Acromegaly is mostly caused by a pituitary adenoma secreting growth hormone ( GH ) , which leads to a wide range of endocrine morbidities, with an insidious onset and slow progression.A long-term overproduction of GH results in elevated insulin-like growth factor-1 ( IGF-1 ) level, which in turn, would cause target organ damage and an increased risk for mortality and decreased quality of life.Herein, the literature regarding the progress of drug therapy for acromegaly in recent five years is reviewed.

Objective To observe the clinical effect and safety of subanesthetic doses of ketamine and fentanyl assisted regional anesthesia.Methods 90 children received abdominal operation or limbs operation were selected in our hospital.They were randomly divided into A,B and C group with 30 children in each group.The children in group A received sub-anesthetic doses of ketamine and fentanyl in nerve block anesthesia; the children in group B received sub-anesthetic doses of ketamine and fentanyl anesthesia aided;while the children in group C accepted traditional ketamine anesthesia.The indexes of respiratory frequency,mean arterial pressure,heart rate and oxygen saturation and other basic vital signs as well as anesthesia adverse events of situation were compared.Results The respiratory frequency,mean arterial pressure and heart rate in group A and B were lower than those in group C,the difference was statistically significant(all P ＜0.05),whereas no difference was observed on the oxygen saturation between two groups(P ＞0.05).The respiratory rate,mean arterial pressure and heart rate in group A and B showed no significant difference (all P ＞ 0.05).In adverse reactions,the muscle relaxants was in good condition in group A and B,no obvious body movement and gastrointestinal adverse events observed either.Group C with muscle relaxants in good condition,but body movement and some gastrointestinal adverse reaction can be observed occasionally.Conclusion Subanesthetic doses of ketamine and fentanyl has good anesthetic effect on regional anesthesia,and can effectively reduce the occurrence of adverse reactions,which is worthy of clinical application.

Objective To evaluate the antitumor effects of chenodeoxycholic acid-verticinone ester ( CDCA-Ver ) on tumor growth and immune system of H22-bearing mice. Methods Antitumor activity against a solid tumor mass was evaluated in Kunming mice. H22 cells were transferred into the abdomen cavity of Kunming mice. H22 cells were inoculated through subcutaneous injection at the right armpit of the mouse to establish a solid tumor model. At 24 h after H22 tumor cells inoculation, 40 tumor-bearing Kunming mice were randomly divided into 4 groups according to random number table ( n=10 each group):model control group, cyclophosphamide ( CTX) group, intraperitoneal CDCA-Ver injection group and intravenous CDCA-Ver injection group. In model control group, sterile 0. 9% sodium chloride solution (10 mL·kg-1 ) was intraperitoneally injected once daily. In CTX group and intraperitoneal CDCA-Ver injection group, CTX (20 mg·kg-1 ) and CDCA-Ver (20 mg·kg-1 ) was intraperitoneally injected once daily, respectively. In intravenous CDCA-Ver injection group, CDCA-Ver ( 20 mg · kg-1 ) was injected through tail vein once daily. CDCA-Ver, CTX and NS were injected into the mice of the experimental groups once daily for 10 days, respectively. The dose volume was 0. 1 mL · ( 10 g )-1 body weight. The positive control drug was cyclophosphamide. Ten mice were treated with 20 mg · kg-1 CDCA-Ver through intravenous injection ( i. v. ) . Ten mice were treated with 20 mg·kg-1 CDCA-Ver through intraperitoneal injection. The thymus and spleen indices and the tumor inhibition rate were assessed, and histopathological examination with haematoxylin and eosin ( H&E) staining was carried out to evaluate the antitumor effects of CDCA-Ver. Results CDCA-Ver ( ivor ip) suppressed the growth of solid tumor in H22-bearing mice. The inhibition rate was 48. 3% at the dose of 20 mg·kg-1 CDCA-Ver (ip). There was no significant difference between CDCA-Ver (ip) and CTX treated group (P<0. 05). Compared with the control, the weight of thymus and spleen of CDCA-Ver (ip) treated group was not obviously changed. But a significant weight loss of thymus and spleen in CTX group was observed, which was attributed to the immune suppression from CTX. The thymus and spleen indices in the CTX-treated mice were significantly lower than those of the control group (P<0. 01). We further conducted histopathological examination to confirm the results. The immune system was not suppressed by CDCA-Ver ( ip ) in tumor-bearing animals. The low toxicity of CDCA-Ver was an outstanding advantage for the development of newly anticancer drug. Conclusion CDCA-Ver treatment can significantly inhibit tumor growth in mice.

