Objective To investigate the effects of continuous stellate ganglion block (SGB) on serum thyroid hormone and cortisol levels in patients with severe brain injury.Methods Eighty ASA Ⅱ or Ⅲ patients with severe brain injury aged 22-61 yr undergoing emergency craniotomy were randomly divided into 2 groups ( n = 40 each): control group (group C) received routine treatment only and continuous SGB group (group SGB) received continuous SGB with 0.2% ropivacaine besides routine treatment. SGB was performed on the operated side after induction of general anesthesia and tracheal intubation. An epidural catheter was placed. A bolus of 0.2% ropivacaine 7 ml was followed by continuous infusion of 0.2% ropivacaine at a rate of 2 ml/h. Continuous SGB was maintained for 48 h. Successful SGB was confirmed by increase in skin temperature by ≥1.5℃ behind earlobe on the operated side.Venous blood samples were obtained at 30 min before and 3 and 7 day after operation for determination of serum thyroid stimulating hormone (TSH), triiodothyronine (T3) ,thyroxine (T4) , reverse triiodothyronine(rT3) and cortisol concentrations. Glasgow prognosis score was used to evaluate the clinical results at 3 months after operation. Results Serum T4 , rT3 , TSH and cortisol concentrations were significantly lower while the serum T3 concentration was higher in the SGB group than in group C at 3 and 7 d after operation. The clinical results were significant better in SGB group than in group C according to Glasgow prognosis scores at 3 months after operation. Conclusion Continuous SGB can inhibit the stress response, and improve hypothalamus-pituitary-thyroid gland axis function and is helpful to patient's recovery from injury.

Objective:To evaluate the efficacy and safety of combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with lobaplatin and docetaxel for treatment of synchronous peritoneal carcinomatosis (PC) from gastric cancer. Methods:Fifty patients with synchronous PC from gastric cancer were treated by 52 CRS+HIPEC procedures with 100 mg of lobaplatin and 120 mg of docetaxel in 12000 mL of normal saline at (43 ± 0.5)℃for 60 min. The primary and secondary endpoints were overall survival (OS) and perioperative safety profiles, respectively. Results:At a median follow-up of 22.5 months, the median OS rate was 14.3 (95%CI:7.6-21.0) months, and the 1-, 2-, and 3-year survival rates were 58%, 40%, and 32%, respectively. No perioperative deaths or serious adverse events occurred in 12 cases (23.1%). Multivariate analysis indicated that completeness of cytoreduction, nor-mality of perioperative tumor markers, and adjuvant chemotherapy of more than six cycles were independent predictors for improved survival. Conclusions:CRS+HIPEC with lobaplatin and docetaxel could improve the OS and ensure perioperative safety of patients with synchronous PC from gastric cancer.

Objective To explore the relationship between fasting serum concentration of uric acid (SUA)and the secretion of insulin under oral glucose tolerance test(OGTT)in 877 eligible subjects.Methods A 75g OGTT was administrated to all 877 eligible subjects,fasting uric acid,concentration of glucose and insulin of 0,30,60,120 and 180 min utes after OGTT were measured.Subjects were divided into high SUA group (HUA)and normal SUA group (NUA)according the concen-tration of SUA.SPSS 13.0 were used to analyze these data.Results Subjects in HUA had higher concentration of insulin in 0,30,60,120 and 180 min utes than NUA.There were positive correlation between SUA and INS in 0,30,60,120 and 180 min utes,Pearson r-value was 0.107,0.154,0.195,0.157 and 0.112(all P <0.01)respectively.By stepwise linear regression analyze,there were four parameters correlated with SUA:gender(female),INS60,cholesterol (TC),high density lipoprotein (HDL),β-vaule was -0.214,0.194,0.253,-0.119 (all P <0.01)respectively.Conclusion SUA positive correlated with secretion of INS after glycemia burden,SUA may be used as a potential biomark of secretin of INS (especially the concentra-tion of INS 60).

