Objective To study the influence of intravenous injection of dezocine and fentanyl under general anesthesia on analepsia and analgesia after children appendectomy.Methods 86 children needed peritoneoscope appendectomy were enrolled in the study.All patients were randomized into two groups.The patients in group A were given intravenous injection of dezocine at half an hour before the end of the operation.The patients in group B were given intravenous injection of fentanyl before the end of the operation.The operation length,the postoperative catheter removal time and the heart rate,respiratory rate,mean arterial pressure,blood pressure saturability at the time of stopping using narcotic (T1),the time of catheter removal (T2),10min after catheter removal (T3) of the two groups were observed and recorded.At half an hour after catheter removal,Riker sedation-agitation scale and FLACC of two groups were estimated.Results The heart rate[(112.47±8.06)beats/min,(111.29±9.03)beats/min] and mean arterial pressure[(69.49±7.33)mmHg,(68.72±6.93)mmHg] of group A at T2,T3 were significantly lower than those of group B[heart rate: (126.98±7.24)beats/min,(131.54±8.62)beats/min and mean arterial pressure: (76.81±5.18)mmHg,(72.05±3.76)mmHg, heart rate tT2=3.294,tT3=5.018;mean arterial pressure tT2=4.029,tT3=2.287,all P<0.05].Besides,the FLACC score[(3.62±0.73)points] and Riker score[(2.93±0.75)points] of group A at half an hour after catheter removal were significantly lower than those of group B[(5.06±0.92)points,(3.96±1.17)points,tFLACC=6.390,tRiker=2.119,all P<0.05].Conclusion Intravenous injection of properdezocine at half an hour before the end of the operation has good postoperative analgesia effect for children appendectomy and children wake up in a more stable state,and the occurrence rate of postoperative analgesia and adverse reaction is low, so it has less influence on cardiovascular reaction and is applicable for clinical application.

Objective: To investigate the abnormalities of the blood system in landfill workers. Methods: A cohort study was conducted for 224 landfill workers who were followed up for 6 consecutive years with abnormal routine blood test results and a low platelet count as the outcome events. The life-table method was used to analyze the incidence rates of these two outcome events, and the incidence rates were compared between first-and second-line workers. Results: A total of 71 workers had abnormal routine blood test results, among whom 29 had abnormal leukocyte count, 14 had abnormal erythrocyte count, 40 had abnormal platelet count, 17 had abnormal hemoglobin, and 29 had a reduction in platelet count. For these landfill workers, the 6-year abnormal rate of routine blood test results was 43.2%, and the incidence rate of low platelet count within 6 years was 13.5%. The first-line workers had a significantly lower abnormal rate of routine blood test results than the second-line workers (P=0.020) , and the relative risk of abnormal routine blood test results in the first-and second-line workers was 0.592. There was no significant difference in the incidence rate of low platelet count between the two groups of workers (P≥0.05) . Conclusion The landfill has an adverse effect on the blood system of landfill workers, and the second-line workers have greater impairment than the first-line workers.

Objective To explore the best way for clinical screening of primary aldosteronism (PA).Methods Three hundred and three suspected cases of PA were collected and divided into groups of primary aldosteronism group, essential hypertension group, and nonsecreting cortical adrenal tumor group.The plasma aldosterone concentration/plasma renin concentration ratio ( ARR) was used to draw the receiver operating characteristic ( ROC) curve and obtain the best cut-off point.Furthermore, the current screening schemes for PA were compared.Results Upright ARR yield had larger areas under the ROC curve than plasma aldosterone concentration or plasma renin concentration under all conditions of testing. The best cut-off point of upright ARR[(pg/ml)/(μIU/ml)] for the diagnosis of PA was 43.45.During the two postural stimulation tests,the two upright ARR exceeded 43.45 with the highest diagnostic sensitivity of PA reaching 0.94.During the two upright tests ARR was less than 43.45, with a sensitivity of 0.74, and a specificity of 0.94.Conclusion To screen for PA in high-risk populations, twice postural stimulation test is recommended.As long as the upright ARR is above 43.45, PA may be considered and further confirmation is needed to prevent misdiagnosis.

