Differential diagnosis and surgical management in chondrosarcoma of the jugular foramen / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the diagnosis, surgical management and outcome of jugular foramen chondrosarcoma (CSA). Methods: Fifteen patients with jugular foramen CSA hospitalized in the Department of Otorhinolaryngology Head and Neck Surgery of Chinese PLA General Hospital from December 2002 to February 2020 were retrospectively collected,of whom 2 were male and 13 were female, aging from 22 to 61 years old. The clinical symptoms and signs, imaging features, differential diagnosis, surgical approaches, function of facial nerve and cranial nerves IX to XII, and surgical outcomes were analyzed. Results: Patients with jugular foramen CSA mainly presented with facial paralysis, hearing loss, hoarseness, cough, tinnitus and local mass. Computed tomography (CT) and magnetic resonance (MR) could provide important information for diagnosis. CT showed irregular destruction on bone margin of the jugular foramen. MR demonstrated iso or hypointense on T1WI, hyperintense on T2WI and heterogeneous contrast-enhancement. Surgical approaches were chosen upon the sizes and scopes of the tumors. Inferior temporal fossa A approach was adopted in 12 cases, inferior temporal fossa B approach in 2 cases and mastoid combined parotid approach in 1 case. Five patients with facial nerve involved received great auricular nerve graft. The House Brackmann (H-B) grading scale was used to evaluate the facial nerve function. Preoperative facial nerve function ranked grade Ⅴ in 4 cases and grade Ⅵ in 1 case. Postoperative facial nerve function improved to grade Ⅲ in 2 cases and grade Ⅵ in 3 cases. Five patients presented with cranial nerves Ⅸ and Ⅹ palsies. Hoarseness and cough of 2 cases improved after operation, while the other 3 cases did not. All the patients were diagnosed CSA by histopathology and immunohistochemistry, with immunohistochemical staining showing vimentin and S-100 positive, but cytokeratin negative in tumor cells. All patients survived during 28 to 234 months' follow-up. Two patients suffered from tumor recurrence 7 years after surgery and received revision surgery. No complications such as cerebrospinal fluid leakage and intracranial infection occurred after operation. Conclusions: Jugular foramen CSA lacks characteristic symptoms or signs. Imaging is helpful to differential diagnosis. Surgery is the primary treatment of jugular foramen CSA. Patients with facial paralysis should receive surgery in time as to restore the facial nerve. Long-term follow-up is necessary after surgery in case of recurrence.

Tiaoqi Jieyu acupuncture for treatment-resistant depression: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of Tiaoqi Jieyu (regulating qi and relieving depression) acupuncture on the clinical symptoms of treatment-resistant depression (TRD), and to explore the relationship between the acupuncture pain sensitivity and symptom's improvement.@*METHODS@#A total of 78 patients with TRD were randomly divided into an observation group (39 cases, 3 cases dropped off) and a control group (39 cases, 4 cases dropped off). The patients in the control group were treated with medications according to the treatment plan of psychiatrists (at least one medication was 5-hydroxytryptamine reuptake inhibitor). On the basis of the control group, the patients in the observation group were treated with Tiaoqi Jieyu acupuncture, and Baihui (GV 20), Yintang (GV 24+), Yanglingquan (GB 34), Taichong (LR 3), Hegu (LI 4), Neiguan (PC 6), Yinlingquan (SP 9) and Zusanli (ST 36), etc. were selected. The acupuncture was given three times a week. Both groups were treated for 8 weeks. After 8-week treatment, the response rate of Hamilton depression scale-24 (HAMD-24) score after was evaluated in the two groups. The scores of HAMD-24 and Hamilton anxiety scale (HAMA) were compared between the two groups before treatment, after 4, 8-week treatment and 12 weeks after treatment (follow-up). After the first treatment and 8-week treatment, the visual analogue scale (VAS) score in the observation group was evaluated, and the correlation between VAS score after the first treatment and HAMD-24 score before treatment, between VAS score after the first treatment and the course of disease in the observation group was analyzed, and the correlation between difference of VAS after 8-week treatment and after the first treatment and difference of HAMD-24 score before treatment and after 8-week treatment was analyzed.@*RESULTS@#After 8-week treatment, the response rate of HAMD-24 score in the observation group was 52.8% (19/36), higher than 17.1% (6/35) in the control group (P<0.001). Compared before treatment, the scores of HAMD-24 and HAMA in the two groups were decreased after 4-week treatment, 8-week treatment and in follow-up (P<0.05), and those in the observation group were superior to the control group (P<0.05). After 8-week treatment, the acupuncture pain VAS score in the observation group was (5.28±2.13) points, which was higher than (3.33±1.62) points after the first treatment (P<0.001). There was a negative correlation between VAS score after the first treatment and HAMD-24 score before treatment in the observation group (r =-0.486, P=0.003); there was no correlation between acupuncture pain VAS score after the first treatment and the course of disease in the observation group (P>0.05). After 8-week treatment, there was a positive correlation between the difference of VAS score and the difference of HAMD-24 score in the observation group (r =0.514, P=0.001).@*CONCLUSION@#Tiaoqi Jieyu acupuncture could improve the depression and anxiety in patients with TRD, and the symptom's improvement is related to the recovery of acupuncture pain sensitivity.

Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis / 中西医结合学报

BACKGROUND@#Acupuncture therapy has shown promise for effectively relieving preoperative anxiety. Nevertheless, previous findings from randomized controlled trials (RCTs) are inconsistent and must be examined in detail.@*OBJECTIVE@#This study systematically evaluates the efficacy and safety of acupuncture therapy for preoperative anxiety as well as the quality of evidence supporting this application.@*SEARCH STRATEGY@#The China National Knowledge Infrastructure Database, Wanfang Data Journal Database, Chinese Biomedical Literature Database, Chongqing VIP, Embase, PubMed and Cochrane Library Databases were queried from their inception to 19, February 2020, using keywords such as "acupuncture therapy," "preoperative" and "anxioty." Manual searches expanded the search breadth and included conference abstracts and other reference lists.@*INCLUSION CRITERIA@#RCTs were included in the current study if they contained a comparison between a group of anxiety patients that received acupuncture therapy and a control group that received sham acupuncture.@*DATA EXTRACTION AND ANALYSIS@#Literature was reviewed, and various articles were selected using the NoteExpress 3.2.0 software. Two researchers independently screened and extracted data and evaluated the risk of bias in the included studies. The RevMan 5.3 software was used for data aggregation and the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) assessment was used to evaluate the quality of the study outcomes.@*RESULTS@#Twelve studies were included in the review, containing a total of 916 patients. Meta-analysis showed that, compared with the control group, patients who received acupuncture therapy had reduced State-Trait Anxiety Inventory Scale (STAI-S) score (mean difference [MD] = -9.07, 95% confidence interval [CI] [-13.19 to -4.96], P < 0.0001) and Visual Analogue Scale (VAS) score (MD = -1.37, 95% CI [-2.29 to -0.45], P = 0.003). However, for the Hamilton Anxiety Scale (HAMA) score, there was no difference between the two groups (MD = -3.98, 95% CI [-12.89 to 4.92], P = 0.38). Further, the GRADE assessment demonstrated that the STAI-S was of moderate quality, the VAS of low quality and the HAMA of very low quality.@*CONCLUSION@#Acupuncture therapy may be able to decrease anxiety in preoperative patients, but the results need to be further verified due to the small sample sizes and the low quality of evidence to date.

Reconstruction of complex tissue defects in temporal region: report of 3 cases / 中华耳鼻咽喉头颈外科杂志

Objective: To discuss the techniques and repairing methods of various degree of compound tissue defects in the auriculotemporal region. Methods: Retrospective analysis was conducted on three cases of different repairing methods for huge compound tissue defects in different degrees in the auriculotemporal region after the resection of the malignant tumor or sinus tract due to repeated infection in our hospital. Results: Following total removal of the tumors or sinus tract in all patients, we applied retroauricular lingual flap transfer repairing, latissimus dorsi flap free transfer repairing and vascular anastomosis, scalp tissue expansion in stage Ⅰ, then repairing the lesion with expanded scalp and filling the huge mastoid cavity with abdominal fat in stage Ⅱ, respectively, according to the characteristics of compound tissue defects in the auriculotemporal region. All free flaps survived well. Conclusions: The anatomy of the auricular-temporal area is complex and involves important vascular and neural structures of head and neck and lateral skull base. The huge composite tissue defect following auriculotemporal region surgery, which is composed of skin, muscle and bone tissue, needs to be repaired in one stage. Therefore, flexible repairing methods should be chosen based on different situations, for attaining the goal of completely removing tumor and lesions, and then, covering the operation cavity.

