Objective To observe the anesthesia and analgesia effect of ultrasound guided inter-scalene brachial plexus block (ISPSP)on upper extremity surgery.Methods Fifty-four patients (male 34 cases,female 20 cases,aged 37-73 years,ASA grade Ⅰ or Ⅱ)scheduled for elective upper limb surgery under ISPBP combined with general anesthesia were randomly assigned into two groups:magnesium sulfate group (group M,n =27)and control group (group N,n =27).0.5% ropivacaine 8ml (40 mg)+10% magnesium sulfate 2 ml (0.5 g)were used in group M ,0.5% ropivacaine 8 ml+ normal saline 2ml (40 mg)were used in group N.After the effects of ISBPB were confirmed,pa-tients were inserted laryngeal mask under intravenous induction.Anesthesia was maintained by inha-ling sevoflurane(MAC 0.8)during the operation.The onset time of sensory and motor block,duration of sensory and motor block,duration of analgesia,pain visual analogue digital score (VAS)4,8,12, 24 hours after operationand complications were recorded.Results Duration of sensory block and du-ration of analgesia of group M was significantly longer than those of group N (P <0.05).The patient`s VAS score of 8,12,24 hours after surgery in group M was significantly lower than that on group N (P <0.05).Onset time of sensory and motory block of both groups was similar.Conclusion 0.5%ropivacaine combined with magnesium sulfate in ultrasound-guided ISPBP can extend the duration of sensory block,reduce postoperative pain,as well as prolong analgesia time.

AIM To establish an HPLC method for the simultaneous content determination of chlorogenic acid,caffeic acid,luteoloside,baicalein,luteolin and rutin in Yinhuang Granules (Lonicerae japonicae Flos and Scutellariae Radix extracts).METHODS The analysis of 80％ methanol extract of this drug was performed on a 30 ℃ thermostatic SunFire-C1scolumn (250 mm × 4.6 mm,5 μm),with the mobile phase comprising of acetonitrile0.4％ phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 239 nm.RESULTS All the six constituents showed good linear relationships within their own ranges (r =0.999 9),whose average recoveries were 94.56％-98.38％ with the RSDs of 0.49％-2.89％.Among fourteen batches of samples,the luteoloside content was found to be of little difference,while the other five constituents' contents were of relatively great differences.CONCLUSION The qualities of Yinhuang Granules and Lonicerae japonicae Flos extracts from different manufacturers are uneven,so supervision should be strengthened.

OBJECTIVETo compare the efficacy differences between fire needling therapy and oxycycline tablets for the treatment of moderate to severe acne vulgaris.

METHODSSixty cases of moderate to severe acne vulgaris were randomly divided into a fire needling group and a medication group, 30 cases in each one. The pricking method of fire needling at Ashi points around damaged skin was applied in the fire needling group, once every five days for totally 4 times. The oral administration of oxycycline tablets, 100 mg, was applied in the medication group, twice daily for 20 days, also external application of adapalene gel before sleep was adopted. The fading time of skin damage, including papule, pustule, nodule and cyst in the two groups was recorded and clinical efficacy was compared. After the treatment, two-month follow-up was performed to observe the recurrence rate in the two groups.

RESULTSThe curative rate was 69.0% (20/29) in the fire needling group, which was statistically different from 40.0% (12/30) in the medication group (P < 0.05). The fading time of each type of skin damage in the fire needling group was shorter than that in the medication group [papule: (2.67 +/- 0.66) d vs (4.36 +/- 0.61) d; pustule: (2.47 +/- 0.57) d vs (4.27 +/- 0.55) d; nodule: (7.76 +/- 1.06) d vs (9.88-1.30) d; cyst: (11.81 +/- 1.54) d vs (14.79 +/- 0.89) d, all P < 0.05]. The recurrence rate was 46.4% (13/28) in the fire needling group, which was not significantly different from 44.0% (11/24) in the medication group (P > 0.05).

CONCLUSIONThe acne vulgaris could be fast and effectively treated by fire needling therapy, which has shorter fading time than oxycycline tablets. However, the preventive effect is not different between the two theraies.

