ve To evaluate the effects of desflurane and sevoflurane on postoperative cognitive function in the elderly to see if there is any difference. Methods Seventy ASA Ⅰ-Ⅱ patients agedl≥65yr undergoing total knee or hip replacement were randomly assigned to one of the two anesthetic groups of thirty-five patients each:desflurane group and sevoflurane group. All patients were premedicated with midazolam 1 mg iv. Anesthesia was induced with fentanyl 1.0-1.5?g?kg-1, propofol 1.0-2.0 mg?kg-1 and succinylcholine 1 mg?kg-1 and maintained with either 2%-4% desflurane or 1.0%-1.5% sevoflurane combined with N2 O in O2 (1:1) and intermittent iv boluses of vecuronium. MAP, HR, ECG, SpO2, PETCO2 and end-tidal concentration of desflurane or sevoflurane were monitored continuously during operation. After tracheal intubation the patients were mechanically ventilated and PETCO2 was maintained at 30-40 mm Hg. The Mini-Mental State (MMS) test was used to assess cognitive function before and at 1, 3, 6 and 24h after surgery. Results Compared with the baseline values the MMS scores decreased significantly at 1h after operation in both groups. However the MMS scores returned to preoperative baseline levels within 6h after surgery in both groups. There were no significant differences in MMS scores between the two groups before and after operation. At 1h after operation 51% of the patients in desflurane and 57% in sevoflurane group experienced cognitive impairment. But at 3h after surgery the percentage of the patients with cognitive dysfunction decreased to 11% in desflurane group and 9% in sevoflurane group. Conclusions In the elderly the postoperative cognitive dysfunction is temporary lasting only a few hours and the effects of desflurane and sevoflurane are similar.

Objective:To evaluate the effect of high intensity interval training on cancer patients.Methods:Web of Science, EBSCO, PubMed, Ovid, EMbase, Cochrane Library, CBM, CNKI and Wanfang database were searched for randomized controlled trials of the effect of high intensity interval training on cancer patients, RevMan5.3 software was used for analysis.Results:Eleven articles with a population of 614 were included in the analysis, which involved 323 cases of the intervention group and 291 cases of the control group. The analysis showed that high intensity interval training could improve the total quality of life ( SMD values were 0.40, 95% CI 0.14-0.65, P<0.01) and peak oxygen uptake ( MD values were 3.00, 95% CI 2.19-3.80, P<0.01) of cancer patients, and reduce carotid intima-media thickness ( MD values were -0.06, 95% CI-0.08--0.03, P<0.01), but did not reduce the high-sensitivity C-reactive protein ( MD values were -0.61, 95% CI-1.23-0.01, P>0.05) and body weight ( MD values were 0.16, 95% CI-3.19-3.51, P>0.05). Conclusions:High intensity interval training has a positive impact on quality of life, cardiopulmonary function and carotid intima-media thickness with cancer patients, but has no significant effects on high-sensitivity C-reactive protein and body weight.

Objective To determine the value of forced expiratory volume in 6 second (FEV6) and forced expiratory volume in 1 second (FEV1)/FEV6 in diagnosis of obstructive and restrictive lung ventilation dysfunction.Methods A total of 470 cases receiving spirometric examinations were analyzed retrospectively.A subject was considered to have obstruction if FEV1/forced vital capacity (FVC) was ＜ 70％.The restriction was defined as FVC ＜ 80％ in the absence of obstruction.The best cut-off of FEV1/FEV6 and FEV6 were determined through receiver-operating characteristics curve,and the sensitivity,specificity,accuracy and Kappa of FEV1/FEV6 and FEV6 were calculated.Results It showed that the current cut-off points used to detect obstruction and restriction could be replaced by FEV1/FEV6 was 71％ and FEV6 was 82％,respectively.FEV1/FEV6 had sensitivity of 97.5％ (154/158),specificity of 98.7％ (308/312),accuracy of 98.3％ (462/470) and Kappa of 0.962 (P=0.000).For restrictive pattern,FEV6 had sensitivity of 96.1％(73/76),specificity of 95.7％ (222/232),accuracy of 95.8％ (295/308) and Kappa of 0.890 (P =0.000).Conclusions FEV6 can be a valid alternative for FVC in the diagnosis of obstructive and restrictive lung ventilation dysfunction.

