Objective To compare the effect of different general anesthesia method on preoperation cognitive function in elderly patients.Methods According to the digital table,82 elderly patients(non cardiac surgical operation) were selected and divided into the two groups,each group 41 cases.The group A was given to sufentanil combined with propofol intravenous injection anesthesia,and the group B was given to sevoflurane inhalation anesthesia.The cognitive function of patients of two groups in preoperative,postoperative 3h,6h,24h were assessed by simple intelligence scale(MMSE),and the indicators of postoperative recovery were evaluated.Results The postoperative sleep time [(6.9 ± 1.2) min],language ability recovery time [(9.8 ± 2.2) min] in the group A were all higher than those of group B (t =6.687,5.640,all P ＜ 0.01).The MMSE scores in group A after 3h [(17.1 ± 2.2) points],6h [(19.6 ±2.7)points],24h[(22.4 ±2.3) points] were lower than those of group B(t =10.026,6.229,5.082,all P＜0.01).And the PCOD rate in group A after 24h was 36.6％,which was higher than 17.1％ in group B(x2 =3.98,P ＜ 0.05).Conclusion The inhalational anesthetic methods has more quickly postoperative recovery,lower incidence of cognitive dysfunction,better clinical effects.

Objective To investigate the multi-organ lesions and the occurrence of coronary aneurysms in children with Kawasaki disease(KD).Methods 92 pediatric inpatients with KD were enrolled and studied.The organs involved and coronary aneurysms(CAA)were determined by checking blood routine,urine routine,stool routine,chest X-ray,electrokardiogram,liver function,echocardiogram,and clinical manifestation.Results The incidence of various organs involved in 92 patients with KD:heart 71.7%;lung 37.0%;liver 34.8%;brain 12.0%;kidney 18.5%;gastrointestinal tract 15.2%;spleen 2.2%;gallbladder 1.1%;joints 9.8%.In addition,the rate of two organs involved simultaneously was 40.2%,three and more 34.8%.The incidence of CAA in brain lesion,joints lesion and pericardial effusion complications of KD was 45.5%,44.4%,and 41.7%,respectively.Conclusions The data shows that the incidence of heart involvement in the sick-children with KD is highest,and other organs,such as lung,liver,kidney,gastrointestinal tract,brain and joints are involved in turn.The incidence of 2 and more organs involved simultaneously amounts to75.0%.CAA is the most serious complication of KD.Our study suggests that the incidence of CAA is obviously high in these lesions of brain,joints and pericardial effusion involvement in KD.

years ago, Noma first applicated the patch\|clamp technique to CN\|treated mamammalian heart cells,evealed specific K + channels which were depressed by intracellular ATP at level greater than 1 mM.He suggested the ATP-sensitive channels are important for regulating cellular energy metabolism in the control of membrane exitability.Recent studies supported the hypothesis and suggested that ATP-sensitive channels play an important role in hypoxia,myocardial ischemia/reperfusion and is chemic preconditioning.

AIM: To determine the effects of phospholipase A 2 (PLA 2) and K ATP on rat ischemia/reperfusion(I/R)-induced arrhythmia. METHODS: Myocardial ischemia and reperfusion were produced by occlusion and reirregation of the left anterior descending artery(LAD). An inhibitor of PLA 2, 5,5-dithio-bis(2-nitrobenzoic acid) (DTNB) (16 mg /kg), a K ATP opener pinacidil (0.2 mg/kg), a K ATP blocker glibenclamide (0.3 mg/kg) was used 5 min prior to 10 min regional ischemia and 10 min reperfusion. RESULTS: DTNB (16 mg/kg) reduced the scores of arrhythmia, creatine kinase (CPK) and lactate dehydrogenase(LDH) (P

The public ethics consciousness,with medical ethics included,fundamentally depends on the gradual improvement in the self-identity of human as objective itself.However,the improvement of humanistic consciousness is a long and painful process.Former recognition of historical culture,including the humanistic ideal in traditional Chinese ethical thoughts and systemic rational thoughts in modern western society,mainly employs transcendental test of abstract anthroposophy as its cultural premise,superficially enhancing certain individuals and their thoughts,motives,and objectives to historical ontology,but actually resulting in the absence of human individuals in realistic history.The self-conscious improvement of human-oriented public ethics can only be realized by the subjective humanistic consciousness which undergoes the regression from axiology,epistemology,to existence theory,making human realize that they themselves are the utmost purpose of all values and significances.

Objective To analyze the present situation of medical service prices in Beijing,and provide scientific basis in order to carry out the reform of medical service prices of the city.Methods Literature review method to collate the administration policy of medical service price in Beijing,and the method of statistical analysis to compare the Beijing medical service prices with 1 9 other provinces across the country.Results The number of medical service projects (4 613 )in Beijing is higher than the national average (4 507),but the average medical service prices (423 yuan)in Beijing is lower than the national average (609 yuan),and medical service price and the regional economic level has no statistical significance Conclusion Medical service prices of Beijing need to be adjusted,and a reform of medical service prices in Beijing should be implemented by the Development and Reform Commission,Health and Family Planning Commission.

