Objective: To compare the anesthetic depth and postoperative recovery of propofol combined with remifentanil or fentanyl when administered through target-controlled infusion (TCI). Methods: Ninety patients receiving elective epigastric surgery were randomly divided into 3 groups: PF-A, PF-B and PR group. Through TCI, patients in PF-A group were administered with propofol (3 μg/ml) and fentanyl (2 μg/L), in PF-B group with propofol (3 μg/ml) and fentanyl (4 μg/L initially and 2 μg/L after intubation), and in PR group with propofol (3 μg/ml) and remifentanil (6 μg/L). Vital signs (including mean aortic pressure and heart rate) and bispectral index values were recorded pre-anesthesia, pre- and post-intubation, post-incision and during operation in 3 groups. Results: In PF-A group, post-intubation MAP and HR were significantly higher than those of pre-intubation (P<0.05), with obvious stress response during intubation. Whereas there was no significant difference in all parameters between those pre-intubation and post-incision. The vital signs maintained stable during anesthesia and operation in PF-B and PR groups. There was no significant difference in BIS values between 3 groups. During recovery phase the awakening time of PR group was significantly shorter than those of PF-A and PF-B groups. Conclusion: Clinical administration of 4 μg/L fentanyl or 6 μg/L remifentanil can effectively suppress the hemodynamic response to tracheal intubation and incision in propofol TCI anesthesia. However, 2 μg/L fentanyl is only enough to suppress the response to incision but not to intubation.

Objective To investigate the carotid arterial stiffness in patients with coronary slow flow ( CSF) .Methods forty-five patients with CSF and Forty -five persons having normal coronary arteries ( NCA) detected by coronary angiography with a similar distri-bution of risk factors were recruited .Stiffness parameter (β), pressure-strain elastic modulus (Ep), arterial compliance (AC) and lo-cal pulse-wave velocity (PWV) were obtained at the level of bilateral carotid artery by a real time echo -tracking system.Serum levels of high-sensitivity C-reactive protein ( hs-CRP) were measured in two groups of subjects .Linear regression analysis were performed to evaluate the correlation between hs -CRP and the parameters of the carotid artery stiffness .Results We found that stiffness parameter (β), Ep and PWV were significantly higher in CSF group those that of control group (β:11.80 ±3.19 vs 9.70 ±3.76,P<0.01;Ep:149.90 ±44.47 vs 130.10 ±41.56,P<0.05;PWV:7.40 ±0.84 vs 7.00 ±1.08,P<0.05), AC was lower than that of control group (0.640 ±0.180 vs 0.760 ±0.192 ,P<0.01).The levels of high-sensitivity C-reactive protein (hs-CRP) was significantly higher in CSF group than that of control group (13.90 ±10.66 vs 9.30 ±6.33,P<0.05).The levels of hs-CRP was positively correlated with theβ(r=0.272,P=0.005), Ep(r=0.411,P=0.003), and PWV(r=0.452,P=0.001), but negatively correlated with AC (r=-0.293,P=0.025).Conclusion Echo-tracking technology is a simple practical method to evaluate carotid artery stiffness in patients with CSF and correlation well with coronary slow flow and artery stiffness .

Objective To understand the status and demand of training of community nurses, and to improve the quality of community nursing services. Methods 161 community nurses were surveyed using a stratified sampling in proportion and self-designed questionnaire. Results 23.0% of nurses in this group had never partiticipated in the training; 52.8% of nurses thought they needed the training very much; 58.4% of nurses thought the training work should be shouldered by the organization such as nursing association. 49.1% of nurses thought the main reason influencing participation in the training for the community nurses was short of funds. Conclusions The on-job training work for community nurses is not extensive and thorough. All levels of government should emphasize the on-job training work for community nurses so as to ensure the continuous development of community nursing services.

Abscess ; diagnosis ; microbiology ; surgery ; Bacteria, Aerobic ; isolation & purification ; Child, Preschool ; Female ; Fever ; Humans ; Prognosis ; Spleen ; pathology ; surgery ; Splenic Diseases ; diagnosis ; surgery ; Treatment Outcome

In order to adapt to the modern medical development,the selective course on bacterial drug-resistance was opened for master postgraduates.This paper analyzed the curricular contents,the teaching methods and the questionnaire-done by the master postgraduates.The students could know well the mechanism of bacterial drug-resistance and the basic principle on apphcation of antimicrobial agents.

