Objective To evaluate the clinical efficacy of total knee arthroplasty(TKA)in patients of osteo-arthris with valgus knee deformity after lateral meniscectomy(LMT). Methods Twenty six cases of osteo-arthris with valgus knee deformity after lateral meniscectomy were treated with total knee arthroplasty. Operation evaluations including the range of motion(ROM),the tibial and femur angle(T-F angle),Knee Society Score System(KSS)and the function score were performed as follow-up. Results The median follow-up periods was 22 months and ranged from 5 months to 3 years. The average ROM improved from 96° preoperatively to 116° at postoperatively. The average KSS improved from 22. 5 points preoperatively to 84. 4 points postoperatively. The average function score improved from 25. 5 points preoperatively to 84. 4 points postoperatively,and the average T-F angle was corrected from 22°( 13° - 31°) of valgus preoperatively to 7. 6°( 0° - 9°) of valgus postoperatively. Conclusion The TKA can provide excellent in patients undergoing osteo-arthris with valgus knee deformity after lateral meniscectomy.

Objective: To investigate the expression of Cyclin G mRNA in leukemia patients and its clinical significance. Methods: RT-PCR was used to analyze the expression of Cyclin G mRNA in the mononuclear cells of 129 leukemia patients and 10 healthy controls. Results: (1) The expression of Cyclin G in acute leukemia (AL) and chronic leukemia (CL) patients was significantly higher than that in healthy controls (both P 50?109/L in AL and AML groups were significantly higher than those with WBC ≤ 50?109/L. (4) Fifty-three of the newly diagnosed cases were Cyclin G positive. The remission rate of patients with high Cyclin G expression(51.7%)was significantly lower than that with low Cyclin G expression(79.1%)(P

The conduction of performance appraisal in the hospital is of great significance to the perfection of the appraisal system and the improvement of the managerial efficiency of the hospital. The authors suggest that in the process of establishing an appraisal system of hospital performance, it is necessary to use for reference enterprises' experience in performance appraisal and the theories of performance management. Firstly, single-faceted pursuit of economic benefits should be avoided, the establishment of an external hospital appraisal system and the establishment of an internal hospital appraisal system should be combined, and attention should be paid to the overall application of performance appraisal in performance management. Secondly, in light of their own experience in hospital management, the authors put forward the suggestion of establishing a performance appraisal system of three levels: the hospital , the department and the post. They also argue that attention should be given to the selection of comprehensive appraisal methods, continuous communication about performance, and readjustment in a timely manner.

Objective:To study TGC on tumor apopotosis and to apply the experimenting basis of TGC's developing and utilizing.Methods:The flow cytometer(FCM) was used for determination apoptosis.The protein expression of Bcl-2 and the mRNA expression of c-myc were evaluated by immunohistochemistry and in situ hybridization.Apoptosis small body were observed by EU.Results:The TGC group appear the Ap apex,the number of cell of G0-G1 period reduce obviously,the cells of S period increase obviously.Bcl-2 and the c-myc mRNA expression levels were decreased in TGC group.The structure of inner membrane was intacted with EU.Chromatin gathered side of cell,the nucleus turns into the nucleus band and nucleus project,there were many cells of the apoptosis and meniscus or the garland shape(the apoptosis corpuscle formatiol) in TGC group.Conclusion:The total glucosides of radix paeoniae induces the tumor cell apoptosising,its mechanism maybe closely related with adjusting expression levels of the Bcl-2 and the c-myc mRNA.

OBJECTIVETo explore the feasibility and safety of dexmedetomidine combined with remifentanil for lower eyelid blepharoplasty.

METHODS50 patients undergoing lower eyelid blepharoplasty ASA I - II were randomly divided into 2 groups (25 in each group) as observation group and control group. Dexmedetomidine (0.3 microg x kg(-1) x h(-1)) and remifentanil (0.05 microg x kg(-1) x min(-1)) were used in observation group. Local anesthesia by lidocaine (1%) combined with midazolam (0.04 mg/kg) intravenous sedation were used in control group. HR, mean arterial pressure (MAP), heart rate (HR), breathing rate (RR), pulse oxygen saturation (SpO2) change were monitored and recorded before and after the administration of the drug, as well as at the beginning of operation, during the operation, at the end of the operation, and 5 minutes after the operation. Patients sedation degree was evaluated by Ramsay. Operation time, recovery time, the incidence of adverse reactions, the satisfaction of patients and doctors were also recorded.

RESULTSPatients had no obvious difference of intraoperative MAP, RR, SpO2, operation time and postoperative recovery time between the two groups (P > 0.05). Compared with control group, HR during the operation were decreased significantly [(64.2 +/- 8.2) bpm, P < 0.05] in observation group. In control group, there were 18 cases of patients with agitation, but they endured the operation anyway. In observation group, 24 cases of patients underwent operation without agitation. The satisfaction of patients and the operation doctors (96%) in observation group were markedly higher than that in control group (P < 0.05).

CONCLUSIONDexmedetomidine combined with remifentanil is practical and safe. The effect of reducing HR should be noticed.

