Objective:To observe the clinical effect of the combined use of dexmedetomidine and propofol for anesthesia in the elderly patients with painless gastroscopy. Methods:Totally 70 elderly patients with painless gastroscopy were selected and randomly divided into the observation group (35 cases) and the control group (35 cases). The observation group was given dexmedetomidine and propofol for anesthesia, while the control group was given propofol for anesthesia. The anesthesia induction time, the vital signs and recovery time of the patients, intraoperative complications and postoperative adverse reactions were observed and compared between the two groups. Results:The anesthesia induction time of the observation group was shorter than that of the control group (P<0. 01). The mean arterial pressure (MAP) in T2, T3 and T4 stage in the two groups were significantly lower than that in T1 stage (P<0. 05, P<0. 01). The HR in T3 stage and RR in T2 stage in the control group were lower than those in T1 stage (P<0. 05). The RR in T2 stage in the observation group was significantly lower than that in T1 stage (P<0. 05). The MAP in T2 and T3 stage in the observation group was significantly higher than that in the control group (P<0. 01), while that in T4 stage in the observation group was significant-ly lower than that in the control group (P<0. 05). The HR in T3 stage in the observation group was significantly higher than that in the control group (P<0. 05). The incidence of intraoperative complications in the observation group was 5. 7%, while that in the con-trol group was 22. 9%, and there was significant difference between the two groups (P<0. 05). The recovery time in the observation group was shorter than that in the control group (P<0. 01). Conclusion:Dexmedetomidine combined with propofol has better anes-thesia effect and higher safety than propofol alone, which is worthy of clinical promotion.

This paper reports the nursing care of 7 patients with liver cirrhosis during pregnancy and childbirth. During the pregnancy period,nursing care focused on integrated management,monitoring of the dynamic changes of liver cirrhosis and individualized care. During delivery and perioperative period,supportive treatment was implemented and complications such as upper gastrointestinal hemorrhage,postpartum hemorrhage and infections were prevented. The 7 patients got through the perinatal period safely.

Objective To investigate the therapeutic effect of oxiracetam combined with dexamethasone for treatment of patients with severe acute carbon monoxide poisoning (ACOP).Methods Eighty-seven patients with severe ACOP admitted to Affiliated Hospital of Xuzhou Medical University from January 2013 to July 2016 were enrolled, and they were divided into observation group (47 cases) and control group (30 cases) according to random number table method. The two groups were given conventional nerve nutrition, hyperbaric oxygen and symptomatic treatment, while in the observationgroup, on the basis of conventional treatment the patients received intravenous drip of dexamethasone 5 mg (with addition of normal saline 100 mL), once a day for consecutive 3 days, and intravenous drip of oxiracetam 3.0 g plus 100 mL normal saline, once a day for consecutive 7 days. The changes of mini-mental state examination (MMSE), Barthel index and Glasgow coma scale (GCS) were observed after discharge for 30 days, and the differences of the incidence of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and hospitalization time between the two groups were compared.Results After treatment the MMSE and GCS scores of the two groups were higher than those before treatment, and the Barthel score was lower than that before onset. After discharge for 30 days, MMSE score (26.93±2.92 vs. 24.20±6.82), GCS (14.41±1.32 vs. 13.98±2.13), Barthel (94.78±12.62 vs. 85.25±19.57) of the observation group were significantly higher than those of control group, and the incidence of DEACMP was obviously lower than that in the control group [8.5% (4/47) to 17.5% (7/40)], the differences between the two groups being statistically significant (allP < 0.05); the hospitalizationtime of the observation group was shorter than that of the control group (days: 10.81±5.49 vs. 13.05±6.84), but there was no significant difference between the two groups (P > 0.05).Conclusion Early combined application of oxiracetam and dexamethasone can significantly improve the cognition and self-care abilities and reduce the incidence of DEACMP in patients with severe ACOP after discharge for 30 days.

