Objective To evaluate the effects of 6% hydroxyethyl starch (HES)130/0.4 and 6% HES 200/0.5 on blood coagulation in patients undergoing major operation under general anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 18-64 yr undergoing major operation under general anesthesia during which the blood loss was expected to be＞20%of blood volume were allocated randomly into 3 groups(n=20 each):Ⅰ control group(C);Ⅱ6% HES200/0.5 group (H) and Ⅲ HES130/0.4 group (V).In group H and V the patients Arterial blood samples were taken before(T1),immediately(T2)and 1 h after the end of fluid infusion(T3)for determination of hematocrit(Hct),platelet count(PLT)and prothrombin time(PT),platelet maximum aggregation test induced by 5 μmol/L ADP,and Sonoclot coagulation and platelet function analysis(gbACT,CR,PF,TP).Activated partial thromboplastin time(Am),coagulation factor Ⅷ (FⅧ)activity and von Willebrand factor(vWF)were measured only in group H and V.Results (1) PT and APTT were significantly prolonged after fluid infusion at T2 and T3 as compared with the baseline values at T1 in group H and V.(2)FⅧ activity and platelet maximum aggregation induced by ADP were significantly decreased at the end of fluid infusion at T2 as compared with the baseline at T1 but increased again at T3 in group H and V.(3)There was no significant change in Sonoclot coagulation parameters after fluid infusion as compared with the baseline except clot formation rate (CR)in group H and V.Conclusion Acute hypervolemic hemodilution with 6% HES130/0.4 or 200/0.5 has minimal effect on blood coagulation and there is no significant difference in blood coagulation changes induced by 6%HES130/0.4 and 200/0.5.

Objective To know the indoor air pollution status in the newly decorated residential houses in Jiaozuo and to study the effect of decoration materials on the pollution. Methods To monitor formaldehyde, ammonia and benzene levels in the indoor air of 39 newly decorated rooms in Jiaozuo. Results The exceed standard rates of formaldehyde, ammonia and benzene in the indoor air were 73.6%, 84.7% and 25.8% respectively. Exceed standard rate of formaldehyde in the room which held the new furniture was the highest, 88.8%. Conclusion Decoration may cause indoor air pollution, the most part of the pollutants are formaldehyde and benzene. The level of the pollution depends on the different usages of the rooms.

Objective To study the pathogenesis,diagnosis and treatment of the compression syndrome of the third common plantar digital nerves.Methods Conservative methods were at first used for all the 34 cases of this disease.Treatment methods includes:wearing shoes with soft bottom and metatarsal pad;the administration of Chinese herbs;the application of direct current iontherapy by filtering Chinese herbs and performing local injection therapy with steroid at the tenderness points.15 patients with no effect following conservative methods and other 3 recurrent cases were treated with section of deep transverse metatarsal ligament and relaxing the nerves compression.Of the 18 cases,5 had additional to excision of the neuroma.Results Of the 34 cases treated with conservative methods,19 had effective results,of which 6 cases recurred,and 15 cases had no effect.18 cases treated with operation had no recurrence.Conclusion Toe extending test and forefoot transversely compressing test provide a valuable basis for diagnosis.Conservative treatment are usually effective in earlier phase.If conservative treatment is not effective,the transverse metatarsal ligament should be sectioned,nerves should be relaxed and the neuroma must be excised.The results of operative treatment are satisfactory.

Adult ; Aged ; Colectomy ; Colonic Neoplasms ; pathology ; surgery ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Rectal Neoplasms ; pathology ; surgery ; Rectum ; surgery ; Stomach Neoplasms ; pathology ; surgery ; T-Lymphocyte Subsets ; pathology ; T-Lymphocytes, Cytotoxic ; pathology ; Th1 Cells ; pathology ; Th2 Cells ; pathology

Endocarditis, Bacterial ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy

Purpose There is no agreement for contrast enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant thyroid nodules. This paper aims to evaluate the diagnostic value of the conventional and contrast-enhanced ultrasonography in the diagnosis of thyroid nodule by meta analysis. Materials and Methods Literature search was performed in PubMed, CNKI and Wanfang databases to identify relevant English and Chinese literatures by using pathological results as the gold standard from January 1990 to September 2014. The quality of each selected study was evaluated by QUADAS. The pooled weighted sensitivity, specificity and the corresponding 95% CI were calculated. Summary receiver operating characteristic curves (SROC), area under curve (AUC) and the Q* index were also calculated. Results A total of 14 literatures (1970 nodules) were included, the pooled weighted sensitivity and specificity of conventional ultrasonography were 0.74 and 0.70; those of contrast-enhanced ultrasonography were 0.86 and 0.82. The AUC by using the two methods were 0.84 and 0.93, respectively, and the Q* index were 0.77 and 0.86, respectively. Conclusion In the diagnosis of thyroid nodule, the accuracy of contrast-enhanced ultrasonography is better than conventional ultrasound; however, both of them have high clinical value in the diagnosis of thyroid nodule, thus they are helpful in avoidance of unnecessary surgical treatment in patients with thyroid disease.

