Objective To study the effect of transcutaneous electrical acupoint stimulation (TEAS) on emergence agitation in children undergoing cochlear implantation.Methods Sixty patients (age range,1-4 years) scheduled to undergo pediatric cochlear implantation were enrolled and randomized into the TEAS group (group T,n =30) that received continuous TEAS and the control group (group C,n =30) that did not receive TEAS.Anesthesia time,operation time,change in blood flow dynamics during the perioperative period,extubation time,and PACU stay time were recorded.The incidence of emergence agitation and postoperative nausea and vomiting (PONV) was monitored.Results No significant intergroup differences were observed in age,sex,weight,operation time,and PACU stay time (P ＞ 0.05).The MAP and HR in group T were lower than those in group C at different time points such as 30 min after the start of surgery,the end of the surgery,the extubation and 5 min after extubation,and the difference was statistically significant (P ＜ 0.05).The FPS-R,FLACC,and PAED scores in group T were lower than those in group C at different time points within 30 min after exmbation (including the time of extubation),and the difference was statistically significant (P ＜ 0.05).Extubation time,anesthesia time,and incidence of PONV were lower in group T than in group C,and the difference was statistically significant (P ＜ 0.05).Conclusion TEAS combined with general anesthesia significantly reduces the incidence of emergence agitation in children undergoing surgery for congenital hearing loss;it also helps control hypotension,reheve dramatic hemodynamic changes during the waking period,and reduce the incidence of PONV.

Objective To explore the effect of preventing adhesion after the orbital blowout fracture on orbit tissue by amniotic membrane. Design Experimental study. Participants Twenty-six New Zealand rabbits. Methods Establishing rabbit orbital blowout fracture model, the right orbit of twenty rabbits was repaired by hydroxyapatite (HA) parceled of amniotic membrane, and left orbit was only repaired by HA, the orbits of the other six rabbits weren't repaired. Then we got the tissue around bone after one week and one month, and compared the difference of three groups. Main Outcome Measures Inflammatory response of tissue around bone was ana- lyzed by HE, picric acid Sirius Scarlet dying, TGF-?immunohistoehemical observation. Results One week after operation, HE and im- munohistochemistry showed that the difference was not significant in inflammatory response between experimental group and control group (P=0.351, P=0.413), and difference is significant between blank group and experimental group (P=0.012, P=0.041). One month after operation, HE and immunohistoehemistry showed that the difference was significant in inflammatory response between experimental group and control group(P=0.037, P=0.048), and there is no significant difference between experimental group and blank group(P=0.285, P=0.472). Conclusion It has an important role of anti-inflammatory and anti-adhesion in the chronic stage of inflammatory after orbital blowout fracture repaired by man-made plates of amniotie membrane.

Objective:To evaluate the effect of dexmedetomidine on the quality of recovery from anesthesia in elderly patients undergoing electroconvulsive therapy (ECT) with propofol anesthesia.Methods:Sixty patients of both sexes, aged>65 yr, weighing 45-80 kg, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective ECT with propofol anesthesia, were assigned into 2 groups ( n=30 each) using a random number table method: control group (group C) and dexmedetomidine group (group D). Dexmedetomidine was intravenously infused in a dose of 0.2 μg/kg (in normal saline 10 ml) over 10 min starting from onset of anesthesia induction in group D, while normal saline 10 ml was given instead in group C. Propofol 1.0-1.5 mg/kg was intravenously injected slowly.Succinylcholine 0.7 mg/kg was intravenously injected after the eyelash reflex disappeared, and oxygen was delivered via a mask to assist artificial ventilation.The mask was removed when the muscle twitching disappeared during depolarization, treatment was performed with an ETC apparatus, and electroencephalogram was monitored.The electrical stimulus intensity was set according to the age of the patient during ECT treatment, and the initial intensity was set at 0.5 times the age of the patient. When the postictal suppression index was less than 80%, a higher level of stimulus intensity was used in the next ECT treatment (the difference between adjacent intensity levels was 25.2 mc, which was 5% of the total stimulus intensity). After the end of ECT procedure, participants were manually ventilated with a mask, and the patients were transferred to postanesthesia care unit when the spontaneous breathing was completely restored.The time to recovery of spontaneous breathing and emergence time were recorded.The development of adverse cardiovascular events, nausea and vomiting, respiratory depression, headache, drowsiness, agitation and delirium during recovery from anesthesia was also recorded. Results:Compared with group C, the incidence of agitation, delirium, hypertension and tachycardia during recovery from anesthesia was significantly decreased, and no significant change was found in the other variables in group D ( P<0.05). Conclusion:Dexmedetomidine can improve the quality of recovery from anesthesia in elderly patients undergoing ECT under propofol anesthesia.

