Objective　To observe the influence of intravenous anesthesia with ketamine or propofol on intraocular pressure (IOP) in pediatric patients. Methods　27 pediatric patients, ASA grade Ⅰ～Ⅱ, were divided into ketamine and propofol groups. Basic anesthesia was conducted with ketamine 4～6 mg*kg-1 combined droperidol 0.04～0.1 mg*kg-1 intramuscularly. Anesthesia maintained with continous infusion of 0.04% ketamine or 0.04% propofol following intravenous bolus of ketamine 1 mg*kg-1 or propofol 1 mg*kg-1 in ketamine group and propofol group respectively. IOP, systemic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR) and pulse oxygen saturation(SpO2) were measured at 10 minutes after basic anesthesia, 3 minutes after intravenous bolus of ketamine or propofol and end of surgery. Results　There were no differences in IOP between two groups after basic anesthesia. IOP increased or decreased significantly after intravenous bolus of ketamine or propofol respectively. IOP in ketamine group decreased near to the level in propofol group at end of surgery. There were no statistic differences in SBP, DBP and HR between two groups priopration. SpO2 did not change (but in one patient decreasing to below 95% ) and significantly decreased within 5 minutes of intravenous bolus of ketamine and propofol respectively. Conclusion　Ketamine increases IOP propofol decreases IOP. Ketamine combined propofol can keep from increase of IOP but strength respiration inhibition.

ObjectiveTo evaluate results of the Lichtenstein tension-free mesh repair and summaraize the clinical experience in the treatment of the inguinal hernia. MethodsIn this retrospective study, 4011 tension-free inguinal hernia repairs were performed in 3631 patients, using a polypropylene mesh (Lichtenstein technique). Results The average hospitalization was 3.8 days, the overall complication rate was 2.4％, the recurrence rate was 0.1％. ConclusionThe Lichtenstein repair for the treatment of inguinal hernia has the advantage of less postoperative pain and low recurrence and is highly suitable for day case surgery.

Objective To explore the risk factors of recurrent cerebral infarction and the preventive meas-ures. Methods The risk factors were compared between recurrent group (246 cases with recurrent cerebral infarc-tion) and unrecurrent group( 100 cases with unreeurront cerebral infarction) by means of multiple logistic regression analysis. Results The recurrent cerebral infarction is correlated closely with hypertension, diabetes, heart diseases and excessive drinking, and the OR values arc 2.206, 2.232, 2.252, 2.842, 2.366 respectively (P<0.05), prophy-lactic treatment had the protective effects against the recurrent cerebral infarction,and the OR value was 0.249. Con-dusions The main risk factors of recurrent cerebral infarction were hypertension,heart diseases,excessive drinking. Prophylactic treatment hed great significance in preventing the recurrence of cerebral infarction.

Objective To investigate the influence of nebulized Pulmieort respules inhalation after endoscopic sinus surgery (ESS)on the expression of epithelial Na~+ channel(ENaC)protein in nasal mucosa. Methods Forty-four patients with nasal polyps undergoing ESS were randomly divided into Pulmieort respules treatment group(n=21,nebulized Pulmieort respules inhalation for 10 d after ESS)and Rhinocort control group(n=23,Rhinoeort aqueous nasal spray for 10 d after ESS).All the patients were performed biopsy of membrane on the residual middle turbinate 14 d after ESS,eosinophils (Eos)and neutrophils(Neu)per hundred inflammation cells were counted under microscope during ESS and after ESS,and the expression of ENaC protein was detected by immunofluorescence assay. Results The percentages of Eos and Neu decreased in two groups after treatment,and the percentage of Neu in Pulmieort respules treatment group was significantly lower than that in Rhinoeort control group(P<0.05).The expression of ENaC protein after treatment in Pulmieort respules treatment group was significantly lower than that in Rhinoeort control group(P<0.01). Conclusion Application of pulmieort respules after ESS can decrease Neu infiltration and inhibit expression of ENaC protein,which can relieve acute inflammation and edema of nasal mucosa.

