Objective To investigate the effect of dexamethasone with subdose ketamine on restraining the pulling-dragging reflex during appendectomy. Methods 114 ASA grade Ⅰ～Ⅱpatients of appendectomy undergoing T 11 ～L 1 epidural anesthesia were randomly divided three groups,each group containing 38 cases. Group Ⅰ recieved the dexamethasone 10mg and ketamine 0 5mg/kg by venous injection before opening abdominal cavity, groupⅡ received pethidine 50mg and droperidol 2 5mg before begining operation, and group Ⅲ without any drugs served as control. The pulling-dragging reflex of appendix, the sedative state at pulling-dragging appendix and the change of pulse oxygen saturation (SpO 2) or mean arterial pressure (MAP) were recorded and analyzed. Results The excellent rates of groupsⅠ, Ⅱ and Ⅲ were 100%, 81 58% and 18 42% respectively,and there was significant difference between group I and the other groups (P

This paper discussed the characteristics,contents and implementation of quality education of medical students during basic education.

Continuous blood purification is continuous, slow removal of water and solute molecules in the blood.So,it is a treatnent modality of organ supports.With the development of blood purification in children,application of continuous blood purification in children is beyond the field of renal replacement therapy.Treatment indications include systemic inflammatory response syndrome,sepsis,multiple organ dysfunction syndrome,acute respiratory distress syndrome,bums,etc.Continuous blood purification has become the most important treatment in pediatric intensive care unit.Because of the children's physiological features,blood purification equipment and the disease spectrum, continuous blood purification requires higher technology and presents more difficultits.

Forensic medical talents with creative ability should have ability to find.analyze and solve problems from complex cases.According to teaching practice on the basis of PBL this article illustrates application methods of PBL teaching characters in the training of forensic medical talents with creative ability.

Objective To explore the temporal expressions of interleukin-10(IL-10)and interleukin-4(IL-4)and their relationship with the wound age during skin incised wound healing in mice.Methods Immunohistochemical and image-analysis techniques were employed in vital skin wounds 0.5h～168h after incision and postmortem incision 0.5h～6h after death.Results Weak expression of IL-10 was detected at 0.5h after incision,which increased subsequently,and peaked at 3h post-injury.Then decreased to the pre-incision level at 24h,but peaked again at 72h after injury.Immunostaining revealed that epidermal cells and infiltrating mononuclear cells were the major source of IL-10.IL-4-positive cells were observed in the dermis at 24h,and reached the maximum level at 96h,which maintained until 168h post-injury.IL-4 was mainly expressed in the fibroblast-like cells of the granulation tissue and dermis.In addition,faint IL-10-positive cells were merely identified in the epidermal cells in the postmortem incision skin within 1～3h after incision.No IL-4-postitive cells were found in the postmortem incision skin.Conclusion The time-dependent expressions of IL-10 and IL-4 during cutaneous wound healing may be used for the estimation of wound age.

Ryanodine receptor is a Ca2+ release channel in cadiocyte.It is reported recently to the obvious change of its function and quantity in such pathological process as the myocardial ischemia and cardiac hypertrophy.These changes will affect the ability of cadiocytes processing intracellular calcium or lead to the calcium overload in the myocardial cells and then induces fatal ventricular arrhythmia,even sudden cardiac death.

Objective To study the relationship between the ultrastructural changes of corneal matrix collagen fibrils diameter and the postmortem interval.Methods Twenty-eight rabbits were killed by the method of air embolism and the samples of cornea were separately cut down in 0,6,12,18,24,48 and 72h after death.The ultrastructure of the collagen diameter was observed by transmission electro microscopy(TEM)and the 4 parameters of area(Y1),perimeter(Y2),average-diameter(Y3)and mean-diameter(Y4)were measured by a computer image technique and analyzed by Excel 2000 and SPSS 10.0 software.Results The 4 parameters of Y1,Y2,Y3 and Y4 were respectively increased from 1 131?53nm to 1 628?26nm,from 132.8?23nm to167.5nm,from 38nm to 45nm and from 37.71?6nm to 44.89?5nm within 72 hours after the death.Conclusion The corneal matrix collagen diameter increase regularly with the postmortem interval in 72h after death,and the parameters of Y1,Y2,Y3 and Y4 could be used as a new reference mark for timing the postmortem interval after death.

