Objective: To supply a scientific basis for standardizing the normal reference value of forced vital capacity (FVC) of Chinese younger women. Methods: We studied the relationship between the normal reference value of 21 767 samples of FVC of younger women and eight geographical factors in 157 areas in China. Results: It was found that the correlation between geographical factors and the normal reference value of FVC of younger women was quite significant (F = 5.884, P = 0.000). By adopting the method of mathematical regression analysis, one regression equation was inferred: Y = 3.146+0.00006919X1+0.01315X4-0.006966X6+0. 09524X8±0.254. In the above equation, Y is the normal reference value of younger women' FVC (L); X1 is the altitude (m); X4 is the annual mean air temperature (°C); X6 is the annual mean relative humidity (%); X8 is the annual mean wind speed (m/s); 0.254 is the value of the residual standard deviation. Conclusion: If geographical values are obtained in a certain area, the normal reference value of FVC of younger women in this area can be obtained by using the regression equation. Furthermore, according to the geographical factors, China can be divided into eight regions: Northeast China Region, North China Region, Shanxi-Shaanxi-Inner Mongolia Region, middle and lower reaches of the Yangzte River Region, Southeast China Region, Northwest China Region, Southwest China Region, and Qinghai-Tibet Plateau Region.

Objective: To supply a scientific basis for standardizing the normal reference value of forced vital capacity (FVC) of Chinese younger women. Methods: We studied the relationship between the normal reference value of 21 767 samples of FVC of younger women and eight geographical factors in 157 areas in China. Results: It was found that the correlation between geographical factors and the normal reference value of FVC of younger women was quite significant (F = 5.884, P = 0.000). By adopting the method of mathematical regression analysis, one regression equation was inferred: Y = 3.146+0.00006919X1+0.01315X4-0.006966X6+0. 09524X8±0.254. In the above equation, Y is the normal reference value of younger women' FVC (L); X1 is the altitude (m); X4 is the annual mean air temperature (°C); X6 is the annual mean relative humidity (%); X8 is the annual mean wind speed (m/s); 0.254 is the value of the residual standard deviation. Conclusion: If geographical values are obtained in a certain area, the normal reference value of FVC of younger women in this area can be obtained by using the regression equation. Furthermore, according to the geographical factors, China can be divided into eight regions: Northeast China Region, North China Region, Shanxi-Shaanxi-Inner Mongolia Region, middle and lower reaches of the Yangzte River Region, Southeast China Region, Northwest China Region, Southwest China Region, and Qinghai-Tibet Plateau Region.

Objective To establish an influencing factors system for the implementation effect of the vertical integration of services between the hospitals and community health service institutions.Methods Primary data related to influencing indicators were collected by literature review,questionnaire method and in-depth interview,and then the analytic hierarchy process (AHP) and Delphi method were used for the construction of final influencing factors indicator system.Results An influencing factors indicator system which coincides with the status of the vertical integration between hospitals and community health service institutions in Nanjing,Wuhan and Zhenjiang was established,including 4 firstlevel indicators,10 second-level indicators and 36 third-level indicators.Conclusion This study can provide a basis for hospitals and community health centers to improve the integration service system,and fill the gap of research on the influencing factors of the vertical integration of the domestic health care system,which are meaningful for the vertical integration of health care system in other districts and patterns.

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Objective To build a regression equation which can indicate the relationship between pH value of Chinese youth' arterial blood and geographical factors in China.Methods We collected pH value of young and geographical factors in China,and studied the relationship between them.Results We worked out a regression equation which could indicate the relationship between the pH value of Chinese youth' arterial blood and the geographical indicators.Conclusion If knowing the geographical indicators of each area in China,we can estimate the pH reference value of young people's arterial blood by using the equation.

Objective To evaluate the usefulness of ultrasound during the operation of 125 I permanent brachytherapy for pancreas carcinoma.Methods According to the mass size,the total radiation dosage and the amount of radioactive seeds were calculated before operation.Then all needles were inserted evenly in the mass and radioactive seeds were implanted through the needles under ultrasonic guidance during the operation. At the end of operation,ultrasonography and/or abdominal radiography were applied to examine the distribution of seeds and to find if any place was left out. Results Thirteen patients were operated on successfully and the mass was displayed clearly with ultrasonography. Under the guidance of ultrasound,needles were exactly inserted in the mass and the whole process of implantment was easily observed. Locations were proved exactly by ultrasonography and abdominal radiography after operation. Conclusions Ultrasound has some important values in this procedure,such as precise orientation,real-time monitoring,follow-up evaluation,etc. Application of ultrasonography has the broad prospect in this field.

Objective To study the best multiple concentration of target controlled infusion of propofol and remifentanil in elderly patients during the induction of general anesthesia. Methods Fifty elderly patients were randomized into five groups, according to the effect site concentration of remifentanil (0, 2, 4, 6, 8 ng/mL). We started the effect site concentration of propofol (PEC) at 2 μg/mL, and added 1 μg/mL every 2 min until bispectral index (BIS) was stable at 40±5. During the induction,we recorded the effect site concentration of remifentanil (REC) and propofol (PEC), heart rate (HR), arterial blood pressure (ABP), BIS, AAI, and isolated forearm technique (IFT). After statistic analysis, the best multiple concentration was judged. Results There was no significant difference (P<0.05) in the changes of hypertension and hypotension among these five groups during intubation. The most smooth hemodynamic conditions were found in group B, i.e. 20% and 10%, respectively. When consciousness was lost, there was a negative correlation between PEC and REC. Group B was the minimum on the change of IFT and the cardiovascular system among these five groups at tracheal intubation. Conclusions It is safe and stable to use REC 2 μg/mL for TCI, combined with propofol in elderly patients under general anesthesia. PEC is (3.5±0.8)μg/mL when the patients' consciousness is lost. And PEC is 5.3 μg/mL at tracheal intubation.

