BACKGROUND: Inadequate hyperventilation may trigger cerebrovascular contraction and lead to lowered cerebral perfusion and oxygen supply-demand imbalance.OBJECTIVE: To investigate the influence of hyperventilation on oxygen saturation in the internal jugular vein, difference in oxygen and lactic acid contents between the cerebral arteries and veins in patients with serious traumatic brain injury.DESIGN: Case analysis.SETTING: Department of Anesthesiology, First Hospital Affiliated to Shantou University.PARTICIPANTS: Sixteen patients who received emergency operations in the First Hospital Affiliated to Shantou University between January and July 2002.METHODS: Patients with traumatic brain injury underwent operation under general anesthesia, and the PaCO2 was maintained at 30 mm Hg for 15 minutes by regulating the respiration rate, followed by decrease to 25 mm Hg, maintained for 15 minutes before restoration to 30 mm Hg for 15 minutes. The fractional concentration of inspired oxygen was adjusted to maintain blood PaO2 at around 100-150 mm Hg, and the blood sample was collected from the artery and internal jugular vein 15 minutes after adjustment of PaCO2 for blood gas analysis. The PaO2 was then increased to 200-250 mm Hg by increasing the fractional concentration of inspired oxygen, and the PaCO2 was adjusted from 30 to 25 and then back to 30 mm Hg in the described manner, and the oxygen saturation in the internal jugular vein, difference in oxygen and lactic acid contents between the arteries and the veins were measured.MAIN OUTCOME MEASURES: Influence of blood PaO2 and PaCO2 on oxygen saturation in the internal jugular vein, difference in oxygen and lactic acid contents between the arteries and the veins.RESULTS: Sixteen patients met the diagnostic criteria and completed data collection. The arterial PaCO2 decreased from 30 to 25 mm Hg when arterial blood oxygen pressure increased from 100-150 to 200-250 mm Hg, which leads to obvious decrease of oxygen saturation in the internal jugular vein and obvious increased difference in oxygen content between the cerebral artery and vein. However the absolute value of oxygen saturation in the internal jugular vein was obviously higher at PaO2 of 200-250 mm Hg than that at PaO2 of 100-150 mm Hg, while the absolute value of cerebral arteriovenous difference of brain oxygen content was obviously lower. Compared to the basal level, the arteriovenous lactic acid difference was obviously increased at PaO2 of 100-150 mm Hg,PaCO2 of 30 and 25 mm Hg, and at PaO2 of 200-250 mm Hg and PaCO2 of 25 mm Hg.CONCLUSION: Relatively higher PaO2 (200-250 mm Hg) and mild hyperventilation (PaCO2 of 30 mm Hg) has no obvious effect on brain oxygen supply-demand balance.

Objective To explore the related factors of the relapse of schizophrenics in unwell developed economic areas.Methods To analyze 718 schizophrenics by single and multiple stepwise regression analyses to explore whether relapse of schizophrenia was related to those factors.Results 2.8％ experienced one time relapse, 14.2％ experienced two times relapse and 83％ three times. The rate of schizophrenic relapse was in turn correlated with treatment compliance, treatment intervention, marriage, clinical features, psychological stress,social support, the way of forming disease, medical expenses and condition of access to medical care. Conclusions More attention should be paid to the factors causing schizophrenic relapse and wider measures of prevention and treatment should be taken.

To retrospectively analyze the clinical data of 305 cases with apoplectic sequela admitted at our general geriatric nursing ward from January 2000 to December 2011.The subjects were divided into 2 groups:hypoalbuminemia and non-hypoalbuminemia.Advanced age (OR =5.624),chronic heart failure (OR =2.298),conscious disturbance (OR =1.575),dysphagia (OR =1.565),complete bedridden (OR=2.874),pneumonia (OR =3.725) and bedsore (OR =5.336) were risk factors for hypoalbuminemia in the patients with apoplectic sequela.And hyperglycemia(OR =0.066)was a protective factor for it.

Objective To compare the low-intensity focused ultrasound (LIFU) and high-intensity focused ultrasound (HIFU) in treating pain due to chronic soft tissue injury.Methods Ninety-three patients with pain due to chronic soft tissue injury, aged 18-80 yr, with body mass index of 18-31 kg/m2,course of the disease 3 months-10 yr, and pain intensity of 4-8 in a numeric rating scale, were randomly divided into 2 groups using a random number table: low intensity group (group LI, n =49) and high intensity group (group HI, n =44).In group LI, the patients received LIFU with the minimum ultrasonic intensity causing senses (acid, hemp, swelling, pain) , and the treatment was continued for 10 min.In group HI, the patients received HIFU with the focused uhrasound intensity that could not be tolerated by the patients, the treatment was continued for 1 min each time and then suspended for 1 min, and the total time for treatment was 10 min.The patients received the treatment once a day, and the course of treatment was 5 days in both groups.When numeric rating scale score ＞ 4 during the treatment, parecoxib sodium 40 mg was injected intramuscularly as rescue analgesic.Both the therapeutic index and improvement in movement were used to evaluate the therapeutic effect, and the quality of life and depression were assessed and scored.The treatment-related adverse events were also recorded.Results The total effective rate was 98％ and 84％ in LI and HI groups, respectively.Compared with group HI, the total effective rate was significantly increased, the quality of life score was increased, and no significant change was found in depression score in group LI.No patients used parecoxib sodium or developed treatment-related adverse events in group LI.One patient (2％) required parecoxib sodium, the incidence of skin burns, nerve damage and abnormal pain was 4％, 2％ and 2％, respectively, and no patients developed tissue swelling in group HI.Conclusion LIFU has higher therapeutic effect than HIFU in treating pain due to soft tissue injury, and the safety is good.

