Objective To investigate the effect of nonintubated intravenous anesthesia combined with local anesthesia on sympathetic nerve chain resection. Method One hundred and sixty palmar hyperhidrosis patients undergoing sympathetic nerve chain resection were divided into two groups, intubation general anesthesia (IGA) group and nonintubated intravenous anesthesia (NIA) group. The patients in IGA group were administrated with intubation general anesthesia. The patients in NIA group were administrated with nonintubated intravenous anesthesia. The physical signs, general anesthetics dosage, anesthesia time, hospital stays, hospitalization costs and postoperative complications were compared between two groups. Results In NIA group, the MAP after anesthesia , HR at 5 min and 10 min after anesthesia were lower than those in IGA group :MAP: (65.83 ± 12.53) , (68.19 ± 9.56), (69.72 ± 8.44), (68.58 ± 13.42) mmHg(1 mmHg = 0.133 kPa) vs. (98.47 ± 13.59), (93.53 ± 10.16), (86.13 ± 11.22), (81.52 ± 9.67) mmHg; HR:(76.36 ± 7.93), (78.42 ± 9.13) bpm vs. (102.67 ± 10.38), (97.66 ± 9.73) bpm, P<0.05. Similarly, the SpO2 and PaO2 after anesthesia in NIA group were also lower than those in IGA group:SpO2:0.93 ± 0.14, 0.94 ± 0.21, 0.93 ± 0.34, 0.94 ± 0.24 vs. 1.00 ± 0.13, 0.99 ± 0.16, 0.99 ± 0.20, 0.98 ± 0.13; PaO2: (83.73 ± 8.35), (68.57 ± 9.32), (63.93 ± 10.54), (65.51 ± 11.72) mmHg vs. (298.65 ± 25.19), (328.58 ± 30.61), (303.26 ± 29.34), (317.49 ± 28.15) mmHg , P<0.05. And the PaCO2 after anesthesia was higher than that in IGA group (52.93 ± 9.27), (61.47 ± 7.32), (71.58 ± 8.23), (68.13 ± 10.58) mmHg vs. (36.86 ± 5.52), ( 35.73 ± 6.14), (37.18 ± 7.39), (36.35 ± 5.87) mmHg, P<0.05. In NIA group, the dosages of propofol and remifentanil, anesthesia time were less than those in IGA group:(235.63 ± 19.42) mg, (446.58 ± 50.32)μg, (66.45 ± 13.35) min vs. (317.86 ± 28.36) mg, (623.47 ± 403.93)μg , (89.27 ± 16.38) min, P<0.05 or<0.01. In hospital stays, hospitalization costs, there were no significant differences between two groups (P>0.05). In NIA group, 8 patients needed artificial respiration, which were more than those in IGA group (8 vs. 0) (P<0.05). In NIA group, the incidences of throat discomfort, nausea and vomiting were lower than those in IGA group:0 vs. 32.5% (26/80) and 25.0% (20/80) vs. 11.2% (9/80), P<0.05. However, the incidence of lung infection was similar to that in IGA group (P>0.05). Conclusions Nonintubated intravenous anesthesia combined with local anesthesia is safe for palmar hyperhidrosis patients undergoing sympathetic nerve chain resection, with less complications and without increasing the workload.

Objective To evaluate transcatheter thrombolysis via the small saphenous vein in the treatment for lower limb acute mix-deep venous thrombosis. Method From Jan 2005 to Mar 2007.37 patients with lower limb acute mix-DVT underwent catheter-directed thrombolysis via the small saphenous vein with urokinase(149 ±71)×104 IU continuous infusion.The venous patency score and the rate of patency improvement were observed by venograms before and after therapy.Twenty-two patients were followed up for(12 ±4)months. Results Venous patency score were significantly improved(Z=-5.330,P＜0.01).The mean rate of venous patency was 50.17%±15%,and there was no complication.Venogram on 6～12 month follow up showed a venous patency of 58%±13%(Z=-3.545,P＜0.01),and that on 13～18 months was 68%±20%(Z=-2.201,P＜0.05). Conclusion This preliminary experience suggests that catheter-directed thrombolysis via the small saphenous vein with urokinase for acute lower limb mix-DVT iS safe and effective.

Objective Taking CNE-2Z multicellular spheroids (MCSs) as the simulation of solid tumors, to investigate the role of SAPK/JNK signaling pathway in multicellular resistance to radiotherapy for human nasopharyngeal carcinoma (NPC). Methods Human NPC cell line CNE-2Z were cultured into multicellular spheroids by using liquid overlay technique, then divided into control MCSs, irradiated MCSs (average dose in one minute: 2 Gy), sp-600125(a specific inhibitor for SAPK/JNK signaling pathway)+irradiated MCSs, sp-600125+MCSs. Western blotting was employed to analyze the activity of SAPK/JNK signaling pathway in MCSs, and the expression of Caspase-3 protein before and after sp-600125 treatment; X-ray induced cell apoptotisis in MCSs before and after sp-600125 treatment was detected by TUNEL. Results The level of SAPK/JNK phosphorylation in MCSs was a dynamic course after radiation, and the phosphorylation peaked at 2 h after irradiation; The apoptotic rate of MCSs (P

