OBJECTIVE:To investigate the influence of dexmedetomidine combined with fentanyl on analgesic effects and hemodynamics of orthopedics patients after surgery.METHODS:A total of 80 patients undergoing orthopedics surgery were randomly divided into observation group (40 cases) and control group (40 cases).Observation group was given patient-controlled analgesia (PCA) of Dexmedetomidine hydrochloride injection+Fentanyl citrate injection,maintaining analgesia for 48 h.Control group was given PCA of Fentanyl citrate injection,maintaining analgesia for 48 h.The MAP,SpO2,HR,VAS and the occurrence of ADR were observed in 2 groups from the application of multi-function monitor to connecting to PCA (T0),12 h after connecting (T1) and 48 h after connecting (T2).RESULTS:At T0,there was no statistical significance in VAS score between 2 groups (P＞0.05).VAS scores of 2 groups at T1-2 were significantly higher than at T0.Those of 2 groups at T1 were significantly higher than at T2;but the observation group was significantly lower than the control group,with statistical significance (P＜0.05).There was no statistical significance in MAP,SpO2 or HR between 2 groups at different time points (P＞0.05).The incidence of respiratory depression,sharp pain,nausea and vomiting,hypotension in observation group were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:Dexmedetomidine combined with fentanyl show significant analgesic effect after orthopedics surgery,and have no effect on hemodynamics with good safety.

The remodeling and reparative process post myocardial infarction (MI) can be divided into three phases:the inflammatory phase,the proliferative phase and the stable phase.The inflammatory immune response plays an important part in the process of cardiac remodeling.First of all,the initiation of inflammatory response relies on the activation of innate immunity with a group of pro-inflammatory cytokines,chemokines and adhesion molecules.These molecules lead to the infiltration of the infarct area with neutrophils and mononuclear cells,further clearing the wound from dead cardiomyocytes and matrix debris.After resolution of inflammatory response,reparative cells and cytokines infiltrate into the heart and promote the differentiation and growth of myofibroblasts and endothelial cells,contributing to wound contraction as well as producing fiber tissue to form a scar.Moreover,overactive immune responses could accentuate infarct injury and dilative remodeling while deficiency of inflammation leads to insufficient repair,which highlights the dual function of the immune response in myocardial injury and repair post MI.Also the intense immune response along with fibrosis in non-infarct area is also closely associated with adverse remodeling.Thus,targeting specific factors in the inflammatory reaction may hold promise in patients with MI.

OBJECTIVE: The latency-intensity function (LIF) of wave V from click ABR of some deaf children showed great variation. We attempted to find out the intrinsic reasons. METHOD: The children recieved tone-burst ABR test. RESULT: Frequencies from 0.5-4.0 kHz have been tested and the thresholds of tone-burst ABR were recorded. The average thresholds of steeply LIF children at 0.5-4.0 kHz were (93.13 ± 7.04), (79.37 ± 7.72), (69.38 ± 8.54) (66.25 ± 8.06) dB respectively, while the average thresholds of shallower LIF children at these 4 frequencies were (65.00 ± 7.32) (68.13 ± 6.55) (70.63 ± 6.80) (78.12 ± 8.34) dB respectively. CONCLUSION The results imply that the child with steeply LIF may have more hearing loss at frequencies 0.5 and 1 kHz than those with shallower LIF. LIF may predict the audiogram configuration.
Audiometry, Pure-Tone ; Auditory Threshold ; Child ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; diagnosis ; Humans

Objective: To investigate the reliability, validity and sensitivity of Chinese scale of clinical neurological deficit of stroke patients (China Stroke Scale, CSS) , so as to assess its clinical application value. Methods: A total of 126 consecutive inpatients with acute stroke onset were included in our study and they were scored by CSS and the United States National Institutes of Health Stroke Scale (NIHSS) score separately; the reliability, validity, and sensitivity of CSS were evaluated. Reliability was evaluated by correlation coefficient r and Cronbach's α coefficient; construct validity was analyzed by factor analysis method of appraisal; criterion validity was analyzed by the correlation coefficient analysis with NIHSS scale as the criterion. Sensitivity in various fields was assessed through standardization of effect (SES). Results: Totally 123 valid questionnaires were collected. CSS showed high intrarater reliability, interrater reliability (0.911-1.000) and good internal consistency, with the Cronbach's α>0.8. There was concurrent validity between CSS and NIHSS (r = 0.86). The prognosis prediction accuracy of CSS was 92.4%, slightly lower than that of NIHSS (94.1%). Logistic regression showed that CSS's "gaze function" and "facial paralysis" were not included in the prediction equation. The facial paralysis had a SES of 0.38, all others had a SES higher than 0.5. Most fields showed a good sensitivity. Conclusion: CSS shows an acceptable reliability, validity and sensitivity in patients with stroke, but the predicative validity of CSS is inferior to that of NIHSS, which needs be further revised.

