Objective: To study influence of acute hypoxia on the current of voltage-gated potassium channel (IK) in pulmonary artery smooth muscle cells (PASMC) of rats. Methods: A total of 20 male SD rats were randomly and equally divided into normoxic control group and acute hypoxia group. The rats in acute hypoxia group were kept in hypoxic chamber for 8 h before experiment. Whole cell patch-clamp technique was used to record IK in PASMC. Results: Acute hypoxia significantly decreased the IK density in PASMC of rats. During -60mV to -10mV of resting membrane potential（RMP）, acute hypoxia did not significantly decrease peak IK density in PASMC of rats, P>0.05; At 0 mV, acute hypoxia significantly decreased the peak IK density in PASMC [from（38.1 ± 5.2） pA / pF decreased to（9.82 ± 2.1） pA / pF ,P<0.05], then along with RMP increase in PASMC, the decreasing amplitude of peak IK density in PASMC gradually increased（P<0.05）; From + 30 mV to+ 60 mV, the decreasing amplitude of peak IK density in PASMC further significantly increased（P<0.01）; At + 60 mV the peak IK density decreased from（38.1 ± 5.2） pA / pF to（9.82 ± 2.1） pA / pF , and the decreasing amplitude reached (46.8±3.3)%. Conclusion: Acute hypoxia can decrease Kv current in PASMC of rats, leading to hypoxic pulmonary vasoconstriction.

Objective To analyze premature ventricular contractions by dynamic electrocardiogram.Method 186 cases of premature ventricualr contractions were divided into two groups:patho-group(organic heart disease group) 106 cases,and the control group(non-organic heart disease group) 80 cases,both were examined by 24 hours dynamic electrocardiogram,the correlation between PVC shape and T-waves and the heart rate variation were analyzed.Result The variability of Lawn's degrees between the two groups was significant,the indexes of premature ventricualr contractions of patho-group were significantly different compared to the control group(P

Objective To compare the laryngeal mask insertion conditions at different plasma target concentrations (Cp) during the induction of anesthesia with target-controlled infusion (TCI) of propofol.Methods Forty-five ASA I - II patients of both sexes aged 18-60 yr, weighing 50-80 kg undergoing minor surgery in which the use of laryngeal mask (LM) was indicated were randomly divided into 3 groups ( n = 15) according to Cp of propofol set during induction of anesthesia: 4, 6 and 8 ?g ? ml-1 . The patients were premedicated with intramuscular scopolamine 0.3 mg. Fentanyl 3 ?g?kg-1 was given i.v. . TCI of propofol was started 3 min later with Diprifusor (Graseby 3500 infusion pump). LM was inserted when the effect-site concentration (EC) of propofol reached 2.5 ?g ? ml -1 as displayed on the infusion pump. LM insertion conditions (mouth opening, gagling, coughing, head and limb movement, overall ease of insertion) were assessed. The total dose of propofol, insertion time, the time needed to reach EC 2.5 ?g?ml-1 were recorded. SP, DP, HR and BIS value were recorded at 6 time points: baseline before induction (T1 ) , at the loss of consciousness (T2), at EC 2.5 ?g ? ml-1 (T3), immediately (T4), 3 min (T5) after insertion of LM. Results The SP, DP, HR and BIS value were decreasing with increasing depth of anesthesia in the 3 groups. The decrease in BP and BIS value after insertion of LM was significantly larger in group 3 (8 ?g ?ml-1) than in group 1 and 2 (P

The expressions of estrogen receptor (ER) α,ERβ1,and ERβ2 in thyroid carcinoma,thyroid adenoma,and adjacent normal thyroid tissue were determined by RT-PCR and immunohistochemistry,and the relationship of expression levels of three ERs and the main clinical pathologic parameters were evaluated.The result showed that ERα mRNA expression in papillary thyroid carcinoma(PTC) tissues was significantly higher than adjacent normal tissue,while,ERβ2 mRNA expression in PTC tissues was significantly lower than normal tissue ( P＜0.05 ).The positive expression of ERβ1 and ERβ2 in the thyroid carcinoma was related with the histological variant of carcinomas; the ERβ2 expressions were related with the lymph node metastasis and TNM staging of the carcinomas.These results suggest that the decreased ERβ2 expression may induce proliferation and carcinogenesis of thyroid follicular epithelial cells as well as progression of the carcinoma,and is a powerful prognostic indicator.

Objective To study the treatment of abdominal compartment syndrome(ACS) secondary to fulminant acute pancreatitis (FAP).Method A retrospective study was conducted from Jan.2009 to Dec.2011 to analyze the therapeutic results of 18 patients with ACS secondary to FAP.Results Three out of 7 patients who received non-operative therapy died (mortality rate 42.9％).Three out of 11 patients treated with early surgery died (mortality rate 27.3％),which was significantly better than those patients treated conservatively.Conclusion A reduction in intra-abdominal pressure improved the function of the viscera in the treatment of ACS secondary to FAP.The decompressive effects of early surgery was efficacious,and it reduced the mortality rate.

Objective To evaluate the procedure and the therapeutic efficacy of duodenumpreserving pancreatic head resection (DPPHR) in treating benign lesions in the head of the pancreas.Methods From February 2003 to August 2011,DPPHR was performed in 21 patients with benign lesions in the head of the pancreas.Thirteen patients were male and eight were female.Age ranged from 30 to 48 years,and the lesions ranged from 2.0 cm to 5.6 cm in diameter.Posterior superior pancreaticoduodenal artery was conserved in all patients.Results There was no hospital death.Pancreatic fistula was the main and the most often morbidity,occurring in 33.3％.After operation all patients with preoperative abdominal pain were completely pain free.Preoperative hypoglycemia in 2 patients turned to eugycemia.There was no recurrences report during following up.Concl~ions DPPHR was safe and effective in treating benign lesion in the head of pancreas.It was important in preserving blood supply to the duodenum by posterior superior pancreaticoduodenal artery.

Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional

Objective To evaluate the efficacy and outcomes with the use of a saline-coupled bipolar sealer during liver resection.Methods 101 patients underwent liver resection for primary hepatic carcinoma at the People's Hospital Affiliated to Zhengzhou University from August 2015 to December 2016.The patients were divided into two groups according to whether the Aquamantys(R) system was used or not.In group A (n =62) the clamp crushing technique was used for liver parenchymal transection.In group B (n =39) the Aquamantys(R) system was used.The intraoperative and postoperative complication rates were compared.Results The operation time in group B was significantly longer than group A (216.4 min vs.253.5 min,P ＜ 0.05).The intraoperaitve blood loss in group B was significantly less than group A (381.1 ml vs.257.2 ml,P ＜ 0.05),and less blood transfusion was required (211.3 ml vs.90.9 ml,P ＜ 0.05).The volume of abdominal drainage fluid in group B in the first and the 5th day was significantly less than group A (242.6 ml vs.199.2 ml,P＜0.05;84.3 ml vs.70.4 ml,P＜0.05,respectively).The drainage tube in group B was taken off earlier than in group A (8.1 d vs.7.0 d,P ＜ 0.05).The average hospitalization stay after surgery in group B was also significantly shorter (13.4 d vs.11.6 d,P ＜ 0.05).There was no significant difference in the overall postoperative complication rate (P ＞ 0.05) between the 2 groups,and no death was observed.Conclusion The use of a saline-coupled bipolar sealer (Aquamantys(R)) in liver resection for hepatocellular carcinoma was associated with less intraoperative blood loss and was better for the patients' postoperative recovery.

Objective To discuss the diagnosis and surgical treatment of solid pseudopapillary tumor (SPTP) of the pancreatic head.Methods From January 2008 to August 2013,the clinicopathological data of 12 patients who were diagnosed and surgically treated in our hospital for this condition were analyzed retrospectively.Results There were 11 women and 1 man,the mean age was 28.7 years,with a range from 11 to 43.The mean diameter of the tumor was 7.5 cm(2 ～ 15 cm),6 of 12 of these tumors were more than 10 cm.Seven patients underwent pancreaticoduodenectomy,2 duodenum-preserving pancreatic head resection,2 local resection of tumor,1 palliative resection,1 pancreaticoduodenectomy combined with resection of part of the portal vein.All the diagnoses were confirmed by postoperative histopathology.In a follow-up which ranged from 3 to 65 months,all the patients were alive with no evidence of disease recurrence.Conclusions Most of the SPTPs of the pancreatic head were huge.The diagnosis was difficult.Complete tumor resection is the best treatment.

Objective To explore the effect of the clinical case oriented management model on nurses comprehensive ability, psychological and critical mind. Methods In 2014 on the implementation ofroutine clinical case management modelas the control group, collected 97 cases of clinical cases. In 2015 on the implementation ofthe clinical case oriented management modelas the observation group, collected 110 cases of clinical cases. Compared two methods of management to improve the nurse management theoretical knowledge, clinical practice ability and deal with the size of the case skills help. When/after clinical special case found the influence for nurses, including psychology, work in the nursing work will, enthusiasm, independent ability to deal with related cases and the nurse critical thinking ability, etc. Results The proportion of the nurses thought that it was helpful to improve the management of theoretical knowledge, clinical practice ability and deal with the size of the case skills and the case analysis of satisfaction were 98.79%(244/247), 99.19%(245/247), 98.79%(244/247), 99.60%(246/247) in the observation group, and 88.57%(217/245), 87.35%(214/245), 87.76%(215/245), 90.61%(222/245) in the control group. The differences were statistically significant (χ2=21.390-27.571, P < 0.01). The proportion of the nurse considered that special case on the psychological effects of nursing work, engaged in the willingness and enthusiasm were the main factor were 15.79%(39/247), 13.77%(34/247), 11.34%(28/247) in the observation group, and 31.84%(78/245), 31.02%(76/245), 30.61%(75/245) in the control group. The differences were statistically significant (χ2=17.475, 21.097, 27.611, P < 0.01). After special case, the percentage of nurses to independently handle the case, help others, loss rates were 97.57%(241/247), 2.02% (5/247), 0.40% (1/247) in the observation group, and 85.71% (210/245), 12.24% (30/245), 2.04% (5/245) in the control group. The proportion of nurses to independently handle the case in the observation group was higher than that in the control group, but the ratio of nurses to help others, loss rates in the observation group were lower than those in the control group, the differences were statistically significant (χ2=22.647, P<0.01).Critical thinking score, the observation group of nurses in the search for truth, open mind, analytical ability, system organization, judging thinking self-confidence, curiosity, cognitive maturity, such as total score were respectively (43.24±4.01), (43.03±4.12), (47.66±4.23), (44.21± 3.92), (44.00 ± 4.97), (52.13 ± 4.44), (48.23 ± 4.85), (319 ± 14.57) points. The control group nurses were respectively (39.00±3.56), (38.90±3.28), (43.65±2.47), (40.55±1.99), (39.00±3.40), (47.87±4.01), (41.89± 5.11), (292.23 ± 6.02) points. The differences were statistically significant(t =12.15-24.19, P < 0.01). Conclusions The clinical case oriented management model can improve nurses comprehensive ability, reduce the adverse impact of the special case for nurses, improve the clinical nurses' critical thinking ability, to ensure patient safety.