OBJECTIVE To evaluate the efficacy and safety of teicoplanin treatment on complicated Gram-positive urinary tract infection.METHODS The patients′ clinical manifestation,laboratory results,bacterial culture changes after intravascular administration of teicoplanin were observed.Each patient was administered teicoplanin(200 mg once a day for 10-14 days,but 400 mg in the first day).RESULTS The effective rate and the bacterial eradication rate were 90.0% and 86.7%,respectively.All patients experienced relief from clinical infective symptoms and systemic reactions.There were no abnormal laboratory findings and adverse reactions.CONCLUSIONS Teicoplanin is an effective and safe antibiotic for the treatment of patients with complicated urinary tract infection.

Bone marrow cell morphology is an important part of clinical hematology and laboratory and is the key and difficult part of teaching.Microscopic digital interactive system consisting of image processing and analyzing software,voice response software and computer teaching software can realize the picture resources sharing,effective teacher-student interaction and change of evaluation mechanism.The application of this system changed the traditional modes of teaching; motivated students' enthusiasm and greatly improved the quality of practice teaching.

Bone marrow cell morphology is the important part of the course of clinical hema-tology and laboratory and is the difficult and key part in the practice teaching of this course. In order to let students better grasp the basic skills, teachers should flexibly use multiple teaching methods of comparison type, communication type, heuristic type, medical record type and PBL type, which will greatly improve the teaching quality of hematology practice teaching.

Objective To study the significance and feasibility of modified early warning scores (MEWS) assessing the conditions and death prediction among the pre-hospital acute poisoning patients.Methods We performed a prospective,observational study of the pre-hospital acute poisoning patients between January 1,2010 and December 31,2010.Data was collected to calculate the MEWS.Numeration data was presented in percentage by using chi-square test,and measurement data was expressed in mean with standard deviation,and P ＜ 0.05 was considered to be different with statistical significance.Observation lasted for 90 days after admission to get the results as observation index and ROC was drew and the area under the curve and the predicting index were calculated.The patients without vital signs and unsuccessful resuscitation were not included in this study.Results It showed 287 person times with 0 ～ 6 scores,accounting 94.4％,17 person times with 7-13 scores,accounting 5.59％,among the dead patients,MEWS were more than those of the survival group with statistical significance (P ＜ 0.05).The area under ROC was 0.99 indicating that MEWS≥7 was the board line for severe pre-hospital acute poisoning patients with sensitivity of 91.7％,specificity of 97.9％,accuracy of 97.7％ and Youden of 0.896 for predicting death.It showed high significance of the application of MEWS in assessing acute poisoning patients and death prediction.Conclusions MEWS assess pre-hospital acute poisoning patients and predict death with good resolution and strong application significance,which is simple,practical and applicable.

Objective To compare the quadriceps strength and short-term outcome in patients who had undergone primary total knee arthroplasty (TKA) with minimally invasive (MIS) or conventional surgical technique.Methods Sixty-eight knees undergoing TKA were evaluated and they were randomly divided into two groups.One group included 34 knees which were undergone conventional approach,and the other group included 34 knees undergone MIS approach.The age,BMI,quadriceps strength,extension lag,American Knee Society Score (KSS),Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS) of pain of all patients were evaluated at the day before surgery and the 1st,2nd,3rd,6th,and 12th months after surgery.Results At the 1st,2nd,3rd,6th,and 12th months after surgery,the quadriceps strength in MIS group was 0.59±0.12,0.74±0.18,0.86±0.16,1.02±0.17,1.05±0.04 N·m/kg respectively,while in conventional group was 0.46± 0.56,0.56±0.12,0.70±0.16,0.94±0.19,1.04±0.03 N· m/kg respectively.The extension lag in MIS group was 13.11°±6.56°,8.53°± 5.12°,4.79°±3.62°,1.53°±2.64°,1.62°±1.76° respectively,while in conventional group was 22.47°±8.41°,16.23°±6.26°,10.58°± 4.4°,2.58°±2.85°,1.62°±1.76° respectively.There were significantly differences in the two groups.Meanwhile,compared with conventional patients,MIS patients demonstrated significantly higher KSS scores at the 1st and 2nd months postoperatively.WOMAC scores were significantly lower in MIS group than in conventional group at the 1st month after surgery.During the first postoperative week,MIS technique significantly decreased VAS scores,showing significance.On the other hand,no significant difference was observed with respect to deep infection incidence and radiological outcome between two groups.Conclusion MIS TKA offers a significant improvement in extensor muscle strength over conventional surgery.These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach.

Adult ; Aged ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Neoplasm Recurrence, Local ; diagnostic imaging ; Neoplasm, Residual ; diagnostic imaging ; Positron-Emission Tomography