Objective To observe the preventive efficacy and safety of dexmedetomidine with parecoxib sodium on the patients with postoperative hyperalgesia induced by remifentanil. Methods A total of 100 female patients undergoing elective surgery under general anesthesia were as-signed into four groups according to the table of random number:the control group (group C),the parecoxib sodium group (group P),the dexmedetomidine group (group D)and the parecoxib sodium combined with the dexmedetomidine group (group DP).The vital signs were monitored and the total intravenous anesthesia was performed.All the patients were give intravenous injection of 0.2μg·kg-1 ·min-1 remifentanil and 4-12 mg·kg-1 ·h-1 propofol to maintain the anesthesia.Patients in group P were given 40 mg parecoxib sodium 30 minutes before the end of the operation.Patients in group D were give intravenous injection of 0.6μg·kg-1 ·min-1 dexmedetomidine consistently till 30 min before the end of the operation.Patients in group DP were given 0.6 μg·kg-1 ·min-1 till 30 min before the end of the operation and were given 40 mg parecoxib sodium.The VAS scores were re-corded at 1,2,6,12,24 hours.The cases of agitation,rigors,nausea and vomiting and increasing of analgesics were recorded.Results The postoperative VAS scores in group P,group D and group DP were significantly lower than group C(P <0.05).The postoperative VAS scores in group DP were significantly lower in group P and group D (P<0.05).Cases of agitation and rigors in group D and group DP were less than group C(P <0.05).The increasing of analgesics in group DP was much higher than other groups(P<0.05).Conclusion After induced,patients were given intravenous in-jection of 0.6 μg·kg-1 ·min-1 dexmedetoniding consistently till 30 min before the end of the opera-tion were given 40 mg parecoxib sodium can effectively prevent hyperalgesia after remifentanil anes-thesia without significant increase in revival time and obtain a better sedation.

OBJECTIVE To analyze the high incision infection rate in abdominal operation in order to take effective preventive measures.METHODS Totally 2302 cases of abdominal operation in general surgery were investigated retrospectively from Jan 2005 to May 2007.The diagnosis standard was based on the Diagnosis Standard of Hospital Infection(Draft) published by Ministry of Health of the People′s Republic of China in Jan 2001.RESULTS From them 113 cases suffered incision infection.The infection rate was 4.85%,accounted for 81.54% of all surgical operation incision infections.The pathogenic bacteria in the samples taken during the operation were the same as those in the secretion of postoperative incision in terms of species and source.CONCLUSIONS The key points of prevention of incision infection are sterile operation,flushing of abdominal cavity and enhanced detection of environment hygiene in operating room.The infection rate could be lowered through observation and nursing care of postoperative incision and proper use of antibiotics.

Objective To investigate the expression of ionic channels of the rat bone marrow mesenchymal stem cells(BMSCs) and provide the basis for the change of ionic channels in the process of differentiation of stem cells.Methods The full marrow from Wistar rats was isolated by Percoll centrifugation and passaged repeatedly.The membrane currents of BMSCs were recorded with the whole-cell patch-clamp technique.The current amplitude of pathway,peal value and time course of activation and deactivation,selectivity of ions pathway,I-V curve were recorded.The currents were identified and analyzed by using various channel blockers.Results The cells began to stick in 24 h and arranged in whirlpool shape after passenger culture.They were positive for CD71,CD44,and negative for CD34,CD45 by flow cytometry,which improved that the cultured cells were BMSCs.The functional ion channels were characterized in cultured rat BMSCs with whole-cell patch clamp and reverse transcription polymerase chain reaction(RT-PCR) techniques.Three types of outward currents were found in BMSCs,including a delayed rectifier K+ current(IKDR),in addition,tetrodotoxin-sensitive sodium current(INa.TTX) and nifedipine-sensitive L-type Ca2+ current(ICa.L) were detected in 24% and 25% BMSCs.Moreover,RT-PCR result revealed the molecular evidence of mRNA for the functional ionic currents,including SCN5A,Kv4.3 and CACNA1C.Conclusion The currents are consistent with the characteristics of excitable cell membrane.

