Objective To observe the effects of dexmedetomidine on the perioperative stress response and immunologic function in hepatectomy patients with hepatitis cirrhosis.Methods Forty patients(Child-Pugh A or B),ASA Ⅱ or Ⅲ with hepatitis cirrhosis undergoing hepatectomy were randomly divided into dexmedetomidine group(group D)and control group(group C)with 20 cases in each.Patients in group D were administered 0.5 μg/kg bolus dose of dexmedetomidine over 10 min, followed by 0.4 μg·kg-1 ·h-1 infusion until closing abdomen.And patients in group C were given normal saline by the same way as in group D.Flow cytometry was used to detect peripheral blood T lymphocytes (CD3 + ,CD4 + ,CD8 + ,CD4 +/CD8 + ),NK cells at 30 min before anesthesia(T0 ),imme-diately(T1 ),24 h(T2 )and 48 h(T3 )after surgery.Enzyme-linked immunosorbent assay was used to detect the levels of inflammatory cytokines concentration(IL-2,IL-10)at T0-T3 and stress hormones (Cor,ACTH,ALD)at T0 ,T2 and T3 .The levels of SBP,DBP and CVP at T0 ,immediately with intu-bation(Ta ),T1 and extubation(Tb ).Results Compared to those at T0 ,the levels of CD3 + ,CD4 + , CD8 + ,CD4 +/CD8 + at T1 and T2 were significantly lower in both groups(P <0.05),and the levels in group D were obviously higher than those in group C(P <0.05).The levels in group D were back to preoperative levels at T3 ,but the levels in group C were still lower than those at T0 (P <0.05).The levels of NK cells were higher at T1 in both groups,and the levels in group D was significantly higher than those in group C(P <0.05).Compared to those at group D,the concentration of IL-2 was lower at T1 and T2 ,the concentration of IL-10 was higher at T2 and T3 in group C (P <0.05).The levels of Cor,ALD,ACTH at T2 and T3 were significantly higher than those at T0 in both groups,but those in group D were markedly lower than those in group C (P < 0.05 ).The SBP,DBP and CVP of two groups was no statistically significant difference at T0 ,and SBP,DBP and CVP of the group D at Ta , T1 ,Tb was lower than that of T0 and group C (P <0.05).Conclusion Patients with hepatitis cirrho-sis underwent general anesthesia has certain immune suppression after liver cancer surgery,and con-tinuous intravenous infusion of dexmedetomidine during anesthesia may suppress the perioperative stress reaction effectively and alleviate the inhibition of immunologic function.

BACKGROUND: Alendronate has been recently used for treating osteoporosis by inhibiting the activity of osteoclasts, but further clinical observation is necessary to compare its therapeutic effect with exclusive use of calcium supplement.OBJECTIVE: To observe the therapeutic effect of oral alendronate (tianke tablet) on the clinical symptoms and bone mineral density (BMD) of middle-aged and elderly patients for comparison with calcium gluconate.DESIGN: A self-controlled study and controlled trial with concurrent patients.SETTING: Department of Orthopedics, Shenzhen Hospital, Peking UniversityPARTICIPANTS: Sixty-eight middle-aged and elderly patients with osteoporosis were admitted in the Department of Orthopedics, Shenzhen Hospital of Peking University between July 1999 and July 2000. From these patients 62 at the age over 45 years without secondary osteoporosis were selected for this study, who were randomly divided into oral alendronate group (n=32) and oral calcium gluconate group (n=30).INTERVENTIONS: On the basis of comprehensive therapies, the patients in the alendronate group were given 10 mg alendronate daily and those in calcium gluconate group had 20 mL oral calcium gluconate solution (containing 100 mg calcium gluconate, equivalent to 9 mg calcium in every 10 mL) three times daily for three months. According to bodily pain relief, occurrence of new fracture and improvement in BMD, the therapeutic effect was assessed in three grades.RESULTS: Thirty patients in the alendronate group and 26 in the calcium gluconate group completed the study. Alendronate treatment for 3months significantly increased BMD of the patients [(0.716±0.082) g/cm2in comparison with that before treatment [(0.667±0.083) g/cm2, t= 2.473,P ＜ 0.01], whereas the BMD underwent no obvious changes after treatment with calcium gluconate [(0.671±0.081) g/cm2 before vs (0.680±0.073) g/cm2after treatment, t=1.812, P ＞ 0.05]. Significant difference in BMD after treatment was noted between the two groups (t=2.384, P ＜ 0.01). The effective rate was significantly higher in alendronate group than in calcium gluconate group (X2=14.9, P=0.005), but 7 patients complained of abdominal discomfort in the former group and the patients in calcium gluconate group reported no adverse effects.CONCLUSION: Alendronate can inhibit bone absorption, promote the recovery of bone matrix, and increase the bone mass, producing better effect than exclusive use of calcium gluconate oral solution in treatment of the osteoporosis in the middle-aged and the elderly.

