Objective To investigate the effect of continuous positive airway pressure(CPAP) on nocturnal polyuria in patients with obstructive sleep apnea syndrome(OSAS). Methods The number of nocturia, the nocturia output, the osmotic pressure of nocturia and the nocturia excretion of Na＋ . Plasma levels of atrial natriuretic peptide (ANP) in night were measured in 8 patients. After treatment with CPAP, the patients were recorded or measured by those index again. Results The number of nocturia ， The nocturia output， The osmotic pressure of Na＋ ,and the plasma leels of NAP in night decreased significantly after tretment with CPAP.The osmotic pressure of nocturia rose significantly.The reduction of ANP corrected with the reduciton of the nocturia output,addition of the osmotic pressure of nocturia and the reduction of the nocturia exeretion of Na＋ .Conclusion CPAP can reduce the number of nocturia, the nocturia output and the nocturia excretion of Na＋ , increase the osmotic pressure of nocturia. The changes probably relate with the reduction of plasma level of ANP.

Objective　To study the effects of deliberated hypotension combined with acute simple hemodilution on blood loss,postoperative hemoglubin of the patients undergoing spinal side(back) protrude correction(SSP).Methods　Twenty four ASA grade Ⅰ to Ⅱ patients undergoing elective SSP were randomly divided into two groups:control group(n＝12) and hypotensive group(n＝12).The all patients received with general anesthesia.In the hypotensive group:acute simple hemodilution was accomplished with infusion of lactated Ringer's solution and Gelofusine of as three times as blood loss.Deliberated hypotensin was induced and maintained with 0.01% sodium nitroprusside 2～6μg/kg/min iv.Intraoperative blood loss,blood transfused volume during operation and postoperative hemoglobin were recorded and compared between both groups.Results　 Blood loss was about 51% lower in the deliberated hypotensive group than that in the control group at the end operation.The average volume of transfused blood during operation was(1200±140)ml in control group,blood transfusion was(400±128)ml in the hypotensive groups.Conclusion Deliberated hypotension combined with acute simple hemodilution can significantly decrease the intraoperative blood loss and the SSP operation can be better tolerated for the indicated patients.

Objective To study the effects of deliberated hypotension combined with acute simple hemodilution on blood loss,postoperative hemoglubin of the patients undergoing spinal side(back) protrude correction(SSP).Methods Twenty four ASA grade Ⅰ to Ⅱ patients undergoing elective SSP were randomly divided into two groups:control group(n=12) and hypotensive group(n=12).The all patients received with general anesthesia.In the hypotensive group:acute simple hemodilution was accomplished with infusion of lactated Ringer's solution and Gelofusine of as three times as blood loss.Deliberated hypotensin was induced and maintained with 0 01% sodium nitroprusside 2～6?g/kg/min iv.Intraoperative blood loss,blood transfused volume during operation and postoperative hemoglobin were recorded and compared between both groups.Results Blood loss was about 51% lower in the deliberated hypotensive group than that in the control group at the end operation.The average volume of transfused blood during operation was(1200?140)ml in control group,blood transfusion was(400?128)ml in the hypotensive groups.Conclusion Deliberated hypotension combined with acute simple hemodilution can significantly decrease the intraoperative blood loss and the SSP operation can be better tolerated for the indicated patients.

Objective To investigate the mechanism of resistance of clinical isolates of Pseudomonas aeruginosa to carbapenems.Methods Fifty-eight strains of imipenem-and meropenem-resistant Pseudomonas aeruginosa were isolated.Modified K-B technique was adopted in the susceptibility test by adding ?-lactamases inhibitors and efflux pumps inhibitors to M-H agar plates.The refined three-dimensional extract test was used to detect ?-lactamases.The genes of metallo-enzyme IMP,VIM,as well as outer membrane porin D2(OprD2) were analyzed with polymerase chain reaction.Results Among the 58 strains of carbapenems-resistant Pseudomonas aeruginosa,53 produced over-expressed active efflux and continuously produced large amont of AmpC enzyme,15 of which were accompanied by the loss of OprD2,and 1 of which were accompanied by extended spectrum ?-lactamases(ESBLs).Among the 5 strains which neither produced over-expressed active efflux nor ?-lactamases,only 1 was found with OprD2 gene deletion.Metallo-enzyme was not detected in any of the 58 strains.Conclusion The mechanism of resistance of Pseudomonas aeruginosa to carbapenems was mainly the production of the over-expressed active efflux combined with the continuous production of large amount of AmpC enzyme.Sixteen of the strains were accompanied by the loss of OprD2 gene.

Objective: To study the correation between carotid artery atherosclerosis and coronary heart disease (CHD). Methods: Color Doppler flow imaging was employed to evaluate carotid artery atherosclerosis in 90 patients with CHD, carotid artery ultrasonography and coronary angiography were performed simultaneously in 20 cases. Results: The thickness of internus-middle membrane and the index number of atheroma both increased remarkably in all cases, and the group with MI had obvious abnomal parameter of blood stream in internal carotid artery. The conformed rate of coronary angiography with ultrasonography in carotid is 75 % in 20 cases,and the moreserious the pathological change of coronary is, the higher the happening rate of carotid artery atherosclerosis is. Conclusion: The degrees of carotid artery atherosclerosis can reflect the degree of pathological changes of coronary indirectly.

