Objective To study the optimal dose of esmolol for maintaining cardiovascular stability in patients with hypertension during tracheal extubation. Methods In post-anestheisa care unit, hypertensive patients after general anesthesia meeting the extubation criteria were included. Patients were divided into 2 groups according the age: group Ⅰ (>65 years old for the elderly hypertensive, 21 cases), and groupⅡ(≤65 years old for the non-elderly hypertensive, 22 cases). All the patients received esmolol bolus before sputum suction and tube extraction, and the tracheal extubation were extubated 2 minutes after esmolol bolus. The systolic blood pressure, diastolic blood pressure and heart rate were was recorded before tracheal extubation, 2 min after esmolol bolus, at the time of sputum suction extubation, 1 min after tracheal extubation, 3 min after tracheal extubation and 5 min after tracheal extubation. Esmolol dose was determined by the up and down method. Initial dose was 0.5 mg/kg, in accordance with the arithmetic dose (0.2 mg/kg) increasing or decreasing progressively. In negative results (the systolic blood pressure at extubation or 5 min after extubation ≥ 20% of the base, or the systolic blood pressure at sputum suction extubation>180 mmHg, 1 mmHg=0.133 kPa) esmolol dose increased progressively, and in positive results (the systolic blood pressure at extubation or 5 min after extubation<20%of the base) esmolol dose decreased progressively. When the crosspoint (from positive to negative result) reached 6, the study was terminated. Results The median effective doses of esmolol for maintaining cardiovascular stability in groupⅠand groupⅡwere (0.6 ± 0.1) and (0.8 ± 0.1) mg/kg. Conclusions Esmolol can maintain cardiovascular stability in patients with hypertension during tracheal extubation. Median effective dose decreases in older hypertensive patients.

Objective To study the use of immunosuppressives for the patients with virus C hepatitis(HCV)after renal transplantation.Methods Twenty-five cases of HCV-RNA(+)and 30 cases of HCV-RNA(-)as control group were analyzed.All patients were divided into the Aza group(n=12),MMF group(n=8)and MP(MMF+Pred)group(n=5).Results Eight casGS revealed abnormal liver function in the Aza group and 2 in MMF group.After stopping the use of CsA and Aza,the liver function all revealed good outcome in the MP group.During one week 30 cases of HCV-RNA(-)recovered due to the readjustment of the dosage of immunosupprexsives(CsA,Aza)in the control group.Conclnsions The therapy of MMF+CsA+Pred is necessary for the patients with HCV-RNA(+)and the function of the renal and liver can be stabilized by MMF.

In order to compare the therapeutics of combined use of MMF with low dose of cyclosporine A (CsA) in renal transplantation, 16 cases were randomly divided into 3 groups:MMF 2.0g group receiving MMF 2.0g per day, MMF 1.5g group receiving MMF 1.5g per day,and Aza group. All the patients in the 3 groups were given the low dosage of CsA and steroid.The results showed that no patients in MMF 2.0g group experienced acute rejection. One patient (20%) in MMF 1.5g group occurred twice acute rejections. In Aza group 3 out of 5 patients (60%) experienced acute rejections. Six months after transplantation, serum Cr level and the used dose of CsA in MMF 2.0g group was obviously lower than that of Aza group. It was concluded that the combined use of 2.0g MMF per day with low dosage of CsA and steroid was safe and efficacy for renal transplanted patients. The clinical results of MMF 2.0g group were superior to those of Aza group.

ObjectiveObserve the efficacy, toxicity and the effection of telomerase activity of allicin combined with paclitaxel plus cisplatin and 5-Fu(TFP)chemotherapy for patients with advanced gastric carcinoma.MethodsFifty-four patients with advanced gastric carcinoma were randomly divided into two groups. A group was treated with allicin and TFP, B group was only treated with TFP. The chemotherapy was paclitaxel (135 mg/m2, dl, 8) plus cisplatin (75 mg/m2, d2-4) followed by 5-Fu (500 mg/m2 d1-5). Allicin was used in 60 days(3 times every day,once 20 mg).Telomerase activity was performed by enzyme-linked immunosorbent assay. ResultsThe total efficiency rate was 40.7 ％ (11/27) in A group and 33.3 ％ (9/27) in B group.There was no statistical difference between the two groups(~ = 0.079,P =0.779).There was significant difference in nausea and vomit (P =0.043), and the incidence of A group was 77.8 ％ (21/27) which was lower than that of B group[92.6 ％(25/27)].There was statistical difference in telomerase activity between the two groups(P =0.000).ConclusionAllicin could reduce the toxicity of chemotherapy and inhibit the telomerase activity in advanced gastric carcinoma.

Objective To study the quick triage assessment system for emergency nurse, establish evaluation model and method, select indicators and contents, guide triage nurses to be accurate, fast, convenient and practical, and also to optimize the use of emergency medical resources. Methods Screening the target population to conduct the research, collecting main indicators and features covered with main symptom and characteristics of severe critical emergency patients, selecting manifestation form of triage assessment system. Results The selected indicators and contents were demonstrated by a table-based form, and the quick triage assessment form for emergency nurse was established to instruct triage work. Conclusions This established quick triage assessment form is simple, intuitive and can improve the quality of emergency triage work. It possesses feasibility, practicality and achieves the optimal medical services with the limited emergency medical resources, which shows both social and economic effect.

