Objective To observe the preventive effect of epidural injection with low - dose of ketamine on postanesthesia shivering(PAS) undergoing percutaneous nephrolithotomy. Methods Sixty ASA Ⅰ～Ⅱ grade patients aged 35 ～ 72 years undergoing PCNL were randomly divided into kctamine group (n = 30, Epidural injection of 0.5mg/kg of ketamine) ,Control group(n = 30, Epidural injection of 10ml saline). The rate of shivering was observed and recorded during operation,and blood pressure and respiration were measured. Results The rate of shivering in ketamine group(10%) was significantly lower than that in control group(46.7%, P ＜ 0.05) ,There were no significant differences of blood pressure and respiration between two groups (P ＞ 0.05). Conclusion Epidural injection 0.5 mg/kg of ketamine on postanesthesia can prevent shivering in PCNL.

Cholangiocytes are the epithelial cells that line the intrahepatic biliary tree and also the target of cholangiopathies. Despite the heterogeneous etiology ,most of cholangiopathies share the common pathological process which is the imbalance between proliferation and apoptosis of cholangiocytes. The article is a review about the characteristics and mechanism of proliferation and apoptosis of cholangiocytes and their relationship to cholangiopathies.

Objeetive To investigate the relationship between 24-hour blood pressure rhythm and carotid scleratheroma in elderly patients with hypertension.Methods 193 elderly patients with hypertension were enrolled in the study and divided into study group (91 cases with carotid atherosclerosis) and control group (102 cases).All the patients were given 24h blood pressure rhythm examination.The characteristics of 24hour blood pressure rhythm was compared between the two groups.Results The 24h average systolic blood pressure(24h-SBP),24h average diastolic blood pressure (24h-DBP),24h average pulse pressure (24h-MBP) between the study group and the control group had no significant differences(P ＞ 0.05).The daytime average systolic blood pressure(d-SBP),diurnal mean diastolic blood pressure (d-DBP),diurnal average pulse pressure (d-MBP),nocturnal mean systolic blood pressure (n-SBP),nocturnal mean diastolic blood pressure(n-DBP),nocturnal mean pulse pressure(n-MBP) of the study group were significantly higher than those of the control group (t =16.92,24.68,6.16,12.87,11.59,6.35,all P ＜0.05).In study group,d-SBP,d-DBP,d-MBP were higher than n-SBP,n-DBP,n-MBP,the differences were statistically significant(F =73.61,P ＜ 0.01).The circadian blood pressure variability of the study group was more than 10％,the 24h ambulatory blood pressure curve graph of the study group was non-dipper curve.The circadian blood pressure variability of the control group was less than 5％,the 24h ambulatory blood pressure curve was dipper type curve.Conclusion The MBPS is strongly associated with carotid scleratheroma,and clinical treatment and study could derive from ABPM data analysis.

Environmental enrichment has become a hot topic in laboratory animal science , which is intended to im-prove the well-being of laboratory animals .This paper reviews the research in this area , focusing especially on the princi-ple and procedure of planning enrichment strategies .The consideration of housing laboratory animals should not only focus solely on animal well-being, manpower and economics , but also on the precision and accuracy of the experimental results . It also introduces the type of environmental enrichment and practice in widespread use currently .

Objective:To evaluate the clinical outcome of transcrestal maxillary sinus floor elevation(TMSFE)in the presence of pseudocyst.Methods:14 cases with pseudocyst were treated by TMSFE.In the operation following osteotome,pseudocyst was not ex-cised and sinus floor membrane was elevated,15 implants were placed for the 14 cases.Definite prosthesis was delivered about 6 months after implant placement.CBCT examination was done before,immediately after and 1-year after surgery,the cyst condition, the gain of vertical bone height and implant stability over time were observed.Results:Pre-operation residual ridge height of the alveo-lar crest was (6.85 ±1.07)mm.The sinus membrane was successfully elevated in all sites without perforation (mean elevation height,6.93 ±2.07)mm.All 15 implants were ossteointegrated.At 1-year revisit the gained bone height was (12.76 ±2.03)mm. Cyst grew bigger in 3 cases,not changed in 3 cases,became smaller in 5 cases and disappeared in 3 cases.Conclusion:Pseudocyst excision is not necessary in TMSFE.

This paper discussed the development of hospice care in our country form five respects , detailed e-laborated our country the main manifestations of lacking hospice medical service policy : relevant policies render fragments;relevant policy interoperability is not strong;Relevant policy lack of financial support;the lack of pub-licity related policy .On this basis , put forward the hospice career development needs of related policies , inclu-ding:set up complete medical security system;establish perfect hospice service classification management mecha-nism;establish and perfect the government funds allocated for hospice care medical services .

Objective To analyze the literature characteristics on environmental enrichment published in China , and provide reference for researchers .Methods The papers relevant to environmental enrichment published in CNKI database and Wanfang database were statistically analyzed from the aspects of publishing year, journal of publication, author, institution and subjects covered by the article with bibliometrics method.Results There were 422 papers published before Dec 31,2015, in which 273 papers published in 126 kinds of journals.The number of papers increased gradually, especially after 2006.The top 3 journals with the most articles published were Chinese Journal of Wildlife(28),Chinese Journal of Rehabilitation Medicine(15) and Chinese Journal of Behavioral Medicine and Brain Science(12).Xinqiao Hospital of TMMU and Fujian Medical University Union Hospital accounted for the top 2 total number of the papers, from which Yan-hui Chen and Cong-min Zhao published the more articles.Those papers covered 17 subjects, neurology, pathergasiology, biology and pediatrics were the main subjects. There were 3 kinds of animal that got enriched, the first was laboratory animals(69.6%), then zoo animals(22.9%),and farm animals(7.5%).Conclusions The research of environmental enrichment was relatively concentrated in terms of neurology and psychiatry.To improve animal welfare was mainly in the zoo animals;laboratory animal research in this direction was less .It is necessary to strengthen the work in this regard.

1 cases of pleomorphic hyalinizing vascular tumor(PHAT) at the right side of neck soft tissue is reported and related literatures are reviewed.The clinical symptoms of PHAT are mild and non-characteristic,imaging examination and postoperative pathological examination may show specificity of the lesion.It is a kind of soft tissue tumor with malignant tendency.Surgical excision is the main treatment,long-term follow-up is recommended.

Anti-adhesive materials were the hot spot in recent clinical study because opinions were vary from different experts . This paper aims to introduce the classification of anti-adhesive materials according to the different properties and expound the mecha-nism and application limitation of anti-adhesive .The pitfalls in current barrier materials research and future research directions are summarized and analyzed .