Background and purpose:Solitary plasmacytoma of bone(SBP) is a rare disease,reports releveant to this disease are rarely seen. The purpose of this study was to investigate the relation between the clinical features and the prognosis of solitary plasmacytoma of bone. Methods:We reviewed the data of 12 patients diagnosed with solitary plasmacytoma of bone from 1998 to 2007 in Peking University third hospital,the clinical features,treatment and prognosis of the patients were analyzed retrospectively. Results:The age ranged from 37-71 years(mean 49.6 years) ,the male/female ratio was 3 to 1. Immunophenotype analysis showed that 11(91.6%) cases were positive for CD79a,10(83.3%) positive forVS38C,and all negative for CD20. With 12 to 87 months follow-up(average 40?22 months) ,three cases(33%) developed to multiple myeloma,two of them died from infection,the median survival time was 73 months,the 3 year and 5 year survival rate were 90 percent and 75 percent respectively. Conclusion:Middle and old male are more likely to develop SP. The prognosis is good,but some of them can progress to multiple myeloma.

Objective This paper focuses on the nursing cooperation and administration related problems on endovascular repair for abdominal aortic aneurysm carried out in the one-stop hybrid operating rooms. Methods By analyzing and concluding 41 endovascular aneurysm repair operations, some nursing and administration experience was accumulated. Results According to the advantages of one-stop hybrid operating rooms, outstanding professional nursing staff were arranged to nurse and administrate before, during and after the operating procedure, which could ensure the quality and effectiveness of the endovascular aneurysm repair surgery. Conclusions Reasonable disposition of human resources, scientific management of nursing and delicate operating cooperation will be the crucial factors of hybrid surgery.

Objective To study the features of CT and MRI diagnosis of intracranial germ cell tumors ,and to improve the un-derstanding of its imaging findings .Methods Fifteen cases of intracranial germ cell tumors proved by pathology and follow-up were retrospectively analyzed .Results Among the 15 cases with intracranial germ cell tumors ,9 cases in pineal body , tumours showed like-round masses,the margin of the masses were well defined .CT was slightly high density,MRI revealed isointense or hypointense signals on T1 weighted and homogeneous hyperintense signals on T 2 weighted image without edema around tumors and homogeneous en-hancement.One cases in CSF spread.Four cases were identified in the saddle-up area, among the 2 cases was cystic,1 cases was sol-id-cystic and 1 cases was solid,CT was isointense or high density in solid,low density in cystic,without edema around tumors.MRI re-vealed slight-hypointense signals on T 1 weighted and hyperintense signals on T 2 weighted image clearly enhanced in solid , cystoid with-out enhance .In the other 2 cases of intracranial germ cell tumors in the basal ganglia region ,CT was inhomogeneous high density ,inho-mogeneous signals on T2 and T1 weighted image, inhomogeneous enhancement .Conclusions Intracranial germ cell tumors show char-acteristic manifestations on CT and MRI,according to location,shape,signal,age characteristic,which is helpful in diagnosis and differ-ential diagnosis and guide treatment plan .

Objective To assess the effect and feasibility of group reminiscence therapy on depression in the elderly.Methods We searched the Cochrane Central Register of Controlled Trials (-2013),Medline (1982-2013),Embase (1974 2013),AMED (-2013),CINAHL(-2013),CMB (1994-2013),VIP,CNKI and Wanfang to collect the randomized controlled trials (RCTs) in which the group reminiscence therapy was used to treat depression in elderly patients.The studies were selected according to the inclusion and exclusion criteria by two reviewers,and the quality of included studies was evaluated according to Cochrane Handbook and performed meta analyses by using the Cochrane Collaboration's RevMan 5.2 software.Results A total of 10 RCTs involving 944 patients were included.The results of meta-analysis showed that as compared with conventional treatment,group reminiscence therapy on the basis of conventional treatment was more effective in decreasing depression score [MD=-4.86,95 ％ C I(-5.10,-4.65)].Compared with psychological counseling,group reminiscence therapy had more effect on decreasing depression score [MD=-9.34,95％ CI (-10.77,-7.91)].There was no significant difference in the dropout rate between group reminiscence therapy and other control treatments [RR=1.22,95％ CI (0.79-1.88)].The descriptive analysis showed that group reminiscence therapy was effective in alleviating the symptoms of depression.Conclusions Group reminiscence therapy can improve the symptoms of depression in elderly patients and conforms to the principle of economic benefit.However,the results should be interpreted with caution because of the low quality of the included studies.

OBJECTIVETo explore the effect of acupuncture-anesthetic composite anesthesia (AACA) on the incidence of postoperative cognitive dysfunction (POCD) and changes of TNF-alpha, IL-1beta, and IL-6 in elderly patients.