Asthma ; Child ; Cough ; Humans ; Rhinitis, Allergic, Perennial ; complications ; diagnosis ; therapy

To investigate the risk of papillary thyroid carcinoma (PTC) in patients with nontoxic multinodular goiter (MNG) compared to that in patients with solitary nodule (SN).From Jan 2006 to Dec 2011,761 patients underwent thyroid surgery were included in the retrospective study.According to pathology,patients were subdivided into two groups,MNG and SN.Preoperative thyroid profiles were correlated with patients' postoperative diagnoses.In whole group,the risk of PTC was significantly lower in MNG than in SN (7.09％ vs 15.58％,P =0.000 9).In patients with nontoxic multinodular goiter,the risk of PTC was lower compared to that of those with SN.

Objective To analyze the effects of Xiaogan capsule, Xiaoyao pill combined with Shu er capsule on hyperplasia of mammary gland and its effect on vascular endothelial growth factor ( VEGF ) and basic fibroblast growth factor ( bFGF ) .Methods 106 cases of patients with breast hyperplasia treated in our hospital from April 2013 to August 2016 were randomly divided into experimental group and control group according to the order of admission, with 53 cases in each group.The control group was treated with Xiaojin Capsule and Xiaoyao Pills.The experimental group was treated with Xiaojin Capsule, Xiaoyao Pill and Shuerjing Capsule.Analyze the total effective rate of clinical treatment, incidence of adverse reactions, visual analogue pain score and the influence on the expression of VEGF and bFGF in the two groups.Results The total effective rate was 96.23%(51/53) in the experimental group and 86.79%(46/53) in the control group,the total effective rate in the experimental group was much higher than that in the control group (P<0.05).The incidence of adverse reactions was 11.32%(6/53) in the experimental group and 13.21%(7/53) in the control group,there was no significant difference in adverse reactions between the two groups.The visual analogue pain score of the experimental group was (2.85 ±0.41) points, the visual analogue pain score of the control group was (5.25 ±1.84),the visual analogue pain score of the experimental group was significantly lower than that of the control group ( P <0.05 ) .After treatment, the expression of VEGF and bFGF in the patients with hyperplasia of mammary gland decreased, and the levels of VEGF and bFGF in the patients with hyperplasia of mammary glands were significantly higher than those in the untreated group (P<0.05),the expression of VEGF and bFGF in the control group was enhanced.Conclusion Xiaojin capsule,Xiaoyao pill and Shu er jing capsule have higher application value in the patients with hyperplasia of mammary gland , and significantly lower the expression of VEGF and bFGF .

Objective:To explore the effect of emotional stress to the intra-islet apoptosis and the it's neural mechanism.Methods: Using the drinking-conflict stress and restraint stress, we investigated diabetes-prone NOD mouse's c-fos expression in it's brain and it's intra-islet apoptosis. Correlation between the two variables was also studied.Results:The average intra-islet apoptosis of the first(3.95?1.05)and the second (5.73?2.60)and third day(5.77?2.75) was higher than the control's(0.82?0.93,P

Objective To investigate the clinical application of the emergency triage criteria in the Hospital Emergency De‐partment Standardization Process by comparing it with the 5 level national triage system (5L NTS) .Methods Totally 984 patients visiting the emergency department of the Wushan County People′s Hospital from January 1 to January 31 ,2015 were chosen to con‐duct the evaluation of 4‐grade classification standard triage with 5L NTS as the control evaluation criteria .The error rate ,evaluation time and degree of difficulty or ease were compared between the two criteria .Results The error rate of 4‐grade triage standard was 4 .7% ,which of 5L NTS was 3 .6% ,the difference was not statistically significant (χ2 =1 .220 ,P=0 .269) .The triage time had sta‐tistical difference between the two criteria (t= -2 .291 ,P=0 .04) ,while the degree of difficulty or ease in using criteria had no sta‐tistical difference(χ2 =1 .143 ,P=0 .285) .Conclusion The 4‐grade triage criteria recommended by the Hospital Emergency Depart‐ment Standardization Process has no obvious differences in the aspects of triage error rate ,degree of difficulty or ease in use com‐pared with the widely recognized 5L NTS in the world ,and has the clinical promotion value .

Bronchopulmonary dysplasia( BPD) is a chronic lung disease that commonly occurs in pre-term. Since the 1980s,with the advances in perinatal care,survival rate of preterm has been raised,while BPD continues to be a significant cause of morbidity and mortality for premature infants. However,the treatment effect of BPD is unsatisfactory. It is urgent to search for innovative ways to reduce the respiratory injury that caused by BPD as well as to improve the quality of life. In recent years,mesenchymal stem cells′( MSC) research has pro-vided a new way for the treatment of BPD. This review primarily summarizes the current status of the MSC ther-apies and its possible mechanism on BPD.