Objective To explore the effects of the different doses of propofol for preventing postoperative agitation in chil-dren.Methods 60 children cases undergoing elective indirect inguinal hernia hernioplasty were selected in the Affiliated Hospital of Traditional Chinese Medicine,Luzhou Medical College from June 2011 to April 2011 and randomly divided into the group Ⅰ,Ⅱ andⅢ.The three groups were performed the general anesthesia with sevoflurane and postoperatively given 0.90% sodium chloride in-jection 0.10 mL/kg by intravenous injection,propofol 1.00 mg/kg by once intravenous injection and propofol 1.00 mg/kg by twice intravenous injection,respectively.The occurrence rate of postoperative agitation within 30 min was compared among 3 groups.The anesthesia recovery agitation score,improved Aldrete score,awakening time and time out of the operation room were also compared. Results The occurrence rates of agitation within postoperative 30 min in the group Ⅰ,Ⅱ and Ⅲ were 65.00%,65.00% and 15.00% respectively,the difference among three groups was statistically significant (P <0.05);the anesthesia recovery agitation score,improved Aldrete score and awakening time had statistically significant differences among 3 groups (P <0.05),the time out of the operation room had no statistical difference(P > 0.05).Conclusion Postoperative twice intravenous injection of propofol 1.00 mg/kg has obvious effect and good safety for preventing the postoperative agitation in children,which has important clinical reference value.

BACKGROUND: Continuous passive motion assisted with diathermia will promote the restoration of joint movement of the extremities.OBJECTIVE: To improve joint movement with continuous motion assisted with diathermia after surgical treatment on simple fracture of upper or lower extremity.DESIGN: A randomized controlled trial.SETTING: Huaxi Hospital of Sichuan University.PARTICIPANTS: Eighty-four cases of simple extremity fracture treated in the Orthopedic Department of Huaxi Hospital of Sichuan University from October 2000 to July 2002 were included in this trial. Of them, 16 cases were elbow movement disorder and 68 were knee movement disorder. They were randomly assigned into two groups with 42 cases each.METHODS: The 42 cases in the treatment group were preheated before continuous passive motion while those in the control group just received continuous passive motion. The improvement of joint movement between thetwo groups were assessed and compared according to the joint movement scale.MAIN OUTCOME MEASURES: The joint movement before and after treatment and the indices of joint movement scale in the two groups.RESULTS: All of the eighty-four cases entered the analysis. The joint movement in the treatment group was better than that in the control group [ (101.40 ± 25.76)° vs (86.14 ± 27.66)°, t = 5.25, P ＜ 0.01 ]. The index of joint movement scale in the treatment group was also higher than that of the control group[ (84.32 ± 16.54) vs(64. 89 ± 13.76) ] ( t = 4.24, P ＜ 0.01 ) ].CONCLUSION: Continuous passive motion assisted with diathermia is better than simple continuous passive motion in improving the joint movement and function of elbow and knee.

Based on B.S. Bloom's taxonomy of educational objectives, development of medical students' core competence requirements is paid great attention to meet the needs of society within worldwide medical education community. The Institute for International Medical Education has developed the “Global Minimum Essential Requirements in Medical Education” of medical students' core competence oriented in the educational objectives of physicians.

Objective To compare the particle pollution to the solution in the ampoule wrapped and broken by non-woven fabrics and medical gauze.Methods Totally 200 pcs of sterile water for injection(2 ml/pc) were randomly divided into the experimental group and the control group,with 100 pcs for each.For the experimental group,the ampoules were wrapped and broken by disinfected non-woven fabrics.For the control group,the ampoules were wrapped and broken by medical gauze.The solution was sucked from the ampoule with a 10 ml syringe and injected into a measuring cup for testing.Results The quantity of particles in the solution in the experimental group was less than that in the control group,and the difference was statistically significant (P＜0.05).Conclusion Wrapping and breaking the ampoule by disinfected non-woven fabrics can reduce particle pollution to the solution,and this method is easy to practice.

Objective To evaluate whether glucose is associated with thrombolysis in myocardial infarction (TIMI) flow before primary percutaneous coronary intervention (PCI).Methods Pre-operation blood glucose level, TIMI flow and baseline characteristics of 120 consecutive acute ST-segment elevation myocardial infarction (STEMI) patients treated with primary PCI were analyzed. Hyperglycemia was defined as whole blood glucose ≥7.8 mmol/L (140 mg/dL). Results Only 18 patients (15%) had TIMI 3 flow before primary PCI and hyperglycemia was observed in 87 patients (72.5%). TIMI grade 3 flow were more commonly found in the normoglycemia group compared with the hyperglycemia group before primary PCI (27.3% vs 10.3%,P

Background Constipation is a common complication after stroke, and the results investigated overseas showed the incidence was about 30% ～60%. The difference of results is so significant because the time investigated and the diagnosis criterion used are different. There are less relative report about risk factors of constipation and no report about the impact of constipation on pragnosis. The study is to investigate the incidence and risk factors of new-onset constipation after stroke in the patients with acute stroke and to evaluate the impact of new-onset constipation occurrence on the prognosis in the patients.Methods A prospective cohort study of new-onset constipation was performed to investigate 154 cases of acute stroke patients who were hospitalized from December 2003 to October 2004 in the department of neurology, the first Affiliated Hospital of Sun Yat-sen University. We recorded the demographics, medical history,stroke severity and medication used. National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI)and Modified Rankin Scale (MRS) were evaluated in the 1st week and 4th week after stroke to evaluate the neurological function and ability of an independent life. BI and MRS were recorded at the 12th week after stroke.Patients were then followed for the development of stroke, the event such as recurrence or death. Constipation was defined by Rome Ⅱ criteria.Results The incidence of new-onset constipation after stroke within 4 weeks was 55. 31%, and the highest risk was within seven days after onset of stroke. Cox regression showed that the incidence of constipation occurrence was strongly related to neurological functional status of patients in the 1st week assessed by BI and the transform of surrounding for defecation. In the 4th week and 12th week after stroke, the rates of poor prognosis in patients with constipation in middling state were both higher than patients without constipation, and the difference was statistically significant respectively(P ＜ 0. 01 ;P = 0. 012).Conclusions The new-onset constipation occurrence in acute stroke is very common and its main risk factor is functional status assessed by Barthel Index at the 1st week after onset and the transform of surrounding for defecation. The results indicate that the new-onset constipation occurrence after stroke has negative effects on the outcome of partial stroke patients.