Human sex glands (ovary and testis) play extremely important roles in reproductive function and sexual behavior by secreting various hormones.However,complex changes in the structure and the function of sex gland occur with ageing,resulting in a series of clinical consequences.This article explores these changes and discuss about their diagnosis and treatment.

This paper analyzes the recently epidemic status of schistosomiasis,the change of natural and social factors,and field survey and evaluation data of schistosomiasis in Ya’an City after Lushan Earthquake on April 20,2013,and proposes that it is necessary to strengthen the conventional schistosomiasis control measures,the control of exogenous infection sources,the con-trol of Oncomelania hupensis snails and health education for ensuring no major epidemics after the disaster. This paper also recom-mends the direction and suggestions for future schistosomiasis control in Ya’an City.

Objective To evaluate the effects of measures on the schistosomiasis control after the earth quake in Lushan County so as to provide the experiences for post-disaster schistosomiasis control. Methods The measures taken in schistosomi-asis control after the earth quake were reviewed in Lushan County in 2013 and the epidemic situation of schistosomiasis was in-vestigated and the results were analyzed. Results The schistosomiasis control in floating population and the control of Oncome-lania hupensis snails were enhanced and no schistosome infections were found in both human and livestock. No infected snails and infested water were found. Conclusion The measures of schistosomiasis control after the disaster are effective in Lushan County and the goal to prevent major plague after the earth quake is achieved.

Objective To evaluate the effect of epidural block on postoperative cognitive dysfunction in elderly patients undergoing laparoscopic radical operation for gastric cancer under general anesthesia.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 65-75 yr,with preoperative Mini-Mental State Examination (MMSE) score ＞ 23,scheduled for elective laparoscopic radical operation for gastric cancer under general anesthesia,were randomized into epidural block group (group E,n =30) and control group (group C,n =30) using a random number table.Epidural block was performed at T8,9 interspace before induction of anesthesia.Anesthesia was induced with iv injection of midazolam 0.03 mg/kg,propofol 1.0-1.5 mg/kg,fentanyl 3-4 μg/kg and rocuronium 0.9 mg/kg.The patients were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of remifentanil 0.15-0.25 μg· kg-1· min 1 and propofol target-controlled infusion (target plasma concentration 2.5-3.0μg/ml).In group E,10 ml of mixture of 0.25％ ropivacaine and 0.04 mg/ml butorphanol was injected via the epidural catheter at 30 min before skin incision.In the two groups,the mixture 10 ml mentioned above was administered via the epidural catheter at 10 min before the end of operation followed by patientcontrolled epidural analgesia.The development of postoperative cognitive dysfunction (MMSE score ＜ 21) was recorded within 72 h after operation.Blood samples were collected from the internal jugular vein to detect the concentration of serum protein S-100β.Results The concentration of serum protein S-100β was significantly lower at 6,12 and 24 h after operation,and the incidence of postoperative cognitive dysfunction within 72 h after operation was lower in group E than in group C (P ＜ 0.05).Conclusion Epidural block can decrease the development of postoperative cognitive dysfunction in elderly patients undergoing laparoscopic radical operation for gastric cancer under general anesthesia.

This paper generalizes the seizures characterized with paroxysmal generalized spike and wave discharges (GSWDs) in the EEG. Recent studies showed that GSWDs disrupt specific neural networks only rather than the entire brain homogenously. Simultaneous EEG and functional MRI (EEG-fMRDI) provides a high spatiotemporal resolution method for uncovering the regions of the brain showing changes in metabolism and blood flow during epileptic activity. Human EEG-fMRI studies to date have revealed the blood oxygenation level dependent (BOLD) signal changes in response to GSWDs in some specific brain regions. Most studies have noted similar BOLD signals decrease in the bilateral cortical regions including frontal, frontal-parietal, posterior cingulated and precuneus cortex, as well as in the basal ganglia, and BOLD signals increase in the bilateral thalamic. Further studies demonstrated that BOLD signals in different regions were dynamic changes in the time course of GSWDs and BOLD changes in the cortical areas occurred before in the thalamus. These cortical-subcortical structures may form the neural networks associated with GSWDs generation and maintenance. More sophisticated analytic techniques will be developed to explore the BOLD time-course of GSWDs and identify the brain structures involved in seizure onset and discharges propagation respectively. The sub-network associated with different behavioral deficits between interical and ictal GSWDs, and the different subtypes of generalized seizures will be further studied. The functional connectivity of the nodes of the neural network of GSWDs can also be further investigated. A better understanding of the neural network responsible for GSWDs generation may help to develop new therapeutic interventions.
Animals ; Brain ; physiopathology ; Brain Mapping ; Brain Waves ; physiology ; Electroencephalography ; Epilepsy, Generalized ; physiopathology ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Neural Networks (Computer)

