Objective To compare the effects of patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia (PCEA) on platelet activation in patients undergoing radical colon cancer operation.Methods Sixty-four ASA Ⅰ or Ⅱ patients,aged 43-65 yr,weighing 45-68 kg,undergoing radical operation for colon cancer,were randomly divided into 2 groups ( n =32 each):PCIA group and PCEA group.PCA pumps were connected at the end of operation.The PCIA solution c6ntained sufentanil 3 μg/kg,tropisetron 5 mg and vitamin B6 100 mg in 130 ml of normal saline.The PCIA pump was set up to deliver a 1.8 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.The PCEA solution contained sufentanil 0.5 μg/kg and 0.125％ ropivacaine in 300 ml of normal saline.The PCEA pump was set up to deliver a 2.5 ml bolus dose with a 20-min lockout interval and background infusion at 5 ml/h after a loading dose of 5 ml. VAS was maintained ≤ 3 after operation.Venous blood samples were taken before anesthesia,at 60 min after beginning of operation,and at the end of operation to determine the concentrations of plasma insulin and cortisol and blood glucose.Venous blood samples were taken at 30 min before operation,1 h after beginning of operation,and at 30 min and 4,12,24 and 48 h after operation (T0-6) to measure the concentration of serum platelet α-granzyme membrane protein-140 (GMP-140).The side effects were recorded after operation.Results Thirty and 29 patients completed the study in groups PCEA and PCIA respectively.There was no significant difference in the concentrations of plasma insulin and cortisol and blood glucose at each time point between the two groups ( P ＞ 0.05 ).The concentration of serum GMP-140 was significantly higher at T1-6 than the baseline value at T0 (P ＜ 0.05).The concentration of serum GMP-140 and incidence of nausea and vomiting were significantly lower at T3-6 in group PCEA than in group PCIA (P ＜ 0.05).One case happened pruritus in group PCIA,and respiratory depression and local anesthetic intoxication were not observed in the two groups.Conclusion PCEA has better inhibitory effect on the overactivation of platelet than PCIA,which may be helpful for preventing metastases of cancer ceils or postoperative thrombosis,and it is more suitable for postoperative analgesia in patients undergoing radical colon cancer operation.

Objective:To identify the contributions of allergen to Th1 and Th2 by determined the levels of IFN-?,IL-4 and the transcription factors T-bet and GATA-3 in peripheral blood mononuclear cells(PBMC)of allergic asthmatics.Methods:①Plasma IFN-? and IL-4 were measured in 35 asthmatics and 32 healthy by ELISA,as well as the production of IFN-? and IL-4 by Dermatophagoides farinae(Df)-activated PBMC in asthmatics and 15 healthy controls.②Twenty-five asthmatics and 15 healthy persons were enrolled.The T-bet mRNA and GATA-3 mRNA expressing levels in PBMC were assayed by one step reverse transcription polymerase chain reaction(RT-PCR).Results:①The plasma IL-4 in the patients was significantly higher than that in healthy(t=3.265 9,P=0.001 7).The plasma IFN-? levels in asthmatics were no significantly different from that of the healthy(t=0.306 8,P=0.760 0).② In the condition of PBMCs activated by Df,the IL-4 and IFN-? levels in asthmatics were increased compared with healthy(t=3.564 4,P=0.001 0;t=3.350 0,P=0.002 0).③ There were some expression of the transcription factors T-bet and GATA-3 of PBMC in asthmatics and healthy.The expression of GATA-3 in the patients was significantly higher than that in healthy(t=2.274 3,P=0.028 0).The expression of T-bet and the ratio of T-bet/GATA-3 in the patients was no significant difference with the healthy(t=0.222 0,P=0.825 8;t=1.115 2,P=0.283 4).④ In the Df-activated PBMC,the expression of T-bet and GATA-3 in asthmatics were significantly higher than that of healthy(t=2.298 2,P=0.027 6;t=3.788 7,P=0.000 6),but the ratio of T-bet/GATA-3 was no significant difference with healthy(t=1.195 9,P=0.249 1).Conclusion:The production of Th2,Th1 cytokines and the expression of GATA-3 and T-bet in allergic asthmatics are both increased.It is suggested that the imbanlance of Th1/Th2 unsatisfactorily explain the pathogenesis of allergic asthma.

Energy conservation has become a problem needing to be immediately solved with the extensive con-struction of hospital information system. As a high computing technology, green computing uses resources economically and effectively and is characterized by energy conservation and environment friendship. Its concept and characteristics, and the status quo of hospital information system construction were described. A green computing framework model was established for hospital information system construction, which plays an active role in implementing the idea of green environment protection, low carbon and energy conservation, and sustainable development, thus laying a foundation for studying the mechanisms underlying energy conservation in hospital information system construction and for assessing and optimizing its strategic system.

