The serial changes in thromboxane (TXA2) prostacyclin(PGI2),circulatory platelet aggregate ratio (CPAR),platelet count,blood viscosity,myocardial enzyme spectrum,cortisol and epinephrine were determined in 42 severely burnt patients randomly divided into two groups.The findings demonstrated that in the control group,both TXA2 and TXA2/PGI2 ratio increased significantly during the early postburn stage.Myocardial enzyme spectrum,blood viscosity,cortisol and epinephrine also increased markedly.However,levels of the above parameters in the anisodamine-treated group were significantly lower than in the control following the infusion of anisodamine.On the contrary,CPAR and platelet count in the treated group increased and were significantly higher than those in the control.Moreover,TXA2 was closely correlated with CPAR,platelet count,blood viscosity and myocardial enzyme spectrum (P

Objective:To observe the clinical effect of the combined use of dexmedetomidine and propofol for anesthesia in the elderly patients with painless gastroscopy. Methods:Totally 70 elderly patients with painless gastroscopy were selected and randomly divided into the observation group (35 cases) and the control group (35 cases). The observation group was given dexmedetomidine and propofol for anesthesia, while the control group was given propofol for anesthesia. The anesthesia induction time, the vital signs and recovery time of the patients, intraoperative complications and postoperative adverse reactions were observed and compared between the two groups. Results:The anesthesia induction time of the observation group was shorter than that of the control group (P<0. 01). The mean arterial pressure (MAP) in T2, T3 and T4 stage in the two groups were significantly lower than that in T1 stage (P<0. 05, P<0. 01). The HR in T3 stage and RR in T2 stage in the control group were lower than those in T1 stage (P<0. 05). The RR in T2 stage in the observation group was significantly lower than that in T1 stage (P<0. 05). The MAP in T2 and T3 stage in the observation group was significantly higher than that in the control group (P<0. 01), while that in T4 stage in the observation group was significant-ly lower than that in the control group (P<0. 05). The HR in T3 stage in the observation group was significantly higher than that in the control group (P<0. 05). The incidence of intraoperative complications in the observation group was 5. 7%, while that in the con-trol group was 22. 9%, and there was significant difference between the two groups (P<0. 05). The recovery time in the observation group was shorter than that in the control group (P<0. 01). Conclusion:Dexmedetomidine combined with propofol has better anes-thesia effect and higher safety than propofol alone, which is worthy of clinical promotion.

Objective To study the effects of continuous passive motion(CPM)on tissue blood oxygen saturation(StO2)in the edge of wound after anterior cruciate ligament(ACL)reconstruction in rabbits.Methods Twenty male New Zealand rabbits,aged 8 months,received an ACL reconstruction by using double semitendinous tendon autograft in the right hind leg.The rabbits were randomly divided into 2 groups postoperatively,namely Cage activity group(n=10)and CPM group(n=10),treated with cage activity and activity by rabbit knee joint continuous passive motion apparatus respectively.On the following day after operation,a near-infrared optical device and ODISseyTM Tissue Oximeter were applied to measure the changes of tissue oxygen saturation(StO2)in the edge of the wound in each cycle(with flexion of 30?-110?)and various CPM speeds(2.35?/s,3.2?/s,and 8?/s),and the optimal CPM range and speed was thus selected for analyzing the changes of StO2 in local tissues of wounds with various angles of CPM in knee joint before the operation and on the 2nd,4th,6th,8th,10th,and 14th postoperative days.Results There was a significant difference with regard to StO2 between CPM group and Cage activity group(P0.05),however,a significant difference was observed among different time points(before the operation,and 2,4,6,8,10,14 days after the operation)(P

Objective To analyze the chest CT appearance of relapsing polychondritis with severer tracheobronchial malacia and improve diagnosis veracity.Methods Five patients with relapsing polychondritis received CT examination and the CT appearances were studied.Results The characteristic appearances in CT were throat tracheal and branch stenosis.The tracheal cartilages thickened and membranous wall was normal.Conclusions Distinguishability of CT is high,which can display the area and characteristics of the pathological changes CT examination is an efficient method of diagnosis of relapsing polychondritis,and can direct selecting treating methods.[Chinese Medical Equipment Journal,2008,29(2):84-85]