Efficacy evaluation of acupuncture plus rehabilitation training for post-stroke deglutition disorders of qi-deficiency blood stasis pattern / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of acupuncture plus rehabilitation training in treating post-stroke deglutition disorders of qi-deficiency blood stasis pattern. Methods: Sixty-six patients with post-stroke deglutition disorders of qi-deficiency blood stasis patter were divided into an observation group and a rehabilitation group using the random number table method. The two groups both received conventional medications and supportive treatment for stroke. In addition, the observation group received acupuncture plus rehabilitation training while the rehabilitation group only received the same rehabilitation training. The interventions were conducted 3 times a week for a total of 4 weeks in both groups. They were evaluated using Kubota water swallowing test (KWST), Fujishima Ichiro food intake level scale (FILS) and symptoms score of traditional Chinese medicine (TCM) before and after treatment, and at the 1-month follow-up. The therapeutic efficacy was assessed at the 1-month follow-up. Results: The KWST grading and FILS result after treatment and at the follow-up were significantly different from those before treatment in both groups (all P<0.001); the results of these two items at the follow-up were not significantly different from those after treatment in the two groups (all P>0.05). There were significant differences in the KWST grading and FILS result between the two groups after treatment and at the follow-up (all P<0.05). The TCM symptoms score changed significantly after treatment and at the follow-up compared with that before treatment in both groups (all P<0.001). The TCM symptoms grading efficacy at the follow-up was significantly different from that after treatment in the observation group (P<0.05), while the difference was statistically insignificant in the rehabilitation group (P>0.05). The TCM symptoms grading efficacy in the observation group was significantly different from that in the rehabilitation group after treatment and at the follow-up (both P<0.05). Conclusion: Based on the conventional treatment for stroke, acupuncture plus rehabilitation training or use of rehabilitation training alone both can improve the clinical symptoms in post-stroke deglutition disorders of qi-deficiency blood stasis pattern, but acupuncture plus rehabilitation training can produce more significant efficacy and better long-term efficacy in improving TCM symptoms.

Rolling needle pricking-cupping therapy and traditional pricking-cupping therapy for cervical spondylosis of neck type: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between rolling needle pricking-cupping (RNP-C) and traditional pricking-cupping (TP-C) for cervical spondylosis of neck type.@*METHODS@#A total of 96 patients with cervical spondylosis of neck type were randomly divided into an RNP-C group, a TP-C group and an electroacupuncture (EA) group, 32 cases in each group. Each group was treated with EA at Jingbailao (EX-HN 15), Fengchi (GB 20), Dazhui (GV 14), Jianjing (GB 21) and @*RESULTS@#Compared before treatment, the scores of NPQ and VAS in each group were all reduced at 2 and 4 weeks into treatment and follow-up (@*CONCLUSION@#TP-C and RNP-C could both improve the cervical pain symptoms in patients with cervical spondylosis of neck type, and improve the overall function of the cervical spine, and the curative effect is similar.

Expression and clinical significance of serum ubiquitin in esophageal squamous cell carcinoma / 医学研究生学报

Objective　Ubiquitin-proteasome system (UPS) plays a central role in the development of esophageal cancer. However, As the executor of UPS, the expression and clinical significance of detection of serum ubiquitin (UB) in Esophageal Squamous Cell Carcinoma(ESCC) patients have not been fully elucidated. The aim of this study was to investigate the expression and diagnostic value of serum ubiquitin (UB) in ESCC.　Methods　A total of eighty-eight ESCC patients and forty healthy controls from February 2018 to May 2019 at the Affiliated Jiangyin Hospital of Nantong University were enrolled. Serum UB was measured by ELISA, and serum squamous cell carcinoma antigen (SCC) and carcinoembryonic antigen (CEA) were determined by chemiluminescence method. The ROC curve was used to analyze the diagnostic value of each indicator. Besides, the correlation between serum UB and clinicopathological features of ESCC were analyzed.　Results　The level of serum UB in ESCC group was significantly higher than that in the control group[(41.96±3.273)ng/ml vs (80.86±7.993)ng/ml, P<0.05]. The level of serum UB in ESCC patients was related to lymphatic metastasis and tumor stage (P<0.05). The sensitivity of UB, SCC, CEA and the three combined diagnosis of ESCC were 65.9%, 52.3%, 51.1%, and 76.1%, respectively. The AUC under the ROC curve were 0.690, 0.677, 0.635, and 0.795, respectively.　Conclusion　Serum UB is highly expressed in ESCC and is closely related to tumor progression. Combined with SCC and CEA, UB can improve the sensitivity of diagnosis of ESCC and can be used as an effective serological screening biomarker.

