Objective To structure a preliminary indicators system for evaluating the projects of Hospital in finished phase.Methods With Delphi method,collect the experts' opinion of the importance of every item.With AHP (Analytic hierarchy process) method,calculate the weight coefficient of every item.Results The positivity of the experts was fine; The authority coefficient of two rounds were 0.859 and 0.833,the consultation results are reliable; The coordination coefficient of two rounds were 0.254 and 0.553,according to the significance test,p values were less than 0.05,indicating that the results were desirable.According to the score of every item,we got the weight index of every items based on the AHP method.Finally we structure the indicators system including 3 primary indicators and 10 secondary indicators.Conclusion The preliminary results of this study provide a reference for the performance evaluation of projects in finished phase of China-Japan Friendship Hospital.

Objective To investigate the effect of ulinastatin in adjuvant treatment of ventilator-associated pneumonia(VAP)and preliminary clinical efficacy of the therapy mechanism.Methods 76 patients with ventilator-associated pneumonia from January 2015 to February 2016 in Qingyuan People's Hospital of Zhejiang Province were selected and randomly divided into control group and observation group,38 cases in each group.Two groups were given mechanical ventilation,phlegm,anti infection,rehydration,nutritional support and other conventional treatment,the observation group on the basis of routine treatment for ulinastatin adjuvant therapy,comparison of two groups of treatment,the simultaneous determination of serum interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)and tumor necrosis factor alpha(TNF-alpha)levels were measured before and after treatment.Results The total efficiency of the observation group was 94.74％,significantly higher than the control group 78.95％,the difference was statistically significant(P<0.05),the two groups after treatment of serum CRP and PCT levels were decreased significantly compared with before treatment,the observation group after treatment,serum CRP and PCT levels were(45.19+5.79)mg/L and(1.08+0.36)μg/L was significantly lower than that before treatment and control group after treatment,the difference was statistically significant(P<0.05),the two groups after treatment of serum IL-6 and TNF-α levels were decreased significantly compared with before treatment,the observation group after treatment,serum IL-6 and TNF-α levels were(165.29+19.23)pm/mL and(1.16+0.25)pm/mL,was significantly lower than that before treatment and control group after treatment,the difference was statistically significant(P<0.05).Conclusion The inflammatory reaction in patients with ventilator-associated pneumonia ulinastatin can effectively reduce auxiliary patients,reduce inflammatory factors on lung injury,can alleviate the disease progression and to improve its prognosis.

Objective The aim of this study was to analyze the influence of combined therapy with L-carnitine and erythropoietin on renal anemia and nutritional status in patients treated with maintenance hemodialysis.Methods The combination of computer and manual searches were used.A Meta analysis was made regarding the effect of combined therapy with L-carnitine and erythropoietin on the improvement of renal anemia and nutritional status in patients treated with maintenance hemodialysis.The quality of the 9 studies was evaluated with the Jadad score.Statistical analysis was carried out by RevMan 5.0.Results A total of 428 patients in 9 reports were analyzed.Metaanalysis showed that there were significant improvement in hemoglobin (Hb) [WMD =9.21,95％ CI (7.69 ～10.73)] and hematocrit (Hct) [WMD =2.61,95％ CI (2.28 ～ 2.93)],albumin (ALB) [WMD =1.64,95％ CI (1.04 ～ 2.24)] and total protein (TP) [WMD =2.72,95 ％ CI (0.67 ～ 4.77)] in the treatment group compared with the control group.The level of erythropoietin dosage [WMD =-38.24,95％ CI (-76.87 ～ 0.39)] was decreased significantly.But there were no significant differences in triglyceride and serum phosphorus.Conclusion Combined therapy with L-carnitine and erythropoietin in patients treated with maintenance hemodialysis leads to significant improvement of renal anemia and nutritional status.

