Acupuncture Analgesia ; Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Catheter Ablation ; Female ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Pain Management

AlM: To observe clinical effect of vitrectomy with intravitreal ranibizumab for the treatment of diabetic retinopathy ( DR) .
METHODS:From February 2011 to February 2013, there were 90 cases in our hospital diabetic retinopathy patients withvitrectomy surgery. lt was randomly divided into observation group ( 45 cases ) and control group ( 45 cases ) . Two groups of patients were performed vitrectomy. Patients in observation group were injected intravitreal ranibizumab before surgery, then vitrectomy was underwent for diabetic retinopathy. Vitrectomy was only underwent in control group.
RESULTS:The patients in observation group with good effect accounting for 71% (32/45) and good rate was 89%(40/45 ), which were significantly higher than that in control group 51% ( 23/45 ) , 71% ( 32/45 ) . Differences were statistically significant ( P < 0. 05 ). Amount of bleeding was 9. 64 ± 2. 27mL, intraocular pressure was 13. 64 ± 3. 27mmHg. lt was significantly less than that in control group 10. 21 ± 3. 14mL, 16. 00 ± 3. 14mmHg. Differences were statistically significant (P<0. 05).
CONCLUSlON: The vitrectomy with intravitreal ranibizumab treatment of diabetic retinopathy can not only reduce blood loss, but also reduce edema and improve effectiveness and safety. lt's worth recommending for clinical practice.

Objective To explore the effect of nursing intervention on negative emotions and coping style for patients with retinal redetachmem.Methods Sixty patients with retinal reenactment were divided into two groups:the intervention group(n=30)and the control group(n=30)randomly.Routine nursing method were used in the control group while systemic nursing interventions,such as the intervention of disease-related knowledge, relaxed therapy, touch care therapy, intervention on families were used in the intervention group. The collected data by using the scales including the self-rating anxiety scale (SAS) , self-rating depression scale (SDS) and coping style questionnaires (CSQ). Results Negative emotions during preoperative period in the study group were less than that in the control group and in the coping style the study group was better than the control group. Conclusions The effective nursing intervention for the preoperative patients with retinal redetachment can alleviate the negative emotions such as anxiety, depression and psychological stress, and ensure the smooth progress of the re-operation.

Objective:To explore the influence of esmolol on the dosing of remifentanil in total intravenous anesthesia(TIVA). Methods:A total of 40 female patients scheduled for thyroid surgery were randomly divided into 2 groups,with 20 patients in each group.The patients in the study group received a loading dose of esmolol through continuous intravenous infusion after tra-cheal intubation.The infusion was stopped after extubation.The control group received the same volume of 0.9% sodium Chlo-ride.The target concentration of propofol was adjusted by bispectral index,and the target concentration of remifentanil was ad-justed by heart rate and mean artery pressure.Intraoperative heart rate,mean artery pressure and bispectral index,as well as postoperative pain scores,were recorded.Results:There was no significant difference in heart rate,mean artery pressure and bispectral index between the two groups(P >0.05).The dosage of remifentanil in the study group was lower than that in the control group(P <0.01).The pain score was higher in the study group at 5 min after entering postanesthetic care unit(PACU) than that in the control group(P <0.05).There was no statistical significance in pain scores at 30 min after entering PACU and at 24 h after surgery (P <0.05)between the two groups.Conclusions:Continuous low dosage infusion of esmolol could signifi-cantly decrease the consumption of remifentanil in TIVA.

Objective To understand the psychological change,mental pressure and relative factors of anxiety in patients with retinal re - detachment and to provide basis for systematic nursing.Methods Ninety patients with retinal re - detachment were selected and surveyed with general condition questionnaire,psychological state questionnaire and Zung's Self-rating Anxiety Scale (SAS).Results Their SAS score was (45.4 ± 10.1) points,with significant difference from the Chinese normal (t=51.990,P ＜ 0.01).The anxiety value of female was significantly higher than that from male [ (49.6 ± 11.3 ) points vs.(42.9 ±10.6) points,F =11.64,P ＜ 0.05 ].There were significant differences in terms of age,education background and mode of medical payment ( F =11.25,10.97,12.36,30.91,respectively; P ＜ 0.05 or P ＜ 0.01 ).The patients were paying 100％ attention to knowledge needs,operation schedule and operation effect.Conclusions Relative nursing measures should be implemented as soon as possible,operation information should he provided timely and systematic nursing intervention should be established to release the mental pressure of the patients.