Acne Vulgaris ; therapy ; Acupuncture Therapy ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To explore the correlation of the throid function and malnutrition in maintenance hemodialysis(MHD) patients.Methods Fifty-four MHD patients and 16 normal controls were enrolled as our subjects and named as MHD group and control group.Serum concentrations of total triiodothyronine (TT3),total thyroxine (TT4),free thyroine (FT4),free triiodothyronine (FT3),and thyroid-stimulating hormone (TSH) were measured by enhanced chemiluminescence immunoassay.Their anthropometry,biochemical assays,malnutrition-inflammation score (MlS) and micro-inflammation parameters such as high sensitivity C-reactiveprotein(hs-CRP) were also measured.Results Serum T3,FT3,T4,FT4 concentration in MHD patients were (1.18 ±0.31) nmol/L,(2.61 ±0.62) pmol/L,(100.00 ± 19.96) nmol/L,(8.56 ±0.85) pmol/L respectively,lower than that of control group ((2.95 ± 0.27) nmol/L,(7.12 ± 0.94) pmol/L,(136.25 ± 19.68) nmol/L,(8.89 ± 0.56) pmol/L respectively,P ＜ 0.01).while there was no significant change on TSH (P =0.058).According to albumin nutrient grading standard:the morbidity of malnutrition was 75％ (39/54).The morbidity of malnutrition was 100％ based on the criteria of MIS.Of which,mild malnutrition rate was 29.63％ (16/54),moderate rate for 37.04％ (20/54) and sever rate for 33％ (18/54).The levels of serum creatinine,hemoglobin,serum iron,upper arm circumference,body mass index(BMI),deltoid skinfold,hs-CRP,T3,FT3,T4,FT4,TSH in MHD patients with mild,moderate and serve rate MIS were significant different(P ＜ 0.01).Of 54 MHD patients,32 cases were with micro inflammatory state,accounting for 59.26％ (32/54).There was a positive correlation between FT3 and albumin (P ＜0.01).T3 was related to serum creatinine(P ＜ 0.05).Thyroid function parameters showed a negative correlation with hs-CRP,MIS(P ＜ 0.01).And a negative correlation was seen between nutrition indices and hs-CRP and MIS (P ＜ 0.01).Conclusion Thyroid function can reflect the nutrition status of MHD patients to some degree,and both relate with miro-inflammation.Furthermore,MIS is a useful index for the estimation of malnutrition inflammation status.

Objective To develop a multiplex PCR-based reverse line blot(mPCR/RLB) hybridization assay to detect,simultaneously,seven genes encoding AR-erm(A/TR),erm(B),mef(A/ E),tet(M),tet(O),aphA-3,aad-6 and two AR-related genes,int-Tn and mreA in group B streptococcus.Methods Nine pairs of specific primers and Oligonucleotide probes targeting erm(A/TR), erm(B),mef(A/E),tet(M),tet(O),aphA-3,aad-6 int-Tn and mreA respectively were modified according to former studies or designed in this study.The primers and probes were labeled with biotin and amino,respectively.The nine genes were amplified simultaneously in the same tube.PCR product hybridized with the probes labeled in the BiodyneC nylon membrane to detect the nine genes.To detect the sensitivity and specificity of the method developed,PCR with single pair of primer targeting each gene were tested in 318 isolates tested and the results were compared with the one abtained by RLB.Results The nine resistance-related genes could be successfully detected by mPCR/RLB assay developed in this study.Based on sequencing,21 of 22 isolates with mef had mef(E)and eight of 353 with int-Tn had an atypical sequence.Except for the above 29 genes,all the others corresponded well with the results obtained by single pair primer PCR.Conclusion The mPCR/RLB assay developed in this study is simple,rapid and suitable for surveillance of antibiotic resistance in GBS.

