Thirty patients, randomly assigned into three groups, received bolus injection of ketamine 0. 5mg/ kg,midazolam 40ug/kg and one of the three narcotics: fentanyl 3ug/kg (group F ) or sufentanil 0. 4ug/kg (group S)or dihydroetorphine 0. 3ug/kg(group D)just before incision, and then a constant infusion of ketamine 0. 8mg/kg, midazolam 40ug/kg and fentanyl 3ug/kg (or sufentanil 0. 4ug/kg, or dihydroetorphine 0. 3ug/kg)mixture in 100ml normal saline at a rate of 3ml/min for 30 min in beginning, and 1 - 1. 5ml/min thereafter for maintenance. The infusion of narcotics and midazolam was terminated about 45min, and he tamine 15min prior to the end of surgery. Blood pressure and heart rate were all stable,with recovery time shortest in group S (6. 5min ) and longest in group D (12. 5min). Anesthesia were satisfactory in all the patients,except one in group D. It is concluded that this combination of tv anesthetics may be simple and effective and can be considered as an alternative anesthesia technique in the management of mass casualties.

Objective: To optimize the extraction process for Huazhuoqingshen Capsules (Radix Polygoni Multiflori, Radix et Rhizoma Rhei, Pericarpium Citri Reticulatae, etc.) Methods: The process was studied by orthogonal design with yield of extract, the content of hesperidin and emodin as the detective markers. Results: The optimum process was that 60% alcohol was used as extracting solution, adding 8 times amount of solution, extracting 3 times (1h each time.) Conclusion: The content of valid was high and its stability was good when the extraction was used. This extraction process was suitable for industrial production.

Based on ESI database, the paper carries out bibliometric analysis on international psychiatry and psychology literatures during 2004-2014, through comparison of country/region, institutions and journal distribution, it demonstrates the academic status and weakness of our country in psychiatry and psychology field, providing references psychiatry and psychology scientific research development in our country.

Objective To investigate the feature of CT perfusion of the lower limb skeletal muscle in patients with diabetic peripheral arterial disease (PAD).Methods It was a prospective study that collected out-patients and in-patients of interventional vascular surgery from January 2008 to January 2013.The patients were divided into three groups,including 27 patients (54 limbs) in diabetic PAD group,27 patients (54 limbs) in common PAD group and 9 patients (18 limbs) in control group.Patients in diabetic PAD group were selected when PAD were diagnosed through CTA and patient had the exact history of diabetes.There were 54 limbs in diabetic PAD group,including 10 limbs in Fontaine Ⅰ class,21 limbs in Fontaine Ⅱ class,14 limbs in Fontaine Ⅲ class and 9 limbs in Fontaine Ⅳ class.Patients in common PAD group were selected when PAD were diagnosed through CTA,patients those had the exact history of diabetes or coronary heart disease were exclusion.Patients in control group were collected with negative CTA results.CT perfusion scans of lower extremities were performed in all patients.Time density curve (TDC),Blood flow (BF),blood volume (BV),mean transit time (MMT) and permeability surface (PS) of skeletal muscle in different pathologic stage were obtained with perfusion software.The differences of perfusion parameters among diabetic PAD group,common PAD group and control group were compared by analysis of variance; and the differences of perfusion parameters among control group and all Fontaine classes in diabetic PAD group were also compared.Results TDC of normal skeletal muscle in control group continued to rise,and raise rapidly at an early stage; TDC of diabetic PAD group and common PAD group continued to rise,but raise slowly; the TDC of ischemia skeletal muscle has smaller slope and lower peak value than that of control group.The values of BF were (10.41±0.92) ml · 100 ml-1 · min-1 in control group,(13.37± 1.15) ml · 100 ml-1 · min-1 in diabetic PAD group and (17.12 ±0.81)ml· 100 ml-1· min-1in common PAD group.The values of BV were (1.04± 0.13)ml/L in control group,(1.23 ±0.16)ml/L in diabetic PAD group and (1.84 ±0.23) ml/L in common PAD group.The values of MTT were (11.63 ± 1.45) s in control group,(7.92±0.35) s in diabetic PAD group and (7.82±0.38) s in common PAD group.The values of PS were (3.46±0.84) ml· 100 ml 1· min-1 in control group,(9.84±0.87) ml· 100 ml-1· min-1 in diabetic PAD group and (12.11 ±0.70)ml· 100 ml-1· min-1in common PAD group.The differences of the values of BF,BV,MTT and PS among the three groups were statistically significant (F values were 10.892,4.492,27.543 and 20.506,P all＜0.05).The differences of the values of BF,BV among control group and all Fontaine classes in diabetic PAD group were not statistically significant(P all＞0.05),the differences of the values of MTT,PS were statistically significant.And the differences of the values of MTT,PS between control group and each Fontaine class in diabetic PAD were statistically significant (P all＜0.05).Conclusions CT perfusion imaging of Lower extremity skeletal muscle can prompt the existence of early skeletal muscle ischemia for diabetic PAD.The method can be valuable for clinical early diagnosis.

OBJECTIVETo observe the clinical effects of clavicular hook plate combined with suture anchor in treating type Tossy III chronic acromioclavicular dislocation.

