Objective To study the effect of positive pressure ventilation extubation on arterial blood gas indexes of patients undergoing cardiac surgery. Methods 50 patients with orotracheal intubation after intracardiac opening operation under direct vision were randomly divided into the control group and the experimental group with 25 cases in each group. We used traditional method to pull out tracheal intubation in the control group. And positive pressure ventilation at 5 ～15 cm H2O during inspiration and pulling out tracheal intubation during expiration in the experimental group. The change of arterial blood PaO2, PaCO2, SaO2, pH and respiratory rate before and 1min、5min、10min after extubation was observed,and also the incidence rate of air tube obstruction was recorded. Results The change amplitude of arterial blood gas indexes of patients in the experimental group was obviously lower,and the length of change time reduced more than 50%. There were 4 air tube obstructions in the control group and there was no obstruction in the experimental group. The difference was statistically significant. Conclusions Positive pressure ventilation extubation can raise lung's compliance and improve oxygenation. And arterial blood gas indexes are more stable. It can decrease the incidence rate of hypoxemia and is a much more safe method.

Objective To investigate the changes in the dose requirements of rocuronium after right hemihepatectomy in donor of living donor liver transplantation. Methods Sixteen ASA Ⅰ patients of living donor liver transplantation, aged 21-49 yr, weighing 51-86 kg, scheduled for right hemihepatectomy, were enrolled in this study. Anesthesia was induced with iv midazolam and fentanyl, and TCI of propofol and rocuronium. Changes in adductor pollicis muscle were monitored by the train of four (TOF) stimulation. The patients were mechaincally ventilated after tracheal intubation when T1/Tc = 0. The target plasma concentration of rocuroniurn was reduced to 1.0 μg/ml after tracheal intubation and the concentration was regulated to maintain 0 < T1 ≤ 10%. Anesthesia was maintained with sevoflurane inhalation, TCI of propofol, intermittent iv injection of fentanyl. The infusion of rocuronium and inhalation of sevoflurane were stopped before the second time of cholangiography, the total time and amount of rocuronium administered and the recovery of muscle relaxation were recorded at this time (before hemihepatectomy). The infusion of rocuronium and inhalation of sevoflurune were rests-ted after right hemibepatectomy. After the peritoneum was closed, the infusion of rocuroniurn and inhalation of sevoflurane were stopped again, the total time and amount of rocuronium administered and the recovery of muscle relaxation were also recorded at this time (after hemihepatectomy). Results The amount of rocuronium administered was significantly reduced after hemihepatectomy compared with that before hernihepatectomy (P < 0.05). The amount of rocurunium administered after hemihepatectomy was (67 ± 13) % of that before hemihepatectomy. Conclusion Right hemihepatectomy can affect the metabolism of rocuronium in the donor of living donor liver transplantation.

Objective To analysis the occurrence and risk factors of ventilator-associated pneumonia(VAP)in intensive care unit in order to direct the clinical work.Method The clinical data of 158 cases receiving mechanical ventilation in ICU were retrospectively analyzed to investigate the incidence of VAP and risk factors.Result Mechanical ventilation and intubation of nasogastric tubes were the main risk factors of VAP(P<0.01).Conclusion The nursing measures such as earlier extubating, keeping the oropharynx clean,decreasing the risk of colonization,strengthening disinfection and air purification,paying attention to the tracheotomy nursing and enhancing nursing procedure skills are important for VAP prevention.

Objective To investigate the optimum techniques for processing Yuhuanlian with microwave. Methods Nine samples were obtained by orthogonal design. Thin-layer chromatography was used to determine berberine in Yuhuanglian. The content of berberine was taken as the index for the evaluation on the superiority of processing techniques. Results The optimal processing techniques for Yuhuanglian with microwave was suggested as follows:A2B2C3, moistened for 90 minutes, put 2 cm thick, with 80% of the microwave, heating 3 minutes. Conclusion The method is simple, easy to control, easy to use, easy to promote, and the quality of processed products is better.