Objective To sum up the specificity in clinical care of repetitive transcranial magnetic stimulation (rTMS),and provide reference for putting forward scientific and effective clinical care project.Methods 200 male schizophrenia patients with rTMS treatment were divided into the research group and the control group with 100 cases in each group randomly.Then,the research group adopted the specific nursing which was obtained from the pre-experiment while the control group adopted the routine care.Moreover,NORS scale was used to evaluate the treatment effect.Changhai Pain Measuring Scale was employed to assess headaches in pre-treatment and post-treatment.Results The data of the research group in NORS scale was obviously lower than the control group,and the difference between two groups had statistical significance.No case occurred adverse reaction in the research group,in contract with many cases with adverse reaction in the control group.Conclusions Specific nursing can reduce complications effectively for schizophrenia patients receiving rTMS treatment,and it is a scientific,effective and mature clinical care method.

Objective:To investigate whether the omental-adipose stromal cells (O-ASCs) exposing to gastric cancer-conditioned medi-um (CM) could be inducted to differentiate into carcinoma-associated fibroblasts (CAFs) and the effect of ERK signaling pathway in the process. Methods: We identified O-ASCs by examining their ability to differentiate osteogenic and adipogenic lineages and through flow cytometry. O-ASCs were co-cultured with MGC803 and SGC7901CM. The expression of CAFs markers (α-SMA, FSP-1, and vimentin) and paracrine factors (VEGFA, TGF-β1, FAP, and SDF-1) were evaluated by RT-PCR and Western blot. In vitro cultures of O-ASCs were divided into three groups:the control, SGC7901-CM, and SGC7901-CM+U0126 groups. Cells were collected after 12 h. West-ern blot was performed to evaluate the expression ofα-SMA, FSP-1, ERK, and p-ERK1/2. Results:The primary cells were O-ASCs. The expression levels of CAFs markers (α-SMA, FSP-1, and vimentin) and O-ASC paracrine factors (VEGFA, TGF-β1, FAP, and SDF-1) clearly in-creased (P<0.05). In comparison with the control, the expression of ERK in SGC7901-CM group did not change (P>0.05), while the ex-pression of p-ERK1/2,α-SMA, and FSP-1 significantly improved (P<0.05). Comparison of SGC 7901-CM+U0126 and SGC 7901-CM groups showed that the expression levels of ERK had no statistical difference (P>0.05), while the expression levels of p-ERK1/2,α-SMA, and FSP-1 decreased (P<0.05). Conclusion:O-ASCs participate in the peritoneal metastasis of gastric cancer through differentiation by CAF and paracrine factors. The ERK signaling pathway is important in the differentiation of O-ASCs towards CAFs.

Objective To study the effect of chloral hydrate on click sound evoked auditory brainstem re-sponse (ABR) in healthy adult guinea pig .Methods A total of 20 healthy wild type albino male guinea pigs were se-lected for ABR assessment with click sound stimulation conscious and cholral hydrate anesthesia conditions .The ABR threshold was determined according to the wave that presents highest occurrence rate under different stimulus intensity .The latency ,interpeak latency of each wave at 90 dB peSPL stimulation as well as the amplitude of waveⅡ ,Ⅲ ,Ⅳ under different stimulus intensity were recorded .Results The ABR threshold in chloral hydrate anes-thesia was 25 .50 ± 2 .76 dB peSPL and at the waking state was 28 .5 ± 3 .66 dB peSPL from control group (P>0 .05) .The latencies of each wave recorded under chloral hydrate anesthesia state were prolonged compared to those of under waking state ,wave Ⅲ ,Ⅳ and Ⅴ had significance differences (P<0 .05) ,but wave Ⅰ ,Ⅱ had no significant differences (P>0 .05) .The interpeak latency between wave Ⅰ - Ⅴ ,Ⅲ - Ⅳ ,Ⅳ - Ⅴ in chloral hydrate anesthesia were longer compared to those of under waking state with significant differences (P<0 .05) ,while interpeak latency between Ⅰ - Ⅱ ,Ⅱ - Ⅲ had no significant differences (P> 0 .05) .The amplitude and occurrence rate of wave Ⅱwere the highest among all the waves in both experimental group and control group .The amplitude of wave Ⅱ and Ⅲ in chloral hydrate anesthesia was higher than that of the waking state under acoustic stimulation conditions ofhigh intensity(P<0 .05) while the amplitude of wave Ⅳ was lower than the waking state (P<0 .05) .Conclusion The chloral hydrate anesthesia may be able to apparently lengthen the ABR latencies of wave Ⅲ ,Ⅳ ,Ⅴ and affect the amplitude .This effect should be considered during the assessment of ABR under anesthesia state in guinea pig ;The ABR threshold of guinea pig could be determined according to the wave Ⅱ because it 's highest occurrence rate .

