Aged ; Humans ; Male ; Nasal Polyps ; Ossification, Heterotopic

ObjectiveTo investigate the effects of acupuncture on neuromuscular block of vecuronium and analgesia under general anesthesia.MethodsNinety ASA Ⅰ or Ⅱ patients,aged 29-80 yr,weighing 50-80kg,scheduled for laparoscopic chotecystectomy,were randomly divided into 3 groups (n =30 each):acupuncture at acupoints combined with general anesthesia group (group A),acupuncture at non-acupoints combined with general anesthesia group (group B) and general anesthesia group (group C).Bilateral Hegu (LI4),Neiguan (PC6),Zusanli (ST36),yanglingquan (GB34),and Quchi (LI11) acupoints were selected in group A.In group B,the points adopted were the midpoints between the meridians in which the acupoints were selected in group A and the adjacent meridians on the lateral side,at the level of selected meridian points correspondingly.Electric stimulation was started from 15-30 min before anesthesia induction and continued until the end of operation.Anesthesia was induced with iv injection of fentanyl,propofol and vecuronium and maintained with intermittent iv boluses of fentanyl and vecuronium.All the patients received patient-controlled intravenous analgesia after operation.The effect time,onset time,clinical duration and recovery index of vecuronium,consumption of anesthetics during operation,and consumption of fentanyl for postoperative analgesia and postoperative adverse reactions were recorded.Results Compared with group C,the elinical duration was significantly prolonged,the consumption of anesthetics during operation and consumption of fentanyl for postoperative analgesia were significantly reduced,and the incidence of nausea was significantly decreased ( P ＜ 0.05 ),while no significant changed was found in the effect time,onset time,and recovery index in group A ( P ＞ 0.05).Compared with group B,the amount of fentanyl consumed during and after operation was significantly reduced in group A ( P ＜ 0.05 ).ConclusionAcupuncture can prolong the clinical duration of vecuronium,and enhance the analgesic efficacy during and after operation under general anesthesia.

BACKGROUND: Endogenous opioid peptides are mainly mediated by μ receptor and produce inhibitory effect on breathing and heartbeat, and because of this, fetal distress happens and develops. Therefore, μ receptor mediation is the most important way that endogenous opioid peptides participate in the fetal distress and the pathological process of suffocation. Β-FNA (β-Funaltrexamine, μ-receptor antagonist) and ICI174864(δ-receptor antagonist) are helpful to reduce the happening of fetal distress.OBJECTIVE: To explore the roles of μ and δ receptors in the fetal distress based on the point of view that opioid peptides are involved.DESIGN: Completely randomized allocation and randomized and controlled trial using experimental animals as the subjects.MATERIALS: Twenty healthy white New Zealand purebred rabbits were randomly divided into 5 groups, and among them 16 rabbits were pregnant for 30 days and were put to death with the method of suffocation. The fetal rabbits were taken out immediately after cesarean section, with 6 - 8 fetal rabbits in each den. The fetal rabbits were classified into the following groups: untreated fetal distress group, (fetal distress group, 29 fetal rabbits), normal saline rabbits group(Normal saline group, 25 rabbits), rabbit distress β-FNA group(β-Funaltrexamine ) (FNA group, 28 rabbits), fetal rabbits ICI174864 treatment group(ICI174864 group, 31 rabbits).INTERVENTIONS: Pregnant rabbits in the saline group, FNA group , ICI group were intravenously given a bolus of normal saline or the opiate antagonist β-FNA or ICI174864 and were then asphyxiated. Another 4 rabbits that were pregnant for 30 days were put to death with the cut on the neck, and 28 fetal rabbits were taken out as the control group. After being delivered by cesarean section, all rabbit fetuses in the above five groups were assessed by Apgar scoring for respiration, heartbeat, skin color, muscle tension, and response to stimulation at 1, 5, 10, 15 and 30 minutes of age.MAIN OUTCOME MEASURES: Apgar scoring for respiration, heartbeat,skin color, muscle tension, and response to stimulation at 1, 5, 10, 15 and 30 minutes of age was made.RESULTS: The total Apgar score for respiration, heartbeat, skin color, muscle tension in the control group was the highest (8. 8 ± 1.1 ). And that of FNA group was 6. 8 ± 1.7, obviously higherthan that of the fetal distress group (2.1 ±1.0) and the saline-treated pups(2.5±1. 1) and(t=2.832 and 2. 795, P < 0.01 ). That of group ICI was 4.9 ± 0.7, markedly higher than that of the saline-treated pups and the fetal distress group( t = 2. 232 and 2. 195, P < 0.05) . There was no marked difference between the saline group and the distress group ( P > 0.05 ) and between the FNA group and the control group(P < 0.05) . The total Apgar scores of the ICI group,saline group, and distress group were significantly lower than that of the control group ( t = 2.913,2. 893, P < 0.01 and t = 2. 174, P < 0.05).CONCLUSION: Endogenous opioid peptides participates in the process of the happening and development of fetal rabbit distress that is mediated by opioid peptides receptor, the effect of μ receptor was much more than that of δ receptor. This study provides a basis for the evaluation of fetal distress and intervening at an earlier stage to enhance prognostic function.

