Objective To investigate clinical therapeutic effect of valsartan/amlodipine compound preparation on patients with hypertension. Methods From Juue 2011 to June 2013, a total of 110 columns with hypertension as the research object, according to randomly divided into two groups.Valsartan/amlodipine compound preparation(group A) and amlodipine combined with metoprolol group(group B), continuous administration for 24 weeks, patients symptoms, former state, improve heart function and blood clots compared curative effect were monitored.Results After 24 weeks of treatment with valsartan/amlodipine compound preparation group, compared with group B, SBP and DBP were decreased significantly, the TC, TG and Glu content were also decreased significantly, clinical symptoms improved ratio was 90.91%(P<0.05).Cardiac function improvement recovery was 89.09%(P<0.05).D-Dimer level was decreased significantly(P<0.05), the former state blood clots were effectively prevented.Conclusion The high blood pressure in treatment with valsartan/amlodipine compound preparation has more therapy advantages in clinical treatment .

Objective To investigate the feasibility of gadopentetate dimeglumine as contrast agent for arteriography and interventional procedures.Methods Nine patients received gadopentetate dimeglumine as contrast agent during interventional procedures. Gadopentetate dimeglumine was used in 2 patients with contraindications to iodinated contrast media. In addition to the standard injection sequences with iodinated contrast media, arteriograms were obtained after administration of gadopentate dimeglumine in seven patients. Diagnostic arteriographies were performed in thoracic aorta, common carotid artery, bronchial artery, intercostal artery, hepatic artery, iliac artery and uterine artery. The doses of gadopentetate dimeglumine used in this series were≤0.3 mmol/kg. Vital signs and arterial oxygen saturation were monitored during the procedures. The blood and urine routine examinations, the hepatic and renal functions tests were done after the procedure. Results There were no significant differences between the gadopentetate dimeglumine and the iodinated contrast media examinations for illustrating the main trunk of these arteries. Angiograms obtained with the iodinated contrast media appeared to be better than that of with gadopentetate dimeglumine for visualizing the distal branches of these arteries and the tumor stain. The interventional procedure was completed successfully in the two patients using gadopentetate dimeglumine alone. No patient suffered from complication related to the use of gadopentetate dimeglumine, and also no worsened renal function was shown after the procedure. Conclusions Diagnostic arteriograms can be achieved safely and successfully by using gadopentetate dimeglumine, especially in patients with allergy to iodinated contrast media and chronic renal insufficiency.

Objective To evaluate the feasibility, advantages and pitfalls of trans-gastric, trans-colonic and trans-umbilical peritoneoscopy, and to compare pure natural orifice transluminal endoscopic surgery (NOTES) with hybrid NOTES. Methods Two female pigs of 30kg were used in the study, one for pure NOTES, the other for hybrid NOTES. Each pig received trans-gastric, trans-colonic and trans-umbilical peritoneoscopy, respectively, followed by postmortem examination for organic lesions and closure of incisions.The two approaches were compared in terms of intra-operative situation and manipulation. Results The vital signs of the pigs were stable during the procedures, with no peri-incision organic lesions. There were blind areas in trans-gastric as well as in trans-colonic peritoneoscopy. It was easier to close the colonic incision than the gastric one. The situation in trans-umbilical peritoneoscopy was similar to laparoscopic surgery. Hybrid NOTES seemed superior to pure NOTES with regard to safe access, stable pneumo-peritoneum and adequate visualization. Conclusion Three routes for NOTES appear to be reasonable and feasible. Hybrid NOTES is more effective and safer than pure NOTES with current instruments.

Based on the theory of value and value ethics,there were 3 aspects problems as following at the present stage of the health care system reform:paying more attention on the quantity of inpatient services rather than the quality of medical services,taking hospital as the center instead of the close cooperation of various sanitary institutions and inappropriate incentive mechanism.It considered that the next step of the health care system reform of China should make efforts to achieve 3 value goals:to improve people's health level,provide high-quality medical services and service experience and affordable health care costs.To achieve these value goals,it proposed suggestions from five aspects:providing integration services,transforming the functional localization of hospitals,changing the incentive mechanism,improving the medical service quality continually and enhancing the participation of the public.

Objective To analyze the clinical characteristics of single renal transplantation from infant kidney donation after death (DCD) and summarize the nursing measures for nursing the infants. Method The clinical data of 36 cases of single kidney transplantation from 18 infant donors from January 2014 to June 2016 in our centre were reviewed and summarize the nursing experience. Results Pulmonary infection occurred in 3 cases, incision infection occurred in 2 cases and graft vascular complication occurred in 2 cases. Urinary fistula occurred in 2 cases, ureteral obstruction occurred in 1 case, delayed graft function (DGF) occurred in 16. Postoperative follow-ups for 1 to 20 months showed all the grafted kidneys survived and 34 of them were well recovery in view of renal function of grafted kidney and the rest two had the grafted kidneys resected because of arterial and venous thrombus in them. Conclusions The renal transplantation from infant DCD is difficult. The nurses should handle postoperative care to the patients, paying attention to the complications. On the other hand, intra-and post-operative monitoring of blood pressure, control of input and output and early observation of complications and treatment is of value for the improvement of survival rate of grafted kidneys, reduction of complication incidence and propelled recovery of the patients.

