Objective To compare the effects of propofol versus sevoflurane combined with remifentanil anesthesia on the activity of nuclear factor-kappa B (NF-κB) in neutrophil granulocyte during one-lung ventilation (OLV) in patients undergoing radical resection of esophagus cancer.Methods Forty ASA physical status Ⅰ or Ⅱpatients of both sexes,aged 40-64 yr,with body mass index 18-25 kg/m2,undergoing radical resection of esophagus cancer,were randomized into 2 groups (n =20 each):propofol-remifentanil group (group P) and sevofluraneremifentanil group (group S).Anesthesia was induced with midazolam,sufentanil,etomidate and cisatracurium besylate in both groups.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propofol 4-8 mg· kg-1 · min-1 in group P,or with inhalation of 1%-3% sevoflurane in group S,and with iv infusion of remifentanil 0.2μg· kg-1 · min-1 and intermittent iv boluses of cisatracurium besylate 7 mg in both groups.The Narcotrend index value was maintained between 40 and 50.Blood samples were taken from the radial artery at 5 min after intubation,the beginning of OLV,30,60 and 90 min of OLV,0 and 10 min after re-expansion of the collapsed lung,and the end of surgery for blood gas analysis and for determination of plasma concentrations of IL-1.The oxygenation index and respiratory index were calculated.The nuclear protein of neutrophil granulocytes was extracted for detection of NF-κB-DNA binding activity.Results Compared with group P,the respiratory index,plasma concentrations of IL-1 and NF-κB-DNA binding activity were significantly increased (P ＜ 0.05),and no significant change was found in the oxygenation index in group S (P ＞ 0.05).Conclusion Compared with sevoflurane-remifentanil anesthesia,propofol-remifentanil anesthesia can inhibit activation of NF-κB in neutrophil granulocyte and is helpful in attenuating the inflammatory response in lung tissues during OLV in patients undergoing radical resection of esophagus cancer.

Objective To explore the application and efficacy of autogenous septal cartilage in the correction of cleft lip nasal deformity.Methods A total of 31 patients with secondary nasal deformity of cleft lip were involved in this study.After autologous nasal cartilage was released,the dislocation of nasal cartilage was corrected,nasal septum cartilage was used as substitute to raise the alar collapse,to reshape the nasal tip cartilage structure and correct the nasal deformity.Results Postoperative incision was primarily healing.For cartilage donor area there was no serious complications,and incision scar was concealed and unobvious; after 6 months to 2 years follow-up,there was no cartilage absorption deformation,the tip of the nose was flat,crack side nosewing collapses,and nasal columella skew was totally corrected,with stable rhinoplasty effects.Conclusions For secondary nasal deformity of cleft lip,the use of nasal septum cartilage to repair nose deformity can not only solve the cartilage source,but also give septal straightening and at the same time the correction effect of external nasal deformity is good.

Objective To explore the imaging diagnosis of chorea associated with nonketotic hyperglycemia by describing its CT and MR findings and correlating those findings with the clinical manifestations. Methods The imaging findings and clinical data from 6 patients with chorea associated with nonketotic hyperglycemia were retrospectively analyzed. All 6 patients had unenhanced CT scans, 1 also had MR imaging examination. Three of 6 patients had follow-up CT scans and 1 of 3 patients had follow-up MRimaging studies. Results CT studies of all 6 patients showed unilateral or bilateral hyperdense striatum.The putamen was involved in all 6 patients, the caudate nucleus or lateral portion of the globus pallidus were involved in 5 of all 6 patients. All 3 follow-up CT studies depicted a decreased or resolved hyperdensity of the abnormal striatum. T1-weighted MR images in 1 patient showed the hyperintense lesions of bilateral lentiform nuclei, T2-weighted MR images of the patient showed the hypointense lesions of the corresponding lentiform nuclei, and its follow-up MR images depicted invariable signal intensity of T1-weighted and T2-weighted images. In all patients, the chorea resolved within 2 to 6 days after treatment of the hyperglycemia. Conclusion The characteristic imaging findings of chorea associated with nonketotic hyperglycemia can suggest an accurate diagnosis.