Anti-CD36 Mediated Platelet Transfusion Refractoriness and Related Cases After Stem Cell Transplantation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyse the cases of platelet transfusion refractoriness after received HLA-matched unrelated donor hematopoietic stem cell transplantation, to analyze and identify the phenotype and genotype of CD36 in both the patient and stem cell donor, as well as the characteristic of antibody induced platelet transfusion refractoriness, and to analyse the efficacy of matched CD36-deficiency platelets transfusions.</p><p><b>METHODS</b>The CD36 expression on platelet and monocyte was analyzed by flow cytometry (FCM) in both patient and donor. Polymerase chain reaction sequence-based typing (PCR-SBT) was used to analyze the exons sequence of CD36 and HPA. Fast monoclonal antibody-specific immobilization of platelet antigen (F-MAIPA) and FCM were used to identify platelet antibodies in the patient. Short tandem repeat polymerase chain reaction (STR-PCR) was applied to monitor engraftment evidence. The platelet level was monitored. CD36- deficiency donor's platelets were selected from CD36- deficiency donor blood bank.</p><p><b>RESULTS</b>The donor was CD36 positive and the patient was typed I CD36 deficiency. The anti-CD36 antibody was identified in patient's serum (after transplantation), while the HLA and HPA-related antibodies were excluded. Sequence analysis of CD36 exon in the patient showed Exon 6 -1G>C(Change in splicing site) homozygote, which was a novel CD36 mutation. STR, HPA and CD36 of the patient (complete chimerism) were conversed to that of donor gene types on day 18 after allo-HSCT. The positive CD36 expression on platelet and monocyte in the patient was observed on day 96 after allo-HSCT. The patient showed the platelet transfusion refractoriness which was significantly improved after platelets transfusions from CD36 deficiency donors.</p><p><b>CONCLUSION</b>Stem cell transplants resulted in anti-CD36 and caused platelet transfusion refractoriness, that was first reported in China. To ensure the efficacy of platelet transfusion, the CD36-deficiency patient should receive CD36 deficiency platelets for transfusion.</p>

Tinnitus Matching-based Clinical Study on Acupuncture Treatment for Tinnitus of Kidney Essence Deficiency Type / 上海针灸杂志

Objective To make a tinnitus matching-based observation of the clinical therapeutic effect of acupuncture on tinnitus of kidney essence deficiency type.Methods Sixty patients with tinnitus of kidney essence deficiency type were randomized to groups A and B, 30 cases each. Group A received acupuncture based on syndrome differentiation- based point selection and group B, acupuncture based on disease differentiation-based point selection. Hearing condition was assessed by pure tone hearing threshold and tinnitus matching (tinnitus frequency and loudness matching test) in the two groups of patients before and after treatment.Results There were statistically significant pre-/post- treatment differences in various thresholds in pure tone audiometry in the two groups (P<0.05). There were statistically significant post-treatment differences in partial thresholds in pure tone audiometry (500 Hz, 750 Hz, 1000 Hz and 2000 Hz) between Group A and group B (P<0.05). Tinnitus matching had no statistically significant pre-/post-treatment difference within the two groups and no statistically significant post-treatment difference between the two groups (P>0.05). There was a statistically significant pre-/post-treatment difference in tinnitus loudness matching in the two groups (P<0.01). There was a statistically significant post-treatment difference in tinnitus loudness matching between Group A and group B (P<0.05).Conclusions Acupuncture is an effective way to treat tinnitus of kidney essence deficiency type. The therapeutic effect of syndrome differentiation-based acupoint selection is better than that of disease differentiation-based acupoint selection.

CD36 Antigen Deficiency and Platelet Transfusion / 中国实验血液学杂志

CD36 is a transmembrane glycoprotein, a multi-ligand receptor, possesses various biological functions. CD36 deficiency may stimulate the body to produce anti-CD36 alloimmune antibodies through the several pathways, such as blood transfusion, pregnancy or organ transplantation and so on, leading to the refractoriness of immune platelet transfusion and other diseases. The recent research advances of CD36 deficiency and its molecular biological basis, platelet transfusion and CD36 antibody detection are summarized briefey in this review.

