Objective To investigate the feasibility of ultrasound-guided interscalenus brachial plexus block used for the emergency surgery.Method From August to December 2007 80 patients from the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou,ASA Ⅰ to Ⅲ,age 18 to 68 years old,weight 45 to 75 kg,without deformity on the shoulder or neck,without limb paresthesia,without contraindications of interscalenus brachial plexus block,were scheduled for emergency surgery of upper limb.They were randomly divided into two groups:interscalenus block guided by ultrasound group(group U,re =40)and nerve stimulator group(group N,re = 40).Patients of both groups received 20 mL mixture of 0.75%ropivacaine and 2%lidocaine.The onset time,and the analgesic efficacy of axillary nerve,lateral antebrachial cutaneous nerve,radial nerve,median nerve,median cutaneous nerve of arm,median antebrachial cutaneous nerve and ulnar nerve,and duration of anesthesia were observed.Statistical analysis was performed by t test,rank sum test and X2 test.Results The onset time of analgesia after nerve block was shorter in group U than that in group N(P＜0.01).The rate of perfect analgesia after nerve block in group U was higher than that in group N(100%vs.87.5%,X2 = 5.267,P = 0.027).The duration of anesthesia lasted in group U was(378 ± 151)minutes and that in group N was(365 ± 163)minutes(t= 0.363,P = 0.718).ConclusionsCompared with the method of nerve block guided by nerve stimulator,the ultrasound-guided interscalenus block offers faster onset and better analgesic efficacy.It is an ideal technique of brachial plexus block for the emergency surgery.

Objective To evaluate the effect and safety of catheter constant drainage combined with pericardial perfusion lentinan in treatment of patients with malignant pericardial effusion caused by lung cancer.Methods One hundred and eighteen patients with malignant pericardial effusion caused by lung cancer were divided into 2 groups by table of random digit,the treatment group (56 cases) was treated by pericardial perfusion lentinan after catheter constant drainage by central venous catheter,and the control group (62 cases) was treated by pericardial perfusion cisplatin after catheter constant drainage by central venous catheter.The therapeutic effect and adverse reaction were contrasted between the two groups.Results There was no significant difference in effective rate between treatment group and control group [89.3％(50/56) vs.83.9％ (52/62),x2 =0.736,P =0.391].The adverse reaction rate of treatment group was significantly lower than that of control group [8.9％ (5/56) vs.24.2％ (15/62),x2 =4.871,P =0.027].There was no significant difference in recurrence rate between treatment group and control group [14.3％(8/56) vs.11.3％(7/62),x2 =0.004,P =0.948].Conclusions Catheter constant drainage combined with pericardial perfusion lentinan for malignant pericardial effusion caused by lung cancer is safety and effective,and can be widely applied to clinical application.

Objective To investigate the value of muhi-detector CT (MDCT) low tension dynamic enhanced scanning on the preoperative assessment of advanced gastric cancer.Methods MDCT low tension dynamic enhanced scanning,tumor diagnosis and staging and prediction of surgery operation were performed on 43 cases of advanced gastric cancer.And the above results were compared with pathology results.Results The 36 cases were treated with resection,while 7 cases were treated by gastrointestinal anastomosis.The MDCT had 76.7 ％ (33/43) of accuracy for the preoperative T staging and 74.4 ％ (32/43) of accuracy for the preoperative N staging,respectively.The stomach wall thickness was closely related to serosal invasion (x2 =20.170 9,P ＜ 0.001).Conclusions The MDCT low tension dynamic enhanced scanning can improve the comprehensiveness and accuracy of preoperative staging of T and N in advanced gastric cancer.It is valuable for the preoperative diagnosis and treatment of gastric cancer.

OBJECTIVE To study the pathogenicity of the Vibrio fluvialis isolated from the coastal seawater.METHODS Virulence experiment group:22 Kunming mice were divided into four subgroups in random:V.fluvialis was injected into abdominal cavity in the test subgroup.And Staphylococcus aureus and Escherichia coli were injected into the positive control subgroups,separately and aseptic physiological saline was injected into the negative control group.Wound infection group:22 SPF mice were divided into four supgroups in random after their legs were injured:the experimental supgroup(soaked in artificial seawater with V.fluvialis);the positive control groups(with S.aureus and E.coli,separately);the negative control group(soaked in aseptic artificial seawater).The general condition,blood routine,blood culture,organ culture and wound secretion culture of the mice were observed.The pathological analysis of the mice was taken after sacrifice on the 3rd day.RESULTS In virulence experiment group,among all the 7 mice′s blood culture of V.fluvialis supgroup,5 mice were found V.fluvialis positive after 12 h injection,and 2 mice kept on positive until 24 h.In wound infection group,pathological examination showed there were a large number of neutrophils distributed over the striated muscle of the injured sites and cellulitis formed.CONCLUSIONS The V.fluvialis isolated from the sea water has pathogenicity,and can cause wound) infection and septicemia when the concentration reached 106 CFU/ml.

OBJECTIVE To explore the NG rapid and accurate detection method,epidemiological characteristics and the control of nosocomical infection.METHODS From 1989 to 2008,46 898 patients were under taken the NG smear test,culture and NG immune latex test.RESULTS In the 46 898 cases,764 cases were found out G-diplococci both inside and outside cells or cell.The positive rate was 1.63%.In 764 positive samples,721 cases were not found out other bacteria(94.37%),NG positive smears had their own features.CONCLUSIONS When no bacteria growth and a large number of swollen neutrophils,particular attention should be paid.NG smears particularly for small media-size community and rural hospitals,without NG culture,PCR and NG antigen/antibody test can be choosed first.

