It is often neglected that hypercapnia may occur during upper epidural anesthesia. To evaluate the necessity and accuracy of P_(ET)CO_2 monitoring through a nasotracheal oropharyngeal cathter during upper epidural anesthesia, 16 patients undergoing radical excision of mammary carcinoma, were investigated for the changes of PaCO_2 and PET CO_2, and the correlation between them. The results showed that the increases of PaCO_2 during the anesthesia were significant (P

Objective:To evaluate the safety of epidural Innovar during upper epidural anesthesia. Method: Fortyeighty patients of breast surgery were divided randomly into 3 groups. Epidural anesthesia was used in control group. Fentanyl 1?g/kg and droperidol 0.05mg/kg were administered intravenously 30 minutes after the epidural injection of local anesthetics in intravenous group. Fentanyl 1?g/kg and droperidol 0.05mg/kg were given epidurally combined with the local anesthetics in epidural group, Respiration,hemodynamic and blood analysis changes were observed in the three groups before and during anesthesia. Result:The decrease of respiratory rate and increase of PaCO_2 were more significant in intravenous group than those in control group. There was no significant change of respiratory rate,but increases of PaCO_2 in epidural group, which was higher than that in control group and lower than that in intravenous group. Conclusion: Small dose of Innovar used epidurally has less influence on the respiration than the same dose of Innovar used intravenously during the upper epidural anesthesia.

Objective To explore the application value of 3.0T magnetic resonance perfusion weighted imaging(PWI)in the rat late brain glioma model.Methods C6 glioma cells were injected stereotactically into the right caudate nucleus of 32 Wistar rats.In 3 weeks after inoculation,the conventional MRI and PWI were performed.The relative cerebral blood volume(rCBV)values were recorded and compared with the pathological results.Results The tumor formation in 30 inoculated rats were confirmed by the sub-sequent pathological examination,with the tumor formation rate of 100%.PWI showed that rCBV values of the brain glioma region and the contralateral mirror image brain tissue were 262.61±72.82 and 189.39±57.21,the difference between them was statisti-cally significant(P<0.05).Conclusion The rat late brain glioma model is suitable for the study on the blood volume of brain tumor tissues.

Objective To observe the effect and nursing measures of treating diabetic peripheral nerve dis-ease with method of Fuming and washing formula of Strengthening Qi to Dredging combined with point massage.Methods 68 DPN patients who were confirmed to the diagnostic criteria were randomly divided into the observation group and the control group with 34 patients in each,they were treated by conventional treatment but additional Fuming and washing formula of Strengthening Qi to Dredging combined with point massage was used in the observation group.The course for both groups was 4 weeks.The curative effects obtained were compared after treatment.Results The total effective rate was higher in the observation group(94.1%) than that in the control group(67.6%).Conclusions Fuming and washing formula of Strengthening Qi to Dredging combined with point massage treatment on DPN has better effect than western medicine alone in promoting DPN restoration.

Objective To summarize the key points of nursing care to pregnant women with acute cholecystitis and gallstones. Methods The clinical data of twenty three pregnant women with acute cholecystitis and gallstones during August 2007 to January 2012 were reviewed and analyzed retrospectively,including 19 cases for conservative treatment,3 cases for surgical treatment,1 case for abortion.Results All patients were cured and discharged with hospital stay for 7 to 21 days,averaged(12.7±4.7)days. Conclusion For pregnant women with acute cholecystitis and gallstones,efforts should be focused on dynamic monitoring of vital signs and fetal conditions,psychological care and diet care in order to ensure the safety of the mathers and infants.

Objective To establish the HPLC determination method of chlorogenic acid for developing the quality standard of Yinqiao Jiedu Oral Liquid.Methods HPLC method was performed on an E.Merck LiChrospher 100RP-18 column(250 mm? 4 mm,5 ? m).The mobile phase consisted of acetonitrle and o.4 % phosphoric acid(10:100).The flow rate was 1.0 mL/min,column temperature was 30 ℃,and the detection wavelength was 327 nm.Results Chlorogenic acid was linear at the range of 0.12～ 0.63 ? g(r=0.999 6),the average recovery was 96.68 %,and RSD was 1.56 % .Conclusion This method is accurate,reliable,reproducible,and can provide evidence for the quality control of Yinqiao Jiedu Oral Liquid.