OBJECTIVE:To evaluate the quality of antidiabetics in Beijing so as to provide the reference for pharmaceutical manufacturers,patients and governmental departments of drug control.METHODS:236package samples of4kinds of common oral antidiabetics(glibenclamide,gliquidone,metformin,and phenformin)in Beijing medicine market were randomly selected and analyzed.RESULTS:4samples were found to be unqualified,with the disqualification rate of1.7%.CONCLUSION:The quality of4kinds of common oral antidiabetics in Beijing medicine market in2004is satisfactory on the whole.

BACKGROUND:Many previous retrospective smal-sample studies analyzed the short-term effects using pedicle screw placement to repair thoracolumbar fracture. Conclusions are relatively thin. Simultaneously, screw placement in the injured vertebra can further stabilize the vertebral body, and reduce screw and rod breakage and loss of correction. OBJECTIVE:To evaluate the long-term effects of pedicle screw placement fixation through the injured vertebra in the repair of thoracolumbar fracture. METHODS: From February 2010 to February 2012, 36 patients with thoracolumbar fracture, who were treated in the Department of Orthopedics, Guangzhou Panyu District Second People’s Hospital, were selected. They were treated by vertebral pedicle screw placement fixation. Height ratio of preoperative injured vertebral leading edge was averagely 36%. Kyphosis angle (Cobb angle) was 25°. Sagittal diameter of the center of the vertebral canal was 60%. Nerve function was classified according to Frankel classification: grade A, 2 cases; grade B, 6 cases; grade C, 10 cases; grade D, 9 cases; grade E, 9 cases. The height ratio of injured vertebra, kyphosis angle (Cobb angle), sagittal diameter of the center of the vertebral canal and Frankel classification of nerve function were compared before and after treatment. RESULTS AND CONCLUSION: The postoperative folow-up was 3-3.5 years. Pain was obviously aleviated postoperatively in 36 patients. Average height ratio of injured vertebra was 95%. Kyphosis angle (Cobb angle) was 3.5°. Sagittal diameter of the center of the vertebral canal was 96%. Significant difference was found in the above indexes before and after treatment (P < 0.05). Postoperative neurologic recovery: grade A in 1 case, grade B in 2 cases, grade C in 3 cases, grade D in 4 cases, and grade E in 26 cases. Postoperative fractures were reset. Complications such as breakage, loosing or correction loss were not found. These findings suggest that pedicle screw placement fixation through the injured vertebra in the repair of thoracolumbar fracture can make a satisfactory reduction, enhance the pressure stability of the spine, reduce the internal fixation of fracture and vertebral height loss, and have good long-term effects, indicating that the implant and host have good biocompatibility.

Objective To study the clinic characteristics and the treatment of acute pancreatitis ( AP) with and without hyperlipidemia. Methods The clinical data of 99 patients in our hospital from Jan. 2013 and Dec. 2013 were studied. Patients were divided into the hyper-lipidemic acute pancreatitis ( HAP) group and the control group ( AP without hyperlipidemia) . All the patients received standardized clinical AP treatment. The patient’ s condition, plasma biochemical index, treatment outcome, length of hospital stay, cost, and relapse were ob-served. Results The proportion of severe pancreatitis of HAP group (13. 6%) was obviously higher than that of control group (7. 8%). Blood sugar and uric acid of HAP group were significantly higher than that of control group, and the average blood sugar of HAP group reached to 171% of the control group. And the blood amylase of HAP group was only 44. 5% of that in the control group. One year recur-rence rate of HAP group (13. 6%) was significantly higher than that of control group (2. 6%) with a singnificant difference (P<0. 01). Conclusion It is suggested that hyperlipidemia condition has significant relations with the condition, performance and outcome of acute pan-creatitis.

