Objective To evaluate the safety of conscious venous anesthesia with fentanyl and propofol in elderly patients over 70 during gastrointestinal endoscopy. Methods Clinical data of 826 elderly patients over 70, who underwent gastrointestinal endoscopy with venous anesthesia, were retrospectively analyzed. The patients were divided into 2 groups according to their ages, with 618 patients aging from 70 to 80 in group A, in which 342 received endoscopy and 276 underwent colonoscopy, and 208 patients older than 80 in group B, in which 112 underwent endoscopy and 96 had colonoscopy. Another cohort of 600 patients younger than 70, who underwent venous anesthetic endoscopy during the same time period, was randomly selected as the control group, in which 400 patients received endoscopy and 200 had colonoscopy. Blood pressure, heart rate, peripheral oxygen saturation (SpO2) and adverse reaction were monitored in each patient during the procedure and compared among different groups. Results No procedure-related perforation or sedation-related mortality was observed, and no procedure was terminated clue to sedation complication. The average dosages of propofol used in procedure of endoscopy in groups A, B and control were 54.22±21.36 mg, 40.22±12.46 mg, and 86.44±34.26 mg, respectively. The average dosages of propofol in colonoscopy were 82.56±40.64 mg, 45.36±15.44 mg and 102.23±46.32 mg, respectively. With same procedure, there was no significant difference in heart rate and blood pressure among different groups, nor was there any difference in these variables before and after the procedure in each group (P>0.05). Sedation exerted more influence on SpO<,2> in elderly patients. A total of 18 cases in groups A and B experienced SpO<,2> <90%, which was mainly due to aspiration of saliva and relieved by oxygen inhalation. Conclusion Under appropriate monitor, it is safe and feasible to give conscious sedation to elderly patients over 70 during gastroimestinal endoscopy.

There are some common problems such as recurrent symptoms and poor compliance among patients with chronic diseases. Although scientific knowledge and skills have been learned from traditional health education, patients with chronic diseases cannot improve their life style continuously. At present, many researches abroad have proved that health coaching contributes to setting feasible goals and encourages continuously behavior change of patients. In China, health coaching is in the stage of becoming familiar with its scientific definition, intervention effect and application characteristics. And health coaching also needs evidences from high-level evidence-based studies. Along with continuous improvement of intervention techniques on health management, health coaching will get further development and standardization.

Parathyroid hormone ( PTH) is an important hormone secreted by parathyroid cells , and regulates the metabolism of calcium and phosphorus in the body .In recent years , the toxic effect of PTH on myocardium has been re-ported.Calcium-sensing receptor (CaSR), a member of G protein-coupled receptor family, can feel the subtle change of extracellular calcium concentration and regulate intracellular calcium concentration through multifarious ways in order to control the secretion of PTH .The expression of CaSR is observed in parathyroid cells , renal tubular epithelial cells , myo-cardial cells, etc.Intracellular calcium, as a second messenger, participates in various cell functions , such as excitation-contraction coupling , fertilization and so on .The injury of myocardial cells is intimately linked with high concentrations of PTH and intracellular calcium , and high expression of CaSR .

[Objective]To investigate a minimally invasive,safe and effective method for treating the nonunion of tibia fracture with Bastianti external fixators.[Method]Bastianti external fixators were used to treat nonunion tibia fracture with axial force followed by functional exercises in early stage.[Result]All cases showed tibia fracture union in 4~12 months after operation.According to the criterion of treatment effects,35 cases were as excellent,7 as good,and 1 as poor.[Conclusion]It is a good method that nonunion of tibia fracture was treated with Bastianti external fixators for maintaining pain-free joint activity and joint functional recovery in early stage.

Functional magnetic resonance imaging(fMRI) is a very powerful method to understand the mechanism of brain function with non-invasive localization, high spatial and temporal resolution. The essential fMRI technique is blood oxygen level dependent (BOLD-fMRI). Basic principles and methodological applications of BOLD-fMRI are reviewed in this paper.

