Heart Failure ; therapy ; Humans

Analysis was conducted on the reason and countermeasures for problems such as un stable research direction in the medical law discipline construction,shortage of teachers and academic team,poor results of scientific research and unpractical personnel training.Strengthening the discipline construction of medical law,firstly we should attach great importance to it and unify the recognition,ensuring that the discipline of medical law can be dcvcloped healthily and within standard ; secondly we should strengthen the construction of discipline content and improve construction level of medical law; thirdly we should combine medicine with law,cultivating high-leveled talents.

Objective:To investigate the effects of Dexmedetomidine for supplemental anesthesia on perioperative hemodynamics and postoperative sedation and analgesia in elderly patients receiving radical gastric cancer surgery under general anesthesia.Methods:From January 2019 to April 2020, 63 patients admitted to our hospital for radical gastric cancer surgery were included as observation objects.They all underwent general anesthesia and were divided into the Dexmedetomidine group(odd-numbered group)and the normal saline group(even-numbered group)according to the parity of serial numbers the subjects were assigned to.Changes in perioperative hemodynamic index values and the amounts of anesthetic drugs used in the two groups were monitored and recorded, and postoperative sedation and analgesia effects were evaluated by using the Ramsay sedation scale and the visual analog scale(VAS).Results:The mean artery pressure(MAP)and heart rate(HR)were lower in the Dexmedetomidine group than in the normal saline group before anesthesia induction(T1), immediately after intubation(T3)and immediately after extubation(T5)( P<0.05). The Ramsay scores were higher and the VAS scores were lower in the Dexmedetomidine group than in the normal saline group at 1 h and 4 h after surgery( P<0.05). The doses of intraoperative propofol and remifentanil were lower in the Dexmedetomidine group than in the normal saline group[(1121.5±198.5)mg vs.(1395.6±332.7)mg, (3.1±0.9)mg vs.(5.5±1.2)mg, P<0.05]. Conclusions:The use of Dexmedetomidine for supplemental anesthesia can effectively maintain the stability of the patient's intraoperative hemodynamics and enhance the sedative and analgesic effects while reducing the amount of anesthetic drugs in patients receiving radical gastric cancer surgery under general anesthesia.

Objective To observe the dynamic changes of interferon gamma(IFN-?) and transforming growth factor bata1(TGF-?_1) in animal model of hyperoxia-induced lung injury,and to explore the mechanism of fibrosis.Methods Thirty-two juvenile Wistar rats were randomly divided into room-air group and hyperoxia group,the hyperoxia group were further divided into 3 subgroups of hyperoxia-exposure for 3,7 and 14 days.The mRNA levels of IFN-? and TGF-?_1 in the lung were measured by reverse-transcription polymerase chain reaction(RT-PCR).The expressions of IFN-? and TGF-?_1 protein were measured by immunohistochemical(stai)-ning.Results The level of IFN-? mRNA of groups under hyperxia-exposure for 3,7 and 14 days were higher than that of control group.The expression of IFN-? mRNA notably elevated and was up to its peak(P

Objective:To observe the clinical effect of mild moxibustion for knee osteoarthritis (KOA) and to explore the role of mild moxibustion in relieving pain,reducing stiffness and improving joint dysfunction in patients with KOA.Methods:Eighty patients with KOA were randomly allocated into either a moxibustion group or a medication group by the random number table,with 40 cases in each group.The moxibustion group used mild moxibustion at Neixiyan (EX-LE 5),Dubi (ST 35),Xuehai (SP 10) and Liangqiu (ST 34),30 min each time,3 times a week;the medication group was given celecoxib capsule (celebrex),0.2 g each time,once a day.Both groups were treated for 4 weeks.The visual analog scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC)scores were evaluated before and after treatment.The efficacy of the two groups was compared after treatment.Results:After treatment,the overall efficacy of the moxibustion group was significantly different from that of the medication group (P＜0.05).The VAS and WOMAC scores of the two groups were lower than those before treatment (both P＜0.01).The changes in the VAS and WOMAC scores after treatment in the moxibustion group were significantly different from those in the medication group (both P＜0.05).After treatment,in single item of WOMAC,the changes in pain and joint dysfunction in the moxibustion group were more statistically significant than those in the medication group (both P＜0.05).Conclusion:Mild moxibustion and oral celebrex can reduce the VAS and WOMAC scores of patients with KOA.Mild moxibustion is superior to oral celebrex in relieving pain and improving joint function.

