Endometrial Neoplasms ; metabolism ; pathology ; secondary ; Female ; Humans ; Mesentery ; Middle Aged ; Neprilysin ; metabolism ; Peritoneal Neoplasms ; metabolism ; pathology ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Sarcoma, Endometrial Stromal ; metabolism ; pathology ; secondary

An allergic reaction was occurred in a 17-years old girl who was undergoing local anesthesia before tonsillectomy. Ptosis was observed in right side of patient shortly after injection of lidocaine to right palate. Then the patient feel grasp and cough, accompanied by nausea and vomiting. The patient was placed in supine position. Dexamethasone and epinephrine was administrated intramuscularly, symptoms were relieved 10 minutes later.
Adolescent ; Anesthesia, Local ; adverse effects ; Eyelids ; drug effects ; Female ; Humans ; Lidocaine ; adverse effects ; Muscle Weakness ; chemically induced

Objective To explore the value and methods of echocardiographic application in percutaneous left atrial appendage(LAA) closure for stroke prevention in patients with nonvalvular atrial fibrillation.Methods 6 male patients with nonvalvular atrial fibrillation were enrolled for percutaneous LAA closure,the mean age was (68.7 ± 5.6) years old,the mean CHADS2 (congestive heart failure,hypertension,age≥75 years,diabetes mellitus,and prior stroke or transient ischemic attacks) score was 3.2 ± 1.0.Rheumatic valvular diseases were excluded by transthoracic eehocardiography(TTE) before closure procedure.Transesophageal echocardiography(TEE) was performed to guide the punctures of the atrial septum and then monitored the operation all through the closure procedure.Diameter of LAA orifice was measure by TEE to help choosing the closure device.Immediate results of closure and complications were inspected by TEE simultaneously.24 hours,7 days,3 months,6 months and 1 year follow-up were performed using TTE.Results All the 6 patients underwent LAA closure successfully.3 LAmbre(Lifetech Scientific,Shenzhen) devices and 3 Watchman(Boston Scientific,Natick,Massachusetts) devices were implanted respectively in the 6 patients.Mean diameter of the LAA orifice was (22.4 ± 3.3)mm,and mean size of the closure devices was (28.0 ± 2.9) mm.2 mm in width residual flow at the inferior edge of closure device existed in 1 ease.No complication was observed.Post-procedure 24 hours and 7 days post-procedure followup showed optimal results in all cases.Conclusions Implantation of both LAA closure devices can be performed with high success rates in patients with nonvalvula ratrial fibrillation,with high risk for stroke,and who either had contraindication or were not willing to accept oral antieoagulation.Echocardiography plays a core role all through the closure procedure and can make it safer and more efficient.

Metabolic syndrome (MS) and breast cancer are common diseases of women. Triple negative breast cancer (TNBCs) is one type of breast cancer, which is of much attention in recent years. Important components of MS include central obesity, high blood sugar, high triglycerides and low level of high-density lipoprotein (HDL-C), which increased the inci-dence risk of TNBCs. Common biomarkers of MS including insulin, adiponectin and leptin play an important role in the oc-currence and development of breast cancer, especially TNBCs. Insulin-like growth factor-IImRNA binding protein 3 (IMP3, an oncofetal protein) may be TNBCs’new invasive cancer biomarkers. In this paper, the research progress on the relation-ship between MS and TNBCs is reviewed.

OBJECTIVE: To investigate the possible effects of recruitment maneuver (RM) imposing on extravascular lung water (EVLW) in patients with acute respiratory distress syndrome (ARDS). METHODS: Twenty patients with ARDS who were eligible for the study were randomized to two groups, one group of which received regular therapy+RM (RM group), and to the other group only regular therapy was given (control group). Mechanical ventilation of all the patients was performed on the principles of lung protective ventilation. RM was carried out in bi-level positive airway passage (BIPAP) mode, and repeated every 8 hours per day until on the 7th day or before weaning of mechanical ventilation. The treatment was same between the two groups except RM. Baseline data and the influencing factors of EVLW were all recorded, which included everyday EVLW, extravascular lung water index (EVLWI) after RM, respiratory mechanics, oxygenation parameters, central venous pressure (CVP), plasma colloid osmotic pressure (COP), dosage of corticosteroid and adrenergic drugs, 24-hour net fluid balance. RESULTS: EVLW and EVLWI in RM and control group showed a tendency of decrease with passage of time, but the difference between both groups had no statistical significance (all P>0.05). The comparisons between the influencing factors of the groups, consisting of CVP, COP, noradrenalin and hydrocortisone, had no significant difference either (all P>0.05). Dopamine dosage in RM group on the 4th day was smaller than that of control group (P<0.05). Net fluid balance in RM group on the 7th day was negative, whereas it was positive in control group (P<0.05). Mean airway pressure [Pmean, RM group (18.8+/-3.2) cm H(2)O (1 cm H(2)O=0.098 kPa) vs. control group (16.6+/-3.9) cm H(2)O] and lung quasi-static compliance [Cstat, RM group (36.5+/-14.5) ml/cm H(2)O vs. control group (29.3+/-12.0) ml/cm H(2)O] in RM group were higher than those in control group (both P<0.05). Cstat on the 5th day was higher than that on the 2nd and 3rd day in RM group (both P<0.05). But oxygenation index (PaO(2)/FiO(2)) showed no distinct difference between the groups (all P>0.05). CONCLUSION: RM for the patients with ARDS can merely improve lung mechanics without obvious effect on EVLW. Neither of the influencing factors involved in the study has impact on emergence and clearance of EVLW.

