Objective To evaluate the effect of preadministration phenylephrine on the hemodynamics result from oxytocin during caesarean section.Methods One hundred parturients,ASA Ⅰ-Ⅱ,with single baby at full term in vertex presentation scheduled for cesarean section under continuous epidural anesthesia were randomly divided into 4 groups,each group was 25 cases.All parturients received injection 10 U of oxytocin in the uterus after delivery,followed by an oxytocin rapid infusion of 10 U (less than 5 min),meanwhile,through the other intravenous channel,injection of phenylephrine 1 μ g/kg in group 1,2 μ g/kg in group Ⅱ,3 μ g/kg in group Ⅲ,while injection of 0.9％ sodium chloride 1 ml in groupⅣ as control.The mean arterial pressure (MAP) and heat rate (HR) at preanesthesia (T0),the time of oxytocin injection after dehvery (T1) and after oxytocin injection 30 s (T2),1 ain (T3),3 min (T4),5 ain (T5),10 min(T6) was recorded.Results There were no significant difference in MAP at T0 and clinical data among the groups (P ＞ 0.05).The level of MAP in group Ⅰ and Ⅳ at T3-T5 was significantly lower than that at T0[(82 ± 7),(79 +5),(83 ± 6) mm Hg(1 mm Hg =0.133 kPa) vs.(90 ± 7) mm Hg,(84 ±7),(76 ± 5),(82 ±7) mm Hg vs.(91 ±7) mm Hg] (P ＜0.05).The level of MAP in group Ⅲ at T2-T3 was significantly higher than that at T0[(93 ± 8),(103 ± 10)mm Hg vs.(91 ± 8) mm Hg] (P ＜ 0.05).Compared with group Ⅳ,the level of MAP in group Ⅱ at T3-T5 was significantly higher,the level of MAP in group Ⅲ at T2-T5 was significantly higher,there was significant difference (P ＜0.05).The level of HR had no significant difference in T0 among the groups (P ＞ 0.05).The level of HR in four groups at T3-T5 was significantly higher than that at T0[(98 + 12),(105 + 12),(96 + 9) times/ain vs.(79 ± 8) times/ain,(89 ± 10),(96 ± 13),(92 + 12) times/min vs.(80 ± 11) times/min,(88 ± 10),(94 ± 12),(90 ± 9) times/min vs.(83 ± 10) times/min,(94 ± 12),(112 ± 13),(102 ± 1 1) times/ain vs.(82 ± 9) times/min](P ＜ 0.05 or ＜ 0.01),and reached to peak value at T4(P＜ 0.01),then gradually declined to the baseline values (T1) except in group Ⅳ at T6.Compared with group Ⅳ,the level of HR in group Ⅲ and group Ⅲ was significantly decreased at T4-T5(P ＜ 0.05).The rate of MAP decrease range above 30％ in group Ⅳ was 24％(6/24),and significantly higher than that in group Ⅱ (0) and group Ⅲ (0),there was significant difference(P＜ 0.05).The rate of nausea in group Ⅳ was significantly higher than that in group Ⅱ and group Ⅲ,there was significant difference (P ＜0.05).The scores of Apgar scale after delivery 1,5 min had no significant difference among four groups (P ＞0.05).Conclusion Haemodynamic stability can be obtained by administration 2 μ g/kg of phenylephrine when parturients received injection 10 U of oxytocin in the uterus after delivery,and followed by an oxytocin rapid infusion of 10 U during cesarean section.

Objective To establish the animal model of periventricular leukomalacia (PVL) caused by lipopolysaccharide (LPS) and investigate the immune mechanisms in the pathogenesis of cerebral palsy due to intrauterine infection. Methods Twenty-six mature pregnant Wistar rats were divided into experiment(n= 15)and control groups(n =11). LPS(0. 3 mg/kg) and distilled water were injected on 15 days of gestation to two groups respectively intraperitoneally. One hundred and twenty-eight neonatal rats of experiment group and 105 in the control group were obtained till the gestation day of 21. The level of IL-2, TNF-? and histology changes in neonatal rats' brain were observed by HE staining and RIA, water content in brain tissues were compared. Results IL-2[(3. 56?0. 450) ng/g] and TNF-? concentrations [(8. 23?0. 47)ng/g] in neonatal rats' brain of the experiment group were significantly higher than those in the control group [(0. 78?0. 2)ng/g and (5. 23?0. 32)ng/g, P

