Objecfive To observe the effect of high thoracic epidural block(HTEB)for preventing myocardial isehemia(MI)in pailents with coronary heart disease undergoing upper abdominal surgery. Methods Twenty patients undergoing upper abdominal surgery were randomly divided into two groups:M group(treated with HTEB,10 patients)was given both general anesthesia and HTEB and patient controlled epidural analgesia(PCEA)after operation and C group(without HTEB.10 patients)was given only general anesthesia and patient controlled intravenous analgesia(PCIA)after operation.The hemodynamies.ECG changes and serum troponin I and myoglobin and ereatine-kinase isozyme,the analgesia efficacy in M group were compared with those in C group.Results The hemodynamics in M group Was more stable than that in C group(P＜0.05).ComparedwithMgroup,thetotalnumberofST-segment depression attracheal extuba- tion moment and 10 hours after operation were significantly increased in C group(P＜0.05).The positive rates of Serum troponin I and creatine-kinase isozyme at 10 hours and 24 hours after operation in C group were much higherthan those in M group(P＜0.05).The an~tgesia effect in M group Was superiortothat in C group (P＜0.05)Conclusion The HTEB combined with general anesthesia may reduce mvocardial is- chemia in patients with coronary heart disease undergoing upper abdominal surgery.

Objective:To explore effect of relevant training on understanding of theory of naive biology for plant reproduction in 5- and 6-years old,and to attempt to provide demonstration for a debate of different views between domain universality and domain specificity cognitive development.Methods:48 preschoolers who did not comprehend concept of plant reproduction screened from 64 preschoolers ages 5 to 6 were surveyed by clinical method.Half of the 48 children were assigned to intervention group,the other to control group.The effects of intervention were compared by the experimental before-after design.Results:Relevant biological knowledge might widely accelerate 5- and 6-year-olds' understandings for plant reproduction,and 6-year-olds had more enhancement than 5-year-olds.Pass rates of intervention group were more 29.2% than control group in 5 year olds,and more 54.1% in 6 year olds.Conclusion:Acquiring specific knowledge will generally improve preschoolers' cognition on plant reproduction.Children' cognitive development is influenced jointly by both domain-specific and domain-general thinking.

OBJECTIVE:To evaluate the efficacy of methotrexate(MTX) vs.gold salt in treating patients with rheumatoid arthritis(RA).METHODS:7 studies on the efficacy of methotrexate(MTX) vs.gold salt in treating patients with rheumatoid arthritis(RA) were subjected to a meta-analysis using homogeneity test and combined effect test.RESULTS:Homogeneity test showed that the cited studies were homogeneous with ?2=25.14,df=6 and P=0.0003;and by combined test,the combined OR was 2.37(95% confidence interval=1.18～4.78,Z=2.41,P=0.02).CONCLUSION:Methotrexate demonstrated better toleration than gold salt for rheumatoid arthritis.