BACKGROUND:The Scutellaria baicalensis is a traditional Chinese herb frequently used. Only its root is used, and its stem and leaf are abandoned in traditional custom. Inorder to make full use of medicinal material resource, the chemical component and pharmacological effects of the stem and leaf have been studied. OBJECTIVE: To observe the preventive effect of total flavones from stem and leaf of scutellaria baicalensis on experimental hyperlipidemia in rats. DESIGN: Randomized controlled trial. SETTING: Institute of Traditional Chinese Medicine, Chengde Medical College MATERIALS: The experiment was conducted in the Institute of Traditional Chinese Medicine, Chengde Medical College from March 1999 to January 2000. Totally 60 male Wistar rats with beginning body mass(200±10)g were provided by Experimental Animal Research Institute, Chinese Academy of Medical Science (Qualification No.01-3008). INTERVENTIONS: Sixty rats were randomly divided into 6 groups:normal control group, high-lipid model group, the groups of 12.5, 25 and 50 mg/kg of total flavonoids (TF group) and clofibrate group (25 mg/kg),with 10 rats in each group. The rats in the normal control group were fed with basic feed. The rats in the high-lipid model group were fed with highlipid feed.Rats in the TF group and clofibrate group were fed synchronously with high-lipid feed and total flavonoids or clofibrate for consecutive 30 days. The change of blood lipid was observed. MAIN OUTCOME MEASURES: The levels of total cholesterol (TC),triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) in the serum of all the rats were measured with CL-7200 type automatic biochemistry analytical instrument at the end of the experiment, and the atherosclerosis indexes (AI) were calculated (AI=TC-HDL-C/HDL-C).RESULTS: Totally 60 rats entered the result analysis. ① Level of TC in the serum of rats: The level in the high-lipid model group was significantly higher than that in the normal control group[(5.01 ±1.05,2.33±0.35)mmol/L, (P ＜ 0.01 )]; The level in the groups of 12.5 mg/kg, 25 mg/kg and 50 mg/kg of TF was (4.15±1.12, 3.03±0.31,2.98±0.56)mmol/L, there was no significant difference between group of 12.5 mg/kg of TF and model group (t=1.74, P ＞ 0.05), but there was significant difference between groups of 25 mg/kg and 50 mg/kg of TF and model group (t=5.66-5.23, P ＜ 0.01). ②Level of TG in the serum of rats: The level in the groups of 12.5 mg/kg, 25 mg/kg and 50 mg/kg of TF was (1.22±0.56)mmol/L,(1.56±0.41)mmol/L,(1.24 ±0.45)mmol/L respectively, compared with model group(2.14±0.74) mmol/L, there was significant difference (t =2.19-3.45, P ＜ 0.05-0.01). ③ LDL-C level of the serum in the rats: The level in the groups of 12.5 mg/kg, 25 mg/kg and 50 mg/kg of TF was (2.67 ±0.45) mmol/L, (1.41 ±0.23)mmol/L, (1.29±0.23) mmol/Lrespcrtively,compared with model group[(3.94±0.42)mmol/L, there was significant difference (t=5.77-12.71, P ＜ 0.05-0.01). ④ HDL-C level of the serum in the rats: the level in the groups of 12.5 mg/kg, 25 mg/kg and 50 mg/kg of TF was (0.72±0.23)mmol/L,( 0.91±0.32)mmoL/L,(1.05±0.23)mmoL/L respectively, there was no significant difference between group of 12.5 mg/kg of TF and model group[(0.56±0.21)mmol/L, but there was significant difference between groups of 25 mg/kg and 50 mg/kg of TF and model group (t=2.92-4.38,0.05 ,P ＜ 0.05-0.01).⑤AI: the level in the groups of 12.5 mg/kg, 25 mg/kg and 50 mg/kg of TF was(2.96 ±1.35), (2.10±0.97), (1.55±0.41)respectively, compared with model group (4.23±0.65) , there was significant difference (t =3.54-9.49 ,P ＜ 0.01). CONCLUSION: TF has significantly inhibitory effect on the increase of TC, TG and LDL-C in the serum of the rats induced by high-lipid feed; it can also increase the level of HDL-C, indicating TF has obviously preventive effect on experimental hyperlipidemia in rats.

