Objective To explore the effect of dexmedetomidine(DEX)for blood pressure,heart rate(HR) and SpO2 levels during anesthesia inquiry in elderly hypertensive(HBP)patients.Methods 96 cases with HBP accepted surgery were selected,and were randomly divided into the observation group and the control group,each group in 48 cases,The patients in the observation group continuous pumped into the 4μg/mL of DEX during surgery, while the control group continuous pumped into 0.9% sodium chloride solution during surgery.Heart rate(HR),sys-tolic blood pressure(SBP),diastolic blood pressure(DBP),pulse oxygen saturation(SpO2 )of the two groups after room entrance(T0),after DEX infusion(T1),before intubation(T2),after 2min intubation(T3)and 10 min(T4)after intubation were recorded and compared,extubated time,spontaneous breathing recovery time,call time to eye opening and hospitalization time and the incidence of adverse reactions in two groups were recorded.Results The difference of HR SBP,DBP and SpO2 at T0 and T4 between the two groups was not statistically significant(all P >0.05);HR, SBP and DBP were significantly lower in the observation group than those in the control group at T1,T2,T3(all P <0.05).There were no significant changes of SpO2 in the patientˊs after the room entrance;extubated time,spontaneous breathing recovery time,call time to eye opening and hospitalization time in the observation group were significantly lower than those in the control group(t =8.874,9.073,8.573,all P <0.05).The adverse reactions rate in the observation group was 4.2%,which in the control group was 6.3%,the difference was not statistically significant(P >0.05). Conclusion Continuous pumped DEX has a significant sedative effect in elderly HBP patients during surgery,and does not produce respiratory depression,can help elderly patients with HBP smoothly pass the perioperative period.

In order to explore more reasonable and scientific accounting method of community health service costs, to improve the accounting method system of community health service cost. In the current existing community health services costing methods, based on the analysis of hospital cost accounting methods system, analyze and imitate the accounting method of hospital costs, establish a more scientific and implemented accounting method system of community health service costs: divide parts of clinics scientifically, redesign the center acollation method of indirect cost, confirm different cost accounting methods for different cost accounting objective and provide suggestion for the improvement of project cost accounting.

To observe the histopathological changes of mice experimentally infected with plerocercoid,mice were infected orally by plerocercoids that were collected from Rana nigromaculatus (5 strips/mouse),and were killed 2-10 weeks later to undergo the histopathological observation.Plerocercoids were found in the skin,muscle,liver,lung cavity of mice.There were diffuse congested spots and capsule formation ;the fat tissue showed severe degeneration and necrosis.In the fibrous tissues ,moderate proliferation of the enveloping adipose tissue was demonstrated.In addition,a large number of acute and chronic inflammatory cell infiltration and abscess formation could be found.It is evident that the plerocercoids parasitize mainly in the subcutaneous tissues and muscles of mice.and mice experimentally infected with plerocercoids show different degree of histopathological changes.

Objective To analyze the effects of dominant hand position on the quality of external chest compression for cardiopulmonary resuscitation (CPR) by the employment of the high-fidelity real-time feedback manikin system.Methods A total of 228 medical students of Wuhan University were enrolled in 2013 after standard CPR training courses.Participants were brought to a simulation scenario in which an adult happened to have heart arrest out of a hospital.Each studeut was asked to do five cycles of conventional CPR.In accordance with the dominant hand and the actual compressing hand position,the students were divided into dominant hand (DH) group and non-dominant hand (NH) group.Comparisons of chest compression rate,chest compression depth and chest recoil between two groups were carried out,respectively.The data were analyzed by the software of SPSS 13.0.Results There was no significant difference in overall chest compression rate between two groups (P ＞ 0.05) while the frequency distributions of chest compression rate showed differences (P ＜0.01),and chest compression rates above 100 cycle per min in DH group were higher than that in NH group (97％ vs.92％,P =0.002).There was significant differences in chest compression depth between two groups (DH 44±8 mm vs.NH 43±8mm,P=0.001).In NH group,the depth in cycle 5 (41 ±8) mm is obviously less than that in cycle 1 (44 ±7) mm,cycle 2 (43 ±7) mm and cycle 3 (43 ±8) mm.Totally,there was no differences in chest recoils between two groups [NH (98 ±8)％ vs.DH (97 ± 10)％,P =0.13],but full chest recoils were seen more in NH group (85％ vs.79％,P ＜ 0.05).Conclusions The dominant hand position can improve the quality of CPR resulted from the higher compression rate,deeper compression depth as well as delayed fatigue.

