Objective To explore the effect of dexmedetomidine on upper limb surgery during brachial plexus block anesthesia and its influence on cognitive function.MethodsFrom May 2015 to May 2016, 60 cases of elbow joint operation patients were studied.The patients were randomly divided into control group (local anesthesia combined with physiological saline) and observation group (using local anesthesia drugs with dexmedetomidine).The mean arterial pressure and heart rate before and after anesthesia in two groups were compared.The changes of anesthesia and cognitive function, and the incidence of adverse reactions were compared between the two groups.ResultsCompared with before anesthesia, the mean arterial pressure and heart rate were significantly lower in the two groups (P<0.05).The mean arterial pressure and heart rate in the observation group were significantly lower than those in the control group (P<0.05).There was no significant difference between the two groups in the onset time of motor block sensory block, while the observation group was significantly longer than the control group (P<0.05).The control group patients with Ramsay score below 3 points, a total of 4 cases, accounting for the observation group of patients with Ramsay score of less than 3 points, a total of 24 cases, accounting for 80%, the observation group was significantly better than the control group (P<0.05) sedative effect.Compared with before anesthesia, two groups of patients with postoperative 20min MMSE score were lower, but the observation group MMSE score was significantly higher than that of the control group (P<0.05).There was no significant difference in adverse reactions between the two groups.ConclusionIn the following surgery, the use of local anesthesia combined with dexmedetomidine anesthesia can prolong the time of nerve tissue, and can obtain better sedation and pain, and has little effect on the cognitive function of patients.

Objective To analyze the risk factors impeding early extubation after off-pump coronary artery bypass grafting (OPCAB) in Chinese patients, so that to identify the applicable patients for "fast track recovery". Methods Clinical data of 680 consecutive patients who had received OPCAB were analyzed retrospectively. The patients were divided into two groups according to the time of extubation (group Ⅰ,n=333, extubation was performed within 12 h postoperation; group Ⅱ,n=347, extubation failed in 12 h). Univariate and multivariate analyses were used to determine risk factors prolonging mechanical ventilation. Results Univariate analyses showed significant difference between the two groups in the percentages of patients over 70 years [25% (84/333) vs 39% (136/347), ?2=15.148, P=0.000], with history of stroke [14% (46/333) vs 22% (75/347), ?2=7.068, P=0.008], with LVEF70 (OR=2.003), LVEF70, severe coronary artery lesion, emergency operation, and poor cardiac function are risk factors impeding early extubation. "Fast track recovery" protocol is applicable to young patients who have good cardiac function without left main lesion and do not need IABP during perioperative period.

Objective To explore the association of apoB gene polymorphisms with dyslipidemia and lipid levels in Xinjiang Shihezi Han Chinese. Methods 150 dyslipidemia patients and 150 normal pople were involved in this study. EcoRI and XbaI polymorphisms of apolipoprotein B was analyzed by PCR-restriction fragment length polymorphism. The levels of plasma total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apoAI and apoB were determined. Results The frequency of E + E -/E - E - genotype and E-Allele(37.3% and 19% ) in dyslipidemia group was significantly higher than that in controls( 12. 7% and 6. 3% ). The levels of TC, TG and LDL-C in the E +E -/E - E - gene type were significantly higher than those of the E + E + gene type in each group ( P ＜0. 01 ). The frequency of X + X -/X + X + genotype and X + Allele( 20. 7% and 1 1% ) in dyslipidemia group was significantly higher than that in controls (8% and 4% ). The levels ofTC, TG, LDL-C and apoB in the X + X -/X + X + gene type patients were significantly higher than those in the X - X - gene type patients in every group ( P ＜ 0. 05 ). Conclusion The EcoRI and XbaI polymorphism of ApoB gene was related to dyslipidemia in population of Xinjiang Shihezi Han Chinese, and the E - and X + Allele may be the genetic risk factors for dyslipidemia.

