Objective To explore the value of angiographic diagnosis and interventional therapy of severe gastrointestinal bleeding.Methods 33 patients in a critically ill state(1000ml of bleeding greater than alimentary canal),who could not or were not willing to go fibre gastroscope/intestines ytterbium checks,were diagnosed by selectivie or surpass-selectivie stomach-bowel angiography,and embolismed or poured into by the surpass-selection artery art after the bleeding artery definiting at the same time.Results The selective stomach-bowel artery radiography group identified 27 patients site of bleeding,the masculine rate was 82%.The surpass-selectivie stomach-bowel artery radiography group identified 31 patients site of bleeding,the masculine rate was 94%.2 patients had no abnormality,26 patients were cured by the embolism,7 patients were treated successfully by pouring into the pharmaceuticals.Among them 8 patients were bleeding again,4 patients were cured through the surgical operation without complication.Conclusions DSA surpass-selectivie stomach-bowel artery radiography can define the site of severe gastrointestinal bleeding and raise the hemorrhage kitchen range recall rate,the embolism can successfully control the bleeding.Throughout the pouring into the pharmaceuticals,those who can't be treated by embolism can save time for the surgical operation,make part of patient cure further gaining time for the surgical operation.

0.05). CONCLUSION: NPY could downregulate the expression of LDL-R in hVSMCs and the downregulation was blocked by benextramine.

Based on traditional Chinese medicine theory and clinical experience, traditional Chinese herbal drug toxicity has its own special connotation. From the perspective of history and logic, the different comprehension of toxicity between Western medicine and traditional Chinese medicine was discussed after retracing the meaning of "drug toxicity" in traditional Chinese medicine. The authors suggest that it's not feasible to study the Chinese medicine coping mechanically and applying indiscriminately the concept and the research idea about modern drug toxicity since there is different understanding of "drug toxicity" between traditional Chinese medicine and Western medicine. Many control elements are involved in the use of traditional Chinese herbal drugs, and Chinese drug components and actions are complex as compared with Western drugs. More and more drugs with toxicity will be found due to the relativity of drug toxicity. Currently, the study of Chinese drug toxicity should pay more attention to the relation between the toxicity and Chinese drug nature, compatibility and the corresponding disease or syndrome pattern after making definition of Chinese drug toxicity and its connotation.

?AlM:To compare the effect of iris location guided sub-bowman keratomileusis ( SBK ) and iris location guided thin - flap laser in situ keratomileusis ( LASlK ) for extremely high myopia treatment.
?METHODS:lris location guided SBK was performed in 64 eyes of 32 patients with extremely high myopia and 42 eyes of 84 patients were received iris location guided thin-flap LASlK. All the patients’ spherical refraction was-9. 00D ~ - 11. 00D and the age was 22 ~ 35 years. Uncorrected visual acuity ( UCVA) , refraction, split-lamp examination, topography examination, central corneal stroma thickness, thickness of central corneal flap, thickness of peripheral corneal flap and complication was examined in these patients and follow-up was 6mo.
?RESULTS:At 6mo after surgery, 93. 8% of the patients received iris location guided SBK and 92. 9% received iris location guided thin-flap LASlK achieved a UCVA better than 20/20. There was no significant difference between two groups. Refraction between ±0. 5D was 89. 1% of SBK group and 84. 5% of LASlK group. There was no significant difference. Corneal rear surface height of SBK was 0. 046±0. 012μm and LASlK was 0. 056±0. 015μm. Thickness of corneal stroma after surgery was 328. 6±14. 7μm in SBK group, while it was 301. 2±21. 6μm in LASlK group and there was significant difference ( t =3. 127, P=0. 001). BUT was 11. 38±4. 02s and 17. 81±4. 89s in SBK and LASlK group respectively, with no statistical difference. There was no serious complication in two groups.?CONCLUTlON:Both iris location guided SBK and thin-flap LASlK are effective for extremely high myopia, but SBK is safer and more predictive than thin-flap LASlK.

Objective To investigate the present situation of nursing professional environments in our hospital and provide theoretical basis for mapping out relevant countermeasures. Method A questionnaire survey was conducted among 338 nurses in our hospital by using the general information questionnaire and practice environment scale (PES). Result The dimensions of PES by their average scores in descending sequence included leadership and ability of nurse administers, doctor-nurse cooperation, foundation for high quality care nurses′participation in hospital affairs, and sufficient manpower and resources. Conclusion In order to provide good and healthy work environment for nurses, nursing administrators should provide enough nursing manpower resoures and apply excitation mechanism in their hospital.

China ; Occupational Health Services

BACKGROUND: It is of great importance to study the genotype distribution of hereditary ataxia in understanding its epidemiologic rule and pathogenetic pathway.OBJECTIVE: To analyze the distribution of different genotype of hereditary ataxia in south China.DESIGN: A case-control observation.SETTING: Department of Neurology, the First Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Forty-three patients (26 males and 17 females) with hereditary ataxia from 36 families and 38 patients with sporadic hereditary ataxia (24 males and 14 females) were selected from the Outpatient Clinic of Neurogenetics, Department of Neurology, the First Affiliated Hospital of Sun Yat-sen University between September 1998 and September 2002. At the same time, 60 healthy individuals from the patients' families and 44randomly-selected healthy physical examinees were taken as controls. All the participants were enrolled voluntarily.METHODS: The fragments of trinucleotide repeats at different sites of mutant genes were amplified with polymerase chain reaction (PCR), and then the lengths were calculated with polyacrylamide gel electrophoresis and imaging analytical software. The repeated numbers of trinucleotide repeats in all the normal and abnormal amplified alleles were calculated respectively.MAIN OUTCOME MEASURES: Different genotype distribution in patients with hereditary ataxia.RESULTS: All the subjects were involved in the analysis of results. Of the detected patients with hereditary ataxia, the Machado-Joseph disease/spinocerebellar ataxia (SCA) 3 was the most common type of autosomal dominant SCA in South China, which was 42.0%, and was followed by SCA2 (7.4%), SCA1 (4.9%), SCA7 (3.7%), SCA6 (2.5%), SCA12 (1.2%).No patient was detected to have SCA8 SCA 10, SCA 17 dentatorubropallidoluysian atrophy (DRPLA) and Friedreich ataxia (FRDA).CONCLUSION: Autosomal dominant SCA3 is the most familiar genotype in South China. Clinical detection of hereditary ataxia should be done firstly aiming at the SCA3 genotype.

