OBJECTIVE:To investigate the protective effects of adjunctive general anesthesia of dexmedetomidine on cardiac and cerebral ischemia-perfusion injury. METHODS:50 patients,ASA physical status Ⅰ-Ⅱ,undergoing selective tracheal intuba-tion,were randomly divided into dexmedetomidine group (group D) and control group (group C) with 25 cases in each group. The patients in group D received a loading dose of 1 μg/kg of dexmedetomidine by infusion pump before anaesthesia,10 min lat-er by a maintenance dose of 0.5 μg/(kg·h)till the end of surgery;whereas patients in group C received normal saline and same induction. HR,SBP and DBP of 2 groups were monitored at the beginning of operation,10 min after incision,30 min after inci-sion,at the end of operation. Blood samples of vena jugularis interna were taken to determine the plasma levels of cardiac tropo-ninⅠ(cTnⅠ) ,adrenaline and norepinephrine before anesthesia induction (T0),at the end of surgery (T1),6 h after surgery (T2),12 h after surgery(T3),24 h after surgery(T4),48 h after surgery(T5). RESULTS:There was no statistical significance in the levels of HR,SBP and DBP in group D between during operation and at the beginning of operation(P>0.05);those in-dex were significantly lower than those of group C at corresponding time points,with statistical significance(P<0.05). The lev-els of cTnⅠ in group D at T2-T5 were significantly lower than in group C,with statistical significance(P<0.05). The levels of adrenaline and norepinephrine at T1-T5 were significantly lower than group C,with statistical significance (P<0.05). CONCLU-SIONS:Adjunctive general anesthesia of dexmedetomidline can improve cardiac and cerebral ischemia-perfusion injury to certain extent.

This paper summarizes the positive significance of non-profit private hospitals development , and an-alyzes the institutional obstacles on the development of non-profit private hospitals in terms of autonomous manage-ment, fair competition, investment and profit , tax relief, management and supervision .Finally, the paper provides some proposals to improve the development of non-profit private hospitals:revising the medical institution regulation , establishing and improving the non-profit private hospital assets finance management system , implementing the opera-tion system, establishing a scientific and standardized supervision mechanism , etc.

Objective To study the effect of Xinji Huoliyin on the apoptosis of myocardial cell and apoptosis-related gene expression of experimental dilated cardiomyopathy rats, and explore its mechanism. Methods Sixty animals were randomly divided into 6 groups. Dilated cardiomyopathy model was made by injecting adriamycin. Experimental rats were given Xinji Huoliyin and Huangqi Shengmaiyin respectively. The genic expression of p53 and Fas was tested by S-P immunohistochemistry technique after 4 weeks. Results The apoptosis rate of myocardial cell of model group was higher than that of normal group (P

Objective To establish a purified model of rat retinal ganglion cells (RGCs) cultured by serum-free medium,and provide a good cell model to investigate the damage of RGCs in glaucoma,retinal ischemia,and degenerative retinopathy. Methods Two monoclonal antibodies,anti-rat SIRP (OX-41) against rat macrophage and antibody against rat Thy-1 (OX-7),were used to purify and characterize RGCs from 1-3-day old Sprague-Dawley (SD) rats by means of two-step filtration.Purified RGCs were cultured in serum-free neurobasal medium containing B27 and ciliary neurotrophic factor (CNTF) meeting the neuronal cell's special requirements.Photomicrographs illustration,immunfluorescence staining of Thy-1,calcein-acetoxymethyl ester (calcein-AM) fluorescence images were used to observe and identify cultured retinal cells and purified RGCs. Results Among the primary cultured rat retinal cells,91% were retinal neurons.Protuberances of RGCs were seen after cultured for 24 hours.At the4th to 8th day,many cells had uniform configuration,large body,and long protuberances. At the 14th day,over 60% cells maintained viability.Immunoflurescence staining of Thy-1 showed the purity of RGCs was about 90%. The results of calcein-AM staining,which stained the living cells only,showed large cell body of RGCs and most of RGCs had a protuberance whose length was twice longer than the diameter of the cells. Conclusion RGCs cultured by serum-free medium has uniform size,good configuration,and high purity,which is adapt to the research of damage of RGCs caused by various factors and to evaluate the protective effects of neuroprotective agents.