Objective: To study the protective effect of Xiaoyao Tablet(XYT)(Radix Bupleuri, Radix Angelicae Sinensis, Rhizoma Atractylodis Macrocephalae, Radix Paeoniae Alba, Poria, Radix Glycyrrhizae, Herba Menthae, Roasted ginger) on liver. Methods: Using the acute hepatic injury model induced by Tetrachloride and D-galactosamine (CD-GaIN) in rats or mice, we observed the influence of XYT on ALT and AST level in the serum, MDA level and glutathione-s-transferase(GST) activity in the liver homogenates. The pain-killing effect was tested by body twisting model induced by glacial acetic acid and by hot plate model in mice. Results: The XYT reduced the serum ALT level significantly in the acute hepatic injury model in rats and mice. In the CCl 4 reduced acute hepatic injury mice model, XYT decreased the MDA level and increased the GST activity in liver significantly, also it reduced the MDA level in the serum. The XYT reduced twisting number in mice induced by glacial acetic acid. In the hot plate test, the pain threshold was increased. Conclusion: The drug has the similar hepatoprotective function to Xiaoyao Pills.

Objective To evaluate the value of IgA and IgG antibodies against α-fodrin in both serum antibodies in SS is also assessed.Methods Samples from 39 patients with SS(25 primary and 14 secondary),8 patients with systemic lupus erythematosus(SLE),and 15 patients with rheumatoid arthritis (RA)as well as 10 healthy blood donors were collected.Anti-α-fodrin antibodies were measured using ELISA.Results The titer of serum anti-α-fodrin was higher in SS than in other connective tissue diseases group and healthy group(P<0.01).IgA type anti-α-fodrin antibodies was detected in 60%.44% of serum and saliva in patients with pSS respectively.IgG antibodies were detected in 43% of sera,and 29% of saliva of patients with pSS.The sensitivity and specificity of serum anti-α-fodrin IgA in SS was 54%and 85%.The level of anti-α-fodrin was positively associated with xerostomia and parotid swelling (P<0.05),and was negatively associated with xeroma,renal tubule acidosis,lung interstitial disease and hepatic damages(P>0.05).Conclusion Saliva and serLlm anti-α-fodrin level may be diagnostic for SS.It may be a useful screening marker.

Objective To investigate the feasibility and effect of synchronization imaging technology of 64-slice spiral CT on urography and angiography(CTUA).Methods 36 adult patients with urinary symptoms that apply for the conventional CTU were selected. Exclusion of iodine allergy,serious heart,liver and renal insufficiency,multiple myeloma,long-term diabetes,hyperthyroidism,etc.All patients were placed intravenous tube.100 mL iohexol(300 mg I/mL),divided into 40-60 mL and 35-40 mL,shall be injected respectively by interval about 25-45 min,and the corresponding injection rate was 2-2.5 mL/s and 3.5-4.0 mL/s.About 20-30 s after the second injection,scan urinary tract for a quick CTUA source image,then scan urinary tract again for a quick source image of CTU with 5 min delay.Two groups of data with reconstruction technique(including MPR,MIP,VR etc.)should be read and diagnosed independently and double-blinded by two doctors with many years'experience in CTU.They also need to evaluate the image quality of the kidneys,urinary tracts and renal vessels,and make a statistical analysis to judge whether the CTUA inspection technique was feasible and effective.Results CTUA was good at showing renal parenchyma,ureters,urinary bladder and renal vessels,and the display rate was respectively:0.83,0.916,1,0.806,by contrast,the conventional CTU was 0,0.972,1,0,accordingly.Compared with the conventional CTU,CTUA was obviously different from the CTU,especial in displaying the distinction between renal cortex and medulla,renal vessels,and CTUA was better than the conventional CTU.While in display of ureters and urinary bladder,they had no difference,both show good.Conclusion CTUA inspection technology is superior to the conventional CTU technique,and using a routine dose contrast medium with twice bolus injection and one scanning can provide information such as the kidneys,urinary tract and renal vessels.

This paper introduces the individual design of oral radiotherapy stent based on 3D printing technology, and expounds its design principle. The modeling of the device is based on CT images and Mimics software, which builds a set of 3D printing oral stent technology. The instrument has more advantage in high precision, fast modeling, individualized production and digital storage. The results show that the construction of 3D printed dental stent is feasible, which provides a new idea and method for the production of oral stents.