Objective To investigate the relationships between parameters of serum iron metabolism and liver in-flammatory activity grades, and to find out the difference in parameters of serum iron metabolism between patients with hepa-titis B and patients with hepatitis C. Methods A total of 166 patients with viral hepatitis were enrolled in this study, in-cluding 135 case of hepatitis B and 31 cases of hepatitis C. The serum iron metabolism indexes including serum iron (SI), se-rum ferritin (SF), transferring (TRF), total iron binding capacity (TIBC) were collected, and the transferring saturation (TS), al-anine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin (ALB) were calculated. Thirty-nine patients were selected from 135 hepatitis B patients by corresponding gender, age and liver function with 31 hep-atitis C patients. The indicators of iron metabolism were compared between two groups. Results There was a positive corre-lation between age , TRF and TIBC. There were positive correlations between SI, SF, TS and ALT, AST, TBIL respectively, and negative correlations between SF, TS and ALB. TRF and TIBC were negatively correlated with ALT, AST and TBIL, but positively correlated with ALB (rs=0.551,P<0.001). The value of SF was significantly higher in patients with hepatitis C than that of patients with hepatitis B. The levels of TRF and TIBC were significantly lower in patients with hepatitis C than those of patients with hepatitis B (P<0.05). There were no significant differences in SI and TS between two groups. Conclu-sion There was a significant correlation between parameters of serum iron metabolism and live inflammatory activity grades. The iron overload phenomenon is much common in patients with chronic hepatitis C than that of patients with chronic hepatitis B.

Objective To explore clinical characteristics of the digestive tract obstruction due to annular pancreas. Methods We reviewed retrospectively clinical features, operative findings and the autopsy of 5 children with annular pancreas. Results Neonate patients usually present complete upper gastro intestinal obstruction because most of them were complicated with duodenal atresia. Infants present chronic incomplete intestinal obstruction duo to annular pancreas. 35.8% of duodenal constriction was caused by annular pancreas. Conclusions All the symptomatic patients with annular pancreas should undergo exploration to restore the consecution of the digestive tract and to detect if there is a concurrent malformation such as intestinal atresia.

Objective To analyze the distribution characteristics of Pseudomonas aeruginosa and Acinetobacter baumannii ,and to investigate the changing pattern of antimicrobial resistance of these strains isolated during 2012 - 2014 .Methods Strains of Pseud‐omonas aeruginosa and Acinetobacter baumannii isolated from January 2012 to December 2014 were collected .Antimicrobial suscep‐tibility of clinical isolates was tested by Kirby‐Bauer method .Results In the past three years ,214 strains of Pseudomonas aerugino‐sa and 347 strains of Acinetobacter baumannii were isolated .The nosocomial infection rate of Pseudomonas aeruginosa decreased year by year ,while the Acinetobacter baumannii ′s increased .Most strains were isolated from sputum ,wound secretion and urine . The strains of Pseudomonas aeruginosa and Acinetobacter baumannii were distributed in various departments of the hospital .The detection rates of these strains were the highest in ICU ,respectively 27 .6% and 34 .9% .Both the resistance rates of Pseudomonas aeruginosa to ceftazidime ,imipenem ,Amikacin and Acinetobacter baumannii to Piperacillin/Tazobactam and imipenem had in‐creased ,while the resistance rates of Acinetobacter baumannii to polymyxin B had decreased with each passing year .Conclusion Pseudomonas aeruginosa and Acinetobacter baumannii causes severe nosocomial infections and the antimicrobial resistance rates in‐creased ,especially the resistance rates to carbapenem are becoming more higher in recent years .Acinetobacter baumannii shows strong antibacterial activity in vitro to Polymyxin B .Therefore ,antimicrobial resistance surveillance should be strengthened to direct rational use of antibiotics .

Objective To compare the efficacy of lymph nodes(LNs) dissection between video-assisted thoracic surgery (VATS) and thoracotomy in the treatment of clinical stage Ⅰ lung cancer.Methods A comprehensive search of PubMed,Ovid Medline,EMBASE,Web of Science,ScienceDirect,the Cochrane Library,Scopus database and Google Scholar was performed to identify studies comparing VATS and thoracotomy in LNs dissection.The data was analyzed by RevMan 5.3 software and SPSS 18.0.Results After selection,23 articles met the inclusion criteria.2 316 patients were involved in VATS group and 3 346 patients were involved in Open group.Meta analysis showed that less total LNs(95％ CI:-1.64--0.60,P ＜ 0.0001),totalLNsstations(95％CI:-0.61--0.01,P=0.04) andN1 LNs(95％CI:-0.28--0.02,P=0.02)were dissected in VATS group.On the left side,more LNs were dissected in VATS group(95％ CI:0.51-3.22,P =0.007).The same number of mediastinal LNs (95％ CI:-0.74-0.15,P =0.20),mediastinal LNs stations (95％ CI:-0.20-0.14,P =0.76),right side LNs (95 ％ CI:-1.52-2.23,P =0.71) were harvested in both groups.Conclusion In the surgical treatment of clinical stage Ⅰ lung cancer,less total LNs,total LNs stations and N1 LNs were dissected in VATS group,while more left side LNs were harvested by VATS.The same number of mediastinal LNs,mediastinal LNs stations right side LNs were harvested in the two groups.This conclusion still needs to be further proved by more high-quality and large-scale RCTs.

