Objective To observe the sedative effect of dexmedetomidine administered at different infusing rates in senile cataract patients with retrobulbar nerve block.Methods Eighty-four senile cataract patients with retrobulbar nerve block were divided into Ⅰ,Ⅱ and Ⅲ group by random systematic sampling method with 28 cases each,the dexmedetomidine infusing rates were 0.2,0.4 and 0.6 μg/(kg·h) accordingly.Ramsay score and mean arterial pressure (MAP),heart rate (HR),respiratory rate (RR),pulse oxygen saturation (SpO2) were recorded before anesthesia (T0),after retrobulbar nerve block (T1),and 1 0,20,30,60min after sedative administration (T2-T5).Results Ramsay scores were higher in three groups at T2-T5 than that at T0 [Ⅰ group:(2.6 ± 0.7),(2.5 ± 0.2),(2.4 ± 0.8),(2.4 ± 0.3) scores vs.(2.0 ± 0.0) scores,Ⅱ group:(3.0 ± 0.7),(3.8 ± 0.7),(4.2 ± 0.2),(4.5 ± 0.2) scores vs.(2.0 ± 0.0) scores,Ⅲ group:(3.8 ±0.6),(4.7 ± 0.4),(5.2 ± 0.8),(5.6 ± 0.6) scores vs.(2.0 ± 0.0) scores],Ⅲ group was higher than Ⅰ group and Ⅱ group,Ⅱ group was higher than Ⅰ groupatT3-T5,difference was statistically significant (P＜0.05).HR was slower in three groups at T3-T5 than that at T0 (P ＜ 0.05),Ⅲ group was slower than Ⅰgroup and Ⅱ group,difference was statistically significant (P＜0.05).There were no significant changes in MAP,RR and SpO2 among groups and the group (P ＞ 0.05).Conclusion Bolus infusion dexmedetomidine 0.5 μ g/kg followed by intravenous infusion at 0.2-0.4 μ g/ (kg· h) is suitable for sedation of senile patients with cataract surgery.

Objectives:To investigate the clinical outcomes of unilateral percutaneous vertebroplasty(PVP) by using curved injection needle in osteoporotic vertebral compression fractures(OVCFs).Methods:From January 2015 to January 2016,47 patients(14 males and 33 females) with OVCFs were enrolled in this study.The patients were 53-89 years old (66.4±6.5 years),36 cases were single segmental vertebral fracture,11 cases were double segment vertebral fracture.T9 fracture occured in 7 cases,T10 fracture in 7 cases,T11 fracture in 9 cases,T12 fracture in 13 cases,L1 fracture in 12 cases,L2 fracture in 9 cases,and L3 fracture in 1 case.The fluoroscopy time and bone cenent dosage were recorded.The VAS score,ODI,relative height restoration of vertebra and Cobb angle were compared between preoperation and postoperation.The bone cement leakage(venous leakage and perivertebral leakage) and other complications were observed.Results:The average fluoroscopy time was 1.6±0.3nin,the average bone cement dosage was 6.7±1.2ml.Bone cement leakage occured in 11 cases with the rate of 23.4％.The patients were followed up for 3-12 months (6.5±1.3 months).The VAS,ODI,the relative height of injured vertebra and the local Cobb angle before operation,at 2 days after operation and final follow-up were:7.6±1.3,(71.4±3.2)％,0.48±0.21,15.5°±4.2°;2.2±1.0,(27.2± 2.6)％,0.82±0.17,7.2°±2.8°;1.7±0.7,(26.5±2.7)％,0.80±0.15,7.5°±3.7°.At 2 days after operation and final follow-up,the VAS score,ODI score,the relative height and Cobb angle of injured vertebra were significantly improved when compared to those before operation (P＜0.05);There was no significant difference between 2 days after operation and final follow-up(P＞0.05).Conclusions:The advantages of unilateral PVP by using curved injection needleless in OVCFs are less fluoroscopy time,even distribution of bone cement,and less leakage.

Objective To compare the efficacy of carotid endarterectomy(CEA)and carotid artery stenting(CAS)for the treatment of high-risk atherosclerotic carotid artery stenosis.Methods We retrospectively studied the surgical outcomes of 58 patients with high-risk atherosclerotic carotid artery stenosis.Among the cases,32 received CEA and 26 underwent CAS.All of the patients were followed up with carotid ultrasonography,CTA or DSA in 30 days,6 months,and 1 year after the procedures,their neurological function was assessed meanwhile.Cumulative incidence of death,stroke,or myocardial infarction within 30 days after the surgical intervention and death or ipsilateral stroke events between 30 days and 1 year were set as the primary endpoint of the study.And the secondary endpoints were the CEA or CAS-correlated complications or severe restenosis within 1 year after the treatment.The outcomes of the two groups were compared.Results The primary endpoint occurred in 3 patients in the CEA group(9.4%)and 4 in the CAS group(15.4%)(?2=0.086,P= 0.769).And the secondary endpoint was found in 4 of the CEA group(12.5%)and 4 of the CAS group(15.4%)respectively(?2=0.000,P=1.000).Conclusions For the patients with high-risk carotid artery stenosis and coexisting conditions,CEA is as safe and effective as CAS.

