Objective To compare the effects of volume preloading with crystalloid and colloid fluid to prevent hypotension associated with thoracic epidural block combined general anesthesia.Methods Ninety ASA Ⅰ～Ⅱ grade patients,scheduled for elective upper abdominal surgery,were randomly allocated to three groups(30 patients in each group).A,B and C group respectively received 1000ml lactated Ringer's solution,500ml and 1000ml polygeline injection for volume preloading in 40min before general anesthesia induction.During volume preloading,epidural catheter was placed at T_ 8～9 and blocked with mixed solution of 1.6% lidocaine and 0.2% dicaine.Results Systolic blood pressure(SBP) and diastolic blood pressure(DBP) were significantly lower in group A and B than those in group C after epidural block,general anesthesia induction and intubation(P

Objective To analyze the clinical efficacy of compound 18 norgestrel combined with estrogen in treatment of dysfunctional uterine bleeding. Methods 78 cases of patients with dysfunctional uterine bleeding in Beijing Ji Shui Tan Hospital and Dongguan city people's hospital of guangdong Province were divided into control group (n=39)and observation group (n=39)by using randomized single-blind allocation. The control group was only given estrogen,the observation group was used compound 18 norgestrel combined with estrogen. The clinical efficacy of the two groups was compared. Results 31 cases were cured and 7 cases were valid of the study group,the total effective rate was 97.4%,significantly higher than the control group's total efficiency of 71.8%,the difference was statistically significant (P<0.05). Each index of observation group and the control group were improved after treatment,the difference was statistically significant (P<0.05 );After treatment,the menstrual cycle in observation group was (29.7 ±7.1)d,the menstrual period was (5.6 ±0.5)d,hemoglobin content was (135.5 ±21.7)g/L,endometrial thickness was (0.63 ±0.15)mm, significant changes than the control group,the difference was statistically significant (P<0.05 ). Conclusion Compound 18 levonorgestrel combined with estrogen has a better effect in patients with dysfunctional uterine bleeding and it can significantly improve patients'hemoglobin,the menstrual cycle and the uterus film thickness and other indicators which is worth promoting in clinical.

BACKGROUND:Epidermal stem cels are the source of cels for repairing the skin and its appendages. To study differentiation and migration of epidermal stem cels is crucial for perfect healing.
Objective: To investigate the effects of substance P in skin wound repair.
METHODS:Thirty Wistar rats were randomized into groups of substance P, capsaicin and control (n=10 per group). After the establishment of skin defect models, exogenous neuropeptide substance P, capsaicin, and normal saline were daily injected at the wound for continuous 5 days. Skin thickness, skin wound area, BrdU-positive cels were detected in the three groups at different time after injection.
Results and conclusions:No difference n the skin thickness was found in the three groups at 14 days after injection (P > 0.05), but with time, the epidermal thickness was reduced. At 42 days, the epidermal thickness was reduced remarkably in the substance P group and decreased certainly in the capsaicin group, but unchanged in the control group. The wound area of the substance P group was significantly lower than that in the control and capsaicin groups at 3, 5, 7 days after injection (P < 0.05), but there was no difference between the control and capsaicin group (P > 0.05). The BrdU positive rates in the three groups were significantly different at 3, 5, 7, 12 days after injection: the substance P group > the control group > the capsaicin group (P < 0.05). These results show that substance P can promote epidermal cel proliferation and accelerate wound healing.

BACKGROUND:There is no clear understanding on the effects of subcutaneous fat and stem cels on wound healing. OBJECTIVE:To explore the therapeutic effects of skin composite prepared with adipose tissue-derived stem
cels on skin defects. METHODS: Epidermal cels, fibroblasts, adipose tissue-derived stem cels as seed cels and bovine colagen gel as a scaffold were used to build a complex with a variety of cels. A 6-mm diameter circular skin defect was made on the both sides of the rat back. The right side as experimental side was implanted with an 8-mm diameter multilayer skin composite, and the left side (control side) was only treated with a simple dressing. RESULTS AND CONCLUSION: For the constructed multi-layer skin composite, the epidermal layer was continuously merged into the multi-layer, the fibroblasts evenly distributed in the corium layer, and lipid droplets existed in the fat layer in which the cels distributed uniformly. Cel aggregation was obviously observed at the junction of different layers. In the experimental side, the rate of wound healing, granulation tissue thickness, the thickness of dermis and the capilary density were significantly higher than those in the control side. Taken together, we can construct multilayer skin composites with a variety of cels as seed cels, such as epidermal cels, fibroblasts and adipose tissue-derived stem cels, and bovine colagen gel as a scaffold, which promote wound healing and increase the thickness of dermis.