In previous study, the 150-ku oxygen-regulated protein(ORP150) was identified as a candidate glycoprotein related to hepatocellular carcinoma.In order to further validate the expression level of ORP150 in hepatocellular carcinoma, protein expression was determined by Western blot and cell immunochemistry, and messenger RNA(mRNA) expression was detected by quantitative real-time polymerase chain reaction.The effect of ORP150 on apoptosis and invasive potential of hepatocellular carcinoma cells was evaluated using the small interference RNA(siRNA) technique.Both the protein and mRNA expression levels of ORP150 were significantly upregulated in hepatocellular carcinoma cell lines compared with a non-tumor human liver cell line.After transfection with the specific siRNA of ORP150, significantly greater apoptosis of hepatocellular carcinoma cells was induced compared with untransfected cells.However, no significant effect on invasive potential was found.Overexpression of ORP150 was associated with hepatocellular carcinoma, and ORP150 might promote the proliferation of hepatocellular carcinoma cells by inhibiting apoptosis.ORP150 could be a potential therapeutic target for hepatocellular carcinoma.

OBJECTIVETo investigate the association of single nucleotide polymorphisms (SNPs) in the interleukin 17 (IL-17) gene and serum protein levels in patients with chronic hepatitis C virus (HCV) infection.

METHODSA total of 228 patients with chronic HCV infection and 81 healthy controls were enrolled in the study. The frequencies of IL-17 rs8193036 and rs2275913 polymorphisms were detected by the TaqMan SNP genotyping assay. Serum levels of IL-17 protein were detected by ELISA. Pairwise comparisons were made by the Chi-square test, and the significance of between-group differences was assessed by the Student's t-test with P less than 0.05.

RESULTSThe patients with chronic HCV infection and the healthy controls showed similar frequencies of the rs8193036 C/T allele (x2 = 1.428, P = 0.232) and the rs2275913 A/G allele (x2 = 0.106, P = 0.744). In addition, the two groups showed similar distribution of the rs8193036 CC (chronic HCV infection: 46.49% vs. healthy controls: 41.98%), CT (45.61% vs. 44.44%) and TT (7.89% vs. 13.58%) genotypes (x2 = 2.346, P = 0.309), and of the rs2275913 AA (16.23% vs. 13.58%), AG (48.25% vs. 50.62%) and GG (35.53% vs. 35.80%) genotypes (x2 = 0.340, P = 0.844). Subgroup analysis of chronic HCV infection patients stratified according to HCV genotypes 1 and 2 showed no differences in the distribution of rs8193036 and rs2275913 alleles (x2 = 1.127, P = 0.288; x2 = 1.088, P = 0.297) and genotypes (x2 = 2.825, P = 0.246; x2 = 0.970, P = 0.616). However, the chronic HCV infection group did show significantly higher levels of serum IL-17 than the controls (97.67+/-39.68 vs. 71.60+/-19.78 pg/ml, t = 2.414, P = 0.033).

CONCLUSIONChronic HCV infection is associated with increased serum IL-17; however, the IL-17 polymorphisms rs8193036 and rs2275913 were not associated with chronic HCV infection susceptibility in this study's Chinese cohort.

Adolescent ; Adult ; Aged ; Alleles ; Case-Control Studies ; Genetic Predisposition to Disease ; Genotype ; Hepacivirus ; Hepatitis C, Chronic ; blood ; genetics ; virology ; Humans ; Interleukin-17 ; blood ; genetics ; Middle Aged ; Polymorphism, Single Nucleotide ; Young Adult

OBJECTIVETo investigate the outcomes of chronic hepatitis C (CHC) patients treated with antiviral regimens of interferon (IFN) plus ribavirin (RBV) using individualized doses and durations.

METHODSThis study was designed as an open-label, prospective clinical trial to analyze the virological responses of 169 CHC patients who received individualized dosages of IFNa-2b or pegylated (Peg)IFNa-2a combined with RBV based on their weight ( less than 60 kg or more than or equal to 60 kg), age (less than 65 years or 65-75 years), morbid state (liver cirrhosis or not), and complications (such as heart disease, diabetes, thyroid disorder). Treatment duration was calculated using the time required to induce HCV RNA negativity. The rates of virological response and adverse effects among the different groups were compared.

RESULTSThe IFNa-2b treatment was given to 116 patients, and PegIFNa-2a was given to 53 patients. Compared to the IFNa-2b group, the PegIFNa-2a group showed significantly higher rates of complete early virological response (cEVR; 76.7% vs. 92.5%, P less than 0.05) and sustained virological response (SVR; 53.6% vs. 92.3%, P less than 0.05) among the patients who had completed their course of treatment; the rapid virological response (RVR) rate was also higher for the PegIFNa-2a group but the difference did not reach statistical significance (48.7% vs. 60.4%, P more than 0.05). Seventy-eight patients received the routine dose, and 91 patients received the low dose; there were no significant differences between these two groups for RVR (53.8% vs. 58.9%, P more than 0.05), cEVR (78.0% vs. 80.8%, P more than 0.05), or SVR (65.5% vs. 58.3%, P more than 0.05).