Objective:To investigate the clinical and imaging features of basal ganglia germinoma in children and adolescents, so as to improve the accuracy of early diagnosis.Methods:The clinical symptoms and imaging findings of 10 cases of basal ganglia germinoma diagnosed by surgical examination or diagnostic radiotherapy in Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2010 to December 2019 were analyzed retrospectively.Results:There were 9 males and 1 female, aged from 5 to 15 years, with an average age of 9.7 years.There were 10 cases of limb weakness or mild hemiplegia, 1 case of headache and vomiting, and 1 case of extrapyramidal tract sign. There were 9 cases of computed tomography (CT) examination, 5 cases of high density, 4 cases of mixed density, and 3 cases of intrafocal calcification. 10 cases of routine magnetic resonance imaging (MRI) examination, MR T1-weighted imaging (T1WI): 5 cases of low signal, 3 cases of slightly low signal, 1 case of equal low signal, 1 case of equal slightly low signal; MR T2-weighted imaging (T2WI): 3 cases of high signal, 5 cases of slightly high signal, 2 cases of high and low mixed signal; T2 fluid attenuated inversion recovery (T2FLAIR): 1 case of low signal, 2 cases of slightly high signal, 1 case of iso-high signal, 5 cases of high signal, 1 case of high and low mixed signal; Diffusion weighted imaging (DWI): 2 cases of low signal, 1 case of equal signal, 1 case of equal slightly high signal, 4 cases of slightly high signal, 2 cases of high signal; 1 case of functional imaging susceptibility-weighted imaging (SWI): 1 case of low signal; 10 cases of MRI enhancement: 2 cases of no enhancement, 5 cases of mild enhancement, 3 cases of moderate/obvious enhancement, and the enhancement methods can be seen in spot, patch, mass and ring enhancement; Functional imaging magnetic resonance angiography (MRA) in 2 cases: 1 case had slender middle cerebral artery, fewer branch arteries than the opposite side, and 1 case showed no obvious abnormality; 2 cases of positron emission (PET)-CT: the metabolism of methionine (MET) on the affected side was significantly increased in 2 cases.Conclusions:Germinoma in the basal ganglia of children and adolescents are more common in men, with weakness or mild hemiplegia as the main symptom. The imaging findings have certain characteristics. Imaging findings combined with relevant clinical data can improve the accuracy of early diagnosis of germinoma in the basal ganglia.

Objective To study the effect of acupuncture combined with clean intermittent catheterization in the treat-ment of neurogenic bladder. Methods A total of 46 patients were randomly divided into test and control groups. There were 23 patients in the each group. The clean intermittent catheterization only used in the control group. However inte-grated acupuncture and clean intermittent catheterization were used in the test group. Final the residual urine volume and the incidence of bacteriuria were researched after 5 months. Results There were 17 cases restored the micturating function in the test group, however only 7 cases in the control group. There were 3 cases suffered bacteriuria in the test group, but there were 11 cases suffered bacteriuria in the control group. The difference between the two groups was sta-tistical ly significantly (P<0.05). Conclusion Combined acupuncture with clean intermittent catheterization can effi-ciently maintain the normal function of bladder, decrease the residual urine volume, and reduce the incidence of bac-teriuria.

Objective:To explore a better practicing scheme of totally implantable venous access ports (TIVAP) maintenance . Methods :From Apr .to Aug .in 2015 ,25 General Surgery nurses in North District of Zhongshan Hospital ,Fudan University , were under a phased quality review of TIVAP maintenance , meanwhile “Nurses Knowledge Questionnaire”and “Patient Questionnaire Notes”were handed ,and complications of patients under maintenance were monitored .Following the standards of JBI ,at first baseline quality maintenance review was practiced ,then evidence‐based scheme was practiced to receive the quality after invitation .Results:After this scheme practiced ,in 5 of 9 standards ,for JBI TIVAP maintenance quality review completing rates were highly increased .Two questionnaires correct rates were improved to some extent .One complication was found in 25 patients in previous baseline quality review ,while after intervention ,no complication was found .Conclusions :The evidence‐based standards of JBI TIVAP maintenance can highly improve nurses , s maintenance skills and patients , self‐management abilities ,reduce the risk of complications ,but it still need to be improved .