Objective To observe the safety and efficiency of two different ways of intravenous anesthesia combined with oropharyngeal airway ventilation in hysteroscope operation.Methods 40 ASA Ⅰ ～ Ⅱ patients undergoing hysteroscopy were randomly assigned into two groups,20 cases in each group.Patients in the group A,B,were administered respectively with sufentanil 0.1 μg/kg or dexmedetomidine 0.5μg/kg by micro-pump in at least 10 minutes before operation.The perioperative hemodynamic index was recorded.The different outcomes including total dose of propofol,hemodynamic changes,recovery time,postoperative uterine contraction pain and episodes of adverse actions were observed and compared.Results Compared with group A,heart rate (HR) and systolic blood pressure (SBP) were higher in group B (P ＜ 0.05).The recovery time in group A was longer than that in group B (P ＜0.05).But there were no statistical differences of the total dosage of propofol,the incidence of respiratory depression,and the incidence rate of drowsiness after operation betwween group A and group B (P ＞ 0.05).Conclusion There was safe and effective of two different ways of intravenous anesthesia combined with oropharyngeal airway ventilation in hysteroscope operation,but the dynamic index was more stable,and the recovery time was shorter in patients with lowdose dexmedetomidine.

Objectives: To observe the effect of total enteral nutrition (TEN)and total parenteral nutrition (TPN)in aged patients with mechanical ventil ation. Methods: 60 cases of aged patients with mechanical ventilation were randomly divided to TEN group and TPN group.All patients accepted the same amount of calorie and nitrogen. Results: with regard to albumin and hemoglobin levels and nitrogen equilibrium TEN group was superior to parenteral nutrition group ( P 0.05). Conclusions: Enteral nutrition can reduce mechanical ventilation time and lower treatment cost in aged patients.

Objective To evaluate the effect of bronchoscopic argon plasma coagulation thera-py on bronchial carcinoma. Methods Thirty-one bronchial carcinoma patients were diagnosed by bronchoscope and pathological tests, with or without atelectasis or obstructive pneumonia on chest X-ray or chest CT. Argon plasma coagulation therapy was performed through bronchoscope. The location of the airway lesions, the degree of obstruction, dyspnea index, and complications were evaluated. Results The patients with bronchial carcinoma were treated 1～4 times by bronchoscopic argon plas-ma coagulation therapy. Full effectiveness was achieved in 15 patients (48.4 %), partial in 12 (38.7%), and mild in the other 4 ( 12.9 % ). The overall effective rate was 100 %. Conclu-sion Bronchoscopic argon plasma coagulation therapy for bronchial carcinoma can remarkably reduce the tumor size, relieve clinical symptoms, and alleviate the obstruction caused by bronchial neoplasm. Brouchoscopic argon plasma coagulation therapy is an effective and safe method for patients with bron-chial carcinoma.

Objective To treat the patients suffering from intractable epilepsy after brain injury with low-dosage linac accelerator stereotactic radiosurgery through positron emission tomography (PET) localization. Methods PET examination based on 18 F-2-fluorine-2-deglucose (FDG) was carried out in 32 patients in order to localize epileptogenic foci followed by radiosurgery with peripheral radiation dose of 9-13 Gy. The follow-up was conducted over one year. The seizure frequency of epilepsy was recorded to evaluate the therapeutic effect. Results The PET imaging showed that the cortical area around the cerebromalacia caused by primary injury presented low metabolic change. The metabolic changes in different injury areas mainly concentrated in the epileptic foci. In some cases,the low metabolic areas not only was localized at the part of impact lesion but also at the part of contrecoup lesion. The seizure frequency gradually decreased after radiosurgical treatment in most patients,with obvious statistical significance compared with pretreatment. According to Wieser's classification of operative effect,the cases at the grades Ⅰ-Ⅱ accounted for 44% (14/32),grades Ⅲ-Ⅳ for 41% (13/32) and grades Ⅴ-Ⅵ for 16%(5/32). No fresh complications were found in all the cases. Conclusions Low-dosage stereotactic radiosurgery with the PET localization is a safe,effective and minimally invasive surgical approach to intractable posttraumatic epilepsy.

