Objective To investigate the influence of traditional Chinese medicine on nutritional status and function of immune in post-esophagectomy patients with esophageal carcinoma.Methods 70post-esophagectomy patients in our hospital were randomly divided into 2 groups:a control group (35 cases)and a observation group (35 cases).The control group were treated with postoperative nutrition programs of our hospital,while the observation group were treated postoperative nutrition programs combined with Chinese traditional medicine group in order to observe and analyze the nutritional status and the function of immune at preoperative and 7 days treatments.Results The TP/ALB/IgG/CD3+were (54.5±18.3)g/L and (50.5±11.8)g/L,(36.3±11.7) g/Land (32.8±12.2)g/L,(8.7±3.1)g/L and (7.5±2.8)g/L,(75.4±12.8)％ and (70.1±12.9) ％ in the observation group and the control group respectively,showing significant difference (P＜0.05).The CD4+/CD8+ were (2.5±0.8)and (2.1 ±0.6)in the observation group and the control group respectively,showing significant difference(P＜0.05).Conclusion The nutritional status and function of immune in post-esophagectomy patients with esophageal carcinoma were declined.Rational application of traditional Chinese medicine assisted the nutritional status and function of immune in post-esophagectomy patients with esophageal carcinoma.

Objective To investigate the in-vitro transdermal permeability of cyclovirobuxine D ethosomes.Methods Ethosomes,liposomes,saturated aqueous solution and 35.5% saturated alcohol solution of cyclovirobuxine D were prepared.The in-vitro transdermal permeability of different kinds of preparations of cyclovirobuxine D was studied by in-vitro permeation experiments.Results Cyclovirobuxine D ethosomes enhanced transdermal flux rate of cyclovirobuxine D and the enhancement ratio was 8.85,superior to liposomes and saturate alcohol.The dermatic hold-up amount of cyclovirobuxine D in 35.5% saturated alcohol solution,liposomes and ethosomes was in a decreasing sequence.Conclusion Compared with the liposomes,the ethosomes can enhance the transdermal flux rate of cyclovirobuxine D,which could increase the systematic action of the drug.

Objective To describe the impact of administrative penalties for medical disputes on the medical staff, including their perception on the penalty and its impact on their mind and body, professional behavior, career development, etc, and to provide a theoretical basis for health policy making and hospital management. Methods The phenomenological research method was adopted to conduct in-depth interview to 10 hospital staff in Taian who were involved in medical disputes and got punished, and the Giorgi qualitative data analysis was used in the research. Results The interviewees′perception and impacts of the punishment were concluded into five aspects:physiologically, psychologically, cognitively, behaviorally and professional development. Conclusions It is concluded that the current punishment to individuals has caused quite negative effects, and a new mechanism should be established to systematically reconstruct the procedure and reduce the medical disputes to the minimum.

Objective To compare the clinical effect and adverse reactions of different concentrations of dezocine epidural anesthesia for cesarean section.Methods According to digital table,120 cases of elective cesarean section were randomly divided into 4 groups with 30 cases in each group, the group D1 was given with dezocine 2.5mg,the group D2 with dezocine 5mg,the group D3 with dezocine 10mg,the group M with morphine 2mg.All the drugs used in postoperative epidural analgesia after cesarean section.To observe resting pain and conduct the VAS scoring at postoperative 4,8,12,24h and record various adveme reactions.Results The VAS scores at postoperative 4,8,12h in the group D1 were lower than those in the D2,D3,M with statistical difference(all P<0.05).The VAS scores at postoperative 4,24h had no statistical difference among D2,D3,M groups(all P>0.05).The VAS scores at postoperative 8h in the group D3 were lower than those in the D2,D3,M with statistical difference(all P<0.05). There were no statistical differences among 4 groups at postoperative 24h(all P>0.05).The incidence rates of nause-a and vomiting the group M were higher than that in the group D1,D2 and D3,showing statistical difference among them(P<0.05).Conclusion Appropriate concentrations of dezocine used in postoperative epidural analgesia after cesarean section has definite effect and less adverse reactions.

Objective To observe the influence of the insulation blanket applied in general anesthesia on the incidence of postoperative delirium.Methods 60 patients with elective laparoscopic cholecystectomy under generalanesthesia with ASA of grade Ⅰ-Ⅱ were selected.According to the random number table,the patients were divided into group A(without insulation blanket)and group B (with insulation blanket),each group in 30cases.The dosage and drug batch number of anesthetic drugs were same.Evaluated each patient using the confusion assessment method-chinese revised (CAM-CR).Recorded the number of cases of delirium for each group when 24 hours,48 hours, 72 hours after operation.Results The incidence of postoperative delirium in group A was 6.7%,which in group B was 0.0%.The incidence of postoperative delirium of group B was lower than group A (P <0.05 ).Conclusion Using insulation blanket to protect body temperature in perioperative operation can reduce the incidence of postopera-tive delirium in perioperative operation.

