Objective To investigate the changes of hemodynamic parameters of superior mesenteric artery (SMA) during peritoneal dialysis (PD). Methods Thirty uremic patients with PD (PD group), 30 uremic patients without PD (non-PD group) and 30 healthy subjects (control group) were enrolled. All cases underwent Doppler ultrasonography and the hemodynamic parameters were obtained.Results The peak systolic velocity (PSV) and diameter (D) were not statistical different among three groups (P>0.05). The resistance index (RI) and pulsatility index (PI) decreased in PD group compared with the other two groups (P>0.05), but no difference was found between non-PD group and control group (P>0.05). The end-diastolic velocity (EDV), time-averaged velocity (TAVM) and blood flow (Q) were higher in PD group than those in non-PD group and control group (P<0.05). No difference of EDV, TAVM and Q was found between the control group and non-PD group (P>0.05). PI and RI were negatively correlated with PD time (r=-0.91,P<0.05;r=-0.66,P<0.05).Conclusion Color Doppler ultrasound can non-invasively evaluate PD through hemodynamic changes of SMA.

In recent years, the incidence of pancreatic cancer shows rising trend and higher mortality. Pancreatic cancer lacks early diagnostic methods with high sensitivity and specificity, and the surgical resection rate is 10 %-20 % with high operation mortality, poor long-term curative effect and less than 5 %survival rate within 5 years. At present, researchers indicate that radiotherapy can improve the quality of life, increase tumor local control rate and prolong the overall survival time of patients with pancreatic cancer in different levels. Diffusion weighted imaging (DWI), as a functional imaging technology of magnetic resonance imaging (MRI), is the only way to react cell levels. This paper will summarize the application of DWI in radiotherapy of pancreatic cancer.

Satisfactory communication skill is the essential requirement for medical students to become future qualified medical doctors.Clinical clerkship is the key process to absorb medical knowledge and professional skill,cultivate the ability to solve practical problems in medical practice,and develop medical students into qualified doctors by guiding them to reasonably handle physician-patient relationship,better solve medical disputes,and gradually improve their legal awareness.Therefore,medical students should strengthen to cultivate their communication ability,and set up reasonable sense of physician-patient communication.

Objective To investigate the change of P300 of the attention - deficit/hyperactivity disorder children before and after they took litalin, according to this objective subject to guide the clinical treatment of ADHD children. Methods Using the looking se-ducible electricity stimulates 22 ADHD children, and check the change of latency and the rate of the wave before and after they took litalin. Results After ADHD children took litalin, their latency of P300 has decreased clearly, and the amplitude had no change. Conclusion The changes of P300 latency in ADHD children after they took litalin can be adopted as the guidelines of clinical treatment for the ADHD children.

Keratorefractive surgery changes the central corneal thickness (CCT) and corneal curvature, which could influence the Goldmann applanation tonometer (GAT) and non-contact tonometer (NCT) measurements of intraocular pressure (IOP), but not dynamic contour tonometer(DCT). During the procedure of LASIK, there is a transient rise of IOP, which increases the risks of optic nerve damage. Meanwhile, the presence of functioning filtering blebs may affect the choice and outcome of refractive surgery, or even becomes a contraindication of surgery. Steroids are typically used after keratorefractive surgery, which could lead to IOP elevation. Hence it is important to monitor IOP after LASIK and to be aware of inaccurate IOP readings due to corneal flap interface fluid. Treating patients with postoperative elevated IOP after keratorefractive surgery is similar to that for patients with glaucoma. This review will address the issues surrounding the safety, relevant complications and implications of keratorefractive surgeries on glaucoma and relevant diagnostic tests.

Adult ; Anesthesia, General ; Bronchoalveolar Lavage ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; surgery ; Ventilators, Mechanical