Objective To evaluate the effectiviness and safety of rituximab in the treatment of immune thrombocytopenia .Meth-ods Standard doses and small doses of rituximab alone or combined therapy with other methods were used in 2 cases with immune thrombocytopenia who diagnosed and treated for the first time ,and 6 cases who diagnosed with refractory recurrent immune throm-bocytopenia .The recent curative effect ,adverse reactions were analyzed .Results The recent curative effect was well in the 2 cases who diagnosed and treated for the first time ,but 1 case recurrenced after 6 months .4 cases of effective in the 6 cases who diagnosed with refractory recurrent ,in which 1 case recurrenced after 2 years ,2 cases had no effect .All of the patients have no obvious adverse reaction in the near future .Conclusion Rituximab treatment of immune thrombocytopenic ,it is of good curative effect ,good safety and tolerability .

Patients with advanced lung cancer should be given proper hospice care .Doctors should not only practice protective medicine on the foundation of laws and regulations , informing the patients about their conditions tactfully , but also try their best to provide the patients with optimal therapeutic strategies , taking the patient's physi-cal tolerance, economy, etc.into account and achieving the goal of humanized and individualized therapy .Mean-while, the construction of professional medical -nursing institution is in urgent need .Only providing general nurs-ing in multiple aspects of illness , mental health , social functions , can we relieve the pain both physically and men-tally, and improve the patient's quality of their terminal times .

Objective To detect the effect of deep hypothermia on the function of mitochondria in hippocampus after global ischemia in rats and to explore the protection mechanism. Methods The animal model of cardiopulmonary bypass (CPB) was established in rats that were then randomly divided into three groups,ie,control group,normothermia ischemia group and hypothermia ischemia group,eight rats per group.The mitochondria was extracted from the hippocampus of each rats for observing the mitochondrial respiratory function,the activities of succinate dehydrogenase (SDH),the cytochrome oxidese(CCO),the lnembrane fluidity and the content of intramitochondria free calcium and MDA. Resuits The content of intramitochondria free calcium and MDA in the normothermia ischemia group was increased significantly compared to the control group and that in the hypothermia ischemia group wag decreased significantly compared with the normothermia ischemia group(P<0.05).Respiratory state Ⅲ (R3),respiratory state IV(R4),P/O ratio and oxidative phosphorylation (OPR) in the normothermia ischemia group were decreased significantly compared to the control group (P<0.05).R3,R4,P/O ratio and OPR in the hypothermia ischemia group were increased significantly compared with the normothermia ischemia group (P<0.05).Membrane fluidity in the normothermia ischemia group wag decreased significantly compared to the control group (P<0.01),while that in the hypothermia ischemia group was increased significantly compared with the normothermia ischemia group(P<0.05).The activities of SDH and CCO in the normothermia ischemia group were decreased significantly compared to the control group (P<0.01),while those in the hypothermia ischemia group were increased significantly compared with the normothermia ischemia group (P<0.05). Conclusion Profound hypothermia exerts a protective effect on the function of mitochondria in the hippocampus after global ischemia in rats.

According to request of the socialism outlook for honor and shame to university students,this article elaborated the principles,connotation and implementation of honesty evaluation system so as to make a beneficial exploration for the honesty education of university students.

AIM: To observe the expression of corticotropin releasing hormone (CRH) within the paraventricular nucleus of hypothalamus (PVN) and to explore the relationship between the activated CRH-containing neurons and sympathetic activity in rats with heart failure (HF).METHODS: Healthy male Sprague-Dawley (SD) rats were subjected to coronary artery ligation to induce HF, and chronic intracerebroventricular (ICV) infusion was performed by osmotic pump for 4 weeks.The rats in sham group and HF group were given vehicle (VEH;artificial cerebrospinal fluid 0.25 μL/h).The rats in HF plus treatment group were treated with CRH competitive inhibitor αh-CRH (15 mg/h).Meanwhile, the Lewis rats and Fischer 344 rats for control study also underwent coronary ligation to induce HF or sham surgery.After 4 weeks, left ventricular end-diastolic pressure (LVEDP) and maximum positive/negative change in pressure over time (±dp/dtmax) were determined.The right ventricular-to-body weight (RV/BW) and lung-to-body weight (lung/BW) ratios were calculated.The renal sympathetic nerve activity (RSNA) was recorded and the plasma norepinephrine (NE) level was measured.The expression of CRH in the PVN combined with the plasma adrenocorticotrophic hormone (ACTH) levels were measured.RESULTS: Compared with the sham-SD rats, the HF-SD rats had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased), accompanied by decreased ±dp/dtmax and increased RSNA, plasma NE, LVEDP, lung/BW and RV/BW.However, ICV treatment with αh-CRH attenuated these changes in the HF-SD rats (P<0.05).Compared with the sham-Fisher 344 rats, the HF-Fisher 344 rats also had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased).In addition, they had significantly increased RSNA and plasma NE level, higher LVEDP, RV/BW and lung/BW, and lower ±dp/dtmax (P<0.05).Compared with the SHAM-Lewis rats, the HF-Lewis rats had not significantly changed in the above parameters.CONCLUSION: In CHF, the CRH-containing neurons in PVN are activated, thus aggravating cardiac function by increasing sympathoexcitation.