METHODSTotally 83 patients undergoing surgical resection of gastrointestinal tumor were randomly assigned to the simple anesthesia group (A group, 41 cases) and the AACA group (B group, 42 cases). Patients in Group A received endotracheal general anesthesia. Those in Group B were induced by acupuncture anesthesia for 30 min by needling at Baihui (DU20), Neiguan (PC6), Zusanli (ST36). The electro-acupuncture (EA) apparatus was connected after arrival of qi, with the wave pattern of density 2/100 Hz. The stimulus intensity was set by patients' tolerance, with the peak current of 5 mA. Then the endotracheal general anesthesia was performed and the EA lasted till the end of the surgery. The cognitive function of all patients was assessed before operation and at day 3 after operation using mini-mental state examination (MMSE). POCD was confirmed if with one or more decreased stand- ard. The peripheral venous blood was collected before anesthesia induction (TO), immediately at the end of surgery (T1), 24 h after operation (T2), and 48 h after operation (T3), and serum concentrations of IL-1beta, IL-6, and TNF-alpha were correspondingly measured using ELISA.

RESULTSThe postoperative anesthesia awakening time was shorter in Group B than in Group A [(20.37 +/- 6.09) min vs (29.24 +/- 7.48) min, P < 0.05]. The remifentanil dose used during the operation was less in Group B than in Group A (P < 0.05). The incidence of POCD at day 3 was lower in Group B than in Group A [10/41 (23.8%) vs 15/42 (36.5%), P < 0.05]. The concentrations of IL-1beta, IL-6, and TNF-alpha at T1-T3 were higher than those at TO in the two groups (P < 0.05). The increment of TNF-alpha and IL-1beta was less in Group B than in Group A (P < 0.05). CONCLUSION AACA could reduce the incidence of POCD and inhibit postoperative release of TNF-alpha, IL-1beta, and IL-6 in elderly patients undergoing colorectal cancer resection.

Acupuncture Analgesia ; Aged ; Cognition Disorders ; etiology ; prevention & control ; Gastrointestinal Neoplasms ; surgery ; Humans ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Postoperative Complications ; prevention & control ; Tumor Necrosis Factor-alpha ; blood

Objective To assess the causes of sildenafil failure and the feasibility of successfully rechallenging non-responding patients. Methods A total of 126 consecutive erectile dysfunction (ED) patients from Jan 2009 to Dec 2009 who claimed poor response to sildenafil (sildenafil 100 mg on demand, at lease 4 epiodes) were enrolled into the study. All patients received sexual reeducation and were treated with sildenafil, taken on a daily dose of 50 mg for 4 weeks. The International Index of Erectile Function-5 (IIEF-5), Rigiscan, serum testosterone or penile Doppler were used to evaluate ED and the cause of on-demand sildenafil failure. End point efficacy of rechallenging was evaluated using the IIEF-5 and the sexual encounter profile (SEP) 'Were you able to insert your penis into your partner's vagina?' and 'Did your erection last long enough to achieve successful intercourse?'. Results The recruited patients comprised of 41 cases with psychological ED, 39 cases with hypogonadism ED, 28 cases with diabetes mellitus ED and 18 cases with vascular ED. Compared with pretreatment and on-demand sildenafil baseline, daily administration of sildenafil significantly enhanced all efficacy outcome variables. The IIEF-5 was significantly improved after daily sildenafil (12.3 ± 2.9 vs18. 8±4.4, P＜0.01), 78 patients responded to daily sildenafil. The overall salvage rate was 61.9%(78/126). Conclusions Sexual reeducation and daily administration of sildenafil may be able to salvage many patients with ED who were sildenafil non-responders.

Objective To estabalish a new conception, Erectile Dysfunction-no sexual life (ED-NS), so as create an evaluating questionnaire, Self-estimation Index of erectile function-No sexual life (SIEF-NS) so as to investigate its clinical reliability. Methods The conception of ED-NS was identified and the SIEF-NS questionnaire was established. Patients who complained of ED-NS and normal controls were enrolled into the research and assessed the erectile function was assessed with SIEF-NS.The SIEF-NS includes 12 questions, such as sexual libido, general erectile function, nocturnal penile erection, erectile function during foreplay, erectile function during audio-video sexual stimulation,confidence, depression, etc and each question has 5 point scales. Results Sixty-one ED-NS patients and 57 controls were enrolled into the study and assessed erectile function with SIEF-NS. The mean score of each question and integral score of SIEF-NS in ED-NS patients were significantly different from normal controls (P＜0. 05). When the integral score was 35 points according to the ROC curve of integral score, the sensitivity of SIEF-NS was 88.5% and specificity was 96. 5%. Conclusions ED-NS is a new conception to define patients who have erectile dysfunction without sexual life. SIEFNS is suggested to be a useful method for the evaluation of ED-NS patients.

ObjectiveTo assess the cause of tadalafil failure and the feasibility of successfully rechallenging nonresponding patients.Methods A total of 80 consecutive erectile dysfunction ( ED ) patients who claimed poor response to tadalafil were enrolled into the study.A self-administered tadalafil-use questionnaire composed of eight questions was applied to assess how they had used tadalafil.Subjects were given thorough instruction based on individual answers and four doses of tadalafil 20mg.After a 2-week follow-up,end point efficacy of rechallenge was evaluated using the sexual encounter profile (SEP),which was recommended by international advisory panel in 2004.ResultsA total of 45 subjects had one or more areas of major suboptimal use of tadalafil:21.2％ did not know that sexual stimulation was necessary for tadalafil to work,87.5％ attempted to use tadalafil less than four times,57.5％ took a maximal dose less than 20 mg,and 84％ felt nervous or anxious.Of the 65 patients undergoing tadalafil rechallenge,30 patients answered “yes” to SEP2 and SEP3.The response rate to rechallenge was 46.2％ ( 30/65 ).ConclusionsInappropriate use of tadalafil was major cause of tadalafil non-pesponse.The efficacy of tadalafil could be improved to a better extent by education of patients.

