Objective To compare the effects of 2 kinds of frequency of transcutaneous electrical nerve stimulation (TENS) on urinary incontinence after stroke. Methods 81 patients with post-stroke urinary incontinence were randomized into group A (n=27), group B (n=27) and group C (n=27), who accepted TENS (biphasic square waves with pulse durations of 150 μs) in 20 Hz, 75 Hz and medcine only, respectively, for 90 days. They were assessed with Overactive Bladder Symptom Scores (OABSS), Barthel Index (BI), and voiding diary before and after treatment. Results The OABSS, BI and voiding diary improved significantly after treatment (P<0.05) in groups A and B, and improved more in the group A than in the group B. There was not significant improvement in the group C (P>0.05). Conclusion TENS of 20 Hz is more effective to reduce the incontinence post stroke.

ObjectiveTo screen the colonization of multidrug resistant organisms (MDROs) and determine their risk factors in intensive care unit (ICU), so as to provide the basis of prophylaxis and treatment of MDROs colonization.Methods A prospective single-center study was conducted in ICU of China-Japan Friendship Hospital from June 2008 to December 2014. The nostril and anal swabs for each patient who stayed in ICU over 24 hours were collected. Each specimen was cultured and tested for drug sensitivity. Clinical findings and relative risk factors were collected. The risk factors of MDROs colonization were analyzed with univariate analysis. The independent risk factor was selected from the risk factors withP< 0.05 with logistic regression analysis to analyze the related factors of MDROs colonization in ICU.Results 1 672 patients were enrolled. At ICU admission, MDROs colonization was present in 604 cases (36.12%), of whom 62 cases (3.71%) were found to be colonized with methicillin-resistantStaphylococcus aureus (MRSA), 529 (31.64%) were colonized with extended-spectrumβ-lactamase (ESBL) enterobacteria, 7 (0.42%) were colonized with multidrug resistantAcinetobacter baumannii (MDR-AB), and 6 (0.36%) were colonized with multidrug resistantPseudomonas aeruginosa (MDR-PA). ICU acquired MDROs colonization were 197/1 068 (18.45%), among whom 24 patients (1.44%) were colonized with MRSA, 118 (7.06%) were colonized with ESBL enterobacteria, 50 (2.99%) were colonized with MDR-AB, and 5 (0.30%) were colonized with MDR-PA. By multivariable analysis, prior administration of more than two kinds of antibiotics [odds ratio (OR) = 2.352, 95% confidence interval (95%CI)=1.847 - 4.464,P = 0.002], prior use of broad spectrum antibiotics within 3 months (OR = 2.862, 95%CI = 1.458-5.631,P = 0.014), duration of prior antibiotic administration (OR = 1.781, 95%CI = 1.152 - 3.413,P = 0.003) and hospitalization days prior to ICU admission> 9 days (OR = 1.766, 95%CI = 1.235 - 3.986,P = 0.021) were independent risk factors of MDROs colonization on admission to ICU.ConclusionsHigh prevalence of MDROs colonization in ICU patients was found in our hospital, and ESBL enterobacteria was the predominant bacteria. ICU acquired MDROs colonization is also worth considering, especially for MDR-AB. Identification of risk factors for MDROs colonization may help identify and screen patients with high risk, and it is also instructive in prophylaxis of MDROs colonization/infection and restriction of the use of broad spectrum antibiotics.

Objective To evaluate the effects of dexmedetomidine on the activity of nuclear factor kappa B (NF-κB) in neutrophil granulocytes during one-lung ventilation in the patients undergoing pulmonary lobectomy.Methods Thirty-eight ASA physical status Ⅰ or Ⅱ patients,aged 40-64 yr,weighing 50-75 kg,scheduled for elective pulmonary lobectomy,were randomized into 2 groups (n =19 each) using a random number table:control group (group C) and dexmedetomidine group (group D).In group D,dexmedetomidine 1.0 μg/kg was infused intravenously over 15 min before induction of anesthesia,followed by infusion at a rate of 0.5 μg· kg-1 · h-1 until 30 min before the end of operation.The equal volume of normal saline was given in group C.At 5 min after intubation,0,30 and 60 min of one-lung ventilation,0 and 30 min of two-lung ventilation,and 30 min after operation,blood samples were taken from the radial artery for blood gas analysis and for measurement of plasma concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).The oxygenation index and respiratory index were calculated.The nuclear protein of neutrophil granulocytes was extracted for measurement of NF-κB DNA-binding activity.Results Compared with group C,the respiratory index,plasma concentrations of TNF-α and IL-6 and NF-κB DNA-binding activity were significantly decreased,and no significant difference was found in the oxygenation index in group D.Conclusion Dexmedetomidine can inhibit the activation of NF-κB in neutrophil granulocytes and is helpful in reducing the systemic inflammatory responses during one-lung ventilation in the patients undergoing pulmonary lobectomy.

