Objective To introduce a method of reducing the postoperative syndrome of the uvulopalatopharyngoplasty(UPPP). Method UPPP was performed for 23 patients with obstructive sleep apnea hypopnea syndrom operation(OSAHS). Before or after the operation, dexamethasone was injected in oropharynx to control the edema of the oropharynx which caused by UPPP. Results Less syndrome had been occurred in these patients. Conclusion The edema of the oropharynx which caused by UPPP can be controlled by injecting dexamethasone in oropharynx. It can reduce the risk of the UPPP, and make the operation safer and more efficient.

Objective To compare the efficacy of patient-controlled intravenous analgesia (PCIA),patient-controlled paravertebral block (PCPB) and patient-controlled epidural analgesia (PCEA) in patients after lobectomy performed via video-assisted thoracoscope (VAT).Methods Forty-eight ASA Ⅰ or Ⅱ patients,aged 50-64 yr,with a body mass index of 20-25 kg/m2,undergoing elective lobectomy via VAT,were randomly divided into 3 groups ( n =16 each):PCIA group,PCPB group and PCEA group.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline,The PCA pump was set up with a 2 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h.PCPB solution contained 0.75％ ropivacaine 60 ml in 250 ml of normal saline and the pump was set up with a 5 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 5 ml/h.The PCEA solution contained 0.75％ ropivacaine 50 ml and sufentanil 1 μg/kg in 250 ml of normal saline.The PCEA pump was set up to deliver a 5 ml bolus dose with a 15-min lockout interval and background infusion at 5 ml/h.VAS score was maintained ≤3.Peripberal venous blood samples were obtained before operation ( baseline),and at 24 and 48 h after operation for determination of the plasma cortisol concentration.The side effects were recorded.Results The plasma cortisol concentration and incidence of Somnolence were significantly lower in groups PCPB and PCEA than in group PCIA ( P ＜ 0.05 ).The plasma cortisol concentration was significantly lower in group PCEA than in group PCPB ( P ＜ 0.05).Compared with the baseline value,the plasma cortisol concentrstion was significantly higher after operation in groups PCIA and PCPB ( P ＜ 0.05),while no significant change was found in group PCEA ( P ＞ 0.05).Conclusion Compared with PCIA,PCEA can inhibit the stress response,while PCPB can reduce the stress response with good safety in patients after lobectomy performed via VAT if they can provide the equivalent postoperative analgesia.

To make a systematic analysis on literatures concerning traditional Chinese medicine (TCM) advices in Treatise on Febrile Diseases, and summarize the main connotations of traditional Chinese medicine advices, relevant TCM advices in Treatise on Febrile Diseases were collected, screened, compared, summarized and analyzed according to TCM dosage form preparation methods, TCM administration methods, medication contraindications and nursing after TCM administration. The literatures concerning medications in Treatise on Febrile Diseases were consulted, summarized and compared to standardize medicine advices and facilitate rational clinical application of TCMs. The standard medicine advices were as follows. The boiling water for TCMs shall be tap water and well water. The decoctions that have effects in promoting blood and meridians can be boiled with wine. The decoctions containing toxic components can be boiled with honey. Some TCMs shall be boiled with special methods, e. g. Herba Ephedra that could be boiled before other medicine and skimmed. Japonica rice could be added in decoctions to measure the duration of decoctions. Different dosages were required for different forms (litre, pill, medicine spoon). Administration times, temperature and frequency shall be adjusted according to target positions, functions and stage of illness. As for dietary contraindications during medication, thick porridges are recommended, where foods impacting medicine efficacy are prohibited. Regarding nursing after medication is important to recover physical functions, particularly warm porridges can go with diaphoretic recipes, while thick porridges can go with purgative recipes. And drug efficacies shall be defined by observing urine and excrements, and blood form. In conclusion, Treatise on Febrile Diseases is the first book that discusses TCM advices and records them in details. In this study, new standard medicine advices were proposed to provide important basis for improving clinical advices of TCMs and supports for developing the TCM dispensing technology.
Chin ; Cooking ; Drug Administration Routes ; Drug Administration Schedule ; Drug Interactions ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; history ; Fever ; drug therapy ; history ; History, Ancient ; Humans ; Medicine in Literature

