Objective To study the effects of acute hypervolemic hemodilution (AHH) with hydroxyethly starch 130/0.4 on function of blood clotting in patients undergoing spinal operation. Methods Thirty patients scheduled for spinal operation were randomly divided into AHH group and control group with 15 cases each. Patients in AHH group were performed AHH by transfusing hydroxyethly starch 130/0.4 (15 ml/kg) with 25 ml/min before skin incision, to achieve expansion of 20% to 30%. Patients in control group were transfused routinely. Blood samples were taken from internal jugular vein before anesthesia induction (T0), at 1 h after anesthesia induction (T1) and termination of operation (T2) for determination of hemoglobin (Hb), hematocrit (Hct), platelet (Plt), prothrombin time(PT), partial thromboplastin time ( APTT), thrombin time( TT) and fibrinogen( FIB), at the same time heart rate( HR), mean arterial pressure (MAP) and central venous pressure (CVP) were observed and recorded. Results HR and MAP in both groups had no statistical difference within or between groups (P > 0.05). CVP at T1 and T2 in AHH group [(11.8 ± 1.0,(11.3 ± 1.0) cm H2O (1 cm H2O = 0.098 kPa)]were higher than that at T0 [(6.3 ±0.7) cm H2O]and that in control group ( P < 0.05). Hb and Hct at T1 and T2 in AHH group were lower than that at T0 and that in control group (P< 0.05). Plt and FIB at T1 and T2 in AHH group decreased significantly than that at T0(P<0.05), while there were no statistical difference between two groups(P> 0.05). PT, TT and APTT in both groups had no statistical difference within or between groups (P > 0.05). Conclusion AHH with hydroxyethly starch 130/0.4 has no significant effect on function of blood clotting in patients undergoing spinal operation.

Background and purpose:Tumor necrosis factor related apoptosis-inducing ligand (TRAIL) is a death receptor ligand that can induce apoptosis in a variety of cancer cell lines, but not all cancer cells . Past studies suggested that some chemotherapeutic drugs intensified the sensitivity of TRAIL induced apoptosis.We investigated the effect and potential mechanism of combined paclitaxel and TRAIL on apoptosis of human gastric cancer cell in vitro. Methods:SGC7901 cells were cultured with paclitaxel at different concentrations(1,5,10,20,40 ?g/ml) and different time(12,24,36,48 hr), methyl thiazolyl tetrazolium (MTT) assay was used to measure the anticancer activity of paclitaxel.The ability of TRAIL alone,paclitaxel alone and TRAIL in combination with paclitaxel to induce apoptosis was measured by a flow cytometer. Expression of DR4,DR5, DcR1,DcR2,Caspase-8 and Bcl-2 mRNA was examined by RT-PCR.Results:The apoptosis rates of control group(C group),paclitaxel group(P group),TRAIL group (T group)and combination group(T+P)in 24 hr were 2.09%,10.65%,7.79% and 24.51%, respectively. The apoptosis rate in T+P group was significantly higher than that in C group, T group and P group(P

Pigment epithelium-derived factor (PEDF ) was originally found fromretinal pigment epithelium. It is confirmed that it plays an anti-angiogenic and apoptosis role in diabetic microangiopathy. Recently ,PEDF has been found to have a close relationship with insulin resistance ,type 2 diabetes and diabetic macroangiopathy. But the mechanism is unclear. More and more researches focused on its role in oxidative stress. PEDF may become a new target for diabetes and diabetic complication treatment and also a predictive factor for the disease.

Objective Through analyzing the causes of iodine contrast agent extravasation,nursing managers develop effective solutions timely and take appropriate precautionary measures to ensure the safety of patients effectively.Methods 600 patients undergoing CT contrast enhanced scan were selected,300 patients from May 2009 to April 2010 were set as the control group and were given routine nursing care,300 patients from May 2010 to April 2011 were set as the study group and they adopted effective preventive measures.The incidence of adverse events after injection of iodine contrast agent between the two groups was compared.Results The incidence of iodine contrast medium extravasation in the study group was significantly reduced to 2％ after taking a series of preventive measures,which was lower than 10％ of the control group.Conclusions Taking a series of preventive measures can reduce the incidence of adverse events of iodine contrast agent extravasation,ensure the safety of patients,decrease the frequency of nursing complaints and nursing deficiencies,as well as improve the quality of nursing service.

Objective To explore the relationship between the change of serum β-HCG and the effect of　conservative treatment in tubal ectopic pregnancy.Methods 95 patients with tubal ectopic pregnancy were treated with single dose methotrexate injection.Among them,87 patients were successfully cured,16 patients were treated with the 2nd dose and Chinese herbal medicine orally:8 patients failed.The change of serum β-HCG levels after the first and 2nd course of treatment were measured.Results It showed that after the first or 2nd course of treatment,the cases which serum β-HCG level reducing less than 15%in patients who had successful treatment were signiflcantly lower than that in patients who failed(P＜0.05).Conclusion Detecting the change of serum β-HCG concentration can evaluate the therapeutic effect in tubal ectopic pregnancy with conservative treatment,and according that surgical operation should be chosen if serum β-HCG reduce less than 15%after two courses of treatment.

