Objective To determine the median effective target plasma concentration (EC50) of remifentanil inhibiting responses to skull-pin placement when combined with propofol in the female patients undergoing neurosurgery.Methods Sixteen female patients,aged 20-60 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective neurosurgery under general anesthesia,were enrolled in this study.Anesthesia was induced with propofol and remifentanil given by target-controlled infusion and iv rocuronium 0.6 mg/kg.The target plasma concentration (Cp) of remifentanil and propofol was set at 5 ng/ml and 3 μg/ml,respectively.At 3 min after tracheal intubation,the target Cp of remifentanil was adjusted and set at 5 ng/ml in the first patient.The skull-pin was placed after the target effect-site and plasma concentrations were balanced.The Cp increased/decreased by 20％ each time in the next patient depending on whether or not the response to skull-pin placement was positive.The ratio between the two successive concentrations was 1.2.The response to skull-pin placement was defined as positive when heart rate and/or mean arterial pressure increased by 20％ of the baseline value within 1 min after placement.The EC50 and 95％ confidence interval of remifentanil required to inhibit responses to skull-pin placement were calculated when combined with propofol.Results The EC50 (95％ confidence interval) of remifentanil required to inhibit responses to skull-pin placement was 3.74 (3.43-4.09) ng/ml when combined with propofol.Conclusion When combined with propofol,the EC50 of remifentanil inhibiting responses to skull-pin placement is 3.74 ng/ml in the female patients undergoing neurosurgery.

Objective To investigate the changes of plasma activated protein C(APC)in the pediatric leukemia patients with acute lung injury(ALI),and the relationship with the outcome.Methods During the study period(from Jan to Dec 2009),17 pediatric leukemia patients with ALI were selected.They were divided into neutropenic(n =10)and non-neutropenic(n =7)group.We collected the basic data including the age,gender,stage of chemotherapy,pediatric critical illness score,mechanical ventilation time,ICU time.The blood gas and plasma APC levels were detected on day 1 and day 4 of ALI onset.Results Compared with the non-neutropenic group,the neutropenic group had a significantly longer mechanical ventilation time [(16.60 ± 1 0.83)d vs(3.79 ± 4.08)d,P =0.009 6],lower PaO2 level on day l[(54.90 ± 17.05)mm Hg vs (92.70 ± 27.53)mm Hg,P =0.009 7],and lower APC level on day 4[(193.06 ± 63.19)pg/mlvs(286.28 ±25.12)pg/ml,P =0.007 7].Conclusion The APC generation is severely impaired in the neutropenic group,especially in those who died.The lower APC level is,the longer is the mechanical ventilation time,the worse is oxygenation,the poorer is the prognosis.APC replacement therapy may be promising in these patients.

Objective To develop perfluorocarbon lipid particles and investigate their basic properties,and target them to human hepatocellular carcinoma cells in vitro by hepatoma monocolonal antibody HAb18 with avidin-biotin interaction.Methods Rotary evaporation and high pressure homogen were used to prepare perfluorocarbon lipid particles, and the appearance and distribution of them were investigated by microscope and electron microscope, the concentration and the size and electric potential were detected.The biotinylated monoclonal antibody HAbl8 was prepared, then the biotinylated degree of the antibody was determined.The biotinylated perfluoroearbon lipid particles labelled with NBD were prepared and targeted to human hepatocellular carcinoma cells in vitro with avidin-biotin interaction.Results These perfluorocarbon lipid nanoparticles were uniform and stable,and the mean diameter of them was 171.9 nm.Hepatocellular carcinoma cells were surrounded by the biotinylated particles labelled with NBD.Conclusions A steady perfluoroearbon lipid particles were prepared and the biotinylated particles can be targeted to hepatocellular carcinoma cells with avidin-biotin interaction.

To investigate the characteristics of scale cataract operations and the effects and experiences of small incision extracapsular cataract extraction with intraocular lens ( lOL) implantation in large - scale vision recovery action.
●METHODS: Four thousand eight hundred ninety - two cases ( 4892 eyes ) of cataract were treated by small incision non-phacoemulcification cataract extraction from March 2010 to November 2011 in our hospital ( Fuming No. 1 surgery car of Shaanxi Province ) which were retrospectively analyzed. Visual acuity, intraoperative and postoperative complications, the recovery of postoperative inflammation were observed.
●RESULTS: Visual acuity reached 0. 3 or more in 4521 eyes (92. 42%) at 1d after the operation, at 3d after the operation in 4571 eyes (93. 44%), there were 4887 eyes with lOL implantation, implantation rate was 99. 90%. All the cases had lesser intraoperative and postoperative complications, and the postoperative inflammation recovered quickly.
●CONCLUSlON: Small incision extracapsular cataract extraction with lOL implantation is simple, effective, economical, safe and adapting for large - scale vision recovery action.