Objective To understand the occupational prevention status of clinical nurses in Guangdong province.Methods We investigated 500 nurses in 15 class-three-grade-one hospitals in Guangdong province on occupational prevention status by questionnaires.Results The incidence of pricking wound and incised wound by ampule was frequent.The percent of everyday incidence reached 44.2% and 49.0%.There were 68.2% of nurses wore gloves when contacting the body fluid and blood of patients,55.3% of nurses wore gloves when contacting chemotherapeutic drugs,53.1% of nurses wore gloves during hemospasia,57.2% of them wore gloves when handling urine.There were 52.1% of nurses did not use gauze for protection when handling ampule.There were 61.3% nurses knew related protection law,18.2% of nurses knew the coping process after the incidence of occupational injury.58.2% of nurses established related preventive measure and instructions,43.1% of nurses thought it was necessry for hospitals to produce more comprehensive and systemic occupational prevention instructions.Conclusions The cognition of occupational prevention of nurses was weak and they lacked occupational prevention knowledge.It is necessary to strengthen the occupational prevention education and training.

Objective To compare the differences in the use of effects of improved and traditional abdominal positioning locator card in the empty nest elderly diabetic patients with insulin pen injection. Methods 100 discharged cases of empty nest elderly diabetic patients with insulin treated were enrolled. They were divided into two groups by random digital table method, 50 cases in traditional positioning card injection group and 50 cases in improved positioning card injection group. Usage rate of two sets of locator cart, adverse reactions in local skin injection and blood glucose control were observed for 12 months. Results After 12 months, 44 cases occupied 88%in improved positioning card injection group were not about using positioning card while 30 cases occupied 60%in traditional positioning card injection group. The difference was statistical significance (P<0.05). After 12 months, only 3 cases in improved positioning card injection group appeared local injection site reactions which was significantly lower than 31 cases in the traditional positioning card injection group, and the difference was statistically significant (P<0.05);12 months later, fasting blood glucose (FBG), 2 hour postprandial blood glucose (2 h PBG), glycosylated hemoglobin (HbA 1c) of improved positioning card injection group and traditional positioning card injection group [(7.0 ±1.5) mmol/L and(7.8±1.9)mmol/L,(10.7±2.1)mmol/L and(12.3±2.2)mmol/L,(7.1±1.3)% and(7.7±1.5)%] were all decreased significantly than before. The difference was statistically significant (P<0.05). FBG,2 h PBG, HbA1c of improved positioning card injection group were decreased more significantly than that in traditional positioning card injection group and the difference was statistically significant (P<0.05). The standard rate of HbA1c [64% (32/50)] in improved positioning card injection group was higher than that in traditional positioning card injection group [42%(21/50)]. The difference was statistically significant (P<0.05). Conclusions The modified abdominal injection locator card can improve patients′positioning card usage rate, optimize insulin injection technique, reduce the occurrence of adverse reactions in local skin injection and improve the control of blood glucose.

Objective To develop a sandplay analysis evaluation matrix for children with tic disor?ders. Methods 113 children were chosen as the study subjects . Based on the grounded theory,the open coding,correlated coding and core coding were carried out on coding elements for sandplay process to gain the third?level,second?level and first?level evaluation codes. The reliability and validity of the codes were tested.Results The sandplay analysis evaluation matrix for children with tic disorders was established inclu?ding 48 third?level,17 second?level and 3 first?level evaluation codes. The codes were proved to be reliable and valid through the comparison and conditional coding with query. Conclusion The sandplay analysis e?valuation matrix for children with tic disorders,which is established based on the grounded theory,is reliable and operable. It can be used as a tool to assess the psychological or behavioral problems of children with tic disorders dynamically.

