Aim Effect of various absorption enhancers on the insulin colonic absorption was investigated. Methods The hypoglycemic effect was examined after colon delivery of INS SOL co administered with various absorption enhancers and the pharmacological bioavailability (PA) was calculated. Results INS SOL (5 U?kg -1 ) containing eucalyptol, sodium caprate, sodium deoxycholate and menthol significantly decreased the blood glucose level ( P

ObjectiveTo investigate the changes in stroke volume variation (SVV) monitored by FloTrac/Vigileo system during mechanical ventilation in patients undergoing pulmonary lobectomy.MethodsForty-four ASA Ⅰ or Ⅱ patients aged 44-64 yr weighing 47-86 kg undergoing elective pulmonary lobectomy performed under general anesthesia were studied.Blood volume was maintained by fluid (crystalloid∶ colloid 1∶1) infusion at a rate of 6-8 ml·kg-1 ·h-1.Cardiac output index (CI),stroke volume index (SVI) and SVV were measured based on arterial pressure wave form analysis by FloTrac/Vigileo System (Edwards Co.,USA) and recorded at following time points:at 5 min of two-lung ventilation (TLV) in supine position,2 min TLV in lateral position,during one-lung ventilation (OLV) before thoracotomy,at 5 and 30 min of OLV after thoracotomy,1 and 15 min OLV + PEEP of 5cm H2 O,before and immediately and 1 min after reflation of the remaining lobes.The normal value for SVV is less than 13％.ResultsThe hemodynamic parameters were stable during lobectomy.CI and SVI were within normal range.SVV was less than 13％ at all time points except that at immediately after reflation of the remaining lobes.ConclusionSVV obtained with FloTrac/Vigileo system can be used to guide fluid therapy during OLV in mechanically ventilated patients undergoing pulmonary lobectomy.

This paper introduces the perioperative nursing of 47 patients undergoing intraperitoneal parastomal hernia repair.After the surgery,two cases suffered from incision infection and two cases with subcutaneous hydrops.Three patients suffered from chronic pain or foreign bodies sensation,which disappeared at 3-6 months later.No recurrence occurred at 6-24 months after the surgery.It is suggested that the key points of perioperative nursing were careful preoperative symptom care and bowel preparation,as well as postoperative observation and correct discharge instruction.

Molecular-targeted therapy is a new method and tendency in the treatment of hepatocellular carcinoma (HCC). To date, sorafinib, a multi-targeted gent, is the only one proved to be effective in improving the survival of patients with advanced HCC. Sorafinib is also the first line systemic agent for advanced HCC. Other multi-targeted agents, such as sunitinib, are also proved to be effective. Erlotinib, gefitinib and eetuximab, which target epidermal growth factor receptor, show effectiveness but still need further investigation. Bevacizumab, which targets vascular endothelial growth factor and vascular endothelial growth factor receptor, shows excellent results and deserves more clinical trials. The effects of bortezomib, sirolimus and imatinib, which target other pathways, are still under investigation. The future studies of molecular-targeted therapy for HCC should be focused on the combination of different targeted medicine, and combination of molecular-targeted therapy and chemotherapy, as well as individualized therapy.

Objective To study curative efficacy of cyclophosphamide combined with VAD regimen in treatment of multiple myeloma and its effects on coagulation function.Methods 78 patients of multiple myeloma who received therapy from July 2013 to July 2016 in our hospital were selected as research objects, and divided into the control group and the observation group , the control group was treated with VAD regimen, while the observation group was treated with cyclophosphamide combined with VAD regimen.Then coagulation factor and anti-coagulation factor activity, adverse reaction, therapeutic effect after treatment between two groups were compared.Results After treatment, decreased blood coagulation factor, Protein C, protein S and antithrombin were increased between two groups , the difference was not statistically significant.Incidence of adverse reactions in observation group was less than the control group[15.38%(6/39)vs 46.15%(18/39)], the difference was statistically significant(P<0.05);The total effective rate of observation group was statistically higher than that in the control group [ 89.74%( 35/39 ) vs 58.97%( 23/39 ) ] , the difference was statistically significant(P<0.05).Conclusion Cyclophosphamide combined with VAD regimen is well for multiple myeloma, which can effectively improve the patient's condition, improve the life quality of patients, and will not cause a greater impact on blood coagulation function.