Objective To know the nursing scientific research status in recent years,and to reveal the differences between Chinese nursing scientific researches and foreign nursing scientific researches,in order to promote the rapid development of nursing cause in China.Methods Five Chinese journals of nursing and four foreign nursing journals were analyzed covered China National Knowledge Infrastructure (CNKI),PubMed and Google data ranged from 2008 to 2013.By adopting bibliometrics method,regional distribution,the number of people participation,the cooperation between units,the source of financial funding,research content and nature of Chinese nursing research papers were analyzed,and also compared to research content and nature of foreign nursing journals.Results The amounts of published papers were 1 527 pieces.The geographical distribution of research papers were all spread over 28 provinces,autonomous regions sand municipalities directly under the central government,most of which was Guangdong province [12.64％ (193/1 527)];The majority of research papers were completed by single unit and more than five people,which about [68.4％(1 045/1 527)],[38.6％(589/1 527)],respectively;Provincial level of research papers were more than national level [81.4％(1 243/1 527) vs.18.6％(284/1 527)];The papers focused on the clinical nursing research [37.8％(577/1 527)] and clinical basic nursing research [34.6％(529/1 527)].Almost researches were descriptive research,while 40.7％(622/1527) of which were clinical analysis.Foreign nursing scientific researches paid more attention to psychological research and nursing profession which were related to humanities and investigation was major method used;Compared with the foreign nursing papers at the same time,the number of Chinese nursing research papers increased rapidly (P ＜ 0.05);Papers were completed more than five units rapidly increased compared with the pre-upgrade,as well as the national subjects,the difference was statistically significant (P ＜ 0.05).Conclusions The number of nursing research programs tended to increase year by year and the enthusiasm of nurses participating in scientific research was higher than before.Different units needed to further strengthen cooperation in scientific research.The research content and direction were diversity,which had not yet formed central tendency.The research method was still limited to descriptive studies,and the creativity of the research methods was needed,especially laboratory research.

Objective To evaluate the efficacy of modification and care improvement in endotracheal tubes (ETTs) to prevent ventilator associated pneumonia (VAP) in patients receiving mechanical ventilation (MV).Methods PubMed,China National Knowledge Infrastructure (CNKI) were searched,literature information was extracted and classified according to the inclusion criteria,the data were statistically analyzed.Results Totally 46 clinical research articles and 6 laboratory research articles were involved,the data showed that polyurethane (PU) cuff [23.809％ (35/147)],silver-coated ETTs [4.830％ (37/766)],subglottic drainage duct [19.492％ (759/3 894)],discontinuous subglottic drainage[13.603％ (256/1 882)] were associated with a decreased incidence of VAP compared with polyvinyl (PVC) cuff [40.179％ (45/112)],non-silver-coated ETTs [7.537％ (56/743)],conventional ETTs[45.733％ (1 088/2 379)],continuous subglottic drainage [25.000％ (503/2 012)],the differences in the incidence of VAP were statistically significant,respectively,P＜ 0.05.The incidence of VAP in cylindrical PU cuff was 25.000％ (8/32),the tapered PU cuff was 21.875％ (7/32),the difference in the incidence of VAP was not statistically significant.Conclusions The modification of the ETTs and the care improvement can effectively reduce the incidence of VAP.

