Radioactive 125I interstitial brachytherapy is easy to cause the intestinal tract tissue damage.Its mechanism possibly correlates to the quick renewal speed of the intestinal tract tissue and a majority of ceils in M, G2 and late S phases. The tolerant dose of intestinal tract tissue is approximately 160 Gy. If the absorbed dose is higher than the tolerant one, the intestinal tract tissue will be damaged. In the clinical practice of radio-active 125I interstitial brachytherapy, through the strict plan of the TPS system before the operation, by using ul-trasound, CT, MR/and other imaging technologies in the operating process and establishing the suitable barrier protection between the seeds and intestinal tract tissue, the radioactive damage of the intestinal tract tissue my be reduced.

Objective The aim of this study was to determine the effective concentration of epidural ropivacaine for analgesia in 50% of parturients (EC50) in the first stage of labor. Methods Thirty-three ASA Ⅰ -　Ⅱ nulliparous women with 2-3 cm cervical dilatation who requested epidural analgesia were enrolled in the study. Epidural catheter was placed at L3-4 and advanced for 3-4 cm in the epidural space in a cephalad direction. 20 ml of ropivacaine solution of which the EC50 was being tested was given through the catheter into epidural space. The EC50 was determined by up-and-down sequential experiment. The initial concentration of the epidural ropivacaine being tested was decided to be 0.15% . If effective the next parturient received ropivacaine of a lower concentration; if ineffective the concentration of ropivacaine was increased in the next parturient. Each time the concentration of epidural ropivacaine increased/decreased by 0.01% . Analgesia was assessed by VAS score (1-10) . If VAS score was less than 3 within 30 min of ropivacaine administration, analgesia was defined as effective.Results Among the 33 parturients enrolled, three were excluded from the study because of uncertain analgesic efficacy. The results showed that the EC50 of epidural ropivacaine for analgesia in the first stage of labor was 0.063% [95% confidence interval (CI) was 0.05972%-0.06688%] .Conclusion The EC50 epidural ropivacaine for analgesia in the first stage of labor is 0.063 % determined by sequential experiment method.

Objective To control the quality of Gongyankang granule.Methods Paconiflorin in Gongyankang granule was determined by HPLC,using a Phenomenex Prodigy Thermouest(250×4.6 mm 5μm BDS C18).Mobile phase was consisted of CH_2OH-H_2O-H_3PO_4(30:70:0.1)with the UV detector set at 230 nm.Results The paeoniflorin showed linear correlation(r=0.9998)within the range of 0.01026～0.06156mg.The average recovery rate was 99.12%with RSD of 1.61%.Conclusion This method was simple,accurate and with good reproducibility,thus it can be used for quality control of Gongyankang Granule.

Objective To explore the clinical significance of interstitial chemotherapy applied in breast cancer.Methods Sixty breast cancer patients with modified radical mastectomy were divided into treatment group (40 cases) and control group (20 cases) according to whether using fluorouracil implants.The control group was given conventional treatment.In treatment group,distilled water washed the wound after conventional treatment,and fluorouracil implants (0.4 g) was placed below local tumor,between pectoralis major and pectoralis minor,below 0.5 cm axillary vessel.The bone marrow suppression,liver and renal function,gastrointestinal reaction,skin flap necrosis,subcutaeous hydrops,local recurrence were observed in the 2 groups.Results There were no significant differences in the rates of bone marrow suppression,liver and renal function abnormal,skin flap necrosis,subcutaeous hydrops and gastrointestinal reaction between treatment group and control group (P ＞ 0.05).The rate of local recurrence in treatment group was significantly lower than that in control group [0 vs.20.0％ (4/20)],there was statistical difference (P ＜0.05).Conclusion Intraoperative application of fluorouracil implants is safe and effective in modified radical mastectomy of breast cancer.

ObjectiveTo investigate the effect of dexmedetomidine on tracheal extubation response in patients undergoing thyroid surgery after general anesthesia.Methods Forty-two patients who ASA classification Ⅰ - Ⅱ,were performed thyroid surgery under total intravenous anesthesia.They were divided into dexmedetomidine group and control group by random number table with 21 cases each.Both groups patients anesthesia induction and maintenance with the same methods,dexmedetomidine group patients at 15 min before anesthesia induction with venous infusion dexmedetomidine 0.6 μ g/kg(finished 10 min infusion),followed by 0.4 μ g/(kg · h) continuous infusion,control group patients with pump equivalent in 0.9％ sodium chloride injection in the same way.Systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR),surgery time,recovery time,extubation time,orientation recovery time,modified Aldrete score ≥9 scores time,rate of recovery from restlessness,tolerance score and recovery from any adverse effects were recorded.ResultsThere were no significant differences between two groups in surgery time,recovery time,extubation time,orientation recovery time,modified Aldrete score ≥ 9 scores time (P ＞0.05).SBP,DBP,HR at immediately and after extubation with 1,3,5 min of dexmedetomidine group were lower than those of control group(P ＜ 0.05 or ＜ 0.01 ).Tolerance score excellent rate of dexmedetomidine group was higher than that of control group[95.2％ (20/21) vs.28.6％ (6/21)] (P ＜ 0.05),the rate of recovery from restlessness of dexmedetomidine group was lower than that of control group[0 vs.28.6％(6/21 ) ] (P ＜ 0.05).ConclusionBefore anesthesia induction in patients with venous infusion dexmedetomidine 0.6 p g/kg(finished 10 min infusion),followed by 0.4 p g/(kg·h) continuous infusion can effectively reduce the patients' cardiovascular response to extubation,strengthen the patients' tolerance to endotracheal tube,reduce the patients' agitation and recover consciousness comfortable.

