Objective To observe the sedative effect of dexmedetomidine administered at different infusing rates in senile cataract patients with retrobulbar nerve block.Methods Eighty-four senile cataract patients with retrobulbar nerve block were divided into Ⅰ,Ⅱ and Ⅲ group by random systematic sampling method with 28 cases each,the dexmedetomidine infusing rates were 0.2,0.4 and 0.6 μg/(kg·h) accordingly.Ramsay score and mean arterial pressure (MAP),heart rate (HR),respiratory rate (RR),pulse oxygen saturation (SpO2) were recorded before anesthesia (T0),after retrobulbar nerve block (T1),and 1 0,20,30,60min after sedative administration (T2-T5).Results Ramsay scores were higher in three groups at T2-T5 than that at T0 [Ⅰ group:(2.6 ± 0.7),(2.5 ± 0.2),(2.4 ± 0.8),(2.4 ± 0.3) scores vs.(2.0 ± 0.0) scores,Ⅱ group:(3.0 ± 0.7),(3.8 ± 0.7),(4.2 ± 0.2),(4.5 ± 0.2) scores vs.(2.0 ± 0.0) scores,Ⅲ group:(3.8 ±0.6),(4.7 ± 0.4),(5.2 ± 0.8),(5.6 ± 0.6) scores vs.(2.0 ± 0.0) scores],Ⅲ group was higher than Ⅰ group and Ⅱ group,Ⅱ group was higher than Ⅰ groupatT3-T5,difference was statistically significant (P＜0.05).HR was slower in three groups at T3-T5 than that at T0 (P ＜ 0.05),Ⅲ group was slower than Ⅰgroup and Ⅱ group,difference was statistically significant (P＜0.05).There were no significant changes in MAP,RR and SpO2 among groups and the group (P ＞ 0.05).Conclusion Bolus infusion dexmedetomidine 0.5 μ g/kg followed by intravenous infusion at 0.2-0.4 μ g/ (kg· h) is suitable for sedation of senile patients with cataract surgery.

Objective To study imaging findings of Sturge-Weber syndrome. Methods The clinical manifestations and imaging findings of 11 cases suffered from Sturge-Weber syndrome were analysed. 10 cases had facial vascular nerves angioma in the trigeminal nerve distribation. Routine CT examination was performed in all 11 cases, 2 cases had head radiography and 8 cases had MRI, 5 cases had enhanced CT and 3 cases had enhanced MRI.Results Imaging finding included:on the affected hemisphere, cortical calcifications (n=11), brain atrophy (n=9), the interfaces between gray matter and white matter blured, dilated subependymal veins,enlargeel choroids plexus (n=7) and increasing thickness of cranial diploe (n=8). The choroids plexus of lateral ventricle was prominent enhanced in 5 cases. Enhancement of cortical areas and vessels on the surface of brain were noted in 6 cases. Conclusion Head radiography has finite effects in the diagnosis of Sturge-Weber syndrome, MRI combined with CT plays an important role in the diagnosis of this syndrome.

OBJECTIVE To approach the effect of empirically applying ?-lactam antibiotics for treatment of hospital-acquired pneumonia on distribution and antibiotic-resistance of pathogenic bacteria.METHODS To investigate 141 patients with hospital-acqired pneumonia in intensive care unit during Jan 2001-Oct 2005,and divide into 3 groups:third generation cephalosporin group;lactamase inhibitor group;and other lactam antibiotics group according to different initial antibacterial strategy,then analyze difference in distribution and antibiotic-resistance of pathogens among each group.RESULTS We acquired 164 strains of pathogens.Comparing with other two groups,the proportion of Gram-positive cocci in lactamase inhibitor group was higher significantly(P

Objective To compare the efficacy of carotid endarterectomy(CEA)and carotid artery stenting(CAS)for the treatment of high-risk atherosclerotic carotid artery stenosis.Methods We retrospectively studied the surgical outcomes of 58 patients with high-risk atherosclerotic carotid artery stenosis.Among the cases,32 received CEA and 26 underwent CAS.All of the patients were followed up with carotid ultrasonography,CTA or DSA in 30 days,6 months,and 1 year after the procedures,their neurological function was assessed meanwhile.Cumulative incidence of death,stroke,or myocardial infarction within 30 days after the surgical intervention and death or ipsilateral stroke events between 30 days and 1 year were set as the primary endpoint of the study.And the secondary endpoints were the CEA or CAS-correlated complications or severe restenosis within 1 year after the treatment.The outcomes of the two groups were compared.Results The primary endpoint occurred in 3 patients in the CEA group(9.4%)and 4 in the CAS group(15.4%)(?2=0.086,P= 0.769).And the secondary endpoint was found in 4 of the CEA group(12.5%)and 4 of the CAS group(15.4%)respectively(?2=0.000,P=1.000).Conclusions For the patients with high-risk carotid artery stenosis and coexisting conditions,CEA is as safe and effective as CAS.

Objective To realize intelligent and refined management of medical war storage materials by designing a management platform based on context awareness.Methods The conditions of medical war storage materials and its storage environment were monitored dynamically,and technologies of context awareness,radio frequency identification,temperature and humidity sensing and etc were used to establish the platform.Results The platform improved the traditional medical war storage materials management system in intelligence and refinement,and implemented auto update and intelligent alarm for the information on medical war storage materials.Conlusion The platform fulfills automatic and intelligent medical war storage materials management,and thus has practical values for medical service support.

