Aerotitis media occurs frequently among flyers. 40 cases have been treated with electro- acupuncture in our hospital with satisfactory results. Xiaguan was selected as local point and Hegu as distal point. The patients were needled once a day or every other day. The total rate of effectiveness was 90.0%. According to Western medicine, this disease is due to poor pressure-equilibrating function of the Eustachian tube. The mechanism of treating this disease was explained by traditional Chinese medicine and western medicine theory.
Acupuncture ; Asian Continental Ancestry Group* ; Eustachian Tube ; Humans ; Medicine, Chinese Traditional

Objective To observe the relationship of awake bispectral index (BISawake) and the postoperative cognitive dysfunction (POCD). Methods 100 patients aged 60~75 years with ASA status Ⅰ~Ⅱ, underwent elective lower abdominal surgery with intravenous anesthesia (propofol, remifentanyl and rocuronium). The BIS was adjusted in 40~60 during the surgery. Their cognitive function was assessed with the neuropsychological test battery commended by International study of postoperative cognitive dysfunction (ISPOCD). Results 8 patients withdrew for unwilling or serious complications. The BISawake was more than 65 in 68 patients (group A), and less than 65 in 24 patients (group B). The difference of the verbal learning immediate and delayed of Hopkins Verbal Learning Test-Revised was more in the group B than in the group A. Conclusion Lower BISawake may be associated with the decline of postoperative cognitive function.

Objective To compare the efficacy of laryngeal mask airway-Advance (ALMA) and laryngeal mask airway-Supreme (S-LMA) in patients undergoing laparoscopic cholecystectomy.Methods Two hundred and forty ASA Ⅰ or Ⅱ patients,aged 18-64 yr,weighing 50-70 kg,undergoing laparoscopic cholecystectomy,were randomly divided into2 groups (n=120 each):group S-LMA (group S) and group A-LMA (group A).LMA was inserted after induction of general anesthesia with propofol 2.0-2.5 mg/kg,sufentanil 0.2 μg/kg and rocuronium 0.6 mg/kg.After LMA was placed,the rim was immediately inflated and positive pressure was applied to the reservoir bag of anesthesia machine circuit to check for leaks.The plateau pressure at which leaks occurred was recorded.BP,HR,SpO2,PErCO2 and Ppeak were monitored during operation.Fiberoptic bronchoscopy was performed and the placement was scored (0 =unable to see the vocal cords and the ventilation of the lungs was inadequate,4=vocal cords were clearly seen and ventilation was adequate).The rate of successful placement,placement time,the incidence of leaks during operation,duration of anesthesia and surgery,extubation time,emergence time,blood stain on the LMA after being removed,backflow after extubation and postoperatve complacations including sore throat,hoarseness and dysphagia were recorded.The efficacy for airway management and the difficulty of placement were scored.Results There was no significant difference in the rate of successful placement,difficulty of placement scores,blood stain on the LMA after being removed,incidence of backflow,sore throat,hoarseness and dysphogia,anesthesia time,duration of surgery,extubation time and emergence time between the two groups.The placement time was shorter in group S than in group A,but the airway sealing pressure,FOB scores and efficacy for airway management scores were significantly higher and the incidence of leaks during operation was significantly lower in group A than in group S.Conclusion Both A-LMA and S-LMA can provide adequate ventilation during laparoscopic cholecystectomy.The efficacy of A-LMA is better.

Objective To assess the accuracy of mixed venous oxygen saturation ( S(-v)O2 ) in reflecting the change in CO during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty-five NYHA Ⅰ -Ⅲ patients of both sexes, aged 50-75 yr, weighing 55-85 kg, undergoing OPCABG, were studied. Anesthesia was induced with midazolam, fentanyl, etomidate and pipecuronium and maintained with propofol infusion and intermittent iv boluses of fentanyl and pipecuronium supplemented with isoflurane if necessary. The patients were mechanically ventilated (VT 8-10 ml/kg, RR 8-10 bpm, I:E 1:2). PETCO2 was maintained at 35-45 mm Hg.Radial artery was cannulated and pulmonary catheter was placed. CI, S(-v)O2 and Hb were monitored and recorded before skin incision, during anastomosis with left anterior descending artery (LAD), right coronary artery (RCA)and left circumflex coronary artery (LCX), when the chest was closed, when the patients' body position was changed and the heart was manipulated. S(-v)O2 and CI were scaled immediately after the pulmonary artery catheter was placed and before anastomosing LAD. Results The CO change in S(-v)O2 was real-time and accurate in reflecting the body positioning and elevation of hearts. There was no simultaneous significant change in CI.Conclusion The CO change in S(-v)O2 is real-time and accurate in reflecting the body positioning and elevation of hearts during OPCABG.

