Objective To discuss the effect of the application of anti-reflux venous indwelling needle after gastrointestinal polyps endoscopic resection.Methods 400 cases of patients after gastrointestinal polyps endoscopic resection were selected in our department.200 cases of patients using ordinary venous indwelling needle were set as the control group.In addition,200 cases of patients chose anti-reflux indwelling needles which were produced by a certain medical instrument Co.,Ltd were set as the experimental group.The incidence rate of phlebitis,tube blocking,blood return and indwelling time in the process of using anti-reflux indwelling needle were observed in two groups.Results During the indwelling time of two kinds of indwelling needles,the incidence rates of phlebitis,tube blocking and blood return of anti-reflux indwelling needle in the experimental group were significantly lower than those of the control group.The average indwelling time of the experimental group was 1.2 days,longer than that of the control group.Conclusions Anti-reflux indwelling needle can effectively protect the blood vessels,ensure the patients to use drugs in time,improve the work efficiency of nurses,reduce the damage to patients and effectively reduce the burden of patients.

OBJECTIVE:To compare the cost-effectiveness among four different antiemetic schemes for prevention vomiting induced by chemotherapy in patients with lung cancer.METHODS:120 patients receiving cisplatin chemotherapy were divided into 4 groups:Ondansetron(Group A),Tropisetron(Group B),Ramosetron(Group C),and Metoclopramide(Group D).The therapeutic effects were monitored and the cost-effectiveness analysis was performed on the four treatment schemes.RESULTS:The effective rates of the four groups were 87.3%,92.7%,90.7% and 61.3% respectively;the cost-effectiveness ratios were 684.77,906.37,222.33 and 45.02,respectively;and the incremental cost-effectiveness ratios of A,B and C group were 2 193.08,2 587.90 and 592.01 respectively as against Group D.CONCLUSION:Ramosetron is the most rational one among the 4 schemes.

Objective:In investigate the status quo of current physician-patient relationship.Method:A self-designed questionnaire is conducted among the medical staff and patients in 40 hospitals(20 grade 3 hospitals and 20 grade 2 hospitals) located in 10 cities of China.Result:9.3% of the total patient responders consider the current physician-patient relationship dissatisfying,with a counterpart ratio of 31.2% in responders of medical staff.Conclusion:Currently in China,main-stream of physician-patient relationship is harmonious,but it can not be denied that medical staff are suffering tremendous stress from the ever tenser physician-patient contradictions.

Objective To evaluate the possible factors that may influence the resting energy expenditure (REE) in patients with newly diagnosed esophageal cancer. Methods Totally, 40 patients with newly diagnosed esophageal cancer were prospectively collected from November 2008 to June 2009 in Xinhua Hospital. Nutritional risk screening 2002 (NRS 2002) was performed. REE and body composition were measured using indirect calorimetry and bioeletrical impedence method, respectively. Results Twenty-seven (67.5%) patients were found with nutrition risk, and NRS score was negatively correlated with prealbumin ( r = - 0.444, P = 0.004) and albumin levels (r = - 0.386, P = 0.014). Measured REE and predicted REE values were ( 6770 ± 1360) and (6021 ± 841 ) kJ/d, respectively (P ＜ 0.001 ). Among all 40 patients, 57.5% of them were hypermetabolic,30.0% were normal, and 12.5% were hypometabolic. Stepwise linear regression analysis showed that fat free mass was the only significant determinant variable for REE (P ＜ 0.001 ). Conclusion Fat free mass is a factor than can influence the energy metabolism in patients with newly diagnosed esophageal cancer.

Objective To gather observational data on resting energy expenditure(REE)of children with newly diagnosed malignant solid tumor, and to examine factors that might be relevant to their energy expenditure change. Methods It is a retrospective study. Data from sixty-one patients with newly diagnosed malignant tumor admitted to department of pediatric surgery in Xinhua Hospital were reviewed in this study. Resting energy expenditure was measured by indirect calorimetry. Patients with benign tumor admitted during the same period were used as the control group. Results The difference of percentage of patients with normal, decreased, or increased REE between benign and malignant groups was not significant(χ2 = 0.466, P = 0.792). Patients with one or more gastrointestinal symptoms had higher percent of Pre-REE compared with patients without any gastrointestinal symptoms, but no significant difference existed(119.8±80.4 vs 91.1±27.2, Z = 0.746, P = 0.456). Different tumor types were associated with different effects on REE. There was no significant difference in REE levels between patients with decreased diet intake and those without(Z = 0.528, P = 0.598). Conclusions It is confirmed that not all patients with malignant tumor have an increased REE. Moreover, the tumor site might be an independent factor affecting patients' REE level.

Cultivation of medical students' clinical practice is an important part of higher medical education.At present,the imbalance of teachers structure and the old and single teaching mode and method etc,have had a great impact on the clinical practice of medical students.Only by strengthening the construction of clinical teachers,establishing access and assessment system of clinical teachers,carring out diverse clinical education reform,such as Problem-Based Learning ( PBL )and Case-Based Learning ( CBL ),etc,and fully mobilizing the initiative of students and enthusiasm for learning to reach teaching and learning complement in virtuous circle.can we truly improve the quality of clinical practice.