Objective To investigate the structural and functional changes of mitral valve in patients with functional mitral regurgitation (FMR) by real-time three-dimensional transthoracic echocardiography (RT-3D-TTE).Methods RT-3D-TTE were performed on 70 patients with at least moderate mitral regurgitation (FMR group;including 35 cases of ischemic cardiomyopathy [ICM] subgroup and 35 cases of dilated cardiomyopathy [DCM] subgroup) and 30 normal controls (control group).The mitral valve parameters were analyzed by TomTec assessment software to detect dynamic changing pattern of mitral valve size and shape during cardiac systole.The differences of parameters between control group and FMR group were compared.The parameters included mitral annulus structural parameters:Anterior-posterior (AP),anterolateral-posteromedial (AL-PM),sphericity (SPI;SPI=AP/AL-PM),annular circumference (AC),commissural diameter (CD),nonplanarity angle (NPA),annular height (AH),tenting height (TH),tenting volume (TV),three-dimensional annular area (AA3D);dynamic parameters..Maximum annular displacement (ADmax),maximum annular displacement velocity (ADVmax).Results The mitral valve parameters present phasic variation law in FMR group.Compared with control group,AH,ADmax and ADVmaxwere smaller and the other parameters were larger than those in FMR group (all P＜0.05).Compared with control group,AH,ADmax and ADVmax were smaller and the other parameters were larger than those in both ICM subgroup and DCM subgroup (all P＜0.05).Compared with ICM subgroup,AH was smaller in DCM subgroup (P＜0.05),there was no statistical difference in ADmax and ADVmax between ICM subgroup and DCM subgroup (P＞0.05),the rest parameters were greater in DCM group (all P＜0.05).Conclusion RT-3D-TTE can be used to quantitatively assess the structural and functional changes of mitral valve in patients with FMR and provide a reference for the clinical treatment of FMR.

Objective To investigate the effectiveness of disposable infusion set for bladder washout in elderly patients with long-term urinary canal placement and improve the nursing quality.Methods Fifty-two elderly patients with long-term urinary canal placement were randomly divided into experimental group and control group.In the experimental group,disposable infusion sets were used to connect the rinsing solution and the urinary canal to accomplish bladder washout.On the contrary,routine method was used to do the bladder washout in the control group.The urine bacterial culture,comfortability of the patients,and the operating time by the nurses were compared between two groups.Results There was no significant difference in the urine bacterial culture between the experimental and the control group (P =0.500 ). The comfortability of the experimental group (92.31％) was significant better than that of the control group (65.38％),the difference was statistically significant (P =0.019).There was also significantly less operating time by the nurses for the experimental group (8.7 ±0.5 )min than the control group (13.5 ± 0.3)rin,the difference was statistically significant (t =41.97,P ＜0.0 1 ).Conclusions The disposable infusion set for bladder washout is simple and easy to operate and is suitable for both at home and in medical caring.

Interaction of salinity (NaCl) and cadmium (Cd) on growth, mineral nutrients, Na and Cd accumulation in four barley genotypes differing in salt tolerance was studied in a hydroponic experiment. Cd, NaCl and their combined stresses reduced Ca and Mg concentrations in roots and shoots, K concentration in shoots, increased K and Cu concentrations in roots relative to control, but had non-significant effect on micronutrients Cu, Fe and Mn concentrations in shoot. The three stresses reduced accumulation of most tested nutrients in both roots and shoots, except NaCl and NaCl+Cd stresses for root K and shoot Cu accumulation in salt tolerant genotypes. The salt tolerant genotypes did not have higher nutrient concentration and accumulation than the sensitive ones when exposed to Cd and NaCl stresses. In conclusion, the affecting mechanism of Cd stress on nutrients was to some extent different from salinity stress, and the NaCl+Cd stress was not equal to additional Cd and NaCl stresses, probably due to the different valence and competitive site of Na(+) and Cd(2+). NaCl addition in the Cd-containing medium caused remarkable reductions in both Cd concentration and accumulation, with the extent of reduction being also dependent on genotypes. The salt-tolerant genotypes had lower Na concentration than sensitive ones.
Cadmium ; metabolism ; toxicity ; Chlorophyll ; metabolism ; Genotype ; Hordeum ; drug effects ; genetics ; metabolism ; Minerals ; metabolism ; Sodium ; metabolism ; Sodium Chloride

