Objective To explore the feasibility and safety of application of left new axillary vein puncture for critical disease via lateral approach in anterior thoracic wall.Methods Totally 100 critical patients were randomly divided into left side group and right side group.Extrathoracic puncture point was located with clavicle and puncture was pointed to cricoid cartilage.The axillary vein catheterization was carried out via lateral approach in anterior thoracic wall.Success rate and puncture times,depth,operating time and complications were recorded respectively. Results Success rate had no significant difference between the two groups(χ2 =0.613,P >0.05).Puncture times, depth,operating time and complications had no significant differences between the two groups(t =0.338,0.126, 0.361,all P >0.05).The total complications rate had no significant difference between the two groups(χ2 =0.149, P >0.05).Guide wire and catheter were inserted smoothly.The two groups had no pneumothorax and hemothorax. Conclusion The left new axillary vein puncture via lateral approach in anterior thoracic wall with clavicle and cricoid cartilage as surface marker was easy and safe without serious complications.It was suitable for critical disease.

Objective To investigate the optimum dose of dezocine combined with ropivacaine for elderly patient -controlled epidural analgesia(PCEA)after transurethal resection of prostate (TURP)surgery.Methods Totally 90 elderly patients underwent TURP surgery with ASAⅡ-Ⅲ were randomly divided into three groups,30 cases in each group.For postoperative epidural analgesia,they were treated with different mixed liquor as following:group F:fentanyl 0.3mg +1.192% ropivacaine 20mL +normal saline to 100mL,group D1:dezocine 5mg +1.192% ropiva-caine 20mL +normal saline to 100mL,group D2:dezocine 7.5mg +1.192% ropivacaine 20mL +normal saline to 100mL.VAS and Bruggrmann Comfort Scale(BCS)and sedation score at 4,8,12,24,36,48h and side -effects,sleep quality score and general satisfaction score at 24,48h after operation were recorded.The ratio of best analgesia was evaluated.Results VAS of 4,8,12,24,36,48h after operation had no significant differences among three groups (F =1.65,1.72,1.75,1.73,1.58,1.63,all P >0.05).BCS of all points had no significant differences among three groups(F =1.48,1.51,1.44,1.38,1.38,1.38,all P >0.05).Sedation score of all time points had no significant differences among three groups(F =1.55,1.60,1.61,1.00,1.00,1.00,all P >0.05).Sleep quality score of 24,48h after operation had no significant differences among three groups(F =1.76,1.84,all P >0.05).General satisfaction score of 24,48h after operation had no significant differences among three groups(F =1.73,1.72,all P >0.05).The excellent and good rates of analgesia in three groups were 90.0%,93.3% and 93.3% respectively,and there were no significant difference (χ2 =0.873,0.873,all P >0.05).Compared with group F and group D1,the incidence rates of nausea and vomit were significantly increased in group D2(χ2 =4.25,4.32,all P <0.05),and the incidence rates of dizziness were significantly increased in group D2 (χ2 =4.36,4.08,all P <0.05 ),and the incidence rates of drowsiness was significantly increased in group D2(χ2 =7.85,7.85,all P <0.05).There were no pruritus and respir-atory depression in three groups.Conclusion The optimum dose of dezocine combined with ropivacaine for elderly PCEA after TURP surgery is 5mg.It can provide adequate pain relief and higher satisfaction with less side -effects.

Neonatal hypoxic-ischemic encephalopathy has high mortality,high morbidity,as well as the lack of effective treatment,which remain difficult problem in the medical profession.Progesterone has been confirmed protective effect for neonatal hypoxic-ischemic encephalopathy as nerve steroid hormone,and has been used in clinical trials Ⅱ.We review the progess in progesterone in hypoxic-ischemic encephalopathy.