Purpose To analyze the echocardiographic features of peripartum cardiomyopathy (PPCM) using Logistic regression, and to screen the indexes which can be used for the prognosis of PPCM. Materials and Methods Fifty patients who were diagnosed as PPCM by echocardiography were divided into recovered group (30 cases) and non-recovered group (20 cases), all the patients underwent echocardiography, left ventricular end-diastolic diameter (LVEDd) was measured in the parasternal long axis view, left ventricular ejection fraction (LVEF) was measured using Simpson biplane method in the apical four-chamber and two-chamber view to look for the evidence of left ventricular thrombosis, if complicated with pulmonary hypertension, continuous wave Doppler was used for measuring the peak velocity of tricuspid valve regurgitation, and estimating of pulmonary artery systolic pressure, Logistic regression model was established and receiver operating characteristic (ROC) curve was generated to evaluate the prediction value of Logistic regression model. Results Compared with non-recovered group, there was statistically significant difference of LVEDd, LVEF, left ventricular thrombosis, pulmonary hypertension and re-checked LVEF (t= -4.33, 7.64 and 11.54, P<0.05; χ2=10.93 and 4.43, P<0.05) in the first examination, while there was no statistical difference in pericardial effusion, mitral valve regurgitation and tricuspid regurgitation between the two groups (χ2=2.21, 0.67 and 3.46, P>0.05). Three sonographic features LVEDd, LVEF and left ventricular mural thrombus) could be used for the establishment of Logistic model (χ2=5.14, 11.59 and 14.58, P<0.05). The prediction accuracy of the model was 90.0% (45/50, P<0.001) and the area under ROC curve was 0.945±0.030 (P<0.001). Conclusion Logistic regression analysis can be applied for the screening of ultrasound index for PPCM, LVEDD, LVEF and left ventricular wall thrombus can predict the prognosis of PPCM accurately.

Objective: To evaluaate the effect of pingyangmycin(PYM ) in the treatment of cavernous hemangioma, strawberry hemangioma and mixed hemangioma in the oro-maxillo-facial region. Methods:The medical records of 520 patients with hemangioma in oro-maxillo-facial region between January 1994 and January 2000 were reviewed. Pingyangmycin(

The enrollment of international medical students has been expanding.How to improve the quality of medical education is a key point.To explore a better way and method to improve the quality of the medical teaching for foreign students in China,the preliminary experi-ences of teaching of Clinical Diagnostics for foreign students are reviewed.

OBJECTIVE:To determine the pharmacokinetic parameters of Xuesaitong injection in rabbits.METHODS:Using ginsenoside Rg1 in Xuesaitong injection as a marker,the determination was carried out with HPLC.The detection conditions were:mobile phase,acetonitrile-water(3∶7);chromatgraph column,Hypersil C18(250mm?4.6mm,5?m);detection wavelength,210nm and flow rate,1 ml/min.RESULTS:After intravenous injection,the plasma concentration time data was found to be in accordance with the 2-compartment model in rabbits.The pharmacokinetic parameters were obtained with PKBP-NI.CONCLUSION:The method is simple,accurate and reliable.It could be used to determine the concentration of ginsenoside Rg1 in plasma.

Objective To know the distribution of pathogenic bacteria in the hospital ,and to provide scientific evidence for con‐trolling hospital infection and clinical medication .Methods Samples of the hospitalized patients and the data of bacteria culture and isolation in the hospital were collected and statistically analysed retrospectively from January 2011 to December 2013 .Bacterial iden‐tification and drug sensitivity test were carried out by using VITEK 2 Compact automated bacterial identification and drug sensitive system .The clinical distribution and drug resistance characteristics of the strains were analyzed by using WHONET5 .4 and SPSS17 .0 software .Results In the hospital ,71 929 specimens were received from 2011 to 2013 totally ,the detection rate of patho‐genic bacteria was 18 .5% .Sputum(62 .8% ) ,secretions and pus(11 .3% ) ,blood(10 .3% ) were the top three types of specimens which had larger positive numbers .Gram negative bacteria are the main kind of pathogenic bacteria in the hospital ,accounting for 73 .3% .Gram positive bacteria accounted for 25 .0% .E .coli(21 .1% ) ,Pseudomonas aeruginosa(14 .8% ) ,Acinetobacter baumannii (12 .5% ) ,Klebsiella pneumoniae (12 .2% ) and Staphylococcus aureus(11 .04% ) were the top five pathogenic bacteria .The drug resistance of the isolates were as follows .Gram‐negative bacteria showed resistance of different extents to broad‐spectrum penicil‐lins ,quinolones ,cephalosporins except for the 4th generationsand and aminoglycosides .Over 80% Staphylococcus aureus showed re‐sistance to penicillin ,erythromycin and clindamycin ,but the rate to Oxacillin were decreasing year by year .Enterobacteria were still most sensitive to carbapenems with a sensitive rate over 98 .6% .However ,the emergence of Carbapenem‐resistent enterobacteria from 2011 to 2013 was worthy of clinical attention .Conclusion The type of positive specimens were mainly sputum .Gram negative bacteria are the main pathogenic bacteria ,and have obvious multi-drug resistance .E .Coli is the superiority strains ,fungal infection rate are increasing year by year .Doctors and hospital infection controlling department should pay attention to the monitoring of bac‐terial resistance and improve the rational use of antimicrobial drugs .

