Objective To investigate the effect of parental presence on the anxiety of children during induction of anesthesia with sevoflurane. Methods One hundred and twenty children (ASA Ⅰ or Ⅱ ) aged 2-12 yr weighing 12-32 kg were assigned to one of 2 groups using a random number table ( n = 60 each): control group (group C) and parental presence group (group P). Preoperatiave visit was made the day before surgery in both groups. In group P a parent played with toys with the children for 15 min before induction of anesthesia, while in group C a nurse played with them. Anesthesia was induced with 8% sevoflurane in O2 delivered at 6 L/min through a scented face mask held by the parent or anesthesiologist talking with them in soft words. Modified Yale preoperative anxiety scale (mYPAS) was used to measure anxiety of the children during preoperative visit, before and during induction of anesthesia. Induction compliance checklist (ICC) was used to measure behavioral compliance during induction. ICC score ＞ 5 implied failure of induction of anesthesia with sevoflurane. Adverse events were recorded. Results The mYPAS scores were significantly lower before and during induction of anesthesia in group P than in group C (P ＜ 0.05), but there was no significant difference in ICC scores between the 2 groups ( P ＞0.05). There was no failure of induction in group P while in group C there were 3 failures. Cough occurred in 2 patients in group P but in 3 patients in group C. One patient vomited during induction of anesthesia in group C.Conclusion Parental presence is effective in reducing anxiety of children during induction of anesthesia.

Objective To compare the effects of chlorpromazine,olanzapine and ziprasidone on cognitive function of patients with chronic schizophrenia.Methods A total of 120 patients with chronic schizophrenia were randomly divided into chlorpromazine group(n =38),olanzapine group(n =41) and ziprasidone group(n =41).The patients were subjected to the Brief Psychiatric Rating Scale(BPRS),Wisconsin Card Sorting Test(WCST),Personal and Social Function of Scale (PSP) and Wechsler Adult Intelligence Scale-Revised (WAIS-RC) assessment respectively,before and after treatment for 12 weeks.Results After treatment for 12 weeks,the score of BPRS significantly decreased in three groups compared with that before treatment [F (5,41) =6.49,P ＜ 0.05].After treatment for 12 weeks,the results of WCST [F (5,47) =18.30,P ＜ 0.05],PSP [F (5,47) =10.02,P ＜ 0.05] and WAIS-RC [F(5,47) =6.74,P ＜ 0.05] test in ziprasidone and olanzapine group were better than that of chlorpromazine group.Conclusion Chlorpromazine,olanzapine and ziprasidone could improve the cognitive function and mental syndrome of patients with chronic schizophrenia.In addition,the effect of ziprasidone and olanzapine was better than chlorpromazine.

Objective To design an arthroscopic universal aiming device for cruciate ligament repairing and evaluate its clinical efficacy. Methods The aiming device was designed on the principle of “a line crossing any point on a spherical surface and perpendicular to it must cross the sphere center”, which enables the surgeon to locate the ligamentous attachment of cruciate ligament precisely for reconstruction. Twelve cases of PCL injuries have been treated with this method. Results The average follow up period was 12.1 months (5-19 months). According to Lysholm scoring system, the average score was improved from 59.2 points to 92.7 points, increased by 33.5 points. Lachman test turned negative in all patients, the average range of motion was 120?. Conclusion The instrument was reasonably designed for easy handling and precise orientation. It is particularly preferable to locate the tibial attachment of cruciate ligament for endoscopic reconstruction on the posteromedial approach.

Objective To investigate the correlation between preoperative anxiety and emergence agitation(EA)in children after sevoflurane anesthesia.Methods A total of 120 children who were going to receive an elective surgery were recruited in this study.The preoperative anxiety in these children was measured through the Modified Yale Preoperative Anxiety Scale(mYPAS)at the following time:during the preoperative interview(T1),waiting period in surgery waiting room(T2),after the children entered the operating room(T3)and at the beginning of sevoflurane inhalation induction(T4).The emergence agitation(EA)scores were obtained by using the Pediatric Anesthesia Emergence Delirium(PAED) Scale after the surgery.Results After adjusting for the effect of age,it was found that the anxiety scores at T1 and T2 had no significant correlation with EA,while those in T3 and T4 showed a statistically significant correlation with EA.The level of anxiety at the beginning of induction showed a strong positive correlation with EA,and the correlation coefficient was 0.708(P<0.01).Conclusion The preoperative anxiety in the operating room and at the beginning of induction of anesthesia is correlated with EA in children receiving sevoflurane anesthesia.

