Objective To explore the atanalgesic effect of propofol combined with fentanyl in intravenous compound anesthesia for painless induced abortion.Methods 150 women which volurnteered to take painless induced abortion and which gestational age were 6 ～ 10 weeks were selected and randomly divided into the two groups for each 75 cases based on the method of number table.The control group were treated with propofol,while the observation group were treated with fentanyl on the basis of the control group.The mouth of the cervix relaxation expansion,blood loss and operative time was observed,and the clinical efficacy and adverse reactions of two groups were compared.Results The blood loss,operative time,mouth of the cervix relaxation expansion,total effective rate and adverse reactions in the observation group was (22.3-± 9.23) ml,(2.1 ± 0.6) h,97,33 ％,97.33 ％,1 4.67 ％,respectively,which were better than those of the control group[(36.7 ± 8.95) ml,(3.4 ± 0.8) h,69.33％,82.67％,38.67％] (t =7.365,8.163,χ2 =8.56,9.23,8.45,all P ＜0.05).Conclusion Propofol combined with fentanyl in intravenousanesthesia for painless induced abortion has an excellent analgesic effect,which is safe and easy to operate.So it is worthy of clinical application.

A simple and efficient method for the determination of organotin compounds ( OTCs) in biota by GC-MS coupling with sodium tetraethylborate ( NaBEt4 ) derivatization was established. The results showed that recoveries for each OTCs spiked in blank freeze-dryed biological samples ( 0 . 1 g ) following extraction (15 mL 0. 035 mol/L methanolic HCl solution for 1 h ) and derivatization (2 mL contained internal standard n-hexane and 0. 5 mL of 2% (m/V) NaBEt4 solution for 30 min) were above 80%. The method is fast and easy to operate for the determination of OTCs in complex biological samples. The minimum limit of detection was about 0. 01 μg/L, and relative standard deviation values were within 10% for three parallel samples.

Objective To explore the effect of upgrade of dialysate quality on the microinflammation in maintenance haemodialysis (MHD) patients. Methods Fifty-three MHD patients in Kidney Center of the First Affiliated Hospital,Medical College,Zhejiang University in January 2003 were enrolled in the prospectively study.The main end-points were survival at 8 years or weaning from haemodialysis during 8-year period including death, receiving renal transplantation or transferring to peritoneal dialysis.The endotoxin level of dialysate and patients' serum levels of interleukin-6 (IL-6),tumor necrosis factor α (TNF-α),C reaction protein (CRP),and albumin were recorded during the observation period. Results After the upgrade of water management system,endotoxin level of dialysate obviously decreased [(0.046±0.012) EU/ml vs (0.454±0.002) EU/ml,P＜0.01],and serum IL-6 [(3.947±3.624) ng/L vs (13.779±7.106) ng/L,P=0.036],TNF-α [(7.935±3.864) ng/L vs (12.804±8.017) ng/L,P=0.012] as well as CRP [(0.194±0.149) mg/L vs (0.561 ±0.309) mg/L,P＜0.01] decreased significantly,while serum albumin increased [(41.900±6.803) g/L vs (38.140±7.083) g/L,P=0.042].Hemoglobin level did not change significantly after the system upgrade,however,the dose of erythropoietin decreased [(93.0±12.7) U·kg-1·week-1 vs (131.0±10.1) U·kg-1·week-1,P=0.015]. Conclusions The upgrade of central dialysis fluid delivery and water management system by application of double reverse osmosis,high frequency heat disinfection and endotoxin filter can improve the quality of dialysate.Improvement of dialysate quality can ameliorate the microinflammation state of MHD patients.

