Objective To evaluate the hemodynamic changes induced by local infiltration with different concentrations of adrenaline during endoscopic sinus surgery under general anesthesia using impedance cardiography (ICG) .Methods Sixty-nine ASA Ⅰ or Ⅱpatients of both sexes (37 males, 32 females) aged 18-60 yrs undergoing elective endoscopic sinus surgery under general anesthesia were randomized to receive local infiltration of nasal mucous membrane with 4 ml of lidocaine containing 20 ?g (group Ⅰ) or 40?g (group Ⅱ) or no adrenaline (group Ⅲ-control) . Hemodynamic changes were monitored by ICG. MAR, HR, cardiac index (CI), systemic vascular resistance index (SVRI) and acceleration index (ACI) were recorded before (baseline) and at 0.75, 1.5, 2.25, 3.0, 3.75, 4.5, 5.25 and 6.0 min after local nasal adrenaline infiltration.Results MAP was significantly decreased while HR increased at 1.5 min after adrenaline infiltration as compared to the baseline values in group Ⅰ and Ⅱ (P

Objective To study the incidence of coronary artery aneurysm (CAA) in patients under coronary angiography (CAG), its clinic features and prognosis Methods Retrospective studies were conducted of the clinical features, treatment and outcome of 2?876 patients under CAG Results Among the 2?876 patients, 26 had CAA, the total incidence of CAA was 0 904% Among these patients, 14 had myocardial infarction, and 24 had narrowing coronary artery (stenosis≥50%) Among the 26 cases of CAA, 20 ateries had thrombosis No CAA had ruptured Conclusion The incidence of CAA in the studied CAG population was 0 904%, CAA could be responsible for myocardial ischemia and myocardial infarction

When applied to treating diseases such as the hemorrhage in alimentary tract and tumors, LDRF-50 RF curer is effective, safe and easy to operate. There is no pollution, tissue adhesion and damage to the endoscope during the process of treatment.

Objective To compare and analyze the index variation of Yang deficiency mice induced by hydrocortisone in different way of administration and dose. Methods The mice model of Yang deficiency were induced by low dose and high dose hydrocortisone(12.5 mg/kg, 25 mg/kg) in two ways of intramuscular and intraperitoneal injection. The symptoms, body weight, the average intake, the index of stress and the coefficient of sex organs and immune organs of animals were observed. Results In the way of intraperitoneal injection, the weight(24.52±3.29)g, body temperature(35.24±0.32)℃ of high dose of model group were significantly lower than that of control group(31.10±6.11)g,(37.02±0.64)℃. The average intake of low dose group(4.30 ± 0.29)g/(per?d) was lower than control group(7.38±0.53)g/(per?d), and the coefficient of preputial glands(0.10±0.02), penis(0.15±0.03), thymus(0.12±0.03)were lower than that of control group. In the way of intramuscular injection, the average intake of high dose group(5.92±2.01)g/(per?d) was lower than control group(8.60±1.33)g/(per?d). The body temperature(34.90±0.22)℃ and the time of swimming in low temperature (34.00±22.41)s of low dose model group were lower than that of control group(36.43±0.91)℃, (67.17±21.93)s, and the coefficient of thymus of two model groups(0.10±0.02),(0.11±0.06)were lower than that of control group. Conclusion Various dose and model establishment methods of Yang deficiency mice have different the time of symptom appearing, the degree of symptom and sensitive index.

Objective To compare ureteroscopic hthotomy (URL)and minimally invasive percuta-neous nephrolithotomy (MPCNL) for the management of upper-ureteral calculi ≥ 1.5 cm. Methods Fifty-eight patients with upper-ureteral calculi ≥ 1.5 cm were selected in randomized for URL group (35patients)or MPCNL group (23 patients). Ultrasonography and intravenous X-ray were performed for all pa-tients before surgery. Results In the URL group, 13 cases (37.1%)were rendered stone-free, 8 stones mi-grated upward to the pelvis of kidney. In these cases,a double- J stent was inserted, and ESWL was per-formed,7 cases had ureteral distortion, 3 cases had ureteral stricture, 4 cases had bad field of vision, MPCNL or open operation was performed in these eases. The mean operative time was 38 minutes (range 25-48 min-utes). In the MPCNL group,21 eases (91.3%)were rendered stone-free. In the other 2 patients,ESWL was performed because the stone fragments migrated upward to the pelvis of kidney. The mean operative time was 34 minutes (range 20-58 minutes). Conclusion Compared with URL,MPCNL is a safe and effective procedure for treating upper-ureteral calculi ≥ 1.5 cm.

Objective To investigate the effect of PBL teaching method in the otomicrosurgery anatomy training.Methods 40 students were randomly divided into 2 groups:the control group received traditional teaching methods(n=20),and the experimental group received the PBL teaching method(n = 20).After the training,all trainees would accept the theory test,while all anatomical specimens of the two groups would receive clinical skills ratings.Results The scores of the basic theory and clinical skills of the experimental group are better than the control group at the end of the training.Conclusion PBL teaching method is very suitable for otomicrosurgery anatomy training and can enable students to achieve better results.