Objective To explore the characteristics of polysomnography (PSG) of depressed patients and the correlation between rapid eye movement (REM) and severity degree of depression. Methods Polysomnography was used to assess patients'sleep condition and Montgomery-Asberg depression scale (MADRS) was used to assess the severity degree of depression. 90 patients and 30 healthy controls were included. Results Compared to healthy controls,sleep progress of depressed patients changed as follow:prolonged sleep latency((25.2 ±15.25) minutes) ,lowered sleep efficiency(0.853 ±0.11) ;the architecture of sleep also changed:percentage of stage 1 increased( (27.7 ± 16.38) % ),percentage of REM sleep increased( (22. 8 ± 6. 1 ) % ) , percentage of stage 2 decreased ((40.2±11.3)%), percentage of slow wave sleep decreased ((11.8 ±9. 32)%); REM sleep significantly changed; decreased REM latency((79. 27 ±30. 44) minutes) , increased REM activity((129. 0 ±53. 12) u) .increased intensity of REM((36.7 ±14.0)u/min), increased REM density((159.2 ±57.2)u/min) were observed in depressed patients. There was no obvious correlation between the variance of REM and severity degree of depression. Conclusion There are a series of changes in sleep progress, architecture and REM sleep of depression and the change of REM sleep can be specified to diagnose depression. However,there is no causality between REM variance and severity of depression.

BACKGROUND:Numerous studies have shown that local lumbar stenosis can cause immunological abnormalities and local chronic inflammation, which is the main cause of pain. At present, studies on inflammatory factors and lumbar spinal stenosis mainly focused on intervertebral discs, facet joint and ligamenta flava. No reports addressed the relationship between inflammatory factor in vein of lumbar spinal canal and lumbar spinal stenosis. OBJECTIVE:To analyze the correlation of serum interleukin-1αand tumor necrosis factor-αlevels with lumbar spinal stenosis. METHODS:A total of 51 patients with lumbar spinal stenosis or lumbar vertebral burst fracture, who underwent posterior lumbar decompression in the Department of Spine Surgery, Shanghai East Hospital, Tongji University in China from September 2011 to December 2013, were enrol ed in this study. Visual analogue scale score of low back pain and Oswestry disability index were evaluated before treatment. Peripheral vein blood and venous blood in the vertebral canal were col ected from patients with lumbar spinal stenosis or lumbar vertebral burst fracture. The concentrations of serum interleukin-1αand tumor necrosis factor-αwere determined using enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION:The concentration of interleukin-1αin degenerative lumbar stenosis group was significantly higher than that in the lumbar burst fracture group and peripheral veins (P<0.05). The more segments of lumbar spinal stenosis, the higher the venous serum interleukin-1αlevels were in the degenerative lumbar stenosis group, but the statistical difference was not significant. Linear correlation analysis results displayed that interleukin-1αlevels were positively associated with low back pain and disability scores in the degenerative lumbar stenosis group (r2=0.359 3, P<0.05;r2=0.526 4, P<0.05). These results indicated that the lumbar spinal venous inflammatory factors may be one of the reasons of low back pain and dysfunction in patients with degenerative lumbar spinal stenosis.