Objective To survey the value of quantitative detection of urinary endotoxin for the diagnosis of gram-negative bacteria infection in urinary system,in order to provide evidences for early diagnosis and treatment.Methods The levels of urinary endotoxin were detected by kinetic turbidimetric technique,at the same time urine was cultured and WBC,CRP were detected.Results In 379 patients with gram-negative bacteria infection in urinary system,132 patients were upper urinary tract infection and 247 were lower urinary tract infection.The level of WBC,CRP and endotoxin were 11.25(7.98,13.99)× 109/L,81.36(76.64,83.50)mg/L and 49.57(17.28,78.37)pg/ml in upper urinary tract infection patients and in lower uri-nary tract infection patients were 10.24(7.94,12.24)×109/L,70.46(70.46,77.32)mg/L and 21.18(21.18,37.31)pg/ml. The group of upper urinary tract infection was higher than lower urinary tract infection on CRP and endotoxin,and have sig-nificant difference between the two groups of patients (P<0.05).Analysis of ROC,the diagnostic Cut-off value of 39.7pg/ml,the sensibility and specificity of endotoxin for the diagnosis of gram-negative bacteria infection on upper or lower urinary system were 84.1% and 90.3%.Conclusion The levels of urinary endotoxin detected by kinetic turbidimetric technique is simple and efficient,and have significant diagnosis value of gram-negative bacteria infection on upper or lower urinary sys-tem.

Delphi method is a kind of forecasting method with several rounds of consultation with experts. It has three major characteristics including anonymity,information feedback and statistical analysis of results. With the continuous development of the method,its application fields is widened from the initial development of sociology to clinical medicine,psychology,nursing and so on. Since pharmacy and clinical medicine is inseparable,Delphi method used in pharmacy field has become the new direction of pharmaceutical research,and it can provide a new method for the pharmaceutical regulations,medical risk assessment and development of clinical pharmacy. In the paper,the application of Delphi method in the field of pharmacy was summarized in order to provide new ideas for the development of pharmacy.

Objective:To enhance the teaching quality of the Tuina Manual Techniques in the high occupational sports colleges.Methods:Performed by multiple educational reforms,including rearrangement of the teaching contents based upon the cognition rules,PBL teaching ideas are involved to improve the teaching condition,increase the multimedia and practical teaching,enrich the teaching resources,and revise the examination and evaluation protocol,etc.Results and Conclusion:By various reforms,the students can not only leam the professional skills,and also elevate their abilities in analyzing and solving their problems.

Objective: To observe the clinical therapeutic effects of acupuncture at the bony clefts in combination with tuina therapy in the treatment of sprains and strains of minor joints at the four extremities. Methods: Ninety cases of sprains and strains of minor joints at four extremities [including metacarpophalangeal (metatarsophalangeal)joints] were divided randomly into three groups by the consulting order. Acupuncture group, in which 30 cases were treated by acupuncture at the bony clefts; tuina group, in which 30 cases were treated by tuina therapy; and observation group, in which 30 cases were treated by acupuncture at the bony clefts and tuina therapy. The treatment was given 6 times a week as one course of treatments, and the therapeutic effects were observed after 2 courses of treatments. Results: The cure rates of the observation group, the acupuncture group and the tuina group reached 50.0%, 20.0% and 16.7% respectively, and the total effective rates reached 93.4%, 70.0% and 73.3% respectively. There were statistical significance between the observation group and the acupuncture and tuina groups (P<0.05); while there was not a statistical difference between the acupuncture group and the tuina group. It was indicated that the therapeutic effect of the observation group was better than that of the acupuncture group and the tuina group. Conclusion: Acupuncture at the bony clefts in combination with tuina therapy is quite effective in the treatment of sprains and strains of metacarpophalangeal (metatarsophalangeal) joints.