Objective To compare the clinical effects of remifentanil combined with sevoflurane or with isoflurane in elderly patients undergoing radical gastrectomy for cancer and their recovery.Methods Sixty-two patients,who scheduled for radical gastrectomy for cancer was randomly divided into remifentanil combined with sevoflurane group ( SR group,n =31 ) and remifentanil combined with isoflurane group ( IR group,n =31 ).They were classified into American Society of Anesthesiology(ASA) physical status Ⅱ and ,The procedure of two Anesthesia was same,in which remifentanil was continually pumped into at the same velocity using micro pump immediately after intubation,tili the target density in plasma increased to 6 μg/L.Sevoflurane at 1.5％ to 2.0％ was inhaled in the SR group,whereas isoflurane at 1％ to 2％ in the IR group.The inhalation was ended at 5 mins before the surgery was completed,Remifentanil was stopped while stuturing,and 0.1 mg of Remifentanil was injected at 20 mins before the surgery was completed.The heart rate(HR) and blood pressure were recorded at before induction of anesthesia (T0),after induction of anesthesia ( T1 ),immediate intubation ( T2 ),surgery after the start of 5 min ( T3 ),30 min (T4) and the time of surgery ( T5 ),respectively.The recovery time and extubation time,and quality score for awakening after extubation (OAAS) were also recorded.Results There were no significant differences in HR,SBP and DBP at every time points observed between the two groups.The recovery time( 10.4 ± 3.9)mins and extubation time(5.9 ± 3.1 )min in SR group was significantly shorter than that of(16.3 ± 5.8) min and (9.7 ±2.5) min in the IR group(t =6.25 and 4.19,P =0.02 and 0.01,respectively ).The OAAS after extubation in the two groups gradually increased,and immediately after extubation and extubation after 10 min,OAAS in the SR group was(4.1 ± 1.2),which was significantly higher than that of (2.9±1.0)in the IR group(t =3.27,P =0.03).Conclusion Either stevoflurane-remifentanil or isoflurane remifentanil anesthesia can be used safely in elderly patients undergoing radical gastrectomy for cancer.Anesthesia with Sevoflurane-remifentanil provides better faster recovery than isoflurane- remifentanil in elderly patients.

Objective To investigate the effect of astragalus injection on serum oxygen free radical, TGF-β1 and vascular endothelial function in diabetes mellitus.Methods 120 cases of type 2 diabetic patients were selected from December 2010 to December 2014 as the object of study, 2 groups of patients underwent diabetic education and diet, exercise therapy, the control group were treated with metformin hydrochloride tablets, and the observation group were combined with astragalus injection, the contents of SOD, MDA and GSH-PX were compared between the 2 groups.The serum levels of TGF-β1, VEGF, ANG-1 and AOPP were compared between 2 groups.Results After treatment, comared with control group, the serum MDA and AOPP were higher, the GSH-PX and SOD were higher; the TGF-β1 were lower; the VEGF and ANG-1 were higher in observation group ( P <0.05).Conclusion Astragalus injection could improve the function of vascular endothelium in patients with diabetes, reduce the transforming growth factor β1, improving the free radical aggregation state.

OBJECTIVE:To determine the serum concentration of Deoxyschisandrin by RP-HPLC.METHODS:The chr-omatographic separation was performed on Phenomenex C18(250mm?4.6mm,5?m) column with column temperature at 30℃.The mobile phase consisted of methanol - water (80∶20) at a flow rate of 1mL?min-1. The detection wavelength was set at 252nm. RESULTS:The calibration curve of Deoxyschisandrin was linear in the concentration range from 0.52 to 33.28?g?mL-1 (r=0.999 6). The average recovery of deoxyschisandrin was (97.27?4.11)%(RSD=4.23%,n=9).CONCLUSION:The method is simple, accurate and sensitive, and it can be used for the determination of serum concentration of Deoxyschisandrin.

