Objective To investigate the safety and feasibility of ketamine,propofol compound fentanyl com-bined with fentanyl in anesthesia for pediatric patients.Methods 70 cases of children with elective pseudo operation were randomly divided into the two groups of 35 cases in each group,the control group were taken ketamine,propofol for anesthesia,while the observation group were treated with fentanyl on basis of that,the anesthesia effect and inci-dence of adverse reactions were observed and compared between the two groups.Results HR and MAP at 15min during operation and after operation of the control group were increased significantly than those before anesthesia,the difference was statistically significant(t=7.33,7.19,8.26,8.11,all P<0.05),while HR and MAP in the observa-tion group at each time point of showed no significant difference(t=1.03,1.10,1.12,2.01,all P>0.05)when compared with pre anesthesia;The postoperative awake time of the observation group was (12.54 ±2.16)min,which was significantly less than (23.54 ±6.27)min of the control group(t=7.78,P<0.05),and its intraoperative and postoperative adverse reaction rate was 11.43%,which was significantly less than 42.86%of the control group(χ2 =8.33,P<0.05).Conclusion Ketamine,propofol combined with fentanyl has a good anesthesia effect better in pedi-atric,which can be maintained stable of hemodynamics,and children can rapid recovery after operation,with fewer adverse reactions.

Aim To investigate the chemical constituents of the secondary metabolites of the roots of Daphne genkwa. Methods The roots of D. genkwa were extracted with 95% ethanol at 60 - 70 ℃ for 7 days to obtain the crude extract. The crude extract was purified by silica gel and Sephadex LH-20 column chromatography as well as the HPLC techniques. The structures of the isolates were elucidated by combined spectroscopic methods including 1D and 2D NMR, MS, UV, IR and CD. Results Three new biflavonoids were isolated from the ethanol extract of the roots of D. genkwa and their structures were identified as daphnodorin H-3-methyl ether (1), daphnodorin H-3"-methyl ether (2) and daphnodorin G-3"-methyl ether (3). Conclusion Compounds 1, 2 and 3 are three new biflavonoids.

Bone Resorption ; China ; Cytokines ; physiology ; Diphosphonates ; pharmacology ; Estrogens ; pharmacology ; Humans ; Jaw ; drug effects ; metabolism

Objective To systematic evaluate the prevalence of secondhand smoke among Chinese mainland rural residents by meta?analysis,so as to provide reference for making relevant smoking control regulations and the carry out of targeted tobacco control action. Methods The related stud?ies were searched and collected from PubMed,CNKI,Wanfangdata,VIP and CBM database,which were published between 2001 and 2015 about the prevalence of secondhand smoke among Chinese mainland rural residents. Meta?analysis was tested by software CMA V2. Results The pooled prevalence of secondhand smoke among Chinese mainland rural residents was 46.6%(95%CI 40.5%?52.8%). Stratified analysis showed that the prevalence of secondhand smoke were 45.7%and 47.5%for male and female,45.7%and 51.1%for eastern and midwest China,22.1%、34.2%and 71.3%for public place,workplace and family,respectively. The prevalence among sex,regions,and places were statistically significant. Conclusion The prevalence of secondhand smoke among Chinese mainland rural residents was relatively high,and the prevalence of secondhand smoke was higher in women than in men,in midwest area than in eastern area,and at family than at public place and at workplace.

Recently,the detection of circulating tumor cells(CTCs)in peripheral blood is used in clinical practice as a form of‘ liquid biopsy’. The self-seeding mechanism of CTCs provides a novel approach to explore the growing mechanism of malignant tumor and developing corresponding targeting therapies. A decade ago,the CellSearch system, which can capture and enumerate CTCs,has been validated by Food and Drug Administration( FDA)as an aid for monitoring the relapse of tumor after radical operation in patients with breast,prostate and colorectal cancer. In recent years,although the separation and detection technique of CTCs has been promoted significantly,the clinical significance of CTCs in tumors of digestive system is still under investigation. This article reviewed the research progress of peripheral blood CTCs in digestive system tumors.

BACKGROUND:Fractures of shafts of the tibia and fibula are the most common diaphyseal fractures among al long bones. The clinical significance of fibula fixation in treatment of distal third shaft fractures is controversial, and the studies are also different. OBJECTIVE:To explore the clinical significance of fibular fixation in treatment of distal third tibia shaft fractures. METHODS:A retrospective review has been performed on the clinical data of sixty-four cases with distal third tibia shaft fracture in Department of Orthopedics, China National Offshore Oil Corporation General Hospital from January 2006 to March 2010. Al cases were divided into two groups based on whether the fibula was fixed or not: fibula fixation group (n=36) and fibula non-fixation group (n=28). Union rate of fracture, bone union time and tibial valgus angle were compared between the two groups. According to Merchant-Dietz criteria, the ankle range of motion and ankle evaluation score were evaluated and compared between the two groups. RESULTS AND CONCLUSION: No significant difference in union rate of fracture, bone union time and ankle range of motion was detected between two groups. Tibial valgus angle was smaler in the fibula fixation group (5.42±1.16)° than in the fibula non-fixation group (7.54±1.90)°(P=0.006). Ankle function score was higher in the fibula fixation group (93.58±0.97) than in the fibula non-fixation group (90.57±3.92) (P=0.000). Three cases in the fibula fixation group suffered from superficial wound infection, and achieved good healing after treatment of anti-infection and changing dresses. Above results verify that fibular fixation can reduce tibial valgus angle and improve ankle joint function in treatment of distal third tibia fractures.

