Objective To compare the effects of target-controlled infusion(TCI) of remifentanil in three different doses in thoracic patients undergoing total intravenous anesthesia.Methods Forty-five ASA Ⅰ～Ⅱ patients aged 40～60yr undergoing thoracic surgery were randomly divided into three groups.The patients were given midazolam 0.05mg/kg and artropine 0.5 mg/kg i.m.before anesthesia.Anesthesia was induced with remifentanil and propofol both given by TCI simultaneously.The target concentration of propofol was set at 3?g/ml and remifentanil at 4,6,8ng/ml(groupⅠ,Ⅱ,Ⅲ).When the patients lost conscionsness,rocuronium 0.6mg/kg was given i.v.to facilitate intubation.Anesthesia was maintained with TCI of propofol-remifentanil and intermittent i.v.boluses of rocuronium.Remifentanil target concentration maintained unchanged during anesthesia.BIS index was controlled at 45～55 by modify propofol target concentration.SBP,DBP,MAP,HR and BIS index was recorded in baseline(T0),before intubation(T1),intubation(T2),skin incision(T3),the opening of the chest(T4),skin closuer(T5),extubation(T6).Vein blood samples were taken for determination of plasma concentration of epinephrine(E) and norepinephrine(NE) by ELASA.Results SBP,DBP,MAP,HR and plasma NE concentration at T2,T3,T4,T5 were higher than T0 in group Ⅰ(P

Objective · To evaluate the clinical characteristics of endometrial pathology in postmenopausal women with asymptomatic thickened endometrium. Methods · A retrospective review was conducted of the patients between October 2013 and October 2015 in the International Peace Maternity & Child Health Hospital. The postmenopausal women with asymptomatic thickened endometrium of 5 mm or more found by transvaginal ultrasonography were recruited. They underwent hysteroscopy and endometrial sampling to analyze the relationship between endometrial pathology and endometrial thickness. Results · A total of 257 patients were recruited. The average age was 61.3 years old, the average menopause period was 122 months, and the average endometrium thickness was 8.6 mm. The endometrial pathology included normal atrophic endometrium, endometrial polyp, submucous myoma, intrauterine adhesion, uterine septum, endometrial hyperplasia and endometrial cancer. The most common pathological type was endometrial polyp, accounting for 66.9% of the all patients and 83.9% (172/205) of all pathological types. Three cases of adenocarcinoma (1.2%) were diagnosed. There was significant difference in endometrial thickness among normal endometrium, endometrial polyp and endometrial cancer (P<0.05). The endometrium in endometrial cancer was the thickest, which was (13.20±5.38) mm averagely. There was significant difference in ages among the pathological types (P=0.004). Conclusion · There are few patients of malignancy among asymptomatic postmenopausal women with thickened endometrium. Follow-up visits were recommended to these women.

Adolescent ; Adult ; Aged ; Bone Nails ; Female ; Fracture Fixation ; methods ; Fracture Healing ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged

Adolescent ; Adult ; Aged ; Child ; Endoscopy ; Female ; Humans ; Intraoperative Period ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Recovery of Function ; Smell ; Young Adult

Objective Detecting the level of IDO and KYN in ulcerative colitis (UC) patients; using ROC curve to discuss their value in the diagnosis of patients with active UC. Methods 60 cases of UC group, 18 cases of dis-ease control group and 20 cases of healthy control group were included in the study. Immunohistochemical staining methods were used to detect the expression of IDO in colonic mucosa of UC, enzyme-linked immunosorbent (ELISA) methods were used to detect the serum levels of IDO, KYN and CRP, and the value with ROC curve method was analyzed. Results ① There was a positive correlation between IDO level and IDO expression (P<0.05). There was a positive correlation between KYN level and IDO expression (P<0.05). ②The levels of IDO and KYN in UC group were higher than those of disease control group and health control group (P<0.05). ③The levels of IDO and KYN in patients with active UC were significantly higher than that in patients with catabasis UC (P<0.01), and the levels increased with severity of inflammation. ④ The levels of IDO and KYN in active UC were positively related to disease activity and CRP levels (P<0.05). ⑤The IDO,KYN and CRP area under ROC curve were 0.976, 0.856 and 0.864;best cut-off point were 53.66 U/L, 2.34 nmol/L and 1.75 mg/ml;sensitiv-ity were 90.5%, 78.65% and 100.0%; specifity were 94.4%, 83.3% and 61.1%; Youden index were 0.839 2, 0.619 0 and 0.611 1. Conclusion The levels of IDO and KYN in serum can be used as an important index to judge the severity of UC. They have important value in the diagnosis of active UC . The value of IDO is higher than KYN and CRP.

Objective To investigate the effects of robot-assisted walking training after total knee replacement (TKR).Methods Forty TKR patients at 1 week post-operation were randomized into a control group (n =20) and a treated group (n =20).For 2 weeks the control group accepted routine rehabilitation therapy.The treated group received the same treatment as the control group,but also walking training using a robot-assisted walking training system.The results were evaluated using the Hospital for Special Surgery knee rating scale (HSS),knee proprioception grading,Berg scores,and 6 minute walking distance in both groups.All the analyses were administered before the operation and 2 weeks,l month,3 months and 12 months after the operation.Results The treated group had significantly better HSS scores,Berg scores,and 6 minute walking distances than the control group on average.However,there was no significant difference in average knee proprioception between the two groups.Conclusion Robot-assisted walking training was significantly more effective than conventional rehabilitation alone in improving knee joint function,balance ability and walking after TKR.

