Objective To investigate the effect of dexmedetomidine on postoperative renal function of patients with rheumatic heart disease following valvular heart surgery. Methods Fifty patients following valvular heart surgery were randomized into experimental group and control group,with 25 cases in each group. The patients in experimental group receiveddexmedetomidine 0.5 μg/kg infusion 15min before induction, and then 0.5 μg/(kg·h) infused to the end of surgery, while those in control group received the same amount of saline in the same way. Blood from central venous was collected before surgery, at the end of surgery, 24 h and 48 h after surgery in order to detect Src, BUN and Cys C and the length of ICU duration was also recorded. Results Src and Cys C of the patients in both groups obviously elevated 24h after surgery when compared with pre-operation , while BUN elevated at both 24 h and 48 h after surgery(P < 0.05). Compared with those in control group, Src, BUN and Cys C were lower in experimental group ( P < 0 . 05 ) , and the length of ICU duration was shorter (P < 0.05). Conclusion Dexmedetomidine could improve the postoperative renal function after valvular heart surgery and lead to a better prognosis.

Objective To analyze the prevalence and economic burden of diabetes in Guandu district of Kunming. Methods We used probability proportional to size (PPS) sampling method to select representative sample of 4595 residents aged 18 or over from this district. Each participant received face to face questionnaire interview and physical examination. We applied different methods to measure the direct,indirect and intangible costs of diabetes. Results In the study population, the overall prevalence of diabetes was 6.2%,and females had higher prevalence of diabetes than males (6.2%vs. 5.6%, <0.05) . The DALY/1000 population of diabetes was 3.52, among which males and females were 5.18 and 6.70, respectively. Mean unit direct costs, indirect costs and intangible costs of diabetes were 3464.49 Yuan,84.48 Yuan and 4 045.97 Yuan,respectively. The total economic burden of diabetes was 401.84 million Yuan. Intangible costs represented the largest component of economic burden of diabetes,followed by direct costs. Conclusion The huge economic burden of diabetes has become the cause for concern in Guandu district. Effective measures are needed to reduce the economic burden of diabetes.

Acute Disease ; Adult ; Aged ; Chemokines ; blood ; Female ; Humans ; Male ; Middle Aged ; Paraquat ; poisoning ; Prognosis ; Young Adult

Objective To explore medical equipment management to decrease medical risks.Methods A medical equipment risk management model was established to deploy medical equipment rationally,evaluate the risk value of medical equipment,calculate the total risk value of medical equipment of the department and to propose the requirements for medical equipment utilization and management.Results The risks of medical equipment could be decreased by improved medical equipment management in deployment,utilization and maintenance as well as emphases on personnel and regulation.Conclusion Risk minimization is of great significance for medical equipment users and management department.

Objective To investigate the life quality and influencing factorin stroke patient.MethodTotally 205 hospi-talized stroke patientin the neurology departmenwere investigated with SF-36 scale .The datwere performed the descriptive sta-tistic,t-tesand multiple linearegression analysi.ResultThe scoreof general healthy statu,physiological function ,physiolog-ical role ,somatipain and social function in the patientwith stroke were significantly lowethan thain the national norm (P＜0 . 01) .The recurrence frequency ,age ,comorbidity ,education level and income were significanfactoraffecting the life quality in the stroke patien.Conclusion The level of general health statu,physiological function ,physiological role ,somatipain and social function are decreased significantly .Therefore iirecommended to perform the pertinenintervention in the clinical work .

Objective To provide useful information on reducing risky drinking for the Dept.of Public Health taking a county in Yunnan province as an example to explore the risk factors related to risky drinking.Methods A total of 574 participants identified as Miao,Yi and Han People at or older than 12 years old,who had been living there for 6 months or more were selected and surveyed in 5 townships in the county through stratified sampling.Alcohol consumption was collected using the beverage-specific quantity frequency (BSQF) method and analyzed using binary logistic regression and chi-square test.Results The number of drinkers in the family,undesirable drinking environment among friends and enculturation (β =0.073) could increase the likelihood of risky drinking.Risky drinking pattern was positively associated with age (β =1.006),and negatively associated with gender (β =-2.947) and awareness of risky drinking among rural residents.Conclusion The important measures to control risky drinking behavior in terms of health promotion and education include reducing the number of drinkers in the family,and preventing from undesirable drinking environment among friends and harmful drinking culture.These measures are crucial to prevent early onset of alcohol drinking among teenagers and to reduce risky drinking among middle aged and aged population.