Objective To investigate the contents of dioxane in shampoo and bath lotion type of cosmetics. Methods Headspace gas_chromatography was applied to determine the concentration of dioxane in cosmetics. Results Significant differences were observed between 122 national products of shampoo with a detectable rate of 63.9% and a value of P95 of dioxane concentration of 173.4 ?g/g and 64 imported and joint_venture products of shampoo with a detectable rate of 56.2% and a value of P95 of dioxane concentrations of 34.68 ?g/g (P

Objective To understand the occurrence of catheter-associated urinary tract infection(CAUTI)in pa-tients with catheterization,and provide evidence for reducing the incidence of CAUTI.Methods Based on monito-ring requirement for CAUTI in competency building project of healthcare-associated infection(HAI)prevention and control established by Hospital Infection Management Committee of Chinese Hospital Association,CAUTI among patients who hospitalized and received urinary catheterization ≥2 days in a hospital from January to December 2014 were analyzed prospectively,incidences of CAUTI in different patients were compared.Results A total of 6 046 patients with urinary catheterization were monitored,166 of whom developed CAUTI,incidence of CAUTI was 2.75%,the total urinary catheter days were 31 833 days,incidence of CAUTI was 5.21 per 1 000 urinary catheter days.There was no significant difference in the incidence of CAUTI among patients of different genders (χ2 =1 .23, P =0.54);incidence of CAUTI in patients > 60 years old was higher than those ≤60 years (4.72% vs 2.07%,χ2=30.38,P <0.01);incidence of CAUTI in patients with different duration of catheterization was significantly dif-ferent(χ2 = 251 .14,P <0.01 );with the prolongation of duration of catheterization,incidence of CAUTI also in-creased(trendχ2 =211 .82,P <0.001 ).Patients in department of neurology had the longest average catheterization time(14.84 days)and highest incidence of CAUTI(15.00%,10.11 ‰);patients in the other departments of surgery had the shortest average catheterization time(3.56 days)and lowest incidence of CAUTI(0.97%,2.74‰);inci-dences of CAUTI in patients with urinary catheterization in different departments were significantly different(χ2 =302.24,P <0.001).166 CAUTI patients were isolated 66 isolates of pathogenic strains,86.36% were gram-nega-tive bacilli,33.33% of which were Escherichia coli .Conclusion CAUTI is related to the age of patients and dura-tion of indwelling urinary catheter.Daily assessment on the necessity of indwelling catheter and timely removal of catheter is helpful for reducing the occurrence of CAUTI.

Objective To establish a bedside available risk scoring system of no-reflow in the acute stage of STEMI.Methods Data from STEMI patients treated with PCI divided into model group and validation group were analyzed.Multivariable binary logistic regression analysis was used to identify independent no-reflow predictors of the model group.Finally,a score according to the odds ratio on logistic regression analysis was designed,and then risk stratification was established,and no-reflow high-risk patients with myocardial infarction were selected.The authenticity and reliability of the logistic regression courses were validated using receiver operator characteristic curve (ROC)and Hosmer-Lemeshow goodness-of-fit.Results Multivariate logistic regression analysis demonstrated that female (OR =0.587,P =0.019),Killip class of myocardial infarction≥2 (OR =3.656,P <0.01),TIMI flow ≤2 before primary PCI (OR =0.774,P =0.013),thrombus burden score ≥4 on baseline angiography (OR =2.629,P <0.01),pain to balloon time ≥ 6 h (OR =1.485,P =0.083)were independent correlate predictors of no-reflow phenomenon in the STEMI after PCI.The risk score system demonstrated a good risk prediction in the model group with AUC of 0.716 (95%CI:0.671 -0.761)based on ROC analysis.There was no significant discrepancy between multivariate logistic regression analysis and Hosmer-Lemeshow goodness-of-fit (χ2 =1.027,P =0.994).In risk stratification,total value <2 was assigned into low risk level,and 2-5 was put into the medium risk level,and >5 was arranged into high risk level.The risk score system demonstrated a good risk prediction in the validation group with AUC of 0.891 (95%CI:0.822 -0.959)based on ROC analysis.ROC analysis in the validation group was applied to Killip class,thrombus burden,score and risk stratification in the validation group ,and the no-reflow score was more accurate,with a larger area under the curve (AUC = 0.851,95% CI:0.776 -0.927 ).Conclusions Establishment of no-reflow scoring system with STEMI patients undergoing PCI was benefit to select high risk patients with no-reflow.