Objective:To investigate the training needs of nursing students during their practice in the emergency department, and to provide evidence for further improvement and development of the training.Methods:A total of 279 nursing students from 24 hospitals in Guangdong Province and 4 undergraduate universities running nursing specialty were investigated by convenience sampling. The contents of the questionnaire included general information and emergency training needs, including teaching contents and teaching methods.Results:Among the surveyed nursing students, 97.13% (271 students) believed it was very necessary to learn first aid knowledge and skills, and 85.66% (239 students) were very interested in learning first aid knowledge and skills. The score of "acute and critical skills" in the emergency training needs was the highest (88.91 points), and the score of "department rules and regulations" was the lowest (76.08 points). Univariate analysis showed that there were significant differences in gender, willingness to engage in nursing work in the future, interest in learning first aid knowledge and willingness to learn first aid knowledge independently by network ( P < 0.05). The three teaching methods ranked the highest in the survey of emergency teaching methods were situational teaching, problem-based learning and action teaching method. Conclusion:Nursing students have a strong demand for training during the emergency internship. Clinical nursing administrators and educators should combine the internship demand of nursing students and the teaching outline of medical colleges to carry out the training arrangement during the emergency practice, so as to meet the learning needs of nursing students during the emergency practice.

Objective To compare the results of susceptibility testing by European Committee on Antimicrobial Susceptibility Testing (EUCAST)and Clinical and Laboratory Standards Institute (CLSI)broth microdilution methods against Aspergillus isolates.Methods The susceptibilities of 116 Aspergillus isolates were determined for amphotericin B, voriconazole, itraconazole,caspofungin and micafungin according to EUCAST (E.DEF 9.1 )and CLSI (M38-A2)methods.The essential agreement (EA),categorical agreement (CA),very major errors (VME)and major errors (ME)of the two methods were compared.Results The EA was 96.3%-100% between the two methods.The CA ,ME,and VME were 98.8%,0-1.2% and 0 respectively for the susceptibility of Aspergillus fumigatus to voriconazole.The CA,ME and VME was 1 00%,0 and 0 respectively for the susceptibility of Aspergillus fumigatus and Aspergillus niger to amphotericin B,or the susceptibility of Aspergillus fumigatus and Aspergillus flavus to itraconazole.Conclusions The results of susceptibility testing by EUCAST and CLSI broth microdilution methods are well consistent against Aspergillus isolates.

A simple and sensitive assay for rapid detection of human coronavirus NL63 (HCoV-NL63) was developed by colorimetic reverse transcription loop-mediated isothermal amplification (RT-LAMP). The method employed six specially designed primers that recognized eight distinct regions of the HCoV-NL63 nucleocapsid protein gene for amplification of target sequences under isothermal conditions at 63 degrees C for 1 h Amplification of RT-LAMP was monitored by addition of calcein before amplification. A positive reaction was confirmed by change from light-brown to yellow-green under visual detection. Specificity of the RT-LAMP assay was validated by cross-reaction with different human coronaviruses, norovirus, influenza A virus, and influenza B virus. Sensitivity was evaluated by serial dilution of HCoV-NL63 RNA from 1.6 x 10(9) to 1.6 x 10(1) per reaction. The RT-LAMP assay could achieve 1,600 RNA copies per reaction with high specificity. Hence, our colorimetric RT-LAMP assay could be used for rapid detection of human coronavirus NL63.
Colorimetry ; methods ; Coronavirus Infections ; diagnosis ; virology ; Coronavirus NL63, Human ; genetics ; isolation & purification ; DNA Primers ; genetics ; Humans ; Nucleic Acid Amplification Techniques ; methods ; Reverse Transcription ; Sensitivity and Specificity