Objective To summarize the sonographic characteristics of Peutz-Jeghers syndrome in children and investigate the diagnostic value of ultrasound.Methods Retrospective analysis of sonographic characteristics of 19 cases with pathologically-confirmed Peutz-Jeghers syndrome were conducted.ResultsExcept for one child,other 18 patients all had more than one polyp with the maximum of sixteen.The polyp with the smallest size of 0.8 cm×0.5 cm×0.8 cm was found in left colic flexure,while the largest one was found in superior rectal with a measurement of 7.6 cm×2.7 cm×3.6 cm.The polyps showed radiatiform echotexture.And hypoechoic and hyperechoic components were present alternately.Blood flow was easily identified within these polyps by color Doppler sonography.Intussusceptions were observed in 11/19 patients.Among them,10 cases were located at small intestine.The sonographic finding was a concentric structure with a polyp at the top.Conclusions The sonographic appearence of Peutz-Jeghers syndrome is characteristic.Before surgery,ultrasonographic examination could achieve a accurate diagnosis for Peutz-Jeghers syndrome.

Objective: To observe the postoperative skeletal changes of mandibular setback via bilateral sagittal ramus split osteotomy (BSSRO) with circummandibular wiring and maxillomandibular fixation. Methods: BSSRO was performed in 14 cases to setback the mandible. The patients were followed up for 6 months by clinical observation and examined with lateral cephalometric radiographs and Schuller's position radiographs before and after surgery. Results: According to the measured parameters the ralapse extent was 27.2%. Multiple regression analysis showed the magnitude of the setback significantly accounted for relapse (P

Objective To study the effect of low-dose FK778 in preventing chronic renal al- lograft rejection in rats.Methods The rat model of chronic renal allograft rejection was established by using micro-surgery technique.The recipients were divided into two groups.The recipients in the study group were treated with FK778 at a dose of 5mg?kg~(-1)?d~(-1)dissolved in carboxymethylcellulose by means of gavage and the controls were treated with carboxymethylcellulose.Urinary protein con- centrations were measured every 4 weeks for 24 weeks.On 24th week after operation,the rats were killed and the kidney grafts were taken out for histological and immunohistological examinations as well as quantitative real-time RT-PCR analysis.Results After 24 weeks of treatment,proteinuria, the severity of chronic rejection,glomeruIosclerosicytes and monocytes/macrophages in the study group were significantly milder than in control group.And the expression of TGF-?mRNA and PDGF-B mRNA was significantly reduced in the study group as compared with that in the control group.Conclusion Low-dose of FK778 might prevent the rats from chronic renal allograft rejection.

Objective To explore the effect of black garlic extract on HeLa cells and its possible molecular mechanisms.Methods Inhibitory rate of HeLa cells was detected with methyl thiazolyl tetrazolium(MTT).Flow cytometry annexin V-fluorescein isothiocyanate/propidium iodide (V-FITC/PI) was used to detect tumor cell apoptosis.Flow cytometry was used to measure cell-cycle changes.Immunohistochemistry method was used to detect expressions of tumor proteins bax and Bcl-2.Results Black garlic extract significantly inhibited the growth of HeLa cells.Black garlic extract significantly induced apoptosis of HeLa cells.The apoptosis rate was (53.26 ± 1.78)％ in the black garlic high-dose group,and (3.68 ±0.11)％ in the control group.Black garlic extract affected cell cycle,upregulated bax expression,and downregulated bcl-2 expression.Conclusions Black garlic extract significantly induced the apoptosis of HeLa cells.This effect might be caused through increasing G2/M cells or changing expressions of bax and bcl-2.

Objective:To investigate the application of leukogenic medicine in cancer patients and standardize the use of WBC increasing medicine in a hospital. Methods:A retrospective analysis of 579 patient records from January 2014 to December in a hospital diagnosed as malignant tumor and issued WBC increasing medicine . The kinds of drugs,timing of administration, dosage,frequency of administration,the use of medication,drug combination and the choice of solvent were analysed by collecting the patients’ essential information, chemotherapy, myelosuppression etc. Results: The l white blood drugs mainly oral preparations;There were 414 rational drug use medication orders,accounting for 71. 50 percent;irrational drug use medical record 165,accounting for 28. 50% . The dosage and duration of treatment in line with requirements,and unreasonable cases mainly suitable varieties and timing of administration based,42. 42% and 27. 88% ,respectively;followed by repeated dosing and combination therapy is not suitable,13. 33% 1and 2. 73,respectively;a lower incidence of solvent choice unsuitable,is 3. 64% . Conclusion:The use of WBC increasing medicine need to be standardized in cancer patients in the hospital. Clinicians need to strengthen studying the knowledge of the application of WBC increasing medicine and use WBC increasing medicine rationally.