AIM: To observe the effect of Jiawei Sini Decoction (JWSND) on glucocorticoid receptor (GCR) in thymocytes of chronic psychological stress rats. METHODS: The rats were randomly divided into 4 groups, control group (C), model group (M), group treated by JWSND (C 1), group treated by ginsenosides (C 2). The number of thymocyte GCR sites and the GCR nuclear thanslocation rate were detected by radioimmunoassay. RESULTS: Compared with the control group, in the model group, the thymocyte weight index lowered significantly ( P

Objective To investigate the correspond of microsatellite instability (MSI) on the prognosis and the effect of chemotherapy for colorectal cancer.Methods The publications about the MSI of colorectal cancer from January 2011 to October 2012 were searched.The Web of Knowledge and MEDLINE (PubMed) databases were used for searching English articles.The CNKI and WanFang databases were used for searching Chinese articles.Statistical analysis and graphics were performed with Comprehensive Meta Analysis V2 software.Results Thirty papers were included in this study.For the prognostic Meta-analysis,MSI-H was a protective factor for the overall survival of patients (OR =0.634,0.558-0.720; P ＜ 0.001).Simultaneously,MSI-H was a protective factor for the disease-free survival of patients (OR =0.571,0.479-0.681; P ＜ 0.001).After using of 5-Fu,the survival rate of MSS/MSI-L patients could be significantly elevated (OR =0.515,0.433-0.611; P ＜ 0.001).However,the survival rate of MSI-H patients did not increase significantly (0.631,0.302-1.318; P =0.220).Conclusions Both the overall survival and disease-free survival of MSI-H patients were significantly better than that of MSS/MSI-L patients.For MSS/MSI-L patients,the chemotherapy effect was remarkable.However,for MSI-H patients,there was no statistics difference between chemotherapy and no-chemotherapy group.

Objective We conducted a systematic review and meta-analysis of the published literature to evaluate the efficacy of prophylactic antibiotics in the prevention of incisional infection of inguinal tension-free hernioplasty.Methods Articles of randomized controlled trials about the efficacy of prophylactic antibiotics in the prevention of incisional infection in the inguinal tension-free hernioplasty published from January 1975 to October 2012 was retrieved and systematically reviewed.Results A total of 11 randomized controlled trials meeting the inclusion criteria were screened.Among the 4159 cases of patients,130 cases had wound infection,and the infection rate was 3.13％.In the prophylactic antibiotics group of 1845 cases,wound infection occurred in 45 cases; the infection rate was 1.94％.In the control group of 2314 cases,85 cases had incision infection; the infection rate was 3.67％.The preventive use of antimicrobial drugs reduced surgical site infection of inguinal tension-free hernioplasty (OR 0.55,95％ CI 0.38-0.80,P =0.002).Conclusions The use of prophylactic antibiotics can effectively reduce the incisional infection in the inguinal tension-free hernioplasty.

Objective:To discuss the role of clinical pharmacists in perioperative drug treatment for a patient after renal transplan-tation. Methods:Clinical pharmacists participated in the drug therapy for a patient after renal transplantation. Pharmaceutical care and health education were performed for the patient in the aspects of immunosuppression, anti-hepatitis B virus, gastric mucosa protection, diarrhea, acute rejection and the other treatment programs. Results:The participation of clinical pharmacists in the clinical treatment for the patient improved therapeutic scheme and promoted therapeutic efficacy. Conclusion:The participation of clinical pharmacists in clinical drug therapy for patients can provide individualized service to improve reasonable, effective and economical drug use.

Objective To summary the experience of management for orthotopic homologous heart transplantation,heart-lung co-transplantation and to discuss the postoperative treatment of short-term complications.Methods Orthotopic homologous heart transplantation and heart-lung co- transplantation on 9 cases were performed from May 2004 to February 2006.The patients were traced closely and all complications were treated in time.Results During hospital stay,hypertension oc- curred in one case,right heart insufficiency in one case,infection of mycetes and cytomegalovirus in 2 cases after the heart transplantation,and in the patient undergoing heart-lung co-transplantation,renal inadequacy,bronchial anastomosis stenosis and fungus infection occurred.All patients obtained symp- tomatic relief before discharge.Conclusion Proper perioperative management,immunosuppressive therapy and management of postoperative complications could reduce mortality and obtain satisfactory therapeutic effect in the near future.