Objective To explore the effect of dexmedetomidine on the stress reaction and incidence of shivering in intravenous inhalation combined anesthesia scheme,and to improve the quality of anesthesia recovery accumulate experience.Methods 76 patients in Affiliated Union Hospital of Fujian Medical University from 2010 March to 2013 April were divided into study group and control group using random double blind method(n=38).Two groups of patients were underwent intravenous inhalation combined anesthesia,the research group in the process of anesthesia administered dexmedetomidine intravenous infusion,the control group was given normal saline intravenous infusion of the same dose,the same rate.The recovery period MAAS (muscle activity score),HR (heart rate),MAP (mean arterial pressure)and the incidence of shivering of two groups were observed and compared.Results The MAAS score on 5 min after extubation of study group was lower than that of control group (P<0.05);the MAP and HR values immediately in the drawing or after extubation 30 min in study group were lower than control group (P<0.05 ).The incidence of shivering and the chill time in study group was lower and shorter than control group (P<0.05).Conclusion Dexmedetomidine could effectively reduce the recovery period of stress level,and reduce the incidence of shivering in treatment of patients with intravenous inhalation combined anesthesia,It is conducive to patient of vital signs stable in recovery period.

Objective To construct a safe data-back-up system with disaster-tolerant ability. Methods Based on the concept of data back -up, the paper puts forward several data back -up modes in common use, and carries out corresponding comparison. Results The author synthesized these back -up modes into an ideal, feasible, and highly secure system architecture with disaster-tolerant ability. Conclusion Constructing a safe data-back-up system are becoming the mostly indispensable elements for the hospital informationization. It can avoid the single fault in the hardware level, and also can repair the logical data fault in the software level.

Objective To investigate the effect of exercise and a loe on serum antioxidant enzyme activity in diabetic rats. Methods Adult male Streptozotocin-diabetic rats were used as research subject. Afte r exercise, aloe and exercise combines aloe treated, the changes in SOD, GSH-Px, CAT activity, MDA contents, blood glucose and insulin were measured. R esults The level of SOD, GSH-Px, CAT activity and insulin of treated diabetic groups were significant higher (P

Objective To investigate the signaling mechanisms underlying synergistic induction of MUC5AC mucin by nontypeable Haemophilus influenzae(NTHi)and epidermal growth factor (EGF).Methods The expression of MUC5AC was measured by real-time quantitative polymerase chain reaction(PCR)and Luciferase assay.Western blot was performed to examine the synergistic induction of phosphorylation of P38,extracellular signal-regulated kinase(ERK)and P21-activated kinase(PAK)4 or the effect of dominant negative mutant of PAK4 on the synerglstic induction of phosphorvlation of P38 mitogen-activated protein kinase(P38MAPK)and ERK in HM3 cells treated with NTHi and EGF.Luciferase asgay was also performed to examine the effect of P38,ERK inhibitors or dominant negative mutants of P38MAPK and ERK on synergistic enhancement of NTHi-induced MUC5AC up-regulation by EGF at transcriptional level.Real-time quantitative PCR was performed to examine the effect of PAK4 siRNA on synergistic induction of NTHi-induced MUC5AC up-regulation by EGF.ResuIts NTHi induced MUC5AC mucin expression at both mRNA and transcriptional levels.Synergistic induction of phosFIhorylation of P38MAPK,ERK and PAK4 were observed in HM3 cells treated with NTHi and EGF.Either SB203580,a specific inhibitor for P38MAPK or PD98059,a specific inhibitor for ERK inhibited synergistic induction of MUC5AC at transcription level.Furthmore, overexpressing dominant negative mutant of P38MAPK and ERK also inhibited synergistic induction of MUC5AC at transcription level. PAK4 siRNA inhibited the synergistic induction of MUC5AC by NTHi and EGF. Overexpressing dominant negative mutant of PAK4 also reduccd synergistic induction of phosphorylation of P38 and ERK. Conclusion Synergistic induction of MUC5AC mucin by NTHi is up-regulated by EGF via PAK4-dependent P38MAPK and ERK pathways.

Objective To improve the reliability of the core database system by ameliorating the scheme of the server system architecture. Methods Combined with practice of the hospital informatization, the security and potential hole of the database server system were analyzed and evaluated. Results Aimed to deal with the security hidden-trouble, a mini-server was adopted instead of PC server, while SAN(Storage Area Network) was utilized instead of RAID-5, and mirror copy technique was used to implement the real-time hot copy of the data. Conclusion Consequently the reliability of the system has been greatly improved.

Objective:To investigate the incidence and related factors with sarcopenia in maintenance hemodialysis patients.Methods:A total of 131 patients with non-hospitalized maintenance hemodialysis who had been maintained for at least 3 months and in a stable condition were enrolled in a cross-sectional study.Bioelectric impedance analysis (BIA) method was employed to examine the muscle mass.MQSGA questionnaire was used to evaluate patients'nutrition status as well as related laboratory indicators.Logistic regression was used to analyze the risk factors of sarcopenia in MHD patients.Results:The incidence of sarcopenia in 131 MHD patients was 41.22％ (54/131).Significant differences were observed in gender,duration of hemodialysis,hs-CRP and the score of M(Q)SGA between the two groups.The incidence of sarcopenia in male was 43.67 times compared with female.And with the increase of hs-CRP levels and MQSGA score,the incidence of sarcopenia was increased as well (P ＜0.05).Conclusion:Sarcopenia has a high incidence in MHD patients,and male,micro-inflammatory state and malnutrition were the risk factors.

