Objective To observe the effect of fluid resuscitation on hemodynamies and oxygen in severe trauma patients. Methods Parameters of hemodynamic and oxygen metabolism in different fluid volume resuscita-tion in 24 severe trauma patients who were injured on abdominal were measured. Results By fluid resuscitation, as the systolic blood pressure was raised from 80～90 mm Hg(1 mm Hg=0.133 kPa) to 100～120 mm Hg,cardiac in-dex rose from (2.0±0.5 ) L/(min·m2) to (3.2±0.6) L/(min·m2) (P<0.05), systemic vascular resistance index rose from (1857.6±750.2) dyn·s/(cm5·m2) to (3741.5±862.1) dyn·s,/(cm5·m2) significantly (P<0.05). Meanwhile, oxygen delivery index rose from (301.1±74.1) ml/(min·m2) to (554.1±80.0) mL/(min·m2) (P<0.05), and oxygen consumption index also rose (99.7±51.4) mL/( min·m2) to (147.2± 60.1) mL/(min·m2) remarkably (P<0.05), the rate of oxygen expenditure decreased from (33.1±9.1) % to (26.6±8.0) % significantly (P<0.05). Conclusion Large volume resuscitation maybe benefit to the improve-ment of hemodynamics and oxygen metabolism in the emergency resuscitation.

OBJECTIVE:To introduce the operation instructions and routine maintenance method of horizontal laminar flow cabinet(HLFC) in PIVAS to provide reference for standardized operation of HLFC.METHODS:The standardized utilization and maintenance of HLFC in respects of compositions,operation principle,operation instructions,etc.RESULTS & CONCLUSIONS:The standardized operation and correct maintenance can ensure the dispensation quality of intravenous drugs and extend service life of HLFC.

Objective To establish the quality standard for Xuanshi Texiao Yaoshui(mainly composed of Radix Sophorae Flavescentis,Cortex Pseudolaricis,etc).Methods Radix Sophorae Flavescentis and Cortex Pseudolaricis were identified by TLC.The content of oxymatrine was determined by HPLC.Symmetry C18 column(4.6 mm? 250 mm,5 ? m)with mobile phase of methanol-water-triethylamine(40:60:0.04)was used.The detective wavelength was 220 nm.Results TLC for Radix Sophorae Flavescentis and Cortex Pseudolaricis was specific .HPLC for oxymatrine had a good separation with other components,and the linear range of oxymatrine was 0.60～ 1.80 ? g and recovery rate was 99.34 %(RSD =0.71 %).Conclusion This method can be used to control the quality of Xuanshi Texiao Yaoshui.

Objective: To study mental state of children with hematological malignancies in hospital and psychosomatic symptoms of their parents Method:EPQ for children and CBCL (Achenbach children's behavior checklist) were applied to 57 children with hematological malignancies in hospital, SCL-90 were applied to their parents Children in the same hospital with other diseases were sampled as control matched by age, sex etc Results:Children with malignancies had lower scores in extro-introversive than control The rate of behavior problems was 21%, manifested as boys with somatic complaints, delinquency and social problems; and girls with depression and social withdraw Parents of children with malignancies had higher score of SCL-90 than parents of children as control There was positive correlation between SCL-90 score of parents and behavior problems of their children with malignancies Conclusion:Family with children with hematological malignancies needs more care and help