ObjectiveTo explore the influencing factors for chronic hepatitis C (CHC) with thyroid dysfunction (TD) in untreated Chinese patients and provide evidence for clinical individualized treatment. MethodsOne thousand and twelve untreated CHC patients were collected nationwide in China. Thyroid function and associated influencing factors (region, age, gender, and hepatitis C virus (HCV) RNA replication level) in the patients were investigated. The relationships between the influencing factors and CHC with TD were analyzed. Between-group comparison of categorical data was performed by χ2 test and Fisher′s exact test. ResultsThere were geographical differences between different types of CHC with TD. Across different regions, the incidence of TD was highest in north and northwest China, i.e., 28.3% and 26.5%, respectively. Subclinical hypothyroidism was the most common type of TD, accounting for 58.8% of the total TD cases. Middle-aged patients were most common among the cases of CHC with TD (44.0%), who had a significantly higher incidence of hypothyroidism than other age groups (χ2=1010、617, P=0.001、0013). Females with CHC had a significantly higher incidence of TD than male patients (58.9% vs. 41.1%, χ2=13.1, P=0.00). Although a high HCV RNA replication level was most common in Chinese patients with CHC, this factor had little influence on TD. ConclusionIn China, CHC with TD is influenced by geographic distribution, gender, and age, but less associated with HCV RNA replication level.

Objective To evaluate the effect of early intervention in preschool children anxiety. Methods Children with Spence anxiety preschool scale score≥48 points were randomly divided into the intervention group and monitor group. The parents of children in intervention group were educated with a total of 6 collective curriculum of children's anxiety management, while the monitor group were followed up only. All the children were evaluated by scale on the third month, sixth month, one year and one and a half years respectively, and then the differences of the two groups were compared. Results The average score of the intervention group decreased continuously on the third month, sixth month,one year and one and a half years,and the differences of the two groups were statistically significant(P<0.05). Conclusion Early short-term education for parents can relieve their preschool children's anxiety effectively with long term effect.

Objective To explore the relationship between non-high density lipoprotein cholesterol(non-HDL-C)level and leptomeningeal collateral circulation in patients with acute middle cerebral artery occlusion.Methods A total of 85 patients with first-onset acute cerebral infarction with middle cerebral artery M1 segment occlusion were enrolled.According to the results of DSA,LMC circulation was assessed by American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Circulation Assess-ment System.All patients were assigned to better LMC circulation group(score 2～4,n = 30)and worse LMC circulation group(score 0～1,n = 55),and the levels of non-HDL-C were compared between the two groups.Results The levels of LDL-C and non-HDL-C in worse LMC circulation group were significantly higher than those of the better LMC circulation group(P = 0.026,P = 0.010).non-HDL-C was an independent risk factor for the worse LMC circulation(OR = 3.019,95%CI:1.053～8.658,P = 0.04).LMC circulatory score of patients was negatively correlated with the levels of non-HDL-C level(r =-0.228,P = 0.036).The AUC of non-HDL-C predicted for the worse LMC circulation was 0.638(95%CI:0.521～0.755,P = 0.036).Conclusions non-HDL-C in patients with acute cerebral infarction was significantly related to worse LMC circulation,and was a risk factor for worse LMC circulation.It is suggested that the higher expression of non-HDL-C could be used to predict worse LMC circulation as a serological indicator.

The massive loss of oligodendrocytes caused by various pathological factors is a basic feature of many demyelinating diseases of the central nervous system (CNS). Based on a variety of studies, it is now well established that impairment of oligodendrocyte precursor cells (OPCs) to differentiate and remyelinate axons is a vital event in the failed treatment of demyelinating diseases. Recent evidence suggests that Foxg1 is essential for the proliferation of certain precursors and inhibits premature neurogenesis during brain development. To date, very little attention has been paid to the role of Foxg1 in the proliferation and differentiation of OPCs in demyelinating diseases of the CNS. Here, for the first time, we examined the effects of Foxg1 on demyelination and remyelination in the brain using a cuprizone (CPZ)-induced mouse model. In this work, 7-week-old Foxg1 conditional knockout and wild-type (WT) mice were fed a diet containing 0.2% CPZ w/w for 5 weeks, after which CPZ was withdrawn to enable remyelination. Our results demonstrated that, compared with WT mice, Foxg1-knockout mice exhibited not only alleviated demyelination but also accelerated remyelination of the demyelinated corpus callosum. Furthermore, we found that Foxg1 knockout decreased the proliferation of OPCs and accelerated their differentiation into mature oligodendrocytes both in vivo and in vitro. Wnt signaling plays a critical role in development and in a variety of diseases. GSK-3β, a key regulatory kinase in the Wnt pathway, regulates the ability of β-catenin to enter nuclei, where it activates the expression of Wnt target genes. We then used SB216763, a selective inhibitor of GSK-3β activity, to further demonstrate the regulatory mechanism by which Foxg1 affects OPCs in vitro. The results showed that SB216763 clearly inhibited the expression of GSK-3β, which abolished the effect of the proliferation and differentiation of OPCs caused by the knockdown of Foxg1. These results suggest that Foxg1 is involved in the proliferation and differentiation of OPCs through the Wnt signaling pathway. The present experimental results are some of the first to suggest that Foxg1 is a new therapeutic target for the treatment of demyelinating diseases of the CNS.