Objective To evaluate the application value of virtual touch tissue quantification(VTQ) in the differential diagnosis of small breast lesions.Methods Fifty-six patients with sixty-nine small breast lesions whose largest diameter were less than or equal to 1 cm were evaluated with VTQ.The shear wave velocity (SWV) of the lesions and normal breast tissue were measured to analyze the diversity of different pathological types lesions of SWV and to find the optimal cut-off points using ROC curve to predict small breast cancer.Resuits The mean SWV(Vm) and the ratio (mean of lesions and normal tissue) of SWV (Vm1/Vm2) in benign group was (2.93 ± 1.32)m/s,1.79 ± 0.63,respectively,and that in malignant group was (5.65 ± 2.63) m/s,3.61 ± 1.35,respectively,there were statistically significant differences between benign group and malignant group (t test,P ＜0.05).The cut-off point of Vm was determined as 4.43 m/ s,the sensitivity,specificity and accuracy of diagnosing breast cancer were 80.5％,89.3％,92.8％,respectively.The cut-off point of Vm1/Vm2 was determined as 2.37,the sensitivity,specificity and accuracy of diagnosing breast cancer were 76.9％,81.2％,89.9％,respectively.Conclusions VTQ technique can provide helpful information in the differential diagnosis of small breast lesions.

OBJECTIVE:To establish a method for the determination of dissolution of Xiaocaihu pill,and compare the differ-ence of preparation from different manufacturers. METHODS:Using 0.1 mol/L HCl as dissolution medium,rotating basket method was used to determine the dissolution of preparations. HPLC was adopted to determine the content of baicalin:column was TSKgel ODS C18 with mobile phase of methanol-water-phosphoric acid (65∶35∶0.7,V/V/V) at a flow rate of 1 ml/min,detection wave-length was 280 nm,column temperature was 30 ℃,and injection volume was 5 μl. RESULTS:The linear range of baicalin was 0.488-124.8 mg/L (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2.0%;recovery was 100.14%-104.78%(RSD=1.58%,n=9). The average t50(50% dissolution time)of baicalin was 85.81 min. CONCLUSIONS:The method is simple with good precision,stability and reproducibility,and can be used for the dissolution determination of Xiaocaihu pill. Xiaocaihu pill from different manufacturers shows great differences,both preparation formulation and clinical use should attach importance to the dissolution of solid preparations.

Objective To evaluate the value of Alberta Stroke Program Early CT Score on diffusion weight-ed imaging(DWI-ASPECTS)in predicting the leptomeningeal collateral circulation(LMA)compensation of isch-emic stroke with middle cerebral artery stenosis or occlusion after intravenous thrombolysis. Methods A total of 178 patients with ischemic stroke confirmed as severe middle cerebral artery stenosis or occlusion by imaging were enrolled in the study.All the patients were treated by rt-PA intravenous thrombolysis.The baseline clinical date, DWI-ASPECTS,mRS and NIHSS were collected. LMA was assessed by cranio-cervical CTA. Results Compared with the poor collateral circulation group,the triglyceride level and DWI-ASPECTS were significantly increased in good collateral circulation group(P<0.05).The proportion of hypertension,NIHSS score,mRS score in good col-lateral circulation group were significantly lower than those in the poor collateral circulation group(P < 0.05). Compared with the poor collateral circulation group,insula,the ASPECTS areas M1 to M4,M6 and insula showed significantly fewer infarctions in good collateral circulation group(P<0.05).ROC analysis showed the area under ROC curve(AUC)of DWI-ASPECTS to predict LMA compensation were 0.932,the cutoff point of DWI-ASPECTS was 7.5.the sensitivity and specificity were 81.% and 94.1%.Conclusions The tissue protective role of good lepto-meningeal collateralization seems to be more pronounced in cortical and subcortical areas M1 to M4,M6 and the in-sula.DWI-ASPECTS can effectively predict the collateral circulation compensation in patients with acute middle ce-rebral artery infarction.

Objective To investigate the diffevential diagnostic value of preinvasive and invasive lung adenocarcinoma (including minimally invasive adenocarcinoma and invasive adenocarcinoma) presented as pure ground-glass nodules(pGGN) by CT.Methods One hundred and fifty-six cases of pGGN verified by operative pathology were retrospectively analyzed,including 58 ca ses of preinvasive adenocarcinoma and 98 cases of invasive adenocarcinoma(TNM staging were T1N0M0).The CT features and sex were statistically processed.The difference between the CT features and sex were performed by thex2 test.The ROC curve of lesion focus size was drawn.Results Statistically significant differences were found in the lesion shape,vacuole sign,air bronchogram,blood vessel through,tumor-lung interface and vascular cluster sign between the two groups(all P＜0.05).The ROC curve showed that the accuracy rate of invasive adenocarcinoma was 75.0％ when the size of the pGGN lesions was larger than 15.35 mm.Conclusion The lesion size,shape,vacuole sign,air bronchogram,blood vessels through and vascular cluster sign have some predictive value.