Objective To evaluate the application effect of quality control circle on reducing the defect rate of health education in perioperative period of gynecologic surgery patients. Methods To carry out quality control circle activities, analysis of gynecological surgery patients in perioperative health education defect rate to the cause, the development of countermeasures, to achieve the purpose of continuous quality improvement. Results Before implementation health defects rate was 43.3%(303/700), after the implementation health education defect rate was 11.4%(223/1 950). The health defects rate before and after the implementation showed significant difference (χ2=8.387, P=0.004). The incidence of anxiety before and after the implementation was 11.8%(23/195) and 4.1%(8/195), the difference was significantly different (χ2=7.885, P =0.005). Conclusions To carry out the quality circle activity, can effectively reduce the perioperative health education defect rate and improve the quality of care and patient satisfaction, method is simple and easy to operate, it is worth clinical promotion.

ObjectiveTo compare the changes in renal blood flow in elderly and adult patients during laparoscopic cholecystectomy.MethodsSixty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-75 yr,weighing 48-78 kg,undergoing elective laparoscopic cholecystectomy were enrolled in this study.The patients were divided into 2 groups according to the age ( n =30): group Ⅰ young and middle-age (18-60 yr) and group Ⅱ elderly (61-75 yr).Anesthesia was induced with midazolam,fentanyl,propofol and vecuromium and maintained with infusion of propofol and remifentanil,isoflurane inhalation and intermittent iv boluses of vecuromium.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 30-40 mm Hg.The probe of transesophageal echocardiography (TEE) was inserted into esophagus after tracheal intubation.The internal diameter and time integral of left renal artery were measured by TEE before pneumoperitoneum (baseline) and at 1,5,10,15,20 and 30 min of pneumoperitoneum and 1,5 min after deflation.The blood flow of left renal artery (LRAF) was calculated.The maximal derease in LRAF during pneumoperitoneum was analyzed.ResultsThe internal diameter and time integral of left renal artery and LRAF were significantly decreased during peumoperitoneum and at 1 min after deflation in both groups ( P ＜ 0.05).LRAF before peumoperitoneum was significantly lower,and the time point of LRAF maximum decrease during pneumoperitoneum was later in group Ⅱ than in group Ⅰ ( P ＜ 0.05).ConclusionThe renal blood flow is temporary decreased during laparoscopic cholecystectomy both in young and middle age and elderly patients.The time point of LRAF maximum decrease in elderly patients is later than that in adult patients.

Objective To evaluate the blood-saving effect of different doses of tranexamic acid in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Ninety ASA physical status l-Ⅲ patients,aged 18-60 yr,with body mass index of 16-25 kg/m2,scheduled for elective cardiac valve replacement with CPB,were equally and randomly divided into 3 groups using a random number table:control group (group C),large-dose tranexamic acid group (group TL) and small-dose tranexamic acid group (group TS).Anesthesia was induced with iv injection of midazolam,sufentanil and pipecuronium.The patients were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with inhalation of isoflurane and iv injection of midazolam,sufentanil and pipecuronium.After induction of anesthesia,tranexamlc acid 20 mg/kg was intravenously infused over 30 min,followed by continuous infusion at 20 mg· kg-1 · h-1 until the end of operation in group TL,tranexamlc acid 10 mg/kg was intravenously infused over 30 min,followed by continuous infusion at 10 mg· kg-1 · h-1 until the end of operation in group TS,while the equal volume of normal saline was given instead in group C.Venous blood samples were taken before induction,at the end of operation and at 24 h after operation for determination of hemoglobin (Hb),hematocrit (Hct),and platelct count (Plt).The volume of chest tube drainage was collected and recorded at 6 and 24 h after operation.The requirement for transfusion of allogeneic red blood cells was also recorded.The development of death and complications during days of hospitalization was recorded.Results Compared with group C,the volume of chest tube drainage was significantly decreased,the requirement for transfusion of allogeneic red blood cells was reduced (P ＜ 0.05),while no significant changes were found in Hb,Hct and Plt at each time point in TL and TS groups (P ＞ 0.05).There was no significant difference in the parameters mentioned above between group TL and group TS (P ＞ 0.05).The development of death and complications during days of hospitalization was not observed in the three groups.Conclusion Small-dose tranexamlc acid is suitable for blood-saving effect in patients undergoing cardiac valve replacement with CPB,that is loading dose of 10 mg/kg and maintenance dose of 10 mg· kg-1· h-1.

Objective:To explore the moderating effect of self-differentiation between life events and coping styles. Methods:Totally 584 college freshmen from Beijing and Jiangsu were selected to fill in the Adolescent Self-Rating Life Events Check-list (ASLEC),Differentiation of Self Inventory(DSI)and Simplified Coping Style Ques-tionnaire (SCSQ). Results:Self-differentiation had a moderating effect between life events and coping styles. The predicting effect of life events on negative coping was 0. 03 in the higher self-differentiation group (P>0. 05 ) while in the lower self-differentiation group,it was 0. 27 (P<0. 00 1 ). Conclusion:It suggests that higher self-differ-entiation could relieve the negative effect of life events to coping styles.