Objective To evaluate the efficacy and safety of different doses of prednisone combined with cyclosporine A(CSA) on the treatment of idiopathic membranous nephropathy (IMN). Methods The data of 64 patients with nephrotic syndrome (NS) diagnosed as IMN by renal biopsy were retrospectively analyzed. Median follow?up time was 10 (7, 19) months. The subjects were divided into 2 groups according to different prednisone dosage. Thirty?two cases were in the low?dose group:prednisone 0.15 mg·kg-1·d-1+CSA, and 32 cases in the moderate?dose group:prednisone 0.4?0.5 mg· kg-1·d-1+CSA. Clinical and laboratory data were collected at baseline, 1, 3, and 6 months after treatment. During follow?up, cumulative recurrence rate and adverse reactions after treatment were recorded. Results Serum albumin (sALB) were significantly increased and 24 h urinary protein (24hUP) significantly decreased after treatment for 1, 3, 6 months compared with baseline data in the two groups. Serum creatine (Scr) increased after treatment with time. The elevation of sALB and the reduction of 24hUP in the moderate?dose group were higher than that of low?dose group at 6 months after treatment (P<0.05). The effective rate of the low?dose and moderate?dose group was 65.6% and 87.5% at 6 months after treatment, respectively (χ2=4.267, P=0.039). Comparison of different doses of CSA in two groups at 6 months after treatment, in low?dose group: the effective rates of CSA<3 mg· kg-1·d-1 and >3 mg·kg-1·d-1 subgroup were 76.5% and 53.3%, respectively (P=0.296); In moderate?dose group:the effective rates of CSA<3 mg·kg-1·d-1 and>3 mg·kg-1·d-1 subgroup were 89.5%and 84.6%, respectively (P=0.077); there were similar effects in patients treated with different dose CSA in the two groups. About 20.4% of the total patients relapsed when followed up for 18 months (low dose group vs moderate?dose group: 9.5% vs 28.6%, P=0.136), which most occurred after prednisone withdrawal or during the reduction of cyclosporine. Renal function decreased in 57.8% patients (low dose group vs moderate?dose group:50%vs 65.6%), mainly in the elderly (9/11) and the long course of treatment of CSA. There was no significant difference on adverse reactions between the two groups (P>0.05). Renal function in patients with high Scr or high blood trough concentration of cyclosporine was difficult to fully recover. Conclusions Remission rate is lower in low?dose prednisone combined with cyclosporine than the moderate?dose group in the treatment of IMN for 6 months. The recurrence rate of IMN or the incidence of adverse reactions are similar between the two groups. Induction therapy of IMN with cyclosporin<3 mg·kg-1·d-1 is safe and effective. The incidence of renal function reduction in the elderly is high, and the renal function is difficult to restore in patients with Scr exceeding normal upper limits.

Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Indenes ; analysis ; Workplace

Objective To evaluate the application of sentinel lymph node biopsy in surgical operation for clinical stage N0 differentiated thyroid carcinoma.Methods One hundred and six patients who were diagnosed clinical stage N0 differentiated thyroid carcinoma in Department of Mammary Gland Thyroid Surgery of Qingdao Women and Children's Hospital between Jan.2012 and Jan.2013 were reviewed retrospectively.Carbon nanoparticles were used to trace sentinel lymph node in the surgery,the patients were divided into the dissection group (46 cases included 2 cases whose sentinel lymph nodes were not detected) and the non dissection group (60 cases) based on the rapid pathological results.The operation index,complications incidence and short-term outcomes were compared.Result The operative time,intraoperative blood loss and the faulty excision of parathyroid gland in dissection group is much higher than those in non dissection group (P ＜0.05).The incidence of provisionality hypoparathyroidism in dissection group is much higher than those in non dissection group (P ＜ 0.05).There were no permanent hypoparathyroidism and damage of laryngeal nerve in the two groups.Postoperative outpatient follow up was 30 months,no significant differences were seen in local regional recurrence rates(6.5％ vs 10％) between the two groups (P ＞ 0.05).There were no distant metastasis occurred in the two groups.Conclusions Lymph node metastasis can be found by sentinel lymph node biopsy,it is helpful for us to decide whether dissect central lymph node or not.Carbon nanoparticles is safe,which is helpful to protect the parathyroid gland.

Objective To investigate the correlation between GSTP1 exon5 A/G polymorphism and clinic phenotype of COPD in the population of the Han nationality from southwest China.Methods Using PCR followed by restriction fragment length polymorphism(PCR-RFLP),genotypes of Ile105Val polymorphism in exon5 of GSTP1 were determined in 91 patients with COPD and 87 healthy control subjects.Results No significant differences were observed in the frequencies of genotypes and alleles of exon5 of GSTP1 between COPD patients and the healthy controls.The frequency of Ile105 in pink puffer patients was much more than that in the blue bloater patients.The CT scores of emphysema in patients with Ile105 was significantly higher than those with Val105.Conclusions The genetic polymorphism of exon5 of GSTP1 may not be associated with the susceptivity of COPD in the populations of the Han nationality from southwest China,but may be correlated with clinical phenotypes and lung parenchyma damage of COPD patients in the present population.

OBJECTIVETo evaluate the clinical results of the medial patellofemoral ligament (MPFL) reconstruction combined with the lateral retinacular release for the treatment of recurrent patellar dislocation.

