Objective To observe the changes of plasma calcitonin gene-related peptide (CGRP) and endothelin (ET) during propofol-induced anesthesia and intubationMethods Thirty-six patients were randomly allocated to receiving intravenous administration with propofol 2mg/kg ( group PP, n=20) or sodium thiopental group (SP, n=16) The venous bloos samples were taken to measure the plasma CGRP and endothelin (ET) concentrations, together with systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR), immediately before induction, 2min after P or SP administration, 2min, 7min, 15min after intubationResults SBP decreased immediately after induction in both groups (P005), increased markedly in group SP (P

Objective To investigate the clinic effects of transcatheter arterial chemoembolization (TACE) combined with injection of hyper- thermic lipiodol into tumor body in treating large hepatic carcinoma. Methods A total of 86 patients with primary hepatic carcinoma were randomly and equally divided into the study group (n = 43) and control group (n = 43). TACE combined with injection of hyper-thermic lipiodol into tumor body was carried out in the patients of the study group , while only TACE was performed in the patients of the control group. The results were compared between the two groups. Results The effective rate of the study group and the control group was 68%and 53%respectively , and the difference between the two groups was statistically significant. The difference in the changes of tumor size after the treatment between the two groups was also statistically significant. In the study group, the survival rates at 6, 12, 18 and 24 months after the treatment were 100% (n = 43), 84% (n = 36), 53% (n = 23) and 33%(n=14) respectively, while in the control group the survival rates were 94% (n=40), 70% (n=30), 37%(n = 16) and 21%(n = 9) respectively. No statistically significant differences in postoperative liver function damage existed between the two groups. Conclusion TACE combined with injection of hyper-thermic lipiodol into tumor body is obviously superior to routine TACE in treating large hepatic carcinoma.

From the Chinese medicine point of view on the physiological functions of healthy atmosphere and vitality, healthy atmosphere and vitality of the relationship, we can know that healthy atmosphere and vitality has important role in the life activities of the body. They complement each other. In the pathogenesis of AIDS, AIDS epidemic poi-son has the characteristics of wounding healthy atmosphere. When it attacks the body upright, vitality will be injured firstly. Because of that it is inextricably linked with the characteristics of the AIDS epidemic poison and vitality physiological functions. Therefore, AIDS epidemic poison attacks healthy atmosphere and vitality co-exist, the injury of healthy atmosphere and vitality is throughout the whole process of AIDS .

AIM: To investigate the effect of low concentration desflurane on hemodynamics and fibrinolysis in patients during general anesthesia. METHODS: Twenty eight ASA grade Ⅰ-Ⅱ patients during general anesthesia, scheduled for elective chest surgery, were studied, and hemodynamics and fibrinolysis were observed after inhalation of desflurane at 0.5 and 1.0 MAC , respectively. RESULTS: Compared with those before anesthesia, SBP, DBP, and MAP remarkably decreased and HR significantly increased at intubation. However, the changes were more remarkable than those of before anesthesia when inhalation of desflurane at 0.5 and 1.0 MAC ; blood pressure did not further decreased; and HR did not increased in comparison with intubation. The level of plasma tissue plasminogen activator (t PA) remarkably increased and the level of plasma plasminogen activitor inhibitor (PAI) significantly decreased when inhalation of desflurane. The level of plasma t PA further increased and the level of plasma PAI further decreased as inhalation of increased desflurane concentration. CONCLUSION: There are some effects of low concentration desflurane on hemodynamics and fibrinolysis in patients with chest surgery during general anesthesia.

Objective:To probe into if human molecular adjuvant hC3d3 promote the immunogenicity of hCG? antigen to human immuno-competent cells on the basis of fusion protein.Methods:The isolated B cells, the combination of B cells and T cells, PBMC and Raji cells were treated in vitro respectively with 1, 10 and 100 nmol/L hCG?, hCG?-hC3d3 or PWM for 8-12 days. The cell proliferation was determined by incorporation of [3H] thymidine. The Ig levels in the 12-day culture supernatants were measured by indirect ELISA. The Ig-secreting cells in the 10-day cultured lymphocytes were detected by the enzyme-linked immunospot(ELISPOT) assay.Results:It was found that the proliferation of B cells, the combined B and T cells, PBMC and Raji following exposure to hCG?-C3d3 fusion protein was significantly higher than that of hCG? alone. The levels of total Ig the in 12-day culture supernatants of B cell, the combined B and T cells, and PBMC treated with 100 nmol/L hCG?-C3d3 fusion protein were 4-fold, 10-fold and 10.85-fold more than that of hCG? alone. The Ig-secreting cells were significantly increased after treated with hCG?-C3d3 fusion protein compared to the hCG? alone.Conclusion:The human molecular adjuvant hC3d3 improves the immunogenicity of hCG? in human immuno-competent cells if fused to the antigen.