Hazards of insomnia and the effects of acupuncture treatment on insomnia / 中西医结合学报

Insomnia is a common disease in modern society; it is made worse by increasingly fierce competition in the workplace and elsewhere, along with rapid economic and social development. Sleep disorders can result in changes in serum biomarkers and decreased immunity, and may cause maladies such as depression and cardiac diseases, as well as many other somatic symptoms. Western medications for treating insomnia can easily lead to addiction and other adverse effects. Fortunately, acupuncture can ease the symptoms of insomnia. This review summarizes the hazards associated with insomnia and the use of acupuncture in its treatment. Furthermore, the authors introduce an effective and low-cost method of treating insomnia with acupuncture. This review indicates that insomnia poses a major threat to mental health through its effects on serum components, heart function and the immune system of patients, which may lead to other physiological disorders. Anxiety and depression are the two main negative emotions affected by insomnia. Acupuncture, which has showed effectiveness against insomnia and its complications, may be an effective and complementary method for the treatment of insomnia and associated maladies.

Protection of Electro-acupuncture for Gastric Mucosa of Patients Undergoing Endoscopic Sinus Surgery / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the effect of electro-acupuncture (EA) on gastric mucosal oxygenation and systemic inflammatory response in patients undergoing endoscopic sinus surgery with controlled hypotension (CH), and to explore its protective effect on gastric mucosa.</p><p><b>METHODS</b>Fifty-four patients, 18-65 years old, grade I-II of American Society of Anesthesiology (ASA), who were scheduled for endoscopic sinus surgery were randomly assigned to two groups, group A (general anesthesia group) and group B (general anesthesia combined EA anesthesia group), 27 in each group. Conrolled hypotension was executed during operation, and mean arterial pressure (MAP) was maintained at 55-65 mmHg. After tracheal intubation gastric tesiometer catheter was indwelled through nasal cavity or oral cavity. After successful indwelling, it was connected with gastric mucosa monitoring mode of multifunctional parameters monitor. Patients' MAP and heart rate (HR), pHi, partial pressure of carbon dioxide (PgCO2), arterial partial pressure of carbon dioxide (Pg-aCO2) and endtidal pressure of carbon dioxide (Pg-etCO2) were measured and recorded at T, (immediately before induced hypotension), T, (20 min following induced hypotension to target MAP), T2 (40 min following induced hypotension to target MAP), T3 (20 min after ending induced hypotension), and T4(40 min after ending induced hypotension). Blood samples were intravenously collected, TNF-alpha, IL-1, and IL-6 were detected by ELISA 24 h before operation, during operation (T3), and 24 h after operation.</p><p><b>RESULTS</b>After hypotension was induced, Pg-CO2, Pg-aCO2 and Pg-etCO2 increased significantly (P < 0.01, P < 0.05), while pHi decreased significantly (P < 0.01) in both groups at T1-T4 than those at T0. During T1-T4, PgCO2, Pg-aCO2, and Pg-etCO2 were higher (P < 0.01, P < 0.05), while pHi was lower in group A than in group B (P < 0.01). Furthermore, TNF-alpha, IL-1, and IL-6 increased significantly in both groups during operation and 24 h after operation, when compared with those 24 h before operation (P < 0.01, P < 0.05). TNF-alpha and IL-1 in group A were higher than those in group B (P < 0.05) during operation and 24 h after operation, but with no significant difference in the plasma concentration of IL-6 (P > 0.05).</p><p><b>CONCLUSION</b>EA exerted obvious protective effect of gastric mucosal injury in endoscopic sinus surgery with controlled hypotension, which might be achieved by increasing gastric mucosal blood flow, maintaining oxygen supply and demand, inhibiting inflammatory response, and alleviating injury of gastric mucosal barrier.</p>

Effects of electroacupuncture on postoperative functional recovery in patients with gynaecological laparoscopic surgery / 中国针灸

