Based on the analysis of 5-year collected data,our study showed that the teacher and course characteristics influence student ratings significantly.The scientific and rea-sonable evaluation approaches provides fundamental information for teaching capacity enhancement and course improvement.

Objective To provide theoretical and scientific evidences for plague control,through understanding the F1 antibody level distribution and affected factor of population having healed from plague from plague natural focus of Rat.flavipectus in Yunnan Province.Methods The places and population investigated were chosen according to plague surveillant data in Yunnan Province from 1986 to 2005,using caso-control study and quesfionary. All samples were detected by indirect hemagghtination(IHA),including 248 serum samples from population having heaIed from phsue in 23 counties as case group.295 senlm samples from healthy population inoculated with EV vaccine in 7 counties as artificial immunization group, and 235 serum samples from healthy population not inoculated it in a non-plagued foei county as negative comparison group,with the diagnosing standard for positive titor being not less than 1:20.Results(①The difference WSS statistically significant(X2=44.80,P<0.05)between plague and non-plagued foci with F1 antibody positive rates being 22.10%(120/543)and 0(0/235),respectively.② The F1 antibodv positive rate of case group,35.89%(89/248)and geometric mean titer(GMT)1:84,was higher than that of artiIicial immunization group,which was 10.51%(31/295)and with GMT 1:34,respectively,the difference being statistically significant(X2=50.41,P<0.0125);the positive rate of case group wgs hisher than the neganve comparison group,the difference being statistically significant(X2=103.39,P<0.0125):the posifive mte of artificial immunization group was higher than the negative comparison group,the difference being statisticallv significant(X2=26.23,P<0.0125).③The differences were not statistically significant in the F1 antibedy positive rates of case group for age,sex,nation and occupation(X2=1.88,2.01,5.46,0.04,P>0.05).④The difference was not statistically significant in 89 plague patients with positive F1 antibody at the time of onset and rehabilitation(t= 1.23,P>0.05).Conclusions ①Plague FI antibody in people distributes the sanle a8 the plague natural focus of Rat.flavipectus does in Yunnan Province.②For naturally infected plague patients,only 1/3 popuhtion get long- term immunity,and still 2/3 can be infected again.The protecting rate and effect of naturally acquired immunity due to infection of plague are better than amfieially acquired immunity from inoculation of EV vaccine.③For the population having healed from plague,the positive rotes of FI antibody are not affected by age,sex,nation and occupation,however for those whose plague F1 antibody is still positive after some time,the titer will remain or even increase.

Renal transplantation to 37 dog was done to study relationship of the fluid imbalance with pathological changes. 1. The 9 dogs of 37 renal homografts without immunosuppressive drug survived more than 3 days. 2. In the 9 cases, BUN was elevated above the 40,K was elevated above the 7.2 mEq/L except 1 case and CI was below the normal level in 5 cases. Sodium was not changed in all cases. 3. Main direct causes of death was other than bleeding, occlusion of renal and fluid imbalance. 4. Almost all cases that showed lymphocyte and monocyte infiltation with intact glomeruli and tubule was thought to be functioning despite of histological findings of rejection. But those case that showed glomeruli and tubular necrosis was thought to be nonfunctioning because of renal ischemia. Renal necrosis and renal rejection were not related with chemical changes of the serum.
Allografts ; Animals ; Cause of Death ; Dogs* ; Hemorrhage ; Ischemia ; Kidney Transplantation* ; Lymphocytes ; Monocytes ; Necrosis ; Sodium