Objective: According to the relevant principles of blood volume monitoring and monitoring methods, to apply online monitoring data information management in the blood volume monitoring for hemodialysis patients. Methods:through the relevant technical form and its function of monitoring data to study and analyze of treatment parameters of hemodialysis patients described in online blood volume monitor, to achieve data analyzed by using information management system. Results: the blood volume can be visually monitored during the hemodialysis to understand changes in the blood volume of hemodialysis patients, it helps to avoid the occurrence of hypotension and evaluation of patients with dry weights during the hemodialysis. The data can be downloaded, exported, and edited at the same the while fully access to treatment data by effective using of blood volume monitoring data management system (BVMS), in order to achieve data analyzed by using information management system. Conclusion:by understanding the correlation betweenΔBV and blood pressure screen composition can help to speculate the reasons for drop in blood pressure;by combining the examination data can help to control dry weight management, by fully accessing to data can help to manage hemodialysis patient data information management system, and according to patients expression and display of blood volume monitoring to determine the appropriate amount of ultrafiltration, adjust dry weight and develop an appropriate treatment plan.

Objective This study aims to study the characteristics of intonation pronunciation in preschool children with hearing impairments .Methods A total of 30 of 4~5 years old children with hearing impairment and 30 of 4~5 years old children with normal hearing were enrolled in this study .With statement intonation and ques-tion intonation as test material ,the compartment between the children in two groups were obtained .Results Pre-school children were generally increased the ending point and slope to distinguish statement intonation .There were still differences between hearing -impaired children and normal children .Under statement intonation condition :the children with hearing impairments showed a significantly lower level of the slope of the high and level boundary tone than the normal children ,the starting point and the ending point of the falling boundary tone in hearing -impaired children were significantly lower than those of in normal children ;Meanwhile ,under question intonation condition :com-pared with normal children ,the slope of the high and level boundary tone ,the rising boundary tone and the falling -rising boundary tone in hearing -impaired children were significantly lower .The starting point ,the ending point ,the high and level boundary tone ,and the falling boundary tone in hearing -impaired children were significantly lower .Conclusion To implement targeted therapy during question intonation training for hearing -impaired children ,the acoustics characteristics of boundary tone are required to assess and monitor the effectiveness of rehabilitation .

Objective To evaluate the effect of mild hypothermia on the recovery from cisatracurium blockade during the recovery from anesthesia in patients .Methods Thirty ASA physical status Ⅰ or Ⅱ patients , aged 18-64 yr , with body mass index 18-25 kg/m2 , scheduled for elective abdominal surgery under general anesthesia ,were enrolled in the study .The patients were divided into 2 groups according to the body temperature recorded when cisatracurium infusion was stopped at the end of surgery .The body temperature 36.0-36.9 ℃served as normothermia group (group N , n=14 ) and 34.0-35.9 ℃ served as mild hypothermia group (group H , n= 16 ) . The body temperature was measured by a thermocouple placed in the nasopharynx . Neuromuscular function was monitored by measuring the evoked mechanical response of the adductor pollicis muscle to supramaximal train-of-four (TOF) stimulation (frequency 2 Hz ,wave length 0.2 ms ,intensity 50 mA ,interval 15 s) of the ulnar nerve at the wrist using TOF-Watch SX? .Cisatracurium was intravenously infused at 1-3μg·kg-1 ·min-1 during surgery to maintain neuromuscular block with 1%

The Chinese acupuncture doesn't only belong to China but rather to the world.The boom of overseas acupuncture education and scientific research as well as the satisfactory working environment compels us to reflect the Chinese traditional medicine education in our country.Especially in higher education specialty courses of acupuncture should not be subdivided;meanwhile,much attention should be paid to elementary education of western medicine.

