Surgery is the main treatment for Cushing's syndrome.The disturbed metabolic consequences such as prolonged exposure to excessive glucocorticoid,high glucose and hypertension will add the risks and difficulties to surgery.This paper reviews the perioperative glucocorticoid replacement,correction of the hypercotisolaemia before operation,and prevention of complications after operation.

0.05).But only 23 lesions(38.3%)showed high signal on T1WI.Conclusion:This research confirmed the MRI-guided HIFU equipment is useful to monitor the HIFU treatment and evaluate the curative effect accurately,which provids a basis for the latter treatment of liver tumors.

Objective To evaluate the effect of crisis prediction score nursing in reducing complication and nursing deficiencies in patients with myasthenia gravis complicated with thymoma.Methods 46 patients were randomly divided into the study group and the control group,the study group was given with crisis prediction score nursing,the control group was given with individual nursing.The postoperative complications incidence,hospitalization time,nursing defect rate,patient satisfaction were compared between two groups,and Osserman efficacy evaluation was implemented.Results Compared with the control group,postoperative complications (hemorrhage,pneumothorax,respiratory tract infections and myasthenia gravis crisis)rates and nursing defect rate in the study group were lower,hospitalization time shortened,and patients' satisfaction degree increased.Conclusions The crisis prediction score care can significantly reduce postoperative complications and nursing defect rate,which is important for patients' health.

Child ; Humans ; Urolithiasis ; diagnosis ; therapy

Objective To study the flurbiprofen axetil (FA) for postoperative analgesia of gynecological laparoscopic surgery and the changes of interleukin-6 in blood.Methods80 cases were selected for gynecologic laparoscopic surgery,the patients were randomly divided into 4 groups with 20 cases each group.Group A was given FA 50 mg and tramadol 1 mg/kg 30 minutes before the end of surgery.Group B was given FA 50 mg 5 minutes before induction of anesthesia and given tramadol 1 mg/kg 30 minutes before the end of surgery,and group C was given FA 50 mg five minutes before induction of anesthesia.Group D was given tramadol 2 mg/kg 30 minutes before the end of surgery.After the surgery,the VAS was observed in real-time of wake up (T1),and 2 hours (T2),6 hours (T6) and 24 hours (T24) after operating.The blood of each group was taken at the different time points including arriving in the room (T0),waking up (T1) and 6 hours (T6) after operating.The blood samples were hold for 30 minutes and centrifuged (3000 r/min,10 min),and IL-6 was detected using double-antibody sandwich ABC-ELISA.ResultsThe experiments showed that VAS in T1 time point of group A,B,C were lower than that of group D(1.40±0.26,1.67±0.37,1.60±0.42 vs 3.13±2.32).In T24 time point,VAS of group A,B were also lower than that of group D(2.13±1.24,2.00±1.25 vs 3.53±1.87),the differences were significant (P＜0.05).The experiments showed that concentration of IL-6 in group D was higher than that in group A,B,C at the T1 time point (12.26±6.56 vs 2.94±2.55,3.37±2.43 vs 2.93±1.16,P＜0.05).ConclusionsThe postoperative analgesic effect of Flurbiprofen axetil combined with tramadol on the ogynecological laparoscopic was superior to using any of the drug alone.Flurbiprofen axetil could inhibit increasing of IL-6 and have an effect against the inflammatory response induced by surgical trauma,and it has a good analgesic effect.

Objective To compare the application value of routine electrocardiogram and dynamic electrocardiogram in the diagnosis of arrhythmia and heart rate variability in children.Methods In our hospital,pediatric arrhythmia patients were given routine electrocardiogram and dynamic electrocardiogram.The relationship between arrhythmia and heart rate variability in children was analyzed.Results Supraventricular tachycardia (13.33%),ventricular tachycardia(5.56%),premature ventricular contraction (21.11%),premature atrial contraction (14.44%),block (12.22%) in the dynamic electrocardiogram were significantly better than the conventional electrocardiogram,and the differences were statistically significant x2=11.93,4.56,9.22,10.74,11.55,all P<0.05).There were significant differences in the heart rate variability between ventricular arrhythmias and non-ventricular arrhythmias in children[(78.85±0.88),(4.68±2.43),(24.78±2.56),(21.66±0.94), t=10.88,11.79,9.84,9.92,all P<0.05].Conclusion Compared with routine electrocardiogram, dynamic electrocardiogram has better diagnostic value for pediatric arrhythmia of ventricular tachycardia.The detection rate of ventricular tachycardia,ventricular tachycardia,premature ventricular contraction,atrial premature contraction,conduction block and other arrhythmias are obviously superior.And dynamic ECG measurement of heart rate variability is helpful to assess the severity of the disease.