Objective To evaluate the effects of tofacitinib on liver function in rheumatoid arthritis (RA) patients.Methods Literature search was performed in databases including PubMed,Cochrane Library,China National Knowledge Infrastructure and Wanfang to identify randomized controlled trials about RA treated with tofacitinib.The retrieval time was up to August 2016.Meta-analysis was conducted by Revman 5.5 software.Results A total of 7 studies were included,involving 2 965 patients.The results of Meta-analysis revealed that the incidence of alanine transaminase (ALT)＞1 upper limit of normal (ULN) in patients receiving both 5 mg and 10 mg bid tofacitinib was significantly higher than placebo [5 mg bid tofacitinib:RR=1.48,95％CI (1.20,1.82),P=0.000 2;10 mg bid tofacitinib:RR=1.67,95％CI (1.37,2.05),P＜0.01];there was no significant difference in the incidence of ALT＞3 ULN [5 mg bid tofacitinib:RR=1.81,95％CI (0.57,5.79),P=0.32;10 mg bid tofacitinib:RR=1.36,95％CI (0.57,5.25),P=0.49];the incidence of aspartate transaminase (AST)＞1 ULN was significantly higher than placebo [5 mg bid tofacitinib:RR=1.59,95％CI (1.25,2.03),P=0.000 2;10 mg bid tofacitinib:RR=1.90,95％CI(1.50,2.40),P＜0.01],there was no significant difference in the incidence of AST＞3 ULN [5 mg bid tofacitinib:RR=1.17,95％CI (0.27,5.17),P=0.83;10 mg bid tofacitinib:RR=0.95,95％CI (0.26,3.44),P=0.94].Conclusion Tofacitinib slightly increases ALT and AST in patient with RA.Due to the limited sources and lack of domestic studies,more randomized controlled trials are still needed to verify the above conclusion.

Objective To analyze the disease burden of Yi nationality.Methods Disability adjusted life years(DALY) was used as the measurement indicator of disease burden.Results The male had greater Years of Life Lost to Premature Death(YLL)per thousand populations,Years of Lived with Disability(YLD) and DALY than did the female almost in each age group.The burden of Neuropsychiatric conditions was the heaviest.The burden of Yi nationality was heavier than Han nationality in diseases during perinatal period and digestive diseases.However,the disease burden of malignant neoplasm of Han nationality was heavier than Yi nationality.Conclusion The prevention and treatment of neuropsychiatric conditions,diseases during perinatal period and digestive diseases should be enhanced in Yi nationality.

Objective:To investigate the prevalence and associated risk factors of pre-hypertension and hypertension in young and middle-aged population in Nanjing.Methods:Subjects of the study were those who underwent physical examination in the physical examination center of Nanjing Drum Tower Hospital from 2009 to 2016. The prevalence and risk factors of pre-hypertension and hypertension in young (aged 18-44 years old) and middle-aged people (aged 45-59 years old) were analyzed.Results:A total of 142 857 participants aged 18-59 years old were analyzed. Among them, 64 220 cases in the pre-hypertension group and 13 912 cases in the hypertension group. The prevalence of hypertension was 9.74% (12.51% in males and 5.82% in females). The prevalence of pre-hypertension was 44.95% (53.31% in males and 33.15% in females). In the middle-aged group, the prevalence of pre-hypertension and hypertension were 51.68% and 15.13%, respectively, which was higher than that in the young group (37.95% and 4.13%, respectively). The prevalence of pre-hypertension and hypertension in 2013-2016 was 45.37% and 10.65%, respectively, which was higher than that in 2009-2012(44.52% and 8.78%). In addition, the prevalence of abnormal blood glucose metabolism, abnormal blood lipid metabolism and abnormal glucose and lipid metabolism in the pre-hypertension group was higher than that in the normal blood pressure group, but lower than that in the hypertension group ( P<0.001). A logistic regression analysis indicated that age, overweight or obesity, hyperglycemia, hypertriglyceridemia and hypercholesterolemia were risk factors of pre-hypertension in male. Age, overweight or obesity, hyperglycemia, hypertriglyceridemia, hypercholesterolemia and hyper-low density cholesterolemia were associated with hypertension in male and with pre-hypertension and hypertension in female. Conclusions:Middle age, overweight/obesity, elevated fasting plasma glucose, elevated triglyceride and elevated total cholesterol were risk factors of pre-hypertension and hypertension in both men and women. Intervention on the related risk factors should be conducted as early as possible.