20 % . In both groups CH was induced with infusion of 0.01 % NTP at a rate 0.5-6.0 ?g?kg-1?min-1 to maintain MAP at 55-65 mm Hg. MAP, HR, CVP and CO were continuously monitored. Arterial lactate concentration was measured by enzyme assay. Arterial and mixed venous blood gases were analyzed, and oxygen delivery (DO2 ) and consumption (VO2) were calculated before AHH (T0) after AHH was performed (T1), 30 min after CH was induced (T2) and 30 min after termination of CH (T3) in group Ⅰ and in group Ⅱ before CH (T1), 30 min after induction of CH (T2) and 30 rain after termination of CH (T3 ) .ResultsIn group Ⅰ(AHH + CH) compared with the baseline values (T0 ) HR significantly decreased while CVP significantly increased after AHH (T1 ) ; cardiac output (CO) significantly increased after AHH (T1 ) and during CH (T2) while DO2 was significantly decreased after AHH (T1) and CH (T3 ) but arterial lactate concentration was significantly decreased during and after CH (T2, T3). In group Ⅱ (CH alone) compared with the baseline values (T1) HR significantly increased while CVP significantly decreased during and after CH (T2, T3 ) ; there was no significant change in CO and DO2 at T2 and T3 but arterial lactate concentration significantly increased during and after CH (T2, T3). There was significantly less blood loss during operation in group I than in group Ⅱ . ConclusionThere was tissue deoxygenation during and after deliberate hypotension as shown by increased arterial lactate concentration while AHH combined with CH can improve tissue perfusion and oxygenation. AHH can also maintain hemodynamic stability during CH.

Functional magnetic resonance imaging (fMRI) is a technology combined with function, anatomy and images to evaluate the brain function in real-time, dynamic, non-invasive ways. fMRI has been applied in the rehabilitation after stroke for the assessment and prog-nosis of motor, speech, cognition and sense function, etc.

Objective To explore the therapeutic efficacy of modified Taohong Siwu Decoctio n(TSD) combined with limited internal fixation and external fixation for the treatment of tibial plateau fracture of Schatzker type Ⅴand Ⅵ. M ethods A total of 31 cases of tibial plateau fractures of Schatzker type Ⅴ and Ⅵ treated with TSD orally combined with limited internal fixation and external fixation were enrolled into the study. Follow-up was carried out for the evaluation of therapeutic effect and postoperative complications. Results All of the cases received follow-up for 6 months to 3 years. According to Merchant scoring criteria, the therapeutic effect was excellent for 15 cases, good for 12 cases, acceptable for 3 cases and inferior for one case, with the excellent and good rate being 87.1%. One case had pin tract infection, and then was cured after symptomatic treatment. Conclusion For tibial plateau fracture of Schatzker typeⅤandⅥwith unsatisfactory skin state, we can perform limited internal fixation and external fixation to take the place of strong steel plate fixation with extensive exposure for surgical treatment, and then give postoperative oral use of TSD, which will be a safe and effective therapy for the fracture by promoting the relief of the clinical symptoms and signs of early fracture.

Objective To compare the distribution and drug resistance of isolates between sterile body fluid and non‐sterile body fluid in the hospital in 2014 .Methods By adopting the retrospective analysis method ,we used BD phoenixTM 100 to conduct bacteria identification and drug susceptibility testing ,the Whonet5 .6 software and SPSS19 .0 software to statistically analysize the drug re‐sistance of the bacteria .Results E .coli ranked the top in sterile body fluid isolates(43% ) while the highest rate in non‐sterile body fluid was P .aeruginosa .E .coli(21% ) .Isolates from sterile body fluid had lower drug resistance rate to 11 kinds of antibacterials such as ampicillin ,chloramphenicol ,ciprofloxacin and aztreonam than the strains isolated from non‐sterile body fluid(P<0 .05) .S . aureus ,isolated from sterile body fluid ,had lower drug resistance rate to 6 kinds of antibacterials such as amikacin ,amoxicillin/cla‐vulanicacid ,ciprofloxacin than the strains isolated from non‐sterile body fluid .P .aeruginosa ,isolated from sterile body fluid ,had lower drug resistance rate to aztreonam than the srains isolated from non‐sterile body fluid .K .pneumoniae ,isolated from sterile body fluid ,had lower drug resistance rate to 6 kinds of antibacterials such as ampicillin/sulbactam ,sulfamethoxazole ,chlorampheni‐col than the strains isolated from non‐sterile body fluid(P<0 .05) .Conclusion There is significant difference between sterile body fluid and sterile body fluid in strain distribution and drug resistance ,so it is vital to enhance the bacterial resistance surveillance of sterile body fluid .