METHODSFrom January 2008 to December 2012,18 patients with type Tossy III chronic acromioclavicular dislocation were treated with clavicular hook plate and suture anchor. There were 12 males and 6 females, aged from 20 to 56 years old with an average of 31.5 years. Ten cases were left dislocation and 8 cases were right dislocation. Operation time was 3 weeks to 4 months after injury with a mean of 1.8 months. Functional exercise was adopted 2 weeks after operation. And Karlsson standard was used to evaluate curative effect.

RESULTSAll patients were followed up for 6 to 24 months with an average of 16 months. According to Karlsson standard, 17 cases were excellent and 1 was poor.

CONCLUSIONClavicular hook plate combined with suture anchor can repair conoid ligament and trapezoid ligament in treating type Tossy III chronic acromioclavicular dislocation, and had advantages of simple operation, less trauma, stable fixation, it can obtain satisfactory effects.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Suture Anchors ; Treatment Outcome ; Young Adult

This article summarized the application of Quality of Life in Parkinson's disease such as in therapy or nurse assessment, and discussed how it can be used to assess the effect of Traditional Chinese Medicine on Parkinson's disease, which suggest that a Sinicized Patient Reported Outcome (PRO) measure should be advanced.

Action Potentials ; drug effects ; Animals ; Estradiol ; pharmacology ; Female ; Guinea Pigs ; Heart Ventricles ; cytology ; Myocardial Contraction ; drug effects ; Papillary Muscles ; drug effects ; physiology ; Progesterone ; pharmacology

Objective To evaluate the results of Four-Step methods in traditional Chinese medicine Course.Methods 40 five-academic-year clinical medical students and 40 seven-academicyear undergraduate students were randomized assigned into experimental group (n=40, 20 five-academicyear clinical medical students and 20 seven-academic-year students) and control group (n=40, 20 five-academic-year students and 20 seven-academic-year students).The control group received conventional teaching, while four-step teaching break the gap between Chinese medicine and western medicine, build the base, form the framework of Chinese medicine and extend knowledge was implemented in the experimental group.Through questionnaire score, group discussion, the final evaluation of the theory and clinical training evaluation, the learning of the experimental group students and the control group students was compared.SPSS 18.0 statistical software was used and t test was employed to make analysis of the relevant data.Results The questionnaire at the end of the semester showed that the average score of students in the experimental group (36.18 ± 0.96) was higher than that in the control group (26.62 ± 1.00), and the difference was statistically significant (P=0.017).In the discussion at the end of the semester, the experimental group paid more attention to the theory and technology of traditional Chinese medicine's learning persistence in future and its application in their professional practice.Scores in theory test were higher in seven-academic-year students in experimental group (88.40 ± 8.79) than in control group (82.15 ± 6.83) and the difference was statistically significant (P=0.017), but there was no difference in five-academic-year students between experimental group (75A0 ± 12.09) and control group (77.85 ± 11.99), which was not considered statistically significant different (P=0.524).In clinical practice, the rate of outstanding students in the experimental group of seven-academic-year was five percentage points higher than the control group, while the rate of outstanding students in the experimental group of five-academic-year was 10 percentage points higher than the control group.Conclusions Four step teaching is helpful to stimulating the learning enthusiasm of the students of traditional Chinese medicine, expanding students' vision of medical field, and promoting their construction of a more comprehensive medical knowledge framework.

Objective To explore ways for the supervision of department directors. Methods Job responsibility agreements with department directors were signed and a series of assessment standards were established. Results The methods adopted were standardized, individualized and easy to use. Conclusion Job responsibility agreements with department directors and a standard assessment system are currently effective measures for the supervision of department directors.

OBJECTIVE Approach the cause of esophageal perforation and the analysis of diagnosis, therapy and its outcome in this disease. METHODS We retrospectively review 11 patients of esophageal perforation between1997 and 2004 in our department. There were 9 cases were taken out foreign bodies from their esophageal, another 2 cases haven't been found any foreignbodies and 1 of 2 was caused by iatrogenic reasons. Perforation occurred in the cervical esophagus was 4, and in the thoracic esophagus was 7. Their symptoms were dysphagia or pain, retrosternal-pain, dyspnea, subcutaneous emphysema, fever, hematemesis or melena. RESULTS 7/11 cases visited the clinic during 24 hours after foreign-body occured, 4/11 cases visited after 24 hours and the last visited clinic on 27th day late. Dysphagia was the most common presenting symptom specially with pain in eating, noted in 9 cases (81.8 %); retrosternal-pain and fever were noted in 8 cases (72.7 %), subcutaneous emphysema in 5 (45.5 %), dyspnea in 2 (18.2 %), hematemesis and melena.in 1 (9.1 %). 5 cases were died and the common mortality was 45.45 % (5/11). The mortality in primary repair with surgery treatment was 66.7 % (2/3); the mortality in conservative management was 37.5 % (3/8). The mortality of the perforation in cervical esophagus was 25 % (1/4), in thoracic esophagus was 57.14 % (4/7). The mortality of the visit time in 24 hours was 28.57 % (2/7),and out of 24 hour was 75% (3/4). CONCLUSION Sophageal perforation is usually caused by foreign body or iatrogenic in ENT-Head&Neck surgery. The esophageal perforation will been cured that decided in early visiting, taking away of foreign-boby, the right choice of antibiotic, nutritional support, primary healthy statement of esophagus. We regard that should perform non-operational conservative therapy in the patients who resulted in esophageal perforation except abscess or remain causing by foreign body. And the high risks in mortality of the repairing in surgery should been noticed.