Objective: To explore early diagnostic value of combined detection of ischemia-modified albumin and other biochemical markers for acute coronary syndrome (ACS). Methods: A total of 156 patients, who received treatment within 4h because of chest pain onset, were divided into ACS group (n=112) and non-ischemic chest pain group (NICP group, n=44) according to coronary angiography (CAG). Blood sample was taken within 4h and during 4~8h after chest pain to measure cardiac biochemical markers, including ischemia-modified albumin (IMA), LDH, CK, CK-MB and cardiac troponin I (cTnI), comprehensive analysis was performed by detected results of above biochemical markers and CAG. Results: For diagnosis of ACS, within 4h after onset IMA possessed highest sensitivity (87.50%) and highest accuracy (80.77%), cTnI possessed highest specificity (95.45%); In 4～8h IMA still possessed highest sensitivity (91.07%), cTnI still possessed highest specificity（97.73%）, CK（85.90%），and IMA（85.25%）possessed highest accuracy （both CK and IMA had no significant difference）; According to comprehensive analysis, regardless of within 4h or during 4~8h after chest pain, IMA possessed highest sensitivity and highest accuracy, cTnI possessed highest specificity. Within 4h after chest pain, detection of IMA combined above-mentioned other four indexes increased sensitivity (89.28%), specificity （95.45%） and accuracy （91.02%）to highest level. Conclusion: For diagnosis of ACS, IMA possesses highest sensitivity and highest accuracy, cTnI possesses highest specificity; IMA combined above-mentioned other four indexes may increase sensitivity, specificity and accuracy to highest level.

Objective To explore the effects of parents'participatory functional training on the prognosis of newborn babies with hypoglycemic brain injury.Methods Functional training was given to 32 parents of newborn babies with hypoglycemic brain injury and then carried out on their babies for three months.The clinical symptoms and clinical efficacy of the babies and parents'satisfaction with nursing care were then observed.Results The clinical symptoms of the babies were improved significantly after training, and the parents had significantly higher satisfaction with nursing care as compared to pretraining (p<0.01).After training, 22 babies showed significant clinical efficacy (68.75%) , 8 babies had the targeted effect (25.00%);and the total effect rate was 93.75%.Conclusion Parents'participatory functional training helps to improve the prognosis of newborn babies with hypoglycemic brain injury and reduce the incidence of neurological sequelae.

Abstract: This retrospective analysis examines the diagnosis and treatment of a case of chronic liver disease infected with Vibrio vulnificus, admitted to the First Affiliated Hospital of Hainan Medical University on August 8, 2023. The patient, a 34-year-old male fisherman, had chronic viral hepatitis B. He sustained a leg abrasion while fishing on August 3, and developed fever and continuous swelling pain in both lower limbs, more severe in the left limb, on the night of the injury. On the fourth day of the disease, he went to the local hospital where he received antibiotic treatment and was transferred to the First Affiliated Hospital of Hainan Medical College on August 8. Upon admission, the patient exhibited low blood pressure, high lower limb skin temperature, poor peripheral blood transport, visible scab, and signs of infectious shock. Within 12 hours of admission, an abscess incision and drainage procedure was performed on his left calf, along with negative pressure wound therapy, and tissue samples from the infected left lower limb were sent for microbial culture.The pathogen culture indicated a Vibrio vulnificus infection, and the histopathology results confirmed necrotizing fasciitis. Treatment included meropenem combined with vancomycin for infection control, maintenance of blood pressure and electrolyte balance, tenofovir disoproxil fumarate for antiviral therapy, and polyene phosphatidylcholine capsules for liver protection based on the drug sensitivity results. Additionally, levofloxacin and cefotaxime were administered for infection control and debridement was performed based on wound conditions. After 17 days of hospitalization, the infection was substantially controlled, but the liver function enzyme was still higher than the normal level, and the wound still had blood and exudation. The patient and his family members requested discharge; however, due to poor wound healing, he was readmitted on September 11, 2023, receiving antiviral and liver preservation treatment. On the fifth day,the secretion culture identified a co-infection with Corynebacterium striatum and Providencia stuartii infection. Corynebacterium striatum was subsequently reported as multidrug-resistant, prompting an immediate switch to sensitive antibiotics and supportive care. Sixteen days after readmission, the patient's general condition improved, but the liver function enzyme levels were still higher than normal, so he was discharged. Four months after discharge, a follow-up phone call revealed that the patient had actively pursued antiviral treatment and abstained from alcohol, showing reasonable wound recovery. The patient's case, with a typical exposure history and clinical manifestations, matches the characteristics of septic shock and necrotizing fasciitis caused by V. vulnificus. Clinically, it is crucial todiagnose and treat V. vulnificus infection early according to its pathological characteristics and clinical characteristics to improve the prognosis of patients.

Objective To observe the clinical efficacy and adverse reaction of the combination of fiudarabine,cytarabine and granulocytecolony-stimulating factor (G-CSF) (FLAG regime) therapy for refractory and relapsed acute leukemia in children. Methods From 2004 to date, a total of 9 patients with relapsed and refractory acute leukemia patients in our hospital accepted the treatment, in 9 cases 8 cases were AML,1cases were ALL; in 9 cases 5 cases were refractory acute leukemia, 4 cases were recurrent acute leukemia.Results Among the 9 cases,6 cases with 1 cycles of chemotherapy achieved complete remission (CR),CR rate was 66.7 ％ (6/9); partial remission (PR) rate was 22.2 ％ (2/9),total efficiency (CR+PR) was 88.9 ％.In 6 CR patients 2 underwent hematopoietic stem cell transplantation, are disease-free survival; this regimen' s main adverse reactions were infection,bone marrow depression and gastrointestinal reaction.Conclusion The remission rate of FLAG regimen in the treatment of children with refractory and relapsed acute leukemia is relatively high, adverse reactions were tolerable; the FLAG program is a choice for the treatment of children with refractory and relapsed acute leukemia,which provides the opportunity for subsequent hematopoietic stem cell transplantation.