Objective To explore the role of Th17 cells in the pathogenesis of asthma .Methods Peripheral blood was obtained from 10 patients with asthma(asthma group) and 10 healthy volunteers(control group) .RORγt mRNA expression of lymphocytes was measured by RT-PCR ,percentage of Th17 cell was detected by FCM ,IL-17 in plasma was examined by ELISA .Results RORγt mRNA level in asthma group(0 .46 ± 0 .07) was significantly higher than that in control group (0 .15 ± 0 .02) ,proportion of Th17 cell in asthma group(28 .53 ± 7 .20)% was significantly higher than that in control group(14 .72 ± 2 .33)% ,P<0 .01 .Com-pared with IL-17 level in control group(59 .68 ± 8 .85)pg/mL ,there was significant increase in asthma group(102 .31 ± 11 .45)pg/mL(P<0 .01) .Conclusion Th17 cell is associated with asthma ,and probably aggravating asthma condition through increasing in-flammation secreting IL-17 .

Objective To observe the effects of Chinese herbal medicine of Yiqi Huoxue (YQHX) on proliferation and expression of E-CD and invasion of human lung cancer cell lines - small cell lung cancer (NC-H446) in vitro. Methods By cell measured method, immunohistochemistry method, technique of image and Boyden Chamber method, the effects of YQHX or all trans-tretinoin acid (ARTA) on proliferation and expression of E-CD and invasion of NC-H446 cell lines with different time cultured by YQHX or ARTA in vitro were studied. Results The proliferation of NC-H446 were inhibited significantly by 5% YQHX or 10-5 mmol/L ARTA (P0.05). The shape and structure of cell NC-H446 was occurred variant. YQHX enhanced remarkably expression of E-CD of NC-H446 with 36 hour cultured (P 0.05). The quantity of NC-H446 cells crossed Matrigel and polyvinylpyrrolidone-free polycarbonate filter were more than the control group (P 0.05). Conclusion YQHX can inhibit the proliferation, enhance expression of E-CD on NC-H446, and decrease invasion and metastasis of NC-H446.

Objective:To establish the quality standard for infantile bronchitis traditional Chinese medicine lotion. Methods:TLC was used for the qualitative identification of Ephedra herba, Paeonia lactiflora Pall. , Poria cocos, Fructus aurantii and Epimedium brev-icornu Maxim. . HPLC was used for the content determination of ephedrine hydrochloride, pseudoephedrine hydrochloride and paeoni-florin. The chromatography conditions for ephedrine hydrochloride and pseudoephedrine hydrochloride were as follows: an AElichrom Pdar-Phenyl Polyphenyl ether-bonded phenyl-bonded silica column (250 mm × 4. 6 mm, 5μm) was used, the mobile phase was aceto-nitrile-0. 2% phosphoric acid solution (1 :99), the flow rate was 1. 0ml·min-1, the detection wavelength was 210 nm, the column temperature was 30℃ and the injection volume was 10 μl. The chromatography conditions for paeoniflorin were as follows:an Inertsil ODS-3 C18 column (250 mm × 4. 6 mm, 5 μm) was used, the mobile phase was acetonitrile-0. 1% phosphoric acid solution (15:85), the flow rate was 1. 0 ml·min-1, the detection wavelength was 230 nm, the column temperature was 30℃ and the injection vol-ume was 10 μl. Results:The TLC results of Ephedra herba, Paeonia lactiflora Pall. , Poria cocos, Fructus aurantii and Epimedium brevicornu Maxim. showed clear spots with good resolution. Ephedrine hydrochloride, pseudoephedrine hydrochloride and paeoniflorin had a good linear relationship within the range of 10.11-101.10 μg·ml-1(r=0.9996), 10.08-100.80 μg·ml-1(r=0.9991) and 20.50-102.5 μg·ml-1(r =0.9996), respectively. The average recovery was 98.80% (RSD =1.87%, n =6), 98.77%(RSD=1. 72%, n=6) and 99. 57% (RSD=1. 56%, n=6), respectively. Conclusion: The established quality standard can be used for the quality control of infantile bronchitis traditional Chinese medicine lotion.

