ObjectiveTo compare the clinical efficacy and safety of anesthesia induction between inhalation of sevoflurane and intravenous injection of propofol for laryngeal mask airway (LMA) insertion in elderly patients.Methods40,ASA physical grade Ⅰ ～ Ⅱ patients scheduled to receive elective total knee arthroplasty were allocated to 2 groups at random. Patients in group one( G1 ) received intravenous induction of propofol infusion by a targetcontrolled infusion system which was set at the effect-site concentration of 4.0μg/ml,while patients in group two(G2)received inhalational induction with sevoflurane using vital capacity manoeuver at the target of end-expiratory concentration of 3.0％. We observed the whole procedure of anesthesia induction and LMA insertion, while recording the changes in hemodynamic state and occurrence of adverse events. ResultsMore than 85％ patients achieved LMA insertion at first attempt using either induction manoeuver. Although consciousness loss time in G1 was 39. ls longer than G2, there was no difference in anesthesia induction time for LMA insertion between these two groups. Contrary to a significant decrease in MAP following induction for patients in G1, there appeared hemodynamically stable in patients of G2,while apnea also significantly seldom occurred in G2 as compared to G1 (20％ vs 85％ ,P ＜0. 05).ConclusionAs compared to intrvenous induction with propofol, inhalation induction with sevoflurane provided a valuable alternative for LMA insertion in adults.

During 131Ⅰ therapy or the natural course of DTC,2％ to 5％ of them will gradually no longer be sensitive to 131Ⅰ therapy and lead to radioactive iodine-refractory DTC (RAIR-DTC).Recent studies found that alterations of critical molecular targets in main signal transduction pathways could decrease the iodine-trapping function of thyroid carcinoma,such as BRAFV600E mutation,followed by negative 131 Ⅰ-whole body scan (WBS) and discounted efficacy.This article reviews novel diagnostic and therapeutic modalities for RAIR-DTC.

Objective To study the epidemiological characteristics of the acute toxicosis cases in a general hospital of a metropolis. Methods The prospective study was performed from Jan. 1st, 2005 to Dec. 31st, 2006 in acute toxicosis patients admitted during that period. The data analyzed included sex, age, occupation, onset time, poisoning cause, variety of poisons, way of poisoning, emergency diagnosis, emergency treatment, etc. Results There were 315 poisoning patients treated during the study period, accounting for 2.33‰ of the total patients visiting in the emergency department. Among these poisoning patients, the sex ratio (males vs females) was 1∶0.84. The age of most of the patients ranged from 20 to 29 (35.9%) years old. Alcohol was the major cause of poisoning (38.4%), followed in order by poisoning due to drugs (20.6%), food poisoning (18.1%), chemical poisoning (10.2%) and pesticide poisoning (5.7%). There was predominant time of the occurrence of poisoning in a year, but it was more frequent in January, February, June, July, November and December. 85.1% of patients were poisoned by oral route. The occupation of patients was mainly technical personnel (21.0%), followed in order by farmers and the laborers, self-employed businessmen, persons taking care of household chores and the unemployed, etc. 98.1% of patients survived in the hospital. Mortality rate was 1.9%. Conclusions Young persons and technical personnel constitute the high-risk group of patients with poisoning. The main poisons were alcohol, drugs, food and other chemical poisons. The main route of poison intake was the digestive tract. There is no obvious seasonal regularity.

Objective To evaluate the application effect of evidence-based care model in hemostasis by compression in patients after renal biopsy.Methods 80 patients undergoing renal biopey from December 2006 to December 2009 in our hospital were chosen as the research object.They were randomly divided into the control group and the observation group with 40 patients in each group.The control group was given routine nursing,and the observation group was treated with evidence-based care model for nusing.The re-bleeding rates,satisfaction degree and the SAS,SDS score,mastering degree of related knowledge,treatment compliance for the two groups before and after nursing were compared.Results The ineidence rate of bleeding in the observation group was higher than the control group,satisfaction degree was higher,and the SAS,SDS score,related knowledge,treatment compliance were all better than the control group,there were significant differences.Conclusions The effect of evidence-based care model in hemostasis by compression after renal biopsy is better.It can significantly reduce the incidence of adverse circumstances and improve the negative emotional state of patients.