Objective To study the clinical features of large-artery atherosclerosis cerebral infarction and perforating artery disease type cerebral infarction.Methods Ninety cases of large-artery atherosclerosis cerebral infarction were set as the observation group and 90 cases of perforating artery disease type cerebral infarction as the control group.The general data and clinical characteristics were performed the comparative analysis.Results The drinking and smoking rates in the observation group were 43.33 ％ and 54.44 ％ respectively,which were in turn higher than 27.78 ％ and 25.56 ％in the control group;the occurrence rates of complicating coronary heart disease and lipid metabolism abnormality in the observation group were 45.56 ％and 58.89 ％respectively,which were in turn higher than 21.11 ％ and 37.78 ％in the control group;while the occurrence rate of complicating diabetes mellitus in the control group was 65.56 ％,which was higher than 42.22％ in the observation group,the differences were statistically significant(P＜0.05).Plasma oxidized low density lipoprotein and circulating endothelial cell count in the observation group were (687 ± 169)g/L and(9.0 ±1.7) × 106/L respectively,which were significantly higher than the normal level in the control group,the level of nitric oxide in the observation group was(77.4±21.1)mol/L,which was lower than that in the control group.The differences between the two groups were statistically significant(P＜0.05).Conclusion The onset factors of large artery atherosclerosis cerebral infarction have larger relation with drinking,smoking,complicating coronary heart disease and lipid metabolism abnormality,while perforating artery disease type cerebral infarction is more related with diabetes.

Irritable Bowel Syndrome(IBS) is a common disease of intestinal disorder.It is characterized by chronic or recurrent abdominal pain or discomfort along with altered bowel function.The underlying mechanisms of IBS remain unclear.Several studies showed that the attack of IBS might be related to the gastrointestinal motility,visceral hypersensitivity,infection of the bowel and several other factors.Existing animal models can be divided into 2 broad categories based on their primary pathogenetic mechanisms: those initiated by a central nervous system-directed(psychosocial) stressor and those stems from a gut-directed stressor(gut inflammation,infection).This article reviews the current research of IBS animal model.

Objective:To investigate and compare the influences of Ghrelin and growth hormone releasing peptide 6(GHRP-6) on the contractility of stomach smooth muscle in guinea pigs,and to study the related mechanism.Methods: The myenteric plexuses of gastric fundus and antrium in guinea pigs were stimulated with electrical field stimulation(EFS) to observe the influence of Ghrelin and GHRP-6 on the contractility of stomach smooth muscle.The influences of N-nitro-L-arginine(L-NNA) and L-Arginine(L-AA) on the effect of Ghrelin and GHRP-6 were studied to disclose the mechanism of the effects of Ghrelin and GHRP-6.Results: The circular muscle tissues of the gastric fundus generated on-relaxations and off-contractions when stimulating myenteric plexuses with 1-16 Hz electrical field;the on-responses induced relaxation could be reduced by L-NNA and the off-contractions induced contraction could be blocked by atropine and guanethidine.In fundic strips,ghrelin and GHRP-6 could decrease the on-response induced relaxation and increase off-response induced contraction of the muscle,with the effect of Ghrelin obviously stronger than that of GHRP-6.L-NNA could increase the effects of Ghrelin and GHRP-6-induced muscle contraction,and L-AA could decrease their effects.In the antral strips,electrical field stimulation of myenteric plexuses led to disappearance of relaxation wave,only leaving off-contractions.Both ghrelin and GHRP-6 could increase that contraction.Conclusion: Both ghrelin and GHRP-6 can promote the contractility of stomach smooth muscle in guinea pigs through stimulating myenteric plexuses of gastric fundus and antrium,which might be related to the NO pathway.

Objective:To investigate the effects of thyroid motilin(MTL) on migrating motor complex(MMC) in fasting rats.Methods: The distribution and quantitative expression of motilin in the thyroids were detected by immunohistochemistry and radioimmunoassay.We also observed the effect of thyriod motilin on the MMC by recording the gastrointestinal motility in conscious rats.Results: Tail vein injection of MTL increased MMC in antrum and duodenum in a dose-dependent manner,as manifested by increased contraction frequency and amplitude(P

Objective To study the efficacy and safety of methylcarboprost suppository in preventing postpartum hemorrhage of cesarean section.Methods Two hundred and nine puerperants with cesarean section were randomly divided into two groups: test group(n=103),1mg methylcarboprost suppository was given sublingually after peritoneotomy,and control group(n=106),20IU oxytocin intravenous drip immediately after neonate delivery. 20IU oxytocin were injected into uterine muscularis in the both groups after neonate delivery.The amount of bleeding in perioperation and 24 hours after delivery were measured.Results The blood loss volumes in perioperation and 24hour after delivery in test group were 191 2ml and 317 2ml respectively, and in control group were 216 6ml and 350 5ml respectively,and there was significant difference in the blood loss volume between the two groups(P