Objective To realize intelligent and refined management of medical war storage materials by designing a management platform based on context awareness.Methods The conditions of medical war storage materials and its storage environment were monitored dynamically,and technologies of context awareness,radio frequency identification,temperature and humidity sensing and etc were used to establish the platform.Results The platform improved the traditional medical war storage materials management system in intelligence and refinement,and implemented auto update and intelligent alarm for the information on medical war storage materials.Conlusion The platform fulfills automatic and intelligent medical war storage materials management,and thus has practical values for medical service support.

Objective To study imaging findings of Sturge-Weber syndrome. Methods The clinical manifestations and imaging findings of 11 cases suffered from Sturge-Weber syndrome were analysed. 10 cases had facial vascular nerves angioma in the trigeminal nerve distribation. Routine CT examination was performed in all 11 cases, 2 cases had head radiography and 8 cases had MRI, 5 cases had enhanced CT and 3 cases had enhanced MRI.Results Imaging finding included:on the affected hemisphere, cortical calcifications (n=11), brain atrophy (n=9), the interfaces between gray matter and white matter blured, dilated subependymal veins,enlargeel choroids plexus (n=7) and increasing thickness of cranial diploe (n=8). The choroids plexus of lateral ventricle was prominent enhanced in 5 cases. Enhancement of cortical areas and vessels on the surface of brain were noted in 6 cases. Conclusion Head radiography has finite effects in the diagnosis of Sturge-Weber syndrome, MRI combined with CT plays an important role in the diagnosis of this syndrome.

OBJECTIVE To approach the effect of empirically applying ?-lactam antibiotics for treatment of hospital-acquired pneumonia on distribution and antibiotic-resistance of pathogenic bacteria.METHODS To investigate 141 patients with hospital-acqired pneumonia in intensive care unit during Jan 2001-Oct 2005,and divide into 3 groups:third generation cephalosporin group;lactamase inhibitor group;and other lactam antibiotics group according to different initial antibacterial strategy,then analyze difference in distribution and antibiotic-resistance of pathogens among each group.RESULTS We acquired 164 strains of pathogens.Comparing with other two groups,the proportion of Gram-positive cocci in lactamase inhibitor group was higher significantly(P

Based on the characteristics of the scientific research for the hospitM in new period,this paper studied on the construction of management regulations for the laboratory animal center combining the developing condition of the laboratory animal in the hospital.

OBJECTIVE To sum up the distribution and drug-resistance of pathogens in hospital-acquired pneumonia(HAP) at each stage,and then to offer references for treatments of HAP.METHODS To retrospectively analyze 46 patients whose course was over 30 day and who were in hospital from Jan 2000 to Oct 2005,and to divide course into prophase,metaphase and anaphase,and then to clinically study the drug-resistance and distribution of pathogens in each phase.RESULTS In prophase the most pathogens were Gram-negative bacilli(accounted for 87.5%),in metaphase the Gram-positive cocci were manifold distinctly;and in metaphase and anaphase drug-resistance of Gram-negative bacilli increased distinctly;and the fungi were not detected in prophase,but were positive in metaphase and anaphase.CONCLUSIONS In prophase application of third generation cephalosporin which is more sensitive to Gram-negative bacilli as an empirical antibacterial therapy is right;based on the drug-resistance and distribution of pathogens,the antibacterial drugs and treatment must be readjusted.

Objective:To establish the quality standard for Tiaojing Zhuyun granules .Methods:A TLC method was used for the qualitative identification of main ingredients of Cornus officinalis and Angelica sinensis, and an HPLC method was used for the determi-nation of loganin in Tiaojing Zhuyun granule with SinoChrom ODS-BP (250 mm ×4.6 mm,5μm) as the analytical column .The mobile phase was composed of acetonitrile-0.1%phosphric acid solution (14∶86) at a flow rate of 1.0 ml· min-1 .The detection wavelength was set at 240 nm and the column temperature was 30℃.Results:The corresponding spots in the granule were clear without any inter -ference from the negative control .The calibration curve of loganin was in good linearity over the range of 50 .40-1008 .00 ng ( r =0.999 9).The average recovery was 98.02%(RSD=2.51%,n=6).Conclusion:The method is simple,feasible and reproducible, which can be used for the quality control of Tiaojing Zhuyun granules .

Objective To comparison anterior cervical decompression and plating techniques for CSM between under microscope and traditional method retrospectively, investigate clinical result of surgery under microscope. Methods Sixty-seven patients with CSM underwent surgery of anterior cervical decompression and plating techniques were evaluated retrospectively from January 2008 to June 2010. Thirty-three patients underwent operation under microscope; thirty-four patients underwent traditional operation. The operating time, bleeding volume during operating and poster operating, walking time post-operation and complication were observed. Clinical outcomes were assessed by Japanese Orthopaedic Association (JOA), Image of before and after operation. Results Microsurgery operation time averaged of 100 minutes. Bleeding volume during the operation averaged of 60 ml, and after operation averaged of 40 ml. The JOA scores were improved from 8.43 pre-operatively to 14.70. Six months post operation, the average rage of JOA improvement were 83.2%. Traditional operation time averaged of 115 minutes. Bleeding volume during operation averaged of 100 ml, and after operation averaged of 50 ml. The JOA scores were improved from 7.45 pre-operatively to 11.84. Six months post operation, the average rage of JOA improvement were 82.1%. There were difference between two groups(P ＞ 0.05) in the JOA scores. No statistical difference (P ＜ 0.05) in bleeding volume and operating time. Conclusion The operation under microscope is restored significantly than the traditional method in bleeding volume, the surgical field, safety of operation, time of recovery and so on.