Objective To evaluate the feasibility of using corrected body weight to set the tide volume for mechanical ventilation during general anesthesia in obese patients.Methods Ninety-six ASA physical status Ⅰ or Ⅱ obese patients,with a body mass index of 28-44 kg/m2,scheduled for elective extremity surgery under general anesthesia,were divided into 3 groups (32 cases of each group) by random digits table method:tide volume based on actual body weight group (group A),tide volume based on ideal body weight group(group B),and tide volume based on corrected body weight group(group C).The pulmonary function of all patients was normal.The patients were endotracheally intubated and mechanically ventilated after induction of anesthesia.According to the corresponding body weight,the initial tide volume was set based on 8 ml/kg in each group(respiratory rate:15 bpm).At 10 min after start of mechanical ventilation,peak airway pressure (Ppeak),airway plateau pressure (Pplat),airwayresistance (Raw) were recorded.Arterial blood samples were collected at 30 min of mechanical ventilation for blood gas analysis and arterial blood oxygen partial pressure (PaO2),arterial blood carbon dioxide partial pressure (PaCO2) and the patients requiring readjustment of tide volume were also recorded.Results The level of Ppeak,Pplat,Raw in group B and group C were significantly lower than those in group A[(15.3 ± 1.8),(18.5 ± 2.6) cmH2O (1 cmH2O =0.098 kPa) vs.(23.2 ±3.3) cmH2O; (11.5 ± 1.6),(14.3 ± 1.4) cmH2O vs.(17.6 ±2.7) cmH2O; (10.8 ± 1.7),(12.5 ± 2.6) cmH2O/ (L·s) vs.(16.8 ± 3.0) cmH2O/ (L·s)],and the level of PaCO2 in group B and group C was significantly higher than that in group A [(48.8 ± 3.1),(40.2 ± 2.3) mmHg (1 mmHg =0.133 kPa) vs.(28.6 ± 3.8) mmHg],there was significant difference(P ＜ 0.01).The level of PaO2 and oxygenation index in three groups had no significant difference (P ＞ 0.05).There were no patients requiring readjustment of tide volume in group C,however,93.8％ (30/32) patients required readjustment of tide volume in group A and 81.2 ％ (26/32) in group B,there was significant difference (P ＜ 0.01).Conclusion Corrected body weight based on 8 ml/kg can be used to set the tide volume for mechanical ventilation during general anesthesia in obese patients with normal pulmonary function.

BACKGROUND: Biliary ischemia-reperfusion injury is one of the main reasons for the injury bile duct following liver transplantation, liver resection and hepatic artery thrombosis after chemotherapy. However, nothing has been decided yet concerning liver can tolerate long intrahepatic bile ducts ischemia under normal temperature. OBJECTIVE: To use the rabbit biliary ischemia-reperfusion injury, model, analyze the rabbit intrahepatic bile ducts ischemia security time. METHODS: Rabbits were randomly divided into sham operation, hepatic artery and common bile duct joint blocking 1.5, 2, 2.5, 3 h groups. Sham operation group only free common bile duct, hepatic artery and portal vein. Hepatic artery and common bile duct joint blocking 1.5, 2, 2.5, 3 h groups, left and right hepatic duct openings superior margin was clamped using artery clamps, and hepatic artery, common bile duct and loose connective tissue were occluded. Following 1.5, 2, 2.5 and 3 hours, artery clamps were removed to recover hepatic artery or biliary tract blood flow. After a week, animal survival was calculated and liver function was tested. RESULTS AND CONCLUSION: None animals in the sham operation and hepatic artery and common bile duct joint blocking 1.5 hour groups died;survival rate was 87.5% following 2 hours of blocking. Animal survival rate was decreased gradually with prolonged blocking time of blood flow. These indicated that the maximum safety time of blocking biliary duct blood flow was 2 hours. Pathological and histological changes were mild within 2 hours of blocking, mainly presenting cell edema and inflammatory cell infiltration, and necrotic focus was punctiform or fragmentis, reversible. While ischemia above 2 hours, bile duct epithelial necrotic shape was significant. The obvious, hepatic necrosis was multifocal, flake, irreversible damage. Histological change also confirmed that 2 hours may be maximum security limitation of rabbit tolerance intrahepatic bile duct flow blocking under normal temperature.

We experienced women's helpless plight of domestic violence and extramarital affairs through the data of survey and case records in Women's Federation.Women in modern society are still experiencing domestic violence from their husbands' abuse and spiritual betrayal that often can't be solved in time.All these cases fully reflected neglect of females and unfair treatment to women from social systems.According to the analysis based on realities,the above hurt women encountered in their lives goes against basic bioethical principles.Not only sufficient attention but also legal measures are required to promote the harmonious development of society.

