Objective To evaluate the effect of sufentanil combined with dexmedetomidine on analgesia in patients with pulmonary lobectomy.Method Totally 80 patients with pulmonary lobectomy in Yanan University Affiliated Hospital were collected from January 2014 to August 2016,which randomly divided into two groups:patients in control group (n-40) were given sufentanil 0.05 μg/(kg·h),and patients in observation group (n =40) were given sufentanil 0.03 μg/(kg·h) combined with dexmedetomidine 0.07 μg/(kg·h),The differences of hemodynamic change,VAS and Ramsay score,and adverse reaction at 1 h,6 h,12 h,24 h and 48 h after operation were compared.Results The hemodynamic change of all patients were relatively stable,and the more stable group B with lower MAP,HR and DBP at 12 h,and SBP at 6 h after operation further contributed the recovery of patients,which difference compared with group A was significance (P ＜ 0.05).However,the difference of SpO2 at the same time after operation was no significance.The VAS score blow 4 showed that the analgesia of all patients was satisfying.Comparing group B with group A,the VAS score was lower after 6 h at post-operation,which difference was significance (P ＜ 0.05).The Ramsay score of group B was higher than group A at 6h and 12 h,which difference was significance (P ＜ 0.05).The Ramsay score with range from 2 to 4 showed the sedation of all patients was not deficient or excessive.The incidence of nausea and vomit (2.5％) and dizziness (0％) in group B was lower than group A,with significant difference between two groups (P ＜ 0.05).Conclusion Combination dexmedetomidine with sufentanil to relief postoperative pain in patients undergoing pulmonary lobectomy is deserved popularization in clinic,which not only increases the efficiency analgesia and sedation,improves hemodynamic,but also decreases sufentanil-induced side-effect.

Objective To summarize clinical experience of reconstruction of breast suspensory structure in correction of mild-to-moderate breast ptosis.Methods Through a periareolar incision,the flabby deep layer of the superficial fascia beneath the upper breast gland was completely removed.Then the gland was lifted up to the normal position and the superior pole of the gland was fixed to the pectoral fascia at the second intercostal space.By using the dermal bra technique,an appropriate amount of skin was excised,and the dermis was fixed to the anterior surface of the breast gland. Or a monofilament polypropylene mesh was implanted and fixed to the anterior or posterior surface of the upper breast gland.Postoperatively,remarkable scar fibrosis reaction developed to form strong supporting structures just like natural ones.Glandular plication or implant augmentation was simultaneously employed to enhance the projection,if necessary.Results A total of 32 cases of mild-to-moderate breast ptosis was treated with this technique,including 10 cases of mastopexy only,20 cases of mastopexy with implant augmentation,and 2 cases of mastopexy using monofilament polypropylene mesh.The operation time was 90~150 min(mean,110 min).The intraoperative blood loss was 30~100 ml(mean,58 ml).No complications such as nipple or areola necrosis or sensory disturbance were found.Follow-up observations for 6~12 months(mean,11.3 months) showed a satisfactory rate of 90.6%(29/32).Conclusions Reconstruction of breast suspensory structure is a simple,safe,and effective method for correction of mild-to-moderate breast ptosis without hyperplasia of mammary glands.

Objective To study the changes of cytokine activation in patients with chronic congestive haert failure(CHF) as indicated by plasma levels of C-reactive protein(CRP)and its relation to adrenomedullin(ADM) and endthelin-1(ET-1).Methods The plasma levels of CRP,ADM and ET-1 of 60 decompensated haert failure(DHF) patients group and 30 essential hypertension patients with compensated cardiac function(CCF) group were tested. CRP was determined by immunoturbidometry,ET-1 and ADM were determined by radioimmunoassay.Results The plasma levels of ET-1 ,ADM and CRP of decompensated heart failure group were significantly higher than the compensated cardiac function group;In the decompensated heart failure group,the plasma levels of CRP and ADM were elevated according to worsening of heart failure(NYHA classification) ;In the decompensated heart failure group,the plasma levels of CRP were positively correlated with ADM(r=0.57).Conclusion There is extensive activation of cytokines,ADM and ET-1 in patients with chronic congestive heart failure.Cytokine activation might play a role in the synthesis of ADM,thus contribute to the hum oral regulation of heart failure,but may not be re- sponsible for the activation of ET-1.

Objective To explore the correlation between the strength of trunk flexors and extensors obtained by isometric and isokinetic concentric tests. Methods The strength of trunk extensors and flexors were measured by isometric and isokinetic concentric tests during trunk flexion and extension in 50 healthy subjects, and the peak torque of flexion and extension (FPT and EPT) and the ratios of FPT/EPT were analyzed with correlation and regression analysis. Results The FPT and EPT of trunk flexors and extensors were positively correlated (r_F=0.827,P0.05, respectively), the regression equations of FPT and EPT were y^=8.158+1.097X and y^=-12.375+0.781X, respectively. Conclusion The isometric test of the trunk extensors and flexors could assess accurately the changes of the trunk muscle strength without aggravating pain and diseases. It is more reasonable to evaluate the stability of trunk with the FPT/EPT ratio at neutral position.