Objective To investigate the relationship between serum uric acid (SUA) levels and insulin secretion and insulin re-sistance in subjects with different glucose loads .Methods Totally 389 patients met the requirements ,and the subjects underwent o-ral glucose tolerance test (OGTT) to measure fasting SUA ,OGTT 0 ,30 ,60 ,120 min glucose (GLU) and insulin (INS) .According to the results of OGTT ,the subjects were divided into normal glucose tolerance group (NGT group ,n= 88) ,pre diabetes group (preDM group ,n=109) and diabetes mellitus (DM group ,n= 182) ,the insulin secretion index (IGI) ,120 min insulin secretion (AUC INS120/AUC GLU120 ) ,insulin resistance index (HOMA-IR) and Matsuda index were calculated .Calculated the quartile of SUA to divide the subjects to four groups ,the levels of insulin secretion and insulin resistance were compared between different glu-cose loading groups at different levels of SUA .The linear regression equation between SUA and insulin secretion and HOMA-IR was calculated .Results The SUA in DM group was lower than that of PreDM group [(346 .66 ± 90 .60)mmol/L vs .(367 .36 ± 92 .34)mmol/L] ,but slightly higher than that of NGT group[(339 .34 ± 89 .51)mmol/L] ,the difference was statistically significant (P<0 .01) .The IGI index and AUC INS120/AUC GLU120 index of DM group decreased with the increase of SUA (P<0 .01) ,and the Matsuda index decreased with the increase of SUA level (P<0 .05) .The linear equation of SUA and the IGI ,AUC INS120/AUC GLU120 ,HOMA-IR ,Matsuda index was Y=4 .050+0 .144X ,Y=2 .343+0 .206X ,Y =1 .288+0 .176X ,Y=129 .373-0 .202X re-spectively .Conclusion SUA was significantly associated with insulin secretion and insulin sensitivity .Insulin secretion in group DM increased with increasing SUA levels ,and insulin sensitivity decreased with increasing SUA levels .The linear equation of SUA and insulin secretion ,insulin sensitivity may be used to assess insulin function .