Chemotherapy is one of main treatments for nasopharyngeal carcinoma (NPC) except radiation therapy. Improving and optimizing chemotherapeutic regimen are helpful to improve the therapeutic effects and reduce side effects. At present, concurrent chemoradiotherapy still is the standard treatment for advanced nasopharyngeal carcinoma. Induced chemotherapy has been shown superiority, but the effect of adjuvant chemotherapy needs further study. This paper analyzed the superior and inferior, effect and side effect of all kinds of chemotherapeutic methods or scheme including induced chemotherapy, concurrent chemotherapy, adjuvant chemotherapy and palliative chemotherapy and introduced simply the mechanism and clinical effect of new drugs of anticancer. It was hoped to offer some reference for the selection of chemotherapy for NPC.
Antineoplastic Combined Chemotherapy Protocols ; Carcinoma ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy

ATP-Binding Cassette Transporters ; metabolism ; Adenosine ; analogs & derivatives ; therapeutic use ; Animals ; Antineoplastic Agents ; therapeutic use ; Biomarkers, Tumor ; analysis ; Cell Differentiation ; Diketopiperazines ; Heterocyclic Compounds, 4 or More Rings ; Humans ; Neoplasms ; drug therapy ; pathology ; Neoplastic Stem Cells ; cytology ; metabolism ; Protein Kinase Inhibitors ; therapeutic use ; Pyrimidinones ; therapeutic use ; Quinazolines ; therapeutic use ; Signal Transduction ; Triazines ; therapeutic use ; Wnt Proteins ; metabolism

Animals ; Drugs, Chinese Herbal ; pharmacology ; PC12 Cells ; Patch-Clamp Techniques ; Potassium Channels, Voltage-Gated ; drug effects ; physiology ; Rats

Gout ; diagnostic imaging ; surgery ; Humans ; Radiography ; Tartrates ; analysis ; Young Adult

Objective To discuss the clinical effects of treatment of femoral intertrochanteric fracture by DHS internal fixation. Methods 42 cases with femoral intertrochanteric fracture were treated by DHS internal fixation. According to AO classification, there were 16 cases of type A1,14 A2,and 12 A3. Results 36 patients were followed up for 6 to 18 months, with an average of 10 months. Their results were satisfactory. Conclusion Treatment of femoral intertrochanteric fractures with DHS internal fixation is an effective method.

Objective To investigate the distribution and antibiotic resistance of A.baumannii during the last five years in our hospital,the basis for the reasonable clinical use of antibiotic was provided to doctor.Methods The strains of A.baumannii isolated from clinical specimens during 2009-2013 were analyzed by VITEK-32 system,the antibiotic resistance was analyzed by WHONET5.4 software.Results A.baumannii strains were mainly isolated from sputum,accounting for 77.3％;the majority of the strains were isolated from ICU,accounting for 42.3％;the resistance rates of A.baumannii to antibiotics appeared increasing,and over 70％ except cefoperazone-sulbactam and imipenem.Conclusion A.baumannii is the major pathogen,and detection rate of A.baumannii is very high,antibiotic resistance status of A.baumannii is very serious.The management of antibiotic application should be strengthened,and the occurrence and prevalence of antibiotic resistant bacteria should be strictly controlled to prevent outbreak and epidemic of nosocomial infection.

OBJECTIVE To study the molecular mechanism of the drug-resistance of Gram-negative bacilli to the third generation of cephalosporins.METHODS MICs of 13 ?-lactams to the eleven Gram-negative bacilli clinical isolates were detected with the standard agar dilution technique.K-B disc confirmatory method was conducted to determine the ESBLs phenotype of the eleven isolates.The ESBLs encoding genes were analyzed by using PCR.RESULTS The eleven isolates were all resistant to the third generation of cephalosporins(MIC≥64 ?g/ml).Disk confirmatory test showed that 10 isolates produced ESBLs.The hydrolytic activity of the ESBLs from the 10 isolates to cefoperazone and cefamandole was very high.However,the hydrolytic activity of the ESBLs from the 10 isolates to ceftazidime was very low.CONCLUSIONS The enzyme activities and the genes of extended-spectrum ?-lactamases from 10 Gram-negative bacilli clinical isolates are preliminarily analyzed.These results provide the basis for further study on the molecular mechanism of the drug-resistence of Gram-negative bacilli.