Atrial Flutter ; diagnosis ; etiology ; therapy ; Electrocardiography ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Treatment Outcome

Objective:To approach the effect of Naotangfang extracts on expression of vascular endothelial growth factor(VEGF) after focal cerebral infarct in rats. Methods:30 Sprague-Dawley(SD) rats were randomly divided into 6 groups:sham operation group,model group,Naotaifang extract groups(low,middle,and high dosage) ,and Naofukang group. Some indexes were detected such as neurological scores,VEGF mRNA expression by RT-PCR,and the number of VEGF positive cells by immunohistochemical methods. Results:The symptoms in nervous function were improved in the Admin. groups,especially in the Naotaifang middle dosage group. The number of VEGF positive cells and VEGF PCR production in Naotaifng middle dosage group was higher than that in the model group. Conclusion:Naotaifang has neuroprotective effect against focal cerebral ischemic injury by improving the expression of VEGF.

ObjectiveTo observe the effect of acupoints stimulation with silver spike point therapy on insomnia.Methods60 patients with insomnia were randomly divided into the trial group and control group with 30 cases in each group. Patients of the trial group were treated by acupoints stimulation with silver spike point therapy and patients of control group were treated only with Clonopin. All patients of two groups were tested with Self-Rating Scale of Sleep (SRSS) before and after treatment.ResultsThe curative effect rate of the trial group was 86.6%; that of the control group was 60%; the curative effect of the trial group was superior to the control group (P<0.05). SRSS difference of the trial group pre-and post-treatment was 12.79±3.20; that of the control group was 10.1±3.89. There was also a significant difference between two groups (P<0.01).ConclusionThe silver spike point therapy has the better curative effect on insomnia than Clonopin.

Objective To investigate the role of p38 mitogen-activated protein kinase (p38MAPK) pathway in the protective effect of remifentanil or ischemic preconditioning (IPC) against hepatic ischemia-reperfusion (I/R) injury in rats.Methods One hundred and forty-four male SD rats,weighing 200-250 g,were randomly assigned into 6 group ( n =24 each):sham operation group (group S),I/R group,remifentanil group (group R),IPC group,SB203580 (a specific p38MAPK inhibitor) + remifentanil group (group SB + R),and SB + IPC group.The animals were anesthetized with intraperitoneal 20％ urethane 1 mg/kg.Partial liver ischemia was produced by clamping the hepatic pedicle supplying left lobe and middle lobe for 30 min,followed by 120 min reperfusion.In group R,remifentanil was infused intravenously at 2μg· kg- 1 · min- 1 starting from 30 min before ischemia until the end of reperfusion.In IPC group,the rats were subjected to 3 episodes of 5 min ischemia at 5 min intervals before I/R.SB203580 0.2 mg/kg was injected intravenously at 5 min before remifentanil infusion or IPC in groups SB + R and SB + IPC,and the equal volume of normal saline was given in the other groups.Six rats in each group were selected at 30,60,90 and 120 min of reperfusion and venous blood samples were taken from inferior vena cava for measurement of serum ALT and AST activities and concentrations of TNF-a and 1L-1β.The rats were then sacrificed and liver tissues were taken for microscopic examination and determination of phosphor-p38MAPK expression by Western blot.Results Compared with group S,serum AST and ALT activities and serum levels of TNF-α and IL-1β were significantly increased at each time point (P ＜ 0.05) and pathological injury was aggravated in group I/R.Compared with group I/R,serum AST and ALT activities and serum levels of TNF-a and IL-lβ were significantly decreased and phosphor-p38MAPK expression was up-regulated at 90 min of reperfusion in groups R and IPC ( P ＜ 0.05).The serum AST and ALT activities and serum levels of TNF-α and IL-1β were significantly increased,phosphor-p38MAPK expression was down-regulated at 90 min of reperfusion ( P ＜ 0.05),and pathological injury was aggravated in group SB + R compared with group R,and in group SB + IPC compared with group IPC.Conclusion Activation of p38MAPK pathway and inhibition of inflammatory response may be involved in the mechanism by which remifentanil or IPC reduces the hepatic I/R injury in rats.