Objective To investigate the clinical effects of fluoxetine combined with small doses of aripiprazole in treatment of post -stroke depression and the influence on the recovery of neurological function. Methods 74 patients with post stroke depression were randomly divided into the two groups,all patients were given routine comprehensive treatment,the control group treated with fluoxetine,while the observation group was treated with fluoxetine combined with small doses of aripiprazole,clinical curative effect,neurological deficits and activities of daily living of the two groups were compared.Results The total effective rate of the observation group was 94.59%,which was significantly higher than 78.38% of the control group (χ2 =9.78,P<0.05);NIHSS scores of the observation group at the end of 4 week and 8 week of treatment were (10.85 ±1.22)and (6.03 ±0.78),which significantly reduced than that of the control group(t=6.18,6.62,all P<0.05 );Barthel index of the observation at the end of 4 weeks and 8 weeks of treatment were (49.56 ±4.68)and (67.43 ±4.75),which significantly increased than that of the control group(t=6.63,7.00,all P<0.05);The incidence of adverse reactions of the two groups had no signif-icantly different(χ2 =2.38,P>0.05).Conclusion Fluoxetine combined with small dose of aripiprazole has an ex-act effect in the treatment of post stroke depression,with high security.

Objective To study the clinical manifestation of preeclampsia complicated with placental abrup-tion and its treatment measures.Methods 160 patients with placenta abruption were selected,and the patients with preeclampsia complicated with placental abruption were selected as the study group(70 cases),and the patients with non preeclampsia complicated with placental abruption were selected as the control group(90 cases).The clinical manifestations,infant outcome and treatment measures of the two groups were compared.Results When the disease attack of the study group often accompanied with vaginal bleeding,but few had symptoms of abdominal pain,the main symptoms of the control group was vaginal bleeding and abdominal pain.The occurrence rate of abdominal pain of the two groups had statistically significant difference(4.3%vs 92.2%,χ2 =11.032,P<0.05);The placental abruption of the study group wasⅡdegree andⅢdegree(81.4%)while the control group wasⅠdegree(62.2%),with signif-icant difference between the two groups(χ2 =10.973,P<0.05);The incidence of fetal distress of the two groups had no statistical significant difference(95.7% vs 93.3%,P>0.05);The incidence of neonatal asphyxia of the two groups had no significant difference(56.6%vs 55.6%,P>0.05);The perinatal mortality of the two groups had sta-tistically significant difference(31.7%vs 11.1%,P<0.05);1 case of patient′s cervix was fully opened in the study group when at 28 weeks gestational,and been given the vaginal delivery,all others were given operation to terminate the pregnancy,3 cases in the control group used the vaginal delivery,there was no significant differences between the two groups(P>0.05).Conclusion The clinical manifestation of preeclampsia was not typical,with a greater harm to the fetus and perinatal infant,operation to termination of pregnancy is the main method for treatment of preeclamp-sia complicated with placenta abruption.

The paper gives an account of the four systems that are currently used for evaluating hospital quality in America, viz. America's Best Hospitals, Solucient 100 Top Hospitals, International Quality Indicator Project, and the Joint Commission on Accreditation of Healthcare Organizations. The "America's Best Hospitals" methodology takes into account three factors, infrastructure, process and outcome. Hospitals are first ranked in specialties, then the index of hospital quality is calculated by means of weighted indexes, and after that the best hospitals are selected according to the specialty rankings and the number of the hospitals. The "Solucient 100 Top Hospitals" methodology selects 100 top hospitals among hospitals of the same size on the basis of hospital quality and safety indexes. The evaluation indexes include eight items, such as index of risk-adjusted mortality rates, index of complications, and disease severity-adjusted average length of hospital stay. The methodologies of "International Quality Indicator Project" and "the Joint Commission on Accreditation of Healthcare Organizations" are used in many countries to evaluate clinical efficiency and enjoy high reputation in monitoring and promoting medical quality.