Objective To evaluate the effects of postconditioning with ischema and propofol on retinal injury induced by limb ischemia-reperfusion (LIR) in rats.Methods Twenty-four male Wistar rats were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S),group LIR,and propofol postconditioning + postconditioning + ischemic LIR group (group P + I + LIR).The model of LIR was established by separating and ligating the femoral artery and vein of bilateral hind limbs for 60 min followed by reperfusion.In group P + I + LIR,the animals were subjected to 4 episodes of 60 min ischemia-5 min reperfusion-5 min ischemia-5 min reperfusion and to 4 cycles of propofol 500 μg· kg-1 · min-1 infused intraperitoneally at the same time (during reperfusion)-no propofol infusion during second ischemia.At 120 min of reperfusion,blood samples were collected from the abdominal aorta for determination of serum malondialdehyde (MDA) concentrations.The eyeball was removed and the retina was cut into sections which were stained with H.E.and examined by microscopy.Results Compared with group S,the serum MDA concentration was significantly increased in group LIR,and no significant change was found in the serum MDA concentration in group P + I + LIR.The serum MDA concentration was significantly lower in group P + I + LIR than in group LIR.The structure of retina was normal in group S,oedema was found in all the layers of retina,vacuolar degeneration was observed in the most of ganglionic layers,and the structure disturbance was found in group LIR.The pathological changes of retina were significantly attenuated in group P + Ⅰ + LIR.Conclusion Postconditioning with ischema and propofol can attenuate retinal injury induced by LIR,and the mechanism is related to inhibition of lipid peroxidation in rats.

Objective:To observe the clinical efficacy and safety of compound hypoglycemic Yuye oral liquor combined with metfo-ma and glimepiride in the treatment of type 2 diabetes mellitus ( deficiency of both Qi and Yin) . Methods:Totally 80 type 2 diabetes mellitus patients were randomly divided into the treatment group and the control group with 40 each, both groups were treated with met-formin hydrochloride tablets and glimepiride tablets, the treatment group was given compound hypoglycemic Yuye oral liquor additional-ly, and the treatment duration was 12 weeks. At the end of the treatment, fasting plasma glucose( FPG) , postprandial 2 hours plasma glucose(2hPG), hemoglobin A1c(HbA1c)and traditional Chinese medicine (TCM ) syndrome in the two groups were compared. Re-sults:In both groups, FPG, 2hPG and HbAlc were decreased after the treatment, and the decrease in the treatment group was more notable than that in the control group with statistically significant difference (P<0. 05 or P<0. 01). As for TCM syndrome, the score in the treatment group was lower than that in the control group with statistically significant difference (P<0. 01). The clinical efficien-cy in the treatment group was 47. 5%, that was 22. 5% in the control group, and the difference between the two groups was statistically significant (P<0. 05). Conclusion:Compound hypoglycemic Yuyeoral liquor can reduce the blood glucose in type 2 diabetes mellitus patients( deficiency of Qi and Yin) , and the improvement of clinical symptom is striking with good safety and clinical application value.

During the installation of a pipe pile, the soil around the pile will be squeezed out. This paper deals with this squeezing effect of open-ended pipe piles using the cylindrical cavity expansion theory. The characteristics of soil with different tension and compression modnli and dilation are involved by applying the elastic theory with different moduli and logarithmic strain. The closed-form solutions of the radius of the plastic region, the displacement of the boundary between the plastic region and the elastic region and the expansion pressure on the external surface of the pipe piles are obtained. When obtaining these solutions, the soil ping in the open-ended pipe pile is considered by employing an incremental filling ratio to quantify the degree of soil plugging. Moreover, the effects of the ratio of tension and compression moduli, angle of dilation and incremental filling ratio on the radius of the plastic region and the expansion pressure on the external surface of the pipe pile are investigated. The parametric analyses show that it is necessary and important to consider the difference between the tension modulus and compression modulus, dilation angle and incremental filling ratio for studying the squeezing effect of open-ended pipe pile installation. It is concluded that the analytical solutions presented in this paper are suitable for studying the squeezing effect of open-ended pipe piles.

OBJECTIVE:To analyze the volatile components in Descurainia sophia and Lepidium apetalum and compare its dif-ferences. METHODS:HS-SPME was conducted for extracting volatile components in D. sophia and L. apetalum,GC-MS was used for detecting components,and area normalization method was adopted for calculating relative content of each component. RE-SULTS:The volatile components in D. sophia and L. apetalum were 25 and 18,accounting for 75.76% and 64.29% of total vola-tile components,respectively,and chemical components with the highest contents were β-caryophyllene and O-tolunitrile. CON-CLUSIONS:The method is simple,reliable,and can be used for the analysis of volatile components in D. sophia and L. apetalum. The volatile components show great differences in the kinds and contents,the study can provide basis for rapid identification of D. sophia and L. apetalum.