Objective To investigate the correlation between uric acid level and macrovascular disease in type 2 diabetic patients.Methods Sixty type 2 diabetic patients with lower limb atherosclerosis of carotid artery were randomly selected in study group who hospitalized in the First Hospital of Zibo from Mar.to Feb.2012.Sixty type 2 diabetes mellitus(T2DM) without carotid and lower limb athemsclerosis were served as control group.The blood pressure,blood lipid,blood glucose and other biochemical indexes,including blood uric acid,serum insulin (FNS),fasting blood glucose (FPG),apolipoprotein a (LP (a)),apolipoprotein A1,B (APO-A1,APO-B),glycosylated hemoglobin (HbA1c),high density lipoprotein cholesterol (HDL-C),low density lipopmtein cholesterol (LDL-C),triacylglycerol (TG) and total cholesterol (TC) were measured and determined.Results There was no significant difference in terms of blood pressure,blood lipid levels,APO-A1,APO-B,HbA1C,FNS and FPG in study group patiems (P ＞ 0.05).The level LP(a) in study group was (0.4 ± 0.2) g/L,significantly higher than that in control group ((0.2 ± 0.2) g/L; t =3.842,P ＜ 0.01).The blood uric acid level in study group was (362.3 ± 112.8)mmol/L,significantly higher than that of the control group((284.8 ±68.6)mmol/L;t =3.188,P＜0.01).Conclusion Uric acid and LP(a) are involved in the oocurrence and development of athemsclemsis,which is close related to the development of type 2 diabetic macmangiopathy.Therefore,in the process of preventing type 2 diabetes with macroangiopathy,we should pay attention to uric acid and LP (a) of the patient beside effective control of blood glucose,blood pressure,blood lipid level.

Objective To evaluate the application value of focused assessment with sonography for trauma (FAST) in treatment of emergency thoracic and abdominal closed injury.Methods FAST examination was performed in 85 patients with thoracic and abdominal closed injury,to determine whether the thoracic and abdominal cavity,pericardial free effusion and abdominal parenchyma organ injury,and the results were compared with conventional ultrasonography,CT scan and operation results.Results FAST was (2.85 ± 1.15) min,conventional ultrasonography was (15.48 ±5.17) min,there was statistically significant difference (t =21.99,P ＜ 0.05).In 85 patients,10 cases were FAST positive,5 cases of abdominal cavity in that amount or a large number of free effusion,underwent emergency operation,postoperative intra abdominal parenchymal organs were confirmed as rupture and hemoperitoneum; 2 cases of renal rupture with perirenal hematoma,confirmed by the whole abdominal CT examination; 2 cases of thoracic free pneumatosis,effusion,confirmed by thoracic CT examination or closed thoracic drainage; 1 case of prompt hemopericardium,confirmed by the pericardium puncture.Conventional ultrasonography was positive in 11 patients,no statistically significant difference between them (P ＞ 0.05).The sensitivity,specificity,accuracy rate of FAST screening thoracic and abdominal closed injury was 10/12,100.0％ (73/73),97.6％ (83/85).Conclusions FAST has high sensitivity and specificity for thoracic and abdominal cavity,pericardial free effusion,check with short time,low environmental requirements,without moving the trauma patients,and may be out of sync with the fluid resuscitation and other emergency measures.For large quantities of trauma patients and patients with severe multiple trauma,FAST can quickly,accurately determine the existence of thoracic and abdominal closed injury,and provide guidance for clinical treatment,which has good application value.

Objective To detect the expressions of vascular endothelial growth factor(VEGF) and Periostin in patients with diabetic retinopathy (DR),and to explore its chnical significance.Methods A total of 52 patients with DR (DR group),36 non-DR diabetic patients (non-DR group) and 30 healthy person (normal control group) were enrolled.The 52 cases of DR patients were divided into non-proliferative DR (PDR) group (non-PDR group,24 cases) and PDR group (28 cases).The expressions of serum VEGF and Periostin were detected with enzyme-linked immunosorbent assay analysis.Results The serum expressions of VEGF and Periostin were significantly higher in non-DR group and DR group than those in normal control group [(122.63 ±28.74),(163.58 ±42.37) mg/L vs.(91.53 ± 19.58) mg/L,(110.15 ±32.62),(146.51 ± 41.74) mg/L vs.(82.26 ± 21.17) mg/L,P ＜ 0.05 or ＜ 0.01].The serum expressions of VEGF and Periostin were significantly higher in DR group than those in non-DR group (P ＜0.05).The serum expressions of VEGF and Periostin were significantly higher in PDR group than those in non-PDR group [(174.15 ±47.31) mg/L vs.(147.66 ±38.25) mag/L,(160.31 ±46.43) mg/L vs.(132.14 ±35.62)mg/L,P ＜ 0.05].The serum expression of VEGF was positively related with Periostin (r =0.415,P ＜ 0.01).Conclusion The high-expressions of VEGF and Periostin are found in DR patients,and which maybe play a key role in the early diagnosis and assessment the progression of DR patients.