Objective To investigate children' s understanding of food,nutrition and its relation to health.Methods Participants were interviewed individually,various experimental tasks were used to explore 5-9 year old children' s spontaneous classification of familiar food and their understanding of food balance.Results Five-year-old children rely more than elders on physical cues.There was significant age difference of their criterion of classification among physical (H_((2))=12.929,P ＜ 0.01),conventional (H_((2))=5.540,P=0.063)land processing criterion(H_((2))=6.076,P＜ 0.05).There was significant SES difference of their choices(X_((1))~2=5.857,P=0.016 ; X_((1))~2=4.510,P=0.034 in two different tasks).Higher SES children tended to choose balanced food(percentage of choosing balanced food in higher SES group was 75.0% ,93.8% ;45.2% ,74.2% in lower SES group).Conclusion The criterion children used is related to their cognitive development and experience.As they become older,more and more children realize the nutritional value of foods.There were a significant age difference in nutrition-balanced food choice ,and children's social economic status influence their performance.

Objective To investigate the changes of intestinal blood flow and motility and their effects on intestinal mucosa barrier in rats with acute cerebral ischemia. Methods 64 male Wistar rats were assigned randomly into cerebral ischemia group (n=32) and control group (n=32).The two groups were divided into four subgroups according to timepoints of 6 h,12 h,24 h and 48 h after operation (8 rats for each subgroup).The intestinal mucosa blood flow,intestinal transmit index and endotoxin level in porlal vein were detected.The displacement ratio of E.coli was marked and counted with fluorescent microscope in tissue homogenate from organs. Results The intestinal blood flow in cerebral ischemia group at 6 h,12 h,24 h and 48 h after operation [(34.5±3.2)PU,(22.7±1.9)PU,(26.2±4.3) PU and (30.5± 4.1) PU] were significantly lower than control group[(46.8 ±5.4) PU,(50.1±3.6) PU,(45.4±4.1) PU and (48.7±7.3) PU] (t=2.650,2.875,2.639 and 2.507,all P＜0.05).The intestinal transmit index in cerebral ischemia group at 6 h,12 h,24 h and 48h after operation[(0.59±0.07),(0.48±0.06),(0.50±0.08)and (0.57±0.04)] were decreaesd as compared with control group [(0.73±0.04),(0.75=0.02),(0.74±0.06) and (0.76±0.03)] (t=2.409,2.758,2.649 and 2.807,all P＜0.05). The levels of endotoxin in cerebral ischemia group started to increase at 6 h and arrived to peak at 24 h,and the levels at four timepoints were (0.382 ± 0.014) Eu/ml, (0.466 ± 0.018) Eu/ml,(0.478 ± 0.029) Eu/ml and (0.412±0.036)Eu/ml,respectively,that were higher than those in control group[(0.102±0.007)Eu/ml,(0.114±0.021)Eu/ml,(0.112±0.018)Eu/ml and (0.108±0.011)Eu/ml] (all P＜0.05).The total E.coli detection rates in multiple organs in cerebral ischemia group (11.4％,18.8 ％,25.0％and 12.5％) were higher than in control group (2.1％,4.2％,2.1％ and 0.0％) at four rime points (all P＜0.05). The level of endotoxin was negatively related with the intestinal blood flow and intestinal transmit index( r =- 0.861 and - 0.796,both P＜ 0.05). Conclusions The higher intestinal mucosa blood flow and intestinal motility play important roles in the increase of intestinal mucosa permeability at early stage after acute cerebral ischemia.

0.05).The clinical outcomes were evaluated according to improvement HSS knee joint function scoring,and the score showed an average of 87.5 points (range,71-97).[Conclusion]The dual-incision technique resulted in accurate fracture reduction with low tissue complication rate,and the medial and lateral plating treatment achieved improved stabilization which enabled mobilization of the knee joint to start immediately after surgery.Medial and lateral plating treatment with dual incisions is a safe and effective technique for Schatzker type Ⅴ tibial plateau fractures.