Objective To study chromatography fingerprints of Zanthoxylum echinocarpum by HPLC.Methods Diamonsil C18 column(250 mm?4.6 mm,5 ?m) was used with acetonitrile-water gradient elution,at flow-rate of 1.0 mL/min,detection wavelength at 278 nm.Results HPLC was used to establish fingerprint chromatograph of water extraction from ten batches of Z.echinocarpum,which had been harvested from the same area in Zhangjiajie at the same time.The result showed that 11 peaks were common.Conclusion The method could be used for the quality control of Z.echinocarpum.

Objective:To evaluate the effects of humanistic care on medication compliance and social function of schizophrenic patients. Methods:76 patients with schizophrenia were randomly divided into two groups within two days of hospital admission. The observational group was applied humanistic care but the control group with rou-tine care. All the information related to the present study was collected using unified language. At the time of ad-mission, day 1, day 14, day 28 and day 56 after the intervention, the effect of humanistic care was evaluated by medication compliance, Brief Psychiatric Rating Scale ( BPRS) , Personal and Social Performance Scale ( PSP) and Family Concern Index Questionnaire ( APGAR) . Results:The patient′s medication compliance rate in the obser-vational group was higher than those in the control group, especially, at the time of day 56, the patients in the ob-servational group ( full compliance : 66%, partial compliance: 44%) was significantly better than those in the control group ( full compliance 19%, partial compliance 66%, incompliance 15%) . There were no statistical difference in the two groups of the BPRS scores on day 1 and day 14 of admission, however, the scores of the pa-tients in the observational group was significantly lower than those in the control group on day 28 and day 56 . As for PSP, the result was similar to BPRS on day 1 and day 14, while the PSP score of the patients in the observational group was significantly higher than those in the control group on day 28 and day 56. In terms of APGAR, the score of the patients in the observational group was significantly higher than those in the control study except day 1 of ad-mission. Conclusion:Humanistic care has positive effects on medication compliance and social function of schizo-phrenic patients especially after hospital discharge. The implementation of humanistic care would guide patients to maintain the capacity of life, labor and social communication, enhance the patient's sense of control over life, and improve their confidence to overcome the disease. With humanistic care, patients are more willing to cooperate with treatment, and further to reduce the recurrence and degradation of social function.

Objective To investigate the effect of rectal washout on prevention of local recurrence in patients with resectable rectal cancer.Methods Relevant studies published on PubMed,Embase database and Google between January 1980 and June 2013 were identified and reviewed.A meta-analysis was performed to compute the risk ratio (RR) and evaluate the effect of rectal washout on local recurrence in patients included in the reviewed studies.Results Eight studies were included in the meta-analysis,in which a total of 427 patients underwent rectal washout and 492 did not during rectal cancer resection.The patients had an overall local recurrence (LR) rate of 6.64 ％ (61/919).Rectal washout,no matter which type of washout solution was used,significantly reduced the risks of local recurrence (3.75 ％,16/427 vs 9.15 ％,45/492,RR =0.46,95 ％ CI =0.26-0.82,P =0.008).Patients with rectal washout showed a low LR rate,when compared with those in the three subgroups who underwent total mesorectal excision (TME) (5.18 ％,10/193 vs 5.32 ％,10/188).However,there was no statistically significant difference in the risk of LR among the three subgroups (RR =0.99,95 ％ CI =0.42-2.30,P =0.98; RR =0.44,95 ％ CI =0.18-1.04,P =0.06; RR =0.46,95 ％ CI =0.20-1.04,P =0.06,respectively).Conclusions The intra-operative rectal washout largely reduces local recurrence after anterior resection of rectal cancer.Rectal washout should be applied routinely during anterior resection.

Objective To evaluate the efficacy and safety of the conscious analgesia/sedation scheme with remifentanil and propofol on the elderly patients under gastroenterological endoscopic procedure. Methods Retrospective analysis was performed on 3 500 cases with remifentanil and small?dose propofol under gastroenterological endoscopic procedures, and the procedure achievement, effects of the narcotic, adverse reactions and satisfactory results were summarized. Results All procedures were completed successfully. The ratio of the patients whose intended sedation depth arrived at referential induction was up to 91?3%(3 196/3 500).Hemodynamic change was slight and almost all patients could open eyes in no time, with short hospital stay. No serious adverse effects were observed except several patients complaining about mild bucking, abdominal distension and stomachache. The degree of patients′ satisfaction was high. Conclusion The conscious analgesia/sedation scheme with remifentanil and propofol can be effectively and safely used on gastroenterological endoscopic procedure among the elderly, but precise monitor and timely treatment of complications are still needed.

Objective To summarize the sonographic characteristics of parathyroid adenomas(PAs) and investigate the diagnostic values and best diagnostic thinking for an early detection. Methods Sixteen cases finally proved with PAs were retrospectively analyzed of their clinical complaints, the department for their initial consultation,indicative ultrasound findings for neck scanning, major manifestations of PAs on a series of three-mode ultrasound imagings,association of adenoma sizes to serum parathyroid hormone(PTH) levels. Results On multimode ultrasound images, the PAs were multidisciplinary morphologic, homogenously hypoeehoic,absent of calculus and necrosis,highly vascularized with color signals,and similar to thyroid in contrast agents perfusion. Serum PTH levels were elevated in accordance with increase of adenomas' size. Among the 16 cases 12 were defined as with parathyroid incidentalomas, to which liver or/ and kidney stones were contributed as indicatives. Conclusions High frequency ultrasound with multiple imaging modes are most suitable for scanning and detection of neck PAs. For those with stones in liver and urinary tracts, unknown bone fracture etc, ultrasound scanning of the neck parathyroids used to reveal latent PAs.