BACKGROUND: So far there is a lack of reliable biomedical evidence about the effects of three-dimensional y (3D) printed porous β-tricalcium phosphate (β-TCP) scaffold loading poly(lactic-co-glycolic acid) (PLGA)/anti-tuberculosis drug control-release microspheres on the growth and proliferation of cel s, especial y osteoblasts. OBJECTIVE: To construct porous β-TCP scaffold loading PLGA/anti-tuberculosis drug control-release microspheres by 3D printing technology and to detect its cytotoxicity. METHODS: Twenty porous β-TCP scaffolds whose aperture was 400 μm were prepared by 3D printing technology. Ten of these scaffolds were randomly selected for loading PLGA/anti-tuberculosis drug control-release microspheres, and the others were without any drugs. Then the extracts from two groups were cultured with osteoblasts for 72 hours. Afterwards, cel morphology was observed by inverted phase contrast microscope, and the absorbance value was detected using cel counting kit-8 assay. Besides, the relative growth rate of osteoblasts was calculated to evaluate the cytotoxicity of the scaffold. RESULTS AND CONCLUSION: The drug-loaded scaffold exhibited with moderate size, regular structure and uniform pores. Within 72 hours of culture in the extracts from the drug-loaded scaffold, elongated or fusiform osteoblasts appeared, with less karyopycnosis. Moreover, the drug-loaded scaffold showed slight cytotoxicity, which was classified as grade 1. In conclusion, the 3D-pinted porous β-TCP scaffold loading PLGA/anti-tuberculosis drug control-release microspheres exhibits no obvious cytotoxicity.

Objective To determine the relationship between neuronuscular block induced by cisatracurium for tracheal intubation during anesthesia induction and types of myasthenia gravis (MG).Methods Sixty-five patients of both sexes with MG,aged 20-75 yr,weighing 53-92 kg,with body height of 155-185 cm,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective videoassisted thoracoscopic thymectomy,were enrolled in the study.Among the 65 patients,there were 8 patients with ocular MG (type Ⅰ),19 patients with mild generalized MG (type]Ⅱ a),33 patients with subacute generalized MG (type Ⅱ b),2 patients with acute MG (type Ⅲ) and 3 patients with late severe MG (type Ⅳ).Neuromuscular monitoring was initiated when the patients lost consciousness after induction of anesthesia.Cisatracurium was administrated with the initial dose of 0.05 mg/kg,and if T1 depression was less than 95％ within 6 min,cisatracurium 0.015 mg/kg was intravenously injected until T1 depression was more than 95％.The patients were then tracheally intubated.The amount of cisatracurium consumed for intubation,onset time (from the beginning of cisatracurium injection to T1 depression ＞95％) and recovery time (recovery of T4/T1 to 25％ of control height) of neuromuscular block were recorded.T1 depression ＞ 95％ within 6 min after administration of 1-fold ED95 cistracuriun was defined as sensitivity to muscle relaxants.The requirement for cistracurium ＞ 1-fold ED95 when T1 depression ＞ 95％ was defined as insensitivity to muscle relaxants.The proportion of sensitivity/insensitivity was calculated.Results There was no significant difference in the amount of cisatracurium consumed for intubation and onset time and recovery time of neuromuscular block between patients with type Ⅰ and those with type Ⅱ a (P＞0.05).Compared with patients with type Ⅰ and type]Ⅱ a,the amount of cisatracurium consumed for intubation was significantly decreased,the proportion of sensitivity/insensitivity was increased,the onset time was shortened,and the recovery time was prolonged in patients with type Ⅱ b (P＜0.05).Conclusion With the severity of MG,the consumption of cisatracurium is gradually decreased when used for tracheal intubation during anesthesia induction,and the sensitivity is gradually increased in the patients with MG.

Objective The observation of curative effect and nursing for micro-penetration heating treating wound arms and legs fracture after the operation. Methods 76 cases of the patients suffered from wound arms and legs fracture are divided into 38 cases as the observation group and 38 cases the comparison group at random. The comparison group is treated by normal method only and the observation group is started to be treated by micro-penetration heating treating device for the ray based on the normal method only the second day after operation. Results The observation group is superior to the comparison group in pain situation, wounded infection rate and coalescence time totally (P<0.05). Conclusion The micro-penetration heating treatment can relieve the pain of wound bone fracture to prevent from wounded infection, coalescence to shorten the time of patients' treatment in hospital so that it has a very consequence for it to relieve press from the psychology and finance.