CONCLUSIONUse of an individualized antiviral treatment strategy designed according to the patient's baseline condition, early viral kinetics, and tolerability to adverse reactions can achieve a high rate of SVR, as well as improve the safety, prognosis, and cost-effectiveness associated with treating CHC patients.

Hepatitis C, Chronic ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Polyethylene Glycols ; therapeutic use ; Prospective Studies ; Ribavirin ; therapeutic use ; Treatment Outcome

OBJECTIVETo investigate the subtype distribution and the prevalence of sequence characteristics of HIV-1 strains in Beijing residents during 2006 and to analyze the relationship between distribution of HIV-1 subtypes and transmission routines.

METHODSBlood samples from 32 new confirmed HIV-1 infected individuals from Beijing residents in 2006 and separated plasma specimens were collected. RNAs were extracted and the gag and env gene were amplified by RT-PCR and nest-PCR. PCR products were sequenced directly and phylogenetic analyses of gag and env gene were performed using the MEGA2 software.

RESULTSAmong 32 HIV-1 plasma samples, 22 gag and 4 env gene fragments were amplified and analyzed. Five HIV-1 subtypes or circulating recombinant forms(CRFs) of HIV-1 including Thai B (2 strains), B (9 strains), C (2 strains), CRF07_BC (5 strains), CRF01 AE (4 strains) were identified being circulated in Beijing. The gene divergences of gag gene inside the subtypes were 6.6%, 4.3%, 6.8%, 4.9% and 3.0% in subtype B, Thai B, C, CRF01_AE and CRF07_BC respectively. Subtypes B were predominant in Beijing, accounted for 40.9% among 22 samples.

CONCLUSIONFive HIV-1 subtypes were identified in Beijing and the surveillance of HIV-1 gene variation should be paid more attention to.

China ; HIV-1 ; classification ; genetics ; Humans ; Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; env Gene Products, Human Immunodeficiency Virus ; genetics ; gag Gene Products, Human Immunodeficiency Virus ; genetics

BACKGROUND: Previous Caucasian studies have described venous thromboembolism in pregnancy; however, little is known about its incidence during pregnancy and early postpartum period in the Chinese population. We investigated the risk of venous thromboembolism in a “real-world” cohort of pregnant Chinese women with no prior history of venous thromboembolism. METHODS: In this observational study, 15,325 pregnancies were identified in 14,162 Chinese women at Queen Mary Hospital, Hong Kong between January 2004 and September 2016. Demographic data, obstetric information, and laboratory and imaging data were retrieved and reviewed. RESULTS: The mean age at pregnancy was 32.4±5.3 years, and the median age was 33 years (interquartile range, 29–36 yr). Pre-existing or newly diagnosed diabetes mellitus was present in 627 women (4.1%); 359 (0.7%) women had pre-existing or newly detected hypertension. There was a small number of women with pre-existing heart disease and/or rheumatic conditions. Most deliveries (86.0%) were normal vaginal; the remaining were Cesarean section 2,146 (14.0%). The incidence of venous thromboembolism was 0.4 per 1,000 pregnancies, of which 83.3% were deep vein thrombosis and 16.7% were pulmonary embolism. In contrast to previous studies, 66.7% of venous thrombosis occurred in the first trimester. CONCLUSION: Chinese women had a substantially lower risk of venous thromboembolism during pregnancy and the postpartum period compared to that of Caucasians. The occurrence of pregnancy-related venous thromboembolism was largely confined to the early pregnancy period, probably related to the adoption of thromboprophylaxis, a lower rate of Cesarean section, and early mobilization.
Asian Continental Ancestry Group ; Cesarean Section ; Cohort Studies ; Diabetes Mellitus ; Early Ambulation ; Female ; Heart Diseases ; Hong Kong ; Humans ; Hypertension ; Incidence ; Observational Study ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, First ; Pregnant Women ; Pulmonary Embolism ; Venous Thromboembolism ; Venous Thrombosis

Head and neck malignant tumor is one of the most heterogeneous diseases.The multi-disciplinary team(MDT)is an essen-tial component for personal precise diagnosis,treatment and integrated care management of oncologic diseases including head and neck malignant tumor.MDT clinical practice is also an important teaching mode for head and neck malignant tumors,but it is limited by time and space in actual teaching.An internet visualization platform was constructed based on the Internet,hospital HIS/PACS/LIS/EMR system,medical visualization screen,oral endoscope,remote consultation platform and other accessible audio and video terminals,and has been applied in MDT clinical teaching of head and neck malignant tumors,allowing medical students to participate in MDT through a networked visualization platform.Medical students will achieve deep learning for the most heterogeneous malignant tumor.MDT sup-ported by the internet visualization platform provides a new pathway for clinical medical education.