Objective To investigate effects of sevoflurane and propofol on hemodynamic changes in patients undergoing cardiac double valve replacement.Methods Totally 80 patients admitted with rheumatic heart disease were divided into sevoflurane group and propofol groups.The anesthetic drugs on hemodynamics,myocardial function and renal function were compared.Results There were statistically significant in CIL concentration,stroke volume index (SVI)and left ventricular -stroke work index (LVSWI)levels between the two groups at the same time points (F =2.467,2.4783,2.553,P =0.032,0.032,0.021).The levels of MAP,HR,PAWP,CIL,SVI and LVSWITBIL between the two groups were statistically significant at different time points (F =2.597,2.468,2.523,2.589,2.532, 2.556,P =0.032,0.021,0.030,0.021,0.024,0.023),and difference at the same group at different time points (F =2.597,2.468,2.523,2.497,2.479,2.538,P =0.032,0.021,0.030,0.034,0.034,0.038).No obvious liver and renal function damage was found during the surgery in the two groups.Conclusion Anesthesia induction of sevoflurane and propofol for patients undergoing cardiac double valve replacement has similar effects on the hemody-namics and cardiac function,without obvious damage to liver and renal function.

OBJECTIVE:To evaluate the cost-effectiveness of salmeterol/fluticasone compound(SFC)and budesonide(BUD)in the treatment of asthma.METHODS:A multicenter randomized controlled clinical trial was performed on386asthma cases,who were administered with SFC50/100?g bid or BUD400?g bid,data on which were retrospectively collected and then the cost-effectiveness analysis was conducted,the effectiveness was measured in terms of successfully-treated weeks,symptom-free days and uninvolved days;The direct healthcare cost was adopted as the cost index.RESULTS:The average daily medical cost of the SFC treatment group(RMB:15.6yuan)was a little bit higher than that of the BUD control group(RMB:13.8yuan),but the costs of every successfully-treated week,every symptom-free day and every uninvolved day for SFC group were166.5yuan,33.4yuan and41.2yuan,respectively,which were all lower than those of the BUD group(which were188.6yuan,50.6yuan and66.1yuan,respectively);Incremental cost-effectiveness ratios for every successful?ly-treated week,per symptom-free day and per uninvolved day for the SFC group were88.7yuan,9.4yuan and10.8yuan,respectively vs.the BUD group.CONCLUSION:The results show that the cost-effectiveness of SFC50/100?g bid is supe?rior to BUD400?g bid in the treatment of asthma.

Objective To explore the clinical application of anticoagulation therapy for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 55 patients with AECOPD were selected and divided into control group(24 cases) and treatment group(31 cases).Oxygen treatment,anti-infection treatment were applied to the patients of the control group.Treatment group was given anticoagulation treatment with heparin at the base treatment of the control group.The treatment efficacy,pulmonary functions,coagulation functions and inflammatory factors were tested and compared.Results There were no significant differences between two groups of total treatment efficacy(80.65％ vs 79.17％,x2 =1.304,P ＞0.05) ;PaCO2 decreased,pH and PaO2 increased significantly after treatments in the two groups(all P ＜ 0.05),which was more significantly in the treatment group (all P ＜0.05) ;FVC,FEV1 and FEV1/ FVC％ increased significantly after treatments in the two groups(all P ＜ 0.05),more significantly in the treatment group (all P ＜ 0.05) ; APTT,PT were prolonged,the level of DD and PAD decreased significantly after treatments in the two groups(all P ＜ 0.05),which was more significantly in the treatment group(all P ＜ 0.05) ;The level of IL-6,IL-10 and hs-CRP decreased significantly in all patients(all P ＜ 0.05),IL-6and hs-CRP were more significantly in the treatment group (all P ＜ 0.05),but the level of IL-10 of the treatment group was higher than that of the control group (P ＜ 0.05).Conclusion Pulmonary functions,Blood-gas indexes could be improved,inflammatory balance and coagulation status could be maintained by anti-coagulation treatment in patients with AECOPD.

Objective To study the possibility and effect of application of clinical pathways (CP) in patients with lumbar vertebrae protrusion undergoing resection of nucleus pulposus. Methods 280 patients with lumbar vertebrae protrusion undergoing resection of nucleus pulposus were selected and divided into the experimental group and the control group randomly. Each group had 140 cases. Clinical pathways was applied to the experimental group, while traditional nursing method was given to the control group. Treatment and nursing effect were compared between the two groups. Results The cost for hospitalization was lower, hospitalization time was shorter, the first time for functional exercise after operation was advanced and satisfaction degree of patients was increased in the experimental group compared with those of the control group. Conclusions Application of clinical pathway in patients with lumbar vertebrae protrusion undergoing resection of nucleus pulposus played a positive and effective role.

