Reoperation for biliary-enteric strictures after hepaticojejunostomy in children with congenital biliary dilatation / 中华普通外科杂志

Objective:To evaluate clinical characteristics and treatment of postoperative anastomotic stricture in pediatric congenital biliary dilatation patients.Methods:The clinical data of 24 children with postoperative anastomotic stricture from Apr 2012 to Oct 2019 in Beijing Children's Hospital was retrospectively analyzed.Results:There were 6 males and 18 females. Patients were divided into bile- leak group (BL, n=6) and non bile-leak group (NBL, n=18) based on whether there was anastomotic leakage after primary surgery. The main symptoms in BL group was persistent obstructive jaundice, and recurrent cholangitis in NBL group. Postoperative symptoms were first shown in an average of 7.0 months in BL group, compared to 59.0 months in NBL group, P<0.05. In BL group, 4 underwent redoing hepaticojejunostomy, 2 underwent anastomosis plasty. In NBL group, 3 underwent redoing hepaticojejunostomy, 15 did anastomosis plasty with multiple biliary stones found necessitating extraction. After reoperation, one patient had bile leakage, 2 patients had recurrent cholangitis within one-month, 21 patients had uneventful recovery. Five were found to have biliary stones in long-term follow-up. Conclusions:Biliary-enteric anastomotic leakage can cause stricture in postoperative patients of congenital biliary dilatation ,reoperation is necessary in symptomatic patients.

Abuse or dependence of narcotic drugs and psychotropic drugs inhospital patients / 预防医学

Objective @#To understand the current situation and characteristics of narcotic drugs and psychotropic drugs abuse or dependence among hospital patients and to provide reference for strengthening the management of narcotic drugs and psychotropic drugs.@*Methods @#We collected clinical data from hospitals in Shandong and Guizhou provinces in 2016 and selected patients with history of narcotic drugs and psychotropic drugs. We investigated them through telephone or face-to-face interview,then described the characteristics of demographic information and abuse or dependence of narcotic drugs and psychotropic drugs in diagnosed drug abusers.@*Results @#A total of 280 patients with drug abuse or dependence were recruited,of which 223 cases from nine hospitals in Shandong and 57 cases from five hospitals in Guizhou. There were 170 male patients,accounting for 60.71%; 193 patients aged 45 years and above,accounting for 68.93%; 223 married patients,accounting for 80.51%; 166 patients with a education level of junior high school and below,accounting for 61.25%; 125 patients engaged in agriculture,accounting for 48.64%. Benzodiazepine was the main drugs abused or dependenced by hospital patients,accounting for 73.57%（206 cases）. There were also 83 cases of polydrug abuse,accounting for 29.64%. Among the patients with drug abuse or dependence,45.71% had no special feelings,41.07% had symptoms or felt uncomfortable after withdrawal; 64.64% was for improving their sleep quality. @*Conclusion @#Most patients with abuse or dependence of narcotic drugs and psychotropic drugs are middle- or senior-aged and have polydrug abuse. Benzodiazepine are the main abused drugs. The common reason for narcotic and psychotropic drug abuse or dependence is to have a good sleep.

Diltiazem in combination with metoprolol for treating aortic dissection / 中华急诊医学杂志

Objective To explore the clinical therapeutic effects of intravenous infusion of dihiazem in com-bination with metoprolol for treating aortic dissection. Method From June 2005 to January 2008, fourteen patients with aortic dissection (male 8, female 4) in the First Hospital of Yichang,were treated with diltiazen 1～5 μg/(kgrate 30 min,60 min, 120 min,6 h, 1 d and 7 d after treatment were recorded. All data were analyzed using self-matching t test. Results The heart rate reduced significantly 60 min after treatment. The heart rate reduced (21±5) beats/min from the baseline. The total effective rate was 100% .The blood pressure reduced significantly 30min after treatment. The systolic pressure reduced to (126.2±11.1 ) mmHg and diastolic pressure declined to (80.3±8.1) mmHg. No severe cardiac side-effect observed. Conclusions Dihiazem in combination with meto-prolol can reduce heart rate and blood pressure markedly and safely in aortic dissection patients.

Cerebral fMRI study of the normal adult on electro-acupuncture Guangming point (GB37) under the vision stimulation condition / 中国病理生理杂志

AIM:To study the human brain hemodynamics responses induced by acupuncturing foot shaoyang gallbladder meridian point GB37 and visual stimulation,and to analyze the effect of acupuncture to activate the cerebral functional area in visual stimulus. METHODS:Twenty five normal subjects were divided into two groups:15 subjects for electro -acupuncture GB37 in visual stimulus group and 10 subjects for electro-acupuncture GB37 groups. The blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) was carried out under the condition of two dif-ferent stimulation patterns (including a vision stimulation task and point GB37 acupuncture under the vision stimulation condition). A scintillating chessboard grid was applied as the vision stimulation task and the frequency was 8 Hz. The activation of cerebral functional areas of tested people under the conditions of the vision stimulation task and acupuncture were analyzed,respectively. RESULTS:Out of 15 subjects of electro -acupuncture GB37 in visual stimulus groups,twelve health volunteers were enrolled. When the vision stimulation task was carried out,the alarge area of brainstem and posterior lobe of cerebellum was seen to be activated. The areas of limbic lobe,hippocampus,middle temporal gyrus and inferior temporal gyrus were also activated. Under the condition of acupuncture only,the areas of posterior central gyrus,inferior parietal lobule,parietal lobe precuneus and the middle frontal gyrus were activated. When doublesided points of gallbladder meridian of foot-shao-yang were electroacupunctured under the visual stimulus status,the areas of superior frontal gyrus,inferior frontal gyrus,parietal precuneus and occipital gyrus lingualis were activated. CONCLUSION:The functional MRI shows the activation of cerebral functional area after acupuncture. Visual stimulus causes significant changes of brain conduction path connection. Under the visual stimulus status,the acupuncture to the points of gallbladder meridian of foot -shao -yang,GB37 has an extent of influence to conduction path conformity of the vision system and with the treat-ment of ophthalmocace. Furthermore,the external stimulation has prominent influence to the acupuncture therapy possibly.