Emergence delirium (ED) is a complex of perceptual disturbances and psychomotor agitation that occurs most commonly in preschool-aged children in the early postanesthetic period.Although these events are often short lived,they increase the risk of self-injury,require additional nursing staff and can increase medical care costs,all of which are causes for concern.A variety of anesthesia-,surgery-,patient-,and adjunct medication-related factors have been suggested to play a potential role in the development of such an event.The risk of ED is lowest when propofol is used as a single-agent anesthetic compared with sevoflurane-based anesthetics.Adjunctive agents can be rated in the following order of most effective to least effective interventions:dexmedetomidine,fentanyl,ketamine,clonidine.This review summarizes the factors that may predict ED and provides an intervention algorithm to guide effective prevention and treatment.

Objective To study the applied value of invasive arterial blood pressure monitoring in the diagnose and treatment of coronary artery intervention. Methods The dynamic changes of ECG, the non-invasive blood pressure, the invasive arterial blood pressure monitoring and the clinical performance were ob-served in 163 patients in the process of coronary artery intervention (CAI). Then the invasive arterial blood pressure change and the non-invasive blood pressure change were compared. Results The change rates of invasive arterial blood pressure were higher than that of non-invasive arterial blood pressure. The difference of both changes had statistical significance. The invasive blood pressure decreased and wave forms changed in 26 cases. These reflected sensitively the patients' condition and the issues in the process of CAI. Conclusions To strengthen the invasive arterial blood pressure monitoring can improve the success rate of CAI more effec-tively and reduce the complication.

Hypoxia-inducible factor-1 ( HIF-1 ) is one of the most important transcriptional factors which regulate the transcription of vascular endothelial growth factor ( VEGF ), HIF-1 plays a critical role in tumor angiogenesis and metastasis. The transcriptional regulation role for HIF-1 in tumor angiogenesis is closely related to its molecular structure,biological character and molecular mechanism and signaling pathways.

The process of tumor angiogenesis is a complicated chain reaction which happens under the action of a series of positive feedback and negative feedback factors . Cancer stem cells are small part cell groups of self-renewal and multilineage differentiation potential in tumors. Many studies indicate that tumor stem cells participate in the process of tumor angiogenesis, and vascular endothelial growth factor can regulate endothelial proliferation and angiogenesis, thereby promoting tumor growth and metastasis.

Objective To explore the influence of pomegranate juice on cognitive behavior of chroniccerebral hypoperfusion in rats and its mechanism.Methods 48 healthy male Wistar rats were selected and randomly divided into 3 groups, sham operation group (SO), permanent bilateral persistence commancarotid artery occlusion or two-vesselocclusion (2VO) group, pomegranate juice group.Chronic cerebral hypoperfusion model was prepared in rats by permanent bilateral common carotid artery ligation.Given the intervention after operation 1 weeks, before the 2 groups were given by sugar water intragastric ( every 100 mL syrup containing 25 g,sucrose 2 g, fructose glucose 2 g) with pomegranate juice, pomegranate juice group ( polyphenol content of 2.4-4.8 mg/mL) were given by gavage,2 mL/d, a total of 7 weeks.8 th weeks after surgery, cognitive behavior ability of 3 groups was tested by space exploration target quadrant swimming time after an interval of 1day;CA1 region of 8-hydroxy deoxyguanosine (8-OHdG), 4-hydroxyl nonenal ( 4-HNE ) expression of 3 groups in cortex and hippocampus detected by immunohistochemical method; observed whether it could improve the chronic cerebral hypoperfusion in rats learning, memory ability, or had antioxidative stress injury.Results On the 4th day and 5th day, the time of rats in SO to find the platform and the shortest time, group 2VO for the longest time, compared with statistical significance between the three groups (P<0.01); the 3 groups of rats in the target quadrant emergence time in sham operation group, the longest (10.05+1.688)s, 2VO group has the shortest time (6.343 ±1.220) s, and there was statistical significance (P<0.05).The integral optical density of positive cells in 3 groups of rats cortex and hippocampal CA1 region of 4HNE, the value of the 8-OHdG IOD is the lowest in the sham operation group, 2VO group was the highest, with statistical significance.Pomegranate juice intervention, cortex of rats and hippocampal CA1 region of 8-OHdG, 4-HNE decreased significantly ( P <0.05).Conclusion Chronic cerebral hypoperfusion may cause oxidative stress injury, pomegranate juice can improve the low irrigation learning and memory ability of rats with chronic cerebral, decrease 8-OHdG and 4-HNE expression may play a protective function through antioxidative stress pathway.

