Objective To explore the effects of combined sevoflurane and remifentanil on shoulder dislocation in elderly patients.Methods A total of 100 elderly patients with shoulder dislocation were randomly divided into the control group and the observation group (n =50,each group).The control group was anaesthetized with remifentanil and the observation group was anaesthetized with sevoflurane and remifentanil.The clinical efficacy of anaesthesia,life quality and the University of California at Los Angeles (UCLA) shoulder rating scale were recorded.Results The excellent rate of anaesthesia was higher in observation group than in control group (92.0％ vs.68.0％,x2 =9.033,P=0.011).There were significant differences in mean arterial pressure (MAP),heart rate (HR) and arterial pulse oxygen saturation (SpO2) between the control and the observation group after anaesthesia [(86.3±3.0) mm Hg vs.(83.1±2.5) mm Hg,(83.2±4.5) times/min vs.(81.1±4.0) times/min,(94.4±5.5)％ vs.(92.0±6.0)％,respectively,t=5.794,2.466,2.085,all P＜0.05].There were significant differences in the onset time of anesthesia,surgery time,recovery time,and hospital stay days between the control and the observation group [(26.6± 6.6)min vs.(5.1±1.3) min,(4.6±2.1) min vs.(2.3±1.2) min,(4.9±2.3) min vs.(2.8±1.1)min,(205.5±121.1) minvs.(121.3±89.3) min,respectively,t=22.600,6.724,5.824,3.957,all P＜0.01].The scores of life quality and UCLA function were significantly higher in observation group than in control group after anesthesia (t =16.873,8.485,both P =0.000).Conclusions The treatment of combined sevoflurane and remifentanil treatment has a good clinical efficacy in elderly patients with shoulder dislocation.It can improve the scores of UCLA and life quality of elderly patients with shoulder dislocation.

Currently, some students place more emphasis on the pursuit of their individual values, but less on their social responsibilities. This can be attributed to the students themselves and the society as well. In order to develop their sense of social responsibilities, the article suggests that we should maintain proper guidance on their values,convert our concept of intellectual fostering and direct college students to participate in social practice.

Objective:To observe the effect of epalrestat on the heart rate variability in diabetes patients with silent myocardial is-chemia. Methods:Totally 60 patients were randomly divided into the control group and the treatment group with 30 cases in each. The two groups were given insulin or other routine drugs to keep blood sugar under control, ARB or ACEI and CCB to bring high blood pres-sure down, and statins to regulate lipid and anti-platelet aggregation, and both groups were without the use of beta blockers. The treat-ment group was given epalrestat 50mg three times a day for 4 weeks additionally. The indices of FPG, 2hPG, HbA1c, SBP, DBP, T-CHOL, TG, HDL-C, LDL-C and heart rate variability were observed after the treatment. Results: Compared with those before the treatment, the values of FPG, 2HPG, HbA1C, SBP, DBP, T-CHOL and LDL-c were decreased after the treatment in the two groups, and the differences were statistically significant (P <0.05), while the differences between the two groups were not obvious(P >0. 05). After the treatment, SDNN, SDANN, SDNNI, RMSSD, PNN50 and Mean HR in the treatment group were obviously im-proved, which were better than those in the control group (P<0.05). The adverse reactions in the two groups were similar (P<0. 05). Conclusion:Epalrestat can significantly improve HRV-related indicators in the diabetes patients with silent myocardial ischemi-a, which can reduce the risk of sudden death without significant adverse reactions in the combination with other drugs.

A new body surface projection method and a method of mapping with the H-C lead, based on the wave array transmission hypothesis of electrocardial solid field, are proposed. The results of mapping with the H-C lead in 31 cases of established chronic myocardial infarction were compared with those made synchronously with Wilson's lead and other limb leads.The present study demonstrated that mapping with the H-C lead had following three advantages: (1) the patterns of the left ventricular infarction were consistent with those of the Wilson's lead mapping; (2) the right border of the infarction outline was quite clear; (3) the configuration of the surface projection of the upper wall and diaphragmatic wall of both ventricular infarction, and the anterior, lateral and posterior wall of right ventricular infarction could be satisfactorily defined. Re-cults of the mapping with H-C lead in 31 cases also showed pseudo-infarction 12.9%, infarction involving right ventricle 35.5%, involving diaphragmatic wall 41.9%, and involving upper wall 45.2%. There were twenty two different patterns of surface mapping in 27 cases in this series.

Objective To explore the feasibility and outcome of percutaneous transluminal angioplasty (PTA) as a primary treatment modality long femoro-popliteal arterial occlusions in critical limb ischemia.Methods Ten cases with 10 lesions in their femoro-popliteal arterial occlusions were treated with PTA, and the symptoms, intraoperative and postoperative DSA characteristics were retrospectively analyzed. Short-term follow-up were obtained in 8 cases. Results The technical success rate related to procedure was 90% and 12 stents were placed after PTA in femoro-popliteal arterial occlusions. One case was suffered fromamputa-lion due to development of compartment syndrome. The primary patency rate and recurrence rate of 12 months after procedure were 70% and 30% respectively. Conclusion Patients with critical limb ischemia could be beneficial from PTA in long femoro-popliteal arterial occlusions.

