Objective To study the application of doses of remifentail intravenous anesthesia in vocal nodule extirpation.Methods Sixty ASAⅠ～Ⅱpatients with vocal nodule were selected and randomly divided into three groups. Group F were given anesthetic induction with fentanil and maintenance with isoflurane; Group L were given anesthetic induction and maintenance with remifentail at the dose of 0.5?g/(kg?min); Group H were given anesthetic induction and maintenance with remifentail at the dose of 1?g/(kg?min).The anesthetic induction time,blood flow dynamics during maintenance phase,recovery time and quality were recorded. Results (1)Anesthesia produce less circulatory fluctuation in group H than in group F and L.(2) Group L and H were faster than group F on recovery profile including the time of response to verbal commands,autonomous breathing,tracheal extubation and discharging from operating room. The OAA/S score was higher in group L and H than in group F 5 min after intubation. There were no significant differences between group L and H. Conclusions Remifentanil intravenous anesthesia can achieve better recovery profile from anesthesia than fentanyl in vocal nodule extirpation. 1?g/(kg?min) remifentanil can inhibit the stress responses to tracheal intubation and laryngoscope inserted effectively with a stable circulatory function.

Objective To search for the normal value and developmental regular rule of motor norve conduction in children.Methods One hundred and fourty-nine children aged from 0 to 14 years old were divided into 7 groups in accordance with age. There were 19 pecrsons aged from 20 to 35 years old in adult group. The motor nerve conduction function of median nerve, ulnar perve, tibial nerve and peroneal nerve of every suhject was determined by nerve evoked potential meter.Results The terminal latency of action potential of every nerve is decreased along with growing up of age before 6 years old and increased after 6 years old. The conduction velocity of ulnar nerve is the fastest,then the peroneal nerve and median nerve, that of tibial nerve is the slowest. Median nerve development quicken after 3 months of birth and approch ulnar nerve at the time of 3 years old. Tibial nerye get into fast development period from 3 months to 1 years old and catch up peroneal nerve. The conduction velocity of every nerve extend to adult level in th period of 3~6 years old.Conclusion The every parameler of nervous conduction has a great difference of age in the period of child,particularly in that of infancy. therefore, the normal values should be set up in accordance with proper age groups. This study shows that it's suitable to divide groups in accordance with new-born, 3 and 6 months, 1, 3 and 6 years old. Adult criterion should be used in the children dbove 6 years old.

ObjectiveTo investigate the clinical phenotypes of familial hypercholesterolemia (FH) caused by exon 13 A606T mutation in low deusity lipoprotein receptor.MethodsClinical data of the suffered family were collected and analyzed,as well as measurement of perivascular intima-medial thickness and follow-mediated-dilation function by ultrasonography.ResultsThere were totally 11 sufferers including 4 males and 9 females,aged 8-90 years,with 2 homozygotes and 9 heterozygotes.Among them, one homozygote showed angina pectoris and hematuria,both homozygotes had skin xanthomata.TC,TG,LDL-C and HDL-C were(7.39 ± 1.30) mmol/L,(0.93 ± 0.36) mmol/L,( 11.76 ± 1.10) mmol/L and ( 1.22 ±0.17) mmol/L,respectively.The left/right sided intima-medial thickness of the common,internal,external and bulb carotid artery were ( 1.15 ±0.45) mm/( 1.30 ±0.60) mm,(0.82 ±0.30) mm/( 1.00 -0.66)mm,(0.77 ±0.28) mm/(0.78 ±0.30) mm and ( 1.40 ±0.59) mm/( 1.46 ±0.71 ) mm respectively.The brachial artery flow mediated dilation rate was (4.85 ±4.80)％.Echocardiography revealed 2 patients with cardiac valvular disease and 3 with atrium septum aneurysm. ConclusionFH patients show a variety of phenotypes incuding extraordinary hypercholesterolemia,subcutaneous xanthomata and premature coronary heart disease.

