Object To study the chemical constituents in the ro ot of Isatis indigotica Fort Methods The s eparations were carried out by column chromatography and identified by advanced physical and spectral data analysis Results Five compounds were isolated and identified as neohesperidin (Ⅰ), ammonium formate (Ⅱ), isol iquiritigenin (Ⅲ), liquiritigenin (Ⅳ), and adenosine (Ⅴ) Conclusio n Neohesperidin, liquiritigenin and isoliquiritigenin are isolated f o r the first time from the plants of Cruciferae, ammonium formate is obtained fro m the root of I indigotica for the first time

ObjectiveTo explore clinical characteristics of fatality cases of hand foot and mouth disease caused by enterovirus 71 (EV71),and to improve the diagnosis and treatment of the disease.Methods Sixteen children infected with EV71 were retrospectively reviewed.Clinical manifestation,laboratory data and death causes were analyzed.ResultsAll cases were younger than four years,and the mean age was 18.9 months.Seasonal variations in incidence were observed,with a peak in incidence during the summer season.These cases typically presented with a brief duration of febrile illness,nonspecific neurological signs including headache,vomiting,limb tremor and convulsions.After two to four days,they all got sudden deterioration,manifested with tachycardia,poor peripheral perfusion,tachypnea and transient hypertension.After intubation,they all had pink frothy or blood from the endotracheal.Tweleve of them died from pulmonary edema or pulmonary hemorrhage,and acute refractory cardiac dysfunction.The other four of cases died from brain stem encephalitis.Atypical presentation such as absence of skin rash should alert the physician.Total white cell count,blood glucose and cardiac troponin I were raised significantly.The protein raised in cerebrospinal fluid.ConclusionHand foot and mouth disease caused by EV71 progresses rapidly.The primary site of attack is the central nervous system,particularly the brainstem,and the cause of death are neurogenic pulmonary edema and/or hemorrhage,acute refractory cardiac dysfunction.

Objective To study the relationship between clinical diagnosis and children ventricular premature beat(VPB) electrocardiogram location and morph.Methods Both organic heart disease and without organic heart disease relationship with 109 cases of children ventricular premature beat electrocardiogram location and morph were retrospectively analyzed.Results Children ventricular premature beat location shows that organic heart disease mostly results from left ventricle, without organic heart disease often comes from right ventricle. There was significant difference between above two groups (? 2=37.25 P

Objective To explore the risk factors for infection following percutaneous nephrolithotomy(PCNL), and provide the basis for prevention of postoperative infection.Methods 96 patients who were performed PCNL in a hospital between August 2010 and August 2013 were chosen,clinical data of patients were retrospectively analyzed, the occurrence of postoperative infection,risk factors and isolated pathogens were analyzed.Results 35 patients (36.46%[35/96])developed infection following PCNL.Univariate analysis revealed that risk factors for postopera-tive infection were the size and shape of stone,duration of operation,and intraoperative perfusion (all P <0.05). 96 patients before operation and 18 patients after operation were performed bacterial culture for urine,a total of 39 strains were isolated,the main isolated pathogens was Escherichia coli (n=12),followed by Pseudomonas aerugi-nosa (n=8),Streptococcus viridans (n =5 ),Klebsiella pneumoniae (n =4)and Enterobacter cloacae (n =3 ). Conclusion Infection rate following PCNL is high,duration of operation and intraoperative perfusion should be re-duced,antimicrobial agents should be used rationally.

Objective To analyze the effectiveness of doctor-patient communication course on improvement of doctor-patient communication ability.Methods Totally 360 eight-year program medical students of clinical medicine from Shanghai Jiaotong University School of Medicine were chosen as the research object and were divided into educational group(n＝l80) and control group(n＝180).Students in educational group study doctor-patient communication course while those in control group do not.SEGUE Framework was used to conduct exploratory research between educational group and control group.Accuracy of questionnaire database was examined by Excel software and logical test.KoImogorov-Smimov(K-S test) was applied to analyze the scores and (x ± s) was used to express the data through SPSS 16.0 statistical software.Comparison between group differences are statistically significant(P＜0.05).Results Overall score was higher in educational group than in control group.Concerning of communication initiation,infomation collection and understanding of patients,scores of educational group were significantly higher than those of control group(P=0.001,P=0.002 and P=0.007,respec-tively).Furthermnore,KoInogorov-Smimov(K-S test) and (x ± s) statistical results showed that scores of detailed items were higher in educational group than in control group as well.Conclusions Doctor-patient communication course is of great importance to help medical students practice physician-patient communication based on related knowledge learning,but course content setting remains to be further improved.

