Objective To investigate the safety and feasibility of ketamine,propofol compound fentanyl com-bined with fentanyl in anesthesia for pediatric patients.Methods 70 cases of children with elective pseudo operation were randomly divided into the two groups of 35 cases in each group,the control group were taken ketamine,propofol for anesthesia,while the observation group were treated with fentanyl on basis of that,the anesthesia effect and inci-dence of adverse reactions were observed and compared between the two groups.Results HR and MAP at 15min during operation and after operation of the control group were increased significantly than those before anesthesia,the difference was statistically significant(t=7.33,7.19,8.26,8.11,all P<0.05),while HR and MAP in the observa-tion group at each time point of showed no significant difference(t=1.03,1.10,1.12,2.01,all P>0.05)when compared with pre anesthesia;The postoperative awake time of the observation group was (12.54 ±2.16)min,which was significantly less than (23.54 ±6.27)min of the control group(t=7.78,P<0.05),and its intraoperative and postoperative adverse reaction rate was 11.43%,which was significantly less than 42.86%of the control group(χ2 =8.33,P<0.05).Conclusion Ketamine,propofol combined with fentanyl has a good anesthesia effect better in pedi-atric,which can be maintained stable of hemodynamics,and children can rapid recovery after operation,with fewer adverse reactions.

BACKGROUND:Fractures of shafts of the tibia and fibula are the most common diaphyseal fractures among al long bones. The clinical significance of fibula fixation in treatment of distal third shaft fractures is controversial, and the studies are also different. OBJECTIVE:To explore the clinical significance of fibular fixation in treatment of distal third tibia shaft fractures. METHODS:A retrospective review has been performed on the clinical data of sixty-four cases with distal third tibia shaft fracture in Department of Orthopedics, China National Offshore Oil Corporation General Hospital from January 2006 to March 2010. Al cases were divided into two groups based on whether the fibula was fixed or not: fibula fixation group (n=36) and fibula non-fixation group (n=28). Union rate of fracture, bone union time and tibial valgus angle were compared between the two groups. According to Merchant-Dietz criteria, the ankle range of motion and ankle evaluation score were evaluated and compared between the two groups. RESULTS AND CONCLUSION: No significant difference in union rate of fracture, bone union time and ankle range of motion was detected between two groups. Tibial valgus angle was smaler in the fibula fixation group (5.42±1.16)° than in the fibula non-fixation group (7.54±1.90)°(P=0.006). Ankle function score was higher in the fibula fixation group (93.58±0.97) than in the fibula non-fixation group (90.57±3.92) (P=0.000). Three cases in the fibula fixation group suffered from superficial wound infection, and achieved good healing after treatment of anti-infection and changing dresses. Above results verify that fibular fixation can reduce tibial valgus angle and improve ankle joint function in treatment of distal third tibia fractures.

Objective To observe the clinical effects of prostaglandin E1 on liver cirrhosis patients and evaluate its security. Methods 68 cases with liver cirrhosis admitted in Luqiao hospital were randomly divided into experimental group(34 cases)and control group(34 cases)equally. Patients in control group were received normal therapy,while in experimental group were added prostaglandin E1 on basis of normal therapy. The efficacy and adverse reactions were observed and compared. Results Compared with before treatment,the average value of albumin in two groups were increased obviously,which in experimental group from (27.9 ±4.1)g/L to (36.5 ±4.3)g/L,control group from (27.8 ±4.0)g/L to (31.7 ±4.2)g/L,the differences were significant(P<0.05 ),and the difference between two groups was significant(P<0.05 ),too. The content of alanine aminotransferase and aspartase aminotransferase in two groups were decreased significantly(P<0.05 ),and experimental group was more lower than control group(P<0.05 ). The number of effcacy in experimental group was 28 and account for 82.35%,while in control group was 1 1 and account for 32.35%,the difference was significant(P<0.05). Conclusion Prostaglandin E1 can improve liver function,and has good clinical effects and high security in treatment with liver cirrhosis patients.

Aim To investigate the chemical constituents of the secondary metabolites of the roots of Daphne genkwa. Methods The roots of D. genkwa were extracted with 95% ethanol at 60 - 70 ℃ for 7 days to obtain the crude extract. The crude extract was purified by silica gel and Sephadex LH-20 column chromatography as well as the HPLC techniques. The structures of the isolates were elucidated by combined spectroscopic methods including 1D and 2D NMR, MS, UV, IR and CD. Results Three new biflavonoids were isolated from the ethanol extract of the roots of D. genkwa and their structures were identified as daphnodorin H-3-methyl ether (1), daphnodorin H-3"-methyl ether (2) and daphnodorin G-3"-methyl ether (3). Conclusion Compounds 1, 2 and 3 are three new biflavonoids.