Objective To set up the quality control standard for Leaf of Chinese Holly; To provide basis for the utilization and development of Leaf of Chinese Holly.Methods Ten batches of Leaf of Chinese Holly samples from different habitats were collected, and the properties were described. The crosscutting and powder of leaf was under microscopic identification. Chlorogenic acid was set as reference substance to conduct thin-layer identification. Moisture, total ash, and acid-insoluble ash of the 10 batches were detected. HPLC was used to detect chlorogenic acid in Leaf of Chinese Holly.Results The properties and microscopic identification were described. Thin-layer chromatography method for chlorogenic acid in Leaf of Chinese Holly was formulated. Check items temporarily required that the moisture in Leaf of Chinese Holly should be less than 13%, total ash less than 13%, and acid-insoluble ash less than 5%. Content determination method for chlorogenic acid in Leaf of Chinese Holly was confirmed. It temporarily required that the content of chlorogenic acid should be more than 0.60%.Conclusion The established method can be used for the formulation of quality control of Leaf of Chinese Holly.

Objective To investigate the apoptosis of renal tubule epithelium after cardiopulmonary resuscitation(CPR)in rats and its possible mechanism.Methods Cardiac arrest was induced by asphyxiation(succinylcholine)and ice-cold 0.5 mol/l KCL in rats,and resuscitation started at 5 minutes after arrest.Forty-eight male SD rats were randomly divided into 6 groups:sham(control group);after cardiopulmonary resuscitation rats were allowed to reperfuse spontaneously for 3 hours,6 hours,12 hours,24 hours and 48 hours(n=8,per group).The apoptosis of renal tubule epithelium was assessed by TUNEL.Fas and Bcl-2 protein expression were observed using immunocytochemistry in every group.Results The apoptosis of renal tubule epithelium was singnificantly increased at 3 hours after resuscitation and peaked at 24 hours(P

AIM: To study mitochondrial mass and structural protein changes in dexamethasone (DEX)-mediated mouse thymocyte apoptosis process. METHODS: DEX-induced mouse thymocyte apoptosis model was established. Annexin V-FITC/PI double staining was used to identify apoptotic and necrotic cells by flowcytometry, JC-1 staining was adopted to test mitochondrial membrane potential (△?_m), and cellular structural protein changes were studied with CFDA-SE staining. RESULTS: By 1?10~(-6) mol/L DEX stimulation, the apoptotic rate was 51.25%?5.51% and had significantly difference from control group (12.03%?2.00%); the necrotic rate in DEX group was 30.25%?3.67% and also had significantly difference from control group (10.11%?1.11%, P

Background Retinal hemorrhage in newborns is a common clinical finding,and serious retinal henorrhage resulting in poor prognosis.The factors affecting retinal henorrhage in newborns are unelucidated now.Identifying these factors is helpful for the early prevention and treatment.Objective This study was to explore the underlying maternal,obstetric,and neonatal clinical factors for degree of retinal hemorrhages in healthy full-term newborns.Methods A cross-sectional study was performed in the approval of Ethic Committee of Zhongshan City People's Hospital.A total of 1 311 full-term infants,with gestational age more than 37 weeks and Apgar ≥9 scores were included in this study.Infants with severe systemic diseases or any other eye diseases were excluded.Ocular fundus of the infants were examined with Ret Cam Ⅲ within 4 days of birth and were independently identified by 2 eye doctors.The newborns of retinal hemorrhage were divided into grade Ⅰ,Ⅱ and Ⅲ groups based on Egge criteria,and the infants without retinal hemarrhage served as the normal control group.Maternal,obstetric,neonatal parameters and general factors were analyzed and compared among different groups,and the risk factors that affected the newborns retinal hemorrhage were analyzed by logistic regression analysis.Results Retinal hemorrhage was seen in 28.30％ infants (371/1 311),and 152,116 and 103 infants were identified as grade Ⅰ,Ⅱ and Ⅲ,with the percentage of 11.59％,8.85％ and 7.86％,respectively.Among the factors that examined in the study,cord around fetal neck was the risk factor of aggravation of degree of retinal hemorrhage in newborns (OR =1.308,95％ CI:1.011-1.693,P =0.041).In the mode of delivery,spontaneous vaginal delivery appeared to be the positive factor of the incidence of retinal hemorrhage (OR=0.134,95％ CI:0.132-0.137,P＜0.001),but cesarean section was not a main risk factor.Conclusions Spontaneous vaginal delivery and cord around fetal neck are the potential risk factors for the aggravation of degree of retinal hemorrhage in full-term infants.Accordingly,infants with these risk factors should be paid more attention to prevent the progression of retinal hemorrhage.

We created the multi-media network-based teaching platform in emergency and critical care medicine teaching and unified the advantages of the network technique,multimedia technique and information commons,to build up a new place for all kinds of persons to learn the emergency and critical care medicine in any time or any places,and to build up a teaching re-source library of emergency and critical care medicine by the digital image processing technique, streaming media technique and database technique.

In combination with the experience teaching overseas students in Emergency and Critical Care Medicine,we probe into the overseas students' characteristics,the choose of teaching materials and teachers,and how to improve theoretical and practical Emergency and Critical Care Medicine teaching quality etc.