OBJECTIVE:To provide reference for promoting clinical rational application of Xueshuantong for injection(lyophi-lized). METHODS:By hospital centralized monitoring method,all medical records were retrieved from Hospital Information Sys-tem of our hospital,who received Xushuantong for injection(lyophilized)from Aug. 7 to Oct. 6 in 2015;general information of patients'drug information,drug utilization and the occurrence of ADR were traced and recorded by clinical pharmacists to evaluate the rationality of clinical utilization of Xushuantong for injection(lyophilized). RESULTS:Totally of 1014 medical records were included in the study. Xueshuantong for injection(lyophilized)was mainly used for fracture,cerebral infarction,coronary disease, cataract and other disease. 22 clinical departments as orthopedics department,neurology department,cardiology department and ophthalmology department were involved,accounting for 56.41% of total. For the patients receiving Xushuantong for injection(ly-ophilized),the average age was 63.12 years,the average course was 11 days and dose was 100-500 mg/time. They were given medicine intravenously once a day,and 0.9% Sodium chloride injection was used as solvent (93.29%). There were 10 kinds of drugs for drug combination averagely. The incidence of ADR was 5.92‰,and all ADR resulted from same batch of drugs (No. 15040211);ADR mainly manifested as erythra,erythema,pruritus,chills,etc. In terms of irrational drug use,the incidence of overlong treatment course was 17.85%;that of inadequate solvent dose was 13.71%;that of fast dripping rate was 7.59%;that of unsuitable solvent selection was 0.69%;that of drug use with no indication was 0.39%. CONCLUSIONS:Xueshuantong for injec-tion(lyophilized)is widely used in middle-aged and elderly in the clinic. There are many varieties and irrational drug use. The oc-currence of ADR is properly related to age,treatment course,solvent,dripping speed,product quality and other factors. Clinical pharmacists are required to monitor drug use,promote the rationality of drug use and reduce the occurrence of ADR.

Objective:To understand the laboratory characteristics for the diagnosis of immunoglobulin G4-related disease (IgG4-RD).Methods:The clinical data of 28 patients with IgG4-RD and renal damage (IgG4-RKD) diagnosed in our hospital from January 2017 to May 2019 were retrospectively analyzed. The correlation between serum IgG4 concentration and clinical features as well laboratory test results was analyzed. The 28 patients were divided into two groups: high serum IgG4 concentration group and normal serum IgG4 concentration group. The serum creatinine value, erythrocyte sedimentation rate, IgG concentration, IgA concentration, complement C3, C4 concentration, peripheral blood eosinophils, hemoglobin, IgG4/IgG and other related parameters were compared between the two groups. SPSS 20.0 statistical software was used for analysis. The two groups of measurement parameters were compared between groups by independent sample t test, non-normal measurement parameters were compared between groups by Mann-Whitney U test analysis, and the correlation between patients' IgG4 and each detection parameter was analyzed by Spearman correlation analysis. Results:Among the 28 patients, 17 were male and 11 were female, with an average age of (62±14) years. The serum IgG4 concentration increased in 75% of the patients ( n=21), with an average value of 3.01(1.41, 7.52) g/L, the serum IgG concentration increased in 64.3% of patients ( n=18), with an average value of 18.91 (12.88, 24.88) g/L, and the complement C3 decreased in 50% of the patients ( n=14), with an average value of(0.77±0.28) g/L. IgG4 was positively correlated with IgG ( r=0.422, P=0.025), IgG4/IgG ( r=0.951, P<0.01), ESR ( r=0.543, P<0.01) and peripheral blood eosinophils ( r=0.487, P<0.01), but negatively correlated with complement C3 ( r=-0.431, P=0.022) and C4 ( r=-0.504, P<0.01) levels. There were significant differences in IgG ( Z=-2.255, P=0.023), IgG4/IgG ( Z=-3.793, P<0.01), C3 ( t=7.380, P<0.01) and ESR ( t=-2.195, P=0.037) between the elevated IgG4 group and the normal group. Conclusion:Serological characteristics of IgG4-RKD combined with clinical manifestations may be able to diagnose IgG4-RKD in early stage.