Combined Modality Therapy ; Head and Neck Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Humans ; Hypopharyngeal Neoplasms ; radiotherapy ; surgery ; Medical Oncology ; education ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Neoplasm Staging ; Otorhinolaryngologic Surgical Procedures ; education

Air ; Animals ; Diving ; Male ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Spleen ; metabolism

Carcinoma, Squamous Cell ; pathology ; surgery ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Minimally Invasive Surgical Procedures ; methods ; Neck ; Neck Dissection ; methods ; Neoplasm Staging

Health Knowledge, Attitudes, Practice ; Humans ; Neoplasm Staging ; Risk Assessment ; methods ; Thyroid Diseases ; surgery ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; adverse effects ; methods

Combined Modality Therapy ; Follow-Up Studies ; Head and Neck Neoplasms ; diagnosis ; epidemiology ; therapy ; Humans ; Quality of Life ; Specialization

Combined Modality Therapy ; Consensus ; Head and Neck Neoplasms ; therapy ; Humans

Objective To study the effect of hypoxia-ischemia (HI) on the brain-derived neurotrophic factor (BDNF) expression in the brain cortex and the hippocampus of immature rats,and to provide new therapeutic strategies for HI brain injury.Methods Three-day-old rats were divided into 2 groups.One group of rat pups were subjected to the left carotid artery ligation followed by 60 mL/L oxygen for 2.5 hours(HI-treated rats).The other group of rat pups were only subjected to the left carotid artery separation without ligation and 60 mL/L oxygen (sham-treated rats).The brain tissues were prepared at 3,7 and 14 d after treatment.Cresyl fast videt(CV) staining was used to evaluate the damage of the cortex and the hippocampus and check whether the models were successfully made.Immunostaining was used to determine the changes in BDNF positive cells in the brain cortex and the hippocampus after HI.Western blot analysis was used to evaluate the expression of BDNF protein in the brain cortex and the hippocampus after HI.Results Models were successfully made.CV staining showed that there was brain damages and area loss in the cortex and the hippocampus after HI.BDNF immunostaining showed that the number of BDNF-positive cells was significantly decreased in the cortex (t =-3.225,-2.298,all P ＜ 0.05) and the hippocampus (t =-3.751,-2.920,all P ＜ 0.05) in the damaged side of the brain compared to the contralateral side in the rats treated with HI and the sham-treated rats at 3 d after surgery,while increased at 7 d(t =3.924,2.838,all P ＜ 0.05 for cortex ; t =4.136,2.256,all P ＜0.05 for hippocampus) and 14 d (t =3.256,2.624,all P ＜ 0.05 for cortex ; t =3.051,2.719,all P ＜ 0.05 for hippocampus) after surgery.Western blot analysis showed protein expressions of BDNF:(1) Hippocampus:the protein expressions of BDNF were significantly decreased in damaged side of the brain compared to the contralateral side of rats treated with HI at 3 d(t =-3.388,P ＜ 0.05) after surgery,while increased compared to the contralateral side of rats treated with HI and the sham-treated rats at 14 d(t =4.874,4.646,all P ＜0.05) after surgery.(2)Cortex:the protein expression of BDNF was significantly decreased in damaged side of the brain compared to the contralateral side of rats treated with HI and the sham-treated rats at 3 d(t =-7.386,-3.256,all P ＜ 0.05) after surgery,compared to the sham-treated rats at 7 d(t =4.439,P ＜ 0.05) and the contralateral side of rats treated with HI and the sham-treated rats 14 d(t =24.161,3.942,all P ＜ 0.05) after surgery.Conclusions The number of BDNF-positive cells and protein expressions are decreased in the cortex and the hippocampus at the early stage of HI injury,and increased at the late stage.BDNF may play a role in the healing stage of HI brain injury.