Objective To investigate the brain protective effects of isoflurane preconditioning for local cerebral is-chemia adult rat model by detecting HIF-1α, HO-1 and Bcl-2 expression level. Methods 84 two-month old Spra-gue-Dawley male rats were randomly divided into sham group, ischemia-reperfusion group ( MCAO group) and isoflurance preconditioning group (ISO group). ISO group was exposed to isoflurane for 30 min and then underwent a 90 min middle cerebral arterial occlusion (MCAO), while MCAO group underwent MCAO only. At 24 h after reperfusion all the groups were investigated by modified neurological severity score for neurological deficits, TTC staining for infarct percentage. Cerebral cortices were harvested for HIF-1α, HO-1 and Bcl-2 protein expression level detection at 6 h, 24 h and 72 h after reperfusion using RT-PCR and western blot. Results The mNSS score and infarct percentage in ISO group decreased significantly compared with those of MCAO group at 24 h after reper-fusion(P < 0. 05). Compared with the MCAO group, ISO group had significantly up-regulated protein levels of HIF-1α, HO-1 and Bcl-2 at 6 h and 24 h after reperfusion(P < 0. 05). There was no difference between ISO group and MCAO group for 3 gene expression at 72 h(P > 0. 05). Conclusion Isoflurane preconditioning plays short-term cerebral protective effect through the up regulation of HIF-1α, HO-1 and Bcl-2 gene expression.

OBJECTIVE: To discuss the application of endotracheal intubation in the rescue of children with severe trachea and bronchial foreign body. By observing the patient's clinical pathological characteristics, the diagnosis and treatment experience were summarized. METHOD: A retrospective analysis of 10 children with severe tracheal and bronchial foreign bodies were performed. They were given emergency intubation and cardiopulmonary resuscitation to relieve respiratory and circulatory failure after reaching hospital. After the restoration of spontaneous respiration, oxygen saturation increased by more than 90 percent and vital signs stable, the foreigh body was removed with bronchoscopy. The role of endotracheal intubation before and after the treatment of tracheal and bronchial foreign bodies in children was observed. RESULT: Ten cases of children were rescued successfully. No one died and the complications such as cerebral palsy, pneumothorax and pneumomediastinum didn't happened. CONCLUSION For the children with severe tracheal and bronchial foreign body, endotracheal intubation can establish effective ventilation in a shorter period of time. The earlier endotracheal intubation, the shorter time required and the higher success rate. Endotracheal intubation can increase the survival rate of children with cardiopulmonary resuscitation, and can reduce disability.
Bronchi ; physiopathology ; Bronchoscopy ; Child ; Foreign Bodies ; therapy ; Humans ; Intubation, Intratracheal ; Retrospective Studies ; Trachea ; physiopathology

Objective To evaluate the performance of ELISA by detecting low quantitative HBsAg in serums.Methods 305 serum samples that the quantitation range was from 0.05 IU/ml to 9.99 IU/ml were collected,and then detected by ELISA. Results The rate of patients with low quantitation of HBsAg was 18.12% in patients with positive HBsAg.The total de-tected rate of ELISA was 87.87%,and the rate of 0.05~0.11,0.12~0.20,0.21 ~0.50,0.51 ~ 1.00,1.01~5.00 IU/ml and 5.01~9.99IU/ml were 36.00%,61.11%,78.38%,84.62%,99.11% and 100.00%,respectively.The differences were statistically significant between the detected rates of each group(χ2 =99.84,P =0.000).There was high correlation coeffi-cient between the results detected by ELISA and by CMIA(r = 0.874,P = 0.000).Conclusion The clinical laboratory should be careful to apply the method of ELISA to detect HBsAg for its missing detection in samples with low quantitation of HBsAg.