Objective To compare the clinical efficacies of polypropylene-polyglactic composite mesh, polyester mesh, polypropylene mesh in Lichtenstein repair for inguinal hernia.Methods The clinical data of 1 080 patients with primary unilateral inguinal hernia who were admitted to the Tianjin People's Hospital from February 2012 to May 2013 were prospectively analyzed.A randomized controlled study was performed based on a random numble table.All the patients were allocated into the ProGrip group (Parietex ProGripTM Self-Fixating Mesh), PET group (ParietexTM Lightweight Monofilament Polyester Mesh) and PP group (BardTM Soft Mesh).Patients received standard Lichtenstein tension-free repair under local anesthesia and were followed up by outpatient examination and telephone interview till May 2014.The indexs observed during the follow-up included occurrence of complications, post-operative pain and postoperative health-related quality of life.The following indexes were recorded : time of mesh fixation, operation time, hernia recurrence, pain degree at postoperative week 1 and month 1, 6, 12 by numerical rating scale (NRS), quality of life at postoperative month 1 by SF-36 questionnaire survey including physical function, role physical, body pain, general health, vitality, social function, role emotional,mental health.Measurement data with normal distribution were presented as x ± s.Comparisons among groups were analyzed by ANOVA and pairwise comparison by t test.Measurement data with skewed distribution were presented as M (range) and repeated measurement data were analyzed using the repeated measures ANOVA.Count data were evaluated by the chi-square test and Fisher exact probability.Postoperative moderate and severe pain rates were evaluated by the Kaplan-Meier method and analyzed by the Log-rank test.Results There were 1 022 patients screened for eligibility including 367 patients in the ProGrip group, 346 patients in the PET group and 309 patients in the PP group.The time of mesh fixation and operation time were (1.3 ± 0.5) minutes and (30 ± 5) minutes in the ProGrip group, (4.9 ± 0.9) minutes and (45 ± 7) minutes in the PET group, (5.0 ± 0.9) minutes and (44 ± 7)minutes in the PP group, respectively, showing significant differences among the 3 groups (F =6.21, 4.33,P ＜ 0.05).There were significant differences in the time of mesh fixation and operation time between the ProGrip group and the PET group (t =1.36, 4.39, P ＜ 0.05), and also between the ProGrip group and the PP group (t =2.67, 2.99, P ＜ 0.05).There was no significant difference in the time of mesh fixation and operation time between the PET group and the PP group (t =0.98, 0.63, P ＞ 0.05).Nine hundred and nine patients were followed up for a median time of 13 months (range, 12-26 months) , with a follow-up rate of 88.943％ (909/1 022).The number of recurred hernia in the ProGrip group, the PET group and the PP group was 1, 0, 0,showing no significant difference (P ＞ 0.05).The NRS scores of pain from postoperative week 1 to postoperative month 12 were ranged from 0 (0-2) to 0 (0-0) in the ProGrip group, from 2(0-5) to 0(0-0) in the PET group and from 1 (0-4) to 0 (0-0) in the PP group.The number of patients with moderate and severe pain was ranged from 52(14.17％) to 0(0) in the ProGrip group, from 87 (25.14％) to 0 (0) in the PET group and from 89 (28.80％) to 0(0) in the PP group.There were no significant differences in the changing trends of NRS scores of pain and number of patients with moderate and severe pain among the 3 groups (F =1.66, x2=1.52, P ＞ 0.05).The scores of physical function in the ProGrip group, PET group, PP group at postoperative month 1 were 52 ± 4,50 ± 6, 50 ± 6, the scores of role physical were 50 ± 6, 50 ± 6, 50 ± 5, the scores of body pain were 52 ± 7, 52 ± 7, 52 ± 7, the scores of general health were 63 ± 4, 57 ± 9, 58 ± 8, the scores of vitality were 63 ± 5, 62 ± 6,63 ± 6, the scores of social function were 58 ± 4, 58 ± 8, 57 ± 8, the scores of role emotional were 59 ± 4, 57 ± 8,58 ± 8, and the scores of mental health were 65 ± 4, 63 ± 5, 63 ± 6, respectively, showing no significant differences in above indexes among the 3 groups (F =2.36,3.65,1.98,2.41, 6.32, 2.33, 4.21, 3.52, P ＞ 0.05).Conclusion Patients undergoing Lichtenstein repair for inguinal hernia with polypropylene-polyglactic composite mesh, polyester mesh and polypropylene mesh have comparative of incidence of postoperative complications, postoperative pain, quality of life, and present postoperative long-term low recurrence, low incidence of pain and relatively high quality of life.