Objective To investigate an X-ray total body irradiation (TBI) technique using anterior-posterior opposed fields with patients at the side-lying position,and to analyze the real-time in vivo dosimetry results.Methods The accelerator with 10 MV X-rays of Varian Trilogy was used for the TBI with the extended source to skin distance of 390 cm.The percent depth dose,off axis factors and absolute dose output were measured.The dose accuracy and homogeneity was monitored real-time using multichannel diode dosimeter for 10 patients.The monitored sites included forehead,mandible,suprasternal fossae,xiphoid,umbilicus,pelvis,middle of thigh,knee,middle of leg and ankle.The patients were irradiated at the side-lying position,with the prescription dose of 1 200 cGy/6 f during 3 days,the middle line dose rate of 5.0 cGy/min.Solid water was used for the compensation of the dose homogeneity.Results The off axis dose homogeneity was less than ± 5.0％ for the TBI geometry.The absolute dose output was 0.072 1 cGy/MU at the maximum dose point.The total body irradiation was finished smoothly for the 10 patients lying on side.The deviation of monitored total dose from the total prescription dose was within -4.9％ to 6.7％ for the 10 monitored sites.The monitored dose homogeneity was less than 5.0％.Conclusions The fractionated anterior-posterior opposed parallel TBI can be finished smoothly with patients side-lying.Accurate and homogenous dose distribution can be obtained using real-time dose monitoring and compensation with solid water.

Objective To analyze the patient-specific dosimetric verification results of 2010 intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans from different treatment sites,and provide a reference for improving the patient-specific dosimetric verification program.Methods A total of 2 010 (965 IMRT and 1 045 VMAT) patient-specific dosimetric verification results were reviewed for isocenter dose difference and percentage of pixels passing planar dose γ analysis.All plans were designed with Eclipse planning system and delivered with Trilogy linear accelerator from February 2012 to February 2016.The dosimetric verification was performed with MatriXX array together with Muhicube phantom.Point dose difference larger than ± 3％ and/or γ pass rate (3％/ 3 mm) less than 90％ was defined as plan failure.Additional analysis was conducted for trends in difference of pass rates with treatment site and delivery technique (IMRT vs.VMAT).Results The mean isocenter difference between measured and calculated doses was-0.3％ ± 2.4％ for 2 010 plans.The mean percentage of pixels passing the γ criteria was 97.9％ ± 3.4％.88.2％ and 96.7％ of plans passed the point and planar dose verification,respectively.The γ pass rate was different among the treatment sites (F =3.09,P ＜ 0.05).The pass rate of point and planar dose difference was different among the treatment sites(x2 =40.93,39.15,P ＜0.05).There was no difference between IMRT and VMAT plans for both point dose and planar dose evaluation (P ＞ 0.05).Conclusions Most of IMRT and VMAT plans passed the tolerance criteria of ±3％ and 90％ for point and planar dose verification with MatriXX together with Multicube phantom,respectively.Both point and planar dose verification results varied among treatment sites,whereas no significant difference was found between IMRT and VMAT.

Objective To discuss the relation between level of Hs-CRP and glycometabolic disturbance in patients with acute coronary syndrom. Methods 155 patients with acute coronary syndrome were divided into 3 groups according to the WHO standard of diabetes diagnosis,normal glucose tolerance group(group A,44 cases),impaired glucose tolerance group(group B,60 cases),diabetes group(group C,51 cases). All cases were checked by the 75g glucose tolerance test, blood Glucose, insulin, HbA1c,lipid,hypersensitive C reaction protein(hs-CRP). 95 patients were checked by coronary angiography(CAG). Statistic comparison were measured among three groups including the levels of hs-CRP,insulin,HbA1c,lipid and coronary artery lesions. Results The levels of Hs-CRP,PBG, FINS, PINS,HbA1c,TC,LDL-C in both group B and C were higher than those in group A;The levels of TG,PINS were not found significant differences between group B and C. The level of Hs-CRP was correlated with the levels of PBG,PINS,HbA1c,TC,LDL-C. The coronary artery lesions showed by CAG in group B and C were more severe than those in group A,coronary multivessel changes in group B and C were more frequent than in group A,it had no significant difference between group B and C.Conclusion Compared with the patients of normal glucose tolerance, patients with glycometabolic disturbance have higher levels of hs-CRP,their coronary artery lesions are more severe.