Objective To investigate the effects of exogenous hydrogen sulfide on brain edema and injury and their mechanisms. Methods Sixty male SD rats were randomly divided into a sham operation group, an ischemia-reperfusion group, a 30 ppm hydrogen sulfide group, and a 60 ppm hydrogen sulfide group (n =15 in each group; 1 ppm =1 mg/L). A model of focal cerebral ischemia for 2 h and reperfusion for 24 h was induced by middle cerebral artery occlusion. The neurological scores were observed after 24 h cerebral ischemia-reperfusion. The cerebral infarction volume, the degree of brain edema, and the changes of blood-brain barrier permeability were measured. Western blotting was used to detect the expressions of occludin and zonula occludens-1 protein (ZO-1) in ischemic penumbra. Results Compared with the ischemia-reperfusion group, the neurological function scores in the 30 ppm and 60 ppm hydrogen sulfide group significantly increased in a dose-dependent manner (al P <0.05) and the neurological deficits and infarct volume reduced (al P < 0.05), and the
brain edema aleviated (al P < 0.05). The content of Evans blue in the ischemic brain tissue in the ischemia-reperfusion group increased significantly compare with the sham operation group (0.74 ±0.14 μg/100 mg vs. 0.19 ±0.06 μg/100 mg; P <0.05). The content of Evans blue in the brain tissue in the 30 ppm hydrogen sulfide group (0.55 ±0.10 μg/100 mg ) and the 60 ppm hydrogen sulfide group (0.35 ±0.08 μg/100 mg ) decreased significantly compared with the ischemia-reperfusion group (al P < 0.05), among them the 60 ppm hydrogen sulfide group was significantly lower than the 30 ppm hydrogen sulfide group (P <0.05). Western blot analysis showed that expression levels of occludin in penumbra (0.621% ±0.101% vs.0.787% ±0.087% vs.0.453% ± 0.127%; P <0.05) and ZO-1 (0.602% ±0.118% vs.0.778% ±0.805% vs.0.426% ±0.146; P <0.05) in the 30 ppm and 60 ppm hydrogen sulfide groups increased significantly compared with the ischemia-reperfusion group, among them, the expression levels of occludin and ZO-1 in the 60 ppm hydrogen sulfide group were significantly higher than those in the 30 ppm hydrogen sulfide group (al P < 0.05). Conclusions Inhalation of exogenous hydrogen sulfide can significantly attenuate brain edema after ischemia-reperfusion in a dose dependent manner, reduce infarct volume, and improve neurological function.Their mechanisms may be associated with inhibiting the downregulated expressions of occludin and ZO-1 and maintaining the integrity of the blood-brain barrier.

Objective To evaluate the efficacy of ultrasound-guided obturator nerve block using proximal interfascial technique.Methods Seventy ASA physical status Ⅰ or Ⅱ patients of both sexes, aged 43-82 yr, with body mass index of 18.0-30.5 kg/m2, scheduled for elective trans-urethral resection of bladder tumor, were randomly divided into 2 groups (n =35 each) using a random number table: remote interfascial technique group (group R) and proximal interfascial technique group (group P).In group R, interfascial injections at 2 planes, lateral and deep to the adductor brevis muscle, were carried out with 0.375％ ropivacaine 7.5 ml to block each obturator nerve branch separately.In group P, 0.375％ ropivacaine 15.0 ml was injected under ultrasound guidance at the interfascial plane inferior to the superior pubic ramus (between the pectineus and obturator externus).The strength of thigh adduction was measured before injection (baseline) and at 5, 10, and 15 min after injection.Then combined spinal-epidural anesthesia was performed at L3,4 interspace.The 50％ strength reduction indicated a successful block.The block performance time was recorded.The success rate of block at 15 min after injection was calculated.It was considered clinically effective when obvious muscle twitching interfering with the surgical procedure did not appear.The clinical outcome was assessed, and the effective rate of clinical outcome was calculated.Results Compared with group R, the block performance time was significantly shortened, the success rate of block, strength reduction at 10 and 15 min after injection, and clinical outcome were increased in group P.There were no significant differences in the effective rate of clinical outcome.Conclusion Compared with remote interfascial technique, ultrasound-guided obturator nerve block using proximal interfascial technique provides easier and rapid procedure, higher success rate of block and better clinical outcome of block.

Objective To study the therapeutic effects of extracorporeal shock wave therapy (ESWT) on temporomandibular joint disorders (TMDs).Methods Sixty patients with a temporomandibular joint disorder were randomly divided into an ESWT group and a control group,each of 30.Both groups were given routine rehabilitation training,but the treatment group additionally received ESWT for 2 weeks.Fricton's index was used to evaluate temporomandibular joint function.The subjects used a visual analogue scale (VAS) to evaluate their pain levels.The SF-36 scale was applied to assess their life quality.Results After two weeks of treatment,the average assessment score and VAS score had decreased significantly in both groups.After treatment the average scores for mandibular movement,muscle palpation,joint noise and joint palpation,and the palpation,dysfunction and craniomandibular indexes were all significantly lower in the ESWT group than in the control group.Significant differences were also found in the average VAS scores and on the social functioning domain of the SF-36 between the ESWT group and the control group.Conclusion ESWT combined with rehabilitation training can significantly relieve the symptoms and pain of TMDs.

Objective To analyze the clinical characteristics and therapy of Nocardia infection, and provide reference for clinical practice.Methods Patients with positive specimen culture of Nocardia from May 2014 to June 2016 were surveyed retrospectively, the body status, clinical features, therapeutic regimen, and prognosis were analyzed.Results A total of 10 cases of Nocardia infection were surveyed, there were 7 males and 3 females;average age was (49.90+13.75) years old.Nocardia infection occurred mostly in population with impaired immune status or underlying diseases, the main infection site was lung, compound sulfamethoxazole was the first choice drug for treatment of infection, amikacin, imipenem/cilastatin and so on were alternative choice according to disease condition, 8 patients all improved after therapy.Conclusion The diagnosis made on the basis of microbiological examination, imaging, and pathological examination, combined with comprehensive judgment according to risk factors of Nocardia infection, patient can be treated timely and rationally, and the prognosis is better.