Objective: To establish an effective fingerprint analysis. Methods: Cluster analysis and mahalanobis distance analysis were adopted to analyze data of HPLC fingerprint of shenmai injection. Results: Precise classification of 18 samples was done by cluster analysis and mahalanobis distance analysis. Conclusion: Authors believe that multivariate statistics analysis applied to fingerprint can be recommanded in the quality control of shenmai injection.

ObjectiveTo compare inhalational anesthesia with sevoflurane and intravenous anesthesia with propofol-sufentanil in patients undergoing gynecological outpatient surgery.MethodsOne hundred and forty ASA Ⅰ or Ⅱ patients,aged 18-35 yr,weighing45-65 kg,undergoing outpatient painless abortion,were randomly divided into 2 groups ( n =70 each):intravenous anesthesia with propofol-sufentanil group (group Ⅰ ) and inhalational anesthesia with sevoflurane group (group Ⅱ ).In group Ⅰ,sufentanil 0.2 μg/kg was injected intravenously,and 1％ propofol was infused at 2-3 mg·kg-1 ·min-1,followed by a rate of 3-4 mg·kg-1 ·h-1 after loss of eyelash reflex.In group Ⅱ,8％ sevoflurane was inhaled and the oxygen flow rate was 6 L/min,and after loss of eyelash reflex,the oxygen flow rate was adjusted to 3 L/min,and the concentration of sevoflurane was adjusted to 2％-3％.The time of induction of anesthesia,emergence time,operation time,intraoperative hypoxemia,body movement and related adverse events were recorded.ResultsCompared with group Ⅰ,the time of induction of anesthesia was significantly prolonged,the incidence of agitation,nausea and vomiting was significantly increased,and the incidence of sexual hallucinations was significantly decreased ( P ＜ 0.05),while no significant change was found in the operation time,emergence time,and incidence of shivering,intraoperative hypoxemia and body movement in group Ⅱ ( P ＞ 0.05 ).ConclusionIntravenous anesthesia with propofol-sufentanil is more helpful in improving the quality of emergence from anesthesia and more suitable for gynecological outpatient surgery than inhalational anesthesia with sevoflurane.

OBJECTIVE To discuss the liable episodes of the urinary tract infection with relation of catheter and propose the prevention measures.METHODS We radomly selected 536 patients with catheter.The urinary tract infection,as well as related factors were observed in patients with indwelling catheter.RESULTS The catheter replacement time interval as well as indwelling time were the risk factors,when the indwelling catheter time was 1-3 days,the CAUTI rate was 10.3%,if the time was ≥10 day,the CAUTI rate was 97.6%.Additionally the antibiotic use would cause dysbacteriosis which also easily caused the urinary tract road infection.CONCLUSIONS When taking care of the patients who had catheter,we should grasp the indications of catheterization,reduce the indwelling time,apply the effective nursing measures and correct choice of antibiotics,that can evidently control the infection.

OBJECTIVE To investigate the hospital acquired MRSA infection death cases and drug-resistance to improve the proper clinical utilization of antibiotics.METHODS The clinical data of the death cases in ICU wards from Mar 2008 to Jun 2008,and the drug sensitivity and resistance results of MRSA from Jan 2007 to Dec 2008 were analyzed retrospectively.RESULTS MRSA isolated from all of the three death cases were susceptible to vancomycin and unsusceptible to other antibiotics.Thirty MRSA strains were isolated from Jan 2007 to Dec 2008.Drug sensitivity test showed 100% drug-resistance rate to penicillin,erythromycin,cefazolin and oxacillin;66.7%-87.0% drug-resistance rate to ciprofloxacin,clindamycin,levofloxacin,and sulfamethoxazole compound.CONCLUSIONS High drug-resistance rate of MRSA to commonly used antibiotics is found.MRSA is usually infected in patients with malnutrition,major surgery or infants long term using ventilator.Sensitive antibiotics should be used in early time and regulations from aspects of hospital infection control,medical administration and nursing management also be carried out to prevent and control the prevalence of MRSA bacteria.

Objective To study the best preparation technique of compound Thallus laminaria granules volatile oil-?-cyclodextrin clathrate and examine the stability of the elathrate.Methods The orthogonal design method was used to optimize the formulation.The yeild of the volatile oil and the content of the clathrate were used as the test target.Results The best preparation process was as follows:?-cyclodextrin:compound Thallus laminaria=12:1(g?mL~(-1)),at 50～60℃for 2 hours.Making distillation twice while adding water to the first decoction, steaming 1h after boiling;A_2 B_1 was the best extraction scheme.Conclusion The preparation process can be a scheme to obtain the clathrate with high content of effective component,which can be used in the preparation of the clathrate.