Objective To compare the effect of etomidate and propofol on cardiac and renal function in perioperative elderly patients. Methods 120 perioperative elderly patients were selected and divided into two groups.60 cases in etomidate group (T group) were anesthesia induced by etomidate, and 60 cases in propofol group ( B group) were anesthesia induced by propofol.Hemodynamics, renal function and perioperative indexes were compared after operation.Results Compared with before induction, SBP, DBP and HR were lower after induction(P<0.05), and compared with T group at the same time, SBP, DBP and HR of B group were lower( P<0.05).Compared with before induction, SI, CI and EV were lower after induction (P<0.05), and compared with T group at the same time, SI, CI and EV of the B group were lower(P<0.05).Compared with B group, Cr, BUN and β2-MG of T group were lower ( P<0.05 ) .Conclusion The effects of etomidate on inhibition of cardiovascular system and damage of renal function is slighter, which has important significance for elderly cancer patients.

Through defining the connotation of division and cooperation among medical institutions, this paper introduces the current status for division and cooperation among medical institutions of Britain, Germany, Singapore and USA. The advantages include excellent general practices, optimal health resource allocation, effective first treat-ment in community health facilities, and effective two-way referral. We analyzed the influence of some new policies on the division and cooperation among medical institutions such as medical association, managed care and the General Practices’ service contract. This provided a lot of experience and revelations, including the dynamics to promote the division and cooperation, the separation of outpatient services and inpatient services, privatization of primary medical institutions, division and cooperation between medical institutions and nursing, rehabilitation institutions, distinguis-hing the division and cooperation from hospitals alliance, and division and cooperation among medical institutions can not resolve the all issues in the medical care supply system.

Objective: To develop an indicator system for assessing public hospital performance. Methods:Based on literature research and expert consultation, we formed an indicator system framework and indicators for as-sessing public hospital performance. Using Delphi expert consultation, focus group interviews, focus group discussion and individual in-depth interview qualitative research methods, we constructed a public hospital performance evalua-tion indicators. Results:There are four dimensions, 11 secondary indicators, 30 tertiary indicators in the indicator system, depending on the level of hospital, the indicators and weights are adjusted. Conclusion:The indicator system is suitable for public-interest-oriented performance assessment of public hospitals, and provides basis for the perform-ance assessment system.

OBJECTIVE: To explore the mechanism of scalp acupuncture (SA) in treating cerebral ischemia. METHODS: Sixty SD rats with middle cerebral artery occlusion (MCAO) were randomized into untreated group and SA-treated group, with another group of 10 SD rats without artery occlusion as sham-operated control. Neurological severity score (NSS), hemetoxylin and eosin (HE) staining and enzyme-linked immunosorbent assay were applied to observing the changes of neurofunctional defect, inflammatory infiltration in cerebral tissue and content of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and IL-10 at 24, 48 and 72 h after ischemia-reperfusion. RESULTS: There existed significant difference in NSS between SA-treated group and untreated group (P<0.01), especially at 72 h after ischemia-reperfusion. The HE staining results of ischemic cerebral tissue showed an apparent reduction of inflamed lesions in SA-treated group as compared with the untreated group (P<0.01), especially at 72 h after ischemia-reperfusion. The content of TNF-alpha and IL-1beta at each phase point after ischemia-reperfusion in SA-treated was decreased as compared with that in the untreated group, and there were differences between SA-treated group and untreated group at 72 h after ischemia-reperfusion (P<0.01). An apparent increase was observed in IL-10 between SA-treated group and untreated group at each phase point after ischemia-reperfusion, and there were significant differences between SA-treated group and untreated group at 48 and 72 h after ischemia-reperfusion (P<0.05, P<0.01). CONCLUSION: Scalp acupuncture can improve neurofunctional rehabilitation, suppress leukocyte infiltration, decrease the content of TNF-alpha and IL-1beta within a certain range and enhance IL-10 expression so as to suppress cytokines-mediated inflammatory reaction and attenuate cerebral ischemia-reperfusion injury.

Objective To explore the underlying mechanisms of scalp electroacupuncture (SEA) in treating cerebral ischemia. Methods A total of 70 healthy male Sprague-Dawley rats were randomized into a sham operated group, a model group and a scalp electroacupuncture (SEA) group. Cerebral ischemia was induced in rats by middle cerebral artery occlusion (MCAO). Rats in SEA group were treated with scalp electroacupuncture immediately after the establishment of the cerebral ischemia model by inserting the needles along anterior oblique line of vertex-temporal and posterior oblique line of vertex-temporal, connecting to the Han's Electro-Acupuncture Apparatus. The rats in sham operated group underwent the same operation as that in SEA group but without occlusion. Neurological severity score (NSS) was obtained to evaluate the neurofunctional defect, hemetoxylin and eosin (HE) staining was used to observe the inflammatory infiltration in cerebral tissue, and enzyme-linked immunosorbent assay(ELISA) to measure the contents of IL-1 beta and IL-10 at various time points. Results SEA group demonstrated significant decline in NSS at 72 h after the operation when compared with that of model group (P < 0. 01 ). An apparent attenuation in in-flammatory infiltration was seen in SEA group comparing with that of model group, especially at 48 h and 72 h after operation (P <0.01 ). Apparent decrease in IL-lbeta in SEA group was observed when comparing with the model group at 72 h (P <0.01 ). Statistically significant increase in IL-10 content was seen in SEA group at 48 h and 72 h after operation comparing with that of model group. Conclusions Scalp electroacupuncture might exert brain pro-tection by suppressing leukocytes infiltration via up-regulation of IL-10 and down-regulation of IL-1 beta expression.