Objective To study the effect of lienal polypeptide injection on immune function in patients with chronic kidney disease(stage CKD5,uremia).Methods 42 patients with maintenance hemodialysis and 42 patients with peritoneal dialysis in stage CKD5 phase were selected as the research subjects.According to the digital table,they were randomly divided into observation group and control group,32 cases in each group.All patients were treated with hemodialysis or peritoneal dialysis,the observation group was treated with lienal polypeptide injection,while the con-trol group was treated without lienal polypeptide injection.The immune function index(CD3+,CD4+,CD8+,CD4+/CD8+) were compared between the two groups after treatment for 15 d.Results In the observation group,the immune index after 15 days treatment were CD3+(58.26 ±7.90)%,CD4+(34.46 ±6.45)%,CD8+(25.33 ±4.47)%,CD4+/CD8+(81.36 ±0.21).In the control group,the immune index after 15 days treatment were CD3+(55.64 ±5.32)%,CD4+(31.79 ±7.15)%,CD8+(27.52 ±4.68)%,CD4+/CD8+(1.16 ±0.18).CD3+,CD4+,CD4+/CD8+ levels of the obser-vation group were significantly higher than those of the control group(t =2.820,t =1.610,t =7.060,all P <0.05). The level of CD8+ was significantly lower than that of the control group(t =0.004,P <0.05).Conclusion Lienal polypeptide can effectively improve the immune function of patients with chronic kidney disease (CKD5 stage).

Objective To compare the clinical effects of combined anesthesia of lumbar plexus-sciatic nerve and superior clunial nerve versus spinal-epidural analgesia in total hip replacement. Methods Fifty cases of total hip replacement were randomly divided into two groups. Patients in group A received combined anesthesia of lumbar plexus-sciatic nerve and superior clunial nerve,while patients in group B received spinal-epidural analgesia. Results There were no significant differences in preoperative HR, SBP,DBP and SpO2 between the groups(P > 0. 05). Compared with pre-anesthesia data,HR,SBP,DBP in group A were significantly lower during the anesthesia(P < 0. 05). In group B,there were no significant changes in HR,SBP,DBP and SpO2 during the anesthesia( P > 0. 05). Patients′ heart rate in group A showed significant changes compared with that in group B. The differences in HR,SBP and DBP between group A and B at the same time points were significant(P < 0. 05). Superior rate of anesthesia in group B is higher than that in group A(P < 0. 05). Conclusion Combined anesthesia of lumbar plexus-sciatic nerve and superior clunial nerve has limited influence on the circulatory and respiratory systems,which can be used for total hip replacement.

Objective To compare Vitek2 Compact and Walkaway 40 in the identification of Brucella.Methods Used Vitek2 Compact and Walkaway 40 automated microbial identification system to identify clinical isolates and compared with the de-tection of 16S rRNA gene sequences analysis.Results The clinical isolates was identified as Bergeyella zoohelcum or Moraxella by Walkaway 40 and as Brucella melitensis by Vitek2 Compact.16S RNA sequence analysis of the isolate,the se-quence was identical to the sequences of 16S rRNA of Brucella,which excluded the possibility of B.zoohelam and Moraxel-la .Determined that the isolate was B.melitensis.Conclusion Vitek 2 Compact can accurately identified Brucella.Use molec-ular methods to corroborate when the isolates was identified as Brucella by Vitek 2 Compact,this method can greatly im-prove the detection rate of brucellosis and reduce the possibility of misdiagnosis.Walkaway 40 cannot accurately identified Brucella,Misidentification of Brucella can result in wrong treatment of the patient and let the staff in the risk of laboratory-acquired infection.Recommend laboratory should be cautious reporting in the identified B.zoohelam or Moraxella by Walk-away 40 and use Vitek2 Compact or molecular methods for review.

Objective To explore the blood sugar controlling for elderly patients with fracture and diabetes mellitus. Methods Twenty patients with fracture complicated with diabetes were managed with mental education and diet controlling. Meanwhile nursing measures were done to prevent infections, bedsores and deep vein thrombosis (DVT). Results The fasting blood sugar levels of the 20 elderly patients were well controlled below 7.8 mmol / L. There were no related complications. Conclusion Such nursing measures as psychological counseling and diet control are helpful for a steady maintenance of blood sugar for feasibility of surgical operation, to ensure successful manipulation of the surgical operation. Prevention of infection, bedsore and DVT is critical for ensuring the success of operations.