OBJECTIVE: The aim of this retrospective study was to analyze the recovery rate of sudden sensorineural hearing loss in children, and explore the prognostic factors in order to guide the clinical diagnosis and treatment. METHOD: A retrospective review was conducted for the prognosis of children with sudden sensorineural hearing loss during the past 5 years (from November 2010 to May 2015) in Chinese PLA General Hospital. This paper have a complete clinical data of 101 patients (113 ears)with sudden hearing loss, ranging from 0 to 18 years old Patients were divided into four groups according to hearing recovery and eight putative prognostic factors were analyzed. RESULT: Among 101 patients (113 ears), the ratio of male and female was 60:53. Treatment was initiated from 1 to 183 days after disease onset, with an average of (18.5 ± 22.1) d. Bilateral and unilateral hearing loss were 24 ears and 89 ears, respectively. The proportion of mild hearing loss, moderate hearing loss, severe hearing loss and profound hearing loss were 7.1%, 6.2%, 23.9% and 62.8%, respectively. Vertigo and tinnitus occurred in 54.9% and 77.9% of the patients, respectively. After the treatment, the complete recovery rate was 9.7% and the overall recovery rate was 36.3%. The degree of hearing loss, earlier treatment onset, sex and bilateral involvement were significantly associated with hearing recovery (P < 0.05). CONCLUSION Sudden sensorineural hearing loss in children was generally identified as severe and profound hearing loss, but after positive and timely treatment, it can be improved or even cured. The mild hearing loss, earlier treatment onset, unilateral hearing loss and female were positive prognostic factors. The concurrence of tinnitus or vertigo, the results of ABR and DPOAE had no significant influence on prognosis.
Adolescent ; Child ; Child, Preschool ; Female ; Hearing Loss, Sensorineural ; diagnosis ; Hearing Loss, Sudden ; diagnosis ; Hearing Loss, Unilateral ; diagnosis ; Hearing Tests ; Humans ; Infant ; Infant, Newborn ; Male ; Prognosis ; Retrospective Studies ; Tinnitus ; complications ; Vertigo ; complications

Objective: To study the clinical outcomes of anatomical hepatectomy combined with intraoperative choledochoscopy in treatment of complicated hepatolithiasis. Methods: The clinical data of 176 patients with complicated hepatolithiasis who underwent operation at the Department of General Surgery of No.960 Hospital of PLA from May 2005 to July 2015 were analyzed retrospectively. The data included general data, clinical manifestations, types of stones, operative methods, postoperative complications and follow-up. Results: There was no perioperative death. The postoperative complications which occurred in 31 patients (17.6%) included lung infection, intra-abdominal infection, bile leakage, and liver failure. Eighteen patients (10.2%) were found to have residual stones. After a follow-up which ranged from 1 to 3 years, 152 patients (94.4%) had good clinical outcomes. Recurrent stones were found in 12 patients (7.5%). Conclusion Anatomical hepatectomy combined with intraoperative choledochoscopy improved operative outcomes in patients with complicated hepatolithiasis and decreased residual stone and recurrence rates.

OBJECTIVETo determine the incidence of human herpes virus (HHV) 1-4 type including herpes simplex virus type-1 (HSV-1), herpes simplex virus type-2 (HSV-2), varicella-zoster virus (VZV), Epstein-Barr virus(EBV) in the saliva of human immunodeficiency virus (HIV) -infected patients.

METHODSThe incidence of salivary HSV-1, HSV-2, VZV and EBV from 245 HIV-seropositive individuals and control group was used to investigate by polymerase chain reaction(PCR) or nested PCR. The data was analyzed by SPSS 18.0 statistical software.

RESULTSIn the 245 HIV-seropositive individuals, the detection rates of HSV-1, HSV-2, VZV, EBV were 29.0%, 3.3%, 4.1%, 82.0%. In the control group, the detection rates of HSV-1, HSV-2, VZV, EBV were 13.3%, 0, 0, 36.7%. Four HHVs were significantly more prevalent in the salivas of HIV-seropositive persons than those in the control group (P < 0.01). The detection rates of HSV-1, HSV-2, VZV and EBV DNA were no difference between the HIV-positive group with highly active antiretroviral therapy (HAART) and HIV-positive group without HAART (P > 0.05).

CONCLUSIONThere is a high prevalence of HHV infection in HIV-infected people in Yunnan. The most common virus are EBV, followed by HSV-1, but VZV and HSV-2 are rarely detected. HHV co-infection is also observed.

Adult ; China ; DNA, Viral ; HIV Infections ; Herpesvirus 3, Human ; Humans ; Incidence ; Polymerase Chain Reaction ; Prevalence ; Saliva