ObjectiveTo compare the clinical efficacies of heat-sensitive point suspended moxibustion versus heat-sensitive point medicinal moxibustion in treating lumbar intervertebral disc herniation.MethodSixty patients with lumbar intervertebral disc herniation were randomly allocated to treatmentand control groups, 30 cases each. The treatment group received heat-sensitive point medicinal moxibustion and the control group, heat-sensitive point suspended moxibustion. The lumbar vertebra JOA score was recorded before and after treatment.ResultThe lumbar vertebra JOA score decreased significantly in both groups of patients after treatment (P<0.05). There was a statistically significant post-treatment difference in the lumbar vertebra JOA score between the treatment and control groups (P<0.05). There was a statistically significant difference in the total efficacy rate between the two groups (P<0.05).ConclusionThe results show that the lumbar vertebra JOA score decreased in both groups after treatment. The total efficacy rate of heat-sensitive point medicinal moxibustion is superior to that of heat-sensitive point suspended moxibustion in treating lumbar intervertebral disc herniation.

The clinical data was collected from 26 orthodontics patients at our hospital .All of them received straight wire appliance .The observed teeth were randomly classified into experiment and comparison groups.After the mounting of orthodontic bracket , Duraphat was smeared on the surface of maxillary central incisor, maxillary lateral incisor, maxillary canine, maxillary first premolar and maxillary first premolar in the experiment group while no Duraphat was applied in the comparison group .After wearing orthodontic appliance for 1, 3, 6 and 9 months, enamel demineralization of each tooth was observed .And the enamel decalcification index ( EDI ) of different areas of each tooth at different timepoints was recorded .More demineralization areas existed in the comparison group than the experiment group (P<0.01).In addition, no Ⅲ degree enamel demineralization was observed in the experiment group after Duraphat applying for 1 month.EDI were 0.20, 0.24, 0.21 and 0.16 in the experiment group after Duraphat applying for 1, 3, 6 and 9 months versus 0.37, 0.44, 0.44 and 0.34 in the comparison group during the same time periods.Therefore EDI and demineralization areas were significantly smaller in the experiment group than those in the comparison group (P<0.01).

Objective To Prepare and prefer method for the determination Wan Tong Yan Kang dripping pills. Methods Based on the Orthogonal test,the roundness and dissolution time were regarded as the index,the proportion of PEG4000 and PEG6000,the ratio of drug and matrix and material temperature were investigated. The pill weight pass rate (%)was regarded as the index to prepare dropping pills,the distance,dropping speed and temperature were investigated.Established isofraxidin content assay by HPLC. Results The best preparation method for drugs is:PEG4000 PEG6000 is 72,rugs:standard is1:4;the material temperature is 90 ℃;the cooling liquid temperature is 5 ℃;dropping distance is 10cm,dropping speed is 30 d/min. Isofraxidin regression equation is Y=26842X-835,R2 =0.998. Isofraxidin has good linear relationship in the range of concentrations 0.852-4.26 μg/mL. Conclusion The dripping pill preparation method is simple and feasible. Determination method has high sensitivity and good repeatability. The experiment provides a basis for the preparation of dripping pills and establishment of quality standards.

Objective To improve the content determination of eight-positive particles,and better control drug quality.Methods Gardenin, emodin and chrysophanol of eight-positive particles were determined by HPLC.Revised content determination standards and improved the standards of quality control. Results The revised content determinations of gardenin, emodin and chrysophanol were simple and feasible, and had high sensitivity.Conclusion Unification the quality standards of eight positive granules,the standards provide the basis for standardizing the market of eight-positive particles.

Objective In the study,the effect of berberine on Diabetic Nephropathy (DN) via oxidative stress was studied.Methods The DN model mice was administered with metformin (0.2g/kg),low-dose berberine (0.036 g/kg),middle-dose berberine (0.072g/kg) and high-dose berberine (0.144g/kg) for 8 weeks.After that,the fasting glucose,insulin,serum creatinine,urea nitrogen,Reactive Oxidative Species (ROS),Superoxide Dismutase (SOD),Kelch-like ECH-associated protein 1 (Keap1) 、Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) and NADPH oxidase 4 (NOX4),24h urine protein,etc were measured.Results Berberine could significantly decrease the fasting blood glucose levels,increase the insulin production,and reduce the levels of 24 h urine protein,serum urea nitrogen,creatinine,improve SOD and Nrf2,decrease ROS,Keap1and NOX4.Conclusion Berberine has the protactive effects in DN mice via the Keap-Nrf2/ARE pathway,and middle/high-dose berberine was much better.The mechanism may be related to the alleviated of the oxidative stress.