Objective To observe the incidence of oculocardiac reflex in cataract surgery and investigate the corresponding measures.Methods One hundred cataract patients with surgical treatment were enrolled in this study,observed the occurrence of oculocardiac reflex in different surgical procedures and taked active preventive measures and first aid.Results The incidence of oculocardiac reflex was 20％(20/100),which the intraoperative effective measures can significantly reduce the incidence of oculocardiac reflex.Conclusion In cataract surgery,the incidence of oculocardiac reflex is not high,but the anesthesiologist must be prepared to work effectively with doctors completed surgery to avoid adverse consequences resulting from oculocardiac reflex.

Objective To investigate the role of clinical pharmacist in medical therapy for a patient with cerebrovascular disease and epilepsy.Methods One patient was hospitalized due to headache and twitch.Clinical diagnosis was cerebral venous sinus thrombosis and epilepsy.During the treatment,the clinical pharmacist gave suggestion on drug selection of anti-infection and anti-epileptic therapy,assessed drug interaction between omeprazole-escitalopram and mannitoldexamethasone,monitored the adverse drug reaction of valproate,and provided medication education to the patient.Results Physician adopted clinical pharmacist's suggestion.The patient discharged with stable condition.Conclusion The participation of clinical pharmacists in the medication therapy of patients with cerebrovascular disease can reduce the risk of drug use and promote the efficacy and safety of medication.

Objective To examine outcomes of superficial vein stripping for vein varicosis caused by combination of superficial and deep venous reflux and the effect on deep vein reflux. Methods From January 2004 to December 2006, twenty patients (22 lower extremities) with combined superficial and deep venous reflux were enrolled for evaluation, patients with superficial venous reflux alone worked as controls.All patients underwent superficial vein stripping and followed up for 2 years. Venous clinic severity score (VCSS) and color duplex ultrasound test were used to evaluate the change of clinic symptoms and valve reflux of deep veins. Results Preoperative VCSS of superficial and deep vein reflux group and superficial vein reflux group was 7.1 ± 2. 9 and 6. 6 ± 2. 0 respectively (P = 0. 44). At two years after operation the VCSS was 2. 3 ± 1.2 and 1.8 ± 0. 8 respectively without significant statistic differences, whereas comparing postoperative VCSS with individual preoperative parameters there was a significant decrease (P <0. 01). In combined superficial and deep vein group, deep venous reflux reduced in 7 limbs, progressed in 4 limbs, no change in 12 limbs. While in superficial reflux alone group, deep venous reflux occurred in 4 limbs.Conclusions Superficial vein stripping effectively improves symptoms of great saphenous vein varicosis of lower extremity caused by combination of superficial and deep vein reflux without a significant effect on the stares of deep vein reflux.

Objective To establish the swine acute heart failure model for surgical experiment, and evaluate the heart function by continuous cardiac index (CCI). Methods Swine heart failure model was attempted to establish by coronary ligation in six swines. CCI was obtained by Swan-Canz catheters and Vigilance monitor, and hemodynamic, biochemical and ultrasonocardiographic results were utilized to evaluate the changes of heart function. Results Five swines accomplished the experiment. Compared with basic status, there were significant differences in mean arterial pressure (MAP) , pulmonary artery systolic pressure (PASP), mixed venous oxygen saturation ( SVO_2) and CCI for swines with heart failure ( P < 0.05) , there was no significant change in biochemical parameters, while left ventricle ejection fraction ( LVEF) significantly decreased (P<0.05). Conclusion CCI is feasible in monitoring and evaluating heart function of animal model. The swine acute heart failure model established by coronary ligations can meet the needs of surgical experiment in principle.

By means of literature review,expert interviews and experts sorting,the authors identified three approaches of medical humanities care,and applied them to three clinical departments of top ten incidence of medical disputes of the hospital in 2012.These departments have similar number of beds,and covered both internal medicine and surgery departments.The purposes of the study are to evaluate the effects of medical humanities care measures in clinical departments,and to make relevant thoughts and suggestions.

Using the method of semi -structure interviews to pre-interview 6 experts and officially interview10 experts , then the record of the interview was compiled into the paper .Using the grounded theory method to encode material of the interview , a summary was made for each case base on data collation and analysis .This paper ana-lyzed the humanities concern the connotation of the application in the construction of a harmonious doctor -patient relationship and the specific measures .On the basis of the application of humanistic care in the construction of a harmonious doctor -patient relationship , significance and limitation is discussed .