Objective To investigatethe EC50 of different doses of dexmedetomidine on etomidate inhibited responses tolaryngeal maskinsertion in patients.Methods 88 with breast cancerfrom surgical department in Zhuji Hospital of Traditional Chinese Medical from August 2014 to August 2015were selected and randomly divided into the control group(groupA)and the experiment group(group B1,group B2 and group B3)with 22 casesin each group,respectively,intravenous pump 0.9％sodium chloride solution and DEX(dose followed by 0.3,0.6,0.9μg/kg).The next sequential intravenous infusion of etomidateafter 10 min.The EC50 and the 95％confidence interval of etomidate were determined by sequential method in each group of patients,the changes of vital signs and adverse reactionsin patients were monitored.Results Four groups of patients with LMA EC50 and 95％confidence interval of etomidate respectively:0.78(0.723～0.835)μg/mL in group A,0.66(0.612～0.711)μg/mL in group B1,0.58(0.532～0.627)μg/mL in group B2,0.46(0.416～0.521)μg/mL in group B3.Four groups of patients with laryngeal mask insertion immediately before MAP and HR were lower than the baseline value,the difference was statistically significant(P<0.05),but the LMA elevated after one min.The control group of four patients with respiratory depression,three cases of patients with bradycardia in group B3,two cases of patients with hypotension were improved after symptomatic treatment.Conclusion In a certain range,increasing the dose of dexmedetomidine reduces the effective concentration of etomidate,which inhibits the laryngeal mask placement reaction.

Objective To explore serratus anterior muscle transplantation for the repair of soft tissue defects in foot and ankle. Methods Seventeen patients consisted of 11 males and 6 females aging from 13 to 58 years with the mean age of 35.2 years. The anatomical parameters of serratus anterior of 17 cases were measured, the thickness of the muscle was (1.24?0.65) cm, and the diameter of origin point of the nutrient artery to the muscle was (1.4?0.6) mm. There were two veins arising from the muscle, the diameter of larger one was (2.5?0.8) mm. The length of vascular pedicle was (8.31?1.48) cm. 17 patients with soft tissue defect of foot and ankle were treated with free serratus anterior muscle transfer and split skin graft overlying the muscle. The primary lesions were soft tissue defect around the ankle and Pilon fracture in 5 cases, non-union of distal tibial fracture in 3, Achilles tendon and soft tissue defect in 3, metatarsal fracture and soft tissue defect in 4, and calcaneal fracture with soft tissue defect in 2. All of the patients suffered from infection or exposure of bone or applied plate, the area of soft tissue defect ranged from 4.5 cm?6 cm to 11 cm?13 cm. Results The average operative time was (6.5?1.2) hours. The complications included local hematoma in 2 cases, superficial infection in 2, winged scapula without function loss in 1,scar pain in 2, and numbness of lateral thoracic wall in 1. Furthermore, weakness and decreased shoulder mobility were noted in 3 patients comparing with the contralateral side, but the condition improved half year following the operation. The transferred muscle flap appeared thinner and less bulky , and healed intimately with the adjacent foot tissue, the patients resumed good function in walking. Conclusion The serratus anterior muscle flap is a good choice for treatment of soft tissue defects in foot and ankle.

Objective To investigate the surgical treatment value to the deep coma patients with spontaneous cerebellar hemorrhage. Methods The clinical manifestations were recorded and analyzed in 43 patients suffering from cerebellar hemorrhage. Thirty-two patients(surgical treatment group) were treated with suboccipital decompression, clot evacuation and external ventricular drainage, and 11 patients (conservative treatment group) were managed conservatively. The level of consciousness was evaluated with Glasgow coma scale (GCS), and GCS scores of all enrolled patients was less than 5. Outcome was assessed with Glasgow outcome scale (GOS) at 6 months after onset. Results At 6 months after onset, the fatality rate in surgical treatment group was 31.25%(10/32), in conservative treatment group was 6/11, and there was no significant difference (χ2=1.04, P=0.310). The rate of bad outcome (GOS 1-3 scores) in surgical treatment group was 75.00%(24/32), in conservative treatment group was 11/11, and there was no significant difference (χ2=2.40, P=0.120). In the patients of more than 60 years old, the rate of good outcome between surgical treatment group and conservative treatment group had no significant difference:5/16 vs. 0,χ2=6.00, P=0.060. Conclusions Although fatality rate is lower, the long-term prognosis couldn′ t be improved by surgical treatment in the cerebellar hemorrhage patients with GCS≤5 scores when the brainstem function isn′t evaluated.

The object of medical research is human life,thus the understanding level of human being determines medical mode and the development of medical science.The origin of Marx's theory on human being is the realistic human,which provides methodological basis for reflecting on the biomedical faults from a logical perspective.Marx held that technology is the objectization of the essential power of human being,while technology under the context of capitalist production relations has been turned into certain means to control workers.Tend of dissimilation also arises in some modern medical fields,thus serious reflection and criticism are in great need.The overall development of human being is the core content in Marx's theory on human being.Since modern medicine is during the transition from bio-medical model to bio-psycho-social medial model,the new medical model calls for an overall development of main body in all aspects including qualification,ability,and social relations,etc.