Objective To investigate the clinical effects of open decompression drainage on acute pulpitis.Methods Totally 180 acute pulpitis patients hospitalized during January 2012 to September 2014 in our department were selected and randomly divided into control group and observation group (n=80 each).The control group was treated with pulp inactivating agent and the observation group was given open decompression drainage.The clinical effects,analgesia efficiencies at 7d after treatment,treatment course and the complications were compared between the 2 groups.Results There was significant difference in the effective rate between control and observation groups after treatment [61.3％ (49/80 cases) vs.86.3％ (69/80 cases),P＜0.05].The analgesia efficiencies at 7d after treatment was 46.3％ (37/80 cases) in control group and 73.8％ (59/80 cases)in observation group (P＜0.05).There was no significant difference in treatment course between two groups [(7.7±1.4) times vvs.(6.1± 1.2) times,P＞0.05]].6 patients developed periapical periodontitis in control group,and only 4 cases in the observation group (P＞0.05).Conclusions Early open decompression drainage has good clinical effects and analgesia efficiencies in treatment of acute pulpitis,which is worthy of clinical application.

Objective To investigate the clinical effect of longxuejie capsule in combination with tinidazole in the treatment of chronic cervicitis and its effects on levels of immunoglobulin.Methods 90 cases in our hospital from January 2013 to June 2014, with chronic cervicitis meeting the inclusion critera were randomly divided into 2 groups by method of stratified randomization equally.Control group (n=45) was treated with tinidazole and conventional treatments, while observation group ( n =45 ) was treated with tinidazole and longxuejie capsule.Then, the curative efficacy, scale of symptoms and levels of immunoglobulin were observed and compared.Results The therapeutic efficiency ratio of observation group was 95.6%, which was significantly higher than that of control group ( 80.0%, P<0.05 ).After the treatment, in comparison with the control group, scale of cervical secretion and severity of cervical lesion was statistically lower respectively than observation group ( P<0.05 ).As to immunological function, concentrations of IgG, IgM, IgA in observation group were statistically higher than that in control group after the treatment (P<0.05).The control group and observation group respectively in 2 cases and 3 cases of abdominal pain, alleviated by themselves without treatment.Conclusion longxuejie capsule combined with tinidazole is effective and reliable for patients with chronic cervicitis, which significantly improves symptoms and elevates levels of immunoglobulin.

Objective To study the reasonable doses, efficacy and safety of regional citrate anticoagulation (RCA) for continuous veno-venous hemofiltration(CVVH) in children. Methods There were 66 patients hospi-ta-lized in Pediatric Intensive Care Unit of Zhujiang Hospital,Southern Medical University treated with RCA-CVVH that were recruited in the study from October 2012 to July 2014. The patients were divided into 4 groups according to their weight:≤10 kg( group Ⅰ) ,20 kg≥weight>10 kg( group Ⅱ) ,30 kg≥weight>20 kg( group Ⅲ) ,>30 kg( groupⅣ),and each group randomly received 2 different doses of anticoagulant acid citrate dextrose formula A(ACD-A):ACD-A(mL/h)=0. 75×blood flow rate(BFR)(mL/min)(A dose) and ACD-A=1. 5×BFR(B dose). Data of hemo-filter duration, activated partial thromboplastin time( APTT) ( systemic and circuit) , ionized calcium( Ca2+) ( systemic and circuit), blood urea nitrogen(BUN), serum creatinine(Cr), alanine aminotransferase(ALT), aspartate amin-otransferase(AST), blood pH, sodium ion(Na+), bicarbonate ion(HCO3-) were collected and analyzed. Results There was no significant difference in BUN,Cr,ALT,AST and APTT of 2 different doses of ACD-A among the groups (all P>0.05);pH of B dose of ACD-A in group Ⅰwas significantly higher than that in A dose(F=7.384,P=0. 015);pH of B dose of ACD-A in groupⅡwas significantly higher than that in A dose(F=4. 492,P=0. 046),HCO3-of B dose of ACD-A in groupⅠwas significantly higher than that in A dose(F=7. 735,P=0. 013);HCO3-of B dose of ACD-A in groupⅡwas significantly higher than that in A dose(F=4. 644,P=0. 042);hemofilter duration of B dose of ACD-A in group Ⅲ was significantly higher than that in A dose(t=-3. 147,P=0. 016);hemofilter duration of B dose of ACD-A in groupⅣwas significantly higher than that in A dose(t=-6. 342,P=0. 000). Conclusions RCA-CVVH is effective and safe for critical children,and different doses of ACD-A for children with different weight can re-duce metabolic alkalosis and enhance regional anticoagulation.