Objective To compare the efficacy and safety of recombinant insulin lispro and insulin lispro in the treatment of type 2 diabetes mellitus(T2DM ) .Methods Forty‐eight T2DM patients with poor blood glucose control were randomly assigned to the recombinant insulin lispro group (observation group ,n=32) and insulin lispro group (control group ,n=16) according to the ratio of 2∶1 .On the basis of injection of the recombinant insulin glargine once daily before sleep ,the two groups were given the re‐combinant insulin lispro injection or insulin lispro injection once before each meal .The period of treatment was 16 weeks .The levels of HbA1c ,2 h postprandial blood glucose(2hPG) and fasting plasma glucose(FPG) before and after treatment were measured and compared between the two groups .The adverse events were evaluated at the end of treatment .Results Forty‐four cases finished the study ,28 cases in the observation group and 16 cases in the control group .The levels of HbA1c ,FPG and 2hPG after 16‐week treatment in the two groups were decreased significantly (P<0 .05) .The decrease amplitudes of HbA1c in the observation group and the control group were (1 .55 ± 1 .50)% and(1 .06 ± 1 .30)% respectively ,which of FPG were (2 .07 ± 5 .01)mmol/L and (1 .09 ± 3 .18)mmol/L respectively ,and which of 2hPG declined (3 .28 ± 5 .71)mmol/L and(3 .60 ± 5 .89)mmol/L respectively . With HbA1c as the main evaluation index and 0 .40 as the non‐inferiority critical value ,non‐inferiority was found in the recombi‐nant insulin lispro injection as compared with the insulin lispro injection (P<0 .05) .The standard‐reaching rate of HbA1c less than 6 .50% in observation group was 14 .29% ,and which of HbA1c less than 7 .00% was 28 .57% ;in control group ,these two stand‐ard‐reaching rates were 18 .75% and 43 .75% respectively ,and there were no statistically significant differences between two groups (P>0 .05) .Conclusion The recombinant insulin lispro injection has non‐inferiority effects in the aspect of effectiveness compared with the lispro insulin injection ,moreover they have the same safety .

OBJECTIVE:To get a clear idea about current situation and trend of the application of eye drops in hospital of Shanghai so as to provide the information for rational clinical application and development of new preparations.METHODS:The kinds and amount of commercial eye drops,used in 47 hospital in Shanghai for the years 1997～2001,were analysed and evaluated.RESULTS & CONCLUSION:The amount of consumption of eye drops was increased year by year.The new type with good quality was received by clinical physicians.

OBJECTIVE: To analyse the situation of use of therapeutic drugs for benign prostate hyperplasia(BPH) in hospitals of Shanghai and to make OBJECTIVE: evaluation as reference for production,sale and consumption departments.METHODS: To investigate the BPH drugs used in 47 hospitals of Shanghai during the 1999 - 2001 period in respect to the amunt of consumption, kinds, sum of money of consumption, DDDs and clinical evaluation .RESULTS: Consumption of BPH drugs was increasing in recent years, but kinds of drugs had no obvious change, major drugs for BPH were Finasteride, Tamsulosin and Prostat .CONCLUSION: Therapeutic drugs for BPH are common drugs, but price is very expensive.To speed up the reseach and development of drugs in our country and to advocate the use of domestic products are suggested.

OBJECTIVE:To get a clear idea about the situation of application of hypolipemic agents in hospitals of Shanghai so as to provide information for departments of production,sale and consumption METHODS:The kind,amount,sum of money and DDDs of hypolipemic agents,used in 47 hospitals in Shanghai during the period 1999～2001,were analysed RESULTS:Vastatin,Fibrate and Chinese materia medica were the most commonly used drugs;Simvastatin,Zhibituo and Fenofibrate occupied the front places in amount of consumption;The sales volume of Zocor(Simvastatin)Pravachol and Xuezhikang was at the top of list;Simvastatin,Fluvastatin,Xuezhikang and Fenofibrate revealed increasing tendency and Gemfibrozil,Zhibituo,Duoxikang and Chondroitine showed decreasing tendency in clinical use CONCLUSION:The market prospects of hypolipemic agents will be wide and bright

Objective To study the clinical characteristics,pathologic change,surgical treatment and survival rate of primary hepatic carcinoma complicated with cancer embolus of biliary tract (PHC-CEBT).Methods Case analysis data,clinical manifestation and pathological findings of 16 cases of PHC were comprehensively analyzed in our hospital.Results No death case was seen after resection. The survival time of 2 patients without tumor resection were 2 5～4 5 months,other 14 patients with tumor resection were 1～4 5 years.Conclusions Surgical operation treatment of PHC-CEBT is effective,it can increase the survival rate and improve life quality.

In the article, it thinks that moral lacking of advertisement is the basic reason which leads to intensified illegal medical advertisement. The main reasons for moral lacking of advertisement: imperfect legal system of medical advertisement, indifferent ethical consciousness of medical advertisement, insufficient social supervision of medical advertisement. Therefore, we should perfect the legislation, establish the correct advertising moral concept, improve the quality of advertising employees, and realize the function of social supervision fully.