<p><b>OBJECTIVE</b>To evaluate electroacupuncture on the efficacy and the safety of gastric and systemic functional recovery in patients with carbon dioxide pneumoperitoneum undergoing gynaecological laparoscopic surgery.</p><p><b>METHODS</b>Sixty patients undergoing gynaecological laparoscopic surgery were randomly divided into a regular anesthesia group (group A) and a combination electroacupuncture anesthesia group (group B), 30 cases in each group. The group A were treated with regular general anesthesia, and on the basis of general anesthesia, the group B were treated with electroacupuncture at bilateral Zusanli (ST 36) and Liangqiu (ST 34) by continuous wave and a frequency of 2 Hz 30 minutes before the surgery until the end of the operation. Sedation scale by Ramsay, nausea, vomiting and mental state scores of postoperative were evaluated and compared between the two groups.</p><p><b>RESULTS</b>Compared with the group A, the sedation scale (1.19 +/- 0.56 vs 1.96 +/- 0.90), nausea score (0.59 +/- 0.80 vs 1.81 +/- 0.88), vomiting score (0.48 +/- 0.94 vs 1.89 +/- 0.93) and mental state score (0.96 +/- 0.73 vs 1.69 +/- 0.75) were all decreased significantly in the group B (all P < 0.01).</p><p><b>CONCLUSION</b>Combination electroacupuncture anesthesia can relieve postoperative irritable, nausea and vomiting, improve mental state after the operation and promote the gastric and systemic functional recovery. It is a good method for the adjustment of carbon dioxide pneumoperitoneum during laparoscopic surgery.</p>

Detection, diagnosis and analysis of the first case of neonatal alloimmune thrombocytopenia purpura associated with anti-HPA-5b in China / 中国实验血液学杂志

This study was aimed to investigate the detection and diagnosis of the neonatal alloimmune thrombocytopenia purpura (NAITP) caused by anti-HPA-5b antibody. The platelet count and clinical manifestation in the newborn were examined. The HPA-1-21bw genotypes of the newborn and her parents were detected by multiple-PCR and DNA sequencing. The HPA-specific antibody in the sera of newborn and her mother were detected and identified by flow cytometry (FCM) and monoclonal antibody-specific immobilization of platelet antigens (MAIPA). The results indicated that the clinical manifestations of the newborn were lighter. The HPA genotyping showed that the genotype of the newborn was HPA-5ab, while that of her mother and father were HPA-5aa and HPA-5ab, respectively. The antibody against the platelet of newborn's father existed in the newborn's mother sera. The HPA antibody of the mother was identified as anti-HPA-5b. It is concluded that the newborn with neonatal alloimmune thrombocytopenia purpura was caused by the antibody against HPA-5b.

Endolymphatic sac tumor with von Hippel-Lindau disease: report of two cases with testing of von Hippel-Lindau gene / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Endolymphatic sac tumors (ELSTs) are rare in the general population with much higher prevalence in von Hippel-Lindau(VHL) disease. The purpose of this study is to present two cases of endolymphatic sac tumor with VHL disease with analysis of VHL gene and to explore their association with VHL disease using molecular analysis.</p><p><b>METHODS</b>Clinical data of these two patients from different VHL families were studied. DNAs extracted from peripheral bloods were amplified by the polymerase chain reaction using oligonucleotide primers corresponding to the VHL gene, then compared the mutations with the Human Gene Mutation Database.</p><p><b>RESULTS</b>In case 1, 6 family members were enrolled in the study. Among them, three had been identified to have a germline missense point mutation at codon 194 of the VHL gene exon 1 (p.S65W). The little sister of the patient (case 1) underwent vitrectomy for retinal hemangioblastoma 5 years ago in another hospital. The mother of the patient (case 1) was further diagnosed to have a cerebellar hemangioblastoma and renal carcinoma in the following physical examination. Case 2 with her parents were also tested. Codon 499 of the VHL gene exon 3 (p.R167W) were detected in case 2 and her mother, but the mother refused further examination.</p><p><b>CONCLUSIONS</b>The genetic diagnosis plays an important role in early detection of symptomatic patients and suspected patients. Clinical screening for members of the VHL families, and close follow-up of carriers allow an early detection of tumors and the metastasis, which is the most common cause of death of these patients.</p>

Impacts of electroacupuncture at different frequencies on the postoperative nausea and vomiting of patients with laparoscopic surgery / 中国针灸