Objective Zika virus disease is an acute infectious disease caused by Zika virus transmitted through Aedes mosquitoes. To explore the therapeutic effect of integrated traditional Chinese and Western Medicine for Zika virus disease, the treatment process of the first imported case in China was reviewed. Methods The first imported Zika virus disease in China was admitted to Ganxian People's Hospital in Jiangxi Province on February 6th, 2016, and the patient received isolation treatment for 9 days and cured later. The effect of antiviral treatments including Xiyanping injection was evaluated based on clinical diagnosis and treatment process of the patient. Results A 34-year old male patient was admitted with chief complaint of fever for 9 days, orbital pain and itching rash for 4 days on February 6th, 2016. ① Epidemiological characteristics: the patient was bitted by mosquitoes during his business trip in Venezuela since January 1st, where Zika virus disease was spreading. On January 20th he had dizziness without fever, and the symptom disappeared after taking medicines without details. Paroxysmal dizziness, chills and mild fever without myalgia was experienced on January 28th. On February 3rd small red rash appeared in the neck, spreading to anterior part of chest, limbs and trunk, and the fever, fatigue, nausea was continued, and a new symptom of paroxysmal pain in back of ears and orbits appeared, during which he had not go to hospital. The symptoms relieved on February 4th. He returned to Ganxian County on February 5th, he had yellow stool 3 times with normal temperature, without abdominal pain, and red rash still appeared in the neck. He went to Ganxian People's Hospital on February 6th, 2016. ② Clinical manifestation: the vital signs showed a temperature of 36.8 ℃, a pulse rate of 80 bpm, a respiratory rate of 20 bpm, and a blood pressure of 110/70 mmHg (1 mmHg = 0.133 kPa). It was showed by physical examination that red rash appeared in the neck, and no superficial enlarged lymph nodes were found. Bilateral conjunctival congestion was obvious, physiological reflex existed and pathological reflex was not found. ③ Auxiliary lab test and examination: no abnormal finding were revealed throughout examination and laboratory tests, including routine blood test, liver function, renal function, serum myocardial enzyme, electrolyte, blood sugar, C-reactive protein (CRP), troponin I (TnI), and procalcitonin (PCT), except slight prolongation in activated partial thromboplastin time (APTT, 38.6 s) on February 6th; and slightly dense shadow in left lung in lung CT scan, considering inflammatory changes and slight emphysema (especially in the left lower lung) as well as bilateral renal calculus on February 8th. No significant abnormalities were found in electrocardiogram and B ultrasound test of liver, spleen, and pancreas. ④ Virus confirmation: Zika virus nucleic acid was positive reported by Jiangxi Province Center for Disease Control and Prevention (CDC) on February 7th and Chinese CDC on February 9th, respectively, though Dengue virus were negative reported by Ganzhou CDC on February 6th. Right after the first diagnosis, anyone who had been in close contact with the patient received medical monitoring. ⑤Treatment process: on February 6th, symptomatic treatment was prescribed since admitted into the infectious isolation wards and daily intravenous drip of Xiyanping injection 250 mg was prescribed for antiviral therapy. On February 7th, the patient had no fever, with occasional chills, neck rash was disappeared, orbital pain relieved and bilateral conjunctival hyperemia range was paler and narrowed, and his condition improved. Ibuprofen was administered for defervesce 3 times a day when his temperature reached to 37.5 ℃ at 16:00. On February 8th, the patient had no fever, times of chills was significantly reduced, without myalgia and rash, orbital pain and conjunctival hyperemia further recovered. On February 9th, bilateral eyes slightly tingling, mild conjunctival congestion, no fever chills or other discomfort was found. The chloramphenicol eye drops was prescribed for relieving sting pain with conjunctival congestion twice a day as recombinant human interferon alpha eye drops was out of store. The patient was comfortable from February 11th to February 13th. Blood and urine test for Zika were reported negative by the Chinese CDC and Jiangxi Province CDC. Because all the discharge criteria were satisfied, the patient was discharged on February 14th. Conclusions At present, there is no specific effective drug to prevent and treat Zika virus disease effectually. After receiving symptomatic treatment and antiviral treatments including Xiyanping injection, the patient's symptoms were relieved. Zika virus nucleic acid in blood and urine was negative. The patient was discharged. Combination of traditional Chinese medicine and Western medicine maybe a good method to prevent and treat Zika virus disease.

Adenocarcinoma ; blood supply ; metabolism ; mortality ; secondary ; Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; Male ; Microcirculation ; Middle Aged ; Neovascularization, Pathologic ; metabolism ; pathology ; Prognosis ; RNA, Messenger ; biosynthesis ; genetics ; Receptors, Cell Surface ; biosynthesis ; genetics ; Receptors, Urokinase Plasminogen Activator ; Stomach Neoplasms ; blood supply ; metabolism ; mortality ; pathology ; Survival Rate ; Vascular Endothelial Growth Factor A ; metabolism