Objective To analyze the phenotypes of lymphocytes in cerebrospinal fluid derived from the patients with neurosyphilis. Methods Samples of cerebrospinal fluid from 12 patients with neurosyphilis and 20 patients with latent syphilis were collected and analyzed by flow cytometry for CD4 and CD25 expression. Results There was a significant increase in the number of white blood cells in the cerebrospinal fluid of patients with neurosyphilis. FACS analysis showed that most leukocytes were lymphocytes predominated with CD4 + T cells in neurosyphilis patients which were almost 4 times more than that in latent syphilis. However, there was a significant decrease in the proportion of CD4+ CD25high regulatory T cells (Tr) in neurosyphilis patients compared with that in latent syphilis patients. Conclusion A dramatic increase in CD4+ T cell frequency suggested its pathogenic role in neurosyphilis, whereas a decrease in CD25high Tr frequency indicated that CD4 + CD25high Tr cells might play an important role in immune homeostasis of central nervous system.

Objective To assess the clinical presentations and treatment of neurosyphilis with mania as the first manifestation. Methods A retrospective study was performed. Clinical data on neurosyphilis patients with mania as the first manifestation collected from July 2009 to June 2010 were analyzed. Results Twenty cases of neurosyphilis were included in this study, which were all misdiagnosed as schizophrenia, anxiety,cerebral infarction, etc. All the patients had manic symptoms at onset, such as irritability, bad temper, impulsive behavior, disturbance in thinking, and so on. Some patients also suffered from a marked decrease in memory, calculation and cognitive ability. Rapid plasma reagin (RPR) test, Treponema pallidum hemagglutination (TPHA)test and cerebrospinal fluid (CSF) venereal disease research laboratory (VDRL) test were positive in all the patients. Varying degrees of symptomatic improvement was achieved after anti-syphilis and anti-psychotic treatment. CSF was retested in 13 patients 3 months after the end of treatment, and CSF VDRL titer decreased in 10 patients, remained unchanged in 2 patients, and turned negative in 1 patient. Conclusions Neurosyphilis lacks distinctive clinical characteristics. For patients with poor response to conventional antipsychotic therapy,neurosyphilis should be considered, and serology and cerebrospinal fluid tests for syphilis are warranted.

Objective To analyze the clinical manifestations and treatment of acquired syphilis in children.Methods A retrospective analysis was conducted.The clinical data on 14 patients with acquired syphilis collected from July 2007 to December 2010 were assessed.Results Among the 14 cases,10 were secondary syphilis,2 early latent syphilis,and 2 late latent syphilis.Seven of the patients had been misdiagnosed as other diseases.All the patients had a history of close contact with syphilis patients or having mouth-to-mouth feeding history after chewing food by adult patients with syphilis.Both rapid plasma reagin (RPR) test and Treponema pallidum haemagglutination assay (TPHA) were positive in all the patients.The skin lesions were mainly located in the oral cavity mucosa and rarely in the trunk,which included leukoplakia,mucosal wet papules,and pustules.Conclusions Acquired syphilis in children is often clinically misdiagnosed or ignored.For children presenting with atypical skin rashes,especially for those having close contact with active syphilis patients,acquired syphilis should be suspected.

