Objective To study the ways which ensure the delivery of enough tidal volume to patients under various conditions close to the demand of the physician. Methods The volume control ventilation model was chosen,and the simulation lung type was active servo lung ASL 5000 or Michigan lung 1601. The air resistance,air compliance and lung type in simulation lungs were set. The tidal volume was obtained from flow analyzer PF 300. At the same tidal volume,the displaying values of tidal volume of E5,Servo i,Evital 4,and Evital XL ventilators with different lung types of patient,compliance of gas piping,leakage,gas types,etc. were evaluated. Results With the same setting tidal volume of a same ventilator,the tidal volume delivered to patients was different with different lung types of patient,compliance of gas piping,leakage,gas types,etc. Reducing compliance and increasing resistance of the patient lungs caused high peak airway pressure,the tidal volume was lost in gas piping,and the tidal volume be delivered to the patient lungs was decreased. If the ventilator did not compensate to leakage,the tidal volume delivered to the patient lungs was decreased. When the setting gas type of ventilator did not coincide with that applying to the patient,the tidal volume be delivered to the patient lungs might be different with the setting tidal volume of ventilator. Conclusion To ensure the delivery of enough tidal volume to patients close to the demand of the physician, containable factors such as the compliance of gas piping,leakage,and gas types should be controlled.

An objective analysis of the status quo of the teaching of"Applied Writing"in medical colleges and universities is first conducted from the perspectives of insufficient importance attached to this course by the school authorities,lack of qualified teachers,lack of good textbooks tailored for medical schools,and unsatisfactory teaching effect and the concrete measures are pro-posed for improving and strengthening the teaching of this course.

Background Cardiomyocytes apoptosis was related to oxidative stress which has been shown to play an important role in ventricular remodeling after myocardial infarction(MI).Probucol is a hypolipidemic and antioxidant agents.Several reports demonstrated its cardioprotective effect after MI.However,the exact effect of probucol on the modification of the apoptosis related gene Bcl-2 and Bax is not clear.Objective To investigate the effects of probucol on mRNA and protein expression of Bcl-2,Bax and oxidative stress in myocardial infarcted rats.Methods Forty-one SD rats that survived 24 h after ligating left anterior descending coronary artery were randomly to receive placebo-saline(5 mL/d,n=20)or probucol(probucol 60 mg/kg?d,n=21).Twelve rats underwent sham operation were served as control(n=12).Six weeks after treatment,hemodynamic pararmeters and left ventricular function were measured with catheterization.Cardiomyocytes apoptosis were determined by TUNEL method.Myocardium mRNA of Bcl-2 and Bax expression levels in the non-infarcted myocardium were as- sessed by RT-PCR.The myocardium protein expression of Bcl-2 and Bax in the non-infarcted myocardium were de- termined by Western blot.Colorimetry was used to determine oxidative metabolism index in myocardium.Results 1)Compared with the sham rats,all MI rats showed marked decrease in Bcl-2 mRNA and protein expression in myo- cardium with increase of Bax mRNA and protein expression and apoptosis index(P

Objective To investigate the effects of probiotics on the occurrence of ovalbumin (OVA) induced food allergy and the regulatory effects on immune function of rat models. Methods Thirty female Brown-Norway rats aged 3 weeks were randomly divided into blank control group,food allergy group and probiotics intervention group(n=10).The levels of serum OVA-IgE and intestinal sIgA were measured by ELISA method.Splenic lymphocytes were isolated and cultured in vitro,and the Treg lymphocyte subgroups in the spleen were analyzed by flow eytometry.The levels of IFN-γ,IL-4 and IL-10 in the supernatant of cultured splenic lymphocytes were measured by ELISA method. Results The serum OVA-IgE level in food allergy group was significantly higher than that in blank control group(P<0.05),while that in probiotics intervention group was significantly lower than that in food allergy group(P<0.05).Compared with food allergy group and blank control group,the level of intestinal sIgA in probiotics intervention group was significantly higher(P<0.05).The percentage of CD4~+CD25~+T lymphoeytes in food allergy group was significantly lower than that in blank contml group(P0.05).The levels of IL-4 and IL-10 in food allergy group were significantly higher than those in blank control group(P<0.05).Probiotics intervention group had significantly lower levels of IL-4,IL-10 and IFN-γ than food allergy group(P<0.05).The ratio of IFN-γ/IL-4 in food allergy group was significantly lower than that in blank control group(P<0.05),while that in probiotics intervention group was significantly higher than that in food allergy group(P<0.05). Conclusion Probioties intervention could prevent the occurrence of food allergy in animal models by modulating the Th1/Th2 eytokine balance.