Objective To explore the clinical experience of liver retransplantation in management of biliary complications after liver transplantation.Methods The clinical data of patients receiving liver transplantion in our department between April 2002 and Aug. 2004 were retrospectively analyzed, including 5 patients being subjected to liver retransplantation because of serious biliary complication.Results Three patients were cured with the survival time being 5 months, 6 months and 8 months respectively. Two patients died at 8th and 43rd day: one died of liver non-function combining with lung infection and heart failure, and another died of renal failure. Complications included liver absess, biliary infection, wound infection, hydrops abdominis and lung infection.Conclusions Liver retransplantation is an effective treatment for serious biliary complications after liver transplantation. Surgical procedure, indication, operative opportunity, perioperative monitoring and so on contribute to the increase of the survival rate of the patients receiving liver retransplantation.

OBJECTIVE To compare the treatment effects of secreory otitis media with artificial eustachian tube insertion and tympanotomy tube insertion.To provide useful information for the treatment of secretory otitis media.METHODS Seventy-one patients(86 ears) with secretory otitis media were randomly divided into tow groups:experimental group(36 cases,44 ears) and control group(35 cases 42 ears).The experimental group was treated by artificial eustachian tube insertion under nasal endoscope.Drugs were injected through the tube into the tympanic cavity everyday after flushing it. The control group were treated by traditional method—the tympanic ventilation tube.All patients were followed up for 6 months.RESULTS The experimental group: 21 ears(47.73%) were cured,19 ears(43.18%) were straightened up,and no effects observed in 4 ears (9.09%).The control group:12 ears(28.57%) cured,17 ears(40.48%) wered straightened up and no effects obsered in 13 ears(30.95%).The efficiency rate of the experimental group(90.91%) was much higher than the control group(69.05%,P

Objective To explore the influence of olanzapine combined with risperidone on the serum level of homocysteine (Hcy) in patients with schizophrenia.Methods Participants included sixty patients diagnosed with schizophrenia,patients were divided into two groups by means of random digital method.The group A was given olanzapine treatment,and the B group was given olanzapine combined with risperidone therapy.After two months follow-up,the curative effect and the level of Hcy were observed.Results Before treatment,Hcy level [(24.4 ± 6.1)μmol/L,(25.8 ± 7.7)μmol/L] and HH number (22 cases,23 cases) in the two groups had no obvious differences (t =1.11,x2 =1.34,all P ＞ 0.05) ;2 months after treatment,Hcy level (11.6 ± 8.6) μmol/L and HH number(16 cases) in group B were significantly lower than those in the group A [(16.3 ± 3.8) μmol/L,8 cases],the differences were statistically significant (t =4.65,x2 =4.32,all P ＜ 0.05).Conclusion Olanzapine combined with risperidone in treatment of schizophrenia have good curative effect,it can improve the symptoms of patients,decrease serum Hcy level and HH number.

Objective To investigate the changes and clinical significance of calcitonin gene related peptide (CGRP) and interleu-kin 1α(IL-1α) before and after warm acupuncture therapy in the patients with lumbar disc herniation (LDH ) .Methods Serum CGRP and IL-1αcontents were detected before and after the warm acupuncture therapy in 60 cases of lumbar disc herniation and 15 healthy control cases by ELISA method for conducting the statistical analysis .The changes of the McGill pain scores and serum CGRP and IL-1αconcentrations before and after the warm acupuncture therapy were observed .Results The McGill pain scores af-ter the warm acupuncture therapy in the LDH patients were significantly decreased ,the difference was statistically significant (P<0 .01) ,and serum CGRP and IL-1α concentrations were significantly decreased ,the difference was statistically significant (P<0 .01) .Conclusion CGRP and IL-1αcan be used as the observation index of the effects for the warm acupuncture therapy in trea-ting LDH ,which can provide the basis for the conservative treatment of LDH .

Objective To explore the release and percutaneous penetration of cyclovirobuxine D patches at different concentrations in vitro. Methods The release curves of cyclovirobuxine D patch in vitro were fitted by ritger-peppas mathematical model, and the patch release mechanism was discussed according to the fitting parameters. At the same time, compared the percutaneous permeability characteristics of 0.25,0.5,1.0,2.0 mg.( cm2 )-1 of cyclovirobuxine D patch by using a modified Franz diffusion cell, with isolated rat skin serving as transdermal barrier. Results Ritger-Peppas model fitting equation for cyclovirobuxine D patch [1.00 mg.(cm2)-1]was: Mt/M=0.964 6 t1.621 6.And the percutaneous penetration curve was best fitted to Higuchi kinetics equation.The drug release rate from the patch matrix was greater than the rate of penetration through the skin, indicating the patch at the time through rat′s skin was a passive diffusion process, and transdermal process was rate-limited by skin. Conclusion Kinetics equation fitting is an effective method for analyzing drug release and permeation behavior of cyclovirobuxine D patch in vitro.