Objective To investigate the placental transfer and neonatal effects of dexmedetomidine during the cesarean section under general anesthesia.Methods Thirty-eight nulliparous parturients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 22-37 yr,weighing 56-82 kg,who were at full term with a singleton fetus,scheduled for elective caesarean section under general anesthesia,were randomly divided into 2 groups (n=19 each) using a random number table:dexmedetomidine group (group D) and normal saline group (group N).In group D,dexmedetomidine was infused in a loading dose of 0.6 μg/kg starting from 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until peritoneal closure.Group N received the equal volume of normal saline.Blood samples were collected from the maternal artery (MA),umbilical vein (UV),and umbilical artery (UA) for blood gas analysis and for determination of plasma dexmedetomidine concentrations (CMA,CUV and CUA) by high-performance liquid chromatography-mass spectrometry,and CUV/CMA and CUA/CUV were calculated.Apgar scores were recorded at 1 and 5 min after delivery,and the occurrence of respiratory depression was also recorded.The I-D interval (the time from administration of anesthetics to delivery) and U-D interval (the time from incision of the uterus to delivery) were recorded.Results There were no significant differences in the blood gas analysis parameters in blood samples collected from the MA,UV and UA,I-D interval,U-D interval,and Apgar scores between the two groups (P＞0.05).No neonatal respiratory depression was found in both groups.In group D,CMA,CUV and CUA were 471±119,359±88 and (321±78) ng/ml,respectively,CUV/CMA was 0.76±0.06,and CUA/CUV was 0.89±0.03.Conclusion Although the metabolism of dexmedetomidine is little after easy placental transfer,dexmedetomidine has no adverse effects on the newborn during the cesarean section under general anesthesia.

OBJECTIVE:To establish an overall teaching evaluation system for clinical pharmacology with PBL(problem-based learning) mode. METHODS:The teaching evaluation system was established by“Delphi”method,and it has been applied to 270 students at China Medical University in 2013-2014. RESULTS:According to the result of test score,PBL method can improve abil-ity of analyzing medical records,while formative evaluation indicates most of the students are satisfied with class response.And PBL method also can enhance student’s skill of clinical practice,broaden the knowledge an so on. CONCLUSIONS:The evaluation sys-tem was comprehensive with contents,systematic and objective,and it also can provide an effective feedback in teaching,which can accelerate the optimization of the teaching mode and improve the quality of education.

Objective Using serum pharmacology method to assess the optimal dose of Rhodiolasachalinensis extract (RSE)and Codonopsispilosula extract (CPE)combination as well as the effects of the combination on the immune function of mice.Methods Using the 3×3 facterial design,nine medicated serum of CPE and RSE mixture were made to assess the optimum combinational dose of CPE and RSE by detecting the T,B lymphocyte proliferation abilities and NK cell activity in vitro .Using the optimum combinational dose and reducing 2.5,5 and 10 times as high,middle and low doses of RSE+CPE groups,and the T,B lymphocyte proliferation abilities and the activity of NK cells in the mice were detected in vivo .Results The result of serum pharmacology indicates that compared with control group,the proliferation abilities of T,B lymphocytes and the activity of NK cells inducing by ConA and LPS in 200 mg· kg-1 RSE + 790 mg· kg-1 CPE group were increased (P < 0.05).The result of in vivo experiment indicated that compared with cyclophosphamide group,the spleen indexes (SI)in middle and high doses of RSE+CPE groups were significantly increased (P <0.05);compared with low dose of RSE+CPE group,the WBC number in middle dose of RSE + CPEgroup was significantly increased (P < 0.05 ). Compared with cyclophosphamide group,the T and B cell proliferation abilities induced with ConA and LPS and killing activities of NK cells in low,middle and high doses of RSE+CPE groups and positive drug CVT-200 group were significantly increased (P <0.05).Compared with CVT-200 group,low and high doses of RSE+CPE groups,the T and B cell proliferation abilities induced with ConA and LPS and the activity of NK cells in middle dose of RSE+CPE group were significantly increased (P <0.05).Conclusion RSE and CPE mixture can enhance the immune function of mice;RES 200 mg·kg-1 and CPE 790 mg·kg-1 are the optimal doses.

Acute Coronary Syndrome ; etiology ; Aortic Valve Insufficiency ; Female ; Heart Valve Prosthesis ; adverse effects ; Humans ; Middle Aged ; Prosthesis Failure