<p><b>OBJECTIVE</b>To assess the impacts on postoperative nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia by electroacupuncture (EA) at different frequencies at bilateral Neiguan (PC 6).</p><p><b>METHODS</b>One hundred and twenty female patients with laparoscopic surgery undergoing the general anesthesia were randomized into 4 groups: 2 Hz EA treatment group (group A), 2 Hz/100 Hz EA treatment group (group B), 100 Hz EA treatment group (group C) and a control group (group D), 30 cases in each one. The same anesthetic program was adopted in each group. For the patients in A, B and C groups, in the first half a hour undergoing the conventional drug anesthesia, acupuncture was applied to bilateral Neiguan (PC 6). After arrival of qi, HANS-200A electroacupuncture apparatus was connected, at the frequency as 2 Hz, 2 Hz/100 Hz and 100 Hz separately. The electric stimulation was discontinued at the end of surgery. The life physical signs after surgery, the occurrence of postoperative nausea and vomiting and the severity grades of postoperative nausea and vomiting were observed and recorded for the patients in each group.</p><p><b>RESULTS</b>The differences in the postoperative 1 h heart rate, mean arterial pressure (MAP), finger pulse oxygen saturation and respiratory frequency were not significant statistically in comparison of the patients among groups (all P > 0.05). The incidence of postoperative nausea and vomiting of the patients in group B was lower apparently than that in A, C and D groups [10.0% (3/30) vs 30.0% (9/30), 36.7% (11/30), 53.3% (16/30), all P < 0.01]. The severity of postoperative nausea and vomiting of the patients in group B was lower apparently than that in the rest three groups (all P < 0.01).</p><p><b>CONCLUSION</b>The electroacupuncture at 2 Hz/100 Hz reduces effectively the incidence and the severity of postopera tive nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia.</p>

A case of neonatal alloimmune thrombocytopenia purpura caused by anti HPA-3a antibody and literature review / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the diagnosis and treatment of a case of neonatal alloimmune thrombocytopenia purpura (NAITP) caused by anti HPA-3a antibody.</p><p><b>METHODS</b>The platelet counts and purpuric symptom in the newborn were clinical examined. The HPA-1-21bw genotypes of the newborn and his parents were detected by multiple DNA-PCR, gene sequencing and genotyping. The HPA specificity antibody in the sera of newborn and his mother were detected by flow cytometry (FCM), and the HPA specificity antibody was identified by monoclonal antibody-specific immobilization of platelet antigens (MAIPA).</p><p><b>RESULTS</b>The newborn had the typical symptom of NAITP, multiple subcutaneous petechia, hematuria and coffee-like vomitus. The HPA genotype of the newborn was HPA-3ab, while that of his mother and his father were HPA-3bb and HPA-3aa, respectively. The sera of newborn and his mother existed antibody against the platelet of newborn's father. The HPA antibody of the newborn and his mother were identified as anti HPA-3a. The newborn was approved a patient of NAITP caused by anti HPA-3a antibody.</p><p><b>CONCLUSION</b>The diagnosis and treatment for NAITP newborn caused by anti HPA-3a antibody in this study was the first domestic report. It could provide successful experiences and references for the similar cases.</p>

Analgesic effect of acupuncture compound anesthesia in functionality nasal endoscopic sinus surgery / 中国针灸

<p><b>OBJECTIVE</b>To verify the analgesic effect of acupuncture compound anesthesia in functionality nasal endoscopic sinus surgery (FNES).</p><p><b>METHODS</b>Ninety patients undergoing FNES were randomly divided into three groups. Group A was treated with routine local anesthesia, and group B and C were treated with electroacupuncture at Yintang (EX-HN 3) and Yingxiang (LI 20) for 30 min before local anesthesia. Group B received routine local anesthesia, and group C received decrement local anesthesia. The dosage of narcotic, modified fingers pain scores and postoperative satisfaction scores were observed in three groups.</p><p><b>RESULTS</b>The operative dosage of decicaine was (118.33 +/- 26.21) mg in group A, (100.83 +/- 4.56) mg in group B, and (71.33 +/- 8.90) mg in group C, with significant differences among the three groups (all P < 0.01), the lowest dosage was used in group C and the highest dosage in group A. The fingers pain scores of group B and C were both lower than that of group A (both P < 0.01), and the postoperative satisfaction scores of group B and C were both higher than that of group A (both P < 0.01).</p><p><b>CONCLUSION</b>Acupuncture compound anesthesia can effectively alleviate the pain, decrease the dosage of local anesthetic, lower the discomfortableness and be helpful for safety of the patients during sinus surgery.</p>

Influence of acupuncture-drug compound anesthesia with different frequency electroacupuncture on immune function in patients undergoing pneumonectomy / 中国针灸

