OBJECTIVE:To investigate the influence of dexmedetomidine combined with fentanyl on analgesic effects and hemodynamics of orthopedics patients after surgery.METHODS:A total of 80 patients undergoing orthopedics surgery were randomly divided into observation group (40 cases) and control group (40 cases).Observation group was given patient-controlled analgesia (PCA) of Dexmedetomidine hydrochloride injection+Fentanyl citrate injection,maintaining analgesia for 48 h.Control group was given PCA of Fentanyl citrate injection,maintaining analgesia for 48 h.The MAP,SpO2,HR,VAS and the occurrence of ADR were observed in 2 groups from the application of multi-function monitor to connecting to PCA (T0),12 h after connecting (T1) and 48 h after connecting (T2).RESULTS:At T0,there was no statistical significance in VAS score between 2 groups (P＞0.05).VAS scores of 2 groups at T1-2 were significantly higher than at T0.Those of 2 groups at T1 were significantly higher than at T2;but the observation group was significantly lower than the control group,with statistical significance (P＜0.05).There was no statistical significance in MAP,SpO2 or HR between 2 groups at different time points (P＞0.05).The incidence of respiratory depression,sharp pain,nausea and vomiting,hypotension in observation group were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:Dexmedetomidine combined with fentanyl show significant analgesic effect after orthopedics surgery,and have no effect on hemodynamics with good safety.

Bronchopulmonary dysplasia( BPD) is a chronic lung disease that commonly occurs in pre-term. Since the 1980s,with the advances in perinatal care,survival rate of preterm has been raised,while BPD continues to be a significant cause of morbidity and mortality for premature infants. However,the treatment effect of BPD is unsatisfactory. It is urgent to search for innovative ways to reduce the respiratory injury that caused by BPD as well as to improve the quality of life. In recent years,mesenchymal stem cells′( MSC) research has pro-vided a new way for the treatment of BPD. This review primarily summarizes the current status of the MSC ther-apies and its possible mechanism on BPD.

Objective To study the indications,feasibility and efficacy of rigid choledochoscopy via biliary fistula tracts to remove bile duct stones.Methods A retrospective analysis was performed on the clinical data of 86 patients with bile duct stones treated with rigid choledochoscopy via biliary fistula tracts at our hospital between November 2011 and July 2016.Patients with bile duct stones were divided into the percutaneous transhepatic cholangio drainage (PTCD) group and the T tube tract group.There were 40 patients who underwent lithotomy using rigid choledochoscopy via the PTCD tract and 46 patients who underwent choledocholithotomy using rigid choledochoscopy via the T-tube tract.A comparison was conducted to compare the duration of the procedures,the amount of perioperative bleeding,the postoperative complication rates and residual stone rates between the two groups.Results In the PTCD group,the average operation time was (77.0 ± 36.5) min,the amount of perioperative bleeding was (26.5 ± 54.1) ml,and the postoperative complication rate was 37.5 ％ (15/40).Complete lithotomy in one-stage was successful in 33 patients,and in two-stages in 1 patient.The residual stone rate was 15.0％ (6/40).In the T tube tract group,the average operation time was (82.5 ± 44.1) min,the amount of perioperative bleeding was (14.8 ± 21.0) ml,and the postoperative complication rate was 32.6％ (15/46).Complete lithotomy in one-stage was successful in 34 patients,and two-stages in 2 patients.The residual stone rate was 21.7％ (10/46).There were no significant differences in the residual stone rates,complication rates and operation time between the two groups (P ＞ 0.05).The amount of operative bleeding was significantly better in the T tube tract group than the PTCD group,(P ＜ 0.05).Conclusions There was no significant differences in the clinical efficacy in the treatment of bile duct stones using choledochoscopy either via the PTCD tract or the T tube tract group.Both approaches can be used for bile duct stones.

