Objective To find out an optimal anesthesia and the d osage used in painless gastroscopy, and to evaluate its efficiency. Meth ods 200 patients undergoing painless gastroscopy were divided into 4 gr oups randomly. 2?g/kg iv of propofol was used in group Ⅰ, fentani 1?g/kg + pr opofol 2?g/kg in group Ⅱ, rimifentani 0.5?g/kg + propofol 1.5?g/kg in grou p Ⅲ, and rimifentani 0.75?g/kg + propofol 0.75?g/kg in group Ⅳ. Observed o bjects induced starting time and depth of anaesthesia, HR, R and SpO2 during o peration, side effects such as cough reflex and larynx spasm, time of regaining consciousness, postoperative side effects such as nausea and vomiting. R esult Significant differences (P≤0.01) were found between group Ⅳand the other 3 groups in starting time and depth of anaesthesia, side effects , time of regaining consciousness and suppression of respiration during operatio n. Conclusion Combined rimifentani 0.75?g/kg + propofol 0.75 ?g/kg are optimal anestheties in painless gastroscopy if side effects are preve nted.

Objective To prepare the PLGA nanoparticles( NPs) loading tetrandrine, investigate in vitro drug release behavior. Methods Tetrandrine loaded PLGA NPs were prepared by the emulsion solvent diffusion method and the preparation process was optimized by changing the stabilizer concentration and emulsion energy. The drug loading and entrapment efficiency were studied to evaluate the drug-loading property.The influence of particles size and pH value of release media on drug release behavior was investigated. Results Nanoparticles in the mean size of(203.4±2.8)nm had spherical shape and showed negative surface charge.Drug loading and entrapment efficiency was(2.17±0.10)% and(67.88±4.27)%, respectively.Tet-PLGA NPs retarded drug release in vitro, the cumulative release percentage was increased with the particle size increasing and it in acidic release medium showed a higher drug release amount. Conclusion Tetrandrine loaded PLGA nanoparticles have good entrapment efficiency, uniform particle size and can retard drug release in vitro.

Aim To study the effect of novel AChE inhibitors, 2-phenoxy-indan-1-one derivatives (YKY-1~7), against glutamatic acid-induced neurotoxicity in PC12 cells and on learning & memory impairment in dementia model mice induced by A?25~35 icv Methods The PC12 cells were preincubated with different concentrations of YKY-1~7 for 24 h and subsequently treated by glutamatic acid, at the high concentration of 2 mmol?L-1 for 15 min to induce cytotoxicity. The cell viability was assessed with MTT method.. Dementia model mice were made by intracerebroventricular injection (icv) of aggregated A?25~35. From the next day, the model mice were administered YKY-7 (2.5, 5, 10 mg?kg-1, ig) for 10 consecutive days and sham control mice or A? model control mice received daily ig saline. After the final treatment, the passive avoidance learning was tested, regional cerebral blood flow at cerebral cortex was assessed, and the activity of AChE in the cerebral cortex, hippocampus and blood serum were determined. Results Six out of the seven YKY compounds appeared to be effective against glutamatic acid-induced neurotoxicity in PC12 cells, with YKY-7 demonstrating the most activity. YKY-7 significantly ameliorated the learning and memory ability in dementia model mice induced by A?25-35 icv, slightly and selectively inhibited the cortical and hippocampal AChE, and gently increased the blood flow at cerebral cortex. Conclusion Some of 2-phenoxy-indan-1-one derivatives reported here have protective effects against glutamatic acid induced neurotoxicity in PC12 cells, and improve the learning and memory impairment induced by A?25-35, which may be partly attributable to its selective inhibition of AChE activity in the cerebral cortex and hippocampus.

Objective To investigate changes in the intraocular pressure(IOP) and anterior chamber angle in patients with chronic renal failure before and after hemodialysis. Methods Fifty?eight patients(116 eyes) with chronic renal failure were measured with Goldmann applanation tonometer and anterior segment optical coherence tomograph. The patients were divided into three groups based on gonioscopy results:the narrow angle group(22 eyes),the Iris neovascular group(3 eyes)and the open angle group(91 eyes). IOP was measured by Goldmann applanation tonometer in patients in the three groups before and after hemodialysis. Anterior chamber angle opening distance (AOD) was detected by anterior segment optical coherence tomograph before and after hemodialysis. The blood urea nitrogen,creatinine,albumin were also determined before and after hemodialysis. All changes in the parameters were analyzed with a paired t test. Results The IOP in narrow angle eyes and in neovascular eyes increased significantly after hemodialysis ,while the IOP in open angle eyes showed no significant changes. The AOD decreased significantly after hemodialysis. The blood urea nitrogen and creatinine decreased significantly in 58 patients,while albumin increased after hemodialysis. Conclusion The IOP in narrow angle eyes and in neovascular eyes increased after hemodialysis ,correlating with the resistance increase of aqueous outflow pathway and the change of plasma osmotic pressure. As a result ,it is recommended that the condition of eye of patients with chronic renal failure should be checked ,and patients should receive appropriate controlling measure or treatment before hemodialysis.