Objective To investigate the role and implication of Engrailed-2 (EN2) in human hepatocellular carcinoma (HCC) and the effect of silencing EN2 genes on the proliferation and invasion of HepG2 cells by RNA interference.Methods Immunohistochemistry was used to detect the expression of EN2 in the HCC tissues and corresponding non-cancerous adjacent liver tissues in 126 patients with HCC.The expressions of EN2 and the relationship between EN2 expression and clinicopathological features and prognosis were analyzed using the Chi-square test.The survival curve was drawn using the Kaplan-Meier method and the survival was analyzed using the log-rank test.EN2-small interfering RNA (siRNA) was transfected into HepG2 cell lines mediated by LipofectamineTM 2000,and the expression of EN2 were detected by Western blotting assay.The cell proliferation and invasion were measured by methyl thiazol tetrazolium (MTT) and Transwell assays.Results EN2 positive expression rate was high (62.7％) in HCC tissue but low in the corresponding peritumoral tissue (23.5％,P ＜ 0.01).The high expression of EN2 was strongly correlated with tumor size,metastasis and AJCC TNM stage.The cumulative 5-year survival rate was 33.9％ in the low EN2 expression group,whereas it was 5.1％ in the high EN2 expression group (P ＜ 0.01).Expression of EN2 in EN2 siRNA group was significantly lower than that in control siRNA group and control group (P ＜ 0.05),respectively.The cell proliferation and invasion ability were significantly reduced in the EN2 siRNA group.Conclusion The expression of EN2 is highly up-regulated in HCC tissues and down-regulation of EN2 could inhibit proliferation and invasion of HepG2 cells,which indicating that EN2 is involved in the process of HCC carcinogenesis and progression and may serve as a biomarker for predicting prognosis of HCC patients.

Objective To observe the association between therapeutic effect of speech disorder and the age on treatment of children with cerebral palsy,and to explore the best treatment period of speech disorder children with cerebral palsy.Methods One hundred and twenty-one cases of speech disorder children with cerebral palsy aged 1 to 6 years in Maternal and Child Health Center of Hebei Province,Hebei Children's Hospital,were selected as subjects,and the patients were randomly divided into training group,which included 64 cases who received scalp acupuncture combined with language and 57 cases treated with speech training group.After 6 courses of treatment,the therapeutic effect for speech disorder of children between 1 to 3 years old and ＞ 3 to 6 years old were compared,the association between children's age for treatment and treatment effects was explored.Results The total treatment efficiency of 1 to 3 years and ＞ 3 to 6 years old children in scalp acupuncture group combined with language training group were 95.45％ and 83.33％ respectively,the difference was significant (x2 =6.859 8,P ＜ 0.05) ; while in 1 to 3 years and ＞ 3 to 6 year-old children in speech training group the total treatment efficiency were 84.62％ and 77.42％,and the difference was significant(x2 =6.625 7,P ＜ 0.05).In both groups,total efficiency of 1 to 3 years and ＞ 3 to 6 years old children were 89.58％ and 80.82％,respectively,and the difference was statistically significant (x2 =9.617 5,P ＜ 0.01).Conclusions The best treatment period of speech disorder children with cerebral palsy is less than 3 years old,as age grows,the effect is gradually decreasing.

Aim To study the protective effect of tetra-hydroxystilbeneglucoside ( TSG ) on cardiac injury and the mechanism involved in silent mating type informa-tion regulation 2 homolog 1 ( SIRT1 ) and adenosine monophosphate-activated protein kinase( AMPK) in the diabetic rats. Methods Type 2 diabetic rats were sac-rificed after administration with TSG for 8 weeks. Blood glucose, blood lipids, liverfunction,creatine ki-nase ( CK ) , lactate dehydrogenase ( LDH ) as well as myocardial nonesterified fatty acids( NEFA) were deter-mined by using biochemical test. The concentration of myocardial fatty acid transport proteins ( FATPs ) and-fatty acid β-oxidase ( FA-β-oxidase ) , and the levels of tumor necrosis factor alpha ( TNF-α) , interleukin -6 ( IL-6 ) , interleukin-1β( IL-1β) in serum were also measured by ELISA method and radio immunoassay re-spectively. The protein expressions of TNF-α, IL-6, IL-1β, SIRT1 and AMPK were detected by Western blot. Results Treatment of TSG reduced the contentof blood lipids, NEFA and collagen without affecting the content of blood glucose and insulin. The levels of TNF-α, IL-6 and IL-1βin serum as well as the protein expressions of TNF-α, IL-6 and IL-1β of cardia were also inhibited by administration with TSG. Treatment of TSG caused a significantly increased concentration of myocaidial FATPs and FA-β-oxidase, and dramatically restored the decreased protein expressions of SIRT1 and pAMPK in diabetic rats. Conclusion The protec-tive mechanisms of TSG against diabetic rats are in-volved in the alleviation of inflammatory mediator injury and improving energy metabolism.