Adult ; Blepharoplasty ; Dexmedetomidine ; therapeutic use ; Double-Blind Method ; Female ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Male ; Middle Aged ; Piperidines ; therapeutic use

Transforming growth factor-β1(TGF-β1)has become an important biological marker and therapeutic target of clinical progression of chronic kidney diseases. Sma- and Mad-related protein (Smad)is a downstream signal transduction protein of the TGF-β family. TGF-β1 activates Smad2 and Smad3 before increasing the transcription of connective tissue growth factors in the nucleus. Smad3 promotes mesangial cell proliferation,extracellular matrix accumulation,epithelial-mesenchymal transition, leading to renal fibrosis. However,Smad2 and Smad7 play a negative regulatory role by inhibiting renal fibrosis. TGF-β1 specific inhibitor (SB431542,etc.) has antifibrosis effect,most of which is in the preclinical stage. The drugs on the market that are effective for DN,such as benzodiazepines,atorvastatin, losartan,and pirfenidone,can inhibit the expression of TGF-β1,while tripterygium wilfordii,cordyceps sinensis,and berberine can delay the process of diabetic nephropathy by reducing TGF-β1 levels.

Objective To evaluate the efficacy of midazolam combined with remifentanil for lower eyelid blephamoplasty.Methods In a double-blind study,200 patients undergoing lower eyelid blephamoplasty were randomly and equally divided into 2 groups (100 cases each):test group (midazolam 0.05 mg/kg and remifentanil 0.5 μg/kg followed by remifentanil 0.05 μg/(kg·min) and control group (midazolam 0.05 mg/kg).Heart rate (HR),mean arterial pressure (MAP),and pulse oxygen saturation (SpO2),respiratory rate (RR),SpO2 change,operation time,recovery time,the incidence of adverse reactions and the satisfactory rate of both patients and surgeons were monitored and recorded before the medication,3 min after the medication,at beginning of the surgery,during and immediately after the surgery,and 30 min after surgery.Results Two groups of patients had no obvious difference in intraoperative MAP,HR,RR,SpO2 and postoperative recovery time (P＞0.05);the incidence of postoperative nausea and vomiting in the test group was significantly higher than that in control group (P＜0.05); Patients and surgeons satisfaction in the test group was higher than that in control group (91.3±11.6)vs (52.7±10.4) (P＜0.05).Conclusions Midazolam combined with remifentanil for lower eyelid blephamoplasty has less inhibitory effect on circulatory and respiratory functions and the patients come round fast after surgery.But there are risks of respiratory inhibition in the induce phase and nausea and vomiting in the recovery stage.

Objective:To investigate Bcl-2 and Bax gene expression in acute myelogenous Leukemia and the relationship between Bcl-2/Bax ratio and drug resistance.Method:Expression of Bcl-2、Bax was detected by immunohistochemical method while drug resistance of AML was detected by cell culture and MTT assay.Results:A high expression of Bcl-2 and a low expression of Bax were detected in AML,respectively,and the ratio between Bcl-2 and Bax was significantly higher than that in normal control (P＜0.01). The ratio in those who are resistant to chemotherapy was significantly higher than that in those sensitive to chemotherapy (P＜0.05).The responsiveness to chemotherapy of those with a high ratio was poorer than thos with a low ratio (P＜0.05).Conclusion:The alteration of Bcl-2 and Bax played certain role in the development of drug resistance in AML,the test of Bcl-2/Bax ratio may have great significance in choice of chemotherapeutic agents and also provide important information for outcome prediction.

OBJECTIVE To investigate the drug sensitivity situation of Acinetobacter baumannii(ABA) in 3 years to instruct clinical application of the antibiotics.METHODS The drug sensitivity test data of the 428 A.baumannii(ABA) strains from 2006 to 2008 were analyzed retrospectively.RESULTS It was showed from the drug sensitivity test in vitro that the most sensitive drug for A.baumannii(ABA) was imipenem,which resistance rate was 11.3-34%.The resistance rate to amikacin was 29.8-49.5% and to penicillins was is 57.7-91%,the resistance rate to of penicillins drugs was 54-74.5%.The resistance of ABA to ampicillin,cefazolin,cefpodoxime and Cefoxitin was over 91%,and showed the multi-drug resistance features.CONCLUSIONS According to the result of drug sensitive test,the most effective antibiotics are imipenem,meropenem and polymyxin B sulfate.

Objective To investigate the effect of intraperitoneal local anesthetic on patients undergone laparoscopic cholecysteetomy (LC).Methods Thirty-six patients (ASAⅠ-Ⅱ),who were undergoing selective LC were randomly divided into there groups.GroupⅠreceived preoperational anesthetic spary with 30 ml of 0.5% ropivacaine.GroupⅡwas given the anesthetic at a same dosage after the operation.While groupⅢwas set as a control by using 0.9% NaCl instead of ropivacaine.The LC was completed under general anesthesia.After the operation,visual analog scale (VAS) was recorded at 6,24,and 48 hours to evaluate the degree of postoperative pain.Meanwhile,the number of the patients who received anesthetics after the surgery,as well as the incidence rates shoulder or back pain and nausea or vomiting were recorded.Results Postoperative VAS of the groupⅠwas significantly lower than that of the other two groups,while the VAS of groupⅡwas significantly lower than that in groupⅢ(both P0.05). Conclusions Intraperitoneal local anesthetic can significantly reduce postoperative pain after LC.It is more effective to give local anesthetic at the end of the procedure than using it before operation.