Objective To investigate the effects of continuous wound infusion of ropivacaine for postoperative analgesia on local inflammation.Methods Forty ASA Ⅰ or Ⅱ patients,aged 45-64 yr,weighing 45-80 kg,undergoing simple nephrectomy,were randomized into either continusous wound infusion of local anesthetic group ( group CWI ) or control group ( group C),with 20 cases each.Group CWI were treated with continuous wound infusion of 0.25％ ropivacaine for postoperative analgesia,while group C were infused with the same volume of normal saline.All patients received patient-controlled analgesia with intravenous morphine.At 6,12,24 and 48 h after operation,the accumulated consumption of morphine was documented,and the concentration of prostaglandinE2 (PGE2) of drainage was determined using ELISA.Results Compared with group C,the accumulated consumption of morphine was decreased,and the PGE2 concentration was decreased in group CWI at each time points.Conclusion The mechanism of postoperative analgesic effect of continuous wound infusion of ropivacaine is related to the suppression of local inflammation in wound sites.

Objective To study the pathologic features,differential diagnoses and pathogenesis of splenic vascular tumors.Methods The records of 7 patients with splenic vascular tumors were reviewed.Immunohistochemical studies were performed by EnVision assay.Results The histopathologic diagnoses were hemangioma (n=2),lymphangioma (n=2) and hemolymplangioma (n=3 ).Positive immunoreactivity of CD31 and CD34 was found in vascular endothelial cells,and D2-40 expression was only identified in lymphatic endothelial cells.Conclusions Immunohistochemical staining of D2-40,CD31,CD34 was very helpful in the diagnosis of splenic vascular tumors.

In view of the present hospital professional and technical personnel in the making , performance e-valuation , salary management , personal development , health management , department management , as well as on the management of some of the ethical issues , analyzes its reason: hospital professional and technical personnel management ethics idea misunderstanding , hospital professional and technical personnel subject ethics value status unclear , hospital professional and technical personnel managers′ethical level is not high .And put forward the con-crete solving measures:strengthen dominated by social responsibilities of ethical supervision and management , es-tablish the principle of fairness , justice , ethics of competition system , director of the department , carried out by both efficiency and fair ethics idea of performance and salary rank management activities , to achieve individual all-round development as the goal of ethical career management , to strengthen the management of managers ethical education .

Objective To investigate the effects of mindfulness behavior training on emotional disorder and immunological function in elderly patients after hip fracture fixation surgery.Methods Sixty elderly patients with fixed hip fracture by operation were randomly divided into a training group and a control group with 30 cases in each group.The training group received mindfulness behavior training in addition to routine rehabilitation training,while the control group only received routine rehabilitation training.The mindfulness behavior training was administered 90 min for once a week,lasting for 5 weeks.The emotional disorder was assessed with the profile of mood states (POMS),and the immune system function were evaluated by the number of CD3 + 、CD4 + 、CD8 + in T cell subgroup before and after 5 weeks of training.Results Before training,there was no significant difference in scores of POMS and the cells number of CD3 +,CD4 +,CD8 + (P ＞ 0.05) between the two groups.After treatment,scores of POMS including tension-anxiety (13.14 ± 3.36 vs 15.90 ± 4.28),depression-dejection (18.10 ± 6.24 vs 20.06 ± 5.42),fatigue-inertia (16.53 ± 3.50 vs 18.98 ± 4.88),vgor-activity (26.68 ± 5.22 vs 22.43 ± 5.20) (P ＜ 0.05),the level of mindfulness practice(58.00 ± 4.78 vs 54.00 ± 4.89) and the cells number of CD3 +,CD4 +,CD8 + (75.75 ± 5.40vs 69.91 ± 4.42 ;39.54 ± 3.29 vs 34.44 ± 4.21 ; 39.82 ± 3.55 vs 36.82 ± 3.55) in experimental group improved more than those in control group (P ＜ 0.05).Conclusion Mindfulness behavior training can improve the patients' mood state and have positive promotion on immunological function.

Objective To examine the clinical application of ultrasonography to detection of mesenteric lymph nodes in chil‐dren with intermittent abdominal pain.Methods A total of 196 children who underwent abdominal ultrasonography for differ‐ent reasons were divided into the intermittent abdominal pain group and non‐abdominal pain group.The location ,size and num‐ber of mesenteric lymph nodes were recorded.Results Statistical difference in the long‐axis diameter(P=0.005)and ratio of short‐to‐long‐axis diameter was found among patients with different ages in non‐abdominal pain group(P= 0.015) ,while no significant difference was seen in short‐axis diameter(P=0.773).No significant difference was observed in the diameter of each axis between different genders in non‐abdominal pain group.There was a statistical difference between abdominal pain group and non‐abdominal pain group in the incidence of lymph nodes with short‐axis diameter of 6 mm and larger(P=0.002)and long‐axis diameter of 14 mm and larger(P=0.007).Conclusion Mesenteric lymph node with short‐axis diameter larger than 6 mm should be considered enlarged in children ,but should not be diagnosed with mesenteric lymphadenitis.It’s common to find en‐larged mesenteric lymph nodes in children without abdominal pain.Further investigations with a larger number of patients are required to confirm these findings .

