Objective To evaluate the safety and feasibility of ketamine-propofol mixture anesthesia for 85 children with congenital heart disease undergoing cardiac catheterization.Methods Eighty-five children with congenital heart disease undergoing cardiac cathete-rization were randomly divided into ketamine group(K group,n=44)and ketamin-propofol group(KP group,n=41).K group:1 mg?kg-1 ketamine was injected intravenously and then infused at 50 ?g?kg-1?min-1 for anesthesia maintenance.KP group:anesthesia was induced with ketamine 1 mg?kg-1 and propofol 1 mg?kg-1 intravenously,and maintained by continuous infusion of ketamine(16.7 ?g?kg-1?min-1)and propofol(33.3 ?g?kg-1?min-1).Electrocardiogram,blood pressure,pluse,respiratory frequency,saturation of blood oxygen were continously monitored.Results Hemodynamic and respiratory function were stable in both 2 groups.Ketamine consumption in K group was significantly more than that in KP group[(52.1?2.8)?g?kg-1?min-1 vs(25.3?7.3)?g?kg-1?min-1],eye opening time and recovery time were also longer in K group than those in KP group [(50.2?16.5)min vs(40.4?18.3)min].Conclusion The ketamine-propofol mixture was a safe,efficacy anesthesia with excellent recovery in children with congenital heart disease undergoing cardiac catheterization.

Adolescent ; Adult ; Aged ; Chromogranin A ; metabolism ; Female ; Gastrointestinal Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Neuroendocrine Tumors ; metabolism ; pathology ; Pancreatic Neoplasms ; metabolism ; pathology ; Synaptophysin ; metabolism ; Young Adult

BACKGROUND: Incidence rate of cervical osteoarthritis in the middleaged and elderly is high. Some researches on risk factor causing cervical osteoarthritis have been performed abroad, but most of the factors are being discussed.OBJECTIVE: To investigate the occurring cervical osteoarthritis risk factors in the middle-aged and elderly from different regions of China and provide evidences for prevention and intervention of cervical osteoarthritis in community.DESIGN: Cross-sectional study.SETTING: Beijing Hospital, Ministry of Health, together with Second Hospital of Xi'an Jiantong University, Institute of Integrated Traditional and Western Medicine of Hebei Medical University, Shanghai Huadong Hospital, Nanfang Hospital, Second Affiliated Hospital of Harbin Medical University, West China Hospital of Sichuan University.PARTICIPANTS: The investigation was conducted from July to August2005. On the basis of stratified multi-stage cluster sampling method, 6 218formal registered permanent residents of over 40 years old from Xi'an,Shijiazhuang, Shanghai, Guangzhou, Harbin and Chengdu were enrolled.They all agreed to join the investigation voluntarily. There were 2 916males of 40-94 years and 3 302 females of 40-86 years.METHODS: Questionnaire investigation of epidemiology of cervical osteoarthritis was performed in the testees, and radiograph was used in the persons with clinical symptom. The basic sample unit was neighborhood committee (city) and village committee (countryside). Sampling method:Taking each city as a whole, composed of two levels, namely city and countryside, in the first phase the persons were extracted from district (county),in the second phase from sub-district (countryside), in the third phase from neighborhood committee (village eommittee). Diagnosis standard of cervical osteoarthritis was positive clinical symptom and 2 grade or above of radiograph Kellgren & Lawrence grading. The content of questionnaire contained 6 aspects: general condition, history of present illness, history of past illness, physical check-up, radiographs and disease diagnosis, totally94 questions and 141 variation indexes. Influential factors of prevalence rate of cervical osteoarthritis were analyzed using multifactor non-conditional Logistic regression analysis. Odds ratio (OR) was used for expressing index of strength of relationship between disease and exposures. If OR ＞ 1,it was indicated that there was positive correlation between disease occurrence and exposures. If OR ＜ 1, it was suggested that there was negative correlation between disease occurrence and exposures.MAIN OUTCOME MEASURES: Prevalence rate of cervical osteoarthritis in each city and OR.RESULTS: Totally 6 218 investigational subjects were included in the result analysis, without drop out. ①Total prevalence rate of cervical osteoarthritis in population of 40 years or above from 6 domestic cities was23.6%. There was significnat difference of prevalence rate in each city (P＜0.01). ②Result of Logistic regression analysis: Age (OR=1.010-1.058),defecation with squat ting pot (OR =1.024-1.997) and history of hypertension (OR =1.815-3.078) were common risk factor in most areas. In northern area the common risk factor compos ed of daily stair climbing or grade climbing (OR =1.018-1.020), while drinking colored wine (OR=3.451, Xi'an), history of osteoarthri tis of father (OR =2.491, Xi'an), history of diabetes (OR =5.013, Shijiazhuang), history of osteoarthritis of mother (OR =2.045, Shanghai), smoking (OR =6.857, Guangzhou), age of starting drinking (OR =3.044, Guangzhou) and full-time athletic sports (OR=9.020, Harbin), etc. emerged in different areas.CONCLUSION: The onset of cervical osteoarthritis has the same risk factor in 6 domestic areas, and main risk factor in different areas has certain differences, which can provide reference data for the prevention and cure of cervical osteoarthritis for the future and reduce waster of medical resources.

