Asthma ; diagnosis ; Exhalation ; Humans ; Nitric Oxide ; metabolism ; Respiratory Function Tests

Objective To investigate the effects of exercise on serum soluble cell adhesion molecules and cytokines of patients with dyslipidemia. Methods Eighty patients with dyslipidemia were randomly and equally divided into an exercise group and a control group. The control group was treated with pravastatin,while exercise was administered in the exercise group in addition to the pravastatin. Both groups were observed for 8 weeks. Results Serum leves of soluble endothelial leucocyte adhesion molecule 1(sELAM),soluble intercellular adhesion molecule(sICAM 1)and interleukin 1?(IL 1?)of patients in both groups were decreased significantly. Moreover,serum levels of soluble vascular cell molecule 1(sVCAM 1)and tumor necrosis factor ?(TNF ?)in addition to sELAM,sICAM 1 and IL 1? were decreased significantly in the exercise group,with a significantly better result in the exercise group as compared with that of the control group. Correlation analysis revealed a positive correlation of individual sELAM,sICAM 1 and sVCAM 1 with blood total cholesterol(TC),and negative correlation of individual sELAM,sICAM 1 and sVCAM with high density lipoprotein cholesterol(HDL C)in exercise group. Conclusion Adequate exercise has beneficial effects on patients with dyslipidemia by reducing serum levels of soluble adhesion molecules and the production of proinflammatory cytokines,which was realized possibly through modulating serum lipids and improving endothelial dysfunction.

Objective A method was developed for the determination diazepam and its main metabolites,nordiazepam, and oxazepam and then in urine by GC-ECD. Method The urine samples were hydrolyzed with ?-glucuronidase were extracted in organic solvent. The extractives were derived with BSTFA and the analytes as trimethylsilyl derivatives were determined by GC. Results Sensitive of the method is as low as snglme, the recovery is high then 70%. Conclusion This method is sensitive enough for the analysis of urine from the subjects over a 48 hour period after receiving a 10mg dose of diazepam orally.

On the basis of the bioluminescent detection technology of the lux gene being a kind of new and progressing environmental detection technology,in this paper,the constitution,function,expression and regulation of the lux gene were introduced,moreover,the recent advance of its application in the study of environmental detection was reviewed

Objective To explore the lesion mechanism and the apoptosis related protein changes of kidney in rat suffered from obstructive jaundice. Methods Choledocho-ligation methods was used to create rat obstructive jaundice model. Six rats in the normal control group and thirty rats of experiment group were observed at day 1, 3, 6,10 and 14 after rat model establishment. HE staining for kidney pathological changes, TUNEL staining for cell apoptosis, SABC for apoptotic related proteins of survivin and bax, xanthine oxidase method for SOD activity and thiobarbiturate method for MAD content were carried out. Results Renal tubular epithelial cell necrosis, cell shedding and aggregation were the main pathological changes in the experiment group. In the experiment group, the apoptosis ratio increased significantly, and reached the peak of (25.2?2.8)% on postoperative day 14. The relative gray value of survivin in the experiment group decreased significantly and of bax increased significantly. The plasma SOD activity in the normal group was (193.6?23.5) U/L, but it in the experiment group decreased significantly. The plasma MDA content and the endotoxin level in the experiment group increased significantly. Conclusion Cell apoptosis is one of the lesion mechanisms of kidney in rats suffered from obstructive jaundice. The down-regulation of survivin and the up-regulation of bax may be the biological factor in the occurrence of apoptosis. The increasing of free radical and endotoxin are important factors in the kidney lesion.

