Objective To summarize recent researches on mechanism of the hepatic ischemic preconditioning(IPC) and its clinical applications on hepatectomy and liver transplantation.Methods Relevant references about basic and clinical researches of hepatic IPC were collected and reviewed.Results Recent experimental researches indicated that IPC could relieve hepatic ischemia-reperfusion injury(IRI) by remaining and improving energy metabolism of liver,regulating microcirculation disorder,decreasing the production of lipid peroxidation and oxyradical.It could also inhibit the activation of inflammatory cells and the release of cytokine,suppress cell apoptosis and induce the release of endogenous protective substance.Till now,most of the clinical researches had confirmed the protective function of hepatic IPC,but there were still some references with opposite opinions.Conclusion Hepatic IPC could relieve liver IRI,but its clinical application value on hepatectomy and liver transplantation still need more researches to prove.

Objective To explore the influencing factors and countermeasures for prevention and health care in community health service.Methods A random sampling method in our county, 13 community health centers, 152 community health stations, 2 county hospitals, 2 special hospitals was used for the investigation to analyzes the obstacles in carrying out the preventive care service and to work out measures.Results By strengthening prevention and health care management, the problems in prevention and shortage of health care funds, feasibility to preventive care service, community nurses'comprehensive quality, poor awareness of community residents were significantly im-proved (p>0.05).Conclusion Pertinent to the influencing factors for health care and prevention work in commu-nity health service, targeted measures should be made to improve the financial problem, improve the feasibility, im-prove community medical service to provide a strong guarantee for the protection of the health of residents.

The paper analyzes the application advantages of information technology in medical informatics education.Takes Shanghai Sipo Polytechnic College as an example, it elaborates the specific application of information technology in medical informatics education, including immersion education based on 3D virtual reality technology, two-way video teaching and other aspects.It also gives solutions on current existing problems.

Objective To establish the capability level classification system and capability level staffing standard of ICUs in tertiary hospitals, in an effort to raise the efficiency of nursing resources while ensuring quality of care of patients. Methods Such methods as experts meetings and Delphi Method were called into play to establish the nurses capability level system in ICUs with the convenient sampling method, we made clinical observation and research in 5 ICUs of 3 tertiary hospitals in Shanghai. Results Nurses in ICUs were classified into four levels, so were their responsibilities and job description. This way the system of nursing staff capability levels takes shape, and the staffing standards for nurses in ICUs of tertiary hospitals come into being. Conclusion Such tiered staffing standards in tertiary hospitals enable clinical nursing managers to deploy and efficiently use nursing staff of all levels.

The hemodynamics of 49 scheduled patients during anesthesia and opration for mitral and aortic valve replacement were studied with the insertion of SwanGanz catheter and by the method of thermodilution technics.Pre-anesthesia CI and LVWI were in the nor mal range with abnormal MPAP, PCWP, PTRI and RVWI.Increase of RAP and decrease in MPA,PCWP, MAP, CI, LVWI and RVWI were observed during induction of anesthesia. The hemodynamic parameters returned to or exceded the pre-anesthesia values after trachcal intubation and sternotomy. The CI, MAP, MPAP, PCWP, LVWI and RVWI decreased signifi- cantly after insertion of aorta and vena cava catheter. The reduction of MPAP, P(IWP,PTRI and RVWI post-cardiopulmonary bypass (CPB) were significant and persistent with no change of PVRI.The lower MAP,SVRI and deterioration of cardiac performance post-CPB indicate that the administeration of positive inotropir agents and restoration of hematocrit are nec essary as early as possible.

Objective: To determine the action site of propofol and hydroxybutyrate sodium relaxing mandibular muscles. Method: Eighty adult patients,ASA class Ⅰ or Ⅱ, were randomly divided into four groups (n=20),receiving intravenous propofol 1.5,3.0mg/kg or hydroxybutyrate sodium 50,80mg/kg, respectively. Train-of-four (TOF), double-burst stimulation (DBS), tetanic stimulation (TS)were applied to ulnar nerve-adductor pollicis or mandibular nerve masseter. Result: (1) After intravenous propofol and hydroxybutyrate sodium,T1 (first twitch height of TOF)and TOF ratio of addutor pollicis were kept unchanged. (2)After intravenous propofol ,T1 induced by stimulating mandibular nerve-masseter was similar to before administration and TOF,DBS and TS ratios were significantly increased; (3) after intravenous hydroxybutyrate sodium,TOF ratios of mandibular nerve-masseter remained stable, but T1, DBS and TS ratios significantly reduced. Conclusion:Neuromuscular transmission of ulnar nerve-addutor pollicis is not affected by propofol and hydroxybutyrate sodium. The action place of propofol relaxing the mandibular muscles is located in central nerve system. Hydroxybutyrate sodium blocks neuromuscular transmission of mandibular nerve-masseter.

40kPaOxygen metabolism and hemodynamics were measured with Swan-Ganz catheter techniques and reverse Fick principleResults Before anaethesia, oxygen delivery(DO_2), mixed venous oxygen pressure (PvO_2) and oxygen extraction ratio(O_2ER) in group Ⅱ were significantly lower than those in group Ⅰ (P

Objective To explore the effects of microstructure grinded on the labial face of porcelain fused to metal crown (PFM) in esthetic prosthesis for anterior teeth. Methods 193 patients with single maxillary incisor tooth defects were repaired with 2 crowns for each one. After the crowns being blent colour and molded, the crown A was not grinded particularly on the labial face and the crown B was done according to the records of the microstructure.The patients were allowed to choose the most satisfied one when 2 crowns were cemented temporarily. Results 36 patients chose the crown A and 157 chose B.The difference was significant ( P0.05). Conclusion The crown has great vitality and accordes with the esthetic standards of the patients by way of being grinded microstructure on the labial face.

Objective To study anesthesia management in the laparoscopic excision of pheochromocytoma. Methods Thirty-seven cases of the epidural associated general anesthesia cured with diazepam 10 mg and scopolamine 0.3 mg administered 30 min before operation , anesthesia was induced with fentanyl 2?g ?kg -1 ,propofol 2mg?kg -1 , vecuronium 0.12mg?kg -1 and maintained with isoflurane,propofol and fentanyl. Vasoactive drugs were used to maintain blood pressure. All cases were sent into surgery intensive care unit after operation, ropivacaine and morphine for analgesia. Results The anesthetic effects and analgesia were satisfactory; all patients were cured. Conclusion Approach of anesthesia management in the laparoscopic excision of pheochromocytoma is feasible.