OBJECTIVE:To observe the effects of dexmedetomidine on hemodynamics of patients underwent cardiac valve re-placement in the anesthesia induction. METHODS:92 patients underwent cardiac valve replacement were randomly divided into ob-servation group and control group,with 46 patients in each group. Both groups received routine anesthesia induction regimen of midazolam 1-2 mg/kg+ fentanyl 0.05 mg/kg+ propofol 1-2 mg/kg+ cis-atracurium 0.15 mg/kg. Observation group was additionally given dexmedetomidine 0.5 μg/kg,within 10 min with pumps,and then maintained with 0.4 μg/(kg·h)till the end of operation;control group was additionally given constant volume of normal saline with pumps. SBP,DBP,MAP,HR,cardiac output(CO), cardiac index(CI),stroke volume(SV),stroke volume variation(SVV)before anesthesia induction(T0),5 min after medication (T1),2 min after anesthesia induction (T2),1 min after intubation (T3),3 min after intubation (T4) and 5 min after intubation (T5)were recorded in 2 groups as well as OAA/S at T0 and 5 min after pumping dexmedetomidine(T1). ADR of 2 groups during anesthesia was also recorded. RESULTS:There was no significantly difference in SVV of 2 groups at T0-T5 (P>0.05);SBP, DBP,MAP,HR,CO,CI and SV of observation group at T0-T5 were all better than those of control group,with statistical signifi-cance(P<0.01);there was no statistically significant difference in OAA/S of 2 groups at T0(P>0.05),and OAA/S of observa-tion group at T1 was decreased significantly and lower than control group,with statistical significance(P<0.01). There was no sta-tistically significant difference in the incidence of ADR as cardiac arrhythmia and hypotension between 2 groups(P>0.05). CON-CLUSIONS:Dexmedetomidine can reduce the influence of anesthesia on the hemodynamics of patients underwent cardiac valve re-placement with good safety.

Objective To observe the protective effect of Racecadotril combined with Succinate Injection on myocardial injury in children with rotavirus enteritis and explore its clinical significance.Methods Totally 116 cases of children with rotavirus enteritis from Huangshi Traditional Chinese Medicine ofEdong Healthcare Group were selected in this study.Patients were randomly divided into Racecadotril control group (n =58) and Racecadotril combined with Succinate Injection observation group (n =58).The levels of CK,CK-MB,LDH,IL-17,IL-6,and TNF-α were detected by ELISA analysis.The rates of clinic effects and adverse reaction were compared.Results There was no significant difference of CK,CK-MB,LDH,IL-17,IL-6,and TNF-α between two groups before treatment.After treatment,they were all decreased in two groups (P ＜ 0.05,0.01).However,they were all lower in observation group than those in control group after treatment (P＜0.05).The rate of clinic effects was 94.8％ in observation group,which was higher than 81.0％ in control group (P ＜ 0.05).The rate of adverse reaction was 8.6％ in observation group and 6.9％ in control group.There was no significant difference between two groups.Conclusion Racecadotril combined with Succinate Injection inhibits the inflammatory response to protect myocardial injury in RVE children,with significantly clinical efficacy and safety.

OBJECTIVE To explore countermeasures to improve the quality of hospital infection control. METHODS The hospital control problems were analyzed through clinical practice. RESULTS Hospital infection control management was restricted by the inadequate understanding of the importance,the lack of related knowledge,the medical treatment cost and economic performance. CONCLUSIONS To establish an effective mechanism dealing with hospital infection control,education of the importance of infection control and training and to implement the target responsibility system are the keys to improve the quality of hospital infection control.

Objective To study the nursing effect of evidence-based nursing in perioperativc period of gynecological laparoscopy operation and prevention of postoperative complications.Methods 238 cases of patients undergoing laparoscopic operation were setas the study group,the evidence-based nursing method was used in this group.Another 212 cases of patients undergoing laparoscopic operation were named as the control group,they were given conventional nursing care.The improvement of complications and anxiety emotion were compared between the two groups.Results The complication rate was 10.92% in the study group,and 29.24% in the control group,the difference between the two groups was significant.The decreased degree of total score of HAMA and psychic anxiety,somatic anxiety score in the study group was higher than those of the control group at discharge.The difference had statistical significance.Conclusions Evidence-based nursing plays an important role in decreasing the postoperative complications and improving the anxiety emotion of patients,which is worthy of clinical popularization.

Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors(TET) before surgical resection.Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively.The TET were reclassified according to Masaoka stage system.The size,homogeneity,sharp,contour,infiltration of surrounding tissue,and metastasis on CT were analyzed with Logistic analysis.The diagnostic value was also evaluated with a ROC curve.Results Masaoka pathologic stages were stage Ⅰ for 36 (35.3 ％),stage Ⅱ for 27 (26.5 ％),stage Ⅲ for 30 (29.4 ％),and stage Ⅳ for 9 (8.8 ％).A multivariable Logistic regression model showed that TET with larger size of tumor (20/35,P =0.0371,OR =4.539),irregular or lobulated tumor contour (26/42,P =0.0230,OR =4.870),heterogeneous (21/33,P =0.0154,OR =6.020),infiltration of surrounding fat (25/32,P =0.0019,OR =14.005),and pleural seeding (11/11,P =0.0032,OR =36.153)were more likely to have stage Ⅲ or Ⅳ disease.The area under ROC curve was 0.940.Conclusions The tumor CT imaging features can differentiate between stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ disease.This helps identified patients more likely to benefit from neoadjuvant therapy.