Objective To analyze the colonization of Candida, Rhodotorula, Penicillium and Aspergillus in skin surfaces of patients with atopic dermatitis, and to assess the relationship between the four common fungal allergens and severity of atopic dermatitis. Methods Fifty patients with atopic dermatitis and 20 healthy controls were enrolled. Scales were scraped from lesional and non?lesional skin of flexural extremities of the patients, as well as from normal skin of the flexural elbow of healthy controls, then were subjected to microscopic examination and culture. Scale specimens were inoculated onto Sabouraud dextrose agar medium and cultured at 25 ℃ in a constant temperature incubator. Subsequently, suspected fungal or yeast?like colonies were collected for pure culture. Finally, fungal strains were identified according to colony morphology, color, growth speed, as well as microscopic features of spores and hyphae. Results No hyphae or pseudohyphae were found in any case by microscopic examination. Candida albicans and Rhodotorula were detected in 29(58%)and 17(34%)out of the 50 patients, respectively, and in 5(25%)and 2 (10%) out of the 20 healthy controls, respectively. The detection rates of Candida albicans and Rhodotorula were significantly higher in the patients than in the controls(χ2=6.23, 4.10, respectively, both P<0.05). Of 25 patients with severe lesions, 19(76%)and 12(48%)were colonized by Candida albicans and Rhodotorula respectively;among 25 patients with moderate lesions, 10 (40%) and 5 (20%) were colonized by Candida albicans and Rhodotorula respectively. An increase was observed in the detection rates of Candida albicans and Rhodotorula in the patients with severe lesions compared with those with moderate lesions(χ2=6.65, 4.37, respectively, both P<0.05). There was no significant difference in the detection rate of Penicillium or Aspergillus between the patients and health controls. Conclusion The colonization rates of Candida albicans and Rhodotorula on skin surfaces were higher in patients with atopic dermatitis than in healthy controls, and higher in patients with severe lesions than in patients with moderate lesions, indicating that the types of colonizing fungi are associated with the health status of skin and severity of symptoms in patients with atopic dermatitis.

Objective To investigate the effects of intrathecal transplantation of bone marrow stromal cells (BMSCs) on inter cellular cell adhesion molecule-1 (ICAM-1) expression and blood spinal cord barrier following spinal cord ischemia reperfusion injury.Methods Ninety Sprague Dawley rats were randomly divided into three groups:sham (Sham group),ischemia-reperfusion injury (I/ R group),and BMSCs transplantation (BMSCs group).Spinal I/R injury was induced by clamping the aortic arch between left common carotid artery and left subclavian artery for 14 min in I/R group and BMSCs group.Sham group was subjected to exposure of aortic arch but without occlusion.I/R group and BMSCs group were intrathecally injected with phosphate buffered saline (PBS) or BMSCs (2 × 106) two days before injury.At 1 d,3 d,and 7 d after injury,neurological function was evaluated and damaged lumbosacral seg ment was removed for measurement of blood spinal cord barrier permeability and ICAM-1 protein expression.Results Compared with Sham group,neurological function score was significantly lower:1 d (F =38:59,P =0.001),3 d (F =31.34,P =0.001),and 7 d (F =27.71,P =0.001) ; ICAM-1 expression was increased 1 d (F =34.33,P =0.001),3 d (F =29.76,P =0.001),and 7 d (F =23.65,P =0.001),and blood spinal cord barrier permeability was higher:1 d (F =42.57,P =0.001),3 d (F =32.75,P =0.001),and 7 d (F =26.89,P =0.001) in I/R group.Compared with I/R group,neurological function score was increased:1 d (F =16.62,P =0.001),3 d (F =21.54,P =0.001),and 7 d (F =12.84,P =0.002) ; ICAM-1 expression was decreased:1 d (F =19.84,P =0.018),3 d (F =17.38,P =0.008),and 7 d (F =22.46,P =0.007),and blood spinal cord barrier permeability was lower:1 d (F =22.38,P =0.016),3 d (F =27.59,P =0.009),and 7 d (F =23.25,P =0.001) in BMSCs group.Conclusions Intrathecal transplantation of BMSCs inhibited ICAM-1 expression and decreased blood spinal cord barrier permeability,and then attenuated spinal cord ischemia-reperfusion injury.

