ObjectiveTo investigate the effects of sevoflurane preconditioning on myocardial connexin 43 (Cx43) during myocardial ischemia-reperfusion (I/R) in rats.MethodsMale adult Wistar rats weighing 220-250 g were anesthetized with intraperitoneal pentobarbital 40 mg/kg and heparin 500 IU/kg.Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃ for 30 min.Sixteen isolated rat hearts were randomly assigned into 2 groups ( n =8 each):I/R group and sevoflurane preconditioning group (group SP).At 30 min of equilibration,group I/R received perfusion for another 20 min,the hearts were purfused with K-H solution saturated with 2.4％ sevoflurane for 15 min followed by 5 min washout with K-H solution in group SP.Then all the hearts underwent 40 min of ischemia followed by 60 min of reperfusion.HR,left ventricular developed pressure (LVDP),+ dp/dtmax and - dp/dtmax were recorded at the end of equilibration,immediately before ischemia and at 30 and 60 min of reperfusion.Myocardial tissues were obtained from apex for microscopic examination and from left ventricle for observation of distribution of Cx43 and determination of Cx43 expression.ResultsCompared with the baseline value at the end of equilibration, + dp/dtmax and - dp/dtmax immediately before ischemia and HR,LVDP,+ dp/dtmax and - dp/dtmax at 30 and 60 min of reperfusion were significantlydecreased in groups I/R and SP (P ＜ 0.01 ).Compared with that immediately before ischemia,HR,LVDP, + dp/dtmax and - dp/dtmax were significantly decreased at 30 and 60 min of reperfusion in groups I/R and SP (P ＜ 0.05 or 0.01).Compared with group I/R,HR,LVDP,+ dp/dtmax and - dp/dtmax were significantly decreased immediately before ischemia,HR,LVDP, + dp/dtmax and - dp/dtmax were significantly increased at 30 and 60 min of reperfusion ( P ＜ 0.01 ),and pathological injury was attenuated in group I/R.Myocardial Cx43 was unevenly distributed in group I/R,while evenly distributed in group SP.There was no significant difference in Cx43 expression between the two groups.ConclusionThe mechanism by which sevoflurane preconditioning protects myocardium against I/R injury may be related to redistribution of Cx43,but not Cx43 expression.

OBJECTIVE: To attempt to apply the research method of evidence-based medicine for the scientific administration of pharmacy. METHODS: The meta-analysis method in evidence based medicine was applied,the pharmacy work basal protocols original sources were established as primary source or data for aggregate analysis. RESULTS: 15 basal protocols and 25 standard operating manual and the associated supervising system had been established. The key problems were discovered through the data analysis and which were solved accordingly. CONCLUSIONS: Applying the research method in evidence based medicine can facilitate digitalization, routinization, and institutionalization in the administration of pharmacy and greatly enhance the efficiency of administration.

Objective To investigate curative effects and prognostic factors of video-assisted thoracoscopic extended thymectomy ( VATET ) for nonthymomatous myasthenia gravis ( NTMG ) . Methods Clinical records of 43 patients with an established diagnosis of NTMG who underwent VATET from December 2009 to September 2014 were reviewed. Three-port thoracoscopic right thymectomy with resection of fat tissue in anterior mediastinum was conducted.The curative effects and prognostic factors were evaluated and analyzed with the Monden standard. Results The VATET was successfully completed in all the 43 patients.The operation time was 75-240 min (mean, 115.4 min).The intraoperative blood loss was 10-200 ml (mean, 42.2 ml). No peri-operative death occurred.Follow-ups for 4 -60 months ( mean, 36.2 months) showed 12 cases of remission, 18 cases of improvement, 10 cases of unchanged disease, and 3 cases of deterioration.The effective rate was 69.8% (30/43).Multivariate logistic regression analysis showed that pathological type of thymic hyperplasia was the independent risk factor for NTMG postoperative outcomes (β=0.921,95%CI:1.866-2.811, P=0.000). Conclusion Video-assisted thoracoscopic extended thymectomy is effective in most myasthenia gravis patients.