Objective To explore the methods and clinical value of transrectal ultrasound (TRUS) in detecting rectal gastrointestinal stromal tumor(GIST) with head scanning probe.Methods A total of 12 patients had the ultrasonic examination through the rectum with the head scanning probe.Preoperative ultrasonic findings were compared with the pathological results.Results Of the 12 patients,the patients were divided into three groups,including 3 cases with low-degree severity,6 cases with moderate-degree severity and 6 cases with high-degree severity.The lymph node metastasis was not found near intestines.Rectal GIST appeared as a hypoechoic mass with clear limit、regular form and expanded growth under TRUS.The CDFI showed abundant flow in the tumor and TRUS had an overall accuracy rate of 75.0%(9/12)in the diagnosis of rectal GIST.The accuracy of TRUS in the staging diagnosis of rectal GIST was 83.3%(10/12).Conclusion The TRUS with the head scanning probe is of great value for pre-operative diagnosis and staging of rectal GIST.Rectal water window and felicitous check-up technique can enhance the accuracy of TRUS.

OBJECTIVETo investigate the effect of local administration of recombinant adenovirus of human adiponectin (hAPN) Ad-hAPN-EGFP on tibial defect repair of SD rats.

METHODSTibial defect (2 mm) models of 36 SD rats (72 sides) were randomly divided into three groups (A, B, and C; n=24). The three groups were injected with Ad-hAPN-EGFP, Ad-EGFP, and normal saline, respectively, during operation and the day after operation. A week after the operation, the expression of hAPN and osteogenesis-related factors were detected by real-time polymerase chain reaction. Three weeks after operation, the tibias were examined by micro-computed tomography, hematoxylin-eosin staining, and Masson staining to evaluate the restoration of bone defects.

RESULTS1) The hAPN expression was detected in group A but not in groups B and C. Osteogenesis-related factors expression of group A was significantly higher than that of the other groups (P<0.05). 2) Osteogenesis (including bone mineral density, relative bone volume, trabecular number and trabecular thickness) in group A were more evident than those in groups B and C (P<0.05). No significant differences were found between groups B and C (P>0.05).

CONCLUSIONLocal administration of recombinant adenovirus Ad-hAPN-EGFP may be an effective strategy to improve the restoration of bone defects in vivo.

Adenoviridae ; Adiponectin ; Animals ; Bone Density ; Bone and Bones ; Humans ; Osteogenesis ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; X-Ray Microtomography

Iridoid glycosides were the main active ingredient of Rehmannia glutinosa, of which catalpol has the highest content. This work will provide theoretical basis for metabolic study and cultivation of iridoids on the basis of the dynamic accumulation of catalpol and total iridoids in the growth of R. glutinosa. The samples of rehmannia 85-5 were gathered in the same filed from July to October. The contents of catalpol and total iridoid glycosides were measured by HPLC and specteophotometric, respectively. The results showed that youngest leaves had the higher content of catalpol and total iridoid glyosides than that of the other two leaf ages in the same growth stage from July to September, while their content of catalpol and total iridoid glycosides were all decreased as the growth of leaves of R. glutinosa. The content of catalpol didn't differ significantly from July to September, whereas it has significantly increased in October in the three leaf stage. In the same stage, the wider the root diameter is, the higher content of the effective components are. In August and September, the total iridoid glycosides have the fastest accumulation. The content of catalpol was increased as the accumulation of total iridoid glycosides.
Iridoid Glucosides ; metabolism ; Iridoids ; metabolism ; Plant Roots ; metabolism ; Rehmannia ; growth & development ; metabolism ; Seasons ; Water ; metabolism