Objective To evaluate the clinical value of microvascular anastomotic devices in the reconstruction of lower extremity defects by free flap transfer.Methods A retrospective review of 42 consecutive patients who underwent lower extremity microvascular reconstruction performed from May 2013 to November 2013 by microvascular anastomotic devices was performed.Patient charts were reviewed for age,sex,etiology of defect,location of defect,flap type,anastomotic technique,complications and flap survival.Results No patients had an arterial or venous anastomosis revised.The vascular anastomosis patency rates was 100％ and the flap survival rate was 97.6％.Total complication rate (9.5％) was due to 1 partial flap loss,1 partial skin graft loss and 2 hematoma.There were no intraoperative or perioperative complications involving the use of a microvascular anastomotic device itself.Conclusion Microvascular anastomotic devices have effective vessel anastomoses in lower extremity microvascular reconstruction.Thus,it presents an ideal tool for lower extremity microsurgical reconstruction.

OBJECTIVEDetection HBV DNA among HBsAg negative children who have been vaccined at birth, in order to improve the evaluation of the indicator for HBV DNA infection.

METHODSSelection HBsAg negative children who have been vaccined at birth and then detection HBV DNA from sera using QIAamp Viral DNA Mini Kit, HBV DNA s region was obtained by nested PCR and sequencing.

RESULTS12 of the 140 children were HBV DNA detected were positive and the infectious rate was 8.6% . No mutant of the 12 HBV DNA in "a" determinant.

CONCLUSIONTo evaluate the effection of the prevention of HBV mother-to-child transmission, the standard method should be established. The detection of HBV DNA should be included in the future.

Child ; Child, Preschool ; DNA, Viral ; blood ; genetics ; Female ; Hepatitis B ; blood ; prevention & control ; transmission ; Hepatitis B Surface Antigens ; blood ; genetics ; Hepatitis B virus ; genetics ; Humans ; Infectious Disease Transmission, Vertical ; prevention & control ; Male ; Mutation

Objective To analyze the clinical value of chemotherapy combined with endocine therapy after standard treatment failure for advanced metastatic breast cancer.Methods 30 metastatic breast cancer patients after standard treatment failure were analyzed.Etoposide (75-100 mg/d) wasused on days 1-10,followed by 11 days of rest combined with medroxyprogesterone 0.5 g,twice per day,or megestrol 160 mg/d for 21 days.Clinical effects and life quility were analysed.Results The median treatment line of this therapy was 6 (range 3-9).The clinical benefit rate is 16.7 ％ (5/30),and the median progression free survival (PFS) was 4.0 months (range 1.0-13.0 months).Conclusion The combination of chemotherapy (etoposide) and endocrine therapy (progesterone) is a choice of treatment after standard drug failure for advanced mastatic breast cancer patients.

Objective To investigate the distribution of water-borne fluoride and the current status of water defluoridation project by improving drinking water quality in endemic fluorosis areas in Shandong province,and to provide scientific basis for making strategies in prevention and control of the disease. Methods According to "the National Technical Scheme for Endemic Disease Control in 2004, 2005 and 2006", 113 endemic fluorosis diseased counties(cities, and districts) of the province's 17 cities were screened in order to investigate the fluoride level in drinking water in fluorosis villages, recheck the fluoride level after implementing the water defluoridation project, and investigate the current status of the water defluoridation project. The fluoride level in drinking water was determined by F-ion selective electrode. Results There were a total of 5816 water defluoridation projects in the province. Most of them were carried out by drilling a deep well to get under-ground water. The wells still in good condition were accounted for 72.80% (4234/5816). Intermittent operated wells were accounted for 3.11% (181/5816). Abandoned wells were accounted for 24.09%(1401/5816). Level of water fluoride was determined in 6940samples from fluorosis villages(villages that not carry out the water defluoridation project as well as villages carried out the water defluoridation project with abandoned wells were included) and the value that lower or equal to 1.00mg/L was determined in 2987 villages which accounted for 43.04% (2987/6940). Level of water fluoride that over 1.00 mg/L was found in 3953 villages which accounted for 56.96% (3593/6940), and the highest level of water fluoride was 11.33 mg/L. Level of water fluoride were determined in 4415 samples from water defluoridation project and the value lower or equal to 1.00 mg/L was in 2983 wells which accounted for 65.53%(2983/4415). The value over 1.00 mg/L was in 1522 wells which accounted for 34.47%(1522/4415), the highest value of water fluoride was 9.71 mg/L. Conclusions Level of water fluoride in up to 1/2 of the villages and 1/3 of the projects, is still higher than the standard in Shandong province. Nearly 1/4 of the project has been abandoned. The current situation for endemic fluorosis control is still not good in the province, countermeasures for endemic fluorosis must be carried out as soon as possible and surveillance of water defluoridation project must be strengthened.