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.

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.

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.

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 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 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.

According to the investigation about the current ability of military hospitals to cope with bioterrorism , we suggest that military hospitals improve the capability for bioterrorism response based on the research above by satisfying mission requirements , combining peacetime with wartime , carrying out crisis management , classifying response and cooperating with local sectors .

Objective To evaluate the relationship between intraocular pressure (IOP) and anterior chamber angle in patients with different types of acute angle-closure glaucoma after phacoemulsification and intraocular lens implantation. Design Retrospective case series. Participants 173 cases of acute angle-closure glaucoma coexisting cataract (173 eyes) in Mingren Eye Hospital from January, 2005 to June, 2007. Methods All patients with acute angle-closure glaucoma underwent phacoemulsification and intraocular lens implantation, and were examined with high-frequency ultrasound biomicroscopy (UBM). Anterior chamber depth (ACD), intraocular pressure (IOP) and anterior chamber angle (ACA) were measured. Follow-up was 1-48 weeks after surgery. Main Outcome Measures Intraocular pressure, phacoemulsification complications, re-open rate of anterior chamber angle. Results At 8th week after surgery, the rate of IOP control in pupillary block group, non-pupillary blocking group, and multimechanism group was 88.9%, 52.0%, 83.4%, respectively and there was a statistically significant between these groups (?2=7.13, P=0.022). At 48th week, the rate of IOP control was 54.2%, 33.3%, 35.8%, respectively(?2=12.56, P=0.003). Fifty patients were follow up with UBM, and 66.7% in pupillary block group, 33.3% in non-pupillary blocking group and 33.3% in multimechanism group in 48 weeks postoperatively showed evidence of the widened anterior chamber angle. No specific postoperative complications were found in this study compared with those with phacoemulsification without glaucoma. Conclusions The use of phacoemulsification and intraocular lens implantation for acute angle-closure glaucoma coexsiting cataract can get best IOP-controlled rates in pupillary block group. It is related to the degree of widened anterior chamber angle.

Objective To reveal the status quo and emerging issues of co-authorship in regional health informatization research community in China.Methods The terms or keywords describing and covering regional health informatization were used to search the most relevant literatures about the subject in CNKI,Wanfang database and PubMed.Software tools were used to extract bibliographic,Social network analysis (SNA);co-authorship,and co-word analysis were used in this study.Results ①11,482 articles with 16,449 authors in the period of 1984-2013 were found.Each publication has an average of 1.43 authors,and each author has 0.70 publications.The number of coauthored literature was 7741 (67.42 ％).Both production and collaboration have been growing steadily.② Coauthored knowledge network was build which composed by 150 high-yielding Authors.The largest component comprises 43 authors(28％,43/156).The intermediate centrality of 57 authors were above 0.③ 230 2-plexes were found,and 65 2-plexes scale was 4 and over;and there was overlap among them.There were extensive cooperation between the military institutions,a large number of regional health information technology research talent were found in army research institutes..Cohesive subgroups density showed an E-I index=-0.901,which indicated that factionalism was comparatively weaker in this field,and the relationship tended to occur among subgroups.④ Cooperative network was established between the provinces and municipalities.Beijing,Guangdong,Jiangsu,Hubei were the core area.⑤ The average distance between the author=3.155,and it consistent with the small-world characteristics.⑥ The largest component of the network research can be summarized into three categories:HIS-related research,electronic medical records related research,and regional health informatization related research.Conclusions Although such collaboration is growing steadily,the collaboration behavior about regional health informatization study needs to be enhanced.Policy makers and researchers can refer to the relevant information and promote cooperation,improve the capacity of regional health information research and construction.

Objective To observe the effect of different methods such as combined treatment of traditional Chinese and western medi-cine, the simple excision and expanded resection for the treatment of granulomatous lobular mastitis. Methods 60 cases of patients treated in our hospital from Jan. 2010 to Jan. 2013 were enrolled in this study, and they were confirmed the diagnosis of granulomatous lobular mas-titis by pathology examination. According to randomly number table, they were divided into three groups and they were given the treatment of combined treatment of traditional Chinese medicine and Western medicine, the simple excision, and expanded resection respectively. Where-after, the therapeutic effect of the three groups were observed. Results There were 9 cases (45. 0%) were of cure and 11 cases (55. 0%) of recurrence in the combined treatment group. There were 16 cases (80. 0%) of cure and 4 cases (20. 0%) of recurrence in the simple ex-cision group. There were 8 cases (90. 0%) of cure and 2 cases (10. 0%) of recurrence in the combined treatment group. It shows that the recurrence rate of combined treatment group was higher than the other two groups (P<0. 05). The satisfactory rate of breast appearance after treatment were 17 (85%), 15 (75%) and 16 (80%) respctively, and there is no significant difference (P>0. 05). Conclusion The effect of extended resectionin for the treatment of granulomatous is better and it has important clinical value.