Objective To improve the selection of flying cadets of the Air Force of People′s Liberation Army of China ( PLAAF) by analyzing the differences of medical identification of lumbar spondylolysis between PLAAF and the US Air Force ( USAF) .Methods Flight crew who had been checked for lumbar spondylolysis during hospitalization at the Air Force General Hospital between 2013 and 2015 were chosen.The results of their medical identification were compaired according to PLAAF and USAF Medical Standards Directory, and their differences and possible reasons were analyzed accordingly.Results The qualified rate of PLAAF was about 85%, which was very close to the standards of USAF, but the difference was not of any statistical significance(P>0.05).Conclusion The standards of our medical identification of lumbar spondylolysis was similar to those of USAF, suggesting that the selection of flying cadets can be improved.

Objective Onto investigate the indoor quality control method for qualitatively detecting the laboratory indicators of TORCH infection (rubella virus IgG ,cytomegalovirus IgG and IgM ,toxoplasma IgG and IgM ) .Methods The statistical method , normal distribution data ,ratio and standard deviation of positive rate detected by the ELISA method were adopted ,1+2s was set as the out of control rules ,the semi Lerey‐Jennings quality control chart was drawn;the direct probability calculation method was a‐dopted for the non‐normal distribution data and small probability event .The testing data of 57 batches were retrospectively ana‐lyzed .Results The positive rate of rubella virus IgG was 86 .66% ,cytomegalovirus IgG/IgM positive rates were 98 .87% and 0 .13% ,toxoplasma gondii IgG/IgM positive rates were 2 .43% and 1 .71% ,the data of 151 ,3 ,5 ,176 ,27 samples had the critical value range of five indicators .The number of out of control was once for cytomegalovirus IgG ,once and 4 times for Toxoplasma gondii IgG/IgM .Conclusion The indoor quality control for the ELISA qualitative detection of TORCH infection can adopt the data of daily detection positive rate or negative rate for monitoring the false positive .The critical value range of specimens should be fur‐ther conducted the recheck or confirmation experiment .

Objective To explore the significant risk factors in patients with Tile C pelvic frac-tures.Methods We conducted a retrospective review of all patients with Tile C pelvic fractures in Nanjing First Hospital from January 2010 to December 2014.The data gathered on each patient in-cluded:age,sex,mechanism of injury,visiting time after injury,shock index,Injury severity scale (ISS),Revised trauma score (RTS),Glasgowcoma scale (GCS),lowest PaO2/FiO2 ,6 h lactate clearance rate,concomitant injures and interventious of Tile C pelvic fractures.The data were tested using Student’t-test,χ2 test and logistic regression method.Results The study include 139 consecutive patients.The total mortality was 29.5%.Among them,36 (25.9%)patients died within 48 hours after admission.Multivariate regression analysis showed that shock index (OR=2.591,95%CI 1.041-4.216), ISS (OR = 47.96,95%,CI 15.89-147.23 ),RTS (OR = 6.917,95% CI 1.147-13.862 ),GCS (OR =4.172,95%CI 2.962-6.268),lowest PaO2/FiO2 (OR= 117.016,95% CI 51.011-176.032),6 h lactate clearance rate (OR=2.785,95%CI 1.191-4.892),concurrent head (OR=6.302,95%CI 2.270-13.175)or chest (OR=12.233,95%CI 5.193-33.985)injures were associated with high morality of Tile C pelvic frac-ture (P <0.01).The performing digital subtraction angiography with intravascular embolization can cut the mortality (OR=0.887,95%CI 0.875-0.899).Conclusion In our study,high trauma score,serious shock, coma,PaO2/FiO2 decreased and 6 h lactate clearance rate decreased,combined with the head and chest inju-ry are the important reasons of mortality in patients with Tile C pelvic fracture.It’s vital to control shock actively,use trauma scale and emphasize multidisciplinary cooperation to reduce mortality in patients with Tile C pelvic fractures.

