OBJECTIVE:To investigate the effects of Dexmedetomidine hydrochloride injection on elderly patients underwent thoracic surgery during anesthesia recovery period. METHODS:Totally 60 elderly patients underwent thoracic surgery in our hospi-tal during Jun. 2014-Feb. 2016 were selected as research objects and then divided into control group and observation group ac-cording to even and odd-numbered admission order,with 30 cases in each group. Control group was given Propofol injection 0.5-1 mg/kg intravenously 5 min after mask oxygen inhalation. Observation group was given Dexmedetomidine hydrochloride injec-tion 0.5-1.0 μg/kg intravenously. Both group were successively given Etomidate emulsion injection 0.1-0.2 mg/kg,Sufentanil citrate injection 0.3 μg/kg and Cisatracurium besilate for injection 0.2 mg/kg intravenously for anesthesia induction;tracheal intubation was performed and ventilator was used to assist ventilation after anesthesia induction. And then control group was given continuous intravenous dripping of propofol 3-6 mg/kg·h;observation group was given continuous intravenous dripping of Dexmedetomidine hydrochloride injection 0.2-0.5 μg/(kg·h). At the same time,both group were given continuous intravenous dripping of sufentanil 0.1-0.2 μg/(kg·min)and cis-atracurium 1.5-2 μg/(kg·min),and continuously inhaled 1%-2% sevoflurane for anesthesia mainte-nance. Hemodynamic index(HR,MAP,SpO2),postoperative recovery,the occurrence of delirium,restlessness,cough and involun-tary movement were observed in 2 groups before surgery (T0),after anesthesia induction (T1),at the moment of sputum suction and extubation(T2),5 min after extubation(T3),30 min after extubation(T4). RESULTS:At T2 and T3,HR and MAP of control group were increased significantly compared to at T0,T1,and higher than those of observation group,with statistical significance (P<0.05). At T0,T1,T4,there was no statistical significance in HR and MAP between 2 groups (P>0.05). At T0,T1,T2,T3, T4,there was no statistical significance in SpO2 level between 2 groups(P>0.05). The breathing recovery time,eye openning time and extubation time of observation group were significantly shorter than those of control group,with statistical significance (P<0.05). The incidence of postoperative restlessness,delirium,cough and involuntary movement in observation group were signifi-cantly lower than control group,with statistical significance (P<0.05). CONCLUSIONS:Dexmedetomidine hydrochloride injec-tion can keep hemodynamics stable in elderly patients underwent thoracic surgery during anesthesia recovery period.,shorten recov-ery time and reduce the occurrence of stress response as postoperative delirium,restlessness,cough,involuntary movement.

Objective To investigate the duration of the first-fundus-examination and the status of diabetic retinopathy in patients with type 2 diabetes mellitus. Design Questionnaire. Participants 956 patients (1905 eyes) with type 2 diabetes in Tongren Eye Center of Beijing Tongren Hospital. Method Self-designed questionnaire was carried out. Patients were divided into different groups by the du-ration of the first-fundus-examination, degree of diabetic retinopathy, duration of diabetes, education background and living area in the data analysis. Main Outcome Measurements Duration of the first- fundus-examination, degree of diabetic retinopathy. Results Dia-betes patients in shorter duration groups finished the first-fundus-examination earlier than in longer duration groups (all P <0.05). Dif-ferent education background didn't show significant influence on duration of the first fundus examination. Urban patients received earli-er first-fundus-examination than rural patients (all P <0.05). The incidences of vitreous hemorrhage, retinal detachment and retinal pho-tocoagulation were rising with the duration of diabetes. The proportions of vitreous hemorrhage and retinal photocoagulation were higher in primary-school education group than in middle-school and college education groups (all P<0.05). Difference of the incidences of vit-reous hemorrhage and retinal detachment weren't found between in Beijing and non-Beijing patients. The incidences of vitreous hemor-rhage and retinal detachment in urban patients were higher than in rural patients (all P<0.05). Conclusion The most diabetic patients finish the first-fundus-examination much later than requested. Diabetic patients in lower-education-level groups and in rural group are even later, and their conditions are more serious.(Ophthalmol CHN, 2009, 18: 279-282)

Screening and diagnosis of early colorectal cancer(CRC)can reduce CRC mortality and improve overall survival. Currently,the major screening methods for early CRC include fecal occult blood test(FOBT)and colonoscopy. FOBT exhibits low sensitivity with high false positive rate,while the gold standard -- colonoscopy is invasive and with low compliance. Therefore,a convenient and effective screening and diagnostic method for early CRC is urgently needed. Plasma SEPT9 gene methylation assay is a new non-invasive screening and diagnostic method for early CRC used clinically in recent years,it exhibits high accuracy,and is convenient for mass screening and diagnosis of early CRC. This article reviewed the research progress and diagnostic value of plasma SEPT9 gene methylation assay for CRC.