Objective To investigate stroke prevention knowledge among primary hypertension stroke patients.Methods The survey was conducted among 100 primary hypertensive stroke patients older than 35 years old for sociodemographic information,and stroke prevention knowledge.Results The stroke prevention knowledge score of 100 patients was (63.22 ± 20.68) points,diet dimension got the best score,came in first,to master the knowledge of the incidence of stroke signs was the worst,came in last.Blood pressure medication,coronary heart disease were stroke-related knowledge influencing factors.Conclusions The level of stroke prevention knowledge among primary hypertension stroke patients is low.In order to help hypertensive stroke patients improve their stroke prevention knowledge,health education should be promoted.

Objective To evaluate the effect of RNA interference in p53 gene on the expressions of genes involved in ultraviolet B (UVB)-induced premature senescence and photocarcinogenesis in human skin fibroblasts (HSFs).Methods A previously established HSF cell clone with repressed expression of p53,which was named as HSF-p53,was cultured and irradiated with a subcytotoxic dose (10 mJ/cm2) of UVB once a day for five consecutive days.The HSFs with normal expression of p53 served as the control.Subsequently,β-galactosidase (SA-β-gal)-staining was performed to estimate the degree of senescence,quantitative real-time PCR array was performed to determine the mRNA expressions of photocarcinogenesis-and senescence-associated genes,including p53,p21,p19,p16,pRb,fibronectin,osteonectin,smooth muscle 22 (SM22),bax,bcl-2,hypoxia-inducible factor-1 α (HIF-1α),vascular endothelial growth factor(VEGF),and human double minute-2 (hdm2).Statistical analysis was carried out by Student's t test using the software SPSS 10.0.Results The percentage of SA-β-gal-positive cells in irradiated HSF-p53 was 19.70％ ± 0.85％,significantly higher than that in unirradiated HSF-p53 (12.77％ ± 0.81％,t =6.45,P ＜ 0.05),but lower than that in irradiated control HSFs (50.48％ ± 5.30％,t =7.86,P ＜ 0.05),and similar to that in unirradiated control HSFs (18.50％ ± 0.45％,t =2.57,P ＞ 0.05).Compared with the control HSFs,the HSF-p53 showed decreased expressions of p21,p19,fibronectin,osteonectin,SM22 and bax genes (all P ＜ 0.05),but increased expressions of bcl-2,HIF-1α,VEGF and hdm2 genes (all P ＜ 0.05),and a similar expression of p16 gene (P ＞ 0.05); the repeated UVB radiation significantly promoted the expressions of p16 and pRb genes (both P ＜ 0.05),but had no obvious effect on the expressions of the other genes in HSF-p53 compared with unirradiated HSF-p53 (all P ＞ 0.05).Conclusions The inhibition of p53 expression may decelerate the UVB-induced premature senescence in HSFs,which may be involved in the p53-dependent tumor suppression.

To observe the clinic effects and complication of Ahmed glaucoma valve(AGV) implantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases ( 44 eyes ) of refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure ( lOP ) , visual acuity, and complication of post - operation were contrasted with those of pre-operation.RESULTS:The success rate was 84. 1%, the mean preoperative lOP in research group was 52. 1±10. 1mmHg, and the last follow up mean lOP was 15. 6 ± 6. 9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber ( 4 eyes ) , choroidal detachment ( 3 eyes), drainage tube shift (1 eye), hyphema (6 eyes), drainage tube blockage ( 1 eye ) , expulsive choroidal hemorrhage (1 eye), and fiber wrap of drainage tray (5 eyes) .CONCLUSlON:AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. lt avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. lt is an effective procedure for refractory glaucoma.

Child ; Erythroblastosis, Fetal ; therapy ; Humans ; Infant, Newborn ; Male ; Rh Isoimmunization ; immunology

An investigation of the current nurse-patient relationship is conducted in Guangzhou city,by analyzing the data it can be concluded that the attitude of nursing service and skills of communication,the degree of nurses' knowledge on their patients' cases have a significant influence on the nurse-patient relationship.Nurses should play a leading role in nurse-patient relationship.There is a lack of mutual consideration and understanding between nurses and patients,which lead to nurse-patient misunderstanding and conflicts.There is a strong desire to discuss the case together intensively between nurses and patients.Furthermore,the lack of effective communication and teamwork between medical staff will also hinder the relief of tension in current physician-patient relationship.

Animals ; Guanylate Cyclase ; metabolism ; Hypercapnia ; metabolism ; Hypoxia ; metabolism ; Lung ; metabolism ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Cytoplasmic and Nuclear ; metabolism ; Soluble Guanylyl Cyclase