Objective To analyze the image and histological results of the combined use of allograft/extracorporeally frozen tumor-bearing bone and vascularized fibular flap for the reconstruction of bony defects following tumor resection,guiding clinical practice.Methods From March 2007 to June 2013,we enrolled 63 patients who had combinative biological reconstruction after bone tumor resection (11 in humerus,22 in femur,21 in tibia,4 in calcaneus).There were 36 male and 27 female in this series.The average age at time of operation was 20 years,ranging from 9 to 48 years.The follow-up ranged from 16 to 102 months with average of 48 months.We investigated the X-ray and CT images for all patients and histological findings of two patients.Patients were assessed functionally with the Musculoskeletal Tumor Society 93 score.Results Three patients with local soft tissue recurrence and one patient with infection underwent amputation.The survival of construct was 93.6％.Bone union achieved in all cases with the average MSTS score of 92.8％.Bone union ranged from 11 to 28 months in allograft group and 9 to 14 months in devitalized tumor bearing bone group.Significant difference of bone union time was found between two groups (Z=-3.638,P=0.000).Viability of the fibular grafts was verified in 58 of 63 patients (92％).Three types of images were observed in complex.Osteopenia and spongy change in fibula were found in 51 patients (81％) with stable fixation of the complex.Five complexes with failed blood supply of fibula and stable fixation revealed no density change of fibula,small amount of callous formation and relative delayed union.In seven complexes (11％) with unstable complex due to patients' incompliance,fibula reacted with dense hypertrophy and microfracture.Fusion of grafts with amount of callus was obviously observed.Union at allograft-host bone junctions occurred by residual host bone-derived external callus and fibular-derived internal callus that bridged the junction and filled the gap between abutting cortices.Callus from fibular graft was mature than that from periosteum of residual host bone.Internal repair was observed at the internal surface of the allografts.Fibula showed significant spongy changes.Conclusion Recycled tumor-bearing bone in combined with fibular flap is a reliable reconstruction as an alternative to traditional Capanna technique.The survival of the fibula is a cornerstone in success of complex reconstruction.Sponginess of fibula and internal repair of allograft compromise the intensity of complex,necessitating the strong instrumentation during reconstruction.

Objective To investigate the characteristics of click -auditory brainstem response (ABR) in nor-mal infants of 1 to 6 months old ,and to establish the normative values for latencies of Wave I ,III ,V and interpeak latencies of I- Ⅲ ,III-V and I-V for younger infants .Methods Click auditory brainstem responses were recorded from infants within 6 months :166 infants of 1 -months old(269 ears) ,141 2 -month old (226 ears) ,111 3 -months old(177 ears) ,58 4-months old(96 ears) ,78 5-months old(121 ears) and 45 6-months old(76 ears) .We compared the latencies of wave I ,III ,V and interpeak latencies of I - Ⅲ ,III-V ,I-V obtained from infants of differ-ent ages at different stimulus intensities .Results The average threshold of 1 to 6 months infants was 16 .18 ± 5 .35 dB nHL ,the average latency of Wave V was 9 .03 ± 0 .49 ms .The differences among the thresholds were statistical-ly insignificant(P>0 .05) .Wave I ,III and V were noticeable in all ears tested at 80 dB nHL .Wave I disappeared first as the stimulus intensity decreased ,and the latencies of Wave I ,III and V prolonged;on the contrary ,interpeak latencies of I -III ,III-V ,I-V shortened significantly .At the same stimulus intensity ,the latencies of Wave III , V and the interpeak latencies of I - Ⅲ ,III-V ,I-V shortened significantly except for Wave I .When comparing the differences among the testing parameters as a function of each month ,we found that there were statistically signifi-cant differences for the latencies of wave III ,V and the interpeak latencies of I -III ,III-V ,I-V before the 4 months old(P<0 .05) ,and there were no significant differences after 4 months old(P>0 .05) .Conclusion It is recommen-ded that 16 .18 ± 5 .35 dB nHL be used as the normative references for the evoked threshold of click auditory brain-stem responses for 1~6 month old infants .The development of central nervous system below the inferior calicles is fast before the 4 months old .

Traditional Chinese medicine ( TCM ) is an important part of traditional Chinese culture . As the car-rier of TCM culture , TCM hospital should continuously strengthen its culture construction . This is conducive to develop TCM advantages , to consolidate the development direction of TCM , to embody basic features of TCM hospital , to improve the core competitive power , to meet needs of the masses of TCM services . Therefore , fur-ther promoting the cultural construction of TCM hospital is worth thinking and practicing deeply . This article discussed the connotation and function of hospital culture , elaborated measures and effects by demonstrating the process of hospital cultural construction , and put forward ideas for the reform and innovation of hospital cultur-al construction .