BACKGROUND: Previous research reveals that, single-layer human amnion is effective to cure superficial bums, but it is still unsatisfactory.OBJECTIVE: To observe the effects of double-layer radiation-treated human amnion on the healing of deep second-degree burn wound.DESIGN, TIME AND SETTING: Randomized control study was performed at the Animal Experimental Center in the First Affiliated Hospital of Harbin Medical University (Harbin, Heilongjiang, China) from December 2006 to May 2007.MATERIALS: Fifty adult Wistar rats of clean grade were burned and then assigned into five groups at post-injury 4, 6, 8,10 and 12 days, with ten rats in each group. Subsequent to the chorion removal, the fresh human amniotic membrane was dried and prepared into double-layer films, which were aporate or porous. Human amnion was then radiated using γ-ray for further use.METHODS: Following dorsal skin epilatiou and the anesthesia, all the rats were immersed for 8 seconds in boiling water to induce rat models of deep second-degree burns. One side of the burn wound was applied human amnion, while the other side was applied oil gauze.MAIN OUTCOME MEASURES: Gross observation of the bum wound was carried out at post-injury 4, 6, 8, 10 and 12 days. Meanwhile, light microscope, scanning electron microscope and transmission electron microscope were employed to detect the histological changes of the burn wound, as well as bacteriological examination.RESULTS: Fifty rats were all involved in the result analysis. Sphacelism and crust were found in the burn wound treated with oil gauze, with the presence of focal ulcer at post-injury 12 days. Under light microscope, few hairs regenerated in dermis, especially hair follicle and hair root; Scanning electron microscope suggested a large amount of inflammatory exudates and leukocytes; Transmission electron microscope revealed an unclear structure of the cells. Bacteriological examination also indicated that the bacteria aecreted on the surface of burn wound. The treatment of double-layer radiation-treated human amniou healed the burn wound at post-injury 10 and 12 days, and the hairs grew with the same manner as that of normal skin. Epidermis tissues were proved to be normal skin at post-injury 12 days by means of light microscope, scanning electron microscope and transmission electron microscope. Bacteriology was detected to be negative.CONCLUSION: Double-layer radiation-treated human amnion plays a protective role on the burn wound in rats. It may facilitate epithelial growth, avoid wound infection and accelerate the healing of deep second-degree burn.

Objective To investigate the effects of lappaconitine on the perioperative immune function.Methods Twenty-four ASA I or II patients aged 23-64 yr undergoing elective radical mastectomy (8 patients),iaminectomy and vertebral canal decompression (8 patients) or femoral head replacement (8 patients ) were randomly divided into 2 groups (n=12 each): control group (C) and lappaconitine group (L).In group L ondansetron 4 mg was given IV and lappaconitine 8 mg was infused IV over 30 rain before induction of anesthesia.In group C equal volume of normal saline was infused instead of lappaconitine.Anesthesia was induced and maintained with propofol,remifentanil and rocuronium.Lappaconitine 0.28 mg/ml was continuously infused at 2 ml/h after induction of anesthesia in group L.When the patients recovered from anesthesia after operation,PCA with 0.28 mg/ml lappaconitine was started (background infusion 2 ml/h,bolus dose 0.5 ml and lockout interval 15 min).In group C pethidine 50 mg and droperidol 2.5 mg were given IM on demand.Venous blood samples were taken at 30 rain before induction of anesthesia(T1,baseline),immediately (T2) and at 24 h(T3) and 48 h (T4)after operation for determination of TNF-α,IL-2,IFN-γ and sIL-6R concentration by ELISA.CD3,CD4,CD8 and NK cell expression was determined using flow cytometry and the ratio of CD4/CD8 was calculated.The concentrations of IgA,IgM,IgG,CD3 and CD4 were determined by radioimmunoassay.Results Plasma SIL-6R and TNF-α concentrations were significantly lower while IL-2,IgA,IgG,IgM concentrations and CD4/CD8 ratio were significantly higher after operation in group L than in group C.Conclusion Lappaconitine can improve perioperafive humoral immune function thus contributing to its analgesic and anfi-inflammatory effects.

The rate of stroke has been rising year by year and become the world's major cause of mortality and disability. The high rate of disability did not only bring economical burden to society and family, but also induce psychological damage to patients. Post-stroke depression (PSD) is a most common mental complications of stroke. In recent years, More and more attentions have been paid to PSD. This article reviewed the cause and mechanism of PSD and the treatment with Chaihu Shugan Powder on it.