OBJECTIVE:To provide reference for improving the service quality of outpatient pharmacy in hospital. METH-ODS:A questionnaire survey was conducted to investigate and analyze the patients’satisfaction and related influential factors to outpatient pharmacy in a third grade class-A hospital in Chengdu. RESULTS:Totally 165 questionnaires were sent out,and 150 were effectively received with effective recovery of 90.91%. The total score for patients’satisfaction was (44.67 ± 7.81) scores, and the rate of satisfaction was(81.22±14.19)%. The top three entries were“the will you choose to come to our hospital again if necessary”,“the notices about time and place for taking the medicine”and“the overall evaluation of the professional ethics of med-ical staff”,scored 4.38,4.25 and 4.25,respectively;the last three entries were“waiting time for taking medicine”,“the notices about how long it takes to take the medicine”and“service facilities and environmental facilities for drug taking”,scored 3.55, 3.63 and 3.95,respectively. The top three suggestions were“long waiting time for taking medicine and inconvenient”,“noisy envi-ronment,bad order”and“expensive drugs charges but less reimburse”. The univariate analysis and multivariate analysis showed that gender,age,marital status,education,occupation,family income per month,resident,drug taking times and payment etc. factors showed no significant effects on patients’satisfaction scores(P>0.05). CONCLUSIONS:The degree of patients’satisfac-tion in outpatient pharmacy have no obvious specificity and preference,the key to improve the degree of satisfaction lies on strengthening the service of the hospital and the perception of the patients. While the next research will focus on how to find the breakthrough points and key points to improve the experience of waiting,standardize process management and logistics manage-ment,and make patients aware of the service development.

Objective To investigate the effect of implementation of hand hygiene(HH)activities on HH compliance among health care workers(HCWs).Methods In May-December 2013,a series of HH intervention measures in a hospital were implemented,compliance to HH among all clinical and laboratory HCWs in April-December 2013 (before and after in-tervention)were surveyed and compared.Results After implementing HH activities,HH compliance rate of HCWs in-creased from 39.82% before intervention to 80.77% after intervention,HH compliance rates of doctors,nurses and clean-ing staff increased from 41.09%,41.30% and 34.33% before intervention to 83.87%,91.89%,and 59.54% after inter-vention respectively,the differences between before and after intervention were all statistically significant (all P <0.001). Except intensive care unit,HH compliance rates of HCWs in departments of surgery,internal medicine,and radiotherapy were all higher than pre-intervention(all P <0.001).Compliance to five indications for HH among HCWs after interven-tion were all higher than pre-intervention(all P <0.001 ),HH compliance rate before touching a patient increased from 23.88% to 73.37%,before clean/aseptic procedure increased from 58.65% to 94.23%.Conclusion Through the imple-mentation and supervision of HH activities,both the awareness and compliance of HH among HCWs have been significant-ly improved,good HH habit is gradually developed.

Objective To observe the learning and memory ability,oxidative stress,apoptosis morphological changes in the hippocampus,and to explore the effects of hyperuricemia on cognitive function.Methods 51 healthy male SD rats were randomly divided into three groups (17 in each group):Blank group,Distilled water group and Hyperuricemia group.Using the lavage methods of yeast extract combined with ethambntol to establish hyperuricemic model.Morris water maze test was used to measure the learning and memory ability.The levels of MDA,GSH-Px,ASAFR,SOD were measured through chemical colorimetry.Hippocampus morphology structures were observed under the HE staining light microscopy to detect the apoptosis of hippocampus cone cell with TUNEL.Results The average escaped latency and passing platform times of Blank group had no significant difference compared with those of Distilled water group and Hyperuricemia group (all P＞ 0.05).GSH-Px,ASAFR,SOD of Hyperuricemia group ((83.70 ± 5.47) nmol/mg,(606.03±46.61) U/L and (55.05 ± 2.11) units/mg) were increased compared with those of Blank group ((67.28±8.37) nmol/mg,(473.84 ± 57.64) U/L,(45.79 ± 2.05) units/mg) and Distilled water group ((71.96±9.47) nmol/mg,(505.97 ± 47.19) U/L,(46.24 ± 3.65) units/mg) (all P＜ 0.05).Compared with Blank group ((3.19±1.14) μmol/L) and Distilled water group ((3.16±1.43) μmol/L),the MDA of Hyperuricemia group ((1.74±0.45) μmol/L) was significantly decreased (all P＜ 0.05).Form and structures of hippocampal neurons of each group were basically normal under the HE staining light microscopy.Compared with Blank group (CA1:(3.59±0.63) ％,CA3:(5.54± 0.78) ％) and Distilled water group (CA1:(3.25±0.97) ％,CA3:(5.96± 0.82) ％),the hippocampal cells of Hyperuricemia group (CA1:(4.04± 0.78) ％,CA3:(5.95±0.80) ％) also had no statistical differences (P＞0.05).Conclusion Hyperuricemia has antioxidant effect on hippocampal neurons and has no effect on cognitive function and hippocampal neural morphology in rats.