<p><b>OBJECTIVE</b>To explore different frequency electroacupuncture in acupuncture-drug compound anesthesia on analgesic effect and immune function in the pulmonary resection patients in order to recommend the best electroacupuncture frequency in acupuncture-drug compound anesthesia.</p><p><b>METHODS</b>One hundred and sixty-three patients scheduled for pneumonectomy were randomly divided into group A (n = 31), B (n = 34), C (n = 32), D (n = 34) and E (n = 32). Houxi (SI 3), Zhigou (TE 6), Neiguan (PC 6) and Hegu (LI 4) were selected in the five groups. Group A was treated with sham acupuncture by pasting needles without needle bodies at acupoints and electroacupuncture at the needle handle, and group B with 2 Hz electroacupuncture, and group C with 2 Hz/ 100 Hz electroacupuncture, and group D with 100 Hz electroacupuncture, and group E with 2 Hz/100 Hz transcetaneous acupoints electrical stimulation, and general anesthesia was produced in all the groups followed by 30 min electrical stimulation and the stimulation was lasted till the end of operation. The dosages of the anesthetics and the changes of surface antigen of leukomonocyte (CD3+ , CD4+ , CD8+ and CD4+/CD8+) and natural killer (NK) cell were observed at 1 day before surgery, intraoperative and 1 day after surgery.</p><p><b>RESULTS</b>In comparison with group A, the dosages of Propofol in group B and D were decreased, Fentanyl in group B, D and E were decreased. CD3+ and CD4+ in 5 groups increased at first and then decreased over time (all P < 0.01), and group E and C could inhibit the decrease of CD3+ and CD4+ in postoperation in comparison with that in the other three groups (all P < 0.05). CD8+ in 5 groups has no change in different times (all P > 0.05), and group E and D could inhibit the decrease of CD8+ in postoperation in comparison with that in the other three groups (all P < 0.05). CD4+/CD8+ in 5 groups has no change in different times (all P > 0.05), and group E and C could inhibit the decrease of CD4+/CD8+ in postoperation in comparison with that in the other three groups (all P < 0.05). NK cells of 5 groups were increased gradually in different times (all P < 0.01), with the similar regulation of NK cells (all P > 0.05).</p><p><b>CONCLUSION</b>Acupuncture-drug compound anesthesia with 2 Hz and 100 Hz electroacupuncture together with 2 Hz/100 Hz transcetaneous acupoints electrical stimulation have the best analgesic effect, and 2 Hz/100 Hz transcetaneous acupoints electrical stimulation and 2 Hz/100 Hz electroacupuncture have the best regulation of immune function. Acupuncture-drug compound anesthesia with 2 Hz/100 Hz transcetaneous acupoints electrical stimulation is recommended for that it can not only decrease the dosages of the anesthetics, but also significantly improve the immunosuppression in patients undergoing pneumonectomy.</p>

Influence of different frequency electroacupuncture on serum IL-1 and IL-6 in patients with pneumonectomy / 中国针灸

<p><b>OBJECTIVE</b>To observe the influence of acupuncture-drug compound anesthesia with different frequency electroacupuncture on cytokine expression in patients with pneumonectomy in order to provide evidence for selection of electroacupuncture frequency in acupuncture-drug compound anesthesia.</p><p><b>METHODS</b>Fifty-six patients scheduled for pneumonectomy were randomly divided into groups I (n=22), II (n=16) and III (n=18). General anesthesia was produced in all the groups. The patients in group II and III were treated with electroacupuncture at Houxi (SI 3), Zhigou (TE 6), Neiguan (PC 6) and Hegu (LI 4), 30 min before general anesthesia. The 2 Hz continuous wave was produced in group II, and the 2 Hz/100 Hz was produced in group III till the operation finished. The serum content of interleukin 1 (IL-1) and 6 (IL-6) was detected by double antibody sandwich enzyme linked immunosorbent assay (ELISA) at the time of 24 hours before operation, 10 minutes after incision and 24 hours after operation.</p><p><b>RESULTS</b>The contents of IL-6 in all the three groups at the time of 10 minutes after incision were all higher than those before operation (all P < 0.01), and the content of IL-1 had no obvious change (all P > 0.05). In comparison with 10 minutes after incision, the contents of IL-1 in group I and III were both significantly increased at the time of 24 hours after operation (both P < 0.01), and there was no obvious change in group II (P > 0.05). The contents of IL-6 in all the three groups at the time of 24 hours after operation were more significantly increased than those at the time of 10 minutes after incision (all P < 0.01).</p><p><b>CONCLUSION</b>Acupuncture-drug compound anesthesia with 2 Hz frequency can partly regulate the expression of inflammatory factors so as to alleviate the stress reaction in perioperative patients and protect organs function.</p>