Natural products especially flavonoids are being explored for their therapeutic potentials in reducing bone loss and maintaining bone health. The present study is to investigate the effects of isoquercitrin from Craibiodendron yunnanense with different concentrations at 1 x 10(-4), 1 x 10(-5), 1 x 10(-6), 1 x 10(-7) mol x L(-1) on proliferation, differentiation and mineralization of MC3T3-E1. Cell proliferation was assessed by CCK-8 kit at 1, 3, 5 and 7 days of culture. Alkaline phosphatase (ALP) activity were performed qualitatively and quantitatively on day 7, and alizarin red S staining was employed to access the mineralization of cells on day 21. The osteogenic markers ALP, collagen type I (COL 1A1), runt-related transcription factor 2 (Runx-2) and Osterix were detected to analysis early osteogenic differentiation of cells on day 3 by RT-PCR. The results showed that isoquercitrin had a dose-dependent effect on the proliferation, osteogenic differentiation, mineralization and gene expression of MC3T3-E1 in the range from 1 x 10(-7) to 1 x 10(-5) mol x L(-1). At concentrations above 1 x 10(-4) mol x L(-1) isoquercitrin showed cytotoxicity, while 1 x 10(-6) mol x L(-1) is the optimal concentration of isoquercitrin to improve the osteoblastic activity. All these results implied that isoquercitrin might be the major composition of traditional Chinese medicine C. yunnanense to treat bone fractures.
Alkaline Phosphatase ; metabolism ; Animals ; Cell Line ; Collagen Type I ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Ericaceae ; chemistry ; Mice ; Osteoblasts ; cytology ; drug effects ; metabolism ; Osteogenesis ; drug effects ; Quercetin ; analogs & derivatives ; pharmacology

Adult ; Aged ; Agranulocytosis ; chemically induced ; Antineoplastic Agents, Alkylating ; administration & dosage ; adverse effects ; therapeutic use ; Brain Neoplasms ; secondary ; therapy ; Carcinoma, Non-Small-Cell Lung ; pathology ; Chemoradiotherapy ; Dacarbazine ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Dose-Response Relationship, Drug ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Remission Induction ; Survival Rate ; Vomiting ; chemically induced

Objective To explore the feasibility of using portable γ spectrometer to rapidly identify the low activity of depleted uranium and the underlying conditions.Methods Firstly,high purity germanium (Ge) γ spectrometer was used to analyze energy spectrum of DU samples (5 g) and calculate nuclide percentage of 235U in an attempt to ascertain the properties of these DU samples.The portable γ spectrometer was used to provide the evidences for identification of DU samples.Secondly,portable γ spectrometer was also used to identify DU samples of same group.These samples contain 1 g DU powder and 0-5 g environmental clay powder,which were sealed with double layer pocket,and then detected with a distance of 1-5 cm during the longest detection time of 10 min.According to the detection of nuclide activity of 238U and 235U in the samples and the subsequent calculation of specific activity,the nuclide percentage composition was calculated and the existence of DU was confirmed if this value of 235U was less than 0.718％.Results The activity of 238U was detected using portable γ spectrometer under all test conditions,while the activity of 235U was detectable only under certain test conditions (MA ≥ 1 g,DN ≤ 1 cm).Under the condition that the 238U and 235U was both detected,the nuclide percentage of 235U was all less than 0.718％,which suggested that the DU was confirmed.Conclusions The energy spectrum of low activity of DU and the type of nuclide could rapidly be identified and evaluated by using portable γ spectrometer.This is same as the conclusions obtained with high purity Ge γ spectrometer,α spectrometer and ICP-MS.

Objective To discuss decision of the safety margin of esophagus in the radical gastrectomy of adenocarcionma of esophagogastric junction.Methods The length of esophageal resection margin of intraoperative,postoperative and pathological large slice under the microscope of 50 cases adenocarcionma of esophagogastric junction underwent radical gastrectomy were measured,and the proximal invasive length of esophagus in large pathological slice were also measured,and the relationship between it and pathological factors was analyzed.Determined the minimum safety cut edge distance.Results In 46 of 50 patients,proximal intramural spread of the tumor was observed.The invasive length of tumor from 0.1 cm to 3.5 cm.The invasive length of tumor was <1.0 cm with 11 patients,1.0-1.5 cm with 19 patients,1.5-3.0 cm with 15 patients,in only 1 patient was the distance of spread 3.5 cm.Invasive length of adenocarcionma of esophagogastric junction had a significant difference between the groups in different pathological factors(P<0.001).Conclusion The length of 3.5 cm is the safety margin of esophagus in the radical gastrectomy of adenocarcionma of esophagogastric junction(SiewertⅡ,Ⅲ type) by abdominal incision.