Objective To investigate the protective effect and the mechanism of isoflurane preconditioning on rat brain tissue suffering from rat liver ischemia-reperfusion injury .Methods 75 SD rats were randomly divided into five groups, sham group (S group);ischemia-reperfusion group (I/R group): liver ischemia for 60 min, reperfusion for 120 min;isoflurane preconditioning group ( ISO group ): 60 min before liver I/R, ISO pretreatment for 30 min; CsA +ISO group;CsA ( MPTP specific blocker ) 50 mg/kg intravenous injection , the same as ISO group after 30 min; CsA group:CsA 50 mg/kg intravenous injection .30 min before I/R.The animals were killed 24 h after ischemia and their brain were excised for measurement of mitochondrial permeability transition pore ( MPTP) and calcium content in mitochondria .The measurement of content of S-100βprotein in serum before ischemia and 120min after reperfusion through the application of Elisa kit.Results The mitochondrial Ca2+concentration of I/R group(287.32 ±26.17)was higher than that in S group (198.54 ±21.02) and the ISO group (209.74 ±29.49) ( P <0.05), and Ca2 + concentration of CsA +ISO group (267.31 ±37.52) was higher than the ISO group (P <0.05);there was not statistical significance between I/R and CsA group(288.63 ±23.15)(P <0.05).MPTP were more opened in I/R group(△S:1.73 ±0.24)than that in S group (△S:2.36 ±0.35)and ISO group(△S:2.11 ±0.32)(P <0.05),but MPTP were more opened in CsA +ISO group than that in ISO group (P <0.05).The content of S-100βprotein in serum was significantly higher in I/R group than that in sham and ISO groups (P <0.05),and the content of S-100βprotein in serum was significantly higher in CsA +ISO group than in the ISO groups ( P <0.05 ) .Conclusion The liver ischemia-reperfusion may injury the brain of the rat and isoflurane preconditioning can protect the brain on the rat .The reduce of mitochondria calcium overload and inhibition of MPTP opening are involved in the mechanism .

Tamoxifen has shown definitive effect when used as the adjuvant hormonal treatment in women with estrogen-receptor-positive breast cancer. However, long-term use of Tamoxifen can induce fatty liver disease. It has been proposed that tamoxifen may act throught mechanisms such as inducing triacylglycerol accumulation in mitochondria, abnormal fatty acid oxidation, and antagonizing actions of estrogen on hepatic lipid metabolism. Therefore, it is necessary to monitor lipid profile and liver function, conduct regular ultrasonography and CT examination in patients receiving tamoxifen treatment. Replacing tamoxifen with toremifene oraromatase inhibitors, or using lipid-lowering medicines may help prevent tamoxifen-induced fatty liver disease.

Eisenmenger syndrome (ES) was considered as a surgical contraindication in the past time. Only a few patients got lung transplantations or heart-lung transplantations due to lack of donors. Most of the patients had to choose conservative treatment to prolong their survival time. Recently, some clinical trials indicated targeted therapies in pulmonary arterial hypertension (PAH) were effective for the treatment of ES. This article reviewed the recent advances in this area.

With the rapid development of China's higher education and the intensified reforms in medical and health services,the problems and contradictions are increasingly prominent in ortho-pedic clinical teaching,especially how to improve medical interns' ability to read images. Picture archiving and communication system (PACS)plays an important role in academic education of medi-cal imaging. Case-based learning (CBL)is a team seminar teaching mode that is guided by cases, based on problems,targeted at students,and dominated by teachers. PACS and CBL were perfectly combined in orthopedic clinical teaching to improve teaching efficiency and the outcome was evaluat-ed through a questionnaire. Results showed that this teaching method inspired students' interests in learning,cultivated the orthopedic clinical way of thinking thus achieved better teaching effects.