Objective To investigate the correlation between platelet-associated antibody and platelet infusion effects.Methods SEPSA was used to detect the platelet-associated antibody of 79 patients with multiple transfusions of platelet,the platelet count before and after platelet infusion was monitored and the corrected count increment (CCI) in lh and 24h were calculated,for those judged to be ineffective platelet infusion,the platelet cross-matching was first done and then received matching infusion again and the infusion effects were analysed. Results 47 cases were detected with platelet antibody positive in 79 patients,accounting for 59.5％ ,the CCI of lh and 24h after infusion in platelet antibody positive group were significantly lower than the negative group, the difference was statistically significant( t = 2. 462、2. 583, all P ＜ 0. 05 ) ;40 cases in positive group had the invalid with the invalid rate of 85.1％which was significantly higher than the negative group, the difference was statistically significant ( x2 = 34. 46, P ＜0. 05 ) ;the CCI of 1h and 24h after infusion in matching success group were significantly higher than the unsuccessful group, the difference was statistically significant( t = 2. 152、2. 230, all P ＜ 0. 05) ;27 cases in matching success group had the effective infusion with the effective rate of 87. 1％ ,which was significantly higher than the unsuccessful group, the difference was statistically significant ( x2 = 4. 34, P ＜ 0. 05). Conclusion The production of anti-platelet antibody was a major immune factor which lead to platelet transfusion refractoriness ,the blood platelet cooperative infusion could be a good solution for the platelet transfusion refractoriness.

The semantic construction of EHR information model has experienced a developmental process from es-tablishing core data set and modeling to two-level modeling, which are usually used in combination in construction of information models at present. In general, the framework (reference model), necessary elements (core data set) and technical specifications for EHR information model were first established when its top architecture was de-signed, which was followed by the establishment of different medical concepts, subjects and special archetypes for different departments according to the framework standards.

Objective To develop a scale for measuring CHD patients' health belief and to rectify its reliability and validity.Methods The primary items were obtained through reviewing literature and semi-structured interviewing with CHD patients.After team discussion and experts evaluation,the pretesting scale was developed.Two hundred and sixty subjects were recruited in the first study to finish the questionnaire by convenience sampling.The reliability and validity of this scale were tested by exploratory factor analysis,reliability analysis and correlation analysis.Results It was found that eight common factors extracted by exploratory factor analysis.Factor loading of each item ranged between 0.489 and 0.850.The 8 factors explained for 60.698％ of total variance.The correlations between the subscales and the total scale were ranging from 0.811 to 0.876.The correlations between the subscales of the scale were ranging from 0.330 to 0.732.The Cronbach's α coefficients of the total scale was 0.802,and the subscales Cronbach's α coefficients were ranging from 0.684 to 0.834.Test-retest reliability was 0.880,and that of subscales were 0.673～0.841.Conclusions The newly developed coronary artery disease health belief scale has showed acceptable reliability and validity,which can be used as a useful tool for the assessment and intervention of patients' health belief.

Objective To explore the effect of auricular-plaster therapy combined with aromatherapy on anxiety and quality of life in patients with colorectal surgery.Methods A total of 135 patients with colorectal surgery were randomly divided into group A (auricular-plaster therapy combined with aromatherapy),group B(auricular-plaster therapy),group C (aromatherapy),group D(blank).Anxiety and life quality levels of four groups were determined by using self-rating anxiety scale(SAS),quality of life instruments for cancer patients (QLICP-CR)and were compared between four groups before and after intervention.Results The SAS and QLICP-CR scores of group A were lower than those of group B,group C and group D after intervention.The SAS and QLICP-CR scores of group B and group C were lower than that of group D after intervention.There were no statistical significant differences in SAS and QLICP-CR scores between group B and group C after intervention.Conclusions Auricular-plaster therapy combined with aromatherapy can effectively alleviate anxiety of patients with colorectal surgery and improve their quality of life,and the effect is better than that of auricular-plaster therapy and aromatherapy.

Objective To introduce a modified replantation for thumb rotating avulsion amputation,and to evaluate its short term clinical outcome.Methods From January 2007 to July 2009,7 patients with thumb rotating avulsion amputation underwent replantation,including 6 males and 1 female,aged from 21 to 47 years (average,28.3 years).The amputation level of each thumb was metacarpophalangeal joint.During operation,fusion of metacarpophalangeal joint was performed according to injury degree of soft tissue; interphalangeal joint of the thumb was fixed in 15 degrees of flexion by sewing flexor pollicis longus muscle tendon and extensor pollicis longus muscle tendon to tendon sheath or soft tissue; the superficial vein harvested from ipsilateral forearm was used to bridge the dorsal carpal branch of radial artery and the ulnar palmacollateral artery of the thumb; direct anastomoses of dorsal veins were performed in 6 cases and venous transplantation in 1 case; and bilateral nerves were transferred to the back of the first metacarpal and anastomosed to the superficial branch of the radial nerve.Results All 7 replanted thumbs survived completely.Arterial crisis occurred in 1 case after operation,which was cured after operative and medication treatment.The follow-up period ranged from 3 to 24 months.The appearance and opposition function of replanted thumbs were satisfactory and the sensation of fingertip recovered to S4 in 4 cases and to S3 in 3 cases.The two point discrimination ranged from 8 to 12 mm.Conclusion Because bridging the dorsal carpal branch of radial artery and the ulnar palmar collateral artery of the thumb with a superficial vein harvested from ipsilateral forearm to reconstruct blood supply of the thumb is available and easy to be performed,this modified replantation is an ideal way to repair thumb rotating avulsion amputation.