Objective To investigate the value of echocardiography in assessing the right heart function of patients with chronic obstructive pulmonary disease (COPD). Methods Forty-four COPD patients who were treated in Beijing Anzhen Hospital of Capital Medical University, from April 2016 to April 2017, were selected as COPD group; and 12 healthy physical examiners were included in healthy control group during the same period. Patients were divided into COPD with pulmonary hypertension (PH) group and COPD without PH group. All subjects were routinely examined by transthoracic echocardiography. The parameters of right heart function of all subjects were measured by echocardiography according to 2010 guideline of American Society of Echocardiography (ASE). Independent sample t test was used to compare echocardiographic routine parameters and recommended parameters of ASE guideline between COPD group and healthy control group. One-way analysis of variance was used to compare the routine parameters of echocardiography and the recommended parameters of the ASE guide in the patients of COPD with PH group and COPD without PH group and the healthy control group. SNK-q test was used for comparison between groups. Results The right ventricle diameter (RVD) in group COPD was wider than that in healthy control group [(20.68±4.21) mm vs (18.17±1.75) mm], and the difference was statistically significant (t=2.92, P=0.005). There was no significant difference in the right ventricular outflow tract (RVOT), main pulmonary artery diameter (MPAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) between the COPD group and the healthy control group. Compared with the healthy control group, the diameter of right ventricle basal segment in the COPD group increased [(35.92±8.12) mm vs (27.75±3.17) mm], tricuspid annular plane systolic excursion (TAPSE) decreased [(19.61±4.08) mm vs (22.67±2.67) mm], right ventricular index of myocardial performance (RIMP) increased [(0.52±0.10) cm/s vs (0.43±0.04) cm/s)], and the differences were statistically significant (t=3.39, P=0.001; t=-2.44, P=0.019; t=4.31, P ＜ 0.001). There was no significant difference in right atrium area, E/A, E/E' and S' between COPD group and healthy control group. There was no significant difference in RVOT, RVD, MPAD, LVEDD, LVESD and LVEF in the patients of COPD with PH group and COPD without PH group and in the healthy control group. There was no significant difference in the right atrium area, E/A, E/E', TAPSE and S'. The right ventricular basal segment diameter and RIMP of COPD with PH group and COPD without PH group were higher than those of healthy control group [(37.99±9.66) mm, (34.47±6.70) mm vs (27.75±3.17) mm; (0.54±0.13) cm/s, (0.51±0.08) cm/s vs (0.43±0.04) cm/s]. The differences were statistically significant (q=6.960, 4.905, 5.796, 4.348, all P＜0.05). However, there was no significant difference in right ventricular basal segment diameter and RIMP between COPD with PH group and COPD without PH group. The RVWT of COPD with PH group was higher than that of COPD without PH group [(5.29±0.69) mm vs (4.54±0.70) mm], and the difference was statistically significant (t=3.313, P=0.002). Conclusions The method recommended in the ASE guidelines for this study was more sensitive than conventional methods for the detection of changes in the structure of the right heart. The change of the right ventricular structure was the first manifestation of right heart involvement in COPD patients, and then the systolic function of the right ventricle diminished. The long-term effect of pulmonary hypertension was thickening of the right ventricular wall at the early stage and then enlargement of the right ventricle.

Objective:To study the degree of recognition about the protection of traditional knowledge of Chi-nese medicine and its influencing factors among Shaanxi University of Chinese Medicine students and provide scien-tific evidence for improving relevant policies.Methods: 1,162 college students were chosen by stratified cluster sampling from Shaanxi University of Chinese Medicine and questionnaires were surveyed among them.Rank sum test and multiple linear regression model were used to explore the related factors on degree of recognition about the protection of traditional knowledge of Chinese medicine.Results: The overall cognition-scoring rate was 36.55％,and subscales in descending order by scoring rate were loss of traditional knowledge of Chinese medicine,international and domestic related protection systems.There were significant differences in scores between age groups,majors,grades,place of origin,family monthly income per capita,parents'educational background,moti-vation of applying for medical school,and whether they had taken the protection of traditional knowledge of Chinese medicine courses(P<0.05).Conclusion:The overall cognition-scoring rate among Shaanxi University of Chi-nese Medicine students was generally low.In order to motivate students to protect traditional knowledge of Chinese medicine and promote a healthy development of Chinese medicine,measures from national institution and school education should be conducted.

Objective     To evaluate the early clinical effect of reimplantation in the treatment of bicuspid aortic valve (BAV) with aortic root aneurysm. Methods     The clinical data of 25 patients with BAV and aortic root aneurysm [mean diameter: 45-63 (52.68±5.55) mm] undergoing reimplantation in West China Hospital from November 2019 to May 2021 were retrospectively reviewed. There were 22 males and 3 females. The mean age was 15-65 (50.00±13.10) years and body surface area was 1.79±0.23 m2. Results    The pathological classification of BAV malformation was confirmed during the operation: Type 0 in 3 patients and Type 1 in 22 patients. There were 12 patients undergoing cusp central plication, and 2 patients were sutured with a closed fusion crest. Postoperative valve leaflet coaptation height was 0.78±0.15 cm, and effective height was 1.27±0.19 cm. In operation, maximum aortic valve flow velocity was 1.65±0.42 m/s, pressure difference was 5.46±3.05 mm Hg, and aortic valve annulus diameter was 21.32±0.95 mm. Cardiopulmonary bypass time was 225.84±35.34 min, and aortic block time was 189.60±26.51 min. In-hospital time was 11.64±3.07 d, ICU stay time was 2.64±0.99 d, and mechanical ventilation time was 1.48±0.87 d. The follow-up time was 17.20±4.70 months, and no death or major complications occurred during the follow-up in all patients. The cardiac function of the patients significantly improved postoperatively (P≤0.05). Echocardiography suggested that 12 patients had no aortic regurgitation, 10 minor aortic regurgitation, 3 mild aortic regurgitation, and no patients with moderate or more severe regurgitation. The diameter of the aortic sinus, left ventricular end-diastolic diameter and volume decreased during the follow-up, compared to preoperative ones (P≤0.05). The maximum flow velocity of the aortic valve was 1.54±0.36 m/s, and the pressure difference was 5.17±2.38 mm Hg during the follow-up. Conclusion    Reimplantation technology has a good clinical effect for highly selective BAV patients. It can effectively avoid long-term postoperative anticoagulation, but the maximum flow rate after surgery is slightly increased, which may be related to the configuration of BAV itself. While compared with valve replacement, the effect is still worthy of recognition.