Objective To assess the efficacy of the mixtures of different concentrations of ropivacaine(R) and chloroprocaine(C)for epidural anesthesia in patients undergoing hysterectomy.Methods Sixty ASAⅠorⅡpatients aged 27-56 weighing 45-75 kg undergoing elective hysterectomy were randomly divided into 4 groups(n= 15 each);groupⅠ0.75% R alone;groupⅡ0.5% R-1% C;groupⅢ0.5% R-1.5% C and groupⅣ0.75% R+1% C.The epidural catheter was placed at L_(2,3)interspace and advanced 3.5 cm into the epidural space in cephalad direction.A total of 22 ml of epidural solution was injected in each group.The onset time,block height and duration of sensory block and the onset time,degree and duration of motor block(using Bromage scale)were assessed.The use of supplementary drugs(ketamine and ephedrine)and side effects were recorded.Results The onset time of sensory and motor block was significantly shorter in groupⅡ,ⅢandⅣthan in groupⅠ(0.75% R alone).The duration of sensory and motor block was significantly shorter in groupⅡandⅢthan in groupⅠandⅣ.The incidence of hypotension was significantly increased but the incidence of discomfort produced by traction on the viscera during operation was reduced in groupⅣas compared with groupⅠ.Conclusion The anesthetic efficacy of epidural 0.5% ropivacaine is significantly enhanced when mixed with 1.0% or 1.5% chloroprocaine.

Objective To isolate and identificate a specific new gene highly related to human bladder cancer and to investigate the carcinogenesis mechanism and genetic susceptibility. Methods Normal bladder epithelia and cancer tissue collected from 8 cases of primary bladder transitional cell carcinoma were studied using the high performance?sensitive technique of mRNA differential display.The differential fragments were found by comparing with genetic expression. 6 of them were reamplificated?cloned?sequenced,and performed the autoploidy index in the public database of genbank. Results (1)37 differential fragments have been isolated.36 of which are expressed or highly expressed in cancer tissues,but not so or lowly expressed in normal tissues;while it has been expressed in 1 normal tissue but not in the cancer tissue.(2)Results of indexing:1 is homologous to TBX3 (T box gene),autoploidy 99%.1 is homologous to cl.Ca4 gene (member 4 of Calcium activated chloride channel gene family), autoploidy 99%.1 is homologous to Cu,Zn SOD gene (Cu,Zn superoxide dismutase),99%.The remaining fragments are not homologous to unknown sequences in the public database of genbank,assigned as YHHQ1,XHL,LHX. Conclusions (1)It is verified at genetic level the relation between the conment's increasing of Cu,Zn SOD in bladder cancer derived tissue and the occurrence,advance of bladder cancer.(2)The relation between TBX3,cl.Ca4 gene and human carcinoma has been observed.(3)YHHQ1 may be the new candidate of anti oncogene related to bladder cancer.XHL and LHX may be the new candidates of oncogene related to bladder cancer.

Objective To investigate the efficacy of ventral bladder mucosa onlay graft urethroplasty for the management of panurethral stricture.Methods From August of 2005 to July of 2013,11 cases of panurethral stricture were treated by ventral bladder mucosa onlay graft urethroplasty.The median age of the patients was 53 years (22-72 year),The median stricture length was 15 cm (12-18 cm).The patient was placed in the lithotomy position,Penile urethra was exposed by circumcoronal incision and degloving of skin,Bulbar urethra was exposed by inverted Y-shaped perineal incision.The strictured urethral segment was then opened ventrally in the midline up to at least 1 cm proximally into the healthy urethra.An appropriate size bladder mucosa graft was harvested,and was quilted to the splited urethra edge,the graft width was 1.5-2.0 cm.Two F10 fenestrated silicone catheters were left as urethral stents,a suprapupic cystostomy tube was left.The urethral stent was removed 4 weeks postoperatively.Follow-up was performed every 3 months for the first year,and annually thereafter.Success was defined as normal voiding with a maximum flow rates ≥ 15 ml/s,and the patients required no further instrumentation,including dilation or urethrotomy.Results The mean follow-up was 18 months (range,9-36 months),the overall success rate was 10/11.One patient developed urethral meatus stenosis 3 months postoperatively,and was managed by meatal dilatation.Conclusion Ventral bladder mucosa onlay graft urethroplasty can be used for the management of panurethral stricture,Bladder mucosa is an alternative substitution for complex urethral reconstruction.

Objective By analyzing 2 560 echinococcosis cases through telemedicine,to explore a new mode for preventing,diagnosing,and treating of echinococcosis.Method From January 2009 to December 2013 in our hospital through remote medical care and consulting we analyzed cases and conducted statistics on consultation's person time,location difference,spectrum of disease and upward referral rate as well as the cost of hospitalization.Result (1) The amount of consultation rose from 182 cases in 2009 to 873 cases in 2013.(2) The proportion of consultation from northern Xinjiang is about 83％-91％,obviously higher than that from south Xinjiang and eastern Xinjiang,which fits those areas mainly with the economical character of the husbandry.(3) Most consultation cases are echinococcosis (99.42％) followed by echinococcosis (0.24％),pelvic cystic echinococcosis (0.19％),cerebral echinococcosis (0.12％),and cardiac echinococcosis (0.03％).(4) Upward referral rate is nearly 7.97％ and about 92.03％ patients were treated in local community hospitals saving medical care budget by RMB 14.78 million.Conclusions Use and establishment of the three level network system for preventing,diagnosing,and treating the echinococcosis by telemedicine effectively enhances primary hospital's ability in the care of these patients and alleviates patients economical burden.

