Health Personnel ; psychology ; Humans ; Love ; Rare Diseases ; therapy

Objective To investigate the effects of different anesthesia methods on cerebral oxygen metabolism in patients with severe traumatic brain injury.Methods Forty-five patients with severe traumatic brain injury from March 2011 to March 2013 were divided into propofol intravenous anesthesia group(group A),sevoflurane inhalation anesthesia group(group B) and intravenous inhalational anesthesia group (group C) by random digits table method with 15 cases each.The mean artery pressure (MAP),heart rate (HR) before anesthesia,immediately after tracheal intubation,2 minutes after intubation,10 min and 30 min after operation set and operation end were observed.The oxygen content of jugular venous (SjvO2),jugular bulb venous oxygen content (Da-jvO2) and cerebral metabolic rate for oxygen (CERO2) before anesthesia induction,immediately finish anesthesia induction,30 min and 1 h after operation set and operatin end were calculated.Results The SjvO2 values in three groups were at 30 min,1 h after operation set and operation end was higher than that before anesthesia induction (group A:0.662 ±0.077,0.689 ±0.067,0.685 ±0.066 vs.0.623 ±0.083; group B:0.661 ±0.074,0.681 ±0.072,0.661 ±0.069 vs.0.598 ±0.092; group C:0.715 ± 0.072,0.743 ± 0.070,0.713 ± 0.075 vs.0.631 ± 0.078),and there was significant difference (P ＜ 0.05).The Da-jvO2 values,CERO2 at 30 min,1 h after operation set and operation end was lower than that before anesthesia induction in three groups [group A:Da-jvO2:(41.2 ± 6.3),(41.6 ± 8.1),(44.2 ± 6.3) ml/L vs.(49.2 ± 9.2) ml/L,CERO2:(33.0 ± 1.9)％,(32.7 ± 2.0)％,(32.3 ± 1.9)％ vs.(36.0 ±2.3)％; group B:Da-jvO2:(41.8 ± 5.6),(40.2 ± 6.9),(41.8 ± 5.6) ml/L vs.(51.3 ± 8.6) ml/L,CERO2:(33.2 ±2.1)％,(33.0 ±2.6)％,(32.8 ±2.1)％ vs.(34.7 ±3.1)％ ; group C:Da-jvO2:(39.5 ±6.8),(38.7 ±7.0),(40.2 ±6.8) ml/L vs.(48.8 ±9.7) ml/L,CERO2:(31.8 ±2.9)％,(31.5 ±3.1)％,(32.9 ±2.3)％ vs.(35.1 ± 2.9)％],and there was significant difference (P ＜ 0.05).And group C was decreased more significantly (P＜0.05).There was no significant difference in MAP,HR among three groups (P＞0.05).Conclusion Propofol intravenous anesthesia and sevoflurane inhalation anesthesia can effectively reduce perioperative cerebral metabolic rate of oxygen,and the balanced anesthesia has better cerebral protection with the stable hemodynamic.

China is the country with the biggest diabetic population in the world.Diabetes has become a heavy financial burden for diabetic patients,families,and society.This article briefly described pharmacoeconomic concepts and analysis methods,and systemically reviewed literatures in health economic data of DPP-4 inhibitors,in the hope of providing a new perspective for clinicians,researchers,and health care policy makers.

Obesity is associated with numerous metabolic abnormalities, including insulin resistance and type 2 diabetes. Losing weight is an effective way of improving insulin sensitivity, thus decreasing the risk of obesityassociated diabetes and chronic cardiovascular disease. There is evidence that Liraglutide, as a human glucagon-like peptide-1 ( GLP-1 ) analogue, either using alone or combining with other glucose-lowering drugs, has effect on improving glycemic control, protecting β-cell function, and reducing body weight via inhibiting feeding behavior and delaying gastrointestinal motility. Therefore, liraglutide is a new option for treating type 2 diabetes patients.

Objective To compare the safety and efficacy of intravaginal prostaglandin E1, misoprostol with ricinus oil meal for labor induction. Methods 120 patients with an indication for induction of labor were randomly assigned to two groups (60 cases each) induction with misoprotol, 50μg intravaginally every 3 hours until active labor, or with that ricinus oil meal was taken. Results The time from start of intuction to vaginal deliery was significantly shorter than in the misoprostol group [(12.2±3.5)h vs (18.1±3.2)h] (P<0.05), and fewer patients in the misoprostol group required oxytocin augmentation (10% vs 40%, P<0.05). The mean change in the Bishop score was significantly higher than in those receiving misoprotol (5.5 vs 3.1, P<0.05). Uterine tachysystole occurred more frequently in patients in the misoprostol group (16.7%) than in the ricinus oil meal group (3.0%). No significant difference was noted in the mode of delivery and patients of successful labor induction. Conclusion Vaginally administered misoprostol is an effective agent for the cervical ripening and induction of labor.