BACKGROUND:The safety and efficacy of paclitaxel-eluting stents (Taxus DES) has been proved by international researchers in clinic investigations.Based on further inclusion criteria,the incidence of in-stent restenosis is still lower than that of bare-metal stent.OBJECTIVE:TO observe restenosis of Taxus DES and the effect on local vessels through applying the follow up of coronary angiography and to investigate the biocompatibility of stent and host.DESIGN:Following-up observation.SETTING:Department of Cardiology,General Hospital of Chinese PLA.PARTICIPANTS:A total of 297 patients who had undergone coronary Taxus DES implantation for coronary artery disease were selected from Cardiovascular Department of General Hospital of Chinese PLA from May 2003 to May 2005.There were 265 males and 32 females and their ages ranged from 36 to 76 years.All patients provided informed consent,and the experiment had got confirmed consent from local ethic committee.METHODS:All patients were implanted Taxus DES and received the follow up within 6 and 12 months.In addition,at 6 months after operation,coronary angiography was used to measure the reference vessel diameter (RVD) and the minimal lumen diameter(MLD),calculate diameter restenosis rate and observe late loss.MAIN OUTCOME MEASURES:Coronary angiography at 6 months after Taxus DES implantation and biocompatibility of stent and host.RESULTS:①Quantitative angiographic analysis(QCA):Angiographic follow-up showed that the late loss of in-stent was significantly higher than that of pro-in-lesion and dis-in-lesion(P＜0.05).②Coronary angiography in-stent restenosis:In 134 angiographic follow-up patients,a total of 14 patients experienced restenosis,and the incidence was 10.4%(14/134).The patterns of restenosis were diffuse in-stent in 7 patients and the rate of revascularization was 6.7%.③Stent aneurysm:Angiographic evidence of aneurysm was observed in one patient among follow-up cases,and the rate of which was 0.75% (1/134).④Clinic follow-up major adverse cardiac events(MACE):Among 297 patients,one patient was attracted sudden death 5 months after intervention (0.34%; 1/297),and one patient was suffered subacute thrombosis 5 days after stent implant (0.34%;1/297),and late thrombosis occurred in 2 patients.The general rate of MACE was 1.35%.CONCLUSION:①The late loss of Taxus DES mainly takes place in in-stent.The patterns of restenosis of Taxus DES are in majority of diffuse in-stent,and the incidence of MACE is low.②Taxus DES possibly results aneurysm in local vessels.The follow up indicates that Taxus DES has a good biocompatibility to patients.

Diabetes is the most important comorbidity of cardiovascular disease, and cardiovascular disease is the main cause of mortality and disability of patients with type 2 diabetes. In order to standardize the diagnosis and treatment of patients with diabetes and cardiovascular disease, the National Health Commission Capacity Building and Continuing Education Center organized the experts from the field of cardiology and endocrinology systematically reviewing the research progresses and expert experiences of relevant disciplines from home and abroad, and formulated this consensus. This consensus covers the diagnosis, drug treatment, and risk factor management for patients with diabetes and cardiovascular disease (including atherosclerotic cardiovascular disease and heart failure) from the perspective of cardiovascular disease and diabetes management aiming to strengthen the comprehensive management of patients and ultimately to improve the prognosis of patients. The management of cardiovascular diseases mainly includes the management of blood pressure, blood lipids, anti-thrombosis, anti-myocardial ischemia, anti-ventricular remodeling and so on. Diabetes management mainly includes lifestyle intervention (including diet, exercise, weight loss, etc.), anti-hyperglycemia therapy (including drugs and insulin), blood glucose monitoring, and hypoglycemic prevention. In addition, specific clinical recommendations are given to patients with special health care needs such as diabetic nephropathy, elderly (>75 years), and cardiovascular critical illness.

Objective To summarize the characteristic of projects accepted by human genetic resources management office in 2016 and put forward further measures.Methods Statistic analyses were carried out based on the overall projects application,then Chinese application units and partners were analyzed separately.Results 1 138 international cooperation projects were approved in total,mainly on clinical research.24 countries were involved with increasing trend of globalization.Conclusions The human genetic resources management played a positive role in the development of the biomedical research and industry.