Objective:To explore the diagnostic value of 68Ga-prostate specific membrane antigen (PSMA)-11 PET/MR multiparameter multimodal functional imaging in the diagnosis of naive prostate cancer (PCa), and to analyze its efficacy in the early stages of PCa. Methods:From July to September 2019, 45 suspected or pathologically confirmed PCa patients (average age: 69 years) who met the inclusion criteria were collected to perform 68Ga-PSMA-11 PET/MR examination in Nanjing First Hospital. After the scanning was completed, the method of region of interest (ROI) was used to semi-quantitatively calculate the tumor radioactive uptake in the fusion image, including the maximum standardized uptake value (SUV max), tumor metabolic volume (MTV) and mean standardized uptake value (SUV mean), and PSMA expression load was calculated(SUV mean×MTV). Apparent diffusion coefficient (ADC) values of ROI were measured in ADC images ( b=1 500 s/mm 2). The efficacy of 68Ga-PSMA-11 PET/MR in the preoperative diagnosis of PCa and the effect on clinical staging were evaluated with the pathological results. The correlation between prostate specific antigen (PSA) and radiation uptake in PCa tissues, PSMA expression load and ADC values was analyzed by Pearson correlation. Independent-sample t test was used to analyze the data. Results:Pathologically, 38 of the 45 patients were with PCa and 7 patients had benign prostatic hypertrophy (BPH), and metastasis occurred in 12 of the 38 PCa patients. 68Ga-PSMA-11 PET/MR detected 39 cases of PCa with one of which was false-positive. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 68Ga-PSMA-11 PET/MR were 100%(38/38), 6/7, 97.4%(38/39), 6/6 and 97.8%(44/45), respectively. The tumor tissues of PCa often showed focal radioactive uptake, and the T 2 weighted imaging (WI) showed focal low signal and limited dispersion. BPH showed slightly uneven uptake, and T 2WI and diffusion weighted imaging (DWI) showed uneven diffuse signals. SUV max of PCa was significantly higher than that of BPH (24.66±19.21 vs 4.97±2.13; t=5.208, P<0.001). ADC values of PCa were significantly lower than that of BPH ((0.91±0.37)×10 -3vs (1.08±0.24)×10 -3 mm/s 2; t=2.816, P<0.05). SUV max and the expression loads of PSMA in PCa were positively correlated with PSA ( r values: 0.42 and 0.71, both P<0.05). ADC values of tumor tissues in PCa were negatively correlated with PSA ( r=-0.37, P=0.013). Conclusion:68Ga-PSMA-11 PET/MR has great merits in the early diagnosis and staging of PCa.

OBJECTIVE:To explore an effective,economical drug purchasing mode for hospital drug warehouse.METHODS:The inventory costs and stock turnover rates for the zero-inventory-ordering system and fixed-interval-ordering system once applied in the Chinese patent drug stockroom in our hospital were analyzed using the analytical method of stock turnover rate.RESULTS:The average inventory costs of 2 policies were 155 600 yuan and 103 800 yuan,respectively,and their average stock turnover rates were 199.23% and 301.16%,respectively.CONCLUSION:The zero-inventory-ordering system is more conducive to the reduction of inventory cost of stock drugs.