Objective To analyze the anesthetic methods and surgical procedures in the treatment of inpatients in N 2 People' s Hospital of Deyang after Wenchuan earthquake. Methods More than 900 patients were sorted for injury triage, among whom 83 patients received emergency surgery within 72 hours after earthquake, and 21 received surgery after 72 hours. After 10 days of the earthquake, the hospitalized patients needing further surgery have been transferred to hospitals in safe regions. Of all patients, 89 (85.58%) were with injuries of extremities, 11 (10.6%) with cerebral trauma, 3 with thoracic injury, and 1 (1.0%) with abdominal trauma. Perioperative noninvasive blood pressure, electrocardiogram, pulse and oxygen saturation were detected during the surgery. All patients were cured except that one patient with traumatic flail chest died 12 hours after the surgery. Results Of all patients undergone surgeries, 35 patients (33.7%) received combined spinal-epidural anesthesia (CSEA), 33 (31.7%) received nerve plexus block (NPB), 5 (4.8%) had CSEA plus NPB, 28 were under general anesthesia (GA) [17 (16.3%) were intubated and 11(10.6%) were non-intubated] and 3 (2.8%) received monitored anesthesia care (MAC). The average ratios of operation time to time for patients stayed in operation room were (51.29±12.38)% in GA group, (53.24±11.39)% in NPB group, (58.43±9.26)% in CSEA group and (77.15±9.27)% in CSEA plus NPB group. There was a significant difference between CSEA + NPB group and the other three groups (P<0.01), and there was no significant difference among GA group, NPB group and CSEA group (P > 0.05). Conclusions During the initial period of rescue, the most common type of injuries are fractures. CSEA plus NPB is encouraged to use as they have the advantages of shorter operation time, higher operation throughput, safety and faster convalescence of the victims.

Objectives To establish the two-dimensional electrophoresis(2-DE)profile of cell. Secreted proteins.Difierential expression profiling of fibroblast cell secreted proteins between nasopharyngeal carcinoma and normal nasopharyngeal tissue was analyzed.Methods Five tissue specimens each from patients with nasopharyngeal carcinoma and nasal polyp were collected individually.Fibroblast eells from above-mentioned tissue were cultured in serum-free medium,and cell-secreted proteins from the cultured medium were harvested by uhrafihration concentration and desalination.Samples were analyzed by 2-DE,and the differentially expressed proteins were analyzed and identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry.Galectin-1 wa8 analyzed by EUSA test.Results 2-DE diagram of fibroblast cell-secreted proteins Was constructed.1 8 protein spots displayed quantitative changes in expression,and 11 protein spots among them were identified by mass speetrometrv.3 proteins including cystatin C,complement subcomponent C1S precursor,heterogeneous nuclear ribonueleoprotein A1 were down-regulated in the cultured medium of nasopharyngeal carcinoma associated fibroblast cells(CAFs). Nevertheless,the rest cell-secreted proteins including galectin-1,14-3-3 protein sigma,eathepsin L and etc,were up-regulated.Meanwhile,the expression of galectin-1 in the cultured medium was also analyzed and Its results were compared between CAFs and the normal fibroblast cells by ELISA.There Was statistical significance difference between them,and galectin-1 was up-regulated in the cIlltured medium of CAFs.Conclusions The changes of fibroblast cell-secreted proteins during nasopharyngeal carcinogenesi8 are analyzed by 2-DE analysis.The variation of pattern of secreted proteins is involved in signal transduction,protein synthesis,degradation and other pathways.CAFs may regulate tumor microenvironment by the abeve-mentioned pathways,and influence nasopharyngeal carcinogenesis,progress,invasion and metastasis.This study provided experimental basis for the eell secreted proteomics studv in future.

Objective To evaluate the impact of splenic vein-left adrenal vein shunting on prehepatic portal hypertension caused by cavernous transformation of portal vein in young patients.Methods From June 2004 to February 2012,9 patients with prehepatic portal hypertension due to cavernous transformation of portal vein received splenic vein-left adrenal venous shunting.The clinical data were reviewed.Results The procedure was uneventful in all the patients.There was no mortality,recurrent hemorrhage or hepatic encephalopathy on follow-up.The patients were discharged home on the 7th postoperative day.Conclusions In young patients with prehepatic portal hypertension secondary to cavernous transformation of portal vein,the left adrenal vein was often found to be large.Spleno-adrenal shunting,utilizing the left adrenal vein as a conduit,represents an excellent option in selected cases.