Objective To discuss the value of high resolution MRI in the evaluation of small intralabyrinthine lesions with the symptom of vertigo. Methods We retrospectively analyzed the imaging examination techniques and imaging finding of 13 cases of labyrinthine hemorrhage or exudate and 6 cases of intralabyrinthine schwannoma (ILS) with the symptom of vertigo. Two cases of labyrinthine hemorrhage or exudate and 3 cases of ILS underwent temporal bone high resolution CT(HRCT) scan and all the 19 patients received highresolution MR examination. Patients of labyrinthine hemorrhage or exudate received fluid?attenuated inversion recovery (FLAIR)T2WI in addition to routine pre?contrast temporal bone MR. Pre?and post?contrast MR of the temporal bone were performed on the ILS patients. In particular, 3 ILS cases received three?dimensional sampling perfection with application?optimized contrasts by using different flip angle evolutions (3D?SPACE) sequence. Results There was no abnormal finding on HRCT of the inner ear of the 2 labyrinthine hemorrhage cases. On T1WI, regions of mild increased signal intensity of the labyrinth of affected side could be spotted in 7 patients whereas no abnormal signal intensity was found in the other 6 patients. On T2WI, all the 13 labyrinthine hemorrhage or exudate cases had no abnormal finding in the inner ear. On FLAIR T2WI sequence, regions of increased signal intensity of the labyrinth of affected side could be found in all the 13 cases. Thress ILS patients that received HRCT scan showed no valuable finding. On T1WI, no abnormal signal intensity was found in the labyrinth of the 6 patients. On T2WI, regions of decreased signal intensity of the labyrinth could be found in only 3 patients. All the 3 cases that received 3D?SPACE sequence appeared as a filling defect in the high?signal labyrinth clearly while 2 of the 3 lesions could not be found on T2WI. After Gadolinium administration, all the 6 ILSs were obviously enhancing. Conclusions High resolution MRI is valuable in the diagnosis of labyrinthine hemorrhage or exudate and ILS. The use of FLAIR T2WI sequence can help us to find labyrinthine hemorrhage or exudate more sensitively. The use of 3D?SPACE sequence can help us to detect and diagnose small intralabyrinthine lesions.

The teaching team of undergraduates of anesthesiology in Anhui Medical University applied the primary trauma care system of encourage, heuristic teaching and practical teaching to further deepen the educational reform and improve teaching quality for undergraduate education.They designed the diversified section such as drills, discussion, teaching, questions, feedback and so on, implemented the simulation training of anesthesia crisis management skills and completed the feedback evaluation of comprehensive ability before and after the teaching, and then achieved the effect of improving the actual operation ability and clinical thinking capacity of students.So it is a good method and worth extending.

Objective To explore the bone mineral density (BMD) status and its influencing factors in schizophrenia patients in order to provide basis for risk assessment in psychiatric nursing.Methods A total of 1,139 hospitalized schizophrenia patients were recruited and assigned into the medication group (n=652) and the non-medication group (n=487) according to previous antipsychotic drug history.T-score and Z-score of BMD were determined using Sunlight Omnisense 7000S Bone Densitometry.Blood calcium,blood phosphorus and serum prolactin levels were measured using fasting blood of ulnar vein.Results Differences in age,BMD,milk intake,level of activity,level of smoking,history of fall,history of fracture,serum Ca2+ and PRL were statistically significant between two groups(P＜0.05);there were significant differences in BMD rank distributions among schizophrenia patients with different courses of disease and lengths of taking antipsychotics (P＜0.001);multiple linear regression showed that influencing factors of BMD with statistical significance were courses of disease,lengths of taking antipsychotics,serum Ca2+,serum PRL,milk intake,level of activity,and level of smoking.Conclusion The BMD was lower in the medication group than that in the non-medication group,and the development of osteoporosis was correlated to various factors.Clinical nurses should master high-risk factors thoroughly and adopt intervention measures in a timely manner.

Total 406 community residents entered in fitness improvement program with “management by objectives model of health promotion” from 2009 to 2011.The fitness status was monitored by Xuhui Physical Constitution Center before and after entering the program.The results showed that the level of fitness assessment,the composite score,lung capacity and reaction time were improved with the years (P ＜ 0.01) ; the step index and sitting-and-reach test in 2010 was better than those in 2009(P ＜ 0.01) ; the grip strength in 2010 and 2011 was better than that in 2009 (P ＜ 0.01); the test of single leg-standing with closing eyes in 2011 was better than that in 2009(P ＜ 0.05).There was no difference in body mass index before and after program (P ＞ 0.05).The results indicate that physical fitness and overall health can be improved by management by objectives model for health promotion.

Moyamoya disease (MMD) is a chronic and progressive cerebrovascular disease which is characterized by the bilateral internal carotid artery ends and (or) stenosis or occlusion of anterior cerebral artery and middle cerebral artery initial segments,compensatory proliferation of small blood vessels in the skull base and formation of abnormal vascular network.Its etiology and pathogenesis remains unclear.The present studies speculate that MMD may be a polygenic disease,inflammation,immune response,abnormal cytokine secretion,endothelial progenitor cell change and nitric oxide level change are associated with the occurrence and development of MMD.This article reviews the advances in research on the genetics and pathophysiological mechanism of MMD.