Objective To compare the clinical effect of drug-eluting stents implantation or pure balloon expansion for the treatment of patients with knee artery lesions. Methods Sixty-eight patients with knee artery lesions were randomly and voluntarily divided into the control group( n=34 )and observation group( n=34 ) . The patients in the control group were given balloon expansion treatment,while in observation group were implanted drug-eluting stents besides balloon expansion. Pathological changes of skin temperature,percutaneous oxygen partial pressure( TcPO2 ),ankle brachial index( ABI),and the recurrence rate of patients before and after treatment for 6 months and 12 months were recorded and compared. Results After 6 months treatment,TcPO2 and ABI in observation group were(35. 4 ± 4. 5)mmHg and 0. 85 ± 0. 04,significantly higher than that in control group(( 28. 2 ± 3. 5 ) mmHg and 0. 62 ± 0. 03 ),and the differences were statistically significant( t=2. 535,2. 185;P﹤0. 05). At 12 months after treatment,skin temperature,TcPO2,ABI in observation group were(32. 4 ± 4. 3)℃,(34. 3 ± 4. 2)mmHg and 0. 80 ± 0. 04,significantly higher than that of the control group ((28. 6 ± 3. 7)℃,(26. 4 ± 3. 6)mmHg,0. 53 ± 0. 02;t =2. 354,2. 648,2. 064;P ﹤0. 05). Meanwhile,the recurrence rate was 5. 9% in observation group,significantly lower than that of the control group( 32. 4%;χ2=8. 463,P﹤0. 05). Conclusion The clinical effect of drug-eluting stents implantation in treatment of patients with knee artery lesions is superior to that of balloon expansion.

OBJECTIVE:To improve the quality of pharmacist consultation,provide real-time,precise and whole-process medi-cine guidance and to promote rational drug use. METHODS:The functions of electronic pharmacy consultation system(EPCS)in our hospital were introduced,and its effects were evaluated. RESULTS:The system had several modules as multiple dimensional knowledge assistant system,real-time prescription checking engine,electronic consultation record method,pharmacist workload and quality statistical analysis. EPCS provided convenient information access,prescription auditing,consultation record and statisti-cal analysis so as to improve consultation efficiency and accuracy. Compared with before using EPCS,EPCS had enhanced speed of inquiring information by 3.75 times,prescription auditing by 4 times,consultation record by 6 times and statistical analysis by 20 times;return visit rate to potients increased from 0.03% to 0.34%. The number of consulting questions increased month by month. The type of consultation question,the identity of the consultant and others could be classified statistically based on the sys-tem. CONCLUSIONS:EPCS helps pharmacist to build a more scientific and effective consultation platform,and promotes rational drug use in the hospital.

OBJECTIVE:To introduce the experience on how to build modern pharmaceutical logistics and dispensing system in outpatient pharmacy,and to provide reference for the construction of modern outpatient pharmacy. METHODS:The pharmaceuti-cal logistics system could be constructed by setting up secondary warehouse,pharmaceutical supply chain management system (PSCMS) and electronic drug storage system (EDSS);pharmaceutical dispensing system could be constructed through allocating automatic drug dispensing machine with different functions reasonably to carry out dispensing way of different modes combination, building automated pharmacy management system and developing emergency plan for the system fault of the automated pharmacy. The effects of logistics and dispensing system in our hospital were evaluated through comparing related index before and after the application of the systems. RESULTS:With the aid of PSCMS,the drug purchase information could be collected and calculated au-tomatically,the frequency and working time of the purchase were reduced by 50% and 75% respectively,and the accuracy of the purchase plan was increased by 12.5%;with the EDSS,the position and number information of the drugs could be acquired imme-diately,and the complementation and inventory time were decreased by 67% and 58% respectively;the time for manual dispens-ing was reduced by 68%,and the incidence of internal mistakes was decreased by 76.7%;under new dispensing system,the pre-scription could be distributed automatically and intelligently,the rate of automatic prescription processing was increased to 72.7%, and the average waiting time to pick up drugs was controlled to below 10 min. CONCLUSIONS:The pharmacists’working effi-ciency and the quality of pharmaceutical care have been improved by the modern pharmaceutical logistics and dispensing system, which settle the foundation for the transformation of the pharmaceutical care mode.