AIM: To observe the effect of continuous epidural analgesia (CEA) of tramadol on postoperative gastrointestinal function and serum motilin level in the patients with cholecystectomy. METHODS: Twenty eight ASAⅠ-Ⅱpatients (8 male, 20 female) aged 24-56 yr, scheduled for elective cholecystectomy under epidural anesthesia, were randomly divided into tramadol group (T, n=14) and control group (C, n=14). The combination of tramadol 800 mg+ bupivacaine 150 mg+ droperidol 5 mg, which diluted with normal saline to 100 ml and pumped 2 ml?h -1, was administered in group T. The combination in group C was bupivacaine 150 mg+ droperidol 5 mg. The VAS values, the first anorectum exhaust timing (FAET), and the time of the first eliminating stool timing (FEST) were recorded, and serum motilin level measured with radioimmunoassay at the different times after surgery. RESULTS: There was a significant difference in the mean VAS values between group T ( 1.2? 1.2) and group C ( 3.3? 1.3) (P

Objective To investigate the clinical and laboratory profiles of a patient with pustular psoriasis-like skin lesion and cerebral palsy due to biotinidase deficiency. Methods A 5 year and 4 month-old boy with biotinidase deficiency was confirmed by urinary organic acid analysis with gas chromatography/mass spectrometry (GC/MS)and biotinidase activity assay of peripheral blood. His clinical features, laboratory findings, treatment and outcome were studied. Results The boy showed difficulty in taking food after birth, gradually eczema and pustules appeared at the age of 2 months, and generalized erythema and intractable pustular psoriasis-like lesion at the age of 8 months. His intellectual development was normal with retardation of locomotor system. He had muscular dystonia at the age of 6 months. Physical examination showed generalized pustular psoriasis-like lesion, generalized paralysis, hypertonic contracture of extremities, sparseness of scalp hair and severe malnutrition. Routine laboratory tests showed a mild anemia, metabolic acidosis and elevation of plasma creatine phosphokinase. Increased excretion of urinary lactate, pyruvate, 3-OH-propionate, propionylglycine, and 3-methylcrontonylglycine were observed. Biotinidase activity of his peripheral blood was below 0.1 pmol/min/3mm (normal 6.3-9.3 pmol/min/3mm). Biotin (10 mg/day) supplementation led to a dramatic recovery of the skin lesion. After the treatment of rehabilitation, his muscle power was also improved gradually. Conclusions Dermatological and neurological manifestations are the main features of biotinidase deficiency. Early diagnosis and biotin administration can greatly improve the clinical symptoms. Generalized pustular psoriasis-like lesion and cerebral palsy of this boy have improved after the supplementation of biotin, but he may be remained wheelchair-dependent because of delayed diagnosis.

Objective:To explore the effect of student standardized patients in experimental teaching of Internal Medicine Nursing. Methods:Totally 440 undergraduate students in Batch 2016 from the Nursing Department of Chengdu Medical College were divided into 9 groups with 5-6 students in each group. The situational teaching method of students' standardized patients playing clinical cases was adopted in internal medicine experimental teaching, and the teaching effect was evaluated by the questionnaire survey after the class.Results:More than 90.45% (398/440) of the students thought that this teaching method could enhance the ability of knowledge understanding and memorizing, 91.36% (402/440) of them thought that it could improve their corporation with classmates, 90.23% (397/440) of them thought that various abilities such as clinical thinking could be improved, and 87.27% (384/440) of them were satisfied with it.Conclusion:Applying standardized patients to the experimental teaching of internal medicine nursing is effective and can stimulate students' learning enthusiasm, thus improving the teaching effect.