Objective:To investigate the clinical efficacy of levodopa combined comprehensive therapy on the children with ametropic amblyopia.Methods:One hundred three patients (180 eyes) with ametropic amblyopia admitted into our hospital from April 2013 to March 2016 were randomly divided into the control group and the study group.Fifty-two patients (90 eyes) in the control group were treated with comprehensive therapy,and fifty-one patients (90 eyes) in study group were treated with levodopa combined comprehensive therapy.After six months of treatment,the treatment efficacy,pattern visual evoked potential (P-VEP),visual sensitivity,and visual function of patients were observed and compared between the two groups,and the adverse reaction were recorded and compared.Results:At six months after treatment,the effective rate of study group was 90.00％,which was significantly higher than that of control group (68.89％,P＜0.05).The wave amplitude ofP-VEP Pl00 of both groups showed a remarkable increase,which was much higher in the study group (P＜0.05);the incubation period in both groups were obviously decreased,while they were markedly lower in the study group (P＜0.05).The visual acuity under 100％,25％,10％ and 5％ of spatial frequency were conspicuously higher than those of control group (P＜0.05).And correction convergence range,and correction separation range in study group were much higher than those of control group,and corrected near stereo vision was markedly lower than that of control group (P＜0.05).Additionally,no significant difference was found in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Levodopa combined comprehensive therapy had a good ability of improving function of visual central neurons,visual acuity and binocular stereo vision functions.

Objective To evaluate efficacy of healthy canteen based-nutritional health promotion so as to provide evidence for popularization and application.Methods A total of 429 college professors and administrative staffs with a healthy canteen were selected as the intervention group in 2012 in Changzhou,and another 947 counterparts without a healthy canteen were selected as the control group.Those of the intervention group was further assigned to the ≥2 times/week and＜2 times/week subgroups.Blood pressure,fatty liver,serum triglycerides,blood glucose,total cholesterol,uric acid,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol and body mass index(BMI)were tested before and after the intervention.Results After the intervention,the mean serum glucose[(5.06±0.62)mmol/L],uric acid[(310.57 ± 71.79)μmol/L],total cholesterol[(4.88 ± 0.86)mmol/L],triglycerides[(1.39 ± 0.67)mmol/L]and low-density lipoprotein cholesterol[(2.51 ±0.62)mmol/L]of the intervention group were significantly decreased(t values were 7.513,2.126,2.062,3.731 and 8.891,respectively; all P＜0.05),and mean high-density lipoprotein cholesterol[(1.43±0.34)mmol/L]were significantly increased(t=-2.309,P＜0.05).After the intervention,mean serum glucose and uric acid of the control group were significantly increased(t values were-3.491 and-7.703,respectively; both P＜0.05),although there was no statistically significant difference of mean serum triglycerides,total cholesterol,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the control group before and after the intervention(all P＞0.05).The abnormality rates of serum glucose,uric acid,total cholesterol,triglycerides,low-density lipoprotein cholesterol and BMI as well as the incidence of hypertension of the intervention group were significantly decreased after the intervention(x2 values were 4.202,3.940,4.031,7.305,59.422,4.273 and 7.385,respectively; P＜0.05).In the control group,although the abnormality rate of serum uric acid and the incidence of fatty liver were significantly inclined after the intervention(x2 values were 23.740 and 7.408,respectively; both P＜0.05),there were no significant difference of abnormal serum triglycerides,glucose,total cholesterol,low-density lipoprotein cholesterol and BMI as well as the incidence of hypertension before and after the intervention(all P＞0.05).Mean serum triglycerides[(1.15 ±0.68)mmol/L]and low-density lipoprotein cholesterol[(2.4 1±0.60)mmol/L]in the ≥2 times/ week subgroup were significantly lower than those of the＜2 times/week subgroup(t values were-4.884 and-2.513,respectively; both P＜0.05),and mean high-density lipoprotein cholesterol[(1.46±0.33)mmo]/L]of the ≥2 times/week subgroup was significantly higher than that of the＜2 times/week subgroup(t=2.032,P＜0.05).The abnormality rates of serum total cholesterol,triglyceride and low-density lipoprotein cholesterol in the ≥ 2 times/week subgroup were significantly lower than those in the＜2 times/week subgroup(x2 values were 3.963,9.947 and 4.589,respectively; all P＜0.05).Conclusion Healthy canteen based-nutritional health promotion model may provide an effective method to prevent and control the development of noncommunicable chronic diseases.