ObjectiveTo assess the effects of constraint-induced movement therapy(CIMT) on sub-acute stroke patients with upper extremity motor dysfunction.Methods63 patients with hemiplegia after stroke were divided into two groups: control group(31 cases) and CIMT group(32 casese). The two groups received the regular rehabilitation training for 14 d. Then the control group went on the the regular rehabilitation training, while the CIMT group received CIMT for 14 d. All patients were assessed by the Action Research Arm Test(ARAT) and Fugl-Meyer(FMA) on the first day, the 15th day and the 30th day after the treatment.ResultsARAT score and FMA scores were higher in CIMT group than in the control group 30 d after the treatment and in CIMT group 15 days after the treatment(P<0.001).ConclusionCIMT is more effective to improve the upper limb motor function of the sub-acute stroke patients than the regular rehabilitation training.

Objective To identify the surface marker of bone marrow-derived liver stem cells and to isolate the stem cells, to investigate the differentiation of the stem cells. Methods The quantitative variations of the cells with stem cell surface markers, including ? 2-microglobulin negative (? 2m -), Thy-1 +,CD34 +,Flt-3 +,IL-3R +,and c-kit + markers, were detected by using flow cytometry in the bone marrow of several rat models with liver injury. Each stem cell population was then isolated using a magnetic bead cell-sorting procedure. The isolated cells were cultured in a system containing cholestatic serum and hepatocyte growth factor (HGF). The morphology of the cells was observed, and the expressions of albumin, AFP, and CK8/18 were detected with immunohistochemistry technique. Results ? 2m - cells elevated significantly in each of the rat models.After being co-cultured with cholestatic serum and HGF, ? 2m - cells showed multilateral transformation and resembled hepatcytes morphologically. The differentiated cells expressed albumin, AFP, and CK8/18, all known to be the characteristic markers of hepatocyte. The other cell population showed little quantitative changes, and did not express the same proteins. Conclusions The quantitative variation of ? 2m - cells corresponds to the severity of liver injury. ? 2m - cells have the ability to trans-differentiated into hepatocytes in vitro. They might be the marker of liver stem cells.

Objective To investigate the clinicopathological characteristics, diagnosis and treatment of primary duodenal malignant tumors (PDMTs). Methods The clinical data of 47 PDMTs confirmed by pathology were retrospectively analyzed. Results Pathological types were adenocarcinoma in 42 cases, leiomyosarcoma in 4, and carcinoid in 1.The most common location of the tumor was the descending portion (35), especially the peri-papillary region (28) of the duodenum. The most common symptoms and signs were abdominal pain, jaundice, upper gastrointestinal hemorrhage, obstruction ,and weight loss. The main diagnostic modalities were gastroduodenoscopy, GI barium meal, ERCP, ultrasound (US) and CT. US together with ERCP was the most useful in improving the diagnosis of peripapilla tumors in the duodenum. Panceraticoduodenectomy and some palliative procedures were performed for 25 and 20 cases, respectively.Surgical mortality and postoperative morbidity were 2.2% (1/45) and 20% (9/45),retrospectively. The 3-year and 5-year survival for those adenocarcinoma without distant metastasis undergoing pancreaticoduodenectomy were 50% and 32%. No long survival was found after the palliative operation. Conclusions Adenocarcinoma is the most common pathological type of PDMTs.No specific symptoms were shown in the early stage of PDMTs, US, CT and ERCP are the main diagnostic procedures. Radical pancraticoduodenectomy can prolong survival time and should be attempted for those without systemic dissemination.Palliative operations should be considered for tumors in advanced stage.

AIM: To explore the feasibility of direct separat and selective enlargement of the bone marrow-derived liver stem cells (BDLSC) from bone marrow cells with a culture system containing cholestatic serum in vitro . METHODS: Bone marrow cells of rats were cultured with selective media containing 2%, 5%, 7% and 10% cholestatic rat serum, respectively. The BDLSC were then induced to proliferate with the addition of hepatocyte growth factor (HGF) on the firth day. BDLSC were characterized using immunocytochemistry and RT-PCR for lineage markers, glycogen staining and urea synthetic assay for functions 2 weeks later. RESULTS: Bone marrow cells were unble to form colony in the presence of 2% cholestatic serum and apopotosis appeared gradually in 7% or 10% cholestatic serum. The BDLSC survived in the medium containing 5% cholestatic serum while the other types of cells did not. The survival cells proliferated with a high speed during the second week and then formed hepatocyte-like colony-forming units (H-CFU). Cells in the H-CFU expressed the characteristic proteins of fetal hepatocytes. Furthermore, they had glycogen storage and urea synthesis functions, two of the critical features of hepatocytes. CONCLUSION: The selective micro-environment effectively selected BDLSC from the bone marrow cell, and will be a new way to provide an abundant source of donor hepatocytes for clinical cell therapy.