Objective Macrophage activation syndrome (MAS) is a severe, potentially life-threatening clinical condition. The clinical features including precipitating events, clinical presentations, treatment strategies, outcome in systemic onset juvenile idiopathic arthritis (So-JIA) children with MAS were reviewed. Perforin A91V gene analysis was also performed. Methods Retrospective review of fourteen MAS cases with So-JIA from 2003 to 2008 from a collected database. Gene-specific polymerase chain reaction ( PCR) primers were used to analyze the perforin A91V gene polymorphism. Results Fourteen patients with age from 4 months to 12 years were considered to have evidence of MAS. Nine of them were boys. The primary diagnosis was systemic onset juvenile idiopathic arthritis. No medication was identified as trigger. Eleven of them had infections prior to MAS. Among them specific infectious agents were identified in four patients. High fever, new onset of hepatosplenomegaly, lymphadenopathy, liver function abnormality, abnormal lipid metabolism and hemophagocytosis were common clinical features. Two cases presented with acute respiratory distress syndrome (ARDS). Multiple organ failure (MOF) occurred in three cases. Three patients died. The variant form (NCBI: SNP rs35947132) of perforin A91V gene was detected in seven systemic onset juvenile idiopathic arthritis compolicated with MAS cases. However no mutation was detected. Clucocorticoid, intravenous immunoglobulin, immunoimpressive therapy were effective treatment of this condition. Plasmapheresis (HP) was successfully used in one case with severe MAS. Conclusions MAS is a rare and potentially fatal complication of childhood rheumatoid diseases such as systemic onset juvenile idiopathic arthritis. In this series, majority of them were male and most of them were preceded by infection. Bone marrow studies support the diagnosis. MOF may be a poor prognostic sign of So-JIA. Aggressive and early therapy is essential. There is no relationship between the variant form (NCBI: SNP rs35947132) of perforin A91V gene and So-JIA with MAS in this small sample's study. More research need to be done by increasing sample's numbers.

Objective To investigate the efficacy of playing games for improving the angle of genu recurvatum in children with spastic cerebral palsy. MethodsFifty children with spastic cerebral palsy were randomly assigned into a control group (25 cases) and an experimental group (25 cases).The children in both groups were treated using conventional comprehensive rehabilitation and guided family rehabilitation.The children in the experimental group also played games in addition to the conventional rehabilitation practices.The angle of genu recurvatum was assessed using a protractor before and after treatment. ResultsNo significant difference in any item was observed between the two groups before treatment.There was a significant difference in the angle of genu recurvatum after 6 months of treatment. ConclusionPlaying games has evident clinical efficacy in improving the angle of genu recurvatum of children with spastic cerebral palsy.

Object To study the immunomodulatory effects of theasinesin (TS) on human peripheral blood mononuclear cells (PBMC) in vitro. Methods The proliferation response of lymphocytes and IL 2 production of human PBMC were detected by MTT method. IL 2R expression was determined by immunocytochemistry and indirect immunofluorescence. The intracellular cAMP level was assayed by radioimmunoassay. Results 50, 150, 500 ?g/mL TS could enhance phytagglutinin (PHA) induced human PBMC proliferation in a dose dependent manner. The IL 2 production and IL 2R expression of PHA activated PBMC were increased markedly under the presence of TS. TS also decreased cAMP level of PBMC and intensively weaken the cAMP upregulating effect of prostaglandin E 1 (PGE 1). Conclusion TS possesses a potential immunoenhancing effect which might be made by decreasing the cAMP level of PBMC, promoting IL 2 production and IL 2R expression.

This study examined the relationship between PDGF-induced proliferation of vascular smooth muscle cells (VSMCs) and Nur77 expression and the effect of atorvastatin on VSMC proliferation and Nur77 in PDGF-treated VSMCs. Rat VSMCs were isolated and cultured. After incubation with atorvastatin or Nur77 siRNA, the cells were stimulated with PDGF and detected for BrdU incorporation to measure the proliferation of the VSMCs. Quantitative PCR and Western blotting were used to determine the Nur77 protein and the CREB phosphorylation level, to observe their relations with PDGF-induced VSMC proliferation. Our results showed that PDGF increased the BrdU incorporation in VSMCs, suggesting that it induced the proliferation of the cells. The VSMC proliferation was associated with increased Nur77 expression and elevated CREB phosphorylation. Atorvastatin inhibited the PDGF-induced VSMC proliferation, suppressed Nur77 expression. After silencing of Nur77 gene, the PDGF-induced VSMC proliferation was decreased. It was concluded that PDGF-induced VSMC proliferation was related to the Nur77 expression and CREB phosphorylation. Atorvastatin reduced the Nur77 expression and, at the same time, inhibited the VSMC proliferation.