OBJECTIVETo compare the perioperative outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for treatment of complex coronary artery disease and left ventricular dysfunction.

METHDOSThe clinical data of 966 patients admitted to our hospital from January 2003 to December 2013 with coronary artery disease and left ventricular dysfunction (ejection fraction ≤50%) were retrospectively reviewed. Among the patients, 386 underwent CABG and 580 received PCI. After matching for EuroSCORE risk factors and preoperative echocardiographic parameters, 135 patients with CABG and 135 with PCI were enrolled in this study. With hospital mortality and perioperative major complications as the endpoints, the early outcomes of the procedures were evaluated. Perioperative echocardiography was performed to evaluate the change of left ventricular geometry and function.

RESULTSCompared with CABG group, PCI group had significantly higher incidences of chronic lung disease (8.1% vs 0.7%, P=0.003) and recent myocardial infarction (64.4% vs 31.9%, P=0.000) but significantly lower left-main disease (12.6% vs 23.7%, P=0.018); the other baseline characteristics were comparable between the two groups. Patients with CABG had a greater number of treated target vessels than those with PCI (2.90±0.81 vs 1.67±0.73, P=0.000), and complete revascularization was more common in CABG group (94.8% vs 51.8%, P=0.000). No significant difference was found in perioperative variations of LVEF between the two groups, but patients with CABG had a greater variation in LVEDD than those with PCI. The hospital mortality and other major complications were similar between the two groups.

CONCLUSIONBoth CABG and PCI are safe and reliable revascularization strategies for complex coronary artery disease and left ventricular dysfunction, but CABG can achieve a higher rate of complete revascularization and better improves the left ventricular function.

Coronary Artery Bypass ; Coronary Artery Disease ; surgery ; therapy ; Echocardiography ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Ventricular Dysfunction, Left ; therapy ; Ventricular Function, Left

OBJECTIVETo compare the mid- to long-term outcomes of patients receiving isolated coronary artery bypass grafting (CABG) versus surgical ventricular restoration (SVR) plus CABG for left ventricular aneurysms.

METHODSThe clinical data were retrospectively analyzed in 205 patients with left ventricular aneurysms admitted to our hospital between January, 1997 and December, 2012, including 115 patients receiving SVR plus CABG and 90 undergoing isolated CABG. By matching preoperative echocardiographic parameters including aneurysm size, left ventricular ejection fraction (LVEF), left ventricular end-systolic volume index (LVESVI) and EuroSCORE risk factors, 32 patients receiving SVR plus CABG and another 32 with isolated CABG were enrolled in this study. The patients were compared for survival rates, major adverse cardiac or cerebrovascular events (MACCEs), left ventricular geometry and function at 1, 3 and 5 years of follow-up.

RESULTSCompared with the patients receiving isolated CABG, those receiving SVR and CABG showed greater improvements in echocardiographic parameters and NYHA functional class. The differences in the echocardiographic parameters between the two groups gradually reduced with time and became comparable at 5 years after the operation (P>0.05). No significant difference was found in the mid- to long-term survival or the incidence of MACCEs between the two groups (P>0.05).

CONCLUSIONCompared with isolated CABG, SVR plus CABG does not reduce the incidence of MACCEs or improve the mid- to long-term survival rate of patients with left ventricular aneurysm with a LVESVI <60 mL/m(2).

