Objective To explore the influence of combination anaesthesia application of midazolam and propofol on stress reactions in radical resection of colon cancer,and to explore novel clinical compatibility of anaesthesia drugs.Methods 40 patients received radical resection of colon cancer were selected and divided into control group and combination group randomly and evenly.Control group received general anesthesia by propofol,while combination group received additional midazolam when anesthesia induction was taken.Glycemia,CRP,complement C3 and cortisol were observed and compared at T1 (before anesthesia induction),T2 (4h after beginning of surgery) and T3 (24h after surgery).Results Compared with T1,glu increased significantly at T2 and T3 (all P ＜ 0.05) ; Compared with combination group,glycemia increased more significant in control group (P ＜ 0.05) ; CRP and cortisol increased significantly in all patients compared with T1 (P ＜ 0.05),more significant in control group (P ＜ 0.05) ; a significant decrease after increase trend was identified for complement C3 (P ＜ 0.05),more significant decrease was found in control group at T2 (P ＜ 0.05).Conclusion Combination anesthesia of propofol and midazolam could decrease the strength of stress reaction in radical resection of colon cancer.

Subarachnoid hemorrhage (SAH) is a common cerebrovascular disease,its disability and mortality rates are higher.It has been confkmed that early brain injury (EBI) and cerebral vasospasm (CVS) are the major pathophysiological mechanisms of causing neurological dysfunction and death after SAH.There are a variety of factors of causing CVS and EBI,including nitric oxide,endothelin,oxyhemoglobin,and proinflarnmatory cytokines.A large number of animal experiments and clinical research have confrmed that statins have neuroprotective effects.This article reviews the neuroprotective effects and its mechanisms of statins in SAH

Doctors and nurses from general outpatient and emergency department usually lack the treatment experience of hemophilia,therefore,emergency system and diagnostic criteria for hemophilia is es-sential.Physicians of emergency department should be trained on identifying the undiagosed patients with inherited bleeding disorders and assessing the condition of bleeding.Prompt clotting factors replacement therapy should be given to the patients with hemophilia once bleeding is suspected.Physicians should be aware that inhibitors make the emergency treatment more complicated.

OBJECTIVE To investigate the infection condition and associated causative factors in our hospital in order to improve the methods of monitoring,preventing and controlling infection.METHODS All patients admitted in 24 hours were investigated.including record review and patient examination.Participants mainly consisted of the specialized staff,with assistant administrative staff for hospital infection.The investigating table was filled for record review and patient examination respectively.Statistical analysis was performed.RESULTS 119 of the 123 hospitalized patients were investigated(96.8%).The current rate for hospital infection was 6.7%.The most infected site was respiratory tract.Antibiotics was used in 39.5% of the patients.CONCLUSIONS The current method can be used for investigating the present state of hospital infection.Based on the investigation,objective monitoring,intensified specimens detection,and reasonable antibiotics administration can be performed to decrease the incidence of hospital infection.

Objective To investigate the cause,prognosis and risk factors of hospitalized patients with acute renal failure(ARF). Methods The clinical data of patients with ARF in our hospital from December 2003 to December 2006 were studied retrospectively. Results There were 108 744 admissions during the study period and 320 met with the diagnostic criteria of ARF.Of 320 ARF patients,135(42.2%)were indentified with the onset of the disease over or at the age of 60.Infection,heart failure and drug were the major causes of ARF.The overall mortality rate of ARF patients was 31.9%.The mortality rate of the elderly was significantly higher than that of the non-elderly.The Logistic regression analysis revealed that heart failure,respiratory failure and malignant tumor were the related risk factors of prognosis.The mortality in replacement therapy group was lower than that in conservative treatment group (23.2% vs 35.6%,P＜0.05).Conclusions The incidence and mortality of hospitalized patients with acute renal failure are high.The prognosis of replacement therapy group is better than conservative treatment group.

Objective To investigate the etiology,prognosis and risk factors of hospitalized elaerly patients with acute renal failure(ARF).Methods The clinical data of elderly patients with ARF in our hospital from De-cember 2003 to December 2006 were studied prospectively.The clinical features were comparea with those of the non-aged patients with ARF during the same period.Results Of 320 patients,135(42.2%)were identified with the onset of ARF.Infections and postrenal obstructive diseases were the major causes of ARF in the elderly.Fifty-one dead patients in the young,thirty-one in the 60-79 years old group,and twenty in the above 80 years old group(P<0.05).The results of logistic regression analysis suggested that oliguria,previous renal inadequacy and heart failure were the related risk factors of prognosis.Conclusion The incidence and mortality of hospitalized elderly patients with ARF are high.With the rising of age.the mortality of ARF increases.Dialysis in time might improve the progno-sis of ARF.