OBJECTIVE:To investigate the situation of ADR reporting entities in Henan province and Hebei province to pro-vide reference for the improvement of ADR monitoring. METHODS:Literatures were consulted to investigate the ADR monitoring at home and abroad. With the subject of ADR reporting entities(pharmaceutical manufacturers,drug distributors and medical insti-tutions)in Henan and Hebei province,questionnaires and descriptive statistical analysis were conducted to analyze the results. RE-SULTS:186 valid questionnaires were received. There were respectively 58 and 62 ADR reporting entities with ADR monitoring de-partment in Henan and Hebei province,all of them had personnel who were responsible for ADR;ADR monitoring mostly belonged to quality control department in pharmaceutical manufacturers and drug distributors,and pharmacy department in medical institu-tions;most were equipped with computer,printer,phone and other basic office equipments;most were not clearly for major duty;there were respectively 24 and 2 entities with special budget for ADR monitoring;95.7% and 96.8% had communication with the local ADR monitoring centers,however,the information feedback was not ideal;86.7%and 98.9%had training for the stuff;stan-dard operation procedure was relatively good in Hebei province;96.7% and 98.9% would report ADR immediately after finding ADR,92.3% and 97.8% would record and backup the reported ADR;the form mainly by network report;the average degree of satisfaction evaluation in Henan province was higher than Hebei. CONCLUSIONS:According to the results,it is suggested to pro-mote the implementation of ADR monitoring by optimizing the work conditions,ensuring work fund and strengthening work feed-back.

OBJECTIVE:To understand the present situation of ADR reporting entities in Shaanxi and Sichuan province,and provide evidence for the improvement of ADR monitoring. METHODS:Getting the overview of ADR monitoring at home and abroad by reading a lot of literature,the ADR monitoring entities(drug manufacturers,drug distributors and medical institutions) in Shaanxi and Sichuan province were selected as subject for cluster sampling,questionnaires were sent out and descriptive statis-tics analysis was adopted to processing and analyze the results. RESULTS:Totally 198 questionnaires were received,100 for Shaanxi province and 98 for Sichuan province. In Shaanxi and Sichuan province,there are 61 and 63 investigated subjects had es-tablished ADR monitoring departments,98.0% and 100% had had personnel for the ADR work;ADR monitoring work mostly be-longed to the quality control department in drug manufacturers and drug distributors,and belonged to pharmacy department in medi-cal institutions;most of them were equipped with computer,printer and other basic office equipment;however,the major duty of most was not clearly;13 and 23 subjects had special budget for ADR monitoring;87 and 89 subjects had communication with lo-cal ADR monitoring center,however,the information feedback was not very ideal;training the workers accounted for 80.0% and 83.0%,respectively;in terms of system construction,the standard operation procedure was relatively good,and the other related was not ideal;reporting quickly when finding ADR was 89.0% and 96.9%,88.0% and 96.9% of which had backup records for ADR reporting,it was mainly network report;Shaanxi province was better than Sichuan province about the satisfaction evaluation of ADR work. CONCLUSIONS:According to the results,it is suggested to adjust the structure of workers,buy related software re-source,improve the responsibilities and strengthen the financial support to promote the implementation of ADR monitoring.

OBJECTIVE:To explore the optimal steaming time of Carapax trionycis during cleansing period,and to optimize and improve production technology of Carapax trionycis recorded by current Chinese Pharmacopoeia. METHODS:The mechanical processing replaced the artificial processing method in Chinese Pharmacopoeia. The content of protein and the appearance of Cara-pax trionycis were investigated after steaming for 30,60,90,120,180,240 min during cleansing period. The extract,decoction, ash content,appearance and property of Carapax trionycis decoction piece processed with vinegar were also investigated after cleansed Carapax trionycis decoction piece was processed by sand scalding and vinegar quenching method. RESULTS:The differ-ent steaming time obtained different quality of cleansed Carapax trionycis decoction piece and Carapax trionycis decoction piece pro-cessed with vinegar. Compared with decoction piece steamed for other duration,when the steaming time was 90 min,the content of protein in cleansed Carapax trionycis decoction piece was higher(31.16%),and its appearance was up to the requirement. Cara-pax trionycis decoction piece processed with vinegar had higher contents of extract and decoction(9.13%,11.39%)and lower con-tent of ash(66.29%),and its appearance was up to the requirement. CONCLUSIONS:Different steaming time have certain effect on the quality of cleansed Carapax trionycis and Carapax trionycis processed with vinegar,the optimal steaming time of Carapax tri-onycis is about 90 min during cleansing. The mechanical processing method maybe replace the artificial processing on Carapax tri-onycis for improving its production efficiency.