Objective To study the disinfection efficacy of c ompound disinfectant of peracetic acid. Methods Suspended liqu id quantitative sterilization test and metal corrosion test were carried out wit h different concentrations of disinfectant compound. Results T he killing rate of Bacillus subtilis var.niger spores e xposed to peracetic acid 500 mg*L-1 or available chlorine 300 mg*L-1 for 15 minutes was 99.94% and 97.91% respectively, while that of the spores e xpos ed to the compound disinfectant containing both of them reached 100%. The influ ence of organic substances on the bactericidal efficacy of this compound disinfe ctant was less than that on the bactericidal efficacy of the single ingredient. The corrosive effect of the compound disinfectant on the metals was milder than that of peracetic acid, but heavier than that of dichlorodimethylhydantoin. Conclusions Disinfectant efficacy of compound disinfectant increase s clearly, while metal corrosiveness decreases.

Objective To evaluate the use safety of a unitary package peracetic acid ( PAA) disinfectant through acute and subacute toxicity experiments in rats.Methods This study was conducted according to the Technical Standard For disinfection ( Version 2002 ) .In the acute toxicity experiment, 60 healthy Wistar rats were randomly divided into different groups of PAA given by single intragastric gavage.Symptoms of poisoning of the animals were observed to calculate the half lethal dose ( LD50 ) .In the subacute toxicity experiment, 40 healthy Wistar rats were randomly divided into three dose groups and negative control group.The rats were given 33-342 mg/kg BW PAA for 28 days.At the end of test, the body weight, the organ-to-body weight ratio and the hematological and biochemical indices were determined, and pathological examination was performed.Results The acute oral LD50 of female rats was 1470 mg/kg BW, and the LD50 of male rats was 1710 mg/kg bw.The results of subacute toxicity test showed that the body weight, the organ-to-body weight ratio and the hematological and biochemical indices had no significant difference between the dose groups and control group.No obvious abnormality was observed in gross anatomy and histopathological examination.Conclusions The results of the acute toxicity test prove that PAA has a low toxicity level, and no significant subacute toxicity was observed at the exposure doses.

Objective To observe the effect of intravesical chemotherapy in papillary urothelial neoplasm of low malignant potential (PUNLMP) urinary bladder after transurethral resection of bladder tumor (TUR-Bt). Methods 44 cases of PUNLMP confirmed by pathological examination from Jan 2004 to Dec 2013 were retrospectively analyzed. Clinical manifestation: 24 asymptomatic, 19 gross hematuria and 1 abdominal discomfort. All cases were treated by TUR-Bt and immediately administered by intravesical instillation of 40 mg HCPT once, then 32 cases (A group) underwent additional intravesical instillation of HCPT once, and 12 cases (B group) underwent instillation qw for 8 times. Results PUNLMP cases accouted for 2.28 %(44/1 926) of bladder neoplasms admitted during the same period. There were 32 males and 12 females. 39 patients had multiple tumors, and 5 had single. All of cases were followed up with the medial follow-up time of 82 months (16-136 months), only one case in B group recurred after 14 months, and postoperatively without pathological progression. The difference of recurrence rates between two groups had no statistical significance (P=0.273). Conclusions PUNLMP has low incidence rate and is more common among middle-aging males. Doctors should consider PUNLMP when patients with bladder neoplasm are asymptomatically detected. Immediate instillation combined with additional one postoperatively could reduce the recurrence rate of PUNLMP obviously with satisfying prognosis. However, maintenance instillation does not enhance effect.

Objective Current study used quantitative research methods to reveal the regional medical information research in hotspots, and summarize the mainstream knowledge base to provide the reference for researchers in the field.Methods A systematic search was conducted to find publications in CNKI, Wanfang Database and PubMed.Bibliometrics method, social network analysis, coword analysis, principal component analysis and multidimensional scaling analysis were used in this study.Results ① total 11,482 articles published from 1984 to 2013 were screened out.The development of research publications showed an increasing trend, and the papers were distributed in 1233 types of journals.The number of authors who located in Beijing, Guangdong, Jiangsu, Shanghai,Shandong ranked top five.② The top 59 high frequency key words were identified that representing the hot contents in regional health information technology research field, and was used to build knowledge network map.Among them, HIS, electronic medical records, hospital information technology,information technology were at the core of this research area.③ We summarized research and development in the field of nine major mainstream knowledge base include: research on electronic medical records, medical personnel, information systems, information security, information networks, information sharing, information integration, information technology, and information management, resident' s health record related studies;qualitative analysis and problem-oriented research;HIS and telemedicine-related research;community related research, two-way referral related research, health care reform and cloud computing-related research, telemedicine related research and V43 related research.Conclusions The development of regional medical information research has good momentum and closely follow the international trend, but the research contents and methods are still distance from international standard..Research mostly focused on hospital information system construction, regional research and applied research are weak and need to be further improved.

