Objective To explore the feasibility of reducing induction dose of remifentanil,deepening anesthesia and intubation after umbilical removal and its effect on maternal,neonatal and anesthesiologists during cesarean section.Methods Thirty cases of ASA Ⅰ-Ⅱ scheduled for elective cesarean section were divided into three groups according random digits table method with 10 cases each.The induction dose of remifentanil was 1.0,1.5,1.0 μ g/kg in group Ⅰ,group Ⅱ,group Ⅲ.Group Ⅰ and group 11 received routine procedure after induction of anesthesia,intubation,while group Ⅲ received anesthesia umbilical removal.Systolic pressure (SBP),diastolic pressure (DBP) and heart rate (HR) were recorded before induction of anesthesia,skin incision and immediately intubation.And the fetal childbirth time,intubation time and neonatal Apgar score at 1,5,10 min were recorded.Results Three anesthesia procedures could meet the requirements of cesarean section.The SBP,DBP and HR at skin incision in group Ⅰ and group Ⅲ were significantly higher than those at before induction of anesthesia [group Ⅰ:(136.5 ±9.7) mm Hg (1 mm Hg=0.133 kPa) vs.(113.5 ±7.8) mm Hg,(96.5 ±9.1) mm Hg vs.(74.2 ±6.0)mm Hg,(98.5 ± 8.7) times/min vs.(81.2 ± 8.4) times/min; group Ⅲ:(138.1 ± 11.4) mm Hg vs.(118.7 ±9.9) mm Hg,(90.1 ±9.9) mm Hg vs.(77.3 ±7.9) mm Hg,(100.3 ±9.0) times/min vs.(81.7 ±9.2)times/min],there were statistical differences (P ＜ 0.05).The SBP,DBP and HR at immediately intubation in group Ⅲ were significantly lower than those in group Ⅰ andgroup Ⅱ [(97.6±10.1)mmHgvs.(138.9±11.2) and (130.1 ± 4.5) mm Hg,(80.1 ± 5.5) mm Hg vs.(97.7 ± 8.9) and (82.0 ± 8.6) mm Hg,(80.4 ±7.8) times/min vs.(99.3 ± 12.2) and (95.9 ± 9.6) times/min],there were statstical differences (P ＜ 0.05).There was no statistical difference in fetal childbirth time among the 3 groups (P＞ 0.05).The neonatal Apgar score at 1 min in group Ⅱ was significantly lower than that in group Ⅰ and group Ⅲ [(7.4 ± 0.9) scores vs.(8.8 ± 0.6),(8.9 ± 0.6) scores],there was statistical difference (P ＜ 0.05).The intubation time in group Ⅲ was significantly longer than that in group Ⅰ andgroup Ⅱ [(8.5±l.8) min vs.(3.0±0.5),(2.8±0.6)min],there was statistical difference (P＜ 0.05),but the intubation time in group Ⅲ was completed within 10 min.Conclusions Using the protocol of remifentanil 1.0 p g/kg induction,midazolam 2 mg,fentanyl 0.2 mg deepening after the umbilical removal can effectively avoid the effect of remifentanil on neonatal 1 min Apgar score,decrease the intubation stress with no effect on anesthesiologists.This method is simple,method of anesthesia for elective cesarean section.

Objective: To investigate the efficacy and safety of sertraline combining with quetiapine in the treatment of obsessive-compulsive disorder (OCD) .Methods: A total of 86 patients who met the criteria for OCD in International Classification of Diseases (ICD-10) were randomly assigned to two groups. One group was treated with sertraline combining with quetiapine and die other with sertraline only for 8 weeks. The efficacy was measured wim the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Hamilton Depression Scale (HAMD) . The side effects were assessed with the Treatment Emergent Symptoms Scale (TESS) . Results: One patient in sertraline group fell off and was out of statistical analysis. At endpoint the significant improvement rate in the combining group was higher than that in the sertraline group (72.1% vs. 47.6% , P = 0.021) . In combining group, the YBOCS score [(25.00 ± 5.19) vs. (11.74 ± 4.50), P < 0.01] and HAMD score [(14.47 ± 4.05) vs. (6. 86 ±2.61), P < 0.001] were decreased after treatment In sertraline group, the YBOCS score [(24.55 ± 3.60) vs. (14.38±4.18), P<0.001] and HAMA score [(14.79 ± 3.77) vs. (8.29 ±3.04), P <0.001] were also decreased after treatment There were significant differences between the two groups (Ps < 0.05) . There were no significant differences between the two groups in the TESS score at the end of 2, 4, 6 and 8 weeks (Ps > 0.05) . The incidence of drowsiness and tachy-heart rate in the combining group was high than that in the control group (37.2% vs. 4.8% , P <0.001; 27.9% vs. 4. 8% , P=0.004) . But most patients with these two kinds of side effects were disappeared in 2 weeks. There were no significant differences between the two groups in other side effects such as nausea, anxiety, headache, and constipation (Ps > 0.05) .Conclusion: The addition of quetiap-ine to sertraline therapy has been found to be effective and well-tolerated approach in patients with OCD.