Objective To investigate the actual pollution status of heating-ventilating-air conditioning(HVAC) systems in five-star grade hotels in Beijing. Methods Seven sets of centralized HVAC system from five five-star grade hotels in Beijing were selected for sampling monitoring and videotaping in situ from August 2003 to October 2003. Results There were six sets HVAC systems seriously polluted and one set was in moderately polluted according collected dust weight. The total counts of bacteria in the dust were in medium pollution grade in four sets of HVAC systems; The total quantity of fungus in the dust were in medium pollution grade in five sets of HVAC systems; The video materials showed that inside the air duct there were fungus, construction rubbish and deposit of large quantity of dust. Conclusion The HVAC systems of those five hotels were seriously polluted.

Objective To investigate the coupling of tibial rotation and extension-flexion motion of knee joint both before and after total knee arthroplasty. Methods Six fresh-frozen left lower limbs from cadavers were tested using a modified Oxford motor rig for the knee joint. Anatomically based multiple loadings of the quadriceps mechanism were applied (Vastus medialis: 24.5 N, Vastus intermedius/rectus femoris: 29.4 N, Vastus lateralis: 19.6 N). The tibial rotation was tracked using a custom-made laser tracking device while the tibial-femoral flexion was measured with goniometer. Total knee arthroplasty (TKA) was performed using ?PFC-PS posterior cruciate ligament substituting knee system. Results Before TKA, when the knee flexed 10?, 20?, 30?, 60?, 90?, 120? and 150?, tibia rotated 5.1??2.3?, 9.3??3.3?, 10.2??4.8?,11.7??3.5?, 13.5??8.4?, 22.0??8.6? and 29.6??9.3? respectively. After TKA, tibia rotated -2.2??1.7?, -2.5??1.5?, -2.0??1.3?, 1.7??2.5?, 3.9??2.4?, 13.5??6.1? and 18.6??4.7? respectively (Tibial rotation was defined as 0? in knee extension; internal rotation as positive and external rotation as negative). Conclusion The tibial internal rotation is coincident with tibial-femoral flexion, its magnitude of tibial rotation varies in different degrees of knee flexion. The tibial internal rotatation is significant in early knee flexion(0? to 30?), then enters into a platform stage on knee bending from 30? to 90?, Once the knee bends over 90?, the tibia rotates internally markedly again, maximum internal rotation is achieved in fully flexion, probably due to relaxation of soft tissue. After TKA, in early flexion (0? to 30?) the external rotation occurs abnormally, but later on 30? to 150?, it rotates again intenally as normal.

Objective To investigate the medial-lateral tilting of patella in two different coordinate systems before and after total knee arthroplasty (TKA). Methods Six fresh-frozen left low limbs from cadaver were tested using a modified Oxford Rig. Anatomically based multiple loading of the quadriceps mechanism was applied(Vastus medialis 24.5 N, Vastus intermedius/rectus femoris 29.4 N, Vastus lateralis 19.6 N). In a three dimensional coordinate system, patellar tilting was tracked using a custom-made Laser tracking device. The femoral trochlea was used as the other coodinate system in skyline view of patellar-femoral joint. Total knee arthroplasty was performed using PFC? posterior cruciate ligament substituting knee system. The tilting angles of patellar were measured before and after TKA. Results In three dimensional coordinate system, when knee flexed 30?,60?,90?,120?,150?, the patella titled :-3.10??2.25?,2.50??1.07?,5.46??2.60?,6.32??2.16?,-2.10??1.90? respectively before total knee arthroplasty was undertaken. After total knee arthroplasty, the patella tilted 3.24??0.35?,2.30??1.39?,1.65??1.17?,1.29??1.03?,-0.86??1.42? respectively. When femoral trochlea was taken as coordinate, the patella tilted 0??0?,0??0?,0??0?,0.24??0.35?,-3.21??1.80?; 0??0?,0??0?,0??0?,0??0?,-1.12??1.20? respectively both before and after TKA (Lateral patella tilting was defined as positive and medial patella tilting, negative). Conclusion Even the relationship between patella and femoral trochlea remains normal, the mode and magnitude of patellar tilting changes significantly after TKA. In early flexion of knee joint, patella tilts medially before TKA while it tilts laterally after TKA. After TKA, patella tilts less laterally than it does before TKA when a knee flexes from 60 to 120 degrees.