Objective To compare the diagnostic value of CT and diffusion-weighted imaging in extremity soft tissue tumors. Methods A total of 104 cases of extremity soft tissue tumors were examined with CT scanning and MRI. All cases were histologically proven. Then we compared the CT value of various types of tumors. The b values of diffusion were 0 and 500 s/mm2. The apparent diffusion coefficient (ADC) values of a large region with no hemorrhage, necrosis, scar tissue, or calcification representing the lesion were measured. ADC values of benign tumors, malignant tumors and normal muscles were compared. Results There were 68 cases of benign tumors and 36 cases of malignant tumors. The CT findings of 45 cases and the MRI findings of 87cases were in accordance with pathological examination. The diagnosis of 59 cases by CT and 17 cases by MRI were wrong. The CT features of soft tissue tumors showed the low density masses. The features of lipoma or cyst were typical on CT. There were large differences among the different types of tumors performance on T1WI and T2WI. The ADC values of the malignant tumors were significantly lower than those of benign lesion sand muscles (P < 0.01). There was no significant difference in ADC values between benign lesions and muscles. there was significant difference between the detection level of CT and MRI (P < 0.01). Conclusion CT can clearly show soft tissue tumor lesions and to clarify their relationship and the surrounding tissue, but can not accurately characterize. MRI diffusion-weighted imaging can better differentiate benign and malignant, and speculate the histological lesions sources. MRI detection level is significantly higher than CT and more consistent with a higher degree of pathology. Thus in the preoperative diagnosis of soft tissue tumors, diffusion-weighted imaging MRI should be preferred.

Objective To compare the inhibitory effects of Butorphanol and Dezocine on Etomidate-induced myoclo?nus. Methods A total of 150 patients with ASA physical statusⅠorⅡ, aged 40-65 yr, with body mass index (BMI) of 20-25 kg/m2, scheduled for elective operations under general anesthesia, were included in this study. Patients were randomly al?located into three groups (A, B and C) with 50 patients in each group. Group A was given intravenous Butorphanol 15 μg/kg for 30 s, group B was given Dezocine 0.1 mg/kg and group C was given equal volume of saline. After 2 min, etomidate 0.3 mg/kg was administrated to three groups. The occurrence and severity of myoclonus were recorded for 2 min after administration of Etomidate. The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) and Bispectral index (BIS) were recorded at the time points before induction (T0), 2 min after the experimental drug treatment (T1), and 2 min after Etomi?date treatment (T2). At the same time, the concentration of serum potassium was determined at T0 and 5 min after endotrache?al intubation (T3) respectively. Results The positive incidences of myoclonus were 12%in group A, 22%in group B and 74%in group C, respectively. Compared with group C, the positive incidence rates of myoclonus and myoclonus scales were significantly lower in group A and group B (P<0.05), but no significant difference between group A and group B (P>0.05). Compared with T0, there was no significant difference in the potassium concentration between patients without myoclonus (grade 0) and patients with myoclonus (grade 1 and grade 2) at T3 (P>0.05). There was a significant increase in potassium concentration in patients with grade 3 (P<0.05). There were no significant differences in MAP, HR, SpO2 and BIS values at T0, T1 and T2 between three groups of patients (P>0.05). Conclusion Pre-treatment of Butorphanol (15μg/kg) or Dezocine (0.1 mg/kg) can reduce the Etomidate-induced myoclonus. At the same time, both therapies show no different effects on cir?culation and respiration system.

Objective To investigate the influence of t he mass screening on the diagnostic status of the conventional ordinary prostati c cancer (CaP). Methods Sixty seven cases of prostate ca ncer detected by mass screening (January 1996～December 2001) and 358 cases diag n osed at the outpatient of various hospitals in Changchun (January 1986～December 2001) were compared in terms of age distribution,clinical stages,level of serum prostate special antigen(PSA),pathological grade and treatment modalities,with a SPSS analysis system. Results The annual average incide nce of CaP during 1999 to 2001 increased 4.72 times when compared to the 1986 to 1989’s.In the screening group,the cases with clinical stage A and B accounted for 58.2%. In the clinical group, it was only 27.9%,and mostly detected incident ally.Furthermore,in the screening group the percentage of the cases beyond 20 ng /ml PSA and of poorly differentiated carcinoma were much lower compared to the c linical group.These differences were statistically significant.The cases of radi cal prostatectomy in the screening group increased 15.3% compared with that of t he clinical group. Conclusions Only the mass screening c an really reveal the actual prevalence of prostate cancer.It can markedly raise the number of prostate cancer,especially the cancer in the early stage.The mass screening is inevitable to detect the curable early stage prostate cancer.