Objective To investigate transcription intermediary factor 1β (TIF1β) expression in paracancerous pancreatic tissue and pancreatic tumor tissue by using tissue microarray.The relationship between TIF1β expression and clinicopathological factors in patients with pancreatic cancer was discussed.Method Tissuc microarray and immunohistochemical assay were utilized to detect expression of TIF1β protein in pancreatic cancer tissues and the corresponding non-tumor tissues from 91 cases.Results TIF1β protein were present in pancreatic cancer tissues as well as corresponding non-tumor tissues with varying degrees of expression,and was located in the nucleus.TIF1β expression in pancreatic cancer tissue was significantly higher than that of adjacent tissues (P ＜ 0.05).And it was noted that there was close correlations between TIF1β expression and clinical pathological staging,lymph node metastasis and TNM grading (P ＜ 0.05).Conclusions TIF1β is highly expressed in pancreatic cancer,clinically correlated with pathological staging,lymph node metastasis and TNM grading.TIF1β may play an important role in development of pancreatic cancer.

Objective To evaluate the effects of peer-assisted learning (PAL) combined with peer feedback in the teaching of operating room nursing. Methods 80 undergraduate nursing students in grade 2012 were assigned to the experimental group (n=40) and control group (n=40) by random number table method. The content of this training is operating room nursing skills. Nursing students in the experimental group received peer-assisted learning combined with peer feedback teaching,while nursing students in the control group received conventional teaching. Results The students′examination scores of the experimental group was (92.25 ± 3.43) obviously higher than that of the control group (89.20 ± 3.55) U=609.500, (P < 0.05), the students' evaluation of the new teaching method was higher than that of the control group (t=-2.76--2.27, P<0.05 or 0.01). Conclusions Peer-assisted learning combined with peer feedback can improve the operational capability of the students in operating room, is helpful to stimulate students′subjective initiative and improve the teaching quality of nursing.

Mesenchymal chondrosarcoma originated in the primitive mesenchymal tissue .It usually devel-ops in the short bones such as hand ,foot and body bone ,while extremeIy rare in the orbit .We report a case of mesenchymal chondrosarcoma of the orbit which is confirmed by pathology .

Objective To investigate the effect of dexmedetomidine on minimal induced dose of propofol and cardiovascular responses to tracheal intubation.Methods A double-blind randomized controlled trial was conducted.Sixty patients who underwent elective laparoscopic surgery were randomly divided into the dexmedetomidine group (treatment group) and control group.Patients in treatment group were given dexmedetomidine at dose of 0.1 μg/kg · min for 10 min before anesthesia induction,and then infused with 0.4 μg/kg · h until the end.Sodium chloride injection was infused at the same rate in control group.After 10 minutes from the start of dexmedetomidine or sodium chloride injection,propofol was infused by 0.4 mg/kg · min.The dosage of propofol used was recorded when eyelash reflex disappearing,and BIS value in 40 to 60.Propofol was infusion at the same rate,and laryngoscope was incubated at 2 minutes after fentanyl and rocuronium were given.The alertness/sedation (OAA/S scores),mean arterial pressure (MAP),heart rate,pluse oxygen saturation (SpO2) and BIS values were recorded at baseline (before dexmedetomidine or sodium chloride injection infusion),5 and 10 minutes after dexmedetomidine or sodium chloride injection infusion,at the time of eyelash reflex disappearing,before endotracheal intubation,placing the laryngoscope,1,3 and 5 min after intubation.Results OAA/S scores and BIS values in the treatment group were significantly lower than that of control group at 5 minutes and 10 minutes after the dexmedetomidine or sodium chloride injection infusion(P ＜0.05).MAP in treatment group was higher than that of control group at the time of eyelash reflex disappearing,before endotracheal intubation,placing the laryngoscope,1,3 and 5 minutes after intubation (P ＜0.05).Heart rate in treatment group was lower than that of control group at 5 and 10 minutes after dexmedetomidine or sodium chloride injection infusion and before the endotracheal intubation(P ＜ 0.05).There was no significant difference in terms of SpO2 between two groups (P ＞ 0.05).When patients consciousness disappeared and BIS values were in 40-60,the minimum induced dose of propofol was (88.00 ± 25.91) mg in treatment group and (117.33 ± 25.45) mg in control group.The dosage of propofol treatment group was obviously less than control group (t =4.423,P ＜ 0.05).Conclusion Dexmedetomidine reduces the minimum induced dose of propofol while maintaining more stable hemodynamic changes during anesthesia induction.However,there has no obvious inhibition effect on cardiovascular response to tracheal intubation.

By using the pharmacophore model of mineralocorticoid receptor antagonists as a starting point, the experiment stud- ies the method of traditional Chinese medicine formula design for anti-hypertensive. Pharmacophore models were generated by 3D-QSAR pharmacophore (Hypogen) program of the DS3.5, based on the training set composed of 33 mineralocorticoid receptor antagonists. The best pharmacophore model consisted of two Hydrogen-bond acceptors, three Hydrophobic and four excluded volumes. Its correlation coefficient of training set and test set, N, and CAI value were 0.9534, 0.6748, 2.878, and 1.119. According to the database screening, 1700 active compounds from 86 source plant were obtained. Because of lacking of available anti-hypertensive medi cation strategy in traditional theory, this article takes advantage of patent retrieval in world traditional medicine patent database, in order to design drug formula. Finally, two formulae was obtained for antihypertensive.
Antihypertensive Agents ; chemistry ; pharmacology ; Databases, Factual ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Medicine, Chinese Traditional ; methods ; Mineralocorticoid Receptor Antagonists ; chemistry ; pharmacology ; Models, Molecular