Objective To design and synthesize derivatives of wanpeinine A, the main steroidal alkaloid isolated from the plant Fritillaria shuchengensis, and further study on the structure-activity relationship of the steroidal alkaloid. Methods Acylation and alkylation were used to synthesize the derivatives and their structures were identified via NMR and MS.Results The acylation of wanpeinine A (1) produced 3β,6α-diacetylwanpeinine A (2), 3β,6α-dipropionylwanpeinine A (3), 3β,6α-dichloracetylwanpeinine A (4), 3β,6α-dibenzoylwanpeinine A (5), and 3β-methoxyacylwanpeinine A (6). The alkylation of wanpeinine A formed 3β,6α-dimethoxymethylwanpeinine A (7). Conclusion All compounds are new except for 3β,6α-diacetylwanpeinine A.

Objective To investigate the short-term effect of pelvic floor muscle training (PFM) with biofeedback on stress urinary incontinence (SUI) in postpartum and post-menopausal women.Methods According to the different period that the SUI occurs,107 women with SUI were divided into two groups:the group of SUI in postpartum with 60 women,and the group of SUI in post-menopausal with 47 women.PFM with biofeedback was performed on all patients for 8 weeks.One hour pad-weighing test,voiding diary,transperineal three-dimensional ultrasound and female pelvic floor muscle assessment were recorded before and after treatment.Results There was statistically significant difference in 1 hour padweighing test between pre-treatment and post-treatment for the group of SUI in postpartum (the negative,mild,moderate,and severe cases of post-treatment:21,24,14,1,of pre-treatment:0,30,28,2; P＜0.05),and the group of SUI in post-menopausal (the negative,mild,moderate,and severe cases of post-treatment:7,22,11,7,of pre-treatment:0,14,25,8; P＜0.05).The strength of the pelvic floor muscles of type Ⅰ and type Ⅱin two groups after treatment were significantly different from those in pre-treatment (P＜0.01).The efficient rate of improvement in symptoms after treatment in the group of SUI in postpartum was 88％ (53/60) and the cure rate was 38％ (23/60).While the efficient rate in the group of SUI in post-menopausal women was 64％(30/47) and the cure rate was 15％ (7/47).There was statistically significant difference in the development of symptoms in two groups after treatment (P=0.003).Conclusion PFM with biofeedback is an effective treatment for SUI in postpartum and post-menopausal women,especially for postpartum ones.

Objective To study the application of continuous infusion of remifentanil combined with propofol with different velocity du-ring induction of general anesthesia in elderly patients. Methods Sixty elderly patients were divided into 4 groups randomly(n=15) and given remifentanil with continuous infusion rate of 0.1,0.15,0.2 and 0.3 ?g?kg-1?min-1,respectively.After given midazolam and propofol,remifentanil infusion started with different velocity.Three minutes later,vecuronium was given and intubation performed 2 min later.After that,propofol infusion rate was adjusted according to the changes of blood pressure and kept at 4 mg?kg-1?h-1 5 min before incision.Blood pressure(BP),heart rate(HR),intubation score(following Grant's method) and all side effects and adjuvant drugs used were recorded. Results Grant scores in all patients were less than 8.Atropine and ephedrine were given more in large dose groups and with decreasing of usage of propofol.HR decreased markedly in 0.3 ?g?kg-1?min-1 group after remifentanil began(P