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.

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 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.

Objective To investigate the pathogens distribution and their drug resistance of blood culture-positive neonates with sepsis in neonatal intensive care unit(NICU) and to provide evidence for clinically reasonable use of antibiotics.Methods One thousand four hundred and fifty neonates admitted to our NICU of Affiliated Hospital of Guangdong Medical College from Jan 2009 to Jul 2011 were enrolled.The blood samples from 1 450 neonates were cultured and isolated,and all of the isolates and their resistances were analyzed retrospectively.Results A total of 9 species and 233 pathogenic strains were isolated from 1 450 specimens,and the positive rate was 16.1％.Among the 233 strains,93 strains were gram-positive cocci,103 strains were gram-negative bacilli,and 37 strains were fungus.Among gram-positive cocci,the most dominant organism was coagulase negative staphylococcus,the next was Staphylococcus aureus;while among gram-negative bacilli,Ktebsiella pneumoniae were the most frequently isolated,the next were Escherichia coli and Acinetobacter baumannii,and among the fungus,monilia were the most isolated.The resistance rates of gram-positive cocci to vancomycin,linezolid and teicoplanin were high.Moreover,the antibiotic resistance rates to penicillin,oxazocilline and the β-lactamase were more than 95％.Gram-negative bacilli were sensitive to levofloxacin,imipenem and meropenem.A majority of fungus was Monilia,which was sensitive to antifungal.Conclusion Coagulase negative staphylococcus,Klebsiella pneumoniae and Escherichia coli are the the most common pathogens of neonatal sepsis in NICU,and have high drug resistance.Clinicians should select sensitive drug treatment according to bacterial identification and susceptibility testing.Besides,mycotic infection cannot be ignored and merit our attention.

This study examined the effect of astilbin on the proliferation of rat aortic smooth muscle cells (RASMCs) induced by angiotensin II (AngII) and explored the possible mechanisms. Cell proliferation model of RASMCs was induced by treatmente with AngII. Cells were randomly divided to 8 groups. Normally cultured VSMCs serves as blank control group; in AngII model group, cells were treated with AngII at 10(-7) mol/L; in three astilbin groups, cells were treated with 10, 15, 30 mg/L of astilbin; in three AngII+astilbin groups, cells were treated with AngII (at 10(-7) mol/L) and astilbin at 10, 15, 30 mg/L. Cell proliferation ability was detected by MTT method and the cell cycles and proliferation index were flow cytometrically determined. The expression of c-myc mRNA was assessed by using reverse transcription polymerase chain reaction (RT-PCR), and the expression of NF-κB in RASMCs was immunocytochemically observed. Our results showed that MTT metabolism in RASMCs in the basic and AngII stimulated situation was inhibited by astilbin, and the cells numbers of G(0)/G(1) phase were increased and that of G(2)/S phase were decreased markedly. Not only highly expression of c-myc gene stimulated by AngII could be inhibited by Astilbin significantly, but also the expression of NF-κB protein can be down regulated by Astilbin. We are led to conclude that astilbin astilbin can inhibit the AngII-mediated proliferation of RASMCs by blocking the transition of RASMCs from G(0)/G(1) phase to S phase and by down-regulating the expression of NF-κB, c-myc gene.

In order to study the effect of nitric oxide (NO) on the expression of hypoxia-inducible factor-1 alpha (HIF-1alpha) mRNA in hypoxic pulmonary hypertension (HPH) rats, 30 healthy male Wistar rats were randomly divided into normoxic control group, chronic hypoxic group and hypoxia plus L-arginine (L-Arg) group. The animal model of HPH was developed. The mean pulmonary arterial pressure (mPAP) was measured by inserting a microcatheter into the pulmonary artery. The HIF-1alpha mRNA expression levels were detected by in situ hybridization (ISH) and semiquantitative RT-PCR. It was found that after 14 days hypoxia, the mPAP in normoxic control group (17.6 +/- 2.7 mmHg, 1 mmHg=0.133 kPa) was significantly lower than that in chronic hypoxic group (35.8 +/- 6.1 mmHg, t=0.2918, P<0.05) and mPAP in chronic hypoxic group was higher than that in hypoxia plus L-arginine group (24.4 +/- 3.8 mmHg, t=0.2563, P<0.05). ISH showed that the expression of HIF-1alpha mRNA in the intraacinar pulmonary arteriolae (IAPA) in normoxic control group (0.1076 +/- 0.0205) was markedly weaker than that in chronic hypoxic group (0.3317 +/- 0.0683, t=3.125, P<0.05) and that in chronic hypoxic group was stronger than that in hypoxia plus L-arginine group (0.1928 +/- 0.0381, t=2.844, P<0.05). RT-PCR showed that the content of HIF-1alpha mRNA in chronic hypoxic group (2.5395 +/- 0.6449) was 2.16 times and 1.75 times higher than that in normoxic control group (1.1781 +/- 0.3628) and hypoxia plus L-arginine group (1.4511 +/- 0.3981), respectively. It is concluded that NO can reduce the mPAP by the inhibition of the expression of HIF-1alpha mRNA, which may be one of the mechanisms through which NO affects the pathogenesis of HPH.
Anoxia/metabolism ; Arginine/pharmacology ; Hypertension, Pulmonary/*metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; Nitric Oxide/*pharmacology ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Random Allocation ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription Factors/*biosynthesis ; Transcription Factors/genetics