OBJECTIVE: To investigate the effect of electroacupuncture pretreatment on the quality of recovery in the patients undergoing laparoscopic gastrointestinal surgery. METHODS: Sixty patients for elective laparoscopic resection of gastrointestinal tumors under general anesthesia were randomly assigned to either an observation group or a control group, with 30 patients in each group. In the control group, the routine inhalation-intravenous combined general anesthesia was adopted. On the basis of the control group, in the observation group, 30 min before anesthesia induction, electroacupuncture was applied to bilateral Neiguan (PC 6) and Neimadian (Extra) for 30 min, using disperse-dense wave and at 2 Hz/100 Hz. The recovery time of spontaneous breathing, awakening time, extubation time, and the post-anesthesia care unit (PACU) stay time were compared between the two groups. Mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO₂) were recorded at multiple time points: before electroacupuncture (T0), before extubation (T1), immediately after extubation (T2), 5 minutes (T3) and 10 minutes (T4) after extubation, and upon discharge from PACU (T5). The visual analogue scale (VAS) score for pain and Ramsay sedation score at T3, T4 and T5 were observed; and the incidence of agitation, nausea and vomiting at T5 was evaluated in the two groups. At T0 and T5, the serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and cortisol were determined in the two groups. RESULTS: In the observation group, the recovery time of spontaneous breathing, awakening time, extubation time, and PACU stay time were shorter (P<0.001), MAP and HR at T2 were lower (P<0.01, P<0.05), the VAS scores for pain at T3, T4, and T5 dropped (P<0.001, P<0.01), and the Ramsay sedation score at T3 reduced (P<0.05) compared with those in the control group. The incidence of nausea and vomiting was lower in the observation group when compared with that in the control group (P<0.05). In comparison with the indexes at T0, the serum levels of TNF-α, IL-6, and cortisol increased at T5 in both groups (P<0.01); and these indexes at T5 in the observation group were lower than those in the control group (P<0.01, P<0.05). CONCLUSION Electroacupuncture pretreatment can enhance the quality of recovery in the patients undergoing laparoscopic gastrointestinal tumor surgery, shorten the time for spontaneous breathing recovery, awakening, extubation and PACU stay, and attenuate postoperative pain and stress response.
Humans ; Electroacupuncture ; Female ; Male ; Middle Aged ; Laparoscopy ; Adult ; Aged ; Anesthesia Recovery Period ; Interleukin-6/blood* ; Pain, Postoperative/therapy* ; Tumor Necrosis Factor-alpha/blood* ; Young Adult ; Gastrointestinal Neoplasms/therapy* ; Acupuncture Analgesia

OBJECTIVE: To compare the image quality of three-dimensional time-of-flight (TOF) magnetic resonance angiography (MRA) with sparse undersampling and iterative reconstruction (sparse TOF) with that of conventional TOF MRA. MATERIALS AND METHODS: This study included 56 patients who had undergone sparse TOF MRA for intracranial artery evaluation on a 3T MR scanner. Conventional TOF MRA scans were also acquired from 29 patients with matched acquisition times and another 27 patients with matched scanning parameters. The image quality was scored using a five-point scale based on the delineation of arterial vessel segments, artifacts, overall vessel visualization, and overall image quality by two radiologists independently, and the data were analyzed using the non-parametric Wilcoxon signed-rank test. Contrast ratios (CRs) of vessels were compared using the paired t test. Interobserver agreement was calculated using the kappa test. RESULTS: Compared with conventional TOF at the same spatial resolution, sparse TOF with an acceleration factor of 3.5 could reduce acquisition time by 40% and showed comparable image quality. In addition, when compared with conventional TOF with the same acquisition time, sparse TOF with an acceleration factor of 5 could also achieve higher spatial resolution, better delineation of vessel segments, fewer artifacts, higher image quality, and a higher CR (p < 0.05). Good-to-excellent interobserver agreement (κ: 0.65–1.00) was obtained between the two radiologists. CONCLUSION: Compared with conventional TOF, sparse TOF can achieve equivalent image quality in a reduced duration. Furthermore, using the same acquisition time, sparse TOF could improve the delineation of vessels and decrease image artifacts.
Acceleration ; Arteries ; Artifacts ; Humans ; Magnetic Resonance Angiography

Objective To investigate the clinical manifestations and genetic features of children with papillorenal syndrome caused by PAX2 gene mutation.Methods Clinical manifestations,imaging changes and sequencing data were collected and analyzed from a family with papillorenal syndrome who were diagnosed in Wuhan Children's Hospital in February 2018."PAX2","papillorenal syndrome" and "renal coloboma syndrome" were used as key words to search in China National Knowledge Infrastructure,Wangfang Data Knowledge Service Platform,PubMed and Human Gene Mutation Database up to April 2018.Results A ten years old girl was admitted due to "edema and urine output decreased for one week".Lab showed BUN 25.30 mmol/L,Scr 766.5 μmol/L,Urine protein 3.6 g/24 h.Imaging examination showed bilateral vesical and ureter reflux combined with left duplex kidney and duplication of ureter.Developmental dysplasia of the left hip was also found.The father of the patient had been diagnosed with chronic kidney disease for 10 years and on hemodialysis for 6 years.Next generation sequencing revealed that both the father and daughter carried a heterozygous nonsense mutation in the exon3 c.219C ＞ G(p.Y73X) of PAX2.No Chinese literature ever was reported about papillorenal syndrome.Ninety-four articles in English were retrieved and 177 patients with papillorenal syndrome were confirmed by gene analysis with a total of 92 PAX2 variants.Ten nonsense mutations had been reported.Developmental dysplasia of the hip (DDH) never be reported before.Conclusion Papillorenal syndrome caused by PAX2 mutation can mainly manifest as abnormal development of both kidney and optic nerve,which may be accompanied by other systemic abnormalities,it is rarely reported in China.DDH may be a new phenotype of papillorenal syndrome.

Objective:To study the effect of Xihuang Capsule combined with GP regimen on the serum levels of tumor necrosis factor-oα (TNF-α),vascular endothelial growth factor (VEGF),matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) of patients with advanced breast cancer.Methods:88 patients with advanced breast cancer admitted in our hospital from March 2014 to February 2015 were selected and divided into the observation group and the control group according to the order of admission.The control group was treated by the GP program,the observation group was given Xihuang capsule combined with GP regimen.The serum levels of TNF-α,VEGF,MMP-2 and MMP-9 in the two groups were compared before and after treatment.The clinical efficacy and incidence of side effects were analyzed.Results:The total effective rate of observation group was significantly higher than that of the control group [84.09％ (37/44) vs 50.00％ (22/44)] (P＜0.05).There was no significant difference in the serum levels of TNF-α,VEGF,MMP-2 and MMP-9 between the two groups before treatment (P＞0.05).After treatment,the serum TNF-α,VEGF,MMP-2 and MMP-9 levels were significantly lower than those before treatment (P＜0.05).The serum levels of TNF-α,VEGF,MMP-2 and MMP-9 of observation group were significantly lower than those of the control group (P＜0.05).There was no significant difference in the incidence rate of nausea and vomiting between the two groups (P＞0.05).The incidence ofalopecia,diarrhea,abnormal liver function,decreased appetite,anemia and leukopenia in the observation group were significantly lower than those of the control group (P＜0.05).Conclusion:Xihuang Capsule combined with GP regimen could more effectively reduce the levels of serum TNF-α,VEGF,MMP-2 and MMP-9 of patients with advanced breast cancer than GP regime alone with higher safety.