Objective To evaluate the efficiency and the timing of continuous blood purification(CBP) in patients with multiple or-gan dysfunction syndrome(MODS) and acute renal failure(ARF) following cardiac surgery. Methods From November,2003 to July,2007,thirty-one patients with MODS and ARF following cardiac surgery were treated with CBP. They were divided into two groups, alive group ( group A) and dead group ( group B). Clinical data of the two groups were reviewed. Before CBP, duration of extracorporeal circulation, du-ated. Mean arterial pressure (MAP), heart rate (HR), oxygenic index (PaO2/FiO2), white blood cell count (WBC), platelet count (PLT) and renal function (blood urea nitrogen, BUN, ercatinine, Cr) were observed before and after CBP. Results The number of im-paired organs of patients in group B was significantly more than that in group A before CBP ( P＜0.05). MODS scores ( 12.9±3.2 vs 6.9 ±2.3, P＜0.05) and APACHE Ⅱ scores (26.3±10.4 vs 17.2±5.1, P＜0.05)of group B were significantly higher than those of group A before CBP. After treatment of CBP for 24 hours, APACHE Ⅱ scores and MODS scores only significantly decreased in group A (P＜0.05 ). After treatment of CBP, Cr and BUN significantly reduced, while MAP and PaO2/FiO2 increased, in all patients, but HR was signif-icantly lower than that before CBP in group A (P＜0.05). The duration of ARF (34.67±32.79 hours vs 13.05±14.09 hours,P＜cantly higher than those of group A. Conclusion MODS scores and APACHE II scores can be used to evaluate the severity of patients with MODS and ARF after cardiac surgery. CBP is an effective treatment for these patients. It is suggested that early CBP therapy is important for reducing the chances of the multiple organ dysfunction syndrome and mortality of these patients.

Objective To study the effect of preoperative blood pressure control on postoperative cardiovascular events in patients with hypertension and gastrointestinal surgery. Methods A total of 238 hypertensive patients who underwent gastrointestinal surgery were selected and divided into control group (n =118)and non-control group (n =120)according to thehypotensor treatment.During the operation,the same anesthetic regimen was used.The use of vasoactive drugs was recorded during anesthesia.Bladder chalone C (Cys C)and cardiac troponin T (cTnT)were de-tected in blood before and after the operation,and so were N-terminal B type natriuretic peptide (NT-proBNP)level on the 1st and 5th day after the operation.The postoperative hospitalization time,fol-low-up of cardiovascular events 28 and 90 days after discharge were recorded.Results Compared with the non-control group,the total dosage of ephedrine in the control group was significantly re-duced [(3.41±1.04)mg vs (7.46 ± 3.29)mg,P <0.05 ],total dose of phenylephrinewas signifi-cantly reduced [(0.17±0.10)mg vs (0.46 ±0.16)mg,P <0.05],postoperative hospital stay was significantly shorter [(5.92±1.15)d vs (9.65±1.61)d,P <0.05],NT-proBNP level in the control group on the 1st day after the operation [(108.00 ± 47.11 )pg/L vs (250.38 ± 62.92 )pg/L,P <0.01]and 5 days after the operation [(62.07 ±25.31)pg/L vs (199.02 ± 60.32)pg/L,P <0.01 ] was obviously reduced.There was no statistical difference in Cys C andcTnT between the two group-safter operation.The incidence of cardiovascular adverse events in the control group was significantly lower than that in the non-control group (28 d:13.6% vs 62.7%,90 d:23.3% vs 23.3%,P <0.05).Conclusion Strict control of preoperative blood pressure control in patients with hypertension can significantly reduce the incidence of cardiovascular events.

Objective:To discuss the relationship between the geographic environment and blood urea nitrogen(BUN) reference values of the healthy people,and to explore the distributional rule of BUN reference values of the healthy people,and to provide the scientific foundation for establishing the BUN reference value standards of different areas.Methods:A total of 23 geographic factors and 33 521 BUN reference values of healthy adults measured by 403 medical facilities from 23 provinces,4 municipalities and 5 autonomous regions were collected.The spatial autocorrelation analysis was used to determine the spatial autocorrelation of the sample data;the correlation analysis was used to detect the factors which correlated significantly with the BUN reference values;the multiple linear regression,principle component analysis and ridge regression analysis were respectively used to construct the predicted models;the paired-sample t test was used to choose the optimal model;the distribution map of BUN reference values was built by geostatistic analysis.Results:There were 5 geographic factors,latitude(X2),altitude(X3),annual mean temperature(X5),annual mean relative humidity(X6) and annual precipitation(X7),correlated significantly with the BUN reference values.The regression equation of optimal model was Y^=5.112+0.000 127 1X2+0.000 094 61X3-0.000 140 5X5-0.000 136 8X6-0.000 139 1X7±0.531 0;the distribution map of predicted values of the BUN reference values was obtained.Conclusion:The overall trend of BUN reference values is low in the east and high in the west.The BUN reference value is negatively associated with the altitude.If the geographic data of a certain region could be obtained,the BUN reference value of this region will be predicted.