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.

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

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.

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.

Objective To compare clinical Pseudomonas aeruginosa different sources of β-lactamase-resistant phenotype differences,as to provide theoretical basis for guiding clinical rational use of antibiotics.Methods Isolation of 478 strains of Pseudomonas aeruginosa were collected from clinical specimens in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2015,by VITEK 2 Compact bacteria identification and drug sensitivity analysis of advanced expert system for β-lactamase-resistant phenotype,statistical analysis of drug resistance phenotype and antibiotic resistance.Results 478 strains of Pseudomonas aeruginosa were mainly composed of phenotype 5 and phenotype 3.Sputum,drainage fluid and bile duct bile specimens of Pseudomonas aeruginosa were based on phenotype 5,accounted for 31.08％,34.71％ and 38.46％.Multiple comparison x2 were 3.893,4.071 and 5.595,There was no statistical difference between groups compare significance (P＞0.05).Urine,secretions and whole blood samples of Pseudomonas aeruginosa were phenotype 3,accounted for 34.88 ％,27.78 ％,45.45 ％;Multiple comparison x2 were 6.654,9.956 and 9.852.There was no statistical difference between groups compare significance (P＞0.05).Sputum,drainage of liquid,bile duct bile and urine,secretion,whole blood specimens respectively source of Pseudomonas aeruginosa resistant phenotype distribution of two comparative difference was statistically significant (x2 =15.056～22.050,P＜0.05).Comparing the resistance of different β-lactamase-resistant phenotypes in Pseudomonas aeruginosa isolates from different sources:the sputum specimen source in imipenem,meropenem,piperacillin and piperacillin/tazobactam had significant difference (x2 =22.225～39.025,P＜0.05).There was statistical significance in department of hepatobiliary surgery only ceftazidime and meropenem differences (x2 =21.890～22.872,P＜0.05).Conclusion The phenotypic analysis of β-lactamase-resistant phenotypes of Pseudomonas aeruginosa from different specimens was different,which provided a theoretical basis for guiding the clinical application of antibiotics and the control of nosocomial infection of Pseudomonas aeruginosa.

Combined training is a new training mode which combines the education of profes-sional degree of clinical medicine graduate and the resident standardization training. Xiangya hospital of Central South University has tried this kind of training mode since 2012. We draw lessons from the advanced training concept in America in combination with the practical situation of our hospital and have established theXiangya-Yalemodel of resident standardization training featuring with the Six Xiangya goals which areprofessional ethics, professional skills, patient safety, medical ethics, teamwork spirit, innovation and self-improvement, highlighting the project manager responsibility system, 360 degree examination and assess-ment, assessment of the OSCE, Mini-CEX evaluation. Through comparing and analyzing the midterm exami-nation scores between the combined training group and non-combined training group, we have found that the combined training group is significantly superior to non-combined training group on clinical skills. In addition, the questionnaire survey results show that most graduate students have positive attitude tocombined training. They believe it will be helpful for them to improve the ability of clinical skills, med-ical practice, doctor-patient communication skills and theoretical knowledge, and contributes to the future career development. Combined training is one major initiative deepening the reform of medical health system and medical education which greatly promotes the development of our country health enterprise, although there still exist some flaws including training teachers, content, implementation, management and evaluation.

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.

Objective To detect the expression level of CXCL9 and IL‐22 in peripheral blood of patients with vitiligo vulgaris and explore its role in the pathogenesis of vitiligo vulgaris .Methods The level of CXCL9 and IL‐22 in peripheral blood from 35 vit‐iligo patients (20 active cases and 15 stable cases) and 20 normal controls were measured by enzyme linked immunosorbent assay . Then ,we compared the differences in different groups and analyzed their correlation with ages ,duration ,psoriasis area and severity index (PASI) .Results The contents of CXCL9 and IL‐22 in active cases and stable cases were obviously higher than those in con‐trols respectively by statistical analysis ,there was significant difference (P< 0 .05) .The contents of CXCL9 and IL‐22 in active ca‐ses were obvious higher than those in stable cases ,there was significant difference(P< 0 .05) .Conclusion CXCL9 and IL‐22 may be involved in the pathogenesis of vitiligo vulgaris .

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.