Objective To investigate the effect of sevoflurane preconditioning on lung compliance and oxygenation index during one lung ventilation( OLV) . Methods In this study, sixty patients, ASAⅠorⅡ, scheduled for pul-monary surgeries were enrolled, and randomly divided into two groups:sevoflurane preconditioning group(n=30) and total intravenous group( n=30 ) . For preconditioning, patients in sevoflurane preconditioning group were ad-ministrated with one minimal alveolar concentration(1MAC) sevoflurane for 30 min after general anesthesia induc-tion and then followed with total intravenous anesthesia. While in total intravenous group, only intravenous anes-thetic agents were administrated for maintenane of anesthesia after induction. The indexes of hemodynamics, pulse oximeter( SpO2 ) , plateau pressure( Pplat) and lung compliance( Cdyn) were recorded at the following time points:before anesthesia( T0 ) , after anesthesia induction at laternal position TLV 30 min( T1 ) ,30 min after OLV( T2 ) , 60 min after OLV( T3 ) and recovering TLV 20 min( T4 ) . Arterial blood samples were taken to measure partial pressure of carbon dioxide( PaCO2 ) , partial pressure of oxygen( PaO2 ) , pH, oxygenation index( PaO2/FiO2 ) at the follow-ing time points: T1 , T2 , T3 , T4 . Results Compared with T1 , the oxygenation index and lung compliance de-creased significantly at T2 ,T3 ( P<0. 05 ); compared with total intravenous group, the lung compliance was obvi-ously higher than that in sevoflurane preconditioning group at T2,T3(P<0. 05). There were no significantly differ-ences in the oxygenation index between total intravenous group and sevoflurane preconditioning group at all time points. Conclusion Compared with total intravenous anesthesia with propofol , sevoflurane preconditioning can im-prove lung compliance, but does not make contribute to improve oxygenation index.

Objective To assess the value of CT in diagnosis and clinical treatment of the traumatic rupture of spleen.Methods There were 35 cases with traumatic repture of spleen,32 cases were comfirmed by operation.Plain CT scans in all cases and contrast-enhanced scans in 4 cases were performed.Results 19 cases were subcapsular hematoma,8 cases were spleen hematoma,6 cases were rended in one place of spleen,2 cases were rended in many places of spleen.Conclusion The difinite diagnosis and classification of traumatic rupture of spleen can be made by CT.The rupture of the organs around the spleen also can be found by CT,that can provide reliable evidence for clinical treatment.

Objective To assess the safety and tolerance of single-dose and continuous intravenous drip of Xuesaitong saline injection in Chinese volunteers,thus to establish the effective clinical dosage.Methods Thirty-one healthy volunteers were randomized into 4 single-dose groups(100,200,400 and 600 mg respectively)and a multiple-dose group(400 mg,qd ? 14 d).Subjective symptoms,objective signs,vital signs including blood pressure,heart rate,respiration were observed,and routine blood tests,routine urine tests,hepatic function,renal function,clotting function,electrocardiogram were monitored after medication.Results In the single-dose groups,there were no abnormal findings in the vital signs and the lab examinations 0h,1h,8h,24h after medication.Dizziness without association with Xuesaitong occurring in one volunteers of the 200 mg group.It could subside after taking a rest.In the multiple-dose group,no significant changes were found in the vital signs and the lab examinations 4 d,8 d,12 d,15 d after the first dosing.Rash occurred in 2 volunteers,being considered potentially related to the drug and disappearing in one week.Conclusions Xuesaitong is safe at a dose of 100 ~ 600 mg in a single administration or at a dose of 400 mg once day for 14 days for male or female Chinese volunteers,400 mg being suggested for the clinical use.However,Further studies are needed to evaluate the safety of xuesaitong in the target population and allergic reaction should be observed.

Objective: To study the diagnosis and treatment of primary hyperparathyroidism.Methods: The clinical data of 8 primary hyperparathyroidism patients(1992 2002) in our hospital were summarized and the references were reviewed.Results: It was found that primary hyperparathyroidism was liable to be misdiagnosed.Information on blood calcium,parathyroid hormone(PTH) and imaging may be helpful for diagnosis. Surgical resection(4 cases), anhydrous alcohol injection (2 cases), electron radiation (1 case) and internal medicine (1 case) were applied. Conclusion:Information on blood calcium,PTH and early imaging is helpful for diagnosis.Operation is the first choice of treatment, and for patients who can not tolerate surgery, anhydrous alcohol injection is an effective and safe treatment.

OBJECTIVE:To reduce patient waiting time for drugs by improving work efficiency via the optimization of the in-telligent workflow of outpatient pharmacy. METHODS:The problems existing in each link in the workflow after the adoption of au-tomated drug dispensing machine in the outpatient pharmacy of our hospital were analyzed. Measures were developed and imple-mented,on the basis of the factors affecting each link including adding drugs,making up a prescription and dispensing drugs,to optimize the workflow. The effect after the optimization was evaluated,with the time it takes to make up a prescription and to dis-pense drugs and patient waiting time for drugs as the indexes. RESULTS:The averaged time it takes a pharmacist to make up a pre-scription and to dispense drugs and patient waiting time for drugs significantly reduced from 3.4 min,9.3 min and 12.7 min to 1.0 min,6.1 min and 7.1 min respectively,after taking measures such as adjusting the number of the drug types,tracks and positions in the machine,adding the contrasting pictures of the drugs which were similar on the system interface for adding drugs,standardiz-ing the process of adding drugs,improving and allocating information labels,adjusting the process of dispensing drugs and adding new small packages of drugs within 6 months. CONCLUSIONS:The optimized intelligent workflow in the pharmacy can reduce pa-tient waiting time for drugs,increase patient satisfaction and promote the development of intelligent pharmacy.