10.3969/j.issn.1007-3969.2013.04.009

Objective To investigate the postoperative epidural analgesia and adverse reactions in total abdominal hysterectomy with dezocine and ropivacaine.Methods Sixty elective transabdominal hysterectomy patients with American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ grade were randomly divided into two groups,dezocine group and morphine group,there were 30 cases in each group.Dezocine group:dezocine (6 mg) + 0.75％ ropivacaine hydrochloride(20 ml) + saline dilution,diluted to 100 ml.Morphine group:morphine(6 mg) + 0.75 ％ hydrochloride ropivacaine (20 ml) + saline dilution,diluted to 100 ml,for postoperative epidural analgesia.Both two groups were adopted in LCP mode with a loading dose:dezocine group,dezocine(2 mg) +saline dilution,diluted to 5 ml; morphine group,morphine (2 mg) + saline dilution,diluted to 5 ml.Continuous infusion of 2 ml/h,a bolus dose of 2 ml,and a lockout interval of 15 min.The analgesia duration was 48 h.Visual analogue scales (VAS) evaluation was employed to assess the analgesic effect,and the postoperative epidural analgesia adverse reaction were also recorded.Results The analgesic effect was both satisfied in the two groups.Comparing the VAS scores postoperative at different time point (4 h,8 h,12 h,24 h,36 h,48 h),dezocine group(2.7 ± 0.4,2.5 ± 0.6,2.2 ± 0.5,1.5 ± 0.5,1.3 ± 0.5,1.1 ± 0.3) were slightly lower than morphine group (2.8 ± 0.5,2.6 ± 0.7,2.3 ± 0.6,1.6 ± 0.7,1.5 ± 0.6,1.2 ± 0.4),but the difference was not significant (within the group:F =2414.96,P ＜ 0.01 ; between the group:F =0.63,P ＞ 0.05 ; interactive:F =2.42,P ＞0.05).Comparison of VAS scores at different time points after operation in two groups,the difference was not statistically significant; And within the group,there was not,the difference was not significant at the time point at 12,24,36,48 h compare to postoperative at 4 h (P ＜ 0.01).the Adverse reaction like nausea and vomiting,skin itching occur rate is lower in dezocine group (3.3 ％ (1/30),0 (0/30)) than that of in morphine group(26.7％ (8/30),20.0％ (6/30)),and there were signficant differences between the two groups (P =0.026,0.024,P ＜ 0.05).Conclusion Dezocine composed with ropivacaine is safe and effective,and with few adverse reactions in total abdominal hysterectomy postoperative epidural analgesia,it is worth of widely use in clinical.

Adult ; Female ; Humans ; Male ; Middle Aged ; Palatine Tonsil ; pathology ; Sleep Apnea, Obstructive ; pathology ; surgery ; Tongue ; pathology

Cytokinesis ; Micronucleus Tests

ObjectiveTo modify the technique of whole small bowel transplantation in rats to improve the survival.MethodsOne hundred and six SD rats served as donors and recipients to establish a homogeneous and orthotopic model of small bowel transplantation without fistula.Anastomosis of aorta and vein was done with three- cuff technique,the vena mesenterica superior of recipient was done under a surgical microscope.End-to-end anastomosis was performed between donor proximal small intestine and receptor jejunum,and also between the remote and receptor ascending colon.Surviving more than 3 days after surgery was defined as the operation was successful.ResultsThe operation was successfully carried out in 48 cases with the survival rate of 90.6％ (48/53).The average warm ischemic time was 0 minute,and the average cold ischemic time was(30 ±2.48)min.The survival rate( ＞7 d) was 97.9％ (47/48).ConclusionsOn the basis of three-cuff technique,the survival of SBT was greatly improved.When the vena mesenterica superior of recipient was done under a surgical microscope,the surgical training time was shortened.