Background Excimer laser corneal refractive surgery is widely used because it reduces the dependency of refractive error eye to glasses.However,the adverse effects of anti-inflammatory drugs is a problem after operation.Lotemax eyedrops is a kind of steroidal anti-inflammatory drug,with a good effect on the operative eye.But its influence on intraocular pressure(IOP) after long-term topical administration is less studied.Objective This study was to investigate the influence of lotemax eyedrops on IOP after long-term topical administration in myopic eyes received excimer laser corneal refractive surgery.Methods An one-month retrospective case serial study was adopted.The case history data of 1552 eyes from 1552 Patients who received excimer laser corneal refractive surgery were collected in Tangshan Eye Hospital from 2011 January to 2012 January,including 321 eyes with laser in situ keratomileusis(LASIK),608 eyes with sub-Bowman keratomileusis (SBK) and 623 eyes with femtosecond laser for flap excimer laser in situ keratomileusis(FS-LASIK).Lotemax eyedrops was topically administered after operation 4 times per day initial and then decreased 1 time weekly for 1 month.IOP was measured in before,1 week,2 weeks,3 weeks,4 weeks after operation with non-contact tonometer.The increasing range of IOP was divided into ＜5 mmHg,5-15 mmHg and ＞ 15 mmHg after operation.Optical head parameters were measured by Heidelberg retina tomography when IOP increasing after operation.Results Within 1 month,elevated IOP was found in 47 of 1552 eyes after administration of lotemax eyedrops,including 3.12％ (10/321) in the LASIK group,3.29％ (20/608) in the SBK group and 2.73％ (17/623) in the FS-LASIK group,without significant difference among them(x2 =1.95,P＞0.05).The IOP elevated 1 week after operation and remained normal after that till drug withdrawal in all eyes.There were no significant differences in the disk area (1.65 ±0.44) mm2 vs.(1.66 ±0.44) mm2,disk volume (0.40 ±0.09)mm3 vs.(0.39±0.08) mm3 and mean nerve fiber layer thickness (0.28 ± 0.08) mm vs.(0.29 ± 0.07) mm in IOP elevation duration compared with 1 month after IOP recovery(t =0.34,0.81,0.48,P＞0.05).Conclusions Topical administration of 0.5％ lotemax eyedrops after excimer laser corneal refractive surgery leads to reversible high IOP.It is very important to monitor the IOP during use of the drug.

Adolescent ; Endoscopy ; methods ; Face ; surgery ; Facial Neoplasms ; surgery ; Female ; Hemangioma, Cavernous ; surgery ; Humans ; Nose ; surgery

Objective To evaluate the role of T?type calcium channels in up?regulation of spinal Ca2+∕calmodulin?dependent protein kinase Ⅱ ( CaMKⅡ) expression in rats with neuropathic pain. Meth?ods Forty?eight male Sprague?Dawley rats, weighing 230-270 g, in which intrathecal catheters were suc?cessfully implanted, were divided into 4 groups ( n=12 each) using a random number table: sham opera?tion group (group S), neuropathic pain group (group NP), normal saline group (group NS), and T?type calcium channel blocker mibefradil group ( group M ) . The model of neuropathic pain was established by chronic compression of the dorsal root ganglion ( DRG) . Normal saline 20μl and mibefradil 200μg ( dilu?ted to 20μl in normal saline) were injected intrathecally at 5 days after compression of the DRG in NS and M groups, respectively. Before intrathecal catheter implantation ( T1 ) , before compression of the DRG ( T2 ) , at 5 days after compression of the DRG and before intrathecal administration ( T3 ) , and at 30, 60, 120 and 240 min after intrathecal administration ( T4?7 ) , the mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured. The rats were sacrificed after the last measure?ment of the pain threshold at T7 , and the lumbar enlargement segments of the spinal cord were harvested for determination of CaMKⅡ expression by Western blot. Results Compared with group S, the MWT was significantly decreased, and TWL was significantly shortened at T3?7 , and the expression of spinal CaMKⅡ was significantly up?regulated in NP and M groups (P<0.05). Compared with group NP, the MWT wassignificantly increased, and TWL was significantly prolonged at T4?6, and the expression of spinal CaMKⅡwas significantly down?regulated in group M (P<0.05), and no significant change was found in the parame?ters mentioned above in group NS (P>0.05). Conclusion T?type calcium channels are opened, the intra?cellular free calcium ion concentrations are increased, and activated spinal CaMKⅡ is involved in the de?velopment of neuropathic pain in rats.

Objective To compare the surgical outcomes between microsurgery lumbar discectomy and microendoscopic discectomy for lumbar disc herniation. Methods A prospective study was conducted on the surgical procedures for lumbar disc herniation.The target of our study was a group of 33 patients who underwent surgery by microsurgery lumbar discectomy(MSLD group)and 36 patients who underwent surgery by microendoscopic discectomy(MED group).The items investigated were the operation time,amount of bleeding,duration of hospitalization,pre-and postoperative scores based on judgment criteria for treatment of lumbar spine disorders established by the Japanese Orthopaedic Association score,visual analog scales (VAS,0 to 10) for lumbago and sciatica before surgery and at discharge,perioperative complications.Results The mean duration of follow-up was 2 years and 2 months (11 months to 4 years).There were no significant differences between the 2 surgical procedures in the frequency of the pre-and postoperative Japanese Orthopaedic Association scores or postoperative VAS for lumbar pain and sciatica,operation time and duration of hospitalization. Statistically significant differences were observed in amount of bleeding and operation time,but the differences were not large, and may not have been clinically significant.Conclusion Both microsurgery lumbar discectomy and microendoscopic discectomy are appropriate for lumbar disc herniation.