Objective: This study aims to observe the efficacy and toxicity of three-dimensional conformal radiotherapy (3DCRT) combined with weekly topotecan hydrochloride (Top-Hyd) chemotherapy on patients with platinum-resistant recurrent ovarian cancer. Methods: Medical data of 42 patients with platinum-resistant recurrent ovarian cancer between June 2008 and June 2011 were retrospectively reviewed. OAOf these 42 patients, 22 underwent 3DCRT combined with weekly Top–Hyd chemotherapy, whereas the remaining 20 underwent simple chemotherapy (SCT). Doses from 45 Gy to 65 Gy were planned to deliver fractions ranging from 1.8 Gy to 2 Gy to patient abdomen and pelvis. Top–Hyd (4 mg/m2) was aintravenously administered 1, 8, and 15 days from radiotherapy, with a cycle of 28 days. Results: By December 31, 2011, the median follow-up time for the 3DRT group was 18.5 months, whereas that for the SCT group was 10.8 months . The total response rate and the clinical beneficial rate were significantly higher in the 3DCRT group than in the SCT group (total response rate, 42.1% vs. 11.1%; clinical beneficial rate, 68.4% vs 22.2% at P< 0.05). The median of progression-free survival time was 9.8 months for the 3DCRT group and 6.6 months for the SCT group. The median total survival time was 19.7 months in the 3DCRT group, and 12.5 months in the SCT group. Significant differences between the 2 groups were indicated (P<0.001). No significant difference in overall toxicity was indicated between the two groups (P>0.05). Conclusion: The combined 3DCRT treatment and Top-Hyd chemotherapy results in enhanced response and tolerable toxicity compared with SCT in patients with recurrent ovarian cancer infiltrating the pelvic and retroperitoneal lymph node metastasis. So, it may be the salvage regimen for recurrent ovarian cancer and provide a new therapeutic option for the consolidation treatment of advanced ovarian carcinoma.

Objective To evaluate the curative effect of percutaneous puncturing drainage in treating liver abscess,to analyze the factors affecting curative effect,and to discuss the methods ior reducing mortality and complication rate as well as for shortening hospitalization time.Methods Clinical data of 121 patients with liver abscess,who were admitted to authors' hospital during the period from January 2011 to January 2016,were retrospectively analyzed.For the patients with confirmed liver abscess,adequate antiinfective therapy was adopted,at the same time CT scan was performed to evaluate the liquefaction of lesion,and under CT guidance percutaneous puncturing drainage was carried out.The mortality,complication rate,hospitalization time and the factors affecting curative effect were analyzed.Results A total of 121 patients with liver abscess were enrolled in this study.Two patients died after percutaneous puncturing drainage,the mortality was 1.6％.The factors affecting mortality included old age,underlying disease,the diameter and solid components of abscess.Two patients developed peripheral hepatic abscess and abdominal wall abscess,the complication rate was 1.6％,and clinical cure was achieved after active treatment in these two patients.The main factor affecting complication rate was inappropriate surgical manipulation.Clinical cure was achieved in all 119 patients,with a cure rate of 98.3％,and the average hospitalization time was (15.1±6.0)days.The risk factors that affected hospitalization time included the number of abscess X6 (r=0.232,P=0.021),abscess size X7 (r=0.26,P=0.005) and white blood cell count X8 (r=0.238,P=0.009).Multiple linear regression equation analysis indicated that statistically significant correlation existed between the above influence factors and hospitalization time (P＜0.05).The multiple regression equation was as follows:Y=-3.438+3.055X6+0.527X7+0.297X8,F=5.819,R2=0.416.No statistically significant correlation existed between the hospitalization time and other factors,including gender,age,diabetes mellitus,pathogenic bacteria and location of abscess (P＞0.05).Conclusion Percutaneous puncturing drainage is an effective treatment for liver abscess,it carries lower mortality and lower complication rate,and its hospitalization time is short.(J Intervent Radiol,2017,

Objective To evaluate the effectiveness of volume therapy guided by the response of CVP and global end-diastolic volume index (GEDVI) in septic shock patients.Methods Twenty-three patients of both sexes aged 18-64 yr who had been in septic shock for ＜ 6 h were randomly divided into 2 groups:control group (group Ⅰ,n =12) and study group (group Ⅱ,n =11 ).Tracheal intubation was performed and the patients were mechanically ventilated in both groups.Right internal jugular vein or subclavian vein was cannulated for CVP monitoring and fluid administration.PiCCO catheter was inserted into femoral artery.Normal saline,6％ hydroxyethyl starch 200/0.5,albumin and plasma were infused via CVP line.CVP was maintained ≥8 mm Hg in both groups while in Ⅱ group GEDVI was maintained at 600-750 ml/m2 during resuscitation.Blood samples were taken from artery and CVP line before (baseline) and at 6 h of volume therapy (T2) for determination of blood lactate concentration and central venous oxygen saturation ( ScVO2 ).The changing rate of lactate ( (baseline lactate concentration-lactate concentration at 6 h of volume therapy) ÷ baseline value × 100％ ) and ScvO2 ( ( ScvO2 at 6 h of volume therapy - baseline ScvO2 ) ÷ baseline value × 100％ ) ) was calculated.Results The changing rate of lactate was significantly higher in Ⅱ group than in Ⅰ group.There was no significant difference in the changing rate of ScvO2 between the 2 groups.Conclusion Volume therapy guided by CVP and GEDVI can provide better tissue perfusion than by CVP alone in septic shock patients.