METHODSFrom March 2011 to June 2013, 15 patients with recurrent patellar dislocation underwent arthroscopic MPFL reconstruction combined with the lateral retinacular release. The graft was autogenous semitendinosus and semimembranosus tendon. There were 5 males and 10 females with an average age of 19.4 years old (ranged,14 to 32 years old). The patients suffered recurrent patellar dislocation at least twice preoperatively. Preoperative conventional X-ray, CT, and MR examination were used to analyze the causes of the patellofemoral joint and MPFL injury. Preoperative Lysholm score was 69.85 ± 11.52. During operation, the arthroscopic examination was performed to evaluate the patellofemoral alignment and patellar tracking.

RESULTSAll the patients were followed up for an average of 27.6 months (ranged,12 to 36 months) with no recurrent dislocation and sub-dislocation. All the patients showed negative apprehension test at straight and 30 ° flexions of knee. The range of motion of knee returned to normal level at 12 months after operation. There were no patients with subjective discomfort of knee. Postoperative Lysholm score was improved to 92.60 ± 5.75.

CONCLUSIONThe technique of arthroscopic MPFL reconstruction combined with the lateral retinacular release is an effective surgical procedure for the treatment of recurrent patellar dislocation, which can relieve the symptom of knee and improve the patella stability and knee function.

Adolescent ; Adult ; Arthroscopy ; Female ; Humans ; Knee Joint ; surgery ; Male ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; physiopathology ; surgery ; Patellofemoral Joint ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome ; Young Adult

Starch a natural polymer that is characterized by cheap, regenerative, and good biodegradation is generally mixed with low density polyethylene, high density polyethylene, polypropylene, and polystryrene to prepare degradable materials. In order to relieve "white pollution" due to undegradability of plastic materials, starch is mixed with polyvinyl alcohol, polylactic acid, poly-hydroxybutyric acid, polycaprolactone, chitosan, derivatives, and other degradable polymers to prepare fully degradable biomaterials. With gradual exhaustion of petroleum and progressive depravation of environmental quality, starch that is regarded as a reinforcing agent is widely used in rubber industry. Starch is characterized by hydrophilicity, difficulty in processing, and poor compatibility to plastic materials, rubber, and other polymers, so starch is firstly modified and then mixed with polymers to make starch. This study was designed to summarize the application of starch in plastic materials, rubber, and other polymer blends and to investigate the latest research progresses of starch in polymer materials.

This study aimed at preparing the chemical reference substance of garcinol.A preparative high-speed countercurrent chromatography (HSCCC) was adopted for the isolation of garcinol from the twigs of Garcinia multifiora Champ,G.esculenta Y.H.Li and the fruits of G.xanthochymus Hook.f.ex T.Anders.The crude extracts were separated by HSCCC with two phase solvent systems composed of n-hexane-ethyl acetate-95％ ethanol-water (8∶8∶12∶4,volume ratio) using the upper stationary phase and the lower mobile phase.Under the conditions of a flow rate of 2.0 and 4.0 mL· min-1,and the apparatus rotation at 850 rpm,the column temperature at 25℃ and the detection wavelength at 254 nm,the fraction containing garcinol was purified by the Sephadex LH20 chromatography.The purity test in the extracts was determined by high-performance liquid chromatography.As a result,the contents of garcinol were 45,281 and 4080mg respectively separated from 104.765 g twigs of G.multiflora Champ,105.270 g G.esculenta Y.H.Li and 102.318 g the fruits of G.xanthochymus Hook.f.ex T.with the purity of 98.72％,98.36％ and 98.42％.Compared with the sample pretreatments and separation efficiency of the three plants,it was found that the fat-soluble extracts rapidly and efficiently extracted using n-hexane-ethyl acetate-95％ ethanol-water (5∶5∶5∶5,volume ratio) contained abundant garcinol taking fruits of G.xanthochymus Hook.f.ex T as the raw material with the combination of HSCCC and Sephadex LH-20 chromatography.In conclusion,it was indicated that the combination method is efficient with high operability and large preparation quantity.