Objective To investigate the computer tomography (CT) and magnetic res-onance imaging (MRI) features of posterior reversible encephalopathy syndrome (PRES) caused by pregnancy-indueed hypertension (PIH). Methods CT scan and MRI scan + diffusion-weighted imaging (DWI) were used in 31 patients with PIH. Results CT scan found low density lesions in parietal-occipital lobe of watershed regions in 31 patients with PIH. CT value was 19 to 23Hu. Among them, MRI showed slight hypointensity lesions on T1-weighted images and slight hyperintensity lesions on T2-weight images in 11 patients, fluid-attenuated inversion recovery (FLAIR) sequence showed hyperintensity lesions, DWI revealed isointense, and apparent diffusion coefficient- did not decrease. The recovery time of clinical symptoms was earlier than that of MRI. Conclusions The lesion sites on cr and MRI had certain characteristics in PIH occurred PRES at late pregnancy, combining clinical history a clear diagnosis could be made.

OBJECTIVE: To explore the three-dimensional ultrasound locatization in endoscopic thyroidectomy for multinodular goiter (MG). METHOD: Thirty two patients with MG underwent ET via bilateral areolar approach. Preoperative ultrasonography were used to locate lesions and marked in the 3-D map designed by us. Dur ing ET procedure, surgery skills were adopted to expose inferior pole of thyroid, glands in the area of Berry ligament or (and) upper pole were retained according to the preoperative location map. RESULT: According to the preoperative ultrasonic orientation, 3 lobectomy were performed in 15 cases of unilateral lesions, 12 subtotal thyroidectomy were performed in 17 cases of bilateral lesions, and 5 patients performed unilateral lobectomy add partial thyroidectomy. All patients had successful ET using bilateral areola approach. No conversions to open surgery, no complication occurred, and no nodules were found missing in the postoperative ultrasonography examinations. CONCLUSION Preoperative ultrasonic orientation and intraoperative operating skills are contributing to a successful ET for MG.
Adolescent ; Adult ; Aged ; Endoscopy ; methods ; Female ; Goiter, Nodular ; diagnostic imaging ; surgery ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Thyroidectomy ; methods ; Ultrasonography ; Young Adult

ObjectiveTo establish a new,rapid,and reliable reversed-phase ultra performance liquid chromatography (RP-UPLC) method for the simultaneous determination of six quaternary ammonium alkaloids (QAAs) in Coptidis Rhizoma.MethodsThe effect of different experimental parameters on the analysis of QAAs by RP-UPLC was evaluatcd.ResultsOptimal resolution was achieved with an Acquity UPLC BEH C18 column using a gradient elution profile and a mobile phase consisting of water spiked with 10 mmol/L ammonium bicarbonate (A,pH adjusted to 10.0 by ammonia water) and acetonitrile (B),at a flow rate of 0.30 rnL/min and wavelength of 345 nm.The column temperature was set at 30 ℃.The proposed method was found to be reproducible,precise,and rapid according to the method validation.Conclusion The proposed method,which is compatible with MS analysis and the preparation of QAA,provides some helpful insights into the quality control of Coptidis Rhizoma.

Obejective To explore the effect of combined use of dexmedetomidine and ultra-low dose naloxone on postoperative hyperalgesia induced by remifentanil. Method 80 ASA gradeⅠ-Ⅱ female patients who were scheduled to perform endoscopic sinus surgery (ESS) were randomly divided into four groups: purely remifentanil group (group R) and remifentanil plus different dosage dexmedetomidine and ultra-low dose naloxone group (group RDN1 ~ RDN3). Then the postoperative VAS on 30 min, 1 h, 2 h, 4 h, 8 h, 12 h and 24 h together with the firstpostoperative pain time , PCA press numbers , fentanyl usage and adverse reaction rate were recorded and evaluated. Results Average VAS of group R are higher than other groups in all 7 time points at the adjusted significant level of 0.0083, and group R > group RDN1 > group RDN2 > group RDN3, while differences between group RDN2 and RDN3 in all time points are not statistical significant.There is no difference between group RDN1 and group RDN2 inthe first postoperative pain time and the PCA press time at 1h after operation. Difference between group RDN2 and group RDN3 in the PCA press time at 24 h after operation was not significant, and the fentanyl usage of RDN groups are significantly less than group R. Conclusions Combined use of dexmedetomidine and ultra-low dose naloxone induced by remifentanil can improving patients′postoperative hyperalgesia , effect increase with the dose of dexmedetomidine increas , and the increasement is more sensitive in acute pain.