Objective To investigate maternal awareness and knowledge of obstructive sleep apnea syndrome (OSAS) and their compliance with polysomnography monitoring in snoring gravidas.Methods This study enrolled 589 volunteered gravidas who were treated at the 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force or Maternal and Child Health Hospital of Jiangxi Province from April 2016 to April 2017.The maternal knowledge of OSAS (0 point:complete lack of knowledge of OSAS;1 to 4 points:with partial knowledge of OSAS;5 points:correct understanding of OSAS) and the way of obtaining this knowledge were studied using a self-designed questionnaire.Influencing factors,including gestational weeks,educational background,snoring and high-risk pregnancy,were also analyzed.Chi-square test was used for statistical analysis.Results The 589 gravidas had few knowledge of OSAS and only 11 of them [1.9％ (11/589)] were able to fully understand OSAS (5 points).The proportion of women who were completely lack the knowledge of OSAS (0 point) in those less-educated women was higher than in those well-educated group [61.9％ (78/126) vs 52.0％ (241/463),x2=3.873,P=0.049].Among the gravidas who were unaware of their snoring condition,those completely lack the knowledge of OSAS (0 point) accounted for 67.0％ (209/312),which was higher than the percentage among gravidas knowing they had or did not have snoring problem [35.6％ (21/59),40.8％ (89/218);x2=20.755,35.687;both P＜0.017].There was no significant difference in OSAS awareness among gravidas regardless of their gestations and whether they were classified as high-risk or not (all P＞0.05).Of 59 gravidas with snoring,only 15 (25.4％) accepted polysomnography monitoring.Eight out of the 589 gravidas (1.4％) were diagnosed with OSAS during pregnancy.Conclusions Gravidas have poor knowledge and awareness of OSAS,especially those with low educational background and not knowing their snoring condition,resulting in poor compliance with polysornnography monitoring and low diagnostic rate of OSAS during pregnancy.

Objective:To analyze the clinical characteristics, therapeutic options and risk factors of mortality in patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infection, and to provide evidence for clinical treatment option and prognosis evaluation of CRAB bloodstream infections. Methods:A retrospective study was carried out in 224 patients with confirmed diagnosis of CRAB bloodstream infection during the period from January 2012 to December 2017 in West China Hospital, Sichuan University. The patients were divided into the death group and the survival group according to the survival status 28 days after collecting blood samples. The clinical features and therapeutic options of antibacterial drugs were reviewed. Student′s t test was used for analyzing normally distributed data and Mann-Whitney U test for non-normal data.Chi-square test was used for categorical variables. Univariate and multivariate logistic analysis were used to analyze the risk factors of mortality associated with CRAB bloodstream infection. Results:Among 224 cases of CRAB bloodstream infection, 121 cases died (54.02%). These patients were mainly in intensive care unit (ICU) and hematology department. The common underlying diseases were severe acute pancreatitis and severe cardiovascular events. The interleukin (IL)-6 level (median (interquartile range)) in the death group (480.40 ng/L (1 432.95 ng/L)) was higher than that of the survival group (107.05 ng/L (263.08 ng/L)), the difference was statistically significant ( Z=4.526, P<0.01). The procalcitionin (PCT) levels in the death group and the survival group were 3.81 μg/L (17.26 μg/L) and 2.12 μg/L (12.74 μg/L), respectively, with no difference between the two groups ( P>0.05). The death rate of empirical treatment with a single or more non-active antimicrobial agents was 57.14% (64/112), that of monotherapy with active agent was 45.68% (37/81), and that of combination therapy with at least one active drug was 64.52% (20/31). The differences had no statistical significance ( P=0.130). The logistic regression analysis showed that the risk factors of mortality associated with CRAB bloodstream infection were renal dysfunction (odds ratio ( OR)=2.181, P=0.024) and multiple organ dysfunction syndrome (MODS; OR=20.376, P<0.01). Conclusions:The fatality rate of patients with CRAB bloodstream infection is high. These patients with renal dysfunction or MODS have poor prognosis. In addition to early effective antibacterial therapy, individual comprehensive treatment should be implemented in order to improve the curative effect.