Objective To localize precisely cerebral central sulcus on the coronal MR imaging. Methods The serieses of 4 mm thickness coronal sections and coronal MR images of brain were prepared on 30 cadaver heads. The preparation of the brain slices in correspondence with MR scan took the line perpendicular to the midpoint of intercommissural line as base one. The important cerebral gyri of cadaver were painted different colors. The coronal MR images of 6 volunteers were also prepared. The localization of central sulcus on the coronal sections was studied by the comparison of MR images with serial coronal sections of the brains. Results On the section of the central sulcus appearing for the first time, the appearing rate of dorsal thalamus was: left side 93%, right side 97%; the appearing rate of pyramidal tract was: left side 20%, right side 13%. The central sulcus almost disappeared on the section through the posterior border of splenium of corpus callosum, the appearing rate of the central sulcus on the superolateral surface was 33% on the both sides. Conclusion The central sulcus appears for the first time on the 1-2 sections which the dorsal thalamus appears on but the pyramidal tract doesn′t appear. On the section through pyramidal tract, the superior frontal, precentral and postcentral gyri can be identified according to the three medullary branches on superolateral surface of cerebral hemispheres. The central sulcus has almost disappeared on the section through the posterior border of splenium of corpus callosum.

AIM: To quantify cyclooxygenase-2 (COX-2) mRNA in carcinoma of larynx and evaluate the correlation between the quantity of COX-2 mRNA and clinical staging or histological grade. METHODS: The expression of COX-2 mRNA in 30 cases of carcinoma of larynx tissue and adjacent non-cancerous tissues were evaluated by PCR, which includes a fluorescence dye , SYBR green Ⅰ, and the sequence specific primer. The GAPDH was used as control. RESULTS: The specificity of products was proved to be COX-2 and GAPDH by the analysis of the melting curve of the amplified products and agarose gel electrophoresis. The expression of COX-2 mRNA was detected in all cancerous tissues of 30 patients (100%), but only in 12 adjacent non-cancerous tissues of 30 patients (40%). The N_ COX value of carcinoma of larynx tissue and adjacent non-cancerous tissues was 16.54?13.27 and 9.24?6.91, respectively, and the expression levels of COX-2 mRNA elevated significantly in laryngeal squamous cell carcinoma tissue and there were significant correlation between the expression levels of COX-2 mRNA and clinical stage or histological grade. CONCLUSION: The expression of COX-2 mRNA in carcinoma of larynx can be determined by real-time PCR technique. An increase in COX-2 mRNA may be associated with carcinogenesis of carcinoma of larynx, and it may be useful as a biomarker in laryngeal cancer.

Objective To evaluate Chinese rural children's blood lead levels (BLLs) and identify its distribution features and to provide data for policy development to the prevention of rural environmental lead pollution. Methods The papers on rural children's BLLs published from 1994 to Oct, 2008 were collected by using CNKI's (China National Knowledge Infrastructure) Chinese Journal Full-test Database and other ways. The papers which were eligible for the following criteria were reviewed:(1) BLLs measured by atomic absorption spectroscopy (graphite or others) or inductively coupled plasma-mass spectrometry; (2) strict quality control; (3) no local lead pollution sources in the areas where the screened subjects live in; (4) children aged from 0 to 14 years old; (5)sample size more than 40. Results Analysis on the included 32 papers indicated that, the mean BLLs of Chinese rural children between 1994 and 2008 was 74.93 ?g/L ( range:41.14-193.54 ?g/L)and 19.32%( range:2.2%-43%) of the subjects had BLLs higher than 100 ?g/L. The rural children’s BLLs changed from 87.53 ?g/L to 71.16 ?g/L after the use of lead free gasoline in 2000 in China, which were both lower than the general children's BBLs before 2000 and after 2001. The children in Beijing city and Shandong province showed the highest mean BLLs , with 99.16 ?g/L and 92.13 ?g/L respectively; while the children in Jilin province and Hebei province showed the lowest levels, with 41.14 ?g/L and 56.14 ?g/L respectively. The comprehensive analysis of 18 papers indicated that the mean BLLs in rural areas and urban areas were 77.90 ?g/L and 87.24 ?g/L respectively ( u=3.73, P