Objective To observe the changes of plasma neuropeptide Y(NPY) and neurotensin(NT) levels in patients with essential hypertension and the relationship between those changes and damage of cardiac function. Methods Eighty patients of essential hypertension and 28 normal controls were chosen. The cardiac function was divided into 3 classes on the standard of New York Heart Association(NYHA). The plasma NPY,NT concentration was determined by radioimmunoassay. Results The level of NPY in hypertension patients was higher than that of the normal controls(P

Objective To explore the relationship between exon mutations of NOTCH3 gene and clinical phenotype in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Methods We consecutively included 30 CADASIL patients with clinical symptoms in 15 pedigrees, who visited Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from May 2015 to Dec. 2017, and collected the clinical data and genetic analysis results. Furthermore, we analyzed the relationship between the exon mutations of NOTCH3 gene and clinical phenotypes, including age at onset, first clinical symptoms and frequency of symptomatic ischemic stroke. Results Twelve mutation sites of NOTCH3 gene were detected in the 15 pedigrees. Seven of them were located in exon 4, 3 in exon 11, 1 in exon 19, and 1 in exon 20. The onset age of the patients carrying exon 11 mutations was the latest ([53.6±13.3] years, n＝7), followed by the patients carrying exon 4 mutations ([42.7±5.7] years, n＝15). The onset age of 8 patients with mutations in other exons (exon 19 and 20) was (33.5±7.5) years, which was significantly earlier compared with the patients with exon 4 and 11 mutation (P0.01 and P0.05). Most of the patients with mutations of exon 4 had motor and speech disorders (11/15, 73.3%), while ones with mutations of exon 19 and 20 had cognitive impairment (7/8, 87.5%). Most of the patients (11/15, 73.3%) carrying mutations in exon 4 had motor and speech disorders at onset, while 7 of 8 patients (87.5%) with mutations in exon 19 and exon 20 had impaired cognition at onset. The times of symptomatic ischemic stroke in patients with mutations in exon 4 was 3 (median) and in patients with mutations in exon 11 was 2 (median), and no symptomatic ischemic stroke occurred in the patients with mutations in exon 19 and 20. Conclusion Exon 4 and exon 11 of NOTCH3 gene are hotspots of mutations in the cohort of CADASIL cases, and the mutations in different exons are associated with onset age, first symptoms and symptomatic ischemic stroke.

AIM:To investigate radiosensitization effect of apatinib, a vascular endothelial growth factor (VEGF) receptor2 tyrosine kinase inhibitor, on human gastric carcinoma cell line SGC-7901 and its mechanism.METHODS:SGC-7901 cells were divided into control group, apatinib group, radiotherapy group and combination group.The cell viability was measured by CCK-8 assay.The changes of cell apoptosis and cell cycle were analyzed by flow cytometry.The protein levels of cell apoptosis biomarkers, such as PARP, cleaved caspase-9, cleaved caspase-3 and Bcl-2, and cell proliferation biomarkers, p-PLCγ1 and p-ERK1/2, were detected by Western blot.γ-H2AX expression was detected by immunofluorescence.RESULTS:Compared with apatinib group and radiation group, the cell viability was inhibited after treatment with both apatinib and X-ray (P<0.01).The protein levels of cell proliferation markers p-PLCγ1 and p-ERK1/2 were down-regulated.The cell apoptosis was enhanced (P<0.01).The protein levels of cell apoptosis makers such as PARP, cleaved caspase-9 and cleaved caspase-3 were up-regulated, while Bcl-2 was down-regulated.The disappearance of γ-H2AX foci in the nucleus was delayed, indicating that apatinib impaired the repair of radiation-induced DNA double-strand breaks.The proportion of G2 phase was significantly increased (P<0.01).The combination treatment had more significant effect on SGC-7901 cells than treating with apatinib or radiotherapy alone.CONCLUSION:Apatinib increases the radiosensitivity of gastric cancer cells via blocking VEGF pathway.

Objective:To study the tonifying Qi and producing blood mechanism of Jianpi Shengxue tablets. Methods: SD rats were randomly divided into the normal group,FeSO4group, and low, medium and high dosage groups(0.65,1.3,2.6 g·kg-1). All the groups except the normal group received low iron diet,to induce anemia. After the two-week intragastric administration, real-time PCR was carried out to identify the changes of Hepcidin mRNA expression, while western blot was applied to test the changes of DMT-1 protein expression. Results:The medium and high dosage groups could significantly increase the DMT-1 expression compared with the normal group,while FeSO4 could reduced the DMT-1 expression. The Hepcidin expression in liver was increased along with the in-crease of the dosage. Conclusion:The Chinese medicine ingredients in Jianpi Shengxue tablets is beneficial to the expression of DMT-1 protein and the expression of Hepcidin mRNA in liver, which can finally improve the iron supply in the body.

Objective To develop tailored scientific research evaluation indexes for medical personnel with different characteristics in the third grade hospital.Methods 40 experts in clinical medicine were interviewed and 2/3 frequency of their opinions were collected,working plan was developed based on such findings.Results Developed a clear orientation to update the scientific research evaluation system for promotion with consideration of different characteristics of various groups,including young people with high medical trainings,general medical staff,skilled clinicians and full-time researchers.Conclusions The system promoted the development of both individual career and hospital.