Antiviral Agents ; therapeutic use ; China ; Hepatitis B ; drug therapy ; epidemiology ; immunology ; prevention & control ; therapy ; Hepatitis B Vaccines ; immunology ; Humans

Diabetes Complications ; drug therapy ; surgery ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Ischemia ; drug therapy ; etiology ; surgery ; therapy ; Lower Extremity ; blood supply

2 weeks ) were screened by BAEP. Results Hearing-ability of 11 children(11/23,47.8%) was abnormal,one month later hearing-ability of 2 children was abnormal, and there months later hearing-ability of only 1 child was abnormal. Conclusion Hyperbilirubinemia may cause hearing-ability damage in neonates and BAEP is one of effective audiometric means.

Objective: To evaluate the prognostic factors of patients with stage Ⅳ gastric cancer. Meth-ods: A total of 138 patients with stage Ⅳ gastric cancer treated with platinum-based chemotherapy were ana-lyzed. Survival rate was estimated by Kaplan-Meier method. The prognostic factors were analyzed by univari-ate (Log rank) and multivariate (Cox model) analysis methods. Results: Univariate analysis and multivariate analysis showed that poor performance status (P=0.001), weight loss (P=0.001), depth of invasion (P=0.000), presence of peritoneal metastasis (P=0.005), more than 1 metastatic site (P=0.029) and elevated total biliru-bin (P=0.018) were independent prognostic factors. According to the outcomes of the Cox model analysis, a formula of the prognostic index was developed. According to the values of PI, 16 patients were categorized as the high-risk group (PI≤9.817), 28 patients were categorized as the moderate-risk group (9.817

In recent years,antiviral therapy for chronic hepatitis B infected patients has achieved great development along with the invention of nucleos (t) ide,nucleos (t) ide analogues,interferon α and pegylated interferon α.The development of antiviral medicine also proposes new demands for the clinical diagnosis and therefore promotes the development of laboratory diagnostic techniques in the detection of chronic hepatitis B.In this review,we focused on the clinical application in the quantitive detection of HBV DNA,and its significance on clinical evaluation,treatment options,follow-up and prognosis in antiviral therapy.

Objective To summarize clinical characteristics, diagnosis and surgery of abnormally origination of left coronary artery from the pulmonary artery. Methods Clinical data of 10 patients with left coronary artery abnormally originating from pulmonary artery were analyzed, including 5 men and 5 women, aged from 13 to 40 years. Definite diagnosis was made by ultrasonic cardiogram (UCG) and cardiac catheter examination. Three cases were simply abnormal origination, six cases combined with MI, and one case combined with both MI and ventricular aneurysm of left ventricular apex. Ligation of the abnormal coronary artery was done in four patients, three were given pulmonary artery inner tunnel plasty under extrocorporeal circulation. Open implantation of left coronary artery to ascending aorta were done in 3 patients, while plasty of mitral valve were performed in 5 and ventricular aneurysm resection in 1. Results One patient died postoperatively. The follow-up ranged from 1 month to 11 years. One patient received replacement of mitral valve 16 months after first surgery due to severe MI. All the followed-up patients presented no myocardial ischemia or infarction, no residual shunt or late death. Cardiac function was rehabilitated to grade 1. Conclusion Obvious blood dynamics and cardiovascular morphology changes existed in patients with left coronary artery abnormally originating from pulmonary artery. Early diagnosis and surgery should be done. Proper surgical approach is the key to success.

[Objective]To explore the treatment of intertrochanteric fracture with expandable proximal femoral nail and prevention and cure of some related complications.[Method]Fifty-eight cases of closed intertrochanteric fracture,including 28 male cases and 30 female,average 73.2 years old(range from 42 to 88)accepted treatment.The type of fracture according to Evans classification:5 cases were type Ⅰ,7 were type Ⅱ,28 were type Ⅲ,13 were type Ⅳ,and 5 were type Ⅴ.All cases were treated with expandable proximal femoral intramedullary nail after close reduction.[Result]Thirty-eight cases were followed up,from 12 to 36 months,average 18.5 months,all of the cases got clinical healing after 8-10 weeks postoperatively.Hip Harris score average was 91.8.Some complications occurred in 6 cases:1 case had secondary fracture nearby the greater trochanter needling insertion point,1 case femoral head peg was outside of the lock hole,and 1 case femoral head peg tip was broken during operation.And after operation,1 case had coxa vara deformation,1 case had femoral middle and superior segment fracture,and 1 case femoral head peg was exited.[Conclusion]Expandable proximal femoral intramedullary nail has some advantages as:minimal invasive,manipulation convenient,fixation reliability,remove easily,but surgeons must be familiar with the construction and fixation principle of the nail in the primary stage,and perform the operating instruction strictly,to reduce or avoid the complications occurrence because of mis-manipulation.