In view of the contradictory phenomenon between yingfen dominating the interior when suffering exogenous epidemic febrile disease and ying disease dominating the exterior in cold pathogenic diseases,the authors revealed the misunderstanding of yingfen dominating the interior in epidemic febrile disease by a systematical analysis on the headstream of the theory,the connotation for diagnosis and treatment and logical relation. Based on the requirement of the theory guiding the clinical effectively,at the same time,the authors put forward a new opinion on classification of diagnosis and treatment on wei,qi,ying,blood system by the theory of the cold integrating the warm,which was a courageous exploration for the purpose of seeking unity of thinking on syndrome differentiation and treatment of external infection diseases.

In view of the contradictory phenomenon between yingfen dominating the interior when suffering exogenous epidemic febrile disease and ying disease dominating the exterior in cold pathogenic diseases,attemping to get the logical demonstration that cold pathogenic diseases and exogenous epidemic febrile diseases can be integrated by yingfen diseases,the authors made a systematic classification and comparison on basis of the collection of related diagnosis and treatment in respective yingfen diseases of cold pathogenic diseases and exogenous epidemic febrile disease. It was of vital importance to connecting cold pathogenic diseases with exogenous epidemic febrile diseases in classification of diagnosis and treatment in wei,qi,ying,blood system.

ObjectiveTo investigate the early diagnostic value of serum level of myelin basic protein (MBP) on spinal cord injury (SCI).Methods54 rabbits were divided randomly into slight, moderate and severe SCI groups, and SCI degrees of each group were judged by cortical somatosensory evoked potential, histopathologic examination and Tarlov′s score. ELISA was used to determine the serum levels of MBP before and after SCI.ResultsThe serum levels of MBP of rabbits in three groups were significantly different at 24th, 48th and 72nd hour after injured (P<0.05), but there were not differences at 7th day (P>0.05).ConclusionThe serum level of MBP can be used as a early diagnostic marker for SCI.

[ABSTRACT]OBJECTIVETo investigate the efficacy and the related complications of combinedpostauricular methylprednisolone injection and systemic therapy for profound idiopathic sudden hearing loss (ISSNHL). METHODSTotal of 60 patients with ISSNHLwho had received therapy from June 2014 to May 2015 in Beijing Anzhen Hospital affiliated to Capital University of Medical Science,were randomly divided into 2 groups,the systemic application group (30 patients): dexamethasone (DEX) was applied intravenously in dose of 10 mg×5 d, and the postauricular injection group (30 patients): methylprednisolone sodium suecinate was injected subperiosteally near the upper one-thirds of postauricular sulcus every day, 40 mg×5 d.All 60 patients received the same medications for 2 weeks to improve the hearing. Hearing and tympanic membrane were monitered before the injections and two weeks after the termination of injections. SPSS 16.0 software was used to analyze the data.RESULTSThe postauricular injection group: 23 of 30 ears had improvement of hearing. No related complications were reported. The systemic application group: 23 of 31 ears had improvement of hearing (P>0.05) No related complications were reported.CONCLUSIONCombined postauricular methylprednisolone injection and systemic medications therapy can be considered as is an effective therapy for profound idiopathic sudden hearing loss. It can avoid the side-effects of high dose systemic corticostemid treatment. For ISSNHL patients, postauricular methylprednisolone injection may be an appropriate treatment.

Objective:To investigate the use of simple pooling and bivariate model in meta-analyses of diagnostic test accuracy (DTA) published in Chinese journals (January to November, 2014), compare the differences of results from these two models, and explore the impact of between-study variability of sensitivity and specificity on the differences. Methods:DTA meta-analyses were searched through Chi-nese Biomedical Literature Database (January to November, 2014). Details in models and data for four-fold table were extracted. Descriptive analysis was conducted to investigate the prevalence of the use of simple pooling method and bivariate model in the included literature. Data were re-analyzed with the two models respectively. Differences in the results were examined by Wilcoxon signed rank test. How the re-sults differences were affected by between-study variability of sensitivity and specificity, expressed by I2 , was explored. Results:The 55 systematic reviews, containing 58 DTA meta-analyses, were included and 25 DTA meta-analyses were eligible for re-analysis. Simple pooling was used in 50 (90. 9%) systematic reviews and bivariate model in 1 (1. 8%). The remaining 4 (7. 3%) articles used other models pooling sensitivity and specificity or pooled neither of them. Of the reviews simply pooling sensitivity and specificity, 41(82. 0%) were at the risk of wrongly using Meta-disc software. The differences in medians of sensitivity and specificity between two models were both 0. 011( P<0. 001, P=0. 031 respectively). Greater differences could be found as I2 of sensitivity or specificity became larger, especially when I2 >75%. Conclusion:Most DTA meta-analyses published in Chinese journals(January to November, 2014) combine the sensitivity and specificity by simple pooling. Meta-disc software can pool the sensitivity and specificity only through fixed-effect model, but a high proportion of authors think it can implement random-effect model. Simple pooling tends to underestimate the results compared with bivariate model. The greater the between-study variance is, the more likely the simple pooling has larger deviation. It is necessary to increase the knowledge level of statistical methods and software for meta-analyses of DTA data.