Objective To evaluate the clinical efficacy of recombinat human brain natriuretic peptide (rhBNP) in the treatment of acute myocardial infarction (AMI) with heart failure in aged patients. Methods Totally 63 elderly patients with AMI and heart failure were randomly divided into therapy (29 cases) and control (34 cases) groups.Besides routine treatment,the therapy group received rhBNP in continuous intravenous infusion, while control group was treated with nitroglycerin.Both drugs were administered for 3-5 days.The dyspnea remission rates after treatment were recorded.At the same time,heart rates and blood oxygen saturation,left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVDD),serum interleukin 6 (IL-6) and high sensitivity C reactive protein (hsCRP) were recorded before and after treatment. Results The total effective rate after the treatment was 79.3 ％ (23/29) in therapy group and 64.7％ (22/34) in control group(P =0.017).The dyspnea remission rate was better in therapy group than in control group (P＜0.05).The heart rate,blood oxygen saturation,LVEF,hsCPR and IL-6 in therapy group were [(120± 11) times/min,(78 ± 6) ％,(28 ± 32) ％,(25.78 ± 2.44) mg/L,(40.74 ± 5.43) μg/L]before treatment,and after treatment [ ( 89 ± 9) times/min,( 97 ± 6 ) ％,(43 ±± 20) ％,( 12.78 ± 2.54 )mg/L,(28.45±2.34) μg/L] (all P＜0.05).The above indexes in control group were [(117±8)times/min,(80±8) ％,(29±31)％,(21.44±1.33) mg/L,(41.87±5.46) μg/L] before treatment,and after treatment[(109± 10) times/min,(34±18) ％,(43±20) ％,(17.63± 1.62) mg/L,(36.56±3.02) μg/L].The heart rate and the levels of IL-6 and hsCPR were reduced,blood oxygen saturation and LVEF were increased in therapy group than those in control group. Conclusions rhBNP is efficient in the treatment of elderly AMI with heart failure.

Objective To evaluate the tolerance and safety of sorafenib for elderly patients with advanced renal cell carcinoma.Methods Forty cases with advanced renal cell carcinoma were enrolled,26 were males and 14 were females,the average age was 70 years.Recurrence or metastasis was found in 32 patients who had received nephrectomy,22 of the 32 cases had received cytokine therapy before recurrence or metastasis.Primary renal lesions of 8 cases could not be resected,so patients get renal tumor biopsy.Pathological type of all patients was clear cell carcinoma.KPS of all the patients were ≥70 points.Sorafenib was used as first-line treatment,with 400 mg twice per day,until intolerance or disease progression occurred.Results The average treatment time was 7.5 months (3-18 months),CR 0 case,PR 6 cases,SD 29 cases,PD 5 cases.The overall objective response rate and disease control rate were 15.0% (6/40)and 87.5%(35/40),respectively.The median follow-up period was 11 months.The adverse reaction included hand-foot skin reaction(70.0%),alopecia (62.5%),rash(52.5%),diarrhea(37.5%),loss of appetite(32.5%),fatigue(27.5%).Most adverse reactions occurred around the second week after drug therapy initiation,their duration did not equal.And most of these adverse reactions could be released by symptomatic treatment,they did not affect the treatment.Conclusions The types of adverse reactions of sorafenib for elderly patients with advanced renal cell carcinoma are similar to those reported in the literature.Generally the degree of adverse reactions is minor,with good tolerance and safety.