Objective To explore the effect of compound lidocaine cream and/or psychotherapy in preventing the catheter-related bladder discomfort (CRBD) of male patients with operation under general anesthesia. Methods Eighty male patients undergoing selective upper abdomen operation were selected, and the patients were divided into 4 groups by random digits table method with 20 cases each:control group (C group), compound lidocaine cream group (L group), psychotherapy group (B group) and compound lidocaine cream combined with psychotherapy group (LB group). The incidence of CRBD after extubation, dosage of fentanyl and the number of patients who need flurbiprofen axetil to relief the pain of CRBD were compared among the 4 groups. Results The incidence of no CRBD after operation in LB group was significantly higher than that in C, L and B group: 90%(18/20) vs. 15%(3/20), 60%(12/20) and 50% (10/20), and there were statistical differences (P<0.05). The incidence of mild CRBD in LB group was significantly lower than that in C, L and B group:10%(2/20) vs. 45%(9/20), 35%(7/20) and 40% (8/20), and there were statistical differences (P<0.05). There were no statistical differences in dosage of fentanyl among the 4 groups (P>0.05). The rate of patients who need flurbiprofen axetil to relief the pain of CRBD in C group was significantly higher than that in L, B and LB group: 40%(8/20) vs. 5%(1/20), 10%(2/20) and 0, and there were statistical differences (P<0.05). Conclusions Both the means of compound lidocaine cream and psychotherapy can reduce the incidence of CRBD. However, the method of compound lidocaine cream combined with psychotherapy is able to basically avoid the occurrence of CRBD, and it is worth spreading in clinic.

Objective To compare the genetic polymorphism of 34 Yersinia pest strains of 3 kinds of ecotypes(Microtus fiscis,Qilian Mountain and Qinghai-Tibet Plateau ecotype)that isolated from the Sanjiangyuan area in Qinghai Province and Shiqu County in Sichuan Province,in order to know the ecotype relationship among the strains.Methods Thirty-four strains were amplified using the application of random amplified polymorphism DNA(RAPD)and were detected with agaroge gel electmphoresis.Results Amplified products by ngarose gel electrophoresis method showed same stripes in 31 strains,only 3 strains had slight differences.Conclusion The Microtus fuscas,Qilian Mountain and Qinghai-Tibet Plateau ecotype strains isolated from Sanjiangyuan area are genetically homologous.

Objective To analyze human plague from 2001 to 2011 in Qinghai Province and to provide a scientific basis for formulating prevention and control measures.Methods Using the descriptive epidemiological methods,epidemiological field survey data and medical records of each case of human plague were collected from 2001 to 2011 in Qinghai Province.Human plague was judged in accordance with the Plague Diagnostic Criteria (WS 279-2008).Results From 2001 to 2011,human plague was reported 14 times,with incidence of 38 cases,17 dead and death rate was 44.74％ in Qinghai Province.Epidemic areas mainly distributed in the 12 townships of 9 counties.Prevalent season was from May to October,September and October accounted for 57.89％ (22/38).There were cases of Tibetan herders and Han farmers,accounting for 76.32％ (29/38) and 23.68％ (9/38),respectively;onset age from 5 to 67 years,mainly around the age of 20-45 [68.42％ (26/38)].The most prevalent clinical types were pneumonic and septicemic plague and initial case was caused by actively contact with infected plague animals.Conclusions Qinghai human plague is mainly caused by approaching the plague infected animals,human plague in Qinghai Province is on the rise,the risk of long-distance transmission of the plague is significantly increased.