Objective To explore the effect of continued nursing on postpartum breastfeeding within 6 months. Methods Two hundred and twenty parturient women were randomly divided into the observation group and the control group using random digits table. The control group received breastfeeding knowledge education and nursing skills instruction. The observation group was given continued nursing and breastfeeding guidance . The two groups were compared in terms of breastfeeding rates at 1 , 2 , 3 , 4 , 5 , 6 months . Result The breastfeeding rates of the observation group were significantly higher than those of the control group at each time point ( all P < 0 . 05 ) . Conclusion According to reasons why the parturient women don′t breastfeed , they are given continued nursing and detailed solutions after discharge , to make them confident in breast feeding and improving breastfeeding rate within six months after delivery .

Objective To explore the clinical manifestation of a patient with hypoparathyroidsmsensorineural deafness-renal dysplasia (HDR) syndrome and to sequence the related GATA3 gene of the patient.Methods A 22 year old person with HDR syndrome was reported in regard to clinical manifestation,laboratory examination,and genetic mutation.Some related literatures were reviewed.Results The patient showed tetany,deafness,and positive Chvosteks' and Trousseau' s signs.The initial laboratory studies showed that serum concentration of calcium was lowed and the iPTH level were lower than normal.Binaural pure tone audiometry showed Binaural sensorineural deafness.Colour doppler ultrasound revealed that his right kidney was not observed and the level of creatinine was increased,indicating renal insufficiency.GATA3 mutations on DNA sequence analysis indicated that the 6 exon IVS6-1G-A (G/A heterozygosis splicing),showed the mutation of G to A is in the upstream of the first base in the six exon.After treating with calcium carbonate and vitamin D,the symptoms and signs were improved.Conclusion HDR syndrome is a rare endocrine disease,that should receive more attention in order to avoid missing diagnosis;The IVS6-1G-A as a novel mutation of GATA3 gene,has not been reported so far.

Objective To investigate the prevalence of hyperglycemia in patients with primary aldosteronism.Methods Thirty two patients diagnosed as primary aldosteronism(PA) in our hospital from 2010 to 2013 (PA group),and 40 patients as essential hypertension (EH group).Two groups were measured and compared,including blood pressure,plasma aldosterone,urine aldosterone,and plasma potassium.Oral glucose tolerance test (OGTT) was performed and homeostasis model assessment-insulin resistance index(HO-MA-IR) were calculated.Results The prevalence of hyperglycemia was 43.75％ in PA group,including 25％ patients of glucose intolerance and 18.75％ patients of diabetes mellitus,which was significantly higher than those of EH group (25％,12.5％,and 12.5％,respectively).PA group's fasting and 2-hour postprandial insulin levels and insulin resistance index were higher than that of EH group.Conclusions The present study indicated that patients with PA had a significantly high prevalence of glucose metabolism disturbance and insulin resistance.Screening test should be performed and avoid missed diagnosis.

Objective To explore the clinical effect of three doses of mifepristone on patients with dysfunc-tional uterine bleeding.Methods 150 patients with dysfunctional uterine bleeding were chosen,and they were randomly divided into 3 groups,including low dose group (50 patients),middle dose group (50 patients)and high dose group (50 patients).All patients adopted routine treatment.On the basis of this,the low dose group received 6.25mg/d mifepristone,the middle dose group received 12.5mg/d mifepristone,the high dose group received 18.25mg/d mifepristone,continued 6 months.The influence of follicle stimulating hormone (FSH),luteinizing hor-mone (LH),estradiol (E),progesterone (P),volume of uterine and endometrail thickness of patients were observed. Results After treatment,the FSH,LH,E and P levels in the three groups were significantly decreased compared with before treatment (FSH:t=4.406,5.329,3.610,LH:t=4.563,6.134,4.455,P=0.000,0.000,0.000;P=0.000, 0.000,0.000;E:t=7.173,6.815,7.018,P=0.000,0.000,0.000;E:t=2.367,6.315,4.351,P=0.020,0.000, 0.000),and the difference were statistically significant (all P<0.05).Before and after treatment,FSH,LH,P levels among the three groups had no obvious differences (P>0.05 ).Compared with the low dose group,E levels in the middle dose group and high dose group significantly decreased(t=3.850,2.085,P=0.000,0.004).Before and after treatment,the uterine volume among the three groups had no significant difference (P>0.05 ).After treatment,the functional uterine bleeding symptoms were significantly relieved in the three groups,the effective rate was 100%.The recurrence rate of the low dose group was 32%,which was significantly higher than 8%and 10%of the middle dose group and high dose group.The amenorrhea rate of the middle dose group and high dose group(6% and 2%)was significantly lower than that of the low dose group (46%).Conclusion The treatment of 12.5mg/d mifepristone is effectively adapted to patients with dysfunctional uterine bleeding.