Objective:The study was aimed to inverstigate the effects of different levels of pressure and dura-tion of carbon dioxide and saline in the neck of rabbits on metabolic, hemodynamic, serum sodium concentrations and hematocrit changes. Method:Twenty-one New Zealand rabbits were randomly divided into 7 groups according to the following pressure of CO_2 or saline:0 kPa, 0. 67 kPa CO_2, 1.33 kPa CO_2,2.00 kPa CO_2 , 0.67 kPa saline, 1.33 kPa saline, and 2.00 kPa saline. In order to make a space for the endoscopic thyroidectomy, we filled the neck of rabbits with carbon dioxide and saline . Arterial partial pressure of CO_2(PaCO_2), pH, heart rate (HR), mean arterial pressure (MAP) , central venous pressure (CVP), serum sodium concentration and hematocrit were measured at baseline, 45 min and 90 min after filling with gas or saline and 30 tnin post-filling. Result:Insufflation of CO_2 at 0.67 kPa did not have any significant effect on the parameters. PaCO_2 increased significantly 45 min and 90 min after insufflation of 1.33 kPa CO_2(P<0.01). Marked changes in PaCO_2, pH and CVP occurred 45 min and 90 min after insufflation of 2.00 kPa CO_2 (P<0.01), and the parameters did not return to baseline in 30min after desufflation(P<0.05). In animals receiving saline irrigation no significant changes occurred in PaCO_2, pH and serum sodium concentrations at any time point. There was a tendency of decrease in HCT, but no statistically significant changes were found (P>0.05). CVP increased significantly 90min after saline irrigation at 1.33 kPa(P <0.05). A significant increase in CVP occurred 45 min and 90 min after saline irrigation at 2.00 kPa(P<0.05). No significant changes in HR and MAP occurred in all animals. Conclusion: Filling with saline which does not cause hypercapnia, acidosis or dilutional hyponatremia can be used in endoscopic neck surgery to create and maintain a working space.

Objective To evaluate the effect of dexmedetomidine on liver injury in the rats with ob?structive jaundice. Methods Forty?five healthy male Sprague Dawley rats, weighing 250-300 g, aged 8-9 weeks, were divided into 3 groups ( n=15 each) using a random number table: sham operation group ( S group) , obstructive jaundice group ( OJ group) and dexmedetomidine group ( D group) . Obstructive jaun?dice was induced in rats by division and double ligation of the common bile duct in OJ and D groups. Dexmedetomidine 100 μg∕kg was injected intraperitoneally at 72 h after establishment of the model in group D. At 3, 5 and 24 h after administration, blood samples were collected from hearts for determination of the plasma alanine aminotransferase (ALT) and C?reactive protein (CRP) levels. After blood sampling at each time point, the specimens from the external right lobe of the liver were obtained for detection of the expres?sion of Toll?like receptor 4 ( TLR4) mRNA ( by real?time polymerase chain reaction) and TLR4 content ( by enzyme?linked immunosorbent assay) in liver tissues and for pathological examination of liver tissues ( with light microscope) . Results Compared with group S, the plasma ALT and CRP levels were significantly increased at each time point after administration, and the expression of TLR4 mRNA in liver tissues was significantly up?regulated, and TLR4 content in liver tissues was significantly increased in OJ and D groups ( P<0?05) . Compared with group OJ, the plasma ALT and CRP levels were significantly decreased at each time point after administration, and the expression of TLR4 mRNA in liver tissues was significantly down?regulated, and TLR4 content in liver tissues was significantly decreased in group D ( P<0?05) . The degree of damage to liver tissues was significantly attenuated in group D compared with group OJ, and was aggrava?ted in group D compared with group S. Conclusion Dexmedetomidine can reduce liver injury in the rats with obstructive jaundice.

ObjectiveTo observe the expression of 67 - KD laminin receptor (67 - KD LN -R) in human laryngeal squamous carcinoma cells and to analyse the correlation between its expressionand clinicopathological characters. MethodsWe examined the expression of 67 - KD LN - R in 30primary laryngeal squamous carcinomas and in 3 cervical metastatic lymph nodes by the immunohistoche-mical SP method on paraffin- embedded sections. ResultsThe positive rate of 67 - KD LN - R inthe primary site of laryngeal squamous carcinomas was 56.7 % (17/30). The immunoreactivity in 3 cer-vical metastatic lymph nodes was consistent with that in primary tumors. There was a significant corre-lation between the level of 67 - KD LN - R and the degree of tumor differentiation, the level being high-er in poorly differentiated tumors ( P<0.05). The level of 67 - KD LN - R in laryngeal squamous car-cinomas with cervical lymph node metastases was higher than that in those without cervical lymph nodemetastases ( P <0.05).Conclusion67 - KD LN - R plays an important role in the differentiation,proliferation, invasiveness and metastasis of laryngeal squamous carcinoma.