Objective To determine whether p38 mitogen-activated protein kinase (p38MAPK) signaling pathway is involved in cerebral fractalkine-induced hyperalgesia in mice.Methods Two hundred and twenty-five male Kunming mice weighing 30-40 g were randomly divided into 4 groups:group control ( group C,n =55 ) ;group fractalkine (group F,n =60); group anti-CX3CR1 + fractalkine (group CF,n =55) and group SB203580 (p38MAPK inhibitor) + fractalkine (group SF,n =55).Fractalkine 100 ng was injected into cerebral lateral ventricle (i.c.v.) in groups F,CF and SF.Anti-CX3CR1 1 μg and SB203580 1 μg were injected i.c.v.at 1 h before fractalkine injection in groups CF and SF respectively.Paw withdrawal latency to a thermal nociceptive stimulus (PWL) was measured at 30 min before the drugs were injected into cerebral lateral ventricle and 30,60,120 and 240 min after fractalkine injection.Five animals were sacrificed after PWL measurement at each time point and their brains were removed for determination of phosphorylated p38MAPK protein expression (by Western blot analysis).Five animals were sacrificed at 30 min before the drugs were injected into cerebral lateral ventricle and 6,12 and 24 h after fractalkine injection for determination of IL-1β and TNF-α contents in the brain (by ELISA) in all the 4 groups.In group F 5 animals were sacrificed at 4 h after fractalkine injection for determination of action of fractalkine on microglia or astrocyte (by immunofluorescence).Results Fractalkine i.c.v.injection significantly reduced PWL and increased phosphorylated 38MAPK,IL-1β and TNF-α levels in group F as compared with group C.Pretreatment with anti-CX3CR1 or SB203580 significantly decreased fractalkine-induced hyperalgesia and phosphorylated-p38MAPK,IL-1β and TNF-α levels in groups CF and SF as compared with group F.Fractalkine was localized at microglia.Conclusion p38MAPK signal transduction pathway is involved in cerebral fractalkine-induced hyperalgesia in mice.

Objective In attempt to improve the reconstruction of small defects in the facial and frontal regions, we developed a modified radial artery perforator-based free flap. Methods The free proxi-mal radial forearm flap was based on the distal perforator of the radial artery and the concomitant radial vein. The vascular pedicle passed through deep fascia. The free flap was transferred to repair the defects of the fa-cial and frontal regions. Results In 6 patients with frontal defects and 4 patients with facial defects, all flaps survived completely. After following up for 6-12 months, flaps underwent plastic surgery to become thin-ner. The flaps of 10 cases were good in skin texture and color at recipient sites. The scars were cosmetically acceptable. The superficial sensibility recovered well. Conclusion A modified radial artery perforator-based free flap was useful in coveting small defects of the facial and frontal regions.

Objective To explore the value of applying personalized medicine in the clinical teaching of gastrointestinal surgery. Methods Totally 100 undergraduates in grade 2008 were ran-domly assigned to experimental class (EC) and control class (CC), with 50 cases in each group. The experimental class accepted personalized medical teaching through introducing idea and method of personalized medicine. The control class accepted conventional teaching. The effect of teaching was evaluated by questionnaire survey and examination. The data were analyzed through t-test and Chi-square test. Results Questionnaire survey of satisfaction showed that 88 students (88%) were inter-ested in the new course, 91 students (91%) thought that the new mode of teaching was better than the old one. Questionnaire survey of teaching effect showed that in EC:44 students (88%) thought that the new course could increase interests of clinical question;43 students (86%) thought that the new course could optimize the process of diagnosis and treatment of gastric cancer;40 students (80%) thought that the new course could strengthen the communication between doctors and patients; 42 students (84%) thought that the new course could widen the minds in diagnosis and treatment;45 students (90%) thought that the new course could enhance the ability of dialectical thinking;while in CC, the proportions of the above issues were 24(48%), 23(46%), 26(52%), 25(50%) and 26(52%) (all P<0.05). Furthermore, there were statistical difference in auerage scores bertween EC and CC [(86.26 ±5.72) vs. (77.00 ±6.16)] (P=0.000). Conclusions Personalized medicine is suc cessfully practiced in the teaching course of gastric cancer, which not only meets the requirement of personal-ized medicine, but also guides the reformation of clinical teaching to certain extent.