Bone Resorption ; China ; Cytokines ; physiology ; Diphosphonates ; pharmacology ; Estrogens ; pharmacology ; Humans ; Jaw ; drug effects ; metabolism

Objective The objective of this study was to determine the effect of curative chemotherapy regimen on breast cancer cells and its mechanism.Methods A tumor-bearing mouse model was established and routine dose of capecitabine was given as a conventional chemotherapy group.Continuous low-dose capecitabine chemotherapy was used as a radiotherapy group and no chemotherapy was used as a control group.The expression of microvessel density(MVD),vascular endothelial growth factor(VEGF)and thrombospondin 1(TSP-1)were measured by flow cytometry.The percentage of myeloid-derived suppressor cells(MDSCs),NK cells and macrophages in the program was observed.The tumor size and blood leukocyte count were measured after chemotherapy.Results MVD and VEGF in the radiotherapy group were significantly decreased and TSP-1 was significantly increased in comparison with the conventional chemotherapy group(P<0.05).The proportion of MDSCs in the radiotherapy group was significantly decreased,the proportion of NK cells and macrophages were significantly increased when compared to the conventional chemotherapy group(P<0.05).The tumor volume was no difference between the control and chemotherapy groups(P>0.05).However,the white blood cell count in the radiotherapy group was significantly higher than that in the conventional chemotherapy group(P<0.05).Conclusion Capecitabine chemotherapy at continuous low-dose inhibits neovascularization and adjusts the proportion of immune cells to suppress tumor formation.Thus,this chemotherapy could reduce side effects caused by chemotherapy and improve the quality of life.

AIM: To establish ()~1H NMR fingerprint of Radix Daphne genkwa to disclose its chemical composition of the secondary metabolites and provide a quick and credible assay for the detoxicated extraction of the active constituents. METHODS: The ()~1H NMR spectrum of petrol-acetone-methanol extract from Radix Dephne genkwa was detected using CDCl_3/DMSO-d_6(1∶1) as the deuterium reagent. The resonance intensity of the proton in the spectrum was indicated in relative integral area of peaks referenced by the resonance intensity of methyl signal in DMSO. The ()~1H NMR of cascade extraction of Radix Dephne genkwa by the reagent in sequence of petrol→acetone→methanol or chloroform→aether→acetyl acetate→methanol was utilized for observing the variation on their chemical compositions. RESULTS: The ()~1H NMR of Radix Dephne genkwa clearly expressed the information of the protons from long chain aliphatics or genkwadaphnin derivatives, aromatic coumarins or flavonoids as well as glycosides with moiety(ies) of pyran saccharide, symbolizing the existence of aliphatics, genkwadaphnin derivatives, coumarins and flavonoids. Remarkable difference was observed in ()~1H NMR spectrum of the extract by different cascade reagent. As the increase in the polarity of reagent, the intensity of the proton signals in upper field was quickly reduced concomitantly with the rapid enhancement of active proton signals from hydroxyls and saccharides in glycosides in down field. CONCLUSION: The ()~1H NMR fingerprint of Radix Dephne genkwa possesses its own characteristics and can be used as a reliable assay for studying the extraction of active constituents with minimum content of toxic diterpenoids. (Key

The resistance to steroid remains a major trouble in the treatment of idiopathic nephrotic syn-drome,and the mechanisms are complicated. Recent studys have shown that multidrug resistance gene l and P-glycoprotein170,glucocorticoid receptor,renal pathology,gene mutation and complications are all closely related to the resistance to steroid. This review is focused on the mechanisms of steroid resistance of children′s idiopath-ic nephrotic syndrome.

Objective To investigate the relationship between evidence-based nursing tactics and quality of life of breast cancer patients so as to provide the reference for the best nursing strategy .Methods 87 patients who were diagnosed with breast cancer received surgical treatment were randomly divided into experimental group (44 cases) and control group (43 cases) .Patients in control group were given general nursing ,while those in experimental group were given evidence-based nursing tactics on the ba-sis of general nursing .Both groups were asked to fill in the quality of life questionnaire after 4 months breast cancer treatment and before treatment .Results The quality of life in experimental group was significantly improved after treatment compared with that of before treatment(P< 0 .05) ,the quality of life in the experimental group received evidence-based nursing tactics is significantly better than that of in control group (P< 0 .05) .Conclusion Evidence-based nursing tactics can improve the quality of life in breast cancer patients .

This article elaborates the present conditions and development of education of postgraduates in medicalcolleges, emphasizing the importance of putting applied computer education on medicine. It declares that the coursesfor computer education of postgraduates should be set according to the feature of the major and some innovation in thecontents and methods of teaching should be made. At the same time, it mentions it is necessary to strengthen practicalcomputer education and train the students' capability of innovation and self-education.[