Aneurysm ; surgery ; Coronary Artery Bypass ; Echocardiography ; Heart Ventricles ; surgery ; Humans ; Incidence ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Survival Rate ; Treatment Outcome ; Ventricular Function, Left

This study was aimed to explore the killing effect of PBMNC induced by IL-23 alone or combined with IL-2 on K562 cells and its mechanism. The PBMNC were induced in vitro by IL-23 (50 ng/ml) alone or IL-23 combined with IL-2 (100 U/ml) for 72 h, and then were co-cultured with leukemia cell line K562. The CCK-8 method was used to detect the effect of PBMNC induced at different times on K562 cells, the ELISA was performed for detecting IFN-γ level in culture supernatant, and the perforin and granzymes B were detected by RQ-PCR. The results showed that the killing effect of PBMNC induced by IL-23 alone or IL-23 combined with IL-2 on K562 cells was observed, and obviously enhanced with prolonging of time, moreover, there was statistical difference among different time points (P < 0.05). The IFN-γ level in supernatant of PBMNC cultured with cytokines significantly increased, and the IFN-γ levels in group of IL-23 combined with IL-2 were higher than that in other groups (P < 0.05). The mRNA expressions level of perforin and granzymes B of the expanded PBMNC in groups cultured with cytokines were higher than that in control group (P < 0.05), and the mRNA expressions of perforin and granzymes B in group of IL-23 combined with IL-2 were significantly higher than that in others (P < 0.05). It is concluded that IL-23 can promote the killing effect of PBMNC on K562 cells. The combination of IL-2 with IL-23 displays synergic effect and a time-dependent manner. IL-23 also enhances the expression of IFN-γ, perforin and granzyme B in PBMNC. Its combination with IL-2 displays synergistic effect, suggesting that the anti-leukemic activity of IL-23 may be realized through inducing PBMNC to express IFN-γ, perforin and granzyme B.
Granzymes ; metabolism ; Humans ; Interferon-gamma ; metabolism ; Interleukin-2 ; pharmacology ; Interleukin-23 ; pharmacology ; K562 Cells ; Monocytes ; drug effects ; metabolism ; Perforin ; metabolism

Objective To explore the effects of problem-based learning (PBL) method on the efficiency of teaching of Chinese medicine dermatology based on medical records. Methods Undergraduate students who were in the same grade were divided into experimental group and control group. The experimental group was taught with the PBL method based on medical records. Teachers selected medical records, combed knowledge points, designed questions and carried out teaching in response to questions. The control group was taught with traditional teaching method. The teaching efficiency of two groups was evaluated by using test scores and questionnaire survey. Results The scores of syndrome differentiation scores, medication scores, and the overall score of experimental group were better than those in the control group. Compared with the control group, learning initiative, ability to involve in the teaching and master knowledge, and ability of logical analysis and communication of experimental group were all improved remarkably. Conclusion PBL method based on medical cases is beneficial for the improvement of the level of diagnosing and treating skin diseases based on syndrome differentiation and ability of solving problem.

Objective To further explore the genetic characteristics of oidiomycetes mutant strains like bacterial morphology on the basis of the study on morphology and structure of mutated candida.Methods The standard strains of candida albicans were induced by low temperature and under the condition of low temperature and nutrient deficiency.Variation of standard strains of Candida albicans were induced by clinical antifungal drugs such as fluconazole with different concentration gradient.Fungal gene template was prepared by boiling method,sequences of 16SRNA and 18SRNA were amplified using bacteria conservative gene sequence of 16SRNA and fungal conserved gene sequence of 18SRNA,and observed and recorded the results agarose gel electrophoresis.At the same time,the amplified fragment of bacterial conservative gene 16SRNA was sequenced,and the sequence was analyzed by BLAST comparison.Results the 16SRNA sequences of candida variant were amplified positive,while the standard strain of candida albicans did not show the corresponding amplification band.Except 2 strains which showed a faint band,the other variants of the 18SRNA sequences did not amplified the target band,while the standard strains of candida albicans showed a corresponding amplification bands.Suggested that proportion of 18SRNA sequences in the genome of oidiomycetes mutant strains like bacterial morphology was not much even lack.The 16SRNA fragments amplified of oidiomycetes mutant strains like bacterial morphology did determination of DNA sequence after purification.BLAST comparison analysis,it was found that sequence of oidiomycetes mutant strains like bacterial morphology had higher similarity with bacterial sequences in the database.Conclusion Oidiomycetes mutant strains like bacterial morphology contained bacterial and a small amount of fungus conservative gene.Oidiomycetes mutant strains like bacterial morphology with original nuclear biological character are ones from eukaryotes.This study is great significance in biological evolution,especially in the evolution of prokaryotic cells and eukaryotic cells.