Objective To evaluate the clinical efficacy of dexmedetomidine given intranasally for day surgery recovery period.Methods 60 pediatric patients who were treated for elective day surgery were selected as study objects,and they were randomly divided into control group and observation group according to the digital table,30 cases in each group.During operation, after induction of 8% sevoflurane inhalation at 8 L/min,3% of sevoflurane was maintained at 1 L/min.After intubation,0.5 g dexmedetomidine was given intranasally in the observation group, 0.9% NaCl saline was given to the control group.Mean arterial pressure (MAP),heart rate (HR),oxygen saturation (SpO2) were observed at different time points.The recovery time, number of cases of agitation, Aono agitation scale, children anesthesia delirium PAED score and the incidence of adverse reactions were observed in the two groups.Results As the time passed by, the MAP,HR,SpO2 in the two groups stabilized, except HR of the observation group at T0 time was higher than the control group[(92.92±3.22)beats/min vs.(89.32±3.22) beats/min], the difference was statistically significant(t=2.34,P<0.05).The children of the observation group recovered more slowly than the control group[(20.55±0.97)min vs.(18.62±1.03)min,t=2.17,P<0.05)],the number of cases of agitation, Aono restless score, anesthesia delirium PAED scores were lower than children in the control group (t=5.38,3.72,2.56,all P>0.05).The overall incidence of adverse reactions was similar in the two groups, there was no statistically significant difference (13.33% vs.10.00%,x2=0.12,P>0.05).Conclusion Dexmedetomidine given intranasally for the children underwent day surgery can significantly improve the quality of children awakeness, reduce the incidence of postoperative delirium, and without significant side effects.

Objective To investigate the relationshp among Gp Ⅱ b/ⅡⅢ a、CD62p in platelet activation mark-er and high-sensitivity C-reactive protein (hs-CRP) in elderly patients with chronic cor pulmonary exacerbation. Methods The subjects were divided into four groups (42 elderly patients with cor pulmonary exacerbation,42 eld-erly patients with cot pulmonary remission,30 cases of healthy elderly subjects and 30 cases of healthy non-elderly subjects) . The expression of Gp Ⅱ b/Ⅲ a and CD62p were measured with tricolor flow cytometry. Hs-CRP levels were measured by nephelometry and turbidimetry in patients and normal controls. Results Compared with cor pul-monary remission group,healthy elderly group and healthy non-elderly group, the levels of Gp Ⅱ b/Ⅲ a, CD62p and hs-CRP increased significantly in patients with chronic cor pulmonary exacerbation ( all P < 0.001 ). Gp Ⅱ b/Ⅲ a and CD62p results of the elderly patients with cot pulmonary remission were higher than those in healthy elderly subjects (P <0.05) and healthy non-elderly subjects (P < 0. 001 ) . The expressions of both Gp Ⅱ b/Ⅲa and CD62p in healthy elderly subjects were statistically higher than that in healthy non-elderly subjects ( P < 0.05 ). There was a positive con'elation between the Gp Ⅱ b/Ⅲ a、CD62p and hs-CRP in elderly patients with chronic cot pulmonary exac-erbation(r =0.59,P<0.01 ; r=0.54,P<0.01 ). Conclusions The platelet in elderly patients with chronic cot pulmonary exacerbation is overactivated,which is correlated with hs-CRP.

Objective　To evaluate the treatment of in-stent restenosis with rotational atherectomy and balloon angioplasty. Methods　The rotational atherectomy and 4～6 atm low pressure balloon angioplasty was performed in 3 patients with in-stent restenosis and follow up after treatment. Results　All cases were succeeded. The bradycardia occurred in one patient was quickly disappeared without treatment, two other patients were found no effect on heart rate, hemodynamic performance, global LV function, or regional wall motion. No complications, angina, death or other coronary event occurred during the follow up for 6～12 months. Two of them was performed coronary angiography after 6 months and showed the diameter of target vessel was less than 30% as compared with that on coronary angiography which performed immedately after operation. Conclusion　The management of in-stent restenosis in target vessels using a combination of rotational atherectomy and balloon angioplasty is safe and efficient.