Objective This study discusses the effect of integrating method in the international students' basic chemistry class of medical colleges.Methods The integrating method was composed of the new teaching methods,such as PBL and micro-learning resources,and traditional method.The experimental group was composed of 76 students from the Class 1 of international students of Grade 2015 in clinical medicine of China Medical University,where integrating method was used,namely the teaching methods and means of problem based learning and micro class were integrated into the experimental courses,while the control group was composed of 80 students in Class 2 from the same major and grade,which was using the traditional method of teaching and practicing.A unified examination was applied to evaluate the teaching efficiency in both two groups and the teaching effect of the experimental group was investigated by questionnaire.The data was entered into SPSS 13.0 for two independent samples t-test.Results In the exams the students in the test group got higher scores than that in the control group.The average scores were (17.6 ± 4.5) and (16.0 ± 4.8) respectively (t=4.42,P=0.00),the differences were statistically significant.The effective recovery rate of the experimental group was 100％,and among them,97.4％ (74) of the students thought that they should continue to use the integrating teaching.Conclusion The application of integrating teaching in the course of basic chemistry experiment can improve students' comprehensive ability,and the effect is better than the traditional teaching.

The paper analyzed the needs for care quality management in large general hospitals and progresses made in hospital quality management theories. In respect of care quality management in hospitals, authors hold that the key to care quality is comprehensive scientific management of hospitals, and it is necessary to put in place a long-term management of care quality in line with the development direction of hospital evaluation and by means of total quality management system, as well as enhanced quality management and quality culture building.

Objective To investigate the relationship of matrix metalloproteinases(MMP?3 and MMP?9)and the tissue inhibitor TIMP?1 with left ventricular hypertrophy(LVH)in patients with primary hypertension. Methods Totally 140 patients with primary hypertension and 132 healthy controls were included. Matrix metalloproteinase?3(MMP?3),matrix metalloproteinase?9(MMP?9)and tissue inhibitor metalloproteinase?1 (TIMP?1)were measured. All subjects were taken echocardiography examination ,then left ventricular mass index(LVMI)was calculated. Re?sults MMP?3,MMP?9,TIMP?1(488.32±100.32 vs 314.59±99.78;340.56±43.21 vs 290.15±33.98;389.16±57.53 vs 243.45±62.31;P<0.001) and LVMI(113.7±9.9 vs 88.3±10.4,P<0.001)in patients with primary hypertension were significantly higher than those in controls. In a multiple stepwise regression analysis with LVMI as the variable,it was found that age,SBP,MMP?3,MMP?9 and TIMP?1 were main determinants for LVMI (r2=0.78,P<0.001). 3. Patients with primary hypertension were divided into two subgroups according to LVMI,i.e.,hypertension with LVH (group A)and hypertension without LVH(group B). SBP,MMP?3,MMP?9 and TIMP?1(178±31 vs 166±25;490.14±99.13 vs 405.56±53.12;340.56±43.21 vs 290.15±33.98;393.45±47.69 vs 301.58±39.57;P<0.05)of group A were significantly higher than those of group B. Conclusion MMP?3,MMP?9 and TIMP?1 are influencing factors for LVH in patients with primary hypertension.

By using the high resolution mass spectrometer TripleTOF 5600 , three kinds of standard proteins including bovine serum albumin ( BSA) , ovalbumin ( OVA) and lysozyme C( LYZC) were analyzed, and the correlationship between the ion intensity of mass spectrometry and the relative content of protein sample was investigated. The protein samples were digested by trypsion and diluted to 1-1024 fmol in 7 μL. The ion counts per second ( cps) were used to stand for the amounts of proteins and peptides. Then the correlation between sum of ion intensity ( cps) of all the peptides, number of peptides detected and the amount of proteins was investigated. By comparing the change of values of the same sample in three parallel experiments, a linear relationship between these indexes and the amount of proteins within 1-1024 fmol was found when the cps was more than 1000. Usually, the maximal ion intensity was no more than 1. 5 times of the minimum value for same peptide in triplicate experiments, which suggested that the 3 times or more change of ion intensity was the minimum threshold to determine the differences of proteins amounts in different samples. This study provides a relative quantitative analysis method using qualitative data of high resolution and high scan speed mass spectrometry, which can quickly and easily provide reference for biological and medical research.

Described in the paper are contents and characteristics of building smart healthcare system at a research hospital,and practices of the hospital in exploring smart healthcare.Specific measures include staged building of an e-hospital emphasizing information security; closed-loop transformation with mobile and barcode technology for higher efficiency and patient safety;optimizing the service flow with smart interconnection to create an orderly outpatient environment; implementing healthcare regulations with information systems to ensure a homogeneous medical environment;and integrating the entire medical system to promote coordinated development of regional healthcare service. These measures help upgrade the information service effectiveness and quality of care of the hospital.

Taxus is the source plant of anti-cancer drug paclitaxel and its biosynthetic precursor, analogs and derivatives, which has been studying for decades. There are many endemic Taxus species in China, which have been studied in the field of multiple disciplines. Based on the recent studies of the researchers, this review comments on the study of Taxus biology and chemistry. The bibliometric method is used to quantify the global scientific production of Taxus-related research, and identify patterns and tendencies of Taxus-related articles. Gaps are present in knowledge about the genomics, epigenomics, transcriptomics, proteomics, metabolomics and bioinformatics of Taxus and their endophytic fungi. Systems biology and various omics technologies will play an increasingly important role in the coming decades.