Xuzhou Cancer Hospital explored a development and reform of the hospital in the PPP framework,while adhering to the principles of Public nature as before,staff status as before,and government supervision as before. The reform features proactive attempts in operation and management,personnel management,and remuneration system,in an effort to build an operation system featuring board governance,total cost accounting,and dynamic total salary management in its reform toward building an innovative mixed ownership.

Objective To compare the efficacy of the laryngeal mask airway Classic (CLMA), Streamlined Liner of Pharyngeal Airway (SLIPA) and laryngeal mask airway ProSeal (PLMA) in patients undergoing laparoscopic surgery. Methods One hundred and twenty-three ASA Ⅰ or Ⅱ patients aged 20-64 yr undergoing elective laparoscopic surgery were randomly divided into 3 groups: CLMA group (group C, n =41 ), SLIPA group (group S, n =42) and PLMA group (group P, n =40). Laryngeal mask was inserted after induction of anesthesia with sufentanil 0.3 μg/kg, atracurium 0.5 mg/kg and propofol 2 mg/kg. Mll the patients were ventilated with intermittent positive-pressure ventilation. Anesthesia was maintained with contiunous infusion of propofol 6-8 mg· kg-1· h-1 and with supplementary administration of sufentsnil 0.1-0.2 μg/kg and atracurium 0.2 mg/kg as required. The degree of difficulty in inserting the laryngeal mask was evaluated. The rate of successful placement at first attempt, device placement time, recovery time and complications were recorded . Peak inspiratory pressure (PIP) and the number of patients with an airway sealing pressure less than PIP were recorded before pneumoperitoneum and when intra-abdominal pressure achieved 12 mm Hg. Results The placement was easier and the placement time and recovery time were significantly shorter in group S, and the placement time was significantly longer,the airway sealing pressure was significantly higher and the number of patients with an airway sealing pressure less than PIP was lower in group P than in group C ( P ＜ 0.05). The placement time and recovery time were significantly longer, the placement was harder, the airway sealing pressure was significantly higher, and the number of patients with an airway sealing pressure less than PIP was lower in group P than in group S ( P ＜ 0.05). PIP was significantiy higher when intra-abdominal pressure achieved 12 mm Hg than that before pneumoperitoneum in all the three groups ( P ＜ 0.05). There was no significant difference in the incidence of complications and rate of successful placement at first attempt among the three groups ( P ＞ 0.05). Conclusion All the three airway devices can provide adequate ventilation during operation, with fewer complications. SLIPA placement is easiest. PLMA can assure good airway sealing and is most suitable for patients undergoing laparoscopic surgery.

0.05).At post- operative 30 days and 90 days,ECD were(6.39?0.90)%,(6.54?1.24)% respectively in the torsional group and(13.17?1.78)%, (13.67?2.36)% respectively in the US group,the differences between two groups were statistically(P0.05).Conclusion The torsional mode may provide more effective lens re- moval with a lower level of phacoemulsification time and energy.It can reduce the ultrasound energy and the intraocular trauma.(Oph- thalmol CHN,2008,17:82-85)

Objective To observe the effect of carvedilol on the expression of Cx43 in rabbits with myocardial infarction and its association with ventricular arrhythmia.Method Thirty-six rabbits were randomly divided into three groups in equal number(n=12),namely,myocardial infarction(MI)group,carvedilol group and sham MI group.Rabbits of carvedilol group were administered with carvedilol 5 mg kg~(-1)?d~(-1)after MI induced,while no carvedilol was administered to the MI group.The following observations were made:(1)Cx43 density of the epicardial border zone measured by quantitative immnuoconfocal laser scanning,and(2)cx43 protein expression analyzed by western blot.Results(1)Under immunoconfocal laser microscope,the relative density of Cx43 was(0.16?0.06)% in the infarction group and was(0.32?0.11)% in the sham MI group [(0.68?0.15)%,both P

OBJECTIVETo investigate the association between pulmonary vascular remodeling and expression of hypoxia-inducible factor-1α (HIF-1α), endothelin-1 (ET-1) and inducible nitric oxide synthase (iNOS) in pulmonary vessels in neonatal rats with hypoxic pulmonary hypertension (HPH).

METHODSA neonatal rat model of HPH was established as an HPH group, and normal neonatal rats were enrolled as a control group. The mean pulmonary arterial pressure (mPAP) was measured. The percentage of medial thickness to outer diameter of the small pulmonary arteries (MT%) and the percentage of medial cross-section area to total cross-section area of the pulmonary small arteries (MA%) were measured as the indicators for pulmonary vascular remodeling. The immunohistochemical reaction intensities for HIF-1α, ET-1 and iNOS and their mRNA expression in lung tissues of neonatal rats were measured. Correlation analysis was performed to determine the relationship between pulmonary vascular remodeling and mRNA expression of HIF-1α, ET-1 and iNOS.

RESULTSThe mPAP of the HPH group kept increasing on days 3, 5, 7, 10, 14, and 21 of hypoxia, with a significant difference compared with the control group (P<0.05). The HPH group had significantly higher MT% and MA% than the control group from day 7 of hypoxia (P<0.05). HIF-1α protein expression increased significantly on days 3, 5, 7 and 10 days of hypoxia, and HIF-1α mRNA expression increased significantly on days 3, 5 and 7 days of hypoxia in the HPH group compared with the control group (P<0.05). ET-1 protein expression increased significantly on days 3, 5 and 7 days of hypoxia and ET-1 mRNA expression increased significantly on day 3 of hypoxia in the HPH group compared with the control group (P<0.05). Both iNOS protein and mRNA expression were significantly higher on days 3, 5 and 7 days of hypoxia than the control group (P<0.05). Both MT% and MA% were positively correlated with HIF-1α mRNA expression (r=0.835 and 0.850 respectively; P<0.05).