Objective To evaluate the effect of stellate ganglion block (SGB) on cellular immune function in diabetic rats.Methods Healthy male Sprague-Dawley rats,aged 3 months,weighing 240-280 g,were used in this study.Diabetes mellitus was induced by intraperitoneal 1％ streptozotocin 60 mg/kg and confirmed by blood glucose ≥ 16.7 mmol/L 3 days later.Forty-eight rats with diabetes mellitus were randomly divided into 2 groups (n=24 each) using a random number table:diabetes mellitus group (group DM) and group SGB.Another 24 healthy rats,aged 3 months,were selected and served as control group (group C).At 1 week after successful establishment of the model,unilateral transection of cervical sympathetic trunk (TCST) was performed in group SGB,while the right cervical sympathetic trunk was only exposed in C and DM groups.Before TCST (T0) and on 1,3,7 days after TCST (T1-3),6 rats were randomly selected from each group,and blood samples were collected from the inferior vena cava for determination of the blood glucose,plasma norepinephrine (NE) concentrations (by enzyme-linked immunosorbent assay),and levels of T lymphocyte subsets CD3+,CD4+ and CD8+ in whole blood (using FACSCalibur flow cytometer).C D4+/CD8+ratio was calculated.The rats were weighed before sacrifice,and the rats were sacrificed to obtain the thymus which was weighed.The thymus index (thymus weight/body weight) was calculated.Results Compared with group C,the blood glucose was significantly increased,and the levels of CD3+ and CD4+ in whole blood,CD4+/CD8+ ratio,and thymus index were significantly decreased at T0-3 (P＜0.05),and no significant change was found in CD8+ levels in DM and SGB groups (P＞0.05),the plasma NE concentrations were significantly decreased at T1-3 in group SGB (P＜0.05),and no significant change was found in plasma NE concentrations in group DM (P＞0.05).Compared with group DM,the blood glucose and plasma NE concentrations were significantly decreased,and the levels of CD3+ and CD4+ in whole blood,CD4+/CD8+ ratio,and thymus index were significantly increased at T1-3 (P＜0.05),and no significant change was found in CD8+ levels in group SGB (P＞0.05).Conclusion SGB can improve the cellular immune function in diabetic rats.

Objective To evaluate the efficacy of oxycodone for patient-controlled intravenous analgesia (PCIA) after hip arthroplasty in elderly patients.Methods Sixty patients of both sexes,aged 65-85yr,weighing 42-89 kg,of American Society of Anesthesiologists physical status Ⅰ or]Ⅱ,scheduled for elective unilateral hip arthroplasty under general anesthesia,were divided into 2 groups (n =30 each) using a random number table:morphine group (group M) and oxycodone group (group O).Parecoxib sodium 40 mg was injected intravenously at 30 min before induction of anesthesia,followed by induction and maintenance of anesthesia.PCIA pump was connected at the beginning of skin closure.PCIA solution contained morphine 0.6 mg/kg and tropisetron 10 mg diluted to 100 ml in normal saline in group M and oxycodone 0.6 mg/kg and tropisetron 10 mg diluted to 100 ml in normal saline in group O.The PCA pump was set up with a background infusion at 2 ml/h,a 0.5 ml bolus dose and a 15 min lockout interval in both groups.Visual analogue scale score was maintained ≤ 3,and postoperative analgesia lasted until 48 h after operation.When analogue scale score ≥ 4,pethidine 50 mg/kg was injected muscularly as rescue analgesic.The requirement for rescue analgesic and occurrence of adverse effects were recorded.Results Ten percent patients required rescue analgesics in group M,and no patients required rescue analgesics in group O.Compared with group M,the requirement for rescue analgesics and incidence of nausea,vomiting and pruritus were significantly decreased in group O (P＜0.05).Conclusion Oxycodone provides reliable efficacy for PCIA after hip arthroplasty in elderly patients with fewer adverse effects,indicating that oxycodone produces good analgesic efficacy for severe somatalgia.

OBJECTIVE:To provide the clinical departments with a reference for promoting rational drug use. METHODS:The inpatient prescriptions given by orthopaedics and burn departments from Jun. to Dec. 2013 were selected randomly. The number of the selected prescriptions by each department accounted for 2% of the total prescriptions given by the corresponding department in that month,including 4 921 cases by orthopaedics department and 1 391 cases by burn department. Statistical analysis of irrational prescriptions was made according to Chinese Pharmacopoeia,New Materia Medica,the package insert, and other relevant references. RESULTS:1 821 prescriptions given by orthopaedics department and 378 by burn department were found to be irrational,accounting for 37.00% and 27.17% respectively. The reasons of irrationality mainly included im-proper compatibility,improper route of administration,contraindication in and use with caution by the elderly and children,re-peated drug use,improper drug combination etc. CONCLUSIONS:The system of prescription review should be strengthened, and clinical staff training system and pharmaceatical knowledge information platform are established to promote rational use of drugs.

