Objective To investigate the efficacy and safety of combination use of diltiazem and nitroglycerin in preventing radial artery spasm in performing coronary angiography via radial artery access. Methods During the period from Dec. 2012 to June 2013 at authors’ hospital, coronary angiography via radial artery access was carried out in a total of 200 patients. The patients were randomly divided into 2 groups: nitroglycerin group (n = 100) and combination group (n = 100). After successful placement of catheter sheath 200 μg of nitroglycerin was injected through the sheath in the patients of the nitroglycerin group, while 200 μg of nitroglycerin together with 2 mg diltiazem was injected through the sheath in the patients of the combination group. The heart rate , blood pressure and electrocardiogram were recorded with an electrocardio-pressure monitor before the injection as well as at 2, 5, 15 and 30 minutes after the injection. The occurrence of radial artery spasm and patient ’s general condition were also under observation. Results Radial artery spasm occurred in 5 patients of the combination group , while it occurred in 13 patients of the nitroglycerin group, the difference between the two groups was statistically significant (P < 0.05). No significant difference in heart rate and electrocardiogram existed between the two groups (P > 0.05). Conclusion For the coronary intervention via radial artery access , combination use of diltiazem and nitroglycerin can more effectively prevent the occurrence of radial artery spasm. Besides , combination use of diltiazem and nitroglycerin has no obvious effect on the heart rate , the blood pressure and the electrocardiogram.

Objective To observe the effect of acupuncture and massage on tiptoe in children with spastic cerebral palsy. Methods 49 children with spastic cerebral palsy were divided into treatment group (n=24) and control group (n=25) in accordance with the order of visiting. The control group accepted routine rehabilitation, and the treatment group accepted acupuncture and massage in addition. They were assessed with Composite Spasticity Scale (CSS), the angle of ankle passive dorsiflexion before and after treatment. Results The scores of CSS and the angle of ankle passive dorsiflexion improved in both groups after treatment (P<0.001), and improved more in the treatment group than in the control group (P<0.001). The rate of improvement was 95.6% in the treatment group, and 78.26% in the control group (P<0.05). Conclusion Acupuncture and massage may further improve the correcting of the tiptoe in children with spastic cerebral palsy.

Contrast-enhanced ultrasound images of tuberculous diaphragmatic muscle abscess of 26 surgically confirmed patients were retrospectively analyzed.The coincidence rate of preoperative diagnosis was 77％.The contrast-enhanced ultrasound images could be divided into three types of homogeneous,uneven and non-enhancement.Contrast-enhanced ultrasonography could decipher the blood supply characteristics and the different extents of tuberculous diaphragmatic muscle abscess.Thus it has important diagnostic values in the diagnosis of tuberculous diaphragmatic muscle abscess.

Objective To investigate the influence of pullulan molecular weight and spacer length on the properties of modified pullulan carriers including morphologies,sizes and in vitro release behaviours of drug-loading carriers.Methods Using cholesterol as hydrophobic ligand,succinic anhydride and 1,6-hexyldiisocyanate as spacers,hydrophobic modified pullulans with different molecular weights were prepared.Self-assembled nanoparticles were then formed in the aqueous solution,and drug-loaded nanoparticles were prepared by dialysis method.The influence of pullulan molecular weight and spacer length on the loading-content,morphologies and in vitro release behaviours of drug-loading nanoparticles were then investigated in detail.Results Self-assembled nanoparticles could be formed by the cholesterol-modified pullulan,and doxorubicin and mitoxantrone could be loaded into cholesterol-modified pullulan to form nanoparticles.Pullulan molecular weight and spacer length show influences on sizes,morphologies and stabilities of pullulan nanoparticles and drug-loaded nanocarriers.Conclusions Before drug loading,nanoparticles with larger moleculare weight and shorter spacer length are more stable in solution,while after drug loading,the influences of these two factors on the nanoparticles are drug-type depended.