Objective To evaluate the efficacy of locally administered dexamethasone for prevention of low back pain after labor epidural analgesia.Methods Two hundred nulliparous parturients who required labor epidural analgesia,of ASA physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n =100 each) using a random number table:control group (group C) and dexamethasone group (group D)).In group D,lidocaine 4 ml and dexamethasone 1 ml (5 mg) were injected around the puncture site.In group C,lidocaine 4 ml and normal saline 1 ml were injected around the puncture site.Epidural puncture was performed after local administration.According to the results of epidural puncture,each group was further divided into two subgroups:single puncture group (Cs subgroup,Ds subgroup) and repetitive puncture group (Cr subgroup,Dr subgroup).The patients were followed up for 72 h,and the development of low back pain was recorded.Results Compared to group C,the incidence of low back pain was significantly decreased,and pain was reduced in group D.The incidence of low back pain was significantly lower in Ds group than in Cs group,and in Dr group than in Cr group.Conclusion Locally administered dexamethasone 5 mg is helpful in reducing low back pain after labor epidural anesthesia.

Objective To study the clinical, laboratory, radiological and pathological findings of patients with hypertrophic cranial pachymeningitis (HCP) in Wegner's granulomatosis (WG) to improve the recognition of the disease, even when it occurs in limited form. Methods Three patients were described and English literatures of biopsy-proven pachymeningitis in WG were reviewed. Results The features of WG-associated pachymeningitis included: ① Frequently occurred early in the course of active limited WG; ② Commonly presented with sever headache and cranial neuropathies in the absence of other meningeal irritative signs; ③ Variable cerebrospinal fluid findings with mild predominantly lymphocytic pleocytosis and elevated protein concentration were major laboratorg findings; ④Elevated ESR and positive serum anti-neutrophilic cytoplasmic antibody (ANCA) could be found in most patients; ⑤ Gadolinium-enhanced brain MRI is very senitive in the detection of pachymeningitis; ⑥A dural biopsy showed granulomatous necrotizing inflammation, giant cell, and evidence of vasculitis;⑦ A favorable response to standard treatment with corticosteroid, cyclophosphamide or other cytotoxic drugs could be observed. Conclusion HCP may be the initial or cardinal manifestation of the limited form of WG. Early diagnosis by ANCA, MRI and dural biopsy may facilitate diagnosis Corticosteroid and immunosupressant are the choices of treatment.

Objective To explore the value of urine formaldehyde test in the diagnosis of Alzheimer's disease (AD),and the influential factors of urine formaldehyde level in AD patients.Methods A total of 52 AD patients and 53 cognitively normal controls were recruited in a cohort study.All subjects were no less than 65 years old,and those with acute infection,or dysfunction in heart,liver or kidneys were excluded.The impact of age,gender,onset age,MMSE score,NPI score,MTA score,and ApoE ε4 gene on urine formaldehyde of AD patients were analyzed by multiple regression analysis.Results Urine formaldehyde level of AD group was statistically higher than that of cognitively normal control group ((13.27±4.16)μmol/L vs (10.76±4.47)μmol/L,t=2.99,P=0.15).Urine formaldehyde of AD patients was statistically negatively correlated with MMSE score (β=-0.35,P=0.03) and MTA score (β=-0.38,P=0.02).The impact of onset age,neuropsychiatric disorders and ApoE ε4 gene on urine formaldehyde of AD patients was not statistically significant(all P>0.05).Conclusion Urine formaldehyde level is worthwhile to be explored as a marker in AD diagnosis and severity assessment.