Objective: To evaluate the clinical value of multislice CT (MSCT) in the diagnosis and preoperative TNM staging of gastric carcinoma. Methods: Fifty patients with advanced gastric carcinoma were examined by MSCT, gastrointestinal series (GI), fiberoptic gastroscopy (FG) and transabdominal ultrasonography (US). The results of the 4 methods were compared with postoperative pathological results. Forty patients, who were diagnosed as having advanced gastric carcinoma by both MSCT and US, had their TNM staging evaluated and the results were compared with postoperative pathological TNM evaluation. Results: The detection rates of MSCT, FG, GI and US for advanced gastric carcinoma were 98%, 100%, 88% and 80%, respectively. The detection rate of MSCT was not significantly different with that of FG, but was obviously higher than that of GI (P=0.027) and US (P=0.004). The accuracy of MSCT in preoperative TNM staging was significantly higher than that of US(92.5% vs 72.5%). Conclusion: MSCT, with two-phase thin slice incremental scanning image, multiplaner reformats (MPR) and three-dimension (3D) image, is more advantaged in detecting the gross type, size, location, invasion and metastasis of advanced gastric carcinoma, thus greatly improving the detection rate and preoperative TNM staging of advanced gastric carcinoma.

Objective:To validate the clinical value of CT-guided curve-needle percutaneous ethanol injection (CNPEI) for celiac plexus block analgesia. Methods: Thirty-two patients with end-stage cancer, including 13 complicated with extensive retroperitoneal lymph node enlargement and fusion, were enrolled in this study. All patients complained of refractory upper abdominal pain and had received narcotic analgesics and radiotherapy, but the analgesic effect was not good. CT-guided CNPEI was therefore prescribed. Results: The effective rates of CT-guided CNPEI were 100%, 100%, 96.9%, 90.6%, 87.5%, and 84.4% immediately,and at 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after treatment, respectively. All enlarged lymph nodes had obvious necrosis and became shrunk. Conclusion: Combined application of bilateral anterior and posterior diaphragmatic crura block and trans-lymph node block can produce good analgesic effects, and curve-needle puncture make the above technique simpler.

Objective:To validate the therapeutic value of CT-guided percutaneous ethanol injection (PEI) in the treatment of metastatic adrenal tumors. Methods: Thirty-one foci (diameter ranging from 1.5 cm to 7.2 cm) in 25 patients with metastatic adrenal tumors were treated with CT-guided PEI for more than twice. Plain and enhanced CT scans were performed 1-2 months after PEI to observe the size and necrosis of the tumors. Results: Post-PEI enhanced CT scan showed that 18 of the 20 foci with diameters less than 3 cm completely necrotized; 11 foci with diameters between 3 cm and 7.2 cm necrotized partially, and 2 foci completely necrotized after another 2-3 courses of PEI treatment. Conclusion: CT-guided PEI is a simple and minimally invasive means for treatment of metastatic adrenal tumors, and the therapeutic effect is satisfactory.

Objective To evaluate the therapeutic efficacy of percutaneous drainage of solitary retroperitoneal abscess under CT guidance.Methods A retrospective analysis was made for percutaneous drainage of solitary retroperitoneal abscess with CT guidance in 13 patients including 4 at the tail of pancreas, 3 nearby the head of pancreas,3 in perirenal space,2 in posterior renal space and 1 case was by the side of psoas muscle.The maximum diameters of retroperitoneal abscess were between 3.5cm and 8cm.Results Out of 13 patients,8 with one time drainage,3 with twice drainages and 2 with thrice drainages.The mean duration of drainage was 16 days with no recurrence or residual lesions during clinical follow up.Conclusion CT guided percutaneous drainage of solitary retroperitoneal abscess is effective and minimally invasive.(J Intervent Radiol,2007,16:828-830)

The prevalence of thyroid cancer has shown an upward trend in China in recent years. Advances in thyroid ultrasound and fine needle puncture cytology have improved the accuracy of the preoperative diagnosis of thyroid cancer. Also,the application of endoscopy-assisted techniques and intraoperative nerve monitoring technology and the further understanding of thyroid lymph node metastasis have made the thyroid surgeries safer and less invasive. This article summarizes the recent advances in the surgical therapy of thyroid cancer.
Carcinoma, Papillary ; surgery ; Humans ; Iodine Radioisotopes ; therapeutic use ; Molecular Targeted Therapy ; Neoadjuvant Therapy ; Thyroid Neoplasms ; surgery ; therapy

OBJECTIVETo study the toll-like receptor 2 (TLR2) Arg753Gln gene polymorphisms of acne patients of Gan-depression induced qi stagnation syndrome and damp-heat in the interior syndrome, thus laying the foundation for genetics studies on its occurrence.

METHODSThe distribution and the frequency of allelic genes were studied in 75 acne patients of damp-heat in the interior syndrome, and 87 acne patients with Gan-depression induced qi stagnation syndrome, as well as 70 healthy subjects (as the normal control group) using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.

RESULTSThere was significant difference in the frequency of the genotype Arg/Gln + Gln/Gln in the TLR2 Arg753Gln genetic polymorphisms [26. 44% (23/87) in Gan-depression induced qi stagnation syndrome, 41.33% (31/75) in damp-heat in the interior syndrome, and 12.86% (9/70) in the normal control group] (P < 0.05).

CONCLUSIONThe existence of 753Gln allele in the Arg753Gln of TLR2 increased the onset risk of acne patients of Gan-depression induced qi stagnation syndrome and damp-heat in the interior syndrome.

Acne Vulgaris ; diagnosis ; ethnology ; genetics ; Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Medicine, Chinese Traditional ; Phenotype ; Polymorphism, Genetic ; Qi ; Toll-Like Receptor 2 ; genetics ; Young Adult