The clinical data of 91 patients with axillary cystic/solid mass receiving ultrasound-guided mass puncture in Hangzhou Red Cross Hospital and Hangzhou Third Hospital from March 2010 to October 2015 were retrospectively analyzed.The biopsy cytology examination and routain bacteria culture of puncture fluid were applied in 44 cases ( control group); while X-pert examination of puncture fluid was performed in addition to biopsy cytology examination and routain bacteria culture in 47 cases ( study group) . The histopathological examination of surgical specimens were used as gold standard.The overall diagnostic accuracy rates of study and control groups were 93.6% (44/47) and 68.2% (30/44), respectively(P=0.002) .The diagnostic accuracy rates for tuberculous abscess in study and control groups were 100.0%(28/28)and 57.7%(15/26), respectively (P=0.000).However, there were no significant differences in diagnosis of other diseases, including metastatic carcinoma, abscess other than tuberculous and lymphatic hygroma between two groups.The study shows that diagnostic accuracy of multiple examination methods of puncture fluid for axillary cystic/solid mass is high and has clinical application value.

AIM:To study the effects of water extraction of Choerospondias axillaris on inhibiting renal calculus. METHODS:The mice were fed 1% ethylene alcohol and 1?(OH)VitD3 to cause renal calculus. The concentrations of calcium and oxalate acid in urine and kidney were determined in mice to evaluate the effects of Choerospondias axillaris. RESULTS:The urinary oxalate of model group (1% ethylene glycol and 1?(OH) VitD3) increased significantly(P

Clinical hematology and hematologic examination is a strong practical curriculum, and experimental class is very important in the aspects of teaching.In order to improve the quality of teaching and train compound laboratory talents with high quality,several effective reform mea-sures were carried out based on the years of teaching practice by the department:improving the methods of experimental teaching;using modern means of teaching;emphasizing on the analysis of experimental results,formulating the rigorous experimental evaluation system and starting the second class etc.

Training anesthesiology postgraduates should be started with clinical skill and scien-tific thinking. This article advocated setting up a multi-level and multi-mode training strategy based on theoretical study ,clinical skill training and scientific ability development according to the features of anesthesiology. Meanwhile,the training should have focus and orientation for postgraduates at different grades. This study solved the problems of training for postgraduates of anesthesiology and made a feasible training strategy to develop the clinical and scientific ability of postgraduates.

Objective To observe the efficacy and the side-effects of sodium valproate (VPA) in patients with epilepsy in rural China. Methods Epilepsy patients were selected from rural areas of Tianmen in Hubei province and Tiandong county in Guangxi province according to the inclusion and exclusion criteria.Efficacy evaluation standard depending on the change of seizure frequency compared with the situation prior to entering the treatment group. Among the treated patients, no seizures, seizure reduced ＞ 75%, seizure reduced 50%-75% sums for the total effective rate. Results All 607 patients with epilepsy were treated and followed up, the male were 395 (65. 1% ) female 212 (34. 9% ), and 579 patients were treated for 12 months. Patients with generalized tonic-clonic seizures were 517 (85.2%), absence seizures 20 (3. 3% )and the other types of seizures 70 (11.5% ) including simple partial seizures, tonic, clonic, myoclonic or atonic seizures etc. The completed control of seizures ( without any seizures) during the period after taking 3 months, 6 months, 12 months were 270 (45.5%), 249 (42. 3% ) and 238 (41.1%) respectively. The total effective rates in the three periods were 65.2% , 75.4% and 85.5% respectively. The 58 patients in the total group showed side-effects during the follow-up period, mainly including drowsiness, lethargy,fatigue, dizziness, headache and tremor. Nineteen patients (3. 1% ) quitted the treatment group.Conclusions The VPA is an effective antiepileptic drug and no more severe side-effects. It is the same as Phenobarbital and suitable to be used in rural areas of China.

Objective To investigate the effect of clinical classification and operational methods of gallblad-der carcinoma on the prognosis.Methods Clinical data of 88 patients with gallbladder carcinoma treated surgically from January 1994 to December 2004 were retrospectively analyzed.Results 8 cases were in class Ⅰ and Ⅱ , 14 in class Ⅲ ,28 in class Ⅳ,38 in class Ⅴ.The mean survival of these 4 classifications was 36.5,9.3,4.6,3.9 months respectively.There was a remarkable difference(P <0.01,P<0.05) in survival among these 4 classifications ex-cept between class Ⅳ and class Ⅴ (P0.05).The mean survival of radical resection and palliative resection in class Ⅳ and Ⅴ was 4.2 and 3.8 months.There was no remarkable difference( P0.05 ) between them.Conclusion The key to increase the therapeutic effect gallbladder carcinoma is early diagnosis and radical resection.