Objective To explore the feasibility of imaging and treatment of cervical cancer xenograft model using 131I mediated by hNIS gene transfection. Methods The cervical cancer xenograft models were established with Hela-NIS( +) cells and Hela cells, respectively. Five Hela-NIS( +) xenograft models and five Hela xenograft models were dynamically imaged at 0.5, 1, 2, 4, 8, 16 and 20 h postinjection of 131I(7.4 MBq). Five Hela-NIS( +) xenograft models were imaged at 0. 5,1,2,4,8,16, 20 and 25 h postinjection of 99TcmO4-(11.1 MBq). Twenty Hela-NIS( +) cervical cancer xenograft models were randomly divided into four groups: Three 131I treating groups and one control group. The therapeutic effects of 131I at threelevels (74,111,148 MBq) were investigated following intraperitoneal injection. Results Hela-NIS( +)human cervical cancer xenografts were established successfully in nude mice. The Hela-NIS( +) xenografts significantly accumulated radioactivity after intraperitoneal injection of 131I, and the radioactivity was persistently present until 20 h postinjection, but Hela xenografts had no radioactive accumulation. The T/B value of the Hela-NIS( +) xenografts reached 17.34 at 8 h postinjection. The imaging with 99TcmO4- showed that the radioactivity was persistently present in Hela-NIS( +) xenografts for almost 25 h. The Hela-NIS( +)xenografts shrinked after 131I treatment. The inhibition ratios of tumor growth in 111 MBq and 148 MBq groups were both significantly higher than that of 74 MBq group (t: 2.74-5.75, P ＜0.05). Conclusions Hela-NIS( +) cervical cancer xenografts in nude mice could persistently accumulate 131I and 99TcmO4- and could be treated successfully with 131 I. 131 I treatment mediated by hNIS gene transfection could be a promising cancer treatment method.

OBJECTIVE To discuss the characteristics and risk factors of nosocomial infection inpatients with chronic kidney disease.METHODS The data from chronic kidney disease(CKD) patients retrospectively analyzed.RESULTS The nosocomial infection rate of CKD patients was 14.73%,urinary tract was the most comun site,The main-pathogens were Gram-negative bacteria,and then Gram-positive bacteria and fungii.The patients with diabetic nephropathy,lupus nephritis,aging,lower glomerular filtration rate,hypoproteinemia,anemia,and long time duration were easy to get nosocomial infection.CONCLUSIONS Nosocomial infection in CKD patients is related to underlying diseases,age,kidney function,serum albumin level,hemoglobin level,duration time in the hospital.

OBJECTIVETo investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury.

METHODSFrom May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method.

RESULTSAll incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case.

CONCLUSIONThe application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

Adolescent ; Adult ; Carpal Joints ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Hamate Bone ; injuries ; surgery ; Humans ; Male ; Metacarpal Bones ; injuries ; surgery ; Metacarpophalangeal Joint ; injuries ; surgery ; Middle Aged ; Sutures ; utilization ; Young Adult

ObjectiveTo summarize the diagnosis, management and prognosis of catastrophic antiphospholipid syndrome (CAPS) in pregnant and postpartum women through a case report and literature review.MethodsThe reported case was a gravida who had a history of antiphospholipid syndrome and was admitted to the Peking University First Hospital in July 2017 due to CAPS in the second trimester. She was fully recovered and discharged after effective management. Clinical data was collected and analyzed. Relevant literatures regarding the diagnosis, treatment and prognosis of pregnancy-related CAPS were reviewed. Results(1) Case report: The patient had taken warfarin after the diagnosis of antiphospholipid syndrome but stopped the medication six months before conception. She was admitted at 22 weeks of gestation due to severe upper abdominal pain accompanied by nausea and vomiting and diagnosed with CAPS based on severe low platelet count and remarkably elevated liver enzymes. After a series of treatment, including anticoagulation, glucocorticoid, plasma exchange and cesarean section, the patient became stable and was fully recovered. (2) Literature review: After searching all published literatures, 13 relevant literatures which including 35 patients were finally reviewed. It is found that CAPS was a rare and life-threatening condition with rapid progression and the mortality rate was 6/14 during gestation and 9％ (2/21) after delivery. Anticoagulation, glucocorticoid, plasma exchange and immunoglobulin were the first-line treatment. Termination of pregnancy was required once CAPS was diagnosed.ConclusionsCAPS is a rare but life-threatening disease. Early diagnosis and timely termination of pregnancy are crucial for gravidas with CAPS.

Construction and application of immunization information system is an important part of health information, which is very useful to improve the quality, efficiency and safety of vaccination. The background, system architecture, functions and applications, working conditions and characteristics of Shandong province Immunization Information System (IIS) are introduced in this article. It is expected to provide experiences for the development of immunization information system of other provinces.