OBJECTIVETo explore etiologic fraction (EF) and interaction of hepatitis B virus (HBV) infection and other risk factors for primary hepatocellular carcinoma (PHC) in Guangxi, China.

METHODSA hospital-based case-control study including 500 PHC patients and 500 nontumorous patients was carried out in Guangxi. EF and interactions of HBV infection and other risk factors for PHC were analyzed by crossover analysis and nonconditional multiple logistic regression.

RESULTSHBV infection, family history of PHC, diabetes mellitus, eating raw fish, heavy alcohol consumption, frequently used drug, low income, mental oppression and blood type B all were risk factors for PHC. With EFs of 0.725, 0.186, 0.119, 0.486, 0.385, 0.438, 0.277, 0.607, 0.299, respectively and with etiologic fractions attributable to interaction [EF(A xB)] of 0.736, 0.643, 0.849, 0.551, 0.592, 0.618, 0.902, 0.577; and indices of interaction of 0.743, 0.651, 0.853, 0.560, 0.600, 0.626, 0.907, 0.586, respectively.

CONCLUSIONMain risk factors for PHC might include HBV infection, family history of PHC, diabetes mellitus, eating raw fish, heavy alcohol consumption, frequently used drug, low income, mental oppression and blood type B. HBV infection with other risk factors might exert synergistic action on developing PHC and increase the risk of PHC.

Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular ; etiology ; China ; epidemiology ; Data Interpretation, Statistical ; Female ; Humans ; Liver Neoplasms ; etiology ; Male ; Middle Aged ; Risk Factors

OBJECTIVETo explore the relationship between clonorchiasis and primary hepatocellular carcinoma (HCC) and analyze the synergistic actions of HBV infection, alcohol consumption and clonorchiasis on HCC development.

METHODSThis hospital-based case-control study was conducted among 444 HCC patients (cases) and 500 non tumor patients (controls) to compare the prevalence of clonorchiasis in the cases and the controls. The risk of clonorchiasis and the synergistic actions between HBV infection, alcohol consumption and clonorchiasis on HCC development were analyzed by crossover analysis and multiple logistic regression.

RESULTSThe prevalence of clonorchiasis in the cases (16.44%) was much higher than that of the controls (2.40%) (X2 = 56.58, P less than 0.01). In the case group, the OR value of those with clonorchiasis was 8.00 (95% CI: 4.34-14.92). The OR value was 4.82 (95% CI: 2.32-10.26) for the subjects whose clonorchiasis was diagnosed less than 10 years before their diagnosis of HCC, and was 17.54 (95% CI: 5.47-57.18) for those whose HCC was diagnosed more than 10 years ago. HBV infection, alcohol consumption and clonorchiasis showed an additive interaction in the development of HCC, with a relative excess risk of interaction of 110.43 and 18.23; attributable proportion of interaction of 0.80 and 0.63; synergy index of 5.18 and 2.84, respectively.

CONCLUSIONClonorchiasis could be an important risk factor for HCC. When the course of clonorchiasis is prolonged, the risk of HCC could increase. HBV infection, alcohol consumption and clonorchiasis might have synergistic actions on the development of HCC.

Adolescent ; Adult ; Aged ; Animals ; Carcinoma, Hepatocellular ; parasitology ; Case-Control Studies ; Clonorchiasis ; Clonorchis sinensis ; isolation & purification ; Female ; Humans ; Liver Neoplasms ; parasitology ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Young Adult

OBJECTIVETo study the correlation of eating raw fish with primary hepatic carcinoma (PHC), and to investigate the synergistic effect of HBV infection, alcohol consumption and eating raw fish on the oncogenesis of PHC.

METHODSA hospital-based case-control study was conducted among 500 PHC patients and 500 non-cancerous patients in order to compare the history of eating raw fish. The synergistic pathogenetic action of eating raw fish, HBV infection and alcohol consumption on carcinogenesis of PHC was analyzed by crossover analysis and multiple logistic regression.

RESULTSThe rates of eating raw fish in the past between the case (54.8%) and the control group (8.4%) were significantly different (P < 0.001). OR value of suffering PHC in the patients who ate raw fish in the past was 13.6 (95% CI: 9.1-19.5) when compared with the non-cancerous patient. HBV infection, alcohol consumption and eating raw fish showed an interactive effect on the development of PHC, with a relative excessive risk of interaction(RERI) of 195.3 and 17.8; attributable proportion of interaction (API) of 0.8630 and 0.5251; and synergy index (S) of 7.5 and 2.8, respectively.