Objective To investigate diagnosis and treatment of venous cerebral infarction.Methods The reasons, clinical findings, imaging characters, treatment methods and prognosis of 19 patients diagnosed venous cerebral infarction were analyzed.Results The most frequent symptoms were headache, focal deficits, epilepsy, increased CSF pressure.Among 19 cases, multiple cerebral lesions were found in 12 cases, lobes lesions in18 cases, cerebral infarction with hemorrhage in 3 cases. After various treatments, 16 patients were discharged and one patient died and 2 patients gave up treatment. Conclusions Venous cerebral infarction has complicated causes, non-specific chinical manifestations and characteristic MR images. Anticoagulation and thrombolysis treatment in early stage may have good therapeutic effect.

Objective: To optimize the extraction process of total flavonoids from Oxytropis falcata bunge.Methods: With the content of total flavonoids as the index,and based on the results of single factor tests, central composite design-response surface methodology was adopted to optimize the extraction technology with the solvent amount, ethanol concentration and extraction time as the factors.Results: The optimal extraction conditions were as follows: extracted twice with 20-fold amount of 66% ethanol, and 84 minute per time.Under the above conditions, the extraction rate of total flavonoids was up to 23.21 mg·g-1.Conclusion: The central composite design-response surface methodology is convenient and highly predictive for the extraction optimization of total flavonoids from oxytropis falcata bunge.

OBJECTIVE:To investigate in vitro antibacterial effect of extracts from Miao medicine Rubus multibracteatus leaves. METHODS:The aqueous extract and 80% ethanol extracts from R. multibracteatus leaves were used to prepare solution with mass concentration of 200 mg/mL. Using ampicillin and fluconazol as positive control (50 mg/mL),cup plate method was used to determine antibacterial effects of the extracts from R. multibracteatus leaves to Staphylococcus aureus,Staphylococcus epi-dermidis,Escherichia coli,Shigella dysenteriae,Proteus vulgaris,Candida albicans and Cryptococcus neoformans. The petroleum ether,acetic ether and n-butyl alcohol were used to extract 80% ethanol extracts in turns. After obtaining relevant extracts (50 mg/mL),cup plate method was used to investigate antibacterial effects of them to above 7 bacterial strains. The parts with antibacte-rial effects and bacterial strains sensitive to drug were screened. Micro-broth dilution method and agar culture medium plate method were used to determine minimum inhibitory concentration(MIC)and minimum bactericidal concentration(MBC). RESULTS:The aqueous extract of R. multibracteatus leaves almost had no inhibitory effect while 80% ethanol extract showed different degrees of antibacterial effect to tested bacterial strains,and it also had higher activity against 5 bacterial stains than 2 fungus. The ethyl ace-tate and n-butyl alcohol fractions of 80% ethanol extracts showed good effect while the petroleum ether and water layer fractions had no antibacterial effect,and all the fractions of 80% ethanol extracts showed no inhibitory effect on fungus. To 5 bacterial stains,MIC and MBC of 80% ethanol extract were 6.25-12.5,12.5-25 mg/mL,those of ethyl acetate fractions were 3.13,6.25 mg/mL and those of n-butyl alcohol fraction were 3.13-6.25,6.25-12.5 mg/mL,respectively. CONCLUSIONS:80% ethanol ex-tract of Miao medicine R. multibracteatus leaves and its ethyl acetate and n-butyl alcohol fractions have obvious in vitro antibacteri-al effect to bacteria.

AIM:To observe the effects and mechanisms of hydroxyethylstarch (HES) 130/0.4 on no-reflow phenomenon after myocardial ischemia-reperfusion in rats.METHODS: SD rats were randomly divided into 4 groups:sham operation group , ischemia-reperfusion ( IR, treated with normal saline ) group, normal saline ischemia-reperfusion (NS-IR, treated with NS) group and HES ischemia-reperfusion (HES-IR, treated with HES) group.Myocardial infarct size and no-reflow range were determined by staining methods , and the activities of myocardial enzymes ( CK-MB, cTnI and MPO) were measured .Meanwhile , cardiac microvascular endothelial cells of the rat were cultured and divided into 4 groups:control group, hypoxia/reoxygenation (H/R) group, NS-H/R group and HES-H/R group.Acute ischemia reper-fusion models were simulated , and the concentration of calcium ions was measured .The relative cell activity was evaluated by CCK-8 assay, and the apoptotic rate was detected by flow cytometry .RESULTS:In HES-IR group, the myocardial in-farct size, the no-reflow zone, CK-MB, cTnI and MPO activity were all significantly lower than those in IR group ( P<0.05).In microvascular endothelial cells , the concentration of calcium ions and the apoptotic rate in HES-H/R group were significantly decreased, while the relative cell activity increased compared with H/R group (P<0.05).CONCLUSION:HES reduces no-reflow in acute myocardial ischemia-reperfusion .The mechanism may be involved in the inhibition of both the infiltration of neutrophils and the calcium overload of endothelial cells .