Objective To observe the effect of agmatine (AGM) on inflammatory factor in Kupffer cells of liver,and to investigate the protective effects of AGM on severe trauma-induced liver injury in mice and its possible mechanism.Methods Forty-two adult male BALB/c mice were randomly divided into sham group,model group,and AGM treatment group,with 14 mice in each group.The mice model of trauma-hemorrhage was reproduced by hindlimbs fracture combined with 35％ of orbital bleeding.The mice in the sham group were only anesthetized without other treatments.The mice in AGM treatment group were given intraperitoneal injection of 200 mg/kg AGM when limited recovery was performed,and the mice in model group were given the equal amount of normal saline.Seven mice in each group were sacrificed at 12 hours and 24 hours,respectively,after modeling,and blood samples and liver tissue were harvested,and liver Kupffer cells were isolated.Serum alanine aminotransferase (ALT),aspartate transaminase (AST)and lactic dehydrogenase (LDH) were determined with automatic biochemistry analyzer.Hepatic pathological changes were observed with light microscope using hematoxylin and eosin (HE) staining.The levels of tumor necrosis factor-α(TNF-o) and interleukin-6 (IL-6) in serum,hepatic homogenate and Kupffer cell supernatant were determined with enzyme linked immunosorbent assay (ELISA).The mRNA expressions of pro-inflammatory cytokines TNF-α and IL-6 in the Kupffer cell were determined by real-time fluorescent quantitation reverse transcription-polymerase chain reaction (RT-qPCR).Results ① The normal liver tissue structure was found in sham group.At 24 hours after modeling in the model group,the changes in pathobiology were found as following:neutrophil infiltration,hepatocytes swelling,hyperemia,and necrosis,as well as the abnormality of parameters reflecting liver function.AGM could significantly improve the pathological changes in liver tissue caused by severe trauma,and ameliorate the liver function.② There were no significant differences in the levels of TNF-α and IL-6 in serum and hepatic tissue at 12 hours after modeling,and the parameters at 24 hours in model group were higher than those at 12 hours,which were significantly higher than those of the sham group [serum TNF-α (ng/L):80.8±4.7 vs.34.7±4.7,IL-6 (ng/L):104.0±9.0 vs.55.4±3.3;liver TNF-α (ng/mg):405.2± 19.6 vs.57.2±10.0,IL-6 (ng/mg):58.4±7.7 vs.14.3±2.1,all P ＜ 0.01].AGM could effectively reduce the levels of TNF-o and IL-6 in serum and hepatic tissue [serum TNF-α (ng/L):58.2 ± 3.1 vs.80.8 ± 4.7,IL-6 (ng/L):74.1 ± 6.6 vs.104.0± 9.0;liver TNF-α (ng/mg):248.7 ± 22.5 vs.405.2 ± 19.6,IL-6 (ng/mg):22.5 ± 3.1 vs.58.4 ± 7.7,all P ＜ 0.01].③ The levels of TNF-o and IL-6 in Kupffer cells supernatant were significantly higher than those of the sham group,and they were further increased after lipopolysaccharide (LPS) stimulation for 24 hours.AGM could effectively reduce the levels of TNF-α and IL-6 in Kupffer cells [TNF-α (ng/L):256.6 ± 5.6 vs.465.5 ± 5.2,IL-6 (ng/L):1 185.5 ± 64.4 vs.2 018.8 ± 53.2,both P ＜ 0.01],and also decreased the mRNA expressions of TNF-α and IL-6 [TNF-α mRNA (2-△△Ct):7.2±0.4 vs.13.5±0.4,IL-6 mRNA (2-△△Ct):13.2±0.7 vs.21.3 ± 1.6,both P ＜ 0.01].Conclusion Agmatine can reduce trauma-induced acute hepatic injury via suppression of cytokines release in Kupffer cells,and can ameliorate the liver function.