Objective To investigate the pharmacodynamics and pharmacokinetics of ropivacaine for epidural anesthesia in renal transplantion. Methods Eight patients undergoing renal transplantation (group R) and eight patients with normal renal function (group C) were included in this study. Nine patients were male and seven female. Age ranged from 27-52 years and body weight from 46-89 kg. Radial artery was cannulated under local anesthesia for blood pressure monitoring and blood sampling. An epidural catheter was placed at L1-2. An epidural bolus of 0.75% ropivacaine 16 ml was given. The level of sensory block was tested every 3 min within 30min after epidural ropivacaine and then every 15 min.The degree of motor block was assessed using Bromage score every minute (0 = the patient can move his/her lower limb freely, 3 = the patient can not flex his/her hip, knee and ankle) . Arterial blood samples were taken before, during and after surgery for determination of plasma concentration of Alphal acid glycoprotein (?1-AGP) using an ultrafiltration technique. Results Demographic data including gender, age and body weight were comparable between the two groups. The onset time of sensory block in group R (20.00?4.63)min was significantly shorter than that in group C (32.14?8.09) min, while duration of sensory block in group R (60.00?27.69) min was significantly tonger than that in group C (43.13 ? 27.64) min. Plasma concentration of ?1-AGP in group R was significantly higher than that in group C ( P

Introduced in the paper are key measures and characteristics of the attending in charge system,following the theory of lean management and under leadership of the department head of the hospital.Authors hold the practice as enhancing administrative functionality of the department head, avoiding disadvantages incurred by traditional attending in charge system,and upholding quality of care management,making it a worthwhile attempt for China's healthcare system.

Objective To investigate the effectsof quercetin on human umbilical vein endothelial cell (HUVEC)-12 undergoing endothelial-to-mesenchymal transition (EndMT) induced by TGF-β1; To discuss its mechanism of action. Methods Cell activity of intervening by quercetin with different concentrations and TGF-β1 for 72 h was detected by CCK-8 method;RT-PCR and immunofluorescence staining were used to detect the transition of endothelial and stromal markers; Western blot was used to detect the signal transduction pathway; RT-PCR was performed to detect the transcription factors that play crucial roles in the process of transformation. Results The results of RT-PCR and immunofluorescence double staining showed that TGF-β1 (10 ng/mL) stimulated HUVEC-12 cells for 72 h to induce fibroblast phenotype, showing more interstitial markers and less endothelial markers;Western blot and RT-PCR results showed that quercetin inhibited the phosphorylation of smad2/3 in a concentration-dependent manner;After TGF-β1 stimulation, the downstream transcription factors EndMT of snail1, twist1, twist2, ZEB1, and ZEB2 significantly increased, while 100 μmol/L quercetin could down-regulate the five downstream transcription factors. Conclusion Quercetin has anti-fibrosis effects through inhibiting HUVEC-12 cells undergoing EndMT.

Objective To determine the optimal volume of plasma that should be used to perfuse through the portal vein (PV) to washout preservation fluid in retrograde reperfusion during liver transplantation.Methods The clinical data of S0 patients who underwent orthotopic liver transplantation (OLT) using retrograde reperfusion via the inferior vena cava (IVC) in our hospital from January 2011 to October 2013 were retrospectively analyzed.The patients were divided into two groups based on the volume of plasma infused via the PV to flush out the preservation fluid.Group 1:27 patients who received 400 ml,and Group 2:23 patients who received 1 200 ml.The preoperative and intraoperative data of the two groups were compared and analyzed.The serum concentrations of K+,Na+,Ca2+,mean arterial pressure (MAP) and pH were continuously monitored in the transplant recipients at different time points during liver transplantation.In addition,for patients in Group 2,the serum K +,Na + and Ca2 + concentrations in the samples of effluent fluid from the liver grafts were collected via the anastomotic stoma of the infrahepatic IVC and measured after infusion of 200 ml,400 ml,600 ml,800 ml,1 000 ml,or 1 200 ml of plasma.Results There were no significant differences in the preoperative and intraoperative data between the two groups.The plasma concentration of K + in Group 1 was significantly higher than that of Group 2 at 1 min after PV revascularization (T3) [(4.31 ± 0.54) mmol/L vs (3.96 ± 0.58) mmol/L,P ＜ 0.05],while the pH was significantly lower in Group 1 than that of in Group 2 (7.26 ± 0.02 vs 7.30 ± 0.04,P ＜ 0.05).The plasma Na + and Ca2 +concentrations,as well as the MAP,were not significantly different between the two groups at this time point.In group 2,no significant changes were observed in Ca2+ concentration in IVC blood following perfusion of 200 ml plasma.The insignificant changes in Na + after perfusion of 400 ml of plasma and for K + after 800 ml of plasma (P ＞ 0.05).Conclusions The electrolyte concentrations,blood pressure and arterial blood pH were fairly normal after resuming flow with PV revascularization after a perfusion volume of 800 ml of plasma.This volume was the most appropriate perfusion volume,balancing its effectiveness with economy to wash out any UW solution during OLT using retrograde reperfusion.