Objective To compare the difference between modified peroral endoscopic myotomy (Liu?POEM) and conventional POEM for achalasia. Methods Thirty achalasia patients treated with Liu?POEM and 30 with conventional POEM were enrolled. A retrospective study was performed to compare the conventional POEM and Liu?POEM procedures by evaluating total operation time, postoperative complications and symptoms( Eckardt score) . Results The average total operation time of Liu?POEM was 27?13 ±11?42 min and the average myotomy time was 13?20±5?09 min. There was no pneumomediastinum, subcutaneous emphysema or fever. The average total operation time of conventional POEM was 51?22 ± 25?63 min. The average myotomy time was 11?18±7?61 min. There were three cases(10%) of subcutaneous emphysema but recovered after two days without any special treatment. One patient who underwent conventional POEM had fever( the highest temperature was 37?6℃) and his temperature subsided to normal after physical cooling in one day. Postoperative Eckardt scores of patients were all less than 3. After postoperative follow?up of 3 to 12 months, no complications occurred in any patient. Conclusion Liu?POEM is a modified approach to treat achalasia, advantageous over conventional POEM in more simplified operation procedure, shorter operation time and less invasiveness.

As the major member of serine/threonine protein ki-nases family, glycogen synthase kinase 3β ( GSK-3β) has well characterized roles in the development of a variety of diseases. However, it is noticed that modulation of GSK-3β in tumor pro-gress is two-faced. Once the activity of GSK-3βas a“pro-onco-genic factor” is inhibited, opposing role as a“tumor suppressor”can also be disrupted, which will trigger the consequent side effect on activation of Wnt/β-catenin signaling pathway. The is-sue has placed a major obstacle to anti-GSK-3β in cancer treat-ment. In fact, functional compartmentalization of a large number of intracellular signaling events cross-talked with GSK-3β can prevent their mutual interference and determine the cell fate. Therefore, understanding the specific mechanisms of GSK-3β in regulation of diverse signaling systems or refinement of a sub-strate competitive inhibitor may have great significance to exploit approaches selectively target GSK-3β in tumor treatment.

Objective To conduct a retrospective study about drug-induced hyperthermia (DIH) based on DIH data obtained in medical practice,and elucidate the relationship between DIH incidence and antibacterials overuse.Methods To investigate successively the medical records of inpatients from orthopaedics department in Fudan university affiliated Jinshan hospital at two different periods,and data of DIH cases were extracted to perform a comparative study.The period for 229 effective cases of group Ⅰ was from Feb.1 to Apr.30,2011,before significant improvement on antibacterials use.The period for 342 effective cases of group Ⅱ was from Jul.1 to Sep.30,2012,after the effective enforcements of regulation on antibacterials use.Inclusion criteria for DIH were:①an oral temperature ≥37.6 ℃ since postoperative day 4,②no evidence of infection,③a time relationship between fever and the administration of causative drugs:a fever occurring with drug administration and disappearing after drug cessation within 3 days,④no other causes for the fever,⑤oral temperature ≤ 37.6 ℃ until leaving hospital.Exclusion criteria for DIH were listed below:①possible pathological fever,e.g.,in cancer,②hospitalization within 3 days,③no surgery,④severe trauma,for example,visceral or central nervous system injury.Results All causative drugs were for injection.By comparison,duration of antibacterial administration is significantly shorter in group Ⅱ than in group Ⅰ (1.7 ± 1.7 vs.4.6-± 1.8days,P ＜ 0.01),and total DIH incidence and antibacterials related DIH incidence were significantly lower in group Ⅱ than in group Ⅰ (7.3％ vs.30.1％,1.5％ vs.25.3％,both P ＜0.01).Conclusion DIH incidence is related with drug type especially with antibacterials overuse,and changed with drug program.DIH was more serious for injection of antibacterials than injection of traditional Chinese medicine.Decrease of antibacterials usage is positively associated with the decreased DIH incidence.Safe medication should begin from safe usage of antibacterials.

OBJECTIVE: To explore the function of outer hair cells and its influencing factors in the workers of occupational exposure to low frequency electric and magnetic fields. METHOD: 502 high-strength LF EMFs-exposed workers were taken as the study subjects. The field intensity indicator and noise analyzer were employed for the examination of the electromagnetic energy intensity and noise value at the working sites. Self-administered questionnaires were adopted. Universal hearing screening by distortion product otoacoustic emission (DPOAE) and pure tone audiometry (PTA) were done. 100 workers who had abnormal POAE were taken as the observation group and 100 workers who had normal DPOAE were taken as the control group. The workers need be confirmed with ABR testing when the pure tone threshold of two consecutive frequencies were above 20 dB HL or DPOAE detection in any frequency did not pass. Multiple factor analysis with logistic regression was performed for the risk factors. RESULT: The average electric power density in job locations was 21-38 KV/m, which was higher than national standard (< 5 kv/m). Average noise-level in job locations was 52-65 dBHL, which was within the standard (< 85 dB(A). Questionnaire presented that low frequency electric and magnetic fields might increase the incidence of headache, insomnia and tinnitus in the observed group. The incidence of abnormal DPOAE was higher in the subjects of the observed group (P < 0.01). At 676, 933, 3616, 5 130, 7253 Hz, the DPOAE amplitudes of the observed group workers were significantly lower than the control group. Multivariate analysis showed that the risk factors of abnormal DPOAE included exposure of EMF, length of service, daily exposure time, conservatory measures might be protective factors. CONCLUSION The changes of DPOAE indicated that the exposure to low frequency electric and magnetic fields had a subtle, discreet and localized impairing effects on outer hair cells. Exposure of low frequency electric and magnetic fields, length of service, daily exposure time might be risk factors, conservatory measures might be protective factors.
Auditory Threshold ; Case-Control Studies ; Electromagnetic Fields ; adverse effects ; Hair Cells, Vestibular ; pathology ; Humans ; Magnetic Fields ; adverse effects ; Male ; Noise ; adverse effects ; Occupational Exposure ; Surveys and Questionnaires