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Objective To evaluate the effect of age on pharmacodynamics of eisatracurium target-controlled infusion(TCI). Methods Forty patients under N_2O-O_2-propofol-fentanyl anesthesia were divided into groups of Ⅰ and Ⅱ with 20 cases each. Under TOF stimulation monitoring, eisatracurium 0. 15 mg/kg was injected and tracheal intubation was performed when TOFr being zero. and the intubation conditions were evaluated. When T1 restored to 50% cisatracurium TCI started to keep TOFr less than 10%. The recovery times of neuromuscular blockade were recorded after stopping infusion. The amount of cisatracurium consumption was calculated. Results Intubation conditions the onset time and recovery index were not significantly different between two groups. The nonresponse period, duration of action, and recovery time were longer in group Ⅰ than those in group B. Cisatracurium consumption was more in group Ⅰ than that in group Ⅱ (P<0.05). Conclusion By TCI,cisatracurium dosage needed for keeping TOFr less than 10% is less,but the recovery process is still longer in the elderly than those in the younger.

Objective To investigate the association between the positive rate of circulating tumor cells (CTC) and clinicopathological parameters, recurrence and metastasis in patients with colorectal cancer. Methods 7.5 ml peripheral blood of 138 cases of newly diagnosed colorectal cancer who met inclusion criteria, 82 post-operative cases of colorectal cancer and 34 healthy controls were collected. The CTC was enriched by beads which packaged the anti epithelial cell adhesion molecule and counting the CTC (CK+ DAPI+ CD45-). To investigate the association between the preoperative positive rate of CTC and clinicopathological parameters, and the relationship between the positive rate of CTC and recurrence and metastasis in post-operative colorectal cancer patients who have not accepted any therapy more than one month. Results The positive rate of CTC in patients with colorectal cancer and healthy controls were 47.1%(65/138), and 0 (0/34) respectively, and the difference was statistically significant (χ2= 25.743, P< 0.001). No association between CTC positive rate and age, gender, primary tumor site, T staging, platelets, cancer embolus, NK cells, regulatory T cell was observed (all P> 0.05); The significant association between the positive rate of CTC and N or M staging was found. CTC positive rates in N0, N1, N2 stage were 38.3 %(23/60), 37.9 % (11/29), and 63.9 % (23/36) respectively (χ2= 6.819, P= 0.033); CTCs positive rates of M0, M1 stage were 38 . 0 % ( 38/100 ) and 71 . 1 % ( 27/38 ) respectively , and there was a statistical difference (χ2= 12.074, P= 0.001). In 82 post-operative cases of colorectal cancer, the positive rates of CTC were 51.6 % (32/62) and 90.0 % (18/20) in non-recurrence and recurrence, respectively, and the difference was statistically significant (χ2=9.365, P=0.002). Conclusion CTC detection may assess the occurrence of metastasis and recurrence in colorectal cancer patients.

Objective:To describe antipsychotic medication prescription patterns and estimate the associated costs for patients with schizophrenia in Tianjin,China. Methods:Data were 30%random sampling from the Tianjin Urban Employee Basic Medical Insurance (UEBMI)database. Adult patients with≥ 1 diagnosis of schizophrenia, antipsychotics prescribed at the first diagnosis of schizophrenia (index date),and 12-month continuous enrollment after the first antipsychotic prescription (follow-up period)between 2008 and 2010 were included. The classes and number of antipsychotics patients prescribed at index date and patterns of antipsychotics patients maintained/changed during the study period were described. The total direct medical costs were also estimated. Results:Among 2125 patients with schizophrenia,1739 (81. 8%)prescribed with antipsychotic medication prescriptions were in-cluded. At the index date,1461 (84. 0%)of the patients prescribed with one antipsychotic medication,278 (16. 0%)with more than two antipsychotics,and 747 (43. 0%)were prescribed with first-generation antipsychot-ics,813 (46. 8%)with second-generation antipsychotics and 179 (10. 2%)with both. During the following 12 months,1387 (79. 8%)patients remained on the index antipsychotic class. The total cost for 1739 patients was (12498. 9 ±14575. 2)CNY. The total direct medical cost was significantly lower for patients only prescribed with second-generation antipsychotics compared with ones only with first-generation antipsychotics [(9064. 1 ±13209. 8) CNY vs. (1 1928. 6 ±13767. 4)CNY,P<0. 001 ]. In addition,the cost for patients prescribed with first-generation and second-generation antipsychotics was 18821. 8 ±15702. 7 CNY. Conclusion:Majority of patients are prescribed with monotherapy,and tend to stay with one antipsychotic medication class. The total medical cost for patients with second-generation antipsychotic medications is lower than first-generation ones.

Bacterial cellulose,as a new material,due to its unique nano-fiber mesh structure with good purity,physical and chemical properties such as mechanical strength and water holding capacity,biocompatibility and adaptability,has been widely used in medicine,food,paper,textile,acoustical materials and other industries.In medical field,especially,it has been rapidly developed in recent years.This review discusses the current bacterial cellulose and its performance optimization products which relates to the medical applications.