One-day-old unvaccinated chicks were inoculated with serotype I virulent strain GA and vaccine strain CVI988, serotype III vaccine strain HVT o f Marek's disease viruses(MDV). By using an indirect immunofluorescence assay of suspensions of peripheral blood mononuclear cells(PBMC) with monoclonal antibo dies(MAb) BA4 and BD8 specific to glycoprotein B of MDV, The dynamic course s of vir emia levels for each of 3 strains from 4 days to 45 days postinfection (PI) were determind. Viremia for virulent strain GA-infected chickens were detected from 4 days PI until days before death of infected chickens, it got its peak at abou t 14 days PI. Viremia in serotype 1 vaccine CVI988-inoculated chickens were mea sured between 4 to 22 days PI, it could be detected from 4 days PI and ended at 18 days PI, it got its peak at 8 days PI. For serotype 3 vaccine HVT-inoculated chickens, viremia could be detected beween 4 to 14 days PI, its peak happened a t about 6 days PI. Such IFA with MAbs BA4 and BD8 could be used to evaluate qu al ity of vaccination process in chicken flocks. The differential dynamic courses o f viremia for different strains may be used to diagnose virulent MDV infection i n vaccinated flocks. The viremia levels measured by IFA with the MAbs and co-cu ltivation assay for plague forming unit(PFU) were compared. The results indicate d that IFA assay of PBMC suspension was more sensitive and specific than co-cu ltivation assay, i.e. viremia levels measured by IFA were 30 to 100-fold higher than that by plague-forming assay in CEF for the same sample.

Objective To compare the influences of general anesthesia and intra spinal anesthesia on circulation, respiration, body temperature and anesthesia-related complications in patients undergoing percutaneous nephrolithotomy (PCNL), and assess the effectiveness and safety of both anesthesia. Methods Forty ASA Ⅰ - Ⅱ patients elective for PCNL surgery were divided into two groups by random digits table with 20 cases each:group Ⅰ (endotracheal general anesthesia) and group Ⅱ (intra spinal anesthesia). The temperature, heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2) values and postoperative shivering, nausea, vomiting, back discomfort and the incidence of sore throat were observed and recorded. Results The anesthesia was stable, there were no changes in MAP, HR at different time in group Ⅰ . The anesthesia in group Ⅱ was effective, MAP at 15 min after anesthesia,and HR,MAP after lithotomy position and prone position were obviously changed in group Ⅱ compared with those before anesthesia and group Ⅰ (P ＜ 0.05 ). The temperature at 30,60,90, 120 min after anesthesia decreased compared with that before anesthesia in two groups (P ＜ 0.05 ), and the temperature at 30,60 min after anesthesia in group Ⅰ [(35.8 ±0.6), (34.8 ± 0.5)℃] was lower than that in group Ⅱ [(36.2 ± 0.6),(35.6 ± 0.5)℃](P＜ 0.05).During recovery,complications such as shivering, nausea,sore throat, back discomfort occurred to some extent, of which the incidence of shivering was the highest. Conclusion Both of two anesthesia are applicable to PCNL. When intra spinal anesthesia is used,the life indicators of patients need to be observed and general anesthesia is preferable for the obesity,less physical and the old with poorly compensatory function.

Combined pulsed-field gradient, shaped pulses, and product operator calculations (algorithm), two-dimensional 1 H-31 P hetero-nuclear multiple quantum coherence ( HMQC) pulse sequence was established with the aid of C language. The result showed that coherent transfer path selection could be achieved by adjusting the ratio of two gradient strength ( g1 , g2 ) . The best ratio of g1 and g2 was -5:4 . The HMQC method based on the above sequence can be used for identifying the alkyl groups coupling with phosphorous nucleus. For the different alkyl groups, the sensitivity of this method decreased in the order methyl>isopropyl>ethyl>propyl. The limit of detection was about 10 mg/L. This method can be directly used for the screening and identification of phosphorus chemical warfare agents and related compounds.

Objective To test the attachment quality of autism children between 2～6 years with attach-ment Q-Sort,and to understand the difference from normal children. Methods Use the AQS to test the parents of 167 normal children and 55 autism children,which can evaluate the children' attachment types. Results The rate of security attachment in normal children was 68.3% ,and the rate of unsure attachment was 31.7%. The rate of security attachment in autism children was 29.1% ,and the rate of unsure attachment was 70.9% ;and the rates of security attachment in normal and autism children were different significantly(X2=26.16, P<0.01). Attachment quality was not associated with sex both in normal and autism children and neither age was. Conclusions Most of the normal children have the security attachment,and the autism children have the unsure attachment. Neither age nor sex is associated with attachment quality both normal children and autism children.

After the functions and requirements of medical information officers and the distribution of enterprises were described, the problems in domestic education of medical informatics ( such as insufficient class hours for medical course and unclear orientation of subjects) were analyzed according to the status quo in training of medical informatics students, and some suggestions were put forward for the orientation of medical informatics education in China.