It is a promising method to use Liposomes as a carrier in the transdermal delivery system.Presently,llposomes,deformable liposomes,and ethosomes are in common use.The transdermal mechanism of the liposomes is to promote the velocity and the amount of the drugs of transdermal absorbance by affecting the keratoderma,acting on the skin appendages and changing the exterior characteristic of the drugs to make them permeate the skins.The Mechanism of the actions includes hydration.penetration,transforamation,and osmotic pressure driving effect,etc.The liposomes have been approved to have abroad prospect of application in the transdermal delivery system.

Objective To observe the effect of grape seed Procyanidins on platelet aggregation and experimental thrombosis in rats.Methods 50 Experimental thrombosis male SD rats of clean grade,weighing 250～300 g,were randomly divided into five groups,normal saline(control)group,aspirin(ASP)group(60 mg/kg),and procyanidins 1 00 mg/kg,200 mg/kg,400 mg/kg group,10 in each.50 experimental thrombosis male Kunming mice of clean grade,weighing 18～20 g,were also randomly divided into five groups,normal saline(control)group,aspirin group(84 mg/kg)and Procyanidins 140 mg/kg,280 mg/kg,560 mg/kg group,10 in each.Intragastric administration was performed in these experimental animals.The effects of Procyanidins were observed on rat platelet aggregation induced by ADP,COL and AA.Experimental rat's thrombosis was induced by method of"arterio-venous"shunt and the death rate within 15 min was determined with collagen plus adrenaline induced thrombus model in mice,aspirin as a positive control.Results Procyanidins in the middle and high-dose group can inhibit ADP,COL,AA-induced platelet aggregation and experimental thrombosis obviously.Conclusion Procyanidins can inhibit experimental thrombosis and have anti-platelet aggregation effect.

Objective To observe the therapeutic effect of Qiyao Xiaoke Capsule(Capsule for Diabetes) on the diabetes type Ⅱ.Methods Totally 240 diabetes type Ⅱ patients were randomized into a treatment group(n=150),and a control group(n=90);and other 30 diabetes patients who didn't regularly take hypoglycemic drugs were set as opening group.The treatment group was administered Qiyao Xiaoke Capsule plus Metformin Hydrochloride Tablets,while the control group was prescribed Xiaokeling Capsule in addition to Metformin Hydrochloride Tablets,and the opening group was given Qiyao Xiaoke Capsule only,with a leading period of two weeks.The patients were treated for 4 weeks.Before treatment and at the end of the 4 weeks' treatment,the fasting blood glucose(FBG),2 hours postprandial blood glucose(2hPG),and glycosylated hemoglobin(HbA1c) of all groups were determined,and scores of TCM syndromes and symptoms were observed to evaluate the therapeutic effect.Results The total effective rate of the treatment group was 74.67%,of the control group 72.22%,and in the opening group 70.00%.Except for the 2hPG of the opening group,the FBG,2hPG and HbA1c of 3 groups were decreased(P

This paper analyzes the concept of hospital financial information management and the current situation.From the perspective of public hospital reform, we proposed the hospital should fulfill the information-based budget management and salary management, construct hospital information-based cost control flowsheet, build message conducting and transferring program, that budget should be achieved as soon as possible, information technology should be applied in hospital management, and build a complex financial information management team as soon as possible.

Objective To investigate the relevant risk factors for,clinical manifestation and treatment responses of symmetric acral keratoderma in 9 patients.Methods Clinical data were collected from 9 outpatients with symmetric acral keratoderma.Skin lesions were photographed,tissue specimens were obtained from the lesions and subjected to fungal and histopathological examinations.The patients were given topical treatment.Results There were 8 males and 1 female in these patients with an average age of 28.2 years and age at onset of 24.6 years.The disease duration varied from 2 months to 16 years.The lesions were predominantly distributed on the dorsum of both hands and wrists symmetrically and circularly.Ankles were the third popular site involved.Generally,the lesions were aggravated in summer,spontaneously cured in winter.Most of the patients had a history of occupational contact with plastics or rubber.Some patients suffered from ichthyosis vulgaris.Microscopic examination for fungal element was negative.Histopathology revealed epidermal hyperkeratosis,acanthosis and mild papillomatosis.The urea and Vitamin E cream mixed with clobetasol propionate cream at a ratio of 1 ∶ 1 proved to be effective.Conclusions Ichthyosis vulgaris may be a risk factor for symmetric acral keratoderma.The whitening of lesions after short exposure to water may be a kind of physical phenomenon with the involvement of water and air.Topical steroids may serve as the first-line treatment choice for symmetric acral keratoderma.