BACKGROUND: Compared with the metal screws, absorbable screws have more obvious advantages, such as does not have to conduct internal fixation removal, non-metal ic components, no influence on the magnetic resonance imaging of patients after implantation, relatively simple operations, namely dril ing-tapping-screws fixation, more in line with the principles of minimal y invasive in orthopedics. OBJECTIVE: To investigate the biomechanical characteristics of absorbable screw fixation in repair of simple lateral mal eolus fractures by means of finite element technology. METHODS: The three-dimensional model of simple lateral mal eolus fractures and absorbable screw model were established, and then fixed according to standard orthopedic surgical techniques. The reference load when the load bearing of fibulotalar joint reaching the peak value in a normal adult gait cycle was loaded. The stress distribution and displacement of fibula and absorbable screws were analyzed. RESULTS AND CONCLUSION: There were total y 38 542 units, 8 790 nodes in the single screw fixation model. When the articular facet of lateral mal eolus loading 300 N, the maximum stress of screws was 89.35 MPa, the maximum displacement was 0.5 mm, the maximum displacement of the distal fracture was 0.5 mm. When the articular facet of lateral mal eolus loading 450 N, the maximum stress of screws was 152.58 MPa, the maximum displacement was 0.59 mm, the maximum displacement of the distal fracture was 0.77 mm. There were total y 43 115 units, 9 496 nodes in the double screws fixation model. When the articular facet of lateral mal eolus loading 300 N, the maximum stress of screws was 38 MPa, the maximum displacement was 0.44 mm, the maximum displacement of the distal fracture was 0.44 mm. When the articular facet of lateral mal eolus loading 450 N, the maximum stress of screws was 66.68 MPa, the maximum displacement was 0.48 mm, the maximum displacement of the distal fracture was 0.49 mm. The experiment verified the biomechanical feasibility of absorbable screw fixation in repair of simple lateral mal eolus fractures. For simple involving only the lower lateral fibular fracture, absorbable screw fixation is entirely feasible, and usual y requires at least two screws to maintain the stability of the articular surface of the reset.

It is imperative to apply information technology in the area of management of clinical research so as to ensure the quality of clinical trials and to improve management efficiency.In this study,the based analysis method was the quality function deployment (QFD).This methodology is used to analysis the clinical trials management information system on a hospital directly under the Ministry of Health.It ensured user participation,lay a solid foundation for software engineers on system design.

Objective To investigate the phenotype,number and distribution of inflammatory cells in early and late stages of spontaneous regression of halo nevi,and to elucidate the immunological mechanisms for spontaneous regression of these nevi.Methods Halo nevi,their surrounding non-lesional skin,and normal control skin were examined by immunohistochemical staining with monoclonal antibodies to CD3,CD4,CD8,CD20,CD1a,CD56 and CD68.Staining results were observed and analyzed by the computer image analysis system,image-pro plus 6.0.Results The number of CD4+,CD8+,CD20+,CD1a+cells,along with the diameter of CD1a+and CD68+ cells was significantly increased in the lesions of early and late stage of spontaneous regression of halo nevi than in non-lesional skin and normal control skin(both P＜0.01).The ratio of CD8+/CD4+ cells in the lesions of late stage of spontaneous regression was also higher than that in the lesions of early stage (2.05∶1 VS 1.82∶1).A massive infiltrate of CD8+ cells was observed in the nests of nevus cells.ConclusionsCD4,CD8,CD20,CD1a,CD56 and CD68 positive cells are all involved in the spontaneous regression of halo nevi,and CD8+ cells may play a predominant role in this process.

Objective　To study the effects of measures for preventing early postburn damage in improving survival rate of burn patients during the third stage. Methods　12 568 burn cases admitted to our institute were chronically divided into three groups (1958-1980;1981-1990;1991-2000). Total burn surface area (TBSA), survival rate, incidence of burn shock, systemic infection and organ damage as well as the main treatments adopted in the recent decade were retrospectively analyzed. Results　Incidence of burn shock, systemic infection and organ damage were significantly lower, and the total survival rate and the survival rate in patients with different TBSA were markedly higher in the third group as compared with those in the first and the second group. Incidence of organ damage in patients treated with delayed fast fluid infusion, early escharectomy en masse, early enteral feeding, early prevention of inhalation injury and gut bacterial translocation were also significantly lower than in the control. Conclusion Measures taken in the third group for preventing early postburn damage play an important role in improving the survival rate of burn patients.