ObjectiveTo study the effects of intermittent subglottic secretion drainage(SSD)with an endotracheal tube on incidience of ventilator- associated pneumonia(VAP). MethodsWe searched computerized databases,including Cochrane library,Pubmed,EMbase,CBM,CNKI,Wanfang and some relevant databases from initializing to March 2012,extracting data about subglottic secretion drainage(SSD)with an endotracheal tube on incidence of VAP using RCT.The data had Meta- analysis by software RevMan5,and to those data which could not be conversed or merged,they underwent descriptive analysis. ResultsWeidentifled 5 randomized clinical trials that met the inclusion criteria with a total of 683 randomized patients.In Meta- analysis,the overall risk ratio for ventilator- associated pneumonia was decreased significantly by intermittent subglottic secretion drainage with an endotracheal tube.There was no significant difference on adverse events or on hospital or intensive care unit mortality.Databases,including ICU and hospital LOS,duration of endotracheal catheterization,bacteria concentration,which were difficult to be conversed and obtained full data,they underwent a descriptive research. ConclusionsCompared with the common endotracheal tubes,the use of endotracheal tubes with subglottic secretion drainage is effective for prevention of ventilatorassociated pneumonia.But it has no effect on adverse events or on hospital or intensive care unit mortality.So large sample RCTs with multiply- center should be carried out to assess the effect of the use of SSD.

ObjectiveTo evaluate the effectiveness of setting PEEP and tidal volume (VT ) according to pressure-volume (P-V) curve during one lung ventilation (OLV) in patients undergoing thoracic surgery.Methods Twenty-five ASA Ⅰ or Ⅱ patients of both sexes aged 44-64 yr weighing 57-75 kg undergoing lobectomy under general anesthesia were enrolled in this study.Double-lumen tube was inserted.Correct positioning was verified by flberoptic bronchoscopy.The patients were mechanically ventilated.P-V curve was measured by SSS system during OLV.Lower inflection point (LIP)and upper inflection point (UIP) were determined.The pressure at LIP (PLIP) and volume at UIP (VUIP) were measured.Bilateral lungs were ventilated for 30 min (T0) at first before OLV was started.PEEP was set at PLIP + 0.196 kPa and VT was set at VUIP,and the patients were ventilated for 30 min (T1).VT was then reduced to 80％ of VUIP.OLV was performed for another 30 min (T2).VT was then further reduced to 60％ of VUIP and the patients were ventilated for 30 min (T3).PEr CO2 was maintained at 4.67-6.00 kPa.Arterial blood and central venous samples were taken at T0-3.Blood gas analysis was performed.Qs/Qt was calculated.MAP,HR,CVP,peak airway pressure (Peak),airway resistance (Rsw) and lung compliance (CL) were measured and recorded at T0-3.ResultsHR,Ppeakk,Rsw and Qs/Qt were significantly increased while CL and PaO2 decreased at T1-3,CVP was significantly increased at T1.2 and MAP and PaCO2 were increased at T3 as compared with the baseline values at T0.Ppeak and Rsw were significantly decreased at T2.3 and PaO2 was significantly increased while Qs/Qt decreased at T2,CVP was decreased,MAP and PaO2 were increased at T3 as compared with the values at T1.ConclusionsMechanical ventilation with VT set at 80％ of VUIPandPEEPatPUIP+0.196kPa provides best ventilatory efficacy for OLV in terms of PaO2 and hemodynamics.

Objective To investigate the effect of intravenous injection of parecoxib before operation on the efficacy of postoperative analgesia in patients undergoiag thoracic surgery.Methods Ninety ASA Ⅰ -Ⅲ patients,aged 38-76 yr,weighing 44-82 kg,scheduled for thoracic surgery under general anesthesia combined with thoracic epidural block,were randomly divided into 3 groups(n = 30 each): group A,B and C.Epidttral anesthesia was performed at the T6-7 interspace before general anesthesia. Anesthesia was induced with sufentanyl 0.4 μg/kg,vecuronium 0.12 mg/kg and propofol 1.5-2.0 mg/kg.Double-lumen bronchial tube was inserted and the patients were mechanically ventilated.Group A received iv injection of normal saline 2 ml 30 min before skin incision.Group B received iv parecoxib sodium 40 mg after extubation.Group C received iv parecoxib sodium 40 mg 30 min before skin incision.Anesthesia was maintained with propofol,vecuronium,sufentanyl and lidocaine.The patients received patient-controlled epidural analgesia(PCEA)with ropivacaine and 0.5 μg/ml sufentanil after surgery.The VAS score was maintained≤ 3.The comfort level was evaluated with Bruggrmann comfort scale(BCS)at 4,12,24 and 48 h after operation.The consumption of sufentanil during operation and within 48 h after operation was recorded.The adverse reactions were also recorded.Results Compared with group A,the consumption of sufentanil was significantly decreased in group B and C,the BCS score was significantly increased at 4 h after operation in group B,and the BCS score was significantly increased at each time point and the consumption of sufentanil during operation was significantly decreased in group C(P ＜ 0.05).The BCS score was significantly higher,and the consumption of sufentanil during operation and within 48 h after operation was significantly lower in group C than in group B(P ＜ 0.05).There was no significance difference in the adverse reactions among the 3 groups(P ＞ 0.05).Conclusion Intravenous injection of parecoxib 40 mg before operation reduces the perioperative sufentanil consumption in patients undergoing thoracic surgery.