Objective To evaluate the effects of pulmonary static inflation with different pressures on postoperative lung function in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Sixty ASA Ⅱ or Ⅲ patients,aged 26-70 yr,weighing 47-78 kg,undergoing elective cardiac valve replacement with CPB,were randomly divided into 2 groups (n =30 each):pulmonary static inflation with 5 cm H2O group (group L) and with 10 cm H2O group (group H).In L and H groups,pulmonary static inflation was performed with the pressure maintained at 5 and 10 cm H2O,respectively,after stopping mechanical ventilation during CPB.Arterial blood samples were taken before skin incision and at 1,3 and 6 h after termination of CPB for blood gas analysis.The alveolar-arterial oxygen pressure difference (D(A-a)O2),respiratory index (RI) and oxy.genation index (OI) were calculated.The indwelling time of endotracheal tube after operation and duration of ICU stay were recorded.Results Compared with group L,D(A-a)O2 and RI were significantly decreased and OI was increased at 1,3 and 6 h after termination of CPB,the incidence of OI less than 300 mm Hg was decreased (P ＜ 0.05),and no significant change was found in the indwelling time of endotracheal tube after operation and duration of ICU stay in H group (P ＞ 0.05).Collusion Pulmonary static inflation with 10 cm H2O can better improve postoperative pulmonary diffusion function than with 5 cm H2O in patients undergoing cardiac valve replacement with CPB.

Objective To evaluate the precise,accurate and specific of two direct methods for measuring low-density lipoprotein cholesterol(LDL-C)based on the principle of selective hydrolysys. Methods Both DAIICHI and Randox reagents were compared with PVS method and the ultracentrifugally separated HDL and LDL fractions were used.Results Both methods all had good precise,the total CV was 3.96%～4.42%(Daiichi)and 0.78%～3.19%(Randox),repectively.The average concentrations of 48 serum samples were 3.68±1.23 mmol/L(PVS method),3.25±1.11 mmol/L(DAIICHI method)and 3.37±1.21 mmol/L(Randox method),respectively.There was no statistics difference between the results from PVS method and other two direct methods.Furthermore it indicated that the results determined by both direct methods had good relationship with that by PVS method.It also indicated that both direct methods had good specific to LDL-C.The dilute test demonstrated that there were good linearity between both direct methods of LDL-C and the linearity range was 9.28 mmol/L at least.Conclusion The direct methods for determining LDL-C based on the principle of selective hydrolysis possessed good precise and accurate and specific to LDL-C,and was meet with clinical application.

Objective To observe the behavior changes and connexin 32(CX32),connexin 43(CX43)expressions in hippocampus and the effect of carbenoxolone on their expression in epileptic immature rats induced by lithium-pilocarpine.Methods Seventy-two SD immature rats of 21 d were randomly divided into control group(n=24),lithium-pilocarpine kindled group(n=24)and carbenoxolone treated group(n=24),each group by 24 h,3 d,7 d and 30 d were subdivided into 4 groups(n=6).Immuno-histochemisty was used to observe the expressions of CX32 and CX43 in hippocampus areas of immature rats,and to observe their behavior changes.Results The scores of the severe elileptiform seizures(Racine Ⅳ/Ⅴlevel)in lithium-pilocarpine group were significantly higher than those in carbenoxolone treated group;The latency in carbenoxolone treated group was prolonged significantly(P

Objective: To analyze the sagittal and vertical skeletal an d dental changes contributing to correction of Class Ⅱ division Ⅰ malocclusion and mandibular retrusion in growing children treated with Herbst appliance. Method: 27 cases of Class Ⅱ division 1 malocclusion were studied, 17 of them were treated with the domestic Herbst appliance and the other 10 case s without treatment served as the controls. Results: After 6 to 8 months (on an average of 7 months) of Herbst appliance therapy, Class II malo cclussion was corrected to Class I occlussion, overjet decreased by 7.2 mm on a n average. SNB, mandibular ramas height (Co-Go), mandibular length (Co-Pg), ma ndibular body length (Go-Pg) and the distance from Pg to OLP plane increased si gnificantly(P

Objective To evaluate the effects of small dose of dopamine on the renal blood flow in the elderly patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Sixty elderly patients,of ASA physical status Ⅱ or Ⅲ,aged 65-74 yr,weighing 52-77 kg,scheduled for elective cardiac valve replacement under CPB,were randomized to receive either normal saline (group C,n =30) or dopamine (group D,n =30).After beginning of surgery,CPB was established routinely.In group D,dopamine was continuously infused for 20 min at a rate of 2 μg· kg-1 · min-1 starting from 10 min after the hearts were perfused with cardioplegic solution for the first time,while the equal volume of normal saline was given in group C.The left renal blood flow velocity was measured by transesophageal echocardiography and mean arterial pressure was recorded before and after dopamine infusion.Blood samples were obtained before surgery and at 24 h after surgery for determination of blood urea nitrogen concentrations.Results Blood urea nitrogen concentrations were significantly increased at 24 h after surgery than that before surgery in the two groups.There was no significant difference in mean arterial pressure and the left renal blood flow velocity before and after dopamine infusion between the two groups.Conclusion Small dose of dopamine (2 μg· kg-1· min-1) dose not increase the renal blood flow or improve the postoperative renal function in the elderly patients undergoing cardiac valve replacement under CPB.

Objective: Design of intelligent safety control system in hospital, in order to effectively safeguard patient’s items or the safety of personnel, improve the management level of hospital. Methods: By RFID (radio-frequency identification), System to realize the real-time monitoring of the patient position and tracking through electronic tag worn by the patient and hospital to install signal receiving device, and monitoring violations by informatization and promptly report to the police. Results: The design of the system in the interests of the parties, prevent the happening of the accident in patients with use of mature information technology. Conclusion: The design of intelligent safety control system in hospital enhances the administrative level of informatization of hospital, the design of the software system has promotion value.