Objective To compare of sevoflurane and propofol on cerebral oxygen metabolism and postoperative cognitive function during anesthesia maintenance.MethodsSeventy emergency trauma patients admitted to Zhoushan Hospital from August 2014 to August 2015, whom were randomLy divided into two groups (n=35 each): The control group anesthesia maintained by propofol;while the observation group were maintained with sevoflurane anesthesia.The changes of cerebral oxygen metabolism were compared between the two groups at different time points during anesthesia maintenance, and the Mini-Mental State Examination(MMSE) score, Trail-Making Test(TMT)completion time and the incidence of adverse reactions after recovery were also compared.ResultsThe SjvO2 values of each group were much higher in 2 min after induction (T2), 2 min after tracheal extubation (T3) than those before anesthesia (T1), while the Da-jvO2 and COER values were significantly decreased in T2 and T3 than those in T1, and the differences were statistically significant (P<0.05).These values were wihtout significant difference between the two groups in each period.The TMT completion time of the control group was prolonged than before induction, while the MMSE score was decreased than before induction, and the differences were statistically significant (P<0.05).There was no significant difference in TMT completion time and MMSE score in the observation group before and after induction.The incidence of adverse reactions between the two groups was not statistically significant.The eye opening time, orientation recovery time and anal exhaust time of control group were much later than those in observation group, and the differences were statistically significant (P<0.05).ConclusionSevoflurane and propofol can meet the need of maintaining the cerebral oxygen balance during anesthesia maintenance, but sevoflurane anesthesia has fewer influences in post-operation cognitive function.

Objective To study the application of census method in estimating the size of population of commercial sex workers(CSW),and estimatie the size of population in CSW in a city.Methods Drawing the map of the place which applied sex service,collect the number of CSW which the manager of place report.Sample 20% place of total,check the amount of all CSW,then adjust the sum of managers reported according the number of investigator checked and the number of manager reported to estimating the size of population in CSW in the city.Results The result of census in estimating the CSW in the city was 18 702.Conclusions It is simple and direct to estimate the size of population in CSW by applying the census method.The result is reliable,but the method need the investigators know very well the palce applied sex service in the area.

Objective To study the application of Capture-Recapture method in estimating the size of population of injecting drug users (IDUs), and estimate the size of population in IDUs in a city using the data of detoxification center. Methods Capture-Recapture method was applied to estimating the size of population in IDUs in the city based on the data of detoxification center. Results The result of Capture-Recapture in estimating the IDUs in the city was 13 017. Conclusions It is economic and feasible to estimate the size of population in IDUs by applying the Capture-Recapture method. The result is reliable and the method is suitable in districts where health resources are limited.

Objective To improve the reliability and accuracy of WBC counting in cerebrospinal fluid (CSF) ,this article is stud-ying the improved method of WBC counting in CSF by finding out the optimum percentage of CSF specimen with the most suitable concentration of acetic acid .Methods CSF specimen was mixed with different acetic acid at different ratio respectively .WBC counts were performed in 5 minutes on diluted samples of various concentrations .A series of 20 CSF specimens were analyzed via the proposed assay and conventional method .The average value and coefficient of variation (CV) of WBC count of each sample were c compared and analyzed .Results The optimum percentage of CSF sample was obtained at 60∶40 ratio .In this percentage , the maximal WBC count (189/μL) was obtained compared that of conventional method (161/μL) .Moreover ,the CV of the WBC counts in this percentage (7% ) was also lower than that of the conventional method (18% ) .Conclusion The reliability and accur-ancy of WBC counting in CSF was the optimum percentage of CSF specimen and 5% acetic acid was 60 :40 .It may lead to a more reliable ,accurate and standard way of WBC counts in CSF .

ObjectiveTo determine the potential natural foci of new bunyavirus,and isolate and identify the new bunyavirus strain in sera from suspected new bunyavirus-infected patients.MethodsImmunofluorescence assay was used to detect the antigens of new bunyavirus in different tissue specimens of wild rodent animals in Tiantai area of Zhejiang province.Fluorescence quantitative real-time RT-PCR was applied to detect the viral nucleic acid in sera of suspected new bunyavirus-infected patients and the amplification products were analyzed by sequencing.The new bunyavirus in the pateints'sera was isolated using Vero cells.Using nucleocapsid protein encoding gene of new bunyavirus as the target gene,the isolated suspected new bunyavirus strain was identified by RT-PCR and sequencing of the amplification product.Moreover,sequence identity of the amplification product of nucleocapsid protein encoding gene of new bunyavirus was analyzed and compared.ResultsOf the 70 wild rodent animals,5.71% were positive in the immunofluorescence assay.The fluorescence quantitative real-time RT-PCR confirmed that two of the four detected patients'serum specimens were positive.One suspected strain of new bunyavirus was isolated from one pf the two positive patients'serum specimens.The results of RT-PCR and sequencing confirmed that the viral strain exactly belongs to new bunyavirus with 92.2% sequence identity to that of the new bunyavirus isolates in Hubei province but distinct with the new bunyavirus isolates from other areas in China.ConclusionThe presence of natural foci of new bunyavirus and new bunyavirus-infected patients in Zhejiang province are firstly confirmed by this study.There is a geographical diversity of the distribution of new bunyavirus in different groups.