Histopathological and ultrastructural changes of the lungs were observed in various intervals after high-velocity bullet wounds of the two thighs of dogs. It was found that histologically there were microvascular dilatation, congestion, capillary rupture, interstitial and alveolar bleeding, focal atelecta-sis and pulmonary emphysema in the first half hour and the 6th hour after injury. In addition, microvascular embolism and hyaline membrane formation were seen in the 24th and 72nd hour after injury. Under electron microscopy, there were swelling of capillary endothelium, swelling, degeneration and necrosis of type I pneumocytes, shortening and decreasing of the microvilli of type II pneu-mocytes, significant vacuolation of the lamonar bodies, accumulation of leucocytes and platelets in the capillary lumen,and obvious decrease of the granules in the leucocytes. The mechanism of the pulmonary injury accompanying bullet wound of the thighs was discussed.

The recent studies have shown a significant relationship between persistent organichorine pollutants(POCPs) and semen quality. The biological characters and source of POCPs, the effect mechanisms of POCPs on semen quality, sperm structure and function were reviewed in this paper. The epidemiological evidences for the reproductive disturbance of men caused by POCPs were discussed and the research direction in the future was pointed out.

Objective This study was designed to investigate the infection sources and transmission range of the first brucellosis outbreak in human in Bijie City in order to take specific control measures.Methods Fangzhu Town of Qixingguan District was selected as the investigation site where the first medical case was reported.① Basic conditions investigation:the population and the livestock conditions were investigated;②Specific investigation:remote specific investigation of the first case was made through telephone by using unified specific investigation form;③Epidemic situation in human:based on the rule of informed consent,serum samples of all sheep raising people were collected for examination;④Epidemic situation in livestock:sheep's serum samples were collected by agricultural sector.Rose-bengal plate agglutination test (RBPT) and standard agglutination test (SAT) were used to test the serum samples.Results There were 6 338 households with 28 682 residents in Fangzhu County totally,including 70 households feeding 2 184 herds of sheep.The fast case had attacked on May 10th,2014,who was transferred to the first people's hospital of Yuanan Province on July 17th,2014,and was diagnosed as brucellosis on July 25th,2014.There were 85 serum specimens from livestock feeders tested totally,17 specimens showed SAT positive,10 cases were confirmed,recessive infection were 7 cases,the infection rate was 20.00％ (17/85),the detection rate was 11.76％ (10/85),and the recessive infection rate was 8.24％ (7/85).A total of 339 sheep serum samples were tested,133 specimens showed RBPT positive.The positive rate was 39.23％ (133/ 339).Conclusion Brucellosis epidemic was exisited in Bijie City among human and animals,and the situations of infection is serious.The prevention and control of brucellosis should be publicity and education on the sheep flocks.

Standardization, objectification, and normalization of TCM syndromes are emphasis, difficulty, and hot issue of inheritance and development of TCM.With the technological development of computer and extensive application of multi-disciplinary integration, research methods for the identification of TCM syndrome classification emerge in endlessly. This article analyzed the application status of multivariate statistical analysis in the identification of TCM symdrome classification, summarized application status and existing problems of cluster analysis, PCA and factor analysis, discriminant analysis and Logistic regression analysis, and structure equation model in the identification of TCM symdrome classification, which provided references for further studies on identification methods of TCM symdrome classification.

Objective To investigate the current work situation of senior clinical nurses to provide some advices for the nursing management .Methods The self-made questionnaires were adopted to investigate the work situation of 60 senior nurses for conduc-ting the descriptive analysis .Results The senior nurses′ satisfaction degrees to the professional self -identity ,the chief nurse′s scheduling ,the current work environment ,the approval by hospital and the emphasis degree by the department were not high .They thought that the suitable position for them was the office nurse and the second was the responsibility group leader .Whereas ,the un-dertaking key post at present was the responsibility group leader and the second was the office nurse .Conclusion Due to the partic-ularity of nursing work and the physiological and psychological change ,the senior nurses are unsuitable to the busy front -line work ;the senior clinical nurses have the rich clinical experience ,the stronger communicational and organizational coordination abili-ty ,and are more suitable for the posts of the office nurse and health education nurse ,and second is the post of responsibility group leader .