Objective This study was designed to evaluate the effect of laparoscopic-assisted subtotal colectomy(LASC)and modified Duhamel procedure in the treatment of severe functional constipation(SFC).Methods From June 2005 to October 2007,100 cases of SFC were treated by LASC combined with modified Duhamel procedure in our institute.After freed the colon under a laparoscope,we made a small incision in the lower abdomen to perform subtotal colectomy while preserved the ileocecal region.Then a side-to-side colorectal anastomosis was conducted.Results In this study,98 cases of LASC were successively completed and 2 cases were converted to open surgery.The operation time of LASC in the 98 cases ranged from 48 to 125 min mean,(76?23)min],and the total operation time was 140-225 min mean,(170?42)min].The intraoperative blood loss was 10-160 m1 mean,(35?18)m1].In the patients,the intestinal function was recovered within 25-52 hours mean,(42?12)h] after the operation;none of them developed postoperative wound infection,anastomotic stoma,or other complications.One week after the operation,2 of the 100 patients showed mild dehydration,and 2 were diagnosed as having incomplete small bowl obstruction.All of the four were cured by conservative treatments.The other 96 patients who had no complication were discharged from the hospital in 5-11 days mean,(7.0?1.5)days] postperation.One year later,the symptoms of constipation were significantly alleviated(defecation 1-3 times/d)in 90 patients;7 cases had various degrees of diarrhea(defecation 4-6 times/d);and 3 patients showed recurrence of mild constipation(defecation 1 time/2-3 d).The gastrointestinal quality of life index(GIQOL)determined in 1 year postperation was(109?20)points,which indicated good results compared to(94?23)points before the operation(maximum:144).Eighty-three cases were satisfied with their frequency of defecation.Conclusions LASC combined with modified Duhamel procedure is an effective method for the treatment of SFC,resulting in less damage,less influence to the internal environment,and quick recovery.The procedure is worth being wildly used.

Objective\ To introduce the speciality of pontine infaction in clinic and screenage.Method\ we made retrospective study on clinical data and image data of pontine infarction caused by BAD,and compared with the data of 31 patients with lacunar infarction in pontine.Result\ Clinical spetiality of BAD group:There are a few disturbance of consciousness,mainly the movement disturbance and dysarthria with ocular movement disturbance.Compared with the control group,there is difference between the two groups(P

Gene transfection is an important method for studying gene function. The origination and development of gene transfection are reviewed in this article. Six methods of gene transfection are introduced, among which, special attention are given to two new ones: particle bombardment and photochemistry transfection technology. Besides, the advantages and disadvantages of these methods are compared in order that more suitable methods can be chosen in researches. The application of the technology in gene research is discussed in the end of this article.

Objective To investigate, in vitro, the co-infection of Caco-2 cells ( epithelial cells of intestinal mucosa) with Candida albicans and Enterohemorrhagic escherichia coli ( EHEC) .Methods The ability of both species to invade the Caco-2 cells was evaluated by inverted microscopy.Damage to Caco-2 cells was evaluated by measuring lactate dehydrogenase ( LDH ) activity. C. albicans virulence gene expression ( ALS3, PLB1 and SAP4 ) was evaluated by quantitative real-time polymerase chain reaction ( qRT-PCR) .Results Compared to simple infections with C.albicans alone, a co-infection invaded Caco-2 cells more rapidly, and C.albicans tended to proliferate more easily presenting in cluster shape of distribution.In addition, the LDH activity in the co-infection group (group 3) was the highest compared to groups 1, 2, 4 and 5, (F values of 14.48, 5.48, 11.74 and 3.45 respectively;all P <0.05);There was no significant difference in LDH activity found between the secondary fungous infection group ( group 5) and the EHEC infection group (group 2) (F=2.03, P=0.54) or between the secondary bacterial infection group (group 4) and the Candida albicans infection group (group 1) (F=2.74, P=0.11).The LDH activities in groups 2 and 5 were significantly higher than that in groups 1 and 4 ( all P <0.05 ) .In addition, an up-regulation of toxicity-related genes ( PLB1 and SAP4 ) were detected.The expression of PLB1 was higher in group 3 than that in group 1 ( P=0.014 3 ) and SAP4 was higher in groups 3 and 5 than that in group 1 (P=0.027 2, P=0.001 8, respectively).Conclusions Using Caco-2 cells for an infection model, this study demonstrated that co-infecting in vitro enterocytes with C.albicans and EHEC enhanced the invasiveness and tissue damaging effects of C.albicans.