CONCLUSIONA history of eating raw fish may be an important risk factor for suffering primary hepatic carcinoma. HBV infection, alcohol consumption and eating raw fish may have a synergistic effect on the developing of primary hepatic carcinoma.

Adolescent ; Adult ; Aged ; Alcohol Drinking ; Animals ; Carcinoma, Hepatocellular ; epidemiology ; etiology ; virology ; Case-Control Studies ; China ; epidemiology ; Eating ; Female ; Fishes ; Hepatitis B ; Humans ; Liver Neoplasms ; epidemiology ; etiology ; virology ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Risk Factors ; Seafood ; Young Adult

The aim of the present study was to study the effect of β-estradiol (β-E(2)) on the large-conductance Ca(2+)-activated potassium (BK(Ca)) channel in mesenteric artery smooth muscle cells (SMCs). The mesenteric arteries were obtained from post-menopause female patients with abdominal surgery, and the SMCs were isolated from the arteries using an enzymatic disassociation. According to the sources, the SMCs were divided into non-hypertension (NH) and essential hypertension (EH) groups. Single channel patch clamp technique was used to investigate the effect of β-E(2) and ICI 182780 (a specific blocker of estrogen receptor) on BK(Ca) in the SMCs. The results showed the opening of BK(Ca) in the SMCs was voltage and calcium dependent, and could be blocked by IbTX. β-E(2) (100 μmol/L) significantly increased open probability (Po) of BK(Ca) in both NH and EH groups. After β-E(2) treatment, NH group showed higher Po of BK(Ca) compared with EH group. ICI 182780 could inhibit the activating effect of β-E(2) on BK(Ca) in no matter NH or EH groups. These results suggest β-E(2) activates BK(Ca) in mesenteric artery SMCs from post-menopause women via estrogen receptor, but hypertension may decline the activating effect of β-E(2) on BK(Ca).
Aged ; Estradiol ; analogs & derivatives ; pharmacology ; Female ; Humans ; Hypertension ; physiopathology ; Large-Conductance Calcium-Activated Potassium Channels ; agonists ; metabolism ; physiology ; Mesenteric Arteries ; metabolism ; physiology ; Middle Aged ; Muscle, Smooth, Vascular ; cytology ; metabolism ; physiology ; Patch-Clamp Techniques ; Postmenopause ; physiology ; Receptors, Estrogen ; antagonists & inhibitors

Objective To observe the effect of self-made digestive decoction of Traditional Chinese Medicine (TCM) in supplying nutrition and preventing complications for severe head injured patients who accept early enteral nutrition support.Methods 46 patients with head severe injury were divided into two groups:study group and control group,with each group having 23 patients.The patients in both groups were given by enteral nutrition support.The patients in study group were fed with self-made digestive decoction of Chinese medieine accompanied with the early enteral nutrition.The calorie of the enteral nutrition after having been injuried for 7 days,as well as pre-albumin,transferrin,blood sugar,and electrolyte level,was compared.In addition,the occurrence rate of complications was recorded.Results Compared to the control group,on 7th day,patients in the study group had higher calories through absorption.And also compared to the control group,patients in the study group did not complained for the occurrence of constipation,and had lower incidences of diarrhea and abdominal distension.In the study group,pre-albumin and transferrin increased signifieanfly,exhibiting a statistical difference.Conclusions Digestive decoction of Chinese medicine acting on stomareh can help to improve the recovery of nutritional status of patients and reduce the related complications among patients.

Objectlve To detect the KChIP2 mRNA level in rheumatic heart disease patients with or without atrial fibrillation (AF) by real-time PCR.Methods Right atrial appendage samples from rheumatic heart disease patients with (n=17) or without AF (n=13) were obtained during cardiac surgery.Total RNA was extracted from the atrial tissues.and the KChIP2 and Kv4.3 mRNA were detected by SYBR Green I real-time PCR with the GAPDH as the house keeping gene.Result The ratio of KChIP2/GAPDH(0.1468 ±0.0452 VS.0.2200±0.0388,P＜0.01)and the ratio of Kv4.3/GAPDH(0.3946±0.1826 vs.0.5257±0.1427.P＜0.05)were significantly lower in AF patients compared to non-AF patients.Conclusion Down-regulated atrial KChIP2 and Kv4.3 mRNA expressions in rheumatic heart disease patients with chronic AF might be one of the molecular bases responsible for the down-regulation of the Ito current density of AF.