CONCLUSIONSPulmonary vascular remodeling is developed on day 7 of hypoxia in neonatal rats. HIF-1α, ET-1 and iNOS are all involved in the occurrence and development of HPH in neonatal rats.

Animals ; Animals, Newborn ; Endothelin-1 ; analysis ; physiology ; Hypertension, Pulmonary ; etiology ; metabolism ; pathology ; Hypoxia ; complications ; Hypoxia-Inducible Factor 1, alpha Subunit ; analysis ; physiology ; Immunohistochemistry ; Nitric Oxide Synthase Type II ; analysis ; physiology ; Pulmonary Artery ; chemistry ; pathology ; Rats ; Rats, Wistar

Objective To investigate the bladder function in primipara and bipara within 1 week after delivery using urodynamic study.Methods Investigations on urodynamic changes were performed in 36 primipara volunteers and 12 bipara volunteers according to the recommendations of the International Continence Society(ICS).Fourteen women with upper urinary tract diseases but having normal lower urinary tract function,who had not experienced parturation were included as controls.Results Functional bladder volume(FBV)of primipara and bipara after delivery and normal desire cytometric capacity (NDCC)were respectively lower than those of control group(437?193)ml and(338?120)ml,however FBV and NDCC between primipara and bipara(310?154),(215?90)ml vs(243?141),(225?115) ml were not significantly different.The static Pure.max and Pure.clos.max of primipara and bipara were respectively higher than those of control group(87?7)cm H_2O(1 cm H_2O=0.098 kPa)and(78?8) cm H_2O(P

Objective To establish a rapid assay with high sensitivity and specificity based on the sequences for group specific gene (GS) and pathogenicity island pag A gene.Methods The PCR primers and probes were designed after the whole sequence was systemically analyzed with bio-informafion tools and blasted with Genebank database.The amplicons were inserted into plasmids so that they could be used as the standard templates to evaluate the sensitivity of the diagnostic system.This assay was based on TaqMan probes and portable Smartcycle PCR machine.Results The detection level was approximately 100 copies per reaction.There was no cross-reaction with other species of Bacillus.This assay could be completed in one hour in laboratory.Conclusion The duplex TaqMan PCR assay could be used to detect Bacillus anthracis rapidly with high sensitivity and specificity.

Objective To report the surgical method and treatment outecome of transfer of free upper limb lateral bone-skin flap for repair of bone defects and nonunion in hand and forearm.Methods 17 cases of hand composite trauma,5 cases of forearm composite trauma and 2 cases of nonunion in forearm were treated with free bone-skin flaps in distal humerus,whose pedicle was the posterior branch of radical collateral artery. Area of the flap was 2cm?3cm to 8cm?10cm,length of exseeted bone was 3～6 cm.Results All the bone-skin flaps completely survived,the donor area all achieved primary healing,On postoperative 1～4 years follow-up,the texture of the flap was excellent,and bone union was obtained in all transplants,the donor area of distal lateral humerus became thicker and thicker with new cortical bones formed.According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association.The hand function had excellent results in 17 cases and good results in 2 cases.Conclusion The bone-skin flap has following advantages:easy dissection,reliable blood supply,and no major vessel needed to be sacrificed,so it is an effective method for repair of skin and soft tissue with bone defects in hand and forearm,It.also can be used to repair refractory nonunion in ulna and radius.

Objective To evaluate the value of ~(125)I permanent plantation in treating osseous metastases.Methods Twenty-two patients with osseous metastases were accepted radioactive seeds ~(125)I permanent plantation.The curative effect was appraised according to the degree of ostalgia relieving and the changing of the radiology imaging in patients.Results Accepted radioactive seeds ~(125)I permanent plantation,relief of pain was obtained and the effective rate is 91%(20/22).However none of the patients showed severe side-effect.Among 32 lesions in 22 cases followed-up by CT in 2 months,4 obtained CR, 18 obtained PR,10 NC and 0 PD.The responsive rate was 68.7%.Conclusion ~(125)I permanent plantation procedure can be a safe and effective method in treating osseous metastases and obtaining good clinical effects with minimal damage and few comnlications.

BACKGROUNDThe aim of this study was to clarify the electrocardiographic characteristics of repetitive monomorphic ventricular tachycardia (RMVT) originating from the left ventricular outflow tract, and to describe the results of treatment with radiofrequency catheter ablation (RFCA).

METHODSRoutine 12-lead surface electrocardiography and electrophysiological studies were performed on 11 RMVT patients with no organic heart disease, who were subsequently treated with RFCA directed at targets identified by pace mapping.

RESULTSThe surface electrocardiogram QRS characteristics of RMVT included an atypical left bundle branch block and right axis deviation, with a low amplitude "rs" or "rS" pattern in lead I, an "rS" or "RS" pattern in V1, and a precordial R wave transition zone in V2 or V3. In 1 patient, a small S wave was observed in V5. Using pace mapping techniques, we selected the left coronary cusp as the ablation target. RMVT was eliminated in all 11 patients immediately after radiofrequency energy delivered. During a follow-up of 13 +/- 7 months, RMVT recurred in only 1 patient.

CONCLUSIONRMVT originating from the left ventricular outflow tract has specific electrocardiographic characteristics, and can be successfully and safely cured using RFCA directed at the left coronary cusp.

Adolescent ; Adult ; Catheter Ablation ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular ; physiopathology ; surgery ; Treatment Outcome