Objective To observe the effect of electromyographic biofeedback therapy and kinesitherapy on patients with radial nerve injury.Methods 82 patients with radial nerve injury were divided into control group (n=41) and treatment group (n=41). The control group was treated with medcine and acupuncture, while the treatment group received electromyographic biofeedback therapy and kinesitherapy in addition. The radial nerve function was assessed and analyzed by electromyogram (EMG) and motor conduction velocity (MCV) before and after treatment. Results After 12 weeks of treatment, limb motor function, EMG and MCV were better in the treatment group than in the control group (P<0.05). Conclusion Electromyographic biofeedback therapy and kinesitherapy can effectively improve the limb motor function of patients with radial nerve injury

OBJECTIVETo study the results of arthroscopic partial meniscectomy for medial meniscal tear in late middle-aged adults.

METHODSFrom October 2010 to October 2012,49 patients meeting inclusion criteria were treated with arthroscopic partial meniscectomy for medial meniscal tear. There were 31 males and 18 females,with an average age of (55.3±2.8) years old. There were 22 left knees and 27 right knees. The average flexion angle was (116.01±12.03)°. The pre-operative HSS Knee Score was 48.73±8.43, and the Lysholm score was 63.95±5.45. The patients were followed up and evaluated. All the patients received a standard surgery, in which the torn tissue was removed, and the anterior part of the meniscus was left in situ.

RESULTSAll the surgeries were successful with no serious complications. All the patients were followed up,and the duration ranged from 12 to 36 months. All the patients had 5 degrees of muscle strength. The average flexion angle was (136.77±18.56)°. There was significant difference between the two angles before operation and after operation. The pre-operative HSS Knee Score was 90.17±4.10, and the Lysholm score was 87.84±5.16. Statistically, the difference between preoperative score and the postoperative score was significant.

CONCLUSIONArthroscopic partial meniscectomy is a good option for medial meniscal tear in late middle-aged adults. Operative indication is crucial and the excellent surgical technique is also critical for the good clinical outcome. All the patients could get good clinical results, although there are some patients with motion restrictions in the early stage after operation.

Arthroscopy ; methods ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Menisci, Tibial ; physiopathology ; surgery ; Middle Aged ; Tibial Meniscus Injuries

Objective:To evaluate the efficacy and safety of continuous intrathecal morphine infusion system for patients with refracto-ry cancer pain. Methods:Seventeen patients with refractory cancer pain were implanted with intrathecal catheters and connected with a continuous external electronic patient-controlled analgesia (PCA) pump for intrathecal morphine analgesia. Visual analogue scales (VAS) score, the dose of routine opioids, and the score for quality of life before and after intrathecal analgesia were recorded. Adverse reactions were observed. Results:After the application of continuous intrathecal morphine analgesia, the VAS score of pain was 2.9±1.8, which is lower than 7.2±2.5 before intrathecal analgesia (P<0.001). Moreover, the dose of routine opioids (i.e., equianal-gesic dose of morphine) was 42.1 ± 7.5 mg/day, which is significantly lower than 282.9 ± 95.5 mg/day before intrathecal analgesia (P=0.004). The scores of general activity, mood, and sleep after intrathecal analgesia were significantly lower than those before intrathe-cal analgesia (P<0.05). However, the analgesic satisfaction of patients considerably increased after intrathecal analgesia (P<0.001). Ad-verse reactions included withdrawal syndrome, headache, urinary retention, and intrathecal infection. Conclusion:The continuous in-trathecal morphine infusion with PCA is effective and safe on analgesic treatment for patients with refractory cancer pain.

Objective To evaluate disinfectant efficacy of air disinfector and ultraviolet lamp.Methods Domestic literatures were searched by computer,RevMan 5 .3 software provided by the Cochrane collaboration was used for quantitative analysis,efficacy of two kinds of air disinfection methods was compared. Results A total of 1 1 articles met the inclusion criteria. Because the heterogeneity of literatures,random effects model analysis was adopted, colony forming unit (CFU)before disinfection(WMD= -26.28,95% CI:[-60.31,7.75],P>0.05 )and immediately-after disinfection(WMD= 22.45,95% CI:[-34.24,79.13],P>0.05)had no obvious difference between two methods respectively,but CFU of air disinfector 2 hours after disinfection was significantly less than ultraviolet lamp group(WMD= -345.11,95% CI:[-478.28,-211.94],P<0.05).Conclusion Air disinfector has good continuous disinfection efficacy.

OBJECTIVE： To analysis the adverse reactions of angiotension converting enzyme inhibitor（ ACEI） ， so as to deepen the understanding to the ARDs and improve the therapeutic effect of ACEI METHODS： The therapeutic effects and ARDs of ACEI were retrospectively reviewed and the incidence of ARDs induced by ACEI and the relationship between different ACEIs and their ARDs were analyzed RESULTS： （ 1） The incidence of ARDs of ACEI was 12％  Stimulating cough， parageusia， gastrointestinal tract discomfort， skin rash， itch of skin， hypotension， headache， dizziness， proteinuria and angioedema were the common symptoms （ 2） Of five kinds of ACEIs， captopril induced the highest incidence of ARDs and stimulating cough， parageusia， gastrointestinal tract discomfort， skin rash and itch of skin were the most common manifestations CONCLUSION： Stimulating cough， parageusia， gastrointestinal tract discomfort and skin rash are the most common symptoms of ARDs， and the symptoms will disappear when drug administration is discontinued