Objective To explore the correlation factors of hospital stay and hospitalization costs among patients with acute ischemia stroke (AIS). Methods The clinical data of the patients with first diagnosis of AIS at Peking University Third Hospital in China from January 1 , 2012 to December 31 , 2012 were retrospectively analyzed to investigate the correlation factors of hospital stay and hospitalization costs using univariate analysis and multiple regression analysis. Results The study involved 496 patients, with a mean age of 63.38 years (range:26~88 years). Multivariate regression analysis showed the significant impact factors for LOS were age, pneumonia, the total score on NIHSS, medication for secondary prevention and stroke subtype. The significant impact factors for cost of hospital stay were payment method, stroke subtype, age, the total score on NIHSS and medication for secondary prevention. Conclusions Age, pneumonia, the total score on NIHSS, stroke treatment and its subtypes are the significant impact factors affecting hospital stay. Payment method, stroke subtype, age, the total score on NIHSS and medication for secondary prevention are the significant impact factors affecting costs of hospitalization.

Objective To study the relationship between adiponectin and pulmonary function, age and gender in pa-tients with chronic obstructive pulmonary disease (COPD). Methods A total of 120 COPD patients with normal body mass index (BMI＜24 kg/m2 ) were selected and divided into acute exacerbation group (n=60) and stable group (n=60). And 60 healthy people were included as controls. There were equal numbers of male and female in each group. The serum level of ad-iponectin was sdetected by ELISA in there groups. The pulmonary function was collected,and values of FEV1/FVC, FEV1%predicted and RV/TLC were calculated in three groups. Results The serum level of adiponectin was significantly higher in acute exacerbation group than that of stable group and control group (P＜0.05). And the serum level of adiponectin was significantly higher in stable group than that of control group (P＜0.05). The serum levels of adiponectin were signifi-cantly higher in female patients than those of male patients (P＜0.05). The values of FEV1%, FEV1/FVC and FEV1%pre-dicted were significantly lower in acute exacerbation group and stable group than those of control group. The value of RV/TLC was significantly higher in acute exacerbation group and stable group than that of control group (P＜0.05). There was a negative correlation in serum levels of adiponectin, FEV1%predicted and FEV1/FVC between acute exacerbation group and stable group. But there was a negative correlation in serum levels of adiponectin and RV/TLC between these two groups ( P＜0.01). There was a positive correlation between serum level of adiponectin and age in male patients (r=0.943,P＜0.01). Con-clusion The serum level of adiponectin was significantly increased in patients with COPD, which suggested that adiponec-tin played an important part in proinflammatory and might be closely related with airway resistance. The serum level of adipo-nectin might exist gender differences and may be related with age.

The reduced level of high density lipoprotein (HDL) in plasma is a strong predictor of atherosclerotic vascular disease risk. However, like low density lipoprotein (LDL), HDL is readily oxidized by a variety of oxidants in vitro . This review briefly discussed about the susceptibility of HDL to oxidation, the site and physiologic oxidants of HDL oxidation in vivo ,structural change in oxidized HDL, as well as the influence of different changes in structure of oxidized HDL on the protective function of HDL against atherosclerosis.

Objective To explore the genetic characteristics, diagnosis, and treatment of hereditary spherical polycythemia (HS). Methods The clinical data of one case of HS was analyzed retrospectively, and related literatures were reviewed. Results The 5-year-old girl presented hemolytic anemia from 6 months old. Incubation of fragility tests was positive. Blood smears and red cell electron microscopy showed spherical red blood cells. DNA sequencing showed alterations in heterozygosity of stopgain SNV. The girl was diagnosed was HS, and was scheduled to undergo splenectomy at 6 years old. Conclusions HS is an autosomal dominant genetic disease, mainly manifested as anemia, hemolytic anemia, and splenomegaly. The early diagnosis depends on genetic testing.

OBJECTIVE To comprehensively analyze the risk factors for infection and colonization of community-acquired MRSA.METHODS The results of 12 studies were analyzed by meta-analysis and the OR value of every factor was calculated.RESULTS All eight risk factors were evaluated:prior hospitalization(OR=2.46,CI1.25-4.85),antibiotics exposure recently(OR=2.77,CI1.34-5.74),contact with healthcare system and medical workers frequently(OR=6.48,CI2.38-17.63),surgery or invasive procedure(OR=2.53,CI1.90-3.36),age(OR=-1.99,CI-9.21-5.23),gender(OR=1.04,CI0.71-1.51),intravenous drug use(OR=1.49,CI0.34-6.54),and underlying diseases(OR=1.12,CI0.55-2.28).CONCLUSIONS Prior hospitalization,antibiotics exposure recently,contact with healthcare system and medical workers frequently and surgery or invasive procedure are risk factors of community-acquired MRSA.The effects of age,gender,intravenous drug use and underlying diseases need further investigation.