Objectives:To investigate the clinical outcomes of unilateral percutaneous vertebroplasty(PVP) by using curved injection needle in osteoporotic vertebral compression fractures(OVCFs).Methods:From January 2015 to January 2016,47 patients(14 males and 33 females) with OVCFs were enrolled in this study.The patients were 53-89 years old (66.4±6.5 years),36 cases were single segmental vertebral fracture,11 cases were double segment vertebral fracture.T9 fracture occured in 7 cases,T10 fracture in 7 cases,T11 fracture in 9 cases,T12 fracture in 13 cases,L1 fracture in 12 cases,L2 fracture in 9 cases,and L3 fracture in 1 case.The fluoroscopy time and bone cenent dosage were recorded.The VAS score,ODI,relative height restoration of vertebra and Cobb angle were compared between preoperation and postoperation.The bone cement leakage(venous leakage and perivertebral leakage) and other complications were observed.Results:The average fluoroscopy time was 1.6±0.3nin,the average bone cement dosage was 6.7±1.2ml.Bone cement leakage occured in 11 cases with the rate of 23.4％.The patients were followed up for 3-12 months (6.5±1.3 months).The VAS,ODI,the relative height of injured vertebra and the local Cobb angle before operation,at 2 days after operation and final follow-up were:7.6±1.3,(71.4±3.2)％,0.48±0.21,15.5°±4.2°;2.2±1.0,(27.2± 2.6)％,0.82±0.17,7.2°±2.8°;1.7±0.7,(26.5±2.7)％,0.80±0.15,7.5°±3.7°.At 2 days after operation and final follow-up,the VAS score,ODI score,the relative height and Cobb angle of injured vertebra were significantly improved when compared to those before operation (P＜0.05);There was no significant difference between 2 days after operation and final follow-up(P＞0.05).Conclusions:The advantages of unilateral PVP by using curved injection needleless in OVCFs are less fluoroscopy time,even distribution of bone cement,and less leakage.

Based on the characteristics of the scientific research for the hospitM in new period,this paper studied on the construction of management regulations for the laboratory animal center combining the developing condition of the laboratory animal in the hospital.

Objective To compare the diagnostic value of CT and NE for lesions of nasal cavity and paranasal sinus area.Methods 80 cases of nasal and paranasal sinus diseases which were examined by both CT and NE at same period and proved by pathology.were reviewed.Results Compare with results of pathology,the accucy rate of both CT and NE was identical in diagnosing sinusitis and tumours of paranasal sinus,NE was higher than CT in nasal and paranasal sinus polyp and nasal cavity tumour,turbinate hyperplasia CT was higher than NE in paranasal sinus cyst and anatomic variations.Conclusion Pathologic biopsy can be taken under NE guide to understand the shape,texture and colour of the illness focus CT can show the size,shape and anatomy relation between lesion and its neighbor tissue.The diagnosis may more perfectly through NE combined with CT.

OBJECTIVE To sum up the distribution and drug-resistance of pathogens in hospital-acquired pneumonia(HAP) at each stage,and then to offer references for treatments of HAP.METHODS To retrospectively analyze 46 patients whose course was over 30 day and who were in hospital from Jan 2000 to Oct 2005,and to divide course into prophase,metaphase and anaphase,and then to clinically study the drug-resistance and distribution of pathogens in each phase.RESULTS In prophase the most pathogens were Gram-negative bacilli(accounted for 87.5%),in metaphase the Gram-positive cocci were manifold distinctly;and in metaphase and anaphase drug-resistance of Gram-negative bacilli increased distinctly;and the fungi were not detected in prophase,but were positive in metaphase and anaphase.CONCLUSIONS In prophase application of third generation cephalosporin which is more sensitive to Gram-negative bacilli as an empirical antibacterial therapy is right;based on the drug-resistance and distribution of pathogens,the antibacterial drugs and treatment must be readjusted.

BACKGROUND:Pedicle screw implantation is a common method to repair many kinds of diseases of the lower cervical spine. Three-dimensional (3D) reconstruction visualization system can be used in order to improve the accuracy of the implant and improve the prognosis.
OBJECTIVE:To investigate the effect of 3D reconstruction visualization system on the accuracy of cervical pedicle screw implantation.
METHODS: The clinical data of 89 patients with cervical spine dislocation, who underwent cervical pedicle screw implantation, were analyzed retrospectively. Patients were divided into control group (46 cases) and observation group (43 cases) according to the navigation method. Patients in the control group underwent C arm X ray two dimensional navigation. Patients in the observation group underwent three-dimensional reconstruction visualization system navigation. Intraoperative placement time was observed, and the accuracy of screw placement was assessed in both groups. The cases were folowed up for 12 months, and the adverse events were recorded and compared.
RESULTS AND CONCLUSION: (1) Intraoperative implantation time was shorter in the observation group than in the control group, but no significant difference was found (P> 0.05). (2) Accuracy rate: There were no three types of nail cases in the observation group, and the accuracy rate was 93% (40/43). In the control group, two cases affected three types of nailing, and the accuracy rate was 81% (37/46). The accuracy rate was significantly higher in the observation group than in the control group (P < 0.05). (3) Postoperative folow-up: None suffered from nerve tissue injury to vertebral artery, blood vessel and spinal cord. The screws of the two groups were in stable condition, without screw breakage or loosening. (4) Results suggested that in lower cervical pedicle nail implantation, 3D reconstruction navigation system can effectively improve the accuracy of screw placement, and does not increase nailing time or lead to adverse events. It is a safe and effective navigation mode.