Objective To investigate the distribution status of coal-burning fluorosis (endemic fluorosis) areas in Luoyang and to provide scientifc evidence for making strategies in prevention and control. Methods In 2006, a household per village was chosen to carry the general survey so as of disease condition, living habits and housing structure among 941 coal-burning pollution fluorine sickness natural villages in Yanshi, Mengjin, Xin'an, Luanchuan counties and Geely area which were under the jurisdiction of Luoyang. In the general survey, the sampled village having a population of more than 500 person was considered as a major survey village, and water fluoride, 8 - 12 year-old child fluorine spot on tooth and the urinary fluoride were surveyed. Water fluoride and the child urinary fluoride determination used the fluoride ion selective electrode method, and the children's dental fluorosis used Dean method. Results The endemic fluorosis of Luoyang existed 742 in endemic fluomsis villages, compared with history, a decrease of 199 in number. Ninety-six point seven per cent( 142 543/147 419) of the households were consuming smoke-free coal. Households using intact kitchens accounted for 93.6%( 137 919/147 419). Of which 63.0%(86 889/137 919) of kitchens were mixed up with bedrooms. Total 125 060 people were using coal- fired furnace for heating, of which 87.8%(109 802/125 060) had smoke-free facilities, 12.2%(15 258/125 060) had none. Among 52 endemic villages with population of more than 500 people surveyed, a total of 183 water samples were collected, 2 had water fluoride exceeding 1.0 rag/L, the highest water fluoride being 1.04 rag/L, averaging 0.39 mg/L Sixteen villages had a prevalence rate of dental fluorosis for children less than 30.00%, accounting for 30.8% (16/52), 36 endemic villages the prevalence of dental fluorosis detection rate of more than 30.00%, accounting for 69.2%(36/52). Twenty-thrce villages had a dental fluorosis index greater than 0.6, severe dental fluorosis was not found. Real-time measurement of 1408 urine samples of children aged 8 - 12 showed that urine fluoride highest value 6.88 nag/L, the minimum value of 0.10 mg/L, geometric mean 1.10 mg/L. The prevalence rate of dental fluorosis for children was 36.06%. Conclusions In Luoyang city, numbers of coal-burning endemic fluorosis villages are less than before, children's dental fluorosis has significantly declined, however some people still use kitchens connecting with bedrooms and lack smoke-free facilities, they need to be educated to change lifestyle and improve furnace to reduce soot fluoride pollution.

Objective To investigate the nutritional risk,undemutrition,and nutrition support in inpatients with early and middle stage gastrointestinal cancer undergoing radical surgery in a tertiary hospital in Weifang,Shandong Province.Methods A total of 8390 inpatients who were treated in the departments of oncological surgery,enterohepatic surgery,and general surgery in our hospital were consecutively recorded from December 2010 to August 2011 and from November 2011 to October 2012.After 153 patients were excluded for hospital length of stay less than 24 hours,age less than 18 years old or more than 90 years old,obnubilation,and/or refusal to participate in the research,8237 patients were sampled.After patients who did not meet the scheduled diagnosis were excluded,300 pathology-confirmed patients with early or middle stage gastrointestinal cancer were enrolled.Nutritional Risk Screening 2002 (NRS 2002) was performed within the first 48 hours after admission and nutrition support was evaluated until the discharge.Results A total of 300 early and middle stage gastrointestinal cancer patients (141 cases of gastric cancer and 159 cases of colorectal carcinoma) who underwent radical surgery met the inclusion criteria.Among them 185 (61.7％) were at nutritional risk.The undernutrition rate was 12.3％ (37/300) if evaluated from the score of nutritional defect part of NRS 2002,and 10.0％ (20/300) if based on body mass index ＜18.5 kg/m2.Totally 165 patients (89.2％) at nutritional risk and 99 patients (86.1％) without nutritional risk received nutrition support.The average ratio of parenteral nutrition to enteral nutrition was 82:1.The intake of calories was (78.1±24.8) k1/(kg,d) [(18.6±5.9)kcal/(kg·d)] and that of nitrogen was (0.10±0.06) g/(kg · d),yielding a ratio of calories vs.nitrogen of (244 ± 164)∶1.Conclusions Inpatients with early and middle stage gastrointestinal cancer tend to have high nutritional risk.The undernutrition rate is 10％-12.3％ in this population.Meanwhile,the application of nutrition support should be further standardized,particularly for patients without nutritional risk.

Objective To study the related factors of tumble among senile cerebrovascular diseases patients,so as to effectively prevent it happening.Methods A total of 102 senile cerebrovascular diseases patients with the history of tumble within 12 months were investigated with self-designed questionnaire.Results The incidence of tumble among male patients was 42.16％,while female patients was6.86％ ;living alone patients was 37.25％,while cohabit patients was 16.67％ ;balance ability abnormal patients was 38.24％,while that normal patients was 22.55％.There was significantly difference between them(x2 =4.95,8.45,5.13 ;P ＜0.05 or P ＜ 0.01).The tumble incidence among patients with different ages,medicine or not,nocturnal enuresis condition,eyesight,intelligence and different chronic diseases was significantly difference(P ＜0.05 or P ＜0.01).Conclusions The incidence of tumble among senile cerebrovascular diseases patients are related to many factors,so it is important to assessment their health condition and establish effective preventive measures to reduce the ratio of tumble.