Objective:To carry out preoperative nutritional risk screening for inpatient to understand their nutritional risk status,and to explore the relationship between postoperative nutritional support and related clinical outcomes.Methods:A total of 378 patients in the Third Ward of Department of General Surgery,the Second Affiliated Hospital of Shantou University,completed NRS 2002 scoring within 48 h after admission.The patients with NRS scores more than 3 points were judged to have nutritional risk,and they were divided into nutrition support group (114 cases) and non-nutrition support group (60 cases) according to whether or not to accept the nutrition support.According to the doctor's advice,the data of nutrition support were obtained,the related clinical outcomes were recorded twice a week,and the relationship between them was analyzed.The influencing factors of hospitalization costs and infectious complications were analyzed.Results:Among the 378 inpatients,the nutritional risk rate was 50.53％.Of the 174 patients enrolled in the cohort study,the nutritional support rate was 65.52％ (114/174).The difference of hospitalization time between the nutrition support group and the non-nutrition support group was statistically significant (P=0.028).There was no significant difference between the two groups in the hospitalization costs.The incidence of infectious complications (P=0.034) and the total complication rate (P=0.012) in the nutrition support group were lower than those in the non-nutrition support group.Disease score and nutrition support were the influencing factors of the incidence of infectious complications (P＜0.10).Hospitalization days,disease score and nutrition score were the influencing factors of hospitalization costs (P＜0.10).Conclusions:General surgery patients have higher nutrition risks,and nutrition support can reduce infectious complications,total complications and shorten hospital stay.NRS 2002 has a superior ability of predicting clinical outcomes.

AIM: To explore the predisposing factors, population characteristics and clinical features of severe fungal keratitis.
METHODS:The data of 233 cases 233 eyes of severe fungal keratitis in my hospital from January, 2008 to November, 2013 was retrospectively reviewed. The predisposing factors, population characteristics and clinical features were analyzed.
RESULTS: In 233 cases of severe fungal keratitis, the number of male patients was 153 ( 65. 7%) and the number ratio of male to female was 1. 9:1. The average age of them was (52. 7±11. 3), and most of them were middle-aged and elderly people living in the rural area (78. 1%) and were farmers ( 66. 1%) with low literacy (59. 7%). In 233 cases, 188 cases (80. 7%) possessed a clear history of ocular trauma, mainly caused by plant-based trauma (60. 9%). 90 cases (57. 3%) were infected with Fusarium, and 47 cases ( 29. 9%) by Aspergillus. The main treatment of severe fungal keratitis was surgery (87. 9%). 83 cases ( 52. 9%) were treated with penetrating keratoplasty, and in Fusarium and Aspergillus infected patients with severe fungal keratitis, 58. 4% ( 80/137 ) were performed with penetrating keratoplasty. In addition, patients treated with eye enucleation or evisceration, 68. 4% (13/19) were infected with Fusarium species.
CONCLUSION: Patients with severe fungalkeratitis in our hospital are mainly elderly male farmers living in rural, because of low economic condition and poor diagnosis consciousness. The main pathogens are Fusarium and Aspergillus species, and the major treatment is penetrating keratoplasty. Most of patients with poor clinical outcomes are infected with Fusarium species.

Objective To evaluate the safety and feasibility of sphincter-preserving transabdominal-anal excision of middle-lower rectal cancer by mucosa-mucosa coloanal anastomosis. Methods There were 169 cases undergoing this procedure including 107 males and 62 females. The low margins of the tumors located between 5~9 cm from the anal verge. Histopathological examination showed adenocarcinoma in 163 cases, mucinous adenocarcinoma in 6, and adenoma with canceration in 6.According to Dukes′ classification,61 belonged to Dukes′ A,101 Dukes′B, and 7 Dukes′C. Results Postoperative complications included stomal leak in 5 cases, stomal stenosis in 3, and defecation frequency increased to 6～12 times daily in all cases during the early stage and gradually back to normal 12～18 weeks postoperation. An average follow-up of 5.8 years was made in 154 cases(91.1%).Local recurrence was 5.8%.Hepatic metastasis was 13.7%.The five year survival rate was 66.9%. Conclusion This anal-sphincter preserving procedure while fulfilling radical resection for middle-lower rectal carcinoma is both safe and feasible alternative approach.

Objective To study the clinical value of color Doppler ultrasonography in typing tuberculous epididymitis.Methods The appearances of color Doppler ultrasound and the findings on operation were analysed in 33 patients with tuberculous epididymitis.Results Of the 33 patients,epididymis appeared as diffusely and heterogeneously enlarged lesions with increased flow in 2 cases,appeared as nodular lesions in 13 cases including nodi with echofree space in 3 cases, nodi with high-level echo patches in 3 cases, and low echo-level nodi in 7 cases. Multiple lesions in scrotum were detected in 17 cases, of whom epididymis up to 11 cases appeared as diffusely enlarged heterogeneous lesions with flow increased.The sonographic appearancs of tuberculous epididymitis could be divided into 3 types:diffusion type, nodus type and complicated type. Nodus type included 3 subtypes: purulence type, calcification type, and cheese type.The accuracy rate of ultrsound diagnosis was 87.9%.Conclusions Testis is easy to be involved when epididymitis appears as diffusion type, so surgical treatments should be early.Purulence type and complicated type need surgical treatments while calcification type does not. Antituberculous drug treatments can be tried before surgical treatments in cheese type.Sonography of urinary system is helpful for the diagnosis of asymptomatic tuberculosis in urinary system when tuberculous epididymitis is first suspected on sonography.