Alveolitis, Extrinsic Allergic ; diagnosis ; therapy ; Humans ; Occupational Diseases ; diagnosis ; therapy

Objective To study the subacute inhalation toxicity of Ivermectin TC, and obtain its non-observed adverse effect level(NOAEL).Methods It was performed on the doses of Ivermectin TC 190, 380, 750 mg/m3, the solvent control group (0.03%Tween-80 solution) , the control group and additional group ( there were 6 female and 6 male Sprague-Dawley rats for each group) .The animals inhaled with nose-only exposure for 4 weeks (4 h/d, 5 d/week) .The additional group should be observed another 14 days after exposing.At the end of experiment, the rats were killed, the routine and biochemical detection, the body weight and organ to body weight ratios were all measured.Results In the high exposure group, clinical signs of rats included hair fluffy, dull, salivation, tremors were recorded at the exposure period;in female rats, feed efficiency was decreased, ALT and liver to body weight ratio were increased; in male rats, BUN and ALT were increased, CHOL and body weight for the 4th week were decreased.Histopathological examinations revealed that swelling in the liver cell was seen in some female rats at high exposure group.Conclusion The results suggested that the NOAEL of Ivermectin TC in SD rats was 380 mg/m3(4 h/d for 28 days).

Objective To investigate the effect of intercostal nerve block combined with general anesthesia on hemodynamics in patients undergoing video-assisted thoracoscopic surgery. Method From January 2014 to January 2016, 100 patients were selected and divided into control group and experimental group according to the principle of complete random grouping. The patients in control group received general anesthesia with intravenous induction and static-occlusion, and the patients in experimental group received intercostal nerve block compound general anesthesia. The changes of visual analogue pain scores (VAS) and hemodynamics were evaluated in both groups. Changes in immune function before and after treatment were compared. Hemodynamic parameters include heart rate (HR), systolic blood pressure (SBP) and pulse oxygen saturation (SpO2). Immune function parameters include serum T cell subsets content. Results The VAS scores of the experimental group were significantly lower than those of the control group at different time points (P < 0.05). The systolic blood pressure and heart rate were significantly higher in the control group than those in the experimental group after the operation (P < 0.05). The CD4+, CD4+/CD8+levels in the test group were significantly higher than those in the control group (P < 0.05). Conclusion Intercostal nerve block composite anesthesia can better control the thoracoscopic patient's cardiovascular response and reduce the immune function inhibition. It is worthy of clinical promotion.

OBJECTIVE: To explore the role of hydrogen sulfide (H2S) in acute liver injury induced by crushing hind limbs of rats. METHODS: The rats were randomly divided into the following groups: control, crushing, H2S donor sodium hydrosulfide (NaHS) + crushing, H2S inhibitor propargylglycine (PAG) + crushing group. The acute liver injury model was established by 'crushing the hind limbs of rats with standard weight. Rats were sacrificed at 30 min and 120 min after the crush. The activities of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured by colorimetric method, and the content of H2S in plasma and the contents of malondialdehyde (MDA), protein carbonyl, glutathione (GSH) in the liver and the activity of H2S generating enzyme (cystathionine y-lyase, CSE) were determined by chemical method. The expression of CSE mRNA in liver was detected by RT-PCR. RESULTS: For crush injury group, the levels of AST and ALT in serum, MDA and protein carbonyl in liver increased. The levels of GSH, CSE, CSE mRNA in liver and H2S in serum decreased. The administration of NaHS before limbs crush could attenuate the changes of liver injury, but the pre-treatment with PAG could exacerbate the changes. CONCLUSION The decrease of H2S production could involve in mediating the acute liver injury induced by traumatic stress in rats.
Alanine Transaminase/blood* ; Alkynes/pharmacology* ; Animals ; Aspartate Aminotransferases/blood* ; Cystathionine gamma-Lyase/metabolism* ; Glutathione/metabolism* ; Glycine/pharmacology* ; Hydrogen Sulfide/pharmacology* ; Liver/injuries* ; Malondialdehyde/metabolism* ; Protein Carbonylation ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sulfides/pharmacology*

Objective To explore methods for performance appraisal of directors of municipal hospitals in Shanghai.Methods To assess the management performance of directors of 24 tertiary hospitals each year,measured by five dimensions of social satisfaction,management efficiency,capital operation,development sustainability and staff satisfaction,and 23 indexes.Results Implementation of the performance appraisal has witnessed constant improvement of patient satisfaction and quality of medical care,as well as rational control of medical expenses and cost.In 2014 for example,the cost of emergency/outpatients per visit at such hospitals were 312 yuan and 1 5 600 yuan per hospitalization respectively,with 7.6 days of stay in average.Also improved were service efficiency,clinical research output and hospital business performance in general.Conclusion Performance appraisal of directors of public hospitals proves an important means for guiding the hospitals to adhere to public welfare, consistent with the government medical institution operation target, and to strengthen internal management of such hospitals.