OBJECTIVE:To build the off-label drug use control system,and to realize automatic prompt for off-label drug use by system when physicians prescribed drugs. METHODS:The module and flow chart of off-label drug use control system were de-signed based on B/S structure. The drugs of the prescriptions were verified one by one in terms of drug indication,drug dosage, age and gender of patient,route of administration,etc. The system prompted automatically off-label drug use when drug use didn’t agree with preset value;at the same time,the management effect of the system was evaluated by taken the amount of attention about antibiotics medical orders as an example. RESULTS:At present,265 kinds of drugs were involved in the system designed by our hospital. Since the system was applied,the system had prompted more than 50 thousand items of off-label drug use prescrip-tions/medical orders,accounting for 0.3% of total. Among the types of off-label drug use,the most number of medical orders were over single dose(745 items),followed by extra-indication(706 items)and over daily dose(671 items). Within 3 months after sys-tem used,the attention numbers of antibiotics medical orders of over daily dose decreased month by month. CONCLUSIONS:Es-tablished off-label drug use control system of our hospital has a stable running and convenient manipulation,and contains powerful practicability. It can monitor off-label drug use of some drugs.

Objective: To evaluate the effect, tolerance and safety of low-dose oral amiodarone in the prevention of AF after coronary artery bypass grafting (CABG). Methods: Between 1998 and 1999, 235 adult patients underwent CABG. They were given 0 6 g of amiodarone (80 patients) or placebo (155 patients) daily for 7 days before surgery and 0 2g of amiodarone or placebo daily for 30 days postoperatively. Results: The incidence of postoperative AF was significantly (P=0 001) lower in treatment group (10%) as compared with placebo (21 94%). Only 3 cases had pro-arrhythmic effects and no side effects in treatment group. Conclusion: 1.Perioperative low-dose oral amiodarone significantly reduced the ventricular rate and reduced occurrence and duration of atrial fibrillation after CABG. 2.Low-dose amiodarone is well tolerated and decreased the risks of severe side effects and pro-arrhythmic effects, especially for these patients with high risk factors in perioperative period.

Objectives To study the clinical results of Liuwei Dihuang Wan plus jinkui Shenqi Wan treating small renal calculus (diameter< 1.0cm) which are not suitable for surgical operation. Methods 200 eases were randomly recruited into a control group and a treatrnent group, with 100 cases in each group. 100 cases in the treatment group was further enrolled into team A (having the syndrome of kidney Yin deficiency) and team B (having the syndrome of kidney yang deficiency), with 50 eases in each team. Team A and team B was treated with Liuwei Dihuang Wan and Jinkui Shenqi Wan respectively. The control group was treated with drugs that removing urinary calculus. Results The cure rate and the effective rate in team A was 60% and 86% respectively; and 62% and 88% respectively in team B. The total cure rate and effective rate of the treatment was 61% and 87% respectively. On the other hand, the cure and effectively rate of the control group was 7% and 35% respectively. The difference between the two groups were significant (P<0.01). Conclusion Liuwei Dihuang Wan plus jinkui Shenqi Wan has good effect in treating small renal calculus.