OBJECTIVE:To study the pharmacokinetics effects of naloxone combination on Shenmai injection in rats in vivo. METHODS:12 rats were randomly divided into monotherapy group (Shenmai injection 9.00 ml/kg,iv) and combination group (Shenmai injection 9.00 ml/kg+naloxone 1.80 ml/kg,iv). The blood samples were collected before administration and 0.083,0.25, 0.5,0.75,1,1.5,2,3,6,12,24,48,96 and 144 h after administration. HPLC was adopted to determine the plasma concentra-tions of ginsenosides Rg1,Re and Rb1,and DAS 2.0 software was used to calculate the pharmacokinetic parameters. RESULTS:Compared with monotherapy group,the plasma concentration of ginsenosides Rg1 in combination group was increased,CL was de-creased,t1/2 and MRT were prolonged,and AUC0-144 h was increased;the plasma concentration of ginsenosides Re was increased,Ke was decreased,t1/2 was prolonged,MRT was shortened,and AUC0-144 h was increased;the plasma concentration of ginsenosides Rb1 was decreased,Ke was increased,t1/2 and MRT were shortened,and AUC0-144 h was decreased,with significant differences(P<0.01 or P<0.05). CONCLUSIONS:Shenmai injection combined with naloxone can slow down the removing of ginsenosides Rg1 and Re in vivo,and obviously the plasma concentration of Shenmai injection is higher than monotherapy group;speed up the removing of ginsenosides Rb1,and the plasma concentration of Shenmai injection is lower than monotherapy group obviously.

Objective To investigate a new technique for small wound repairs on the faces.Methods 71 skin lesions of 42 patients were selected in the study and removed with ring-cutting drills.The new formed small wounds were treated with nature repair technique under the help of bFGF and hyaluronic acid (HA).The bFGF and HA were applied on the wounds 3 times a day until the wounds were healed completely.The early and long-term healing effects were estimated.Results The wounds were all cured with very small scars.The wounds were healed within 15 days for the size of 7 mm × 7 mmand25 days for the size of 15 mm × 15 mm.63 lesion spots from 35 patients were followed up 12 months later.Compared with original skin lesion,the small scar contracted about 50％in size with flat appearance and similar skin color.Conclusions The tissue regeneration and nature repair technique is an ideal surgical procedure for small wounds on the faces with good appearance in quality and aesthetics.

Objective To develop a technique of aesthetic repair procedures for the skin and soft tissue defect after injury.Methods Nineteen cases of patients with skin and soft tissue defects after injury were chosen in this study,in which there were 19 wounds involved.Thirty-seven expanders were inserted into the subcutaneous pockets beside the wounds in the right time and were inflated by a fast expansion model (one time every two days). After completion of inflation,the expanded skin flaps were made and transferred to repair the wounds.Results All the 37 expanders were inflated successfully in duration of 46-63 days.Five expansion areas presented complications that were correctly controlled.All of the wounds were covered and healed well after the expanded skin flap transplantation.Twelve patients were followed up for 6 months after operation.The long-term results showed that the color and texture of the flaps matched the recipient sites well without swelling.The aesthetic appearance of the repaired sites looked satisfactory.Conclusions The rapid tissue expansion is a better option for repairs of some skin and soft tissue defects after injury in certain areas.