Objective To observe the clinical effects of prostaglandin E1 on liver cirrhosis patients and evaluate its security. Methods 68 cases with liver cirrhosis admitted in Luqiao hospital were randomly divided into experimental group(34 cases)and control group(34 cases)equally. Patients in control group were received normal therapy,while in experimental group were added prostaglandin E1 on basis of normal therapy. The efficacy and adverse reactions were observed and compared. Results Compared with before treatment,the average value of albumin in two groups were increased obviously,which in experimental group from (27.9 ±4.1)g/L to (36.5 ±4.3)g/L,control group from (27.8 ±4.0)g/L to (31.7 ±4.2)g/L,the differences were significant(P<0.05 ),and the difference between two groups was significant(P<0.05 ),too. The content of alanine aminotransferase and aspartase aminotransferase in two groups were decreased significantly(P<0.05 ),and experimental group was more lower than control group(P<0.05 ). The number of effcacy in experimental group was 28 and account for 82.35%,while in control group was 1 1 and account for 32.35%,the difference was significant(P<0.05). Conclusion Prostaglandin E1 can improve liver function,and has good clinical effects and high security in treatment with liver cirrhosis patients.

Objective To compare and determine the reproducibility of apparent diffusion coefficient (ADC)values of the normal liver parenchyma in respiratory-triggered,breath-hold,and free-breathing diffusion weighted magnetic resonance imaging (DWI). Methods 11 volunteers did three times of breath-hold (excitation number is 1,at the end of the expiration,thickness/gapping=5 mm/1 mm), respiratory-triggered (excitation number is 2,at the end of the expiration,thickness/gapping=5 mm/1 mm),free-breathing (excitation number is 4,thickness/gapping=5 mm/1 mm)and for a total of nine axial liver DWI,the gradient factor was 800 s/mm2 .Then they were all coronally reconstructed (thickness/gapping=8 mm/1 mm).The nonparametric test was used to compare all axial and coronally reconstructed liver ADC values;and the Bland-Altman method was used to evaluate the ADC values’repeatability in coronally reconstructed images.Results The breath-hold DWI’s mean ADC value was (1.09±0.07)×10-3 mm2/s significantly lower than the respiratory-triggered DWI(1.16± 0.09)×10-3 mm2/s and the free-breathing DWI(1.19±0.10)×10-3 mm2/s(P<0.005),the axial and coronal images’results were similar.The ADC values’average difference and scope of consistency of coronal image were (-0.09 to -0.01±0.09 to 0.48)for breath-hold DWI,(-0.04 to 0.01±0.11 to 0.17)for respiratory-triggered DWI,(-0.07 to -0.02±0.11 to 0.18)for free-breathing DWI,respectively.Conclusion The breath-hold DWI’s ADC value of normal liver parenchyma is lower than the respiratory-triggered and free-breathing DWI,and showed more poorer repeatability.It is suggested that the measurement of ADC values of the liver parenchyma should be done within the respiratory-triggered or free-breathing DWI.

Objective The objective of this study was to determine the effect of curative chemotherapy regimen on breast cancer cells and its mechanism.Methods A tumor-bearing mouse model was established and routine dose of capecitabine was given as a conventional chemotherapy group.Continuous low-dose capecitabine chemotherapy was used as a radiotherapy group and no chemotherapy was used as a control group.The expression of microvessel density(MVD),vascular endothelial growth factor(VEGF)and thrombospondin 1(TSP-1)were measured by flow cytometry.The percentage of myeloid-derived suppressor cells(MDSCs),NK cells and macrophages in the program was observed.The tumor size and blood leukocyte count were measured after chemotherapy.Results MVD and VEGF in the radiotherapy group were significantly decreased and TSP-1 was significantly increased in comparison with the conventional chemotherapy group(P<0.05).The proportion of MDSCs in the radiotherapy group was significantly decreased,the proportion of NK cells and macrophages were significantly increased when compared to the conventional chemotherapy group(P<0.05).The tumor volume was no difference between the control and chemotherapy groups(P>0.05).However,the white blood cell count in the radiotherapy group was significantly higher than that in the conventional chemotherapy group(P<0.05).Conclusion Capecitabine chemotherapy at continuous low-dose inhibits neovascularization and adjusts the proportion of immune cells to suppress tumor formation.Thus,this chemotherapy could reduce side effects caused by chemotherapy and improve the quality of life.

This article elaborates the present conditions and development of education of postgraduates in medicalcolleges, emphasizing the importance of putting applied computer education on medicine. It declares that the coursesfor computer education of postgraduates should be set according to the feature of the major and some innovation in thecontents and methods of teaching should be made. At the same time, it mentions it is necessary to strengthen practicalcomputer education and train the students' capability of innovation and self-education.[