Objective To evaluate the efficacy and toxicity of gimeracil and oteracil porassium capsules combined with nedaplatin in the treatment of the patients with distant metastatic nasopharyngeal carcinoma.Methods Fourty cases were randomly divided into the observation group and control group by random digital table.19 cases in the observation group were treated with oteracil potassium capsules combined with nedaplatin.21cases in the observation group were treated with gemcitabine combined with nedaplatin.The response rate,response rate(RR) and progression free survival(PFS),toxicity were evaluated according to response evaluation criteria in solid tumors (RECIST).Results The response rate were 52.6％,52.3％ respectively,the median progression-free survival were 5.5 and 5.2 months,respectively.Grade Ⅲ an Ⅳ platelet supression were 10.5％,38.0％ between the observation group and control group.It was statistically significant between the two group(x2 =4.89,P ＜ 0.05).Conclusion Oteracil porassium capsules combined with nedaplatin is similar with gemcitabine combined with nedaplatin in the distant metastatic nasopharyngeal carcinoma,the adverse reaction was lighter than that of the control group.

Objective:To explore the relationship between serum uric acid (SUA) level and restenosis after percutane-ous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) .Methods:A total of 389 patients , who were diagnosed as ACS and received PCI in our hospital from Jan 2010 to Dec 2013 ,were selected .The 82 pa-tients with hyperuricemia were regarded as hyperuricemia group ,and the remaining patients with normal SUA level were treated as normal SUA group (n= 307) .Clinical condition and restenosis after PCI were observed and com-pared between two groups .Results:Compared with normal SUA group ,there were significant rise in percentages of hypertension (41.04% vs .58.54% ) ,Killip> class Ⅰ (16.61% vs .26.83% ) and multi-vessel coronary disease (50.16% vs .64.63% ) ,restenosis rate after PCI (9.12% vs .15.85% ) in hyperuricemia group ,P<0.05 all .Con-clusion:Serum uric acid level is closely related to restenosis rate after PCI in ACS patients ,which is worth attention .

Objective To investigate and analyse the status and influential factors of nurses' palliative care knowledge in Shanghai city.Methods Using cluster sampling method,a questionnaire survey using Palliative Care Quiz for Nursing (PCQN) was conducted on 973 nurses in 9 hospitals of Shanghai city.Results 939 nurses completed the survey whose scores were 8.88±2.51.The status quo of palliative care knowledge of Shanghai nurses were not very desirable.The scores of palliative care philosophy and principles and psychological,social and spiritual support were 0.376±0.009 and 0.310±0.008.The scores of knowledge of the pain and symptomcontrol was 0.496±0.005,which was better than the other two aspects.There were differences between dimension 1 and dimension 2,3 (t=-1 1.78,5.465,P＜0.01),and also between dimension 2 and 3 (t=19.673,P＜0.01).Conclusions Lacking of education and training,insufficient recognition of related institutions and the limit of traditional ideas caused the defect in the knowledge structure of palliative nursing.

Objective To investigate the clinical effect of early laparoscopic cholecystectomy in the treat -ment of elderly patients with acute cholecystitis .Methods 68 elderly patients with early acute cholecystitis were di-vided into the two groups according to the surgical procedures .33 cases in OC group were given traditional open sur-gery,while 35 cases in LC group received early laparoscopic cholecystectomy .The operative time,postoperative bowel recovery time and postoperative hospital stay time were compared between the two groups .Results The operative time,postoperative bowel recovery time ,postoperative hospital stay time in LC group were (43.7 ±5.8)min,(36.4 ± 3.9)h,(4.8 ±1.4)d,which were significantly shorter than (68.6 ±7.3)min,(65.2 ±4.5)h,(8.3 ±2.9)d in the OC group(t=3.317,3.862,3.029,all P<0.05).The incidence rate of postoperative complication of LC group was 14.29%,which of the OC group was 24.24%,the difference was not significant(P>0.05).Conclusion Early lap-aroscopic cholecystectomy in the treatment of elderly patients with acute cholecystitis can significantly shorten the operation time, promote postoperative recovery of gastrointestinal function and reduce postoperative hospital stay , reduce the burden of patients ,improve the quality of life and the incidence rate of complications is low .

Objective To quantitatively detect CA125 with self-designed synthetic gold nanoparticle probes by the colorimetric immunoassay and to initially investigate the feasibility of clinical application .Methods The capture antibody of detective CA125 was conjugated to the gold nanoparticle surface for preparing the gold nanoparticle probes .The gold nanoparticle aggregation was formed by the antigen-antibody immunoreaction .CA125 was quantitatively detected by the colorimetric immunoassay .Results The gold nanoparticle probes was successfully prepared ,which could detect the serum CA125 content rapidly and conveniently ,the de-tection results were coincident with the pathological diagnosis .The lowest limit of quantitation was 0 .5 U/mL ,which was far lower than that in ELISA .Conclusion This gold nanoparticle probes are simple to be prepared ,rapid and easy to operate with low cost , and have the important application value in clinical early detection of ovarian cancer marker CA 125 ,especially in the primary hospi-tals .