Objective To investigate the effects of Stichopus variegatus mucopolysaccharide on plasma nitric oxide (NO) and serum endothelin(ET) after angioplasty in rabbits. Methods 50 New Zealand rabbits were randomly divided into four groups: Stichopus group, simvastatin group, model group and normal group. Endothelium of iliac arteries in Stichopus group, simvastatin group and model group were denuded by balloon catheter and the rabbits were fed with 2%cholesterol, 3%lard and 3%yolk mixed forage for six weeks, and then, atherosclerotic stenosis was showed by iliac angiography.When transluminal balloon angioplasty was done, from then on the feeds was changed from high cholesterol to ordinary forage. Stichopus (0.5g?kg -1?d -1) and simvastatin (0.5mg?kg -1?d -1) were given by gastric canal. While NaCl solution (0.9%) was given in model group. All rabbits were fed in separate cages and free drinking. After four weeks since transluminal balloon angioplasty, blood was collected from carotid artery to measure the changes of concentrations of endothelin(ET) and nitric oxide(NO). Examination of pathology by optical and electron microscope were done at same time. Results After four weeks since transluminal angioplasty, the concentration of plasm ET in model group increased significantly compared with the normal group(114.86?24.89 ng?L -1 vs 75.62?9.68 ng?L -1) and serum NO decreased significantly(37.50? 12.79?mol?L -1 vs 106.37?18.01 ?mol?L -1).The concentration of plasm ET in model group was higher than that in the simvastatin groups and Stichopus groups(114.86?24.89 ng?L -1 , 81.08?14.71 ng?L -1 and 83.34?11.41 ng?L -1 ,respectively),and the concentration of serum NO decreased obviously(95.63?8.62 ?mol?L -1,98.80?9.06 ?mol?L -1 and 37.50?12.79 ?mol?L -1,respectively). Conclusion After iliac arterial TA the concentrations of plasm ET were increased and the serum NO were decreased, the endothelial function fell into disorder. The Stichopus variegatus mucopolysaccharide had the effects of improving the endothelial function after angioplasty in rabbits by adjustment of plasm ET and serum NO.

Adult ; Branchial Region ; Fistula ; surgery ; Humans ; Male ; Neck ; surgery ; Pharynx ; surgery

Objective To investigate the distribution and antimicrobial resistance of pathogens from lower respira-tory tract in patients in intensive care unit (ICU),so as to provide reference for clinical treatment.Methods Distri-bution and antimicrobial susceptibility of pathogens isolated from ICU patients’sputum obtained through fiberbron-choscope between 2011 and 2014 were analyzed retrospectively.Results A total of 3 454 pathogenic strains were isolated between January 1 ,2011 and December 31 ,2014,the percentage of gram-negative bacteria,gram-positive bacteria,and fungi were 84.11 %,14.50%,and 1 .39% respectively.The detection rates of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella spp .in 2011 -2014 were 38.46% -73.33% and 26.95% -37.06% respectively. Enterobacteriaceae strains had low resistance rates to imipenem and meropenem (<20.00%);resistance of Acinetobacter baumannii was higher than Pseudomonas aeruginosa ,both had low resistance rates to amikacin(3.32%-37.16%);vancomycin-and linezolid-resistant strains were not found among Staphylo-coccus .In 2011 - 2014,detection rates of methicillin-resistant Staphylococcus aureus (MRSA)were 42.86% -61 .22%,methicillin-resistant coagulase-negative staphylococcus (MRCNS)were 86.96% - 91 .67%;resistance rates of Enterococcus faecium was higher than Enterococcus faecalis ,vancomycin-resistant strains were not found among Enterococcus faecalis and Enterococcus faecium ;the major fungus was Candida albicans .Conclusion Anti-microbial resistance of pathogens isolated from lower respiratory tract is getting more serious,clinicians should pay attention to non-antimicrobial infection control strategies in addition to rational use of antimicrobial agents.

Objective To observe the effects of action observation therapy based on mirror neuron theory on upper-extremity motor function and performance in activities of daily living(ADL) after stroke.Methods Eightyone stroke patients were randomly assigned to an observational group (41 cases) or a control group (40cases).Both groups received conventional rehabilitation,and the observational group also received action observation therapy for 16 weeks,10 times per week.Upper-extremity motor function and ADL performance were assessed before treatment using the Fugl-Meyer assessment (FMA) and the Barthel index (BI) and then again after 4,8 and 16 weeks of treatment.Results The average FMA scores and BI scores in the observational group at the 4th week (32.50 ± 9.32 and 67.41 ± 16.81),the 8th week (36.35 ± 8.32 and 78.74 ± 15.63) and the 16 th week (41.32 ± 13.45 and 93.85 ± 13.45) had increased significantly compared with the pre-treatment assessment and were significantly better than at the same time point for the control group (P ＜ 0.05).Conclusion Action observation therapy based on mirror neuron theory can promote the recovery of upper-extremity motor function and ADL performance after stroke.