Objective To observe the effect of single and low dose propofol administered near the end of surgery on the cardiovascular and adverse response during extnhation in patients undergoing ovarian cancer operation. Methods Fifty ASA Ⅰ - Ⅱ patients undergoing selective ovarian cancer operation were randomly allocated into group S and group P,with 25 patients in each group. In group S, inhalation of sevoflurane was discontinued at about 2 minutes before the end of operation. In group P, inhalation of sevoflurane was discontinued at about 5 minutes before the end of operation,and at the same time,0.5 mg/kg of propofol was administered intravenously. The systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) and recovery time of consciousness were recorded at 5 min before extubation (t_1),during extubation (t_2), 1 min after extubation (t_3), and 5 rain after extubation (t_4). The incidence of agitatian,bucking,nausea and vomiting were recorded by an observer who was blind to this study. Results There were statistical differences in HR,SBP,DBP at t_2-t_4 between two groups. The recovery time was (10.39 ± 1.26) min in group P,and(9.57 ± 1.25) min in group S,there was significant difference between group P (2 cases) and group S (9 cases)(P< 0.05). There was significant difference in the incidence of agitation between two groups (P< 0.05). Conclusion Low dose propofol before extubation can inhibit stress and cardiovascular response and decrease the incidence of agitation, bucking, nausea and vomiting.

Objective: To develop a Chinese version of the Schedule for the Deficit Syndrome(SDS) and examine its reliability and validity. Methods: 123 schizophrenic patients finished the Chinese version of SDS and were subtyped into deficit (n=30) and nondeficit(n=93) groups. In addition, all patients completed BPRS, SANS and SAPS. The reliability analysis of SDS included Cronbach's ?琢 coefficients and mean inter-item correlations and the inter-rater reliability; while the validity analysis included construct validity and criteria validity. Results: The Cronbach's ?琢 coefficient and the mean interitem correlation coefficients of the negative symptoms severity subscale of SDS were 0.8441 and 0.4818, respectively. The inter-rater reliability for categorization was 0.8777. The correlation coefficients of the six negative symptom items with the total score ranged from 0.685 to 0.875,and that among the six negative symptom items ranged from 0.437 to 0.794. The negative symptom items and the total score of SDS were significantly correlated with the anergia factor score from the BPRS and the total score and several subscale scores of SANS, while none of them was correlated with subscale scores and total score of SAPS. Conclusion: The Chinese version of SDS was a reliable and valid measure for the diagnostic classification of deficit and nondeficit schizophrenia.

Objective To study the effects of integrated liposomal prostaglandin E_1(PGE_1)and calcium dobesilate on aristolochic acid nephropathy(AAN).Methods Forty-six patients of AAN who came from the First Affiliated Hospital,China Medical University from 2003 to 2005 were randomly divided into control group(PGE_1)and treatment group(PGE_1+calcium dobesilate).Scr and Hb were compared between two groups before and after the treatment.Results Scr had been decreased significantly and Hb had been increased in both groups,but more significantly in treatment group than in control group.Conclusion Integrated liposomal prostaglandin E_1 and calcium dobesilate can ameliorate renal function in AAN.

Objective To investigate the effect of hypoxia on the expression of vascular endothelial growth factor (VEGF) in villous explants, and the effect of hypoxia-inducible factor 2? (HIF-2?) on the VEGF expression. Methods The villous were obtained from women who underwent suction and curettage for termination at 6-8 gestational weeks. Four groups were divided: normoxia group; hypoxia group; sense HIF-2? oligonucleotide group and anti-sense HIF-2? oligonucleotide group. All villous were cultured in vitro. In anti-sense and sense group, villous were incubated under hypoxia with HIF-2? oligonucleotide. The villous explants were collected after 48 h of cultivation. The protein level of HIF-2? was detected by Western blot and the mRNA of HIF-2? and VEGF were examined by real-time PCR. Results The expression of HIF-2? mRNA and VEGF mRNA as well as the protein level of HIF-2? were increased in hypoxic group comparing with the normoxia group. Compared with the sense group, the expression of HIF-2? protein and HIF-2?, VEGF mRNA showed significant decrease in anti-sense group. Conclusions Hypoxia may result in the increased expression of VEGF in villous explants during the early trimester, which might be mediated by HIF-2?.