OBJECTIVE:To investigate the present situation of adverse drug reaction(ADR)reporting entities in Jiangsu prov-ince and Guangdong province,and provide reference for the improvement of ADR monitoring. METHODS:With the overview of ADR monitoring at home and abroad by reading literatures,the ADR reporting entities(drug manufacturers,drug distributors and medical institutions) in Jiangsu province and Guangdong province were selected as objects for cluster sampling by questionnaires, and descriptive statistical analysis and other methods were adopted to process and analyze the results. RESULTS:There were totally 205 effective questionnaires. In Jiangsu province and Guangdong province,67 and 60 of the surveyed ADR reporting entities had specialized ADR monitoring departments,98.1% and 99.0% had equipped with specialized personnel for ADR work;ADR moni-toring mostly belonged to quality management department in drug manufacturers and distributors,and pharmacy department in medi-cal institutions;most entities were equipped with computers,printers,copiers and other basic office equipments;but most entities’ responsibilities were not clear enough;27 and 15 entities had specialized budget for ADR monitoring;97.2% and 96.9% had com-munication with ADR ,monitoring center,but the feedback information was unsatisfactory;85.0% and 86.7% had related training for personnel;establishing standard operating procedures of the system construction was relatively good,the other related system construction was still not ideal;91.6% and 90.8% would report ADR immediately after discovery,92.5% and 97.9% would back-up recording the ADR,mainly by internet reporting;the average scores in terms of job satisfaction in Jiangsu province were higher than Guangdong province. CONCLUSIONS:According to the results,it is suggested to improve the system construction of ADR monitoring,optimize working conditions,ensure financial support of ADR monitoring,and strengthen work communication and system construction and other measures to promote conduct of ADR monitoring.

BACKGROUND:Co-culture withembryonic stem cels or embryonic tissues can induce differentiation of carcinoma cels into normal epithelial cels or decreasemalignancyof carcinoma cels.Acelular embryoid bodies retain the structure and important cytokines of embryonic tissues.
OBJECTIVE:To prepare acelular embryoid bodies from mouse embryonic stem cels and to investigate their effects on differentiation of mouse Lewis lung carcinoma cels at three-dimensional culturein vitro.
METHODS:Mouse embryonic stem cels(D3)were dynamicaly cultured for 7 days to produce embryoid bodiesfolowedbydecelularization with 0.1% sodium dodecyl sulfate. Mouse Lewis lung carcinoma cels were co-cultured with acelular embryoid bodiesas test group or culturedinthree-dimensionalmatrigel mediumfor 7 days as control group, respectively. Cel proliferation and expression of E-cadherin were detected by immunohistochemical staining and western blot assay, respectively. In addition, mRNA expressions ofSlug and E-cadherin were observed using RT-PCR technology.
RESULTSAND CONCLUSION:Uniform mouse embryoid bodieswere successfuly prepared, andwere completely decelularized with sodium dodecyl sulfate. After 7-day three-dimensionalmatrigelculture, in the control group,multicelular tumor spheroidswere formed,accompanied byahigherKi67positive rate;Lewis lung carcinoma cels in the test group were repopulated in the acelular embryoid bodies showing significantly lowerKi67positive rate. Compared with the control group, the absorbance ofPaxilin in the test group was significantly smaler, and the absorbance of E-cadherin was significantly higher (P< 0.05). Besides, mRNA expressions of Slug and E-cadherin were significantly decreased and increasedin the test group compared with the control group, respectively(P< 0.05). These findings indicate that the acelular embryoid bodies can promote differentiation of mouse Lewis lung carcinoma celsinthree-dimensional culturein vitro.