Objective To investigate the effects of preoperative nutrition support on postopreative clinical outcome in patients with nutritional risk with pancreaticoduodenectomy.Methods Forty six patients with pancreaticoduodenectomy complicated with malnutrition from June 2011 to September 2013 in Department of Hepatobiliary and Lapoaroscopic Surgery of People's Hospital of Wuhan University were randomly divided into experimental group (n =23) and control group (n =23) with random number table,patients in experimental group received preoperative nutrition support,but patients in control group did not receive preoperative nutrition support.The preoperative and postoperative nutritional status,the incidence of postoperative complications,the length of hospital stay,and the cost of hospitalization in the two groups of patients was compared.Results In terms of intra-operative blood loss and the operative time,experimental group was significantly lower than those in control group [(340 ±90)min vs (420 ± 104)min,(761 ± 100)ml vs (901 ± 150)ml,P＜0.01],on the 1st day of preoperation,the 1st day,7th day and 14th day of post operation,the levels of serum albumin was significantly higher than those in control group [(30.6 ± 1.8) g/L vs (24.6±2.2) g/L on the,P＜0.05];and on the 1st day of pre-operation,the 1st day,7th day of post operation,the levels of transferrin were significantly higher in experimental group than in control group [(3.23 ± 0.65) g/L vs (2.38 ± 0.49) g/L on the,P ＜ 0.05);the rate of post operative complication were significantly lower in experimental group than that in control group (52.2％ vs 21.7％,P=0.000);the postoperative anal exhaust time was earlier in experimental group than that in control group [(6.4 ± 0.6) d vs (9.5 ± 0.6) d,P =0.000),and the length of hospital stay was shorter in experimental group [(20.1 ± 6.5) d vs (26.7 ± 9.5) d,P =0.014),and the cost in experimental group was lower [(99 ± 13) thousand yuan vs (115 ± 13) thousand yuan,P =0.000),however,the cost of nutrition support between the two groups was not significantly different (P =0.210).Conclusions Preoperative nutrition support is helpful to reduce the incidence of postoperative complications,shorten the length of hospital stay,to save medical costs for patients with pancreaticoduodenectomy.

Objective To analyze the impact of obesity on short-term prognosis in patients who underwent surgery for cirrhotic portal hypertension with hypersplenism.Methods The clinical data of 310 patients with cirrhotic portal hypertension who underwent splenectomy and portaazygous devascularization between Apr.2002 and Jue.2012 were prospectively analyzed.According to the body mass index (BMI),these patients were divided into the non-obesity group (BMI ＜ 28 kg/m2) and the obesity group (BMI ≥28 kg/m2).There were 78 patients in the obesity group (male:female 56:22; mean age 48.7 ± 8.3years).There were 232 patients in the non-obesity group (male:female 166:66; mean age 46.3 ± 6.9years).The postoperative outcomes in the two groups were analyzed.Results When compared with the nonobesity group,there were significant differences in age (48.7 ± 8.3 in obesity group vs 46.3 ± 6.9 years in non-obesity group),perioperative blood transfusion (400 ± 100 vs 200 ± 100 ml),intraoperative blood loss (370 ± 110 vs 240 ±60 ml),operation time (180 ±40 vs 150 ±35 min),serum albumin level after surgery (28.1 ±2.6 vs 31.2 ±2.3 g/L),drainage volume (280 ±70 vs 230 ±60 ml) and hospital stays (10.5 ±3.0 vs 8.5 ± 2.5 days) in the obesity group (P ＜ 0.05).However,there were no significant differences in gender,preoperative level of liver function,platelet counts (preoperative and postoperative) and postoperative deaths (P ＞ 0.05).Conclusion BMI was a significant independent prognosis risk factor for patients with cirrhotic portal hypertension undergone splenectomy and portaazygous devascularization.

Objective To investigate the role of Chinese traditional medicine-Tianlongchuankeling in modulation of the transdifferentiation of sub-epithelial fibroblasts into myofibroblasts induced by rhTGF-?1,and the involved mechanism of the signal transduction.Methods Human primary bronchial sub-epithelial fibroblasts(HPBFs)were incubated with either Tianlongchuankeling or its main components of Qingtiankui,Danfuzi and Faxia respectively before being treated with rhTGF-?1(10 ?g/L)for different time.Total protein of cells were collected at different timelapse(10min,30min respectively).Phosphorylated MAPKs for p38,ERK1/2,phosphorylated smad2 and the expression of ?-SMA were detected by using Western blotting.Total RNA was extracted at 20 h and 72 h and subjected to RT-PCR for evaluation of the expression of ?-SMA gene.Results The induction of ?-SMA in HPBFs by TGF-?1 was down-regulated significantly in the cells treated with Tianlongchuankeling or Danfuzi.The phosphorylation of ERK1/2 under TGF-?1 stimulation was inhibited significantly in Tianlongchuankeling and Danfuzi group.No difference of the level in phosphorylation of p-38 and smad2 was found among groups.Conclusion Tianlongchuankeling has the capability to suppress the induction of ?-SMA by TGF-?1 through down-regulation of the phosphorylation of ERK1/2,thereby preventing the transdifferentiation of sub-epithelial fibroblasts into myofibroblasts,which may be responsible for the treatment of airway hyperresponsiveness in asthma.Danfuzi,one of main components of Tianlongchuankeling,may make a major contribution to this process.

Objective To explore the diagnostic value of cerebrospinal fluid(CSF) biochemical indexes in central nervous system (CNS) infection .Methods The results of CSF culturing and detection of biochemical indexes including glucose(Glu) ,lactate dehy‐drogenase(LDH) ,chloride ion(Cl) and protein(PRO) were collected from the First Affiliated Hospital of Xi′an Jiaotong University from September to December 2013 .Taking the results of CSF culturing as golden standard ,the biochemical indexes were analyzed by using receiver‐operating characteristic(ROC) curve for single index and combined indexes .Results A total of 157 CSF speci‐mens were collected ,including 39 culture‐positive specimens and 118 culture‐negative specimens .Areas under ROC curve(AUC) of Glu ,LDH ,Cl and PRO were 0 .653 ,0 .633 ,0 .626 ,0 .671 ,respectively .The AUCs of combined detection of these biochemical inde‐xes were higher than those of single index ,and the AUC of combined detection of these four indexes was the largest ,up to 0 .694 , but all were less than 0 .7 .Conclusion Glu ,LDH ,Cl and PRO all could be independent biochemical indexes for diagnosing CNS in‐fection ,among which PRO has the highest diagnostic value .And combined detections of these indexes are better than single detec‐tions ,especially combination of four indexes ,which is the strongest indicator ,but accuracy is low whether single or combined detec‐tion .More sensitive and specific biomarkers of CSF should be explored for rapid diagnosis of CNS infection .