To explore the mechanisms of scalp acupuncture in treating cerebral ischemia in rats.

Objective To establish the model of VX2 soft tissue xenograft in rabbit, and choose the best time for PET-CT imaging. To analyze the result of the imaging with semi-quantitative, and evaluate the feasibility of the study with VX2 soft-tissue tumor model in rabbit for PET-CT imaging. Methods 20 Japanese white rabbits were successfully implanted with VX2 tumors in thighs by the injection of tissue mass suspension.Then they were scanned with PET-CT after the diameter of the tumor is ＞2 cm. Results The diameter of the tumor＞2 cm at 14 d post implant. The average volume of tumor was (114.57±9.87) cm3.The average SUVmax of tumor's and normal tissue's in the other thigh was 5.85±0.92 and 0.22±0.09 (t=27.03, P＜0.01). SUVmax was not associated with tumor volume (r=0.02, P=0.93).Conclusion The imaging of VX2 soft tissue xenograft is clear by clinic PET-CT, and it is suitable for the study of PET-CT.PET-CT imaging performed at 14 d post implantation had the highest imaging quality.

Objective To explore the relationship between plasma homocysteine levels and diabetic peripheral neuropathy (DPNP). Methods A crossectional analysis was conducted on 227 patients with type 2 diabetes. Peripheral neuropathy was confirmed using electromyography (EMG). The risk factors possibly associated with diabetic neuropathy or plasma homocysteine levels were analyzed in relation to likelihood of occurrence of DPNP. Results Eighty patients with neuropathy and 147 patients without neuropathy were included. Plasma homocysteine levels were significantly higher in patients with diabetic neuropathy [( 12. 6 ± 3.6 ) μmol/ L] than without diabetic neuropathy [( 8. 2 ± 0. 9 ) μmol/L] ( P ＜0. 001 ), and the relationship remained significant after adjusting for duration of diabetes, glycosylated hemoglobin A1c (HbA1c), age, renal status, serum folate acid and vitamin B12, and metformin [OR 1.15( 1.02-1.28 ) ,P ＜ 0. 05]. In addition, per increase of 4. 0 μmol/L plasma homocysteine was closely related to the occurrence of neuropathy after controlling for per unit increase of other confounding factors [OR 1.17(0. 94-1.33), P ＜ 0. 05]. Conclusions Hyperhomocysteinemia was an independent risk factor for the occourence of diabetic peripheral neuropathy.

Objective To investigate the effect of transcutaneous electrical acupoint stimulation(TEAS)on postoperative sore throat(POST)in patients undergoing double-lumen bronchial intubation based on general anesthesia.Methods A total of 103 patients,45 males and 58 females,aged 18-64 years,BMI 18-28 kg/m2,ASA physical status Ⅰ-Ⅲ,who received selective operation of double-lumen bronchial intubation under general anesthesia were selected.The patients were divided into two groups using the random number table method:TEAS group(n = 51)and control group(n = 52).In the TEAS group,TEAS on Tiantu acupoint and bilateral Hegu acupoints started 30 minutes before anesthesia induction,and the stimulation lasted until the patients were sent to the recovery room.In the control group,electrodes were placed on the same acupoints without electrical stimulation.The Mallampati grade,number of tracheal intu-bation attempts,compression of cricoid cartilage,resistance during intubation,and double-lumen endobron-chial tube(DLT)retention time were recorded.The incidence and severity of POST,VAS pain scores of sore throat,and the incidence of hoarseness 1 hour,6,and 24 hours after extubation were recorded.Results Compared with the control group,the incidence of POST,the incidence of POST level 1,and VAS pain scores of sore throat were significantly decreased 1 hour,6,and 24 hours after extubation(P＜0.05),the incidence of POST level 2 was significantly decreased 6 hours after extubation in the TEAS group(P＜0.05).There were no significant differences in the situations related to tracheal intubation,and the inci-dence of hoarseness 1 hour,6,and 24 hours after extubation between the two groups.Conclusion The transcutaneous electrical acupoint stimulation on Tiantu acupoint and bilateral Hegu acupoints can signifi-cantly reduce the incidence and severity of postoperative sore throat,and VAS pain scores of sore throat in patients undergoing double-lumen bronchial intubation.

OBJECTIVETo determine a network solution to meet the network requirements of the heavy data flow, load balance, and potential network storms from expansion of picture archiving and communication system (PACS) application.

METHODSIntel Netstructure 480T Giga Switch was used as the main switch and connected to each building by fiber channel at 1 Giga speed to archive 100 MB/s to each port. At the same time, the in-dependence of the original network construction was physically kept. The layer 3 and 4 switchers were used as load balance to reduce the heavy load of the network, and all the cabling for PACS used the super CAT5 along with the Intel NetStructure 1520 to prepare for potential network storms.

RESULTSAn advanced intranet was set up to fully meet the high standard requirement of the PACS. The foundation for upgrading the whole network system to 1 Giga application was built to achieve sharing and transmission of images, information, and patient data within the hospital. The base was established for the standardized management of the hospital.

CONCLUSIONGood planning is the first step in setting up PACS, and the equipment forms the necessary platform to run PACS and all kinds of hospital information system (HIS). The networking construction is the foundation of e-hospital.