OBJECTIVE: To discuss the clinical characteristic and surgical treatment of nasal sinus osteoma. METHOD: Fifty-one cases with nasal sinus osteoma were diagnosed by nasal sinus X ray or CT scan. All of these osteoma patients were cured by surgical resection. Supraorbital Lynch approach were applied in forty-two cases, lateral rhinotomy Moure approach in 4 cases, Caldwell-Luc approach in 3 cases and Dandy approach that combined with cranium and facial route in 2 cases. RESULT: Operative incisions in all cases healed in 1 period, no complications such as brain spinal fistula occurred. All cases were followed up for 6 months to 5 years, there were no recurrence of osteomas and occurrence of mucus cysts. CONCLUSION Osteomas in nasal sinus grow slowly. X ray or CT scan is helpful to confirm the diagnosis and choose the surgical approach reasonably.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Osteoma ; diagnostic imaging ; surgery ; Paranasal Sinus Neoplasms ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objective:To establish and evaluate the effect of graded training mode of clinical nutrition nursing in general hospital.Methods:A clinical nutrition nursing group was established, including core management group, quality control group, education and training group and liaison nurse group. Hierarchical training and practice of clinical nutrition nursing was conducted throughout the hospital, and effect of training was evaluated.Results:The nurses' nutrition knowledge increased from (66.60±9.72) to (85.06±7.85) points, nutrition attitude increased from (72.38±5.55) to (92.50±5.10) points, nutrition behavior increased from (66.87 ± 6.83) to (88.76 ± 7.60) points, and the differences were statistically significant ( t values were -15.520, -11.128, -12.238, P<0.01). The nutritional risk screening rate and nutritional intervention rate of patients were improved to 100%, and the academic level of nurses in nutritional nursing was further improved. Conclusion:The application of graded training mode of clinical nutrition nursing can improve nurses' nutritional knowledge and skills, improve nurses' professional and academic level, and improve patient clinical outcomes.

Objective To compare the genotype distribution of HPV in cervical cells of natural crowd and tissues of cervical in‐traepithelial neoplasia(CINⅢ grade) and cervical carcinomas patients .Methods PCR and gene‐chip technology were utilized for the genotype detection of 23 kinds of HPV in cell specimens from 1 047 women of natural crowd (normal group) and tissue specimens from 173 cases of cervical intraepithelial neoplasia(precancerosis group) and 133 cases of patients with cervical carcinoma (cervical carcinoma group) .Results There were 109 ,159 and 121 cases of HPV positive specimens respectively in normal group ,precancer‐osis group and cervical carcinoma group ,and the HPV infection rates were 10 .41% (109/1 047) ,91 .91% (159/173) and 90 .98%(121/133) ,respectively .Conclusion PCR and gene‐chip technology can be used to detect HPV genotypes in cervical cells and cer‐vical tissues specimens .

Objective To analyze the clinical and laboratory characteristics of systemic lupus erythematosus (SLE) in children. Methods Fifty-three inpatients, 5 boys and 48 girls with SLE, who aged from 7 to 14 years with a median age at 12 years, were enrolled into this study. A retrospective study was carried out to assess the clinical and laboratory features of these pediatric patients. Results The ratio of male to female patients was 1:9.6. Skin eruption was the most common initial manifestation (41.51%), followed by fever (20.75%) and arthralgia (20.75%). Systemic involvement was common, and 84.90% of these patients had hematological abnormalities, 60.38% renal involvement, 18.87% nervous involvement. The most common manifestation of hematological, renal and nervous involvement was anemia, proteinuria and seizures, respectively. Among the immunologic parameters tested, anti-nuclear antibody showed the highest positivity rate of 90.57%, followed by anti-dsDNA with a positivity rate of 67.92%. There was no significant difference between the male and female patients in the age of onset, SLEDAI score at admission and discharge, duration of hospitalization or the dose of corticosteroid used initially and at the discharge. Conclusion The manifestations of pediatric SLE are various, and multisystem involvement is common in these patients. Early diagnosis and active treatment might benefit the prognosis of pediatric SLE.