Objective To develop a system for hand function evaluation and training based on virtual reality. Methods 5DT Data Glove 5 Ultra, Visual Studio 2010 were integrated as the development environment and DirectX 9.0 as components, and the system was developed based on the MFC programming framework. Results and Conclusion The system can assess the fingers function, recognise gestures and can be used as a 3D environment for virtual training, which may guide the patients to take the training actively.

Objective:To analyze the high risk behaviors of HIV/AIDS and its influencing factors in men who have sex with man(MSM)in a city,so as to provide evidence for the targeted intervention.Methods:Between July 2006 and October 2006,1000 MSM were sampled by snowball sampling and had a face to face interview by well trained investigators with informed consent.Questions on age,education background,and sex orientation were designated and 3 ml blood samples were obtained for examination of HIV and syphilis.?2 test and logistic regression analysis were used for statistical analysis.Results:The average age of the 1 000 MSM was 27.8?9.1 years old.In the past 6 months,43.6% of them had 3 or more male sex partners,53.6% had unprotected anal intercourse with men,8.0% had commercial sex with men,and 24.3% had sex with women.Elder subjects had a higher ratio of unprotected anal intercourse and male-female sex;subjects with lower educational background had more sex partners and male-female sex.Subjects working in the bathhouse had a higher ratio of commercial sex and male-female sex.Subjects with a male-female sex orientation or undetermined sex orientation had a higher ratio of commercial sex.Syphilis was detected in 93(9.3%)subjects and HIV was detected in 104(10.4%)subjects;among them 18 subjects had both syphilis and HIV.Multivariate logistic regression analysis showed that the aged(OR=3.5,95%CI 1.7-7.1),the number of male sex partners(OR=3.8,95%CI 1.9-7.6),the behavior of unprotected anal intercourse(OR=1.9,95%CI 1.0-3.5)and the infection of syphilis(OR=2.1,95%CI 1.4-3.4)were independently associated with the risk of HIV/AIDS prevalence;the knowledge of AIDS was the protective factor of HIV/AIDS prevalence(OR=0.5,95%CI 0.3-0.7).Conclusion:High risk behaviors of HIV exist in MSM population in the researched city;there is local epidemic of HIV.Interventions should be given according to age,educational background,sex orientation,etc.

Objective To survey the high risk behavior and infection of HIV/AIDS among men who have sex with men(MSM)and provide scientific evidence for HIV/AIDS prevention and control.Methods MSM were sampled by snowball sampling method and were interviewed by well trained investigators face to face under the informed consent.Their venous blood samples were collected for HIV seropositivity rate.Results A total of 1000 MSM,averagely aged(27.8?9.1)years,were interviewed,among whom 43.9% perceive AIDS knowledge.78.6% had anal intercourse with male partners,31.8% of whom always used condom in the past 6 months.8.0% participants had commercial sex with men in the past 6 months.The prevalence of HIV in the surveyed subjects was 10.4%.Conclusion Potential risk of HIV epidemic threatens local MSM who spread the risk to general population.High risk behavior is ubiquitous among MSM.It is imperative to carry out targeted interventions among MSM.

Objective To investigate infection pathogens and drug resistance of patients in the department of geriatrics ,so as to guide the rational use of antibacterial agents .Methods Retrospectively analysed data on clinical specimens of 1 563 cases of elderly patients from 2014 to 2013 .Results A total of 591 non‐repeated strains was isolated and the positive rate was 37 .8% .Strains mostly were isolated from sputum specimens (299 strains ,accounted for 50 .6% ) ,followed by urine specimens(171 strains ,accoun‐ted for 28 .9% ) ,secretion specimens(75 strains ,accounted for 12 .7% ) and blood specimens(15 strains ,accounted for 2 .5% ) .The isolated pathogenic bacteria mainly were gram‐negative bacteria(72 .60% ) ,which mostly were Pseudomonas aeruginosa .Acineto‐bacter baumannii ,Escherichia coli and Staphylococcus aureus has relatively high resistance rates against most of antibacterial agent . A total of 54 strains of multi‐drug resistant bacteria were isolated ,which was accounted for 56 .3% .Conclusion The pathogenic bacteria in the elderly patients mainly are gram‐negative bacteria ,pathogens have high resistance rates to antimicrobial agents ,and the multi‐drug resistance is serious ,so it is necessary to use antibacterial agents rationally based on the results of drug susceptibility tests .

Objective To assess the life quality of patients with chronic hepatitis B after the treatment of lamivudine,to find an ideal way of medical treatment for the chronic hepatitis B.Methods The quality of life of 150 patients with chronic hepatitis B and 50 healthy controls were assessed by the quality of life questionnaire.The laboratory data and marks of questionnaires were compared before and after the using of lamivudine in order to assess its comprehensive curative effect on chronic hepatitis B.Results The marks of SF-36 of chronic hepatitis were significantly different compared with those of control group (P