BACKGROUND:The research at home and abroad for appropriate immature myocardial cardioplegia has no breakthrough, and it may be a better mean to improve the protection effect of existing cardioplegia on immature myocardial by adding ingredients. Adenosine can reduce ischemia and neutrophil-mediated reperfusion injury, and salvia miltiorrhiza can reduce the content of ischemic myocardial lipid peroxide and increase the scavenging of myocardial cells to oxygen radical. OBJECTIVE:To investigate the protection effect of improved myocardial protection fluid containing adenosine and salvia miltiorrhiza on the heart, liver and kidney. METHODS:Sixty cases of infant open heart operation of the first time were randomly divided into three groups, 20 cases in each group. The adenosine group received the improved myocardial protection fluid added with adenosine, the combination group received the improved myocardial protection fluid added with adenosine and miltiorrhiza salvia, and the control group received the improved myocardial protection fluid in the same volume. The blood samples were taken at the time before anesthesia induction, 30 minutes after cardio pulmonary bypass beginning, 1 hour after cardio pulmonary bypass end and 24 hours after cardio pulmonary bypass end. The serum levels of the creatine kinase, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, tumor necrosis factor-α, interleukin-6, interleukin-8 and interleukin 10 were detected. RESULTS AND CONCLUSION:The serum levels of the alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine and creatine kinase in three groups were increased, but the control group was increased significantly (P<0.01), and there were significant differences between adenosine group and combination group (P<0.05);the levels of tumor necrosis factor-α, interleukin-6 and interleukin-8 were significantly increased after operation (P<0.05). The levels of tumor necrosis factor-α, interleukin-6 and interleukin-8 in the control group were significantly higher than those in the adenosine group and combination group before induction and at the same time point (P<0.01);at 3 minutes and 24 hours after cardio pulmonary bypass, the level of interleukin-10 was increased in three groups, but the level of interleukin-10 in the adenosine group was significantly higher than that in the control group (P<0.01). The results indicate that improved myocardial protection fluid has great protection effect on immature myocardial, and can significantly reduce the serum levels of tumor necrosis factor-α, interleukin-6 and interleukin-8, promote the secretion of interleukin-10 that can inhibit inflammatory cytokine and can significantly reduce the inflammatory response caused by cardiopulmonary bypass. So the improved myocardial protection fluid has protection effect on important organs, such as heart, lung, liver and kidney.

Objective To study the effects of emodin on apoptosis and mRNA and protein of apoptosis inducing factor (AIF) and Endonuclease G (Endo G) in human bladder cancer cells BIU87,and to investigate the anticancer mechanism of emodin. Methods The BIU87 cells were divided into 4 groups,control group,Z-VAD-FMK group,emodin group,emodin combined with Z-VAD-FMK group.The effects of different concentrations of emodin at different action time on cells proliferation of BIU87 in vitro culture were measured by methylthiazole (MTT) chromatometry,the cells apoptosis were detected by flow cytometry,and expression of AIF and Endo G were examined by reverse transcription PCR (RT-PCR) and Western blot.Results MTT assay demonstrated that the higher concentration of emodin and the longer action time,the more significant inhibition of tumor cell growth.Based on the IC50 value,80 μmol/L and 72 h of emodin intervention were selected as an intervention condition.The apoptosis rate in emodin group (44.57 ± 1.52 ) ％was significantly higher than that in emodin combined with Z-VAD-FMK group (35.58 ± 1.61 ) ％ ( P ＜0.01).RT-PCR and Western blot showed that the mRNA and protein of AIF in emodin combined with Z-VAD-FMK group,emodin group,control group,Z-VAD-FMK group were ( 1.74 ± 0.11 ) and (2.59 ±0.13),(1.36±0.08) and (1.89±0.14),(0.37 ±0.02) and (0.53±0.11),(0.42 ±0.06) and (0.44 ± 0.07),respectively.There were significant differences between emodin group and the other groups (P ＜0.01 ).The mRNA and protein of Endo G in emodin combined with Z-VAD-FMK group,emodin group,control group,Z-VAD-FMK group were (2.28±0.15) and (3.31 ±0.36),(1.85 ±0.13) and (2.15 ±0.27),(0.53 ±0.07) and (0.71 ±0.16),(0.61 ±0.04) and (0.67 ±0.22),respectively.The differences were significant between emodin group and the other groups ( P ＜ 0.01 ). Coneltusion Emodin can upgrade the expression of AIF and Endo G in bladder cancer cells BIU87,which can induce apoptosis through Caspase-independent pathway.

ObjectiveTo study the suppressive role of emodin on the growth and its effect on the proliferation cycle and apoptosis of human bladder cancer cell line BIU87.MethodsThe effect of different concentration of emodin at different time point on cell proliferation of BIU87 were measured with methylthiazole (MTT) chromatometry, the cell proliferation cycle were detected with flow cytometry, expressions of bc1-2 and caspase-3 were detected by SP of immunohistochemistry.ResultsWithin a certain range, the higher concentration of emodin (10 ～ 80 μg/ml) and the longer action time are positive related the more significant inhibition of tumor cell growth and the higher apoptosis rate [(9.84 ± 1.13)％, (18.32 ±2.14)％ ,(29.73+1.42)％ ,(42.13 +2.36)％ ,respectively].Compared with control group [(2.01 ±0.92)％], the differences were statistically significant(F =531.85, P ＜0.01).Emodin could inhibit the proliferation of human bladder cancer cell BIU87 by blocking BIU87 cell in G0/G1 stage, thus cut down cell proportion in stage of S [(33.27 +1.26)％ ,(29.17 ±1.39)％, (16.94 ±0.86)％ ,(10.85 ± 1.47)％,respectively], compared with the control group [(35.45 ± 0.38) ％], the differences were statistically significant(F =524.64, P ＜0.01).After 48 h of emodin treatment, the bc1-2 expression(Grayscale values:122.65 + 2.12,131.37 ± 1.62,134.81 ± 1.36,145.55 ± 2.01, respectively) was decreased and the caspase-3 expression(Grayscale values : 135.26 + 1.41,130.22 ± 1.74,126.11 ± 1.77,118.36 + 1.53, respectively) was increased in a dose dependent manner.Compared with control group (Grayseale values:108.42 + 3.73,149.35 ± 1.82, respectively), the differences were statistically significant (F = 216.23,224.83, P ＜0.01).ConclusionsEmodin could significantly inhibit the growth and induce apoptosis of BIU87 cells in vitro, which may be through down regulation of bc1-2, and up regulation of caspase-3, and blocking BIU87 cell in G0/G1 stage.