Objective To investigate the characteristics of the pharmacodynamics of rocuronium bromide in patients with hepatobiliary disease. Methods Forty-eight patients undergoing abdominal surgery were divided into four groups, group A: patients with liver cirrhosis and portal hypertension (n = 12); group B1 : patients with cholelithiasis and obstructive jaundice (n = 12); group B2 : patients with cholelithiasis but no obstructive jaundice ( n=12);group C: patients without hepatobiliary disease ( n = 12) . Their renal function was normal. Patients with cardiovascular and neurological diseases were excluded. Premedication consisted of intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with midazolam 0.05 mg?kg-1 , fentanyl 2?g?kg-1 , propofol 2 mg?kg-1 and rocuronium 0.6 mg?kg-1 . The patients were intubated and mechanically ventilated. PETCO2 was maintained at 30-35 mm Hg. Anesthesia was maintained with iv infusion of propofol and fentanyl. Additional bolus dose of rocuronium 0.15 mg?kg-1 was given when T, recovered to 25% and each patient received six additional doses irrespective of duration of operation. Neuromuscular function was monitored using Datex-Ohmeda NMT mechanosensor. Onset time (from the end of injection to maximum depression of muscle twitch), clinical duration of intubating and additional dose (25 % recovery of T1 ) and recovery index (T1 from 25 % -75 %) were recorded. Results The demographic data were comparable among the four groups. The onset time was significantly longer in group A than that in group B, , B2 and C ( P

Objectives:To observe the characteristics of rocuronium bromide in cirrhotic patients. Methods:Six healthy patients and six patients with hepatic cirrhosis undergoing intraabdominal operation were studied. Rocuronium 0.6 mg/kg was given to all of the patients,and the twitch high of adductor pollicis muscle was recorded using NMT mechanosensor (Datex Ohmeda). The time of onset, T 1 Maximum depression, the clinical duration of initial dose, the clinical duration of repeated maintenance doses and the spontanous recovery index were observed. Results:The time of onset was markedly prolonged in the cirrhotic compared with the healthy group( P

Myasthenia gravis is an autoimmune disease resulting from the production of antibodies against acetylcholine receptors of the endplate. These antibodies impair postjunctional membrane and reduce the number of functional acetylcholine receptors of endplate. Thymectomy is an effective therapeutic method for adult myasthenic patients. In this paper, the author reviewed the pathophysiological characteristics and problems related to anesthesia, such as preoperative evaluation, the effect of preoperative medical treatment on the anesthesia, patients'response to muscle relaxants and postoperative management.

Background The disability of theory of mind (ToM) has been confirmed in chronic or acute medicated schizophrenic patients.The role of ToM ability in first-episode, drug-naive schizophrenic patients was investigated in this study.Methods ToM was assessed with the Eyes task and Faux pas task in first-episode, drug-naive schizophrenic patients( n =52)compared with healthy controls ( n =64). Verbal Fluency Test (VFT) and Digit Span Test (DST) were also examined in two groups. Psychiatric symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS).Results The tests that involved the ToM ability (I. E. Mind reading and Faux pas questions) were impaired in the schizophrenic group. The schizophrenia performed worse than the normal controls on the VFT. The schizophrenic negative subgroup performed worse than the positive subgroup in Mind reading and VFT. There was a significantly positive correlation between the performances of the tests that involved the ToM ability and the scores of VFT in schizophrenic patients. There was a significantly negative correlation between the performances of the tests that involved the ToM ability and negative symptom scores in the patients.Conclusions The patients with schizophrenia exhibit ToM deficit that is probably associated with the frontal lobe dysfunction.The performance of ToM dysfunction might be different between negative subjects and positive ones.

Objective: To explore the mediating effect of parental hostile attribution bias on depression and anxiety between parents and children, so as to provide the reference for the promotion of children's mental health. Methods: Students of grades 2-6 in two public primary schools in Linping District, Hangzhou City and their parents were investigated using stratified sampling method in November 2022. Emotions of children were surveyed using Depression Self-Rating Scale for Child (DSRSC) and Screen for Child Anxiety Related Emotional Disorders (SCARED), while emotions and hostile attribution bias of parents were surveyed using Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS) and Social Cognitive Screening Questionnaire (SCSQ). Mediating effect of parental hostile attribution bias on depression and anxiety between parents and children was analyzed using a structural equation model. Results: Totally 300 questionnaires were allocated, and 263 valid questionnaires were recovered, with an effective rate of 87.67%. There were 137 boys (52.09%), and 126 girls (47.91%), with a mean age of (9.95±1.44) years. There were 69 fathers and 194 mothers investigated. The prevalence of depression among parents was 27.00%, the prevalence of anxiety among parents was 4.18%, and the median score of hostile attribution bias was 1.00 (interquartile range, 2.00). The prevalence of depression among children was 11.03%, and the prevalence of anxiety among children was 29.66%. Parents' depression and anxiety affected children's depression and anxiety directly (effect value=0.270, 95%CI: 0.131-0.436), and also indirectly affected children's depression and anxiety by increasing their hostile attribution bias (effect value=0.028, 95%CI: 0.004-0.082), with the mediating effect contributed 9.40% of the total effect. Conclusion Parents' depression and anxiety affect children's depression and anxiety directly or indirectly through hostile attribution bias.