Objective To explore the pharmacodynamic action of the extract from raw materials of Rhizoma Anemarrhenae and Cortex Phellode ndri, a classic herb pair in traditional Chinese medicine, on mice with diabetic peripheral neuropathy(DNP). Methods The mice were administrated with intraperitoneal injection of streptozotocin (STZ, 30 mg/kg) and fed with high-fat diet to establish the DNP mouse model. One hundred and sixty male C57BL/6j mice were divided into normal group, model group, metfomin group(130 mg/kg), Xuezhikang group(200 mg/kg), high- and low-dose Rhizoma Anemarrhenae extract group(360, 90 mg/kg) , high-and low-dose Cortex Phellodendri extract group(135, 45 mg/kg), 20 mice in each group. The medication lasted for 24 weeks. On medication week 8, 16 and 24, the plasma levels of glucose (GLU), total cholesterol (TC), triglyceride(TG), low density lipoprotein-cholesterol(LDL-C) and insulin(INS) were determined respectively. On medication week 10, oral glucose tolerance test(OGTT)was carried out. On medication week 24, the plasma nuclear factor kappa B(NF-κB) activity and the plasma levels of transforming growth factor-beta 1(TGF-β1), superoxide dismutase(SOD) and reduced glutathione(GSH) were detected. Results Five weeks after injection of STZ, the body mass of the model group was firstly increased and then decreased, and FBG was increased(P<0.05 compared with the normal group). Compared with the normal group, FBG, TC, TG, LDL-C and INS levels were increased(P<0.01 or P<0.001), plasma NF-κB activity, TGF-β1 and SOD levels were enhanced, and GSH level was decreased in the model group, the difference being statistically significant (P<0.01 or P<0.001). Contrasted with the model group, FBG, TC, TG, LDL-C and INS levels in high-and low-dose Rhizoma Anemarrhenae extract group and in high-and low-dose Cortex Phellodendri extract group were decreased to various degrees. After continuous medication, plasma NF-κB activity and TGF-β1 and SOD levels in high-dose Rhizoma Anemarrhenae extract group and in high-dose Cortex Phellodendri extract group were reduced(P<0.05 or P<0.001), and plasma GSH level was increased(P<0.01). Conclusion Extract from raw materials of Rhizoma Anemarrhenae and Cortex Phellodendri has obvious hypoglycemic effect and protective effect on experimental mice with DPN.

Objective To investigate the effects of ropivacaine infiltration combined with dezocine on the agitation during recovery from general anesthesia in the patients undergoing cerebral surgery.Methods Sixty patients of both sexes,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,undergoing elective neurosurgery under general anesthesia,were randomly divided into 4 groups (n =15 each) using a random number table:control group (group C),ropivacaine group (group R),dezocine group (group D),and ropivacaine + dezocine group (group RD).Group C received local infiltration with normal saline 20 ml at 10 min before skin incision,and normal saline 2 ml was injected intravenously at 30 min before the end of operation.The patients received local infiltration with 0.5％ ropivacaine 20 ml at 10 min before skin incision,and normal saline 2 ml was injected intravenously at 30 min before the end of operation in group R.Group D received local infiltration with normal saline 20 ml at 10 min before skin incision,and dezocine 10 mg was injected intravenously at 30 min before the end of operation.The patients received local infiltration with 0.5％ ropivacaine 20 ml at 10 min before skin incision,and dezocine 10 mg was injected intravenously at 30 min before the end of operation in group RD.The time for recovery from anesthesia,extubation time,and development of agitation after extubation in PACU were recorded.Agitation was assessed and scored.Ramsay sedation score and VAS score were recorded immediately after extubation.The development of cardiovascular events and respiratory depression was recorded within 10 min after extubation.Before induction of anesthesia (T0),at the end of surgery (T1) and immediately after extubation (T2),blood samples were collected from the dorsal artery of foot for deter mination of the levels of blood glucose,plasma cortisone,epinephrine and norepinephrine.Results Compared with group C,the agitation score,incidence of agitation,VAS score,and incidence of postoperative hypertension were significantly decreased in R,D and RD groups,especially in R and D groups.The time for recovery from anesthesia and time for extubation were significantly shorter in R and RD groups than in group C.Ramsay sedation scores were significantly higher at the onset of extubation in R,D and RD groups than in group C.Ramsay sedation scores were significantly higher in D and RD groups than in group R.Compared with group C,the levels of blood glucose,plasma cortisone,epinephrine and norepinephrine were significantly decreased in R,D and RD groups,especially in group RD.Conclusion Ropivacaine infiltration combined with dezocine can reduce the agitation during recovery from general anesthesia in the patients undergoing cerebral surgery.