Objective To explore the correlation between adiponectin/leptin(A/L) ratio and metabolic syndrome diagnosis in elderly men. Methods A total of 256 elderly men (≥60 years) were enrolled and divided into metabolic syndrome group(n= 109) and non metabolic syndrome group (n= 147). Serum levels of adiponectin and leptin were measured by radioimmunoassay (RIA) and the A/L ratio was calculated. Metabolic syndrome diagnosis is based on the definition provided by China Diabetes Society (CDS) in 2004. Results (1) In metabolic syndrome group versus non metabolic syndrome group, the serum levels of leptin and adiponectin were (10. 3±7.0) vs (6.8±4.9)μg/L and(7.8±5.6)g/L vs (9.5±5.9)g/L, and A/L ratio was 0. 94±0. 78 vs 2.15±2.13 respectively. (2) A/L ratio was positively correlated with high density lipoprotein cholesterol (HDL-C) and negatively correlated with body mass index (BMI), triacylglycerol (TG) and serum uric acid(P< 0. 001). (3) The higher value of A/L ratio, the lower possibility of metabolic syndrome. When the A/L ratio was more than 5, the incidence of metabolic syndrome was decreased to O(X2 =34. 891 ,P< 0.001). (4) The more components of metabolic abnormality, the lower value of A/L ratio(F= 10. 876,P<0. 001). Conclusions The A/L ratio may be useful in evaluating the extent of metabolic disorder and diagnosing metabolic syndrome in elderly men.

BACKGROUND: Long-term radioactive ray accumulation leads to surrounding tissues fibrosis accompanied by limitation of mouth-opening, which seriously affects life quality of tumor patients. OBJECTIVE: To observe pathological change of soft tissues in rats with radiation masseter injury and the level of transforming growth factor β1 (TGF-β1) mRNA expression in vivo.METHODS: A total of 30 Wistar rats were randomly divided into control group (n=10) and radiated group (n=20). Radiated group were radiated with linear accelerator at a dose of 40 Gy. The pathological changes of vessels were observed under light microscope and electron microscope and expression of TGF-β1 was detected by RT-PCR. RESULTS AND CONCLUSION: The microvessel density of radiated group was obviously decreased than that of the control group (P < 0.01), but the mRNA expression of was higher than that in the control group (P < 0.01). It suggests that radiated injury can induce fibrosis to repair the radiated injury.

Objective To develop a new instrument to assess swallowing function which will be suitable for nurses to screen dysphagia in the patients with stroke.MethodsItems closely related to symptoms and signs of dysphagia were found with literature review, forming a preliminary instrument. All items retrieved were selected and modified by experts interview and a pilot study in patients with stroke. Then, a clinical nursing swallowing assessment tool (CNSAT) was formulated.ResultsTotally, seven items of symptoms and signs related to dysphagia in patients with stroke were found with literature review. All the seven items retrieved were selected again by experts interview and finally a CNSAT was formed with six modified items by a pilot study in 10 patients with stroke, each item with four choice based on its severity of their symptoms and signs.ConclusionCNSAT is a simple, convenient and safe instrument and suitable for nurses to assess swallowing function of patients with stroke.

Objective To study the effects of As_2O_3 on tumor model of hepatocarcinoma.Methods HepAgrafed hepatocarcinoma mouse model was established by subcutaneously injection of mouse hepatoma cells(1×10~6)into the oxter of mice.After treated by As_2O_3,the volume change of tumor and tumor inhibition rates were observed.The expression of vascular endothelial growth factor(VEGF) was detected by immunohistochemical and calculated the difference of MVD.Results The volume of tumor and the tumor inhibition rates were significantly decreased in As_2O_3 group compared with control group(P<0.05).The As_2O_3 could inhibit angiogenesis of xenograft tumor,depress expression of VEGF and decrease microvascular density(MVD).Conclusion As_2O_3 can inhibit the growth of tumor,inhibit the expression of VEGF and decrease MVD.

OBJECTIVE:To optimize the purification process of the extract from Yiqi guben granules. METHODS:The purifi-cation effect of the process was investigated with transfer rate of polysaccharide,calycosin glucoside and dry paste as evaluation in-dexes,using ZTC1+1 type Ⅱ,and shell poly sugar and 95% ethanol as clarifying agents. The purification process of the extract from Yiqi guben granules was optimized by orthogonal test using the ratio of material to liquid,the amount of clarifying agent and standing time as factor. The validation test was conducted. RESULTS:Selecting ZTC1+1 type Ⅱ as a clarifying agent,the best trans-fer rate of effective component had been obtained;optimal purification process was as follows as the ratio of material to liquid 1:2, the ratio of ZTC1+1 type Ⅱ A liquid 5%,the ratio of B liquid 10%,standing time of 5 h. The results of verification test showed transfer rates of dry paste in 3 tests were 71.54%,70.98%,69.21%,respectively;those of polysaccharide were 82.55%, 81.78%,82.15%,respectively;those of calycosin glucoside were 91.92%,92.34%,91.58%,respectively (all RSD≤1.72%, n=3). CONCLUSIONS:The optimized purification process is effective,stable and practical,and can be used for the purification of the extract from Yiqi guben granules.