Objective To study the prevention of pressure ulcer for bed-ridden patients by simple turn-over pillow and turn-over mattress.Methods Self-made simple turn-over pillow and turnover mattress were used in 1300 patients who had high risk of pressure ulcer,and the application effect was observed.Results No pressure ulcer occurred in 1300 patients when they were discharged.Conclusions Simple turn-over pillow and turn-over mattress showed definite effect to prevent pressure ulcer,they have application value,and are worthy of wide spread.

Objective To explore the teaching effect of cooperative learning approach in the training class of basic nursing operation techniques for male students. Methods A total of 82 male nursing students who were admitted into college in 2013 with a 3-year study program were divided into two groups based on mechanical sampling method, 42 students in the experimental group were trained with cooperative learning approach, while 40 students in the control group were trained with traditional teaching method. At the end of the semester, surveys were conducted and the results of students′operative skill were analyzed. Results The result of operative skills evaluation in the experiment group was 88.0 ± 6.9while that in the control group was 79.0 ± 9.2. The comparative difference between the two groups had statistical significance(t = 4.392,P<0.01). The qualified rate in the experiment group was 95.23%(40/42)while that in the control group was 70.00%(28/40).The comparative difference between the two groups had statistical significance(χ2=9.118,P<0.01). Conclusions Cooperative learning approach can improve the teaching effect of nursing operative skills for male nursing students. Thus it is an effective teaching method that deserves promotion and application in the practice teaching of Basic Nursing Techniques.

To introduce the academic thoughts of traditional Chinese medicine(TCM)master GUO Zi-guang based on the analysis of clinical cases.His main academic thoughts are:①He proposes the theory of six meridians and their differentiation in the diagnosis and treatment of typhoid.The six meridians are bases for the treatment of all diseases,and their differentiation provides a fundamental principle for the differentiation of diseases.②He uses the method of combining the disease and syndrome in diagnosis and treatment,which widens the horizon of traditional differentiation and diagnosis in TCM and avoids the absence of syndrome in the practice of differentiation.In this way,the therapeutic effects of Chinese medicine can be guaranteed so as to meet the needs of medical and social development.③He emphasizes that it is fundamental to improve the therapeutic effects of TCM for its development.The approach is to combine disease and syndrome in diagnosis and treatment,and the way is to apply different methods in disease treatment.

Objective:To assess the anatomy of portal vein and hepatic vein with three dimensional 16-MSCT angiography.Methods:A total of 100 healthy subjects underwent upper abdominal MSCT examinations in our department.All subjects were administered 90～120ml of IV contrast material at an injection rate of 3ml/s.The scan delay time was 45～60s and 90～120s for portal venous and hepatic venous phase with automated bolus tracking,respectively.All data sets were reconstructed in 1-mm section and 0.5mm interval,and then were transferred to a workstation for maximum intensity projection(MIP)and volume ren-dering(VR) econstruction.The portal vein anatomy was classified according to Couinaud and Atri’s classification;the hepatic veinanatomy according to Nakamura’s,Marcos’s and Kawasaki’s classification.Results:① Normal portal vein anatomy was seen in 76 cases,type Ⅱin 16,type Ⅲ in 6,type Ⅳ in 2.②Nakamura’s TypeⅠof hepatic vein was presented in 72 cases;type Ⅱ in 22.type Ⅲ in 6.The branching pattern of the middle hepatic vein was type Ⅰin 65 cases,type Ⅱin 19,and type Ⅲ in 16.Segment IVb vein branched from the middle hepatic vein in 42 cases,and from the left hepatic vein in 58.Conclusion:3D 16-MSCTA is a significantly valuable tool which can provide complete and comprehensive information on the anatomy of portal vein and hepatic vein combined with MIP and VR image.

Sanger sequencing technology is the most commonly used method for genetic analysis in inherited eye disease in the past few decades on account of its long DNA sequencing read length and high accuracy.However,application of this method is limited in genetically heterogeneous diseases because of the high economic and time cost.Next generation sequencing (NGS) technology is a high-throughput,cost-effective,and highly automated method which has been widely used since 2005.Although NGS is especially suitable for studies on genetically heterogeneous inherited eye disease,overdependence on the technique itself and neglect of the assessment of the phenotype may lead to misjudgment of the testing results and higher economic burden for the patients.So far,the most common method on researches of monogenic inherited eye disease is to combine NGS and Sanger sequencing technique.Precise evaluation of the clinical phenotype of patients is very important,as it is related with selection of detection methods and determination of disease-causing mutations.

Usher syndrome (USH) is the most common syndromic retinitis pigmentosa (RP),which is an autosomal recessive disorder.RP is highly clinically and genetically heterogeneous.A total of 12 loci including nine genes have been identifiedas causing various clinical subtypes of USH.The USH2A gene is thought to be involved in the pathogenesis of most USH2 cases.Moreover,mutations of the USH2A gene is also responsible for atypical USH and nonsyndromic retinitis pigmentosa.Some studies found that the mutation spectrum among Chinese RP patients might differ from European Caucasians.Herein,the further survey should be performed to ascertain the hot gene mutation spectrum.