Objective To investigate the effectiveness of ilioischial plating through modified Stoppa and iliac fossa approaches for complex acetabular fractures. Methods A consecutive series of 40 patients with complex acetabular fracture were treated operatively from January 2014 to February 2015. Of them, 20 were treated through modified Stoppa plus iliac fossa approaches as an experimental group ( including 12 males and 8 females with a mean age of 46. 8 ± 10. 3 years ) . The anterior column was stabilized with a recon-struction plate for the iliac wing along the iliopectineal line to the pubis in all cases. The posterior column was fixed with a newly developed ilioischial plate running from the ilium to the ischial ramus. The other 20 patients ( 10 males and 10 females with a mean age of 45. 6 ± 11. 7 years ) served as a control group, treated with a reconstruction plate for the conventional posterior column fixation through the Kocher-Langenbeck approach. The 2 groups were compared in terms of operative time, intraoperative blood loss, reduction and functional recovery of the hip. Results The 40 patients obtained an average follow-up of 18 months ( from 8 to 24 months ) . The experimental group reported significantly shorter operation time ( 2. 1 ± 0. 7 hours ) and signifi-cantly less intraoperative bleeding ( 320. 8 ± 100. 4 mL ) than the control group ( 2. 9 ± 0. 6 hours and 621. 6 ± 118. 7 mL, respectively ) ( P <0. 05 ) . According to modified Matta's criteria for reduction, the experimental group had 15 excellent, 3 good, one fair and one poor cases ( giving an excellent to good rate of 90％) while the control group had 17 excellent, one good, one fair and one poor cases ( giving an excellent to good rate of 90％) . According to the modified Merle d'Aubigné and Postel scoring for the functional recovery of the af-fected hip at the final follow-ups, the experimental group had 14 excellent, 3 good, 2 fair and one poor cases ( giving an excellent to good rate of 85％) while the control group had 12 excellent, 4 good, 3 fair and one poor cases (giving an excellent to good rate of 80％). There were no significant differences between the 2 groups in the above comparisons ( P> 0. 05 ) . There were no significant differences in the MOS item short form health survey score and postoperative complication rate between the experimental group and the control group. Conclu-sion Ilioischial plating through modified Stoppa and iliac fossa approaches has advantages of reliable fixa-tion, limited invasion, less intraoperative blood loss and fewer complications for complex acetabular fractures.

Objective To explore the radiation dose from body γ-knife treatment to the nontargeted region's sensitive organs before and after shielding.Methods 20 patients suffering tumors less than 5 cm were selected.Calibrated thermoluminescence dosimeters (TLD) were placed above the sensitive organs,such as lens,thyroid gland and sexual gland,to measure the radiation dose received before shielding.Different plans were prepared for the patients with lung and renicapsule tumors using calibrators of different size.Radiation dose was measured by the aid of water phantom.For selected lungtumor treatment plan,the radiation doses were measured at the same location on the water phantom shielded with and without 1,2 and 4 cm lead,respectively.Results The maximum doses were 1 023.3 mGy for lens,1 235.7 mGy for thyroid gland and 1 176.8 mGy for sexual glands after treatment,respectively,being higher on the left site than the right.The radiation doses to the sensitive organs were higher for the water phatom with more tartgted points,decreasing by 55％-91％ after being covered with 1,2 and 4 cm lead shieldings.There were significant differences in doses received before and after lead shielding (t =14.4,12.9,13.3,P ＜ 0.05).Conclusions In the course of body γ-knife treatment,the additional factors would increase the dose to the sensitive organs.Therefore,it is necessary to provide lead shielding protection to the teenagers and adults with fertility when they undergo body γ-knife treatment.Trial registration Chinese Clinical Trial Registry,ChiCTR-OOC-16008259.

Objective To investigate the relationships of suicide risk and its associated risk factors in adult patients with epilepsy.Methods All 211 adult patients with epilepsy from the epilepsy clinic of the Second Affiliated Hospital,Zhejiang University School of Medicine,were enrolled to evaluate the presence of suicide risk and depressive disorder by using the suicide module and the depressive disorder module of the Mini International Neuropsychiatric Interview (MINI).Demographic variables for age,gender,employment status,marital status,years of education,and seizure factors for age of onset,types of seizure,seizure frequency and epilepsy duration,result of MRI and types of antiepileptic drugs were also recorded.We compared the differences of risk factors between the two groups with or without suicide risk and investigated the relationships between the depressive disorder and suicide risk.Results The suicide risk of the patients was 21.3％ (45/211),and 17.1％ (36/211) of the patients had depressive disorder.The suicide risk of the epilepsy patients associated with depressive disorder was 75.0％ (27/36),and the suicide risk of the epilepsy patients associated with no depressive disorder was 10.3％ (18/175).There was statistical difference between the two groups (x2 =74.525,P ＜ 0.01).About 60.0％ (27/45) of the patients with suicide risk was accompanied with depressive disorder.As suicide risk increased,the proportion of concurrent depressive disorder elevated.There was significant statistical difference in the rates of depressive disorder among the different suicide risk groups.Conclusions The patients with epilepsy have suicide risk.The suicide risk is higher in patients with depressive disorder.