BACKGROUND:Chitosan is a kind of biomaterial with good hemostatic, antibacterial and absorption properties. The guanidine modified chitosan holding better antibacterial and absorption abilities is a commonly used chemical separation material. However, its coagulation property is still unclear. OBJECTIVE:To evaluate the in vitro hemostatic property and cytotoxicity of the guanidine modified chitosan, and to explore its availability as a hemostatic material.METHODS:The guanidine modified chitosan was synthesized with the raw materials of chitosan and arginine, and the coupling agents of EDC and NHS. The coagulation ability was evaluated preliminarily through the whole blood coagulation time, and three in vitro coagulation indexes (activated partial thromboplastin time, prothrombin time and thrombin time). The guanidine modified chitosan extracts were co-cultured with the mouse fibroblasts, and then the cell growth was observed by MTT assay and fluorescence microscope. RESULTS AND CONCLUSION:The guanidine modified chitosan shortened the whole blood coagulation time, suggesting its hemostatic property. In vitro coagulation results indicated that the guanidine modified chitosan exerted the effect not through the traditional endogenous and extrinsic coagulation pathways. Guanidino group has not been proved to be hemostatic, so the chitosan may be the effective component. MTT assay showed that the cell proliferation rate was 87.8%and the toxicity level was grade 1. Fluorescent staining observed abundant live cells, and few dead cells, indicating that the guanidine modified chitosan exhibits low cytotoxicity.

Objective To analyze the predictive value of platelet related indicators for patent ductus arteriosus (PDA) in extremely low birth weight infants (ELBW). Methods The data of 79 ELBW infants born from June 2013 to June 2016 were retrospective analyzed. There were 48 cases without PDA (nPDA group) and 31 cases with PDA (PDA group). Among 31 cases with PDA, there were 17 cases of non-haemodynamically significant PDA (nhsPDA group) and 14 cases of haemodynamically significant PDA (hsPDA group). The clinical feature and platelet related indicators among nPDA group, PDA group, nhsPDA group and hsPDA group were compared. Multivariate logistic regression was used to analyze the effects of various factors on the occurrence of PDA. ROC curve analysis was performed to evaluate the early predictive value of platelet related indicators for PDA. Results Compared with the nPDA group, the PDA group had a smaller gestational age, a higher proportion of male infants, and a smaller platelet distribution width (PDW), and there were statistically significant differences in all of those (P all<0.05). Multivariate logistic regression analysis indicated that the risk of PDA was increased as the PDW was decreased (OR=1.26, 95%CI: 1.05~1.52). The ROC curve analysis showed that the best diagnostic value of PDW was 13.4 GSD, and the sensitivity of early prediction of PDA was about 67.74%, and the specificity was 68.75%. Compared with nhsPDA group, hsPDA group had a smaller gestation age, lower cesarean section rate, and there were statistically significant differences (P all<0.05). There was no significant difference in platelet related indicators between hsPDA group and nhsPDA group (P>0.05). Conclusion PDW has certain early predictive value for PDA in ELBW. ELBW infants with PDW<13.4 GSD need to be watched closely for the occurrence of PDA.

Adult ; Cervical Vertebrae ; pathology ; surgery ; Humans ; Male ; Spinal Neoplasms ; pathology ; surgery ; Teratoma ; pathology ; surgery

Objective:To analyze the characteristics of hospital infection of hematological disease, so as to provide reference for clinical therapy. Methods: Bacterial strains and antimicrobial resistance of pa-tients with hospital infection in Department of Hematology, Peking University Third Hospital from Jan. 2011 to Dec. 2013 were identified and analyzed retrospectively. The specimens were from their blood, urine, sputum, throat swabs and etc. Results:Among the total of 168 isolates of bacteria,the majority of the bacteria strains were from sputum (42. 9%);114(67. 9%) bacteria strains were gram negative and 54(32. 1%) bacteria strains were gram positive;the pathogen testing showed that 20. 8% were Pseudo-monas aeruginosa,18. 5% Escherichia coli,17. 9% Staphylococcus aureus, 9. 5% Klebsiellar pneumonia, 5. 9% Staphylococcus epidermis and 27. 4% other bacteria ;The gram negative bacilli to cefepime, ami-kacin and carbapenems showed the lowest antimicrobial resistance rates, and S. aureus showed the lowest antimicrobial resistance rates to vancomycin and linezolid. Conclusion:Patients with hemopathy are the main population of hospital infections, the gram negative bacteria are the most common pathogens. It is very important to promptly know the change in distribution of the pathogens in order to rationally select antibiotics and reduce the incidence of bacterial infections.

A maxillary first molar with 2 distinct palatal roots and an accessory canal was diagnosed by CBCT and microscope.An enamel protuberance at the cervical area was found.A properly usage of CBCT and microscope is helpful for the diagnosis and treatment of tooth with complex root canal system.