Objective To investigate the inhibitory effect of emodin on hetertransplanted human bladder cancer in nude mice and explore its mechanism.Methods Heterotransplanted models of human bladder cancer cell line BIU87 cells in nude mice were established.The mice were randomly divided into 4 groups during the experiment:blank control group,Z-VAD-FMK group,emodin group and emodin combined with Z-VAD-FMK group.The growth of tumors was observed and the growth curve was mapped.The nude mice were sacrificed 4 weeks later,the tumors were isolated and weighed.The pathological changes of tumor were observed after HE staining,the cells apoptosis were detected with flow cytometry,and the expression of AIF and Endo G were examined by reverse transcription PCR (RT-PCR) and Western blot.Results The tumor growth rate in emodin group was lower than that in the other three groups.The tumor quality in emodin group [(0.41 ± 0.05 ) g] and emodin combined with Z-VAD-FMK group [( 0.69 ±0.07)g]were lighter than that in the other two groups[(1.08 ±0.13,1.04 ±0.09)g,],and the differences were statistically significant( F =90.56,27.49,P ＜0.01 ).The quality difference in emodin group and emodin combined with Z-VAD-FMK group was statistically significant ( t =10.01,P ＜ 0.01 ).The apoptosis rate in emodin group [(42.71 ±2.69)％]was significantly higher than that in emodin combined with Z-VAD-FMK group[(34.38 ± 1.73)％] ( t =6.38,P ＜0.01 ).The expression of AIF and Endo G in emodin combined with Z-VAD-FMK group was significantly increased than other groups [( 1.65 ±0.12)vs(1.24±0.08),(0.51 ±0.07),(0.48 ±0.04);(2.12 ±0.16)vs(1.75 ±0.13),(0.57 ±0.06),(0.59±0.07);(2.42±0.13)vs(1.73 ±0.11),(0.78 ±0.07),(0.75 ±0.08);(3.13 ±0.25)vs(2.15± 0.18 ),(0.85 ± 0.09 ),(0.81 ± 0.14 )],and the differences were significant ( F =303.22,319.32,409.38,258.53,P ＜ 0.01 ).Conclusions Emodin could significantly inhibit the growth of hetertransplanted human bladder cancer in nude mice.The mechanism might be partly due to the expression increase of AIF and Endo G in bladder cancer cells,which might induce apoptosis through Caspase-independent pathway.

Objectives To understand essential basis data availability for implementation of cost accounting in TCM hospitals. Methods Costs of a total of 1588 TCM hospitals were investigated by conducting the baseline survey via questionnaires in 2013. Results Departmental basic data (including ratio of office staff and entire staff, ratio of outpatient and inpatient departments in clinical department), and construction data for housing were well accessible, while utility fee and internal service data were not. Conclusion ①Public TCM hospitals need to improve and specify the basic cost data. ②Differences exit among different types and levels of hospitals in the availability of data. ③There are still difficulties in carrying out cost accounting in public TCM hospitals, which needs strong supports from all relevant departments.

Objective To evaluate the role of combination of three-vessel views in ultrasound diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.Methods The data of 66 cases of fetal aortic arch and pulmonary arterial branch anomalies were retrospectively analysed,including echocardiographic data,autopsy and operation records and postnatal follow-up results.Echocardiogaphic features and display frequencies on three vessels and trachea view(3VT),three vessels view(3VV)and three vessels and pulmonary arterial branches view(3VP)were summarized.Results There were 52 cases of aortic arch abnormalities,including 32 cases of right aortic arch with left ductus arteriosus,4 cases of double aortic arch,7 cases of aberrant right subclavian artery,6 cases of coarctation of aorta and 3 cases of interruption of aortic arch.Fourteen cases were diagnosed pulmonary aterial branch abnormalities,including 1 0 cases of crossed pulmonary arteries,2 cases of anomalous origin of left pulmonary artery from aortic arch and 2 cases of pulmonary artery sling.The display frequencies of fetal aortic arch and pulmonary arterial branch anomalies on 3VT,3VV and 3VP were 80.3%,19.7% and 39.4%.Conclusions The combination of three-vessel views is of great value in prenatal diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.