neurotransmitter NE, DA and 5-HT in post-stroke depression rats, and throught it to probe the possible mechanism of anti-depressive.Methods 60 rats were divided into five groups randomly, as the normal group, MCAO group, PSD group, Siguan group, and fluoxetine group. Except the normal group, the rats of other groups were used to establish left side of the MCAO models by modified Longa filament method. PSD model was prepared by living alone in combination with mild stimulation by chronic unpredictable after stroke model success 7 days. The Siguan group was received electroacupuncture at Siguan point, and the fluoxetine group was gastrically perfused with fluoxetine, and all rats were received sugar consumption experiment in different period of treatment. After continuous treatment for 21 days, contents of NE, DA and 5-HT in hippocampal tissue were measured with RP-HPLC-fluorescent method. Results At the seventh day, compared with PSD group, the ratio of sugar water consumption(51.09%± 3.68%vs. 38.97%± 4.07%)has a significant increase in the Siguan group(P<0.01), while no significant changes in the fluoxetine group. At the fourteenth day, the ratio of sugar water consumption(68.25%± 4.69%vs. 39.64%± 4.49%)continued to rise in the Siguan group, the fluoxetine group also had significantly increased compared with the PSD group, the two groups were significantly higher than those in the PSD group (P<0.01), but the Siguan group was higher than that of the fluoxetine group(P<0.01).At the twenty-first day, the ratio of sugar water consumption (41.56%± 2.12%vs. 41.56%± 2.12%)increased further in the Siguan group and the fluoxetine group, which was significantly higher than those in the PSD group (P<0.01), but the Siguan group and fluoxetine group had no obvious difference(P>0.05). Compared with the PSD group,the contents of NE(244.93 ± 44.57 ng/g vs. 129.27 ± 11.68 ng/g), DA(86.80 ± 14.64 ng/g vs.44.22 ± 7.60 ng/g), 5-HT(526.31 ± 54.41 ng/g vs.221.56 ± 39.57 ng/g) in the hippocampus tissues were significantly higher than many in the Siguan group and fluoxetine group(P<0.01), but the difference between the two groups was not obvious(P>0.05). Conclusion The symptoms of PSD rats pleasure disappeared can be improved by electroacupuncture atSiguan. Its mechanism may be related with the increased contents of monoamine neurotransmitters in the hippocampus of rats.

Objective To evaluate the effect of intrathecal cardamonin on diabetic neuropathic pain (DNP) in rats.Methods Healthy adult male Sprague-Dawley rats,aged 2 months,weighing 180-220 g,were included in the study.Diabetes mellitus was produced by intraperitoneal injection of streptozotocin 60 mg/kg after intrathecal catheterization.When decrease in pain threshold＞50％ of the baseline at 21 days after diabetes mellitus was produced,the induction of DNP was considered successful.Twenty-four rats with DNP were divided into 4 groups (n=6 each) using a random number table:group DNP,rapamycin group (group R),cardamonin 50 μg group (group D50) and cardamonin 100 μg group (group D100).Another 6 healthy age-matched rats were used as normal control (group C).In DNP,R,D50 and D100 groups,dimethyl sulfoxide 10 μl,rapamycin 5 μg and cardamonin 50 μg and 100 μg were intrathecally injected,respectively,once a day for 7 consecutive days starting from 21 days after successful estabiishment of the model.Mechanical paw withdrawal threshold (MWT) was measured before establishment of the model,on 7,14 and 21 days after establishment of the model,and on 1,4 and 7 days after intrathecal injection.The rats were sacrificed after the last MWT measurement,and their L3-5 segments of the spinal cord were removed for determination of the expression of S6K,p-S6K and synapsin Ⅱ by Western blot.Results Compared with group C,MWT was significantly decreased,and the expression of spinal S6K,p-S6K and synapsin Ⅱ was up-regulated in group DNP (P＜0.05 or 0.01).Compared with group DNP,MWT was significantly increased,and the expression of spinal S6K,p-S6K and synapsin Ⅱ was down-regulated in R,D50 and D100 groups (P＜0.05 or 0.01).Compared with group D50,MWT was significantly increased,and the expression of spinal S6K,p-S6K and synapsin Ⅱ was down-regulated in group D100 (P＜0.05).Conclusion Intrathecal cardamonin can relieve DNP in rats,and the mechanism is related to inhibiting spinal mammalian target of rapamycin activity and down-regulating the expression of synapsin Ⅱ.

Objective: To screen, diagnose and follow up the abnormal mutation in the gene screening of neonatal deafness. Methods: A total of 24161 newborns born in Zhuhai Maternal and Child Health Hospital from February 1, 2015 to January 31, 2008 were screened for hearing and deafness genes, and audiological screening, diagnosis and 1-3 years follow-up were carried out for the newborns with positive gene screening. Results: There were 991 cases of deafness gene mutation (533 males and 458 females), and the rate of abnormal mutation was 4.10%(991/24 161). Among them, 921 cases were single heterozygous mutation, 130 cases were failed in primary hearing screening, 11 cases were failed in secondary hearing screening, 8 cases were abnormal in audiological diagnosis finally. In these 8 cases, 3 were diagnosed as otitis media and passed audiological follow-up after cure, 2 cases of single ear sensorineural injury caused by high-risk factors, passed after close audiological follow-up, and the other 3 cases were closely audiological follow-up while none of them were successfully sequenced. All of them were moderate to severe sensorineural deafness, 1 case was heterozygous mutation at 3 loci of GJB2(c.235delC,c.408C>A,c.134G>A), 1 case was heterozygous mutation at 2 loci of GJB2(c.235delC, c.109G>A), and 1 case was single heterozygous mutation of GJB2(c.235delC). The remaining 913 cases who passed the primary screening, secondary screening or hearing diagnosis were followed up for 1 to 3 years. Three cases of multiple heterozygous mutation were found in gene screening(2 cases were SLC26A4 2168A>G, IVS7-2A>G, 1 case was GJB2 c.176_191del 16bp, c.299_300del AT), all of them passed both primary and secondary hearing screening. In these 3 cases, the final audiological diagnosis was moderate sensorineural deafness in both ears, with no improvement in the follow-up of 1-3 years. There were 9 monogenic homozygous mutations, 7 failed in primary hearing screening, 3 failed in secondary hearing screening and also failed in audiological diagnosis and 1-3 years′ audiological follow-up, all of whom were GJB2 c.235 del C homozygous mutations, and one of whom had a definite family history of deafness. The remaining 6 cases of homozygous mutation diagnosed by primary screening, secondary screening or hearing diagnosis were GJB2 c109G>A homozygous mutation, and passed the 1-3 years′ hearing follow-up. 58 children with mtDNA mutations, including 2 with 12S rRNA 1494C>T homozygous mutation, 47 with 1555A>G homozygous mutation, and 9 with 1555A>G heterozygous mutation, all passed the primary or secondary hearing screening, and were instructed to ban ototoxic drugs for the whole life, and passed the 1-3 years′ hearing follow-up. Conclusions The audiological follow-up of children with monogenic heterozygous mutations in deafness gene screening is generally normal. In case of abnormality, the influencing factors such as otitis media should be excluded at first. In case of unexplained moderate to severe sensorineural deafness, the whole-gene sequencing should be performed to find possible pathogenic factors. The children with homozygous mutation or compound heterozygous mutation in gene screening, most of whom show different degrees of hearing loss, should be followed up for a long time, and provide parents with scientific and reasonable genetic counseling according to the mutation genes and loci,. The hearing of drug-induced deafness gene carriers is normal after birth. Parents should be advised to strengthen prevention and follow-up is generally enough.