Objective To understand the effect of health management to enhance the community hypertensive patients' self-efficacy. Method With the method of stratified random sampling, 347 patients who come from communities were diagnosed as hypertension were selected as research subjects from the range of Yingze in Taiyuan of Shanxi province. There were 191 males and 156 females, the age ranged from 38 to 72 (55.90±9.60) years. The self efficacy promotion plan was conducted on high blood pressure patients. A comparison before and after six months of health management was made among the self efficacy scores, daily life scores, health behavior scores, drug behavior scores, medical compliance behavior scores by using self-efficacy scale. Excel 2007 and SPSS 19.0 were used for data analyses. Result Before the implementation of health management, the self efficacy scores of research subjects were 26.96 ± 0.77. After the implementation of health management, the value increased to 29.51 ± 0.86 (t=-41.23, P<0.05). In four dimensions, daily life (before and after management 6.85 ± 0.20 and 7.49 ± 0.31, t=-40.66), drug behaviors (before and after management 7.52 ± 0.21 vs. 7.98 ± 0.23, t=-26.93) and medical compliance behavior scores (before and after management 5.26±0.15 vs. 6.78±0.19, t=-115.97) were higher than those before the health management except health behaviors (before and after management 7.25 ± 0.40 vs. 7.26 ± 0.40, t=-1.94, P<0.05). Conclusion Health management regulated the self care behavior of patients with hypertension, improved the patients' compliance and enhanced self efficacy, which played an important role in controlling the development of disease.

Objective To investigate the incidence of renal dysfunction among patients received radical nephrectomy during 5-year follow-up and to discover the risk factors for chronic kidney dysfunction (CKD).Methods Data of 339 patients who underwent radical nephrectomy for renal cell carcinoma between Jan.2006 to Dec.2007 were investigated,and those who suffered renal dysfuntion before surgery or lost follow-up were excluded.Finally,148 patients were enrolled in this retrospective study.GFR after surgery were replaced by eGFR which were calculated with the abbreviated equation of MDRD.It will be defined as CKD when eGFR was less than 60 ml/(min · 1.73 m2).Postoperative occurence rate of CKD was estimated using the Kaplan-Meier methods.Rank sum test and chi-square test were used for the univariate analysis in term of CKD between groups.Multivariate Logistic regression analysis was used to judge the independent risk factors for CKD.Results Patients were followed up for 42-60 months.CKD occurred in 58 cases,and the 5 year cumulative incidence of CKD was 42.7％.As many as 17.4％ of the patients with a normal eGFR during the first 3 months follow-up would progress to CKD 5 years later.Clinical characteristics,including age at surgery,weight,body mass index,hypertension,preoperative total GFR and contralateral GFR,complications,size of tumor,pathologic type,eGFR calculated shortly after operation,were significantly different between the CKD group and the normal group (P＜0.05).Multivariate Logistic regression analysis shows that age at surgery (P =0.016,OR =1.106),size of tumor (P =0.048,OR =0.680) and eGFR calculated within one week postoperatively (P=0.002,OR=0.874) were the independent risk factors for postoperative CKD.Conclusions The incidence of CKD after radical nephrectomy in patients with renal cell carcinoma is not uncommon.The of age at surgery,size of tumor and eGFR value calculated within one week postroperatively have a close relation with the incidence of postoperative CKD.

Objective To investigate the satisfaction degree of students and teachers towards PBL teaching method and to provide a basis for continuing to carry out PBL teaching.Methods Anonymous questionnaires of PBL teaching method in teaching plan and procedure was conducted among 49students (2008 grade) and teachers.SPSS 13.0 software package was used to analyze the data and P ＜ 0.05 stands for statistically significant differences.Results Both students and teachers were satisfied.Teachers' evaluation scores of 17 projects were all higher than 4 points and students' evaluation scores of 13 projects were all higher than 4 points; scores for the rest projects were all higher than 3 points.Conclusions PBL teaching method combined with stomatology is effective and measures should be taken to strengthen the management of PBL teaching in stomatology.