Objective To discuss the surgical skills and clinical value of laparoscopic splenectomy with a safe approach to the splenic hilum through first mobilizing the lower pole of the spleen.Methods A total of 88 patients with hypersplenism secondary to liver cirrhosis who underwent laparoscopic splenectomy in our department from September 2015 to September 2016 were selected into this study.And these patients were divided into two groups based on whether to take the safe approach to the splenic hilum through first mobilizing the lower pole of the spleen in laparoscopic splenectomy.The control group included 40 cases who underwent the traditonal laparoscopic splenectomy,while the observation group included 48 cases who took the safe approach to the splenic hilum through first mobilizing the lower pole of the spleen in laparoscopic splenectomy.The clinical data were collected retrospectively by medical clinical records review.Results There was no mortality occurred in this study.The blood loss of the observation group was (247.50±135.89)mL,which was obviously lower than (361.75±144.43)mL of the control group,and the difference was statistically significant (P<0.05).The operation time of the two groups were (194.69±47.99)min and (232.75±45.26)min respectively,and the difference was statistically significant (P<0.05).No significant difference was found in terms of rate of conversion to laparotomy,rate of intraoperative blood transfusion,postoperative hospital stay and complications (P>0.05).Conclusion It is very crucial for a safe approach to the splenic hilum through first mobilizing the lower pole of the spleen to establish a tunnel behind the splenic hilum in laparoscopic splenectomy.It is safe and feasible to perform a safe approach to the splenic hilum through first mobilizing the lower pole of the spleen in laparoscopic splenectomy.The technique is generalized in clinics,especially for freshmen.

In the background of the crisis of doctor-patient relationship and the effectiveness of medical humanities education doubts we need to think about how to achieve,transform and reflect the value of doctors' understanding on their professional meaning,how to realize the functional significance of doctorpatient cooperation and how to make doctors put themselves in patients' place by the curriculum and its operating mechanism.This paper discussed the external environment and the microcosmic environment from the externality and connotation of the humanities curriculum.And the way to reflect and achieve the value transformation of the medical humanistic curriculum in the mechanism of education was considered.This paper put forward combining the institutional mechanism of policy leading,the subject mechanism that is the basis of the curriculum,the constitutive mechanism of curriculum system and the cultural mechanism to make students study and internalize,and made some suggestions.

OBJECTIVE:To investigate the effects of etomidate combined with propofol on painless gastrointestinal endoscopy and cognitive function of elderly patients. METHODS:Totally 90 elderly patients with painless gastrointestinal endoscopy were ran-domly divided into propofol group(30 cases),etomidate group(30 cases)and combination group(30 cases). Propofol group was given Fentanyl injection 1 μg/kg+Propofol injection 1.5 mg/kg;etomidate group was given Fentanyl injection 1 μg/kg+Etomidate injection 0.3 mg/kg;combination group was given Fentanyl injection 1 μg/kg+Propofol injection 1 mg/kg+Etomidate injection 0.15 mg/kg. The levels of SBP,DBP,HR,MAP and SpO2 at different time points,examination time,anesthesia induction time,recov-ery time and recovery time of orientation were observed in 3 groups. NCSE and MMSE score at different time points,the occur-rence of ADR were also observed in 3 groups. RESULTS:During examination,SBP,DBP,MAP and SpO2 of propofol group were significantly lower than before anesthesia,after examination and those of combination group,with statistical significance(P<0.05);but there was no statistical significance in above indexes of propofol group between during examination and before anesthesia (P>0.05). The recovery time and recovery time of orientation in combination group were significantly shorter than propofol group and etomidate group,with statistical significance(P<0.05),but there was no statistical significance in above indexes between etomidate group and propofol group(P>0.05). The proportion of patients'memory ability,computing ability,orientation ability passing examination in combination group were significantly higher than propofol group,with statistical significance(P<0.05). There was no statistical significance in above indexes between combination group and etomidate group,between etomidate group and propofol group(P>0.05). There was no statistical significance in MMSE score of combination group at different time points (P>0.05);MMSE score of propofol group 15,30 min after anesthesia and that of etomidate group 15 min after anesthesia were significantly lower before anesthesia and combination group,with statistical significance(P<0.05). There was no statistical signifi-cance in MMSE score of propofol group 1 h after anesthesia,etomidate group 30 min and 1 h after anesthesia,compared to before anesthesia(P>0.05). The incidence of apnea,hypotension and injection pain in combination group and etomidate group were low-er than propofol group,the motor response,myoclonus,nausea and vomiting in combination group and propofol group were lower than etomidate group,the tachycardia ease in combination group was lower than propofol group,with statistical significance(P<0.05). CONCLUSIONS:Etomidate combined with propofol anesthesia shows good therapeutic efficacy for painless gastrointestinal endoscopy of elderly patient,can reduce cognitive dysfunction and shortens recovery time,but doesn't increase the occurrence of ADR.