Objective To investigate the clinical value of multidisciplinary team (MDT) assessment for chronic constipation.Methods The clinical characteristics of 346 patients with chronic constipation who were admitted to the Third Peolep's Hospital of Hangzhou from January 2010 to December 2013 were multidisciplinarily assessed.The muhidisciplinary team was involved surgeons from the department of colorectal surgery,urology,gynecology,psychiatry and psychology,and tools including questionnaires,defecography,anorectal manometry,colon transit study,urodynamic tests,gynecological examination were applied in the study.The measurement data with normal distribution were presented as (x) ± s,the comparison between groups was analyzed using the ANOVA,and the count data were analyzed using the chi-square test.Results Three hundred and forty-six patients who met criteria of this research were selected,including 86 males and 260 females with the ratio of 1 ∶ 3;the mean age was (55 ± 11)years.Of the 346 patients,slow transit constipation accounted for 7.52％ (26/346),defecatory disorder for 60.98％ (211/346),and mixed constipation for 31.50％ (109/346).A total of 93.85％ female patients (244/260) had anterior rectocele,75.43％ (261/346) patients had internal rectal mucosal prolapse,66.76％ (231/346) patients had perineum descending,23.99％ (83/346) had achalasia or inappropriate contraction of internal anal sphincter,18.79％ (65/346) had puborectalis rectocele muscle thickening,5.49％ (19/346) had rectal prolapse.A total of 82.37％ (285/346) patients were involved in other subjects than colorectal surgery.A total of 28.61％ (99/346) patients presented with urinary symptoms,including 65 cases with stress urinary incontinence,23 cases with unstable bladder and 19 cases with bladder neck obstruction (some patients had multiple urological systoms).The incidence of reproductive organ prolapse in female patients was 31.92％ (83/260),the incidence of uterine prolapse and anterior vaginal prolapse were 26.15％ (68/260) and 29.23％ (76/260),respectively.Patients with anxiety and/or depression accounted for 36.13％ (125/346).The male and female patients of slow transit constipation,defecatory constipation and mixed constipation were 10 vs 16,30 vs 79,46 vs 165,respectively,the age was 60 ± 12,56 ± 11,52 ± 10,showing no significant differences (x2=4.046,F =2.877,P ＞ 0.05).In the three kinds of constipation,patients with urinary diseases accounted for 26.92％ (7/26),26.61％ (29/109) and 29.86％ (63/211),patients with gynecological diseases accounted for 11.54％ (3/26),20.18％ (22/109),27.49％ (58/211),patients with psychological diseases accounted for 38.46％ (10/26),39.45％ (43/109),34.12％ (72/211),respectively,showing no significant difference (x2=4.090,P ＞ 0.05).Conclusion MDT assessment for patients with chronic constipation can reflect comprehensively clinical characteristics of chronic constipation,therefore multidisciplinary team should be emphasized in clinical diagnosis and treatment of chronic constipation.

Objective To investigate the diagnostic value of color Doppler ultrasonography in congenital muscular torticollis (CMT). Methods The sonographic characteristics of 62 children with CMT confirmed clinically were retrospectively analyzed. Results Abnormal ultrasound features could be visualized in all of 62 children with CMT. According to the sonogram features, 62 children were divided into 2 types: mass-forming (32/62, 51.61%) and diffuse type (30/62, 48.39%). Arterial flow signals were detected in 18 children (18/62, 29.03%); RI was 0.73-0.88. Conclusion Ultrasonography has specific value for the diagnosis of CMT.

Objectives To compare the co-infection statues of HSV, HBV and HCV in patients with STD and HIV infection for providing evidence of developing prevention and control strategies. Methods Serum samples confirmed to be infected with HIV/AIDS by Western blot, and serum samples of patients with STDs (syphilis, gonorrhoea and chlamydial infection) were tested for HSV2-IgG, HSV2-IgM, HBsAg and HCV-IgG by ELISA. The detection levels were compared between the two groups. Results Out of 76 specimens in STD group, HSV2-IgG was detected in 24 specimens (31.58%), HSV2-IgM in one specimen (1.32%), HBsAg positive in 8 (10.53%), and HCV antibody positive in 4 (1.32%). In 14 specimens of HIV/AIDS group, HSV2-IgG were detected in 7 (50.00%); HSV2-IgM in 5 (35.71%);8 (578.14%) were positive for HBsAg and 3 (21.43%) for HCV. In a total of 90 specimens, both HSV and HBV were detected in 6 specimens, both HSV-IgM and HBV in 2, and the four above-mentioned antibodies in 2. The infection rates of HSV, HBV and HCV were significantly higher in HIV-infected specimens than those in the STD specimens (P