Objective: To study the group consultation in preventing psychological disorders causing by retirement. Methods: Implement group consultation to 23 elderly staff members from a government organization. Both the self-designed health knowledge and SCL-90 questionnaires were used before and after he/she participated the group consultation. Comparisons were conducted of the results getting from 18 old people who had never had the consultation. Results: There was significant difference in two groups. Experiments show that group consultation can impressively held to improve the psychological and behavior disroders. Conclusion: Group consultation is an effective way to prevent psychological problems causing by retirement.

Objective:To compare the current status of domestic violence(DV)by geographic settings in Hunan province.Methods:Using a multi-stage sampling strategy,3087 households in urban,3070 in rural areas and 3294 in industrial district in Hunan were surveyed.Multiform clue investigation and face-to-face interviews were combined to investigate the current status of DV.Results:The lifetime and 12-month prevalence of spousal abuse,child abuse and elder abuse varied significantly by geographic settings(P

Objective To compare the efficacy of uniportal VATS and single utility port VATS in treatment of spontaneous pneumothorax.Method From January 2013 to December 2015, we retrospectively collected clinical data of 53 patients with spontaneous pneumothorax who were treated with uniportal VATS, as study group; compared with control group: 53 patients received single utility port VATS in the same period. The clinical data was compared between the two groups, including the operation time, intraoperative blood loss, drainage time, postoperative extubation time, postoperative pain score, postoperative hospitalization and recurrence.Results All patients were successfully completed the operation, no death and serious complications occurred. There were no significant differences in intraoperative blood lose, duration of chest drainage, duration of hospital stay and incidence of serious postoperative complications between two groups (P > 0.05). Mean Visual Analogic Scale (VAS) score for 24 h post-operative pain was: (2.60 ± 0.71) for uniportal VATS and (3.38 ± 0.84) for single utility port VATS (P > 0.05), 72 h post-operative pain was: (1.30 ± 0.51) for uniportal VATS and (1.58 ± 0.62) for single utility port VATS (P > 0.05). Follow up 5 ~ 36 months, median follow up was 19 months. No recurrence occurred during follow up.Conclusions The study suggested that both surgical approaches to spontaneous pneumothorax are safe and effective. Significant differences were found for early post-operative pain between the two approaches, the uniportal way is better. It is worthy of clinical promoting.

Objective To explore the spread patterns of retropharyngeal lymph node (RLN) metastasis of nasopharyngeal carcinoma. Methods From July 2003 to March 2005, three hundred and three patients with nasopharyngeal carcinoma in initial treatment were enrolled in this study. All patients underwent magnetic resonance imaging (MRI) before treatment, meanwhile measured the minimal and maximal axial diameters, the longitudinal diameter and the central and craniocaudad locations of each positive RLN. Results A total number of 264 positive RLN were found in 177 patients. The minimal and maximal axial diameters and longitudinal diameter of positive RLN were 9.9, 12.9 and 22.4 mm, respectively. Ipsilateral metastatic RLN were noted as follows: two nodes in 21 patients, three nodes in 3 patients and four nodes in 1 patient. According to the longitudinal central location of 263 positive lateral RLN, the numbers of nodes at occipital bone, C1, C1/C2, C2, C2/C3 and C3 were 27, 166, 40, 23, 5 and 2, respectively; the mean minimal axial diameters of nodes were 6.8, 9.9, 12.5, 10.4, 9.3 and 8.0 mm, respectively. Conclusion Multiple metastatic ipsilateral RLN are not common in NPC. The rate of RLN metastasis shows the trend of decreasing from vertebral C1 to C3.The maximal diameters of RLN are in the C1/C2 intervertebral space, and reveal a decreasing frequency along the craniocaudal directions of occipital and vertebral C1.