China ; Esophageal Diseases ; surgery ; Humans ; Lung Diseases ; surgery ; Thoracic Injuries ; surgery ; Thoracic Neoplasms ; surgery ; Thoracic Surgery ; Trachea ; surgery

Objective To investigate the effects of goal‐directed volume therapy (GDVT )on the intracranial pressure(ICP) and the balance of cerebral oxygen consumption and supply in selective neurosurgery. Methods Twenty‐four patients sched‐uled for intracranial tumor resection were randomly divided into 2 groups:conventional fluid management group (group C ,n=12) and GDVT group(group G ,n=12). Patients in group C received introperative fluid transfusion according to classical fluid management strategies while those in group G received GDT according to stroke volume variation (SVV) ,guided by Flotrac‐Vigileo system.Mean arterial pressure(MAP) ,heart rate(HR) ,cardiac index(CI) ,ICP ,SVV and jugular bulb oxygen saturation (SjvO2 )were recorded before the anesthesia induction(T1 ) ,at the moment of intubation(T2 ) ,at the moment of opening the hard meninges(T3),1hafteropeningthehardmeninges(T4),andattheendofthesurgery(T5).Thecerebraloxygenextractionra‐tio(CERO2 )was calculated. The duration of surgery ,crystalloid volume ,colloid volume ,blood transfusion volume ,urinary output and bleeding volume were recorded as well.Results The colloid transfusion volume ,the total fluid transfusion volume and uri‐nary output were significantly increased in group G when compared with those in group C (P<0.05).MAP ,CI ,and SjvO2 were much higher and CERO2 were much lower at T4 and T5 in group G than in group C(P<0.05). There was no significant differ‐ence in the ICP at each time point between groups G and C (P>0.05).Conclusion Goal‐directed fluid therapy optimizes the cardiac preload without increasing the ICP in selective neurosurgery ,and it also improves the balance of cerebral oxygen con‐sumption and supply.

The conception of evidence-based medicine (EMB) has a strong influence on the medical world since it built up.This concept has been widely used in all sorts of clinic and basic medical research,however,it is little reported to be practised in our fundamental medical education.As for it,this article will briefly analyze the importance of introducing the idea into fundamental medical education,and for one thing,suggest some more reform measures for medical teaching staff.

Apelin is a polypeptide consisting of 77 amino acids. Apelin receptors are found to be the angiotensin-like G protein coupled receptor (APJ). Apelin/APJ system is widely distributed in the peripheral and central nervous system. Apelin-13 is one of the subtypes of Apelin, which has strong biological activity. This study reviewed the new research prog?ress of Apelin-13 on physiological and pathological processes involved in the cardiovascular system, respiratory system, ner?vous system, digestive system and endocrine system.

Medicare work runs throughout the whole process of military training and directly affects the quality of military training. Good preparation,medical service and preventive health care work were done to reduce the injury rate during military training from recognizing significances ,char-acteristics,rules and methods of medicare. Additional health-related military programs,targeted tech-nical and tactical training and optimization and integration of teachers are effective ways to expand the military direction,improve and enrich the content o military training.

Objective To explore early diagnosis and treatment of congenital esophageal atresia and tracheoesophageal fistula.Methods Clinical data of 11 patients with congenital esophageal atresia and tracheoesophageal fistula were analyzed retrospectively.Definite diagnoses were made for all cases in 24 hours through making an esophagus opacification with acetrezoic acid or iodinated oil.And an esophagus anastomosis outside pleura was made.Some experience of diagnosis and therapy were summarized.Results All of the 11 cases underwent operation.Among them,9 cases were cured (81.8%),and 2 cases died(18.2%).Anastomosis stenosis of esophagus was found in 1 case after operation,which was cured through esophagus dilatation.Tracheoesophageal fistula was found in another case after operation and it was cured through combined treatment including anti-infection, nutritional support and sufficient draining.Conclusion Early diagnosis and surgical treatment, postoperative care,prevention and cure of complication are very important to improve the survival rate of the patients with congenital esophageal atresia and tracheoesophageal fistula.

Acupuncture Therapy ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Gastritis, Atrophic ; therapy ; Humans ; Male ; Middle Aged

Acupuncture Points ; Adult ; Aged ; Female ; Gout ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Female ; Gout ; therapy ; Humans ; Male ; Middle Aged

Abundant experiences have already been accumulated in treatment of stroke with acupuncture. Development of rehabilitation theory also brings unprecedented opportunity and challenge to acupuncture. Combined with the modern rehabilitation theory and practice, it is very helpful to deepen the understanding on treatment of acupuncture for cerebral apoplexy and enhance the therapeutic effect in clinic by studying the mechanism of acupuncture treatment, opportunity of intervention, selection of acupoints, needling manipulations and quantity of stimulations etc. Through analysis on the necessity and the way of combination of acupuncture and modern rehabilitation, it is concluded that rehabilitation evaluation, rehabilitation phases and obstacle analysis should be taken as references by acupuncturists to reinforce the therapeutic effect and creditability of acupuncture treatment on cerebral apoplexy.
Acupuncture Therapy ; methods ; Hemiplegia ; rehabilitation ; therapy ; Humans ; Stroke ; therapy ; Stroke Rehabilitation