Contraindications ; Desensitization, Immunologic ; Humans

Objective To observe vancomycin and vancomycin in elderly patients with renal toxicity.Methods 105 cases because of infection from March 2013 to October 2014 were collected and randomly divided into two groups, one had 52 patients and were given vancomycin for anti-infection treatment, another group had 53 patients and were given norvancomycin for anti-infective treatment.Changes of serum urea nitrogen and creatinine levels and adverse reactions were observed and compared between two groups.Results Creatinine levels of patients with vancomycin group after 10 days and 7 days after withdrawal were (97.86 ±8.27)μmoI/L, (82.03 ±5.72)μmoI/L, and the norvancomycin group were (98.67 ±8.34)μmoI/L, (83.47 ± 5.91)μmoI/L, the difference were not significant.Urea nitrogen levels of patients with vancomycin group after 10 days and 7 days after withdrawal were (6.71 ±1.15)mmoI/L,(6.09 ±1.09)mmoI/L, respectively, and the norvancomycin group were(6.75 ±1.17)mmoI/L,(6.15 ±1.12)mmoI/L, the difference were not statistically significant.The total effective rate of vancomycin group was 78.85%, and norvancomycin group was 75.47%, the difference was not statistically significant.Adverse reactions of vancomycin group during treatment was 13.46%, and norvancomycin group was 13.21%, the difference was not statistically significant.Conclusion Vancomycin and norvancomycinboth have anti-infective effect on renal function in patients with certain adverse effects, urea nitrogen, creatinine levels in two groups were elevated during treatment, but decreased after withdrawing medicine.

Objective To investigate the safety and efficacy of same session ureteroscopical lithotripsy as a valuable treatment for the bilateral upper urinary stones.Methods 32 cases with bilateral upper urinary stones were enrolled into this study from Jan 2013 to Dec,including 19 male and 13 female.The age ranged from 19 to 79 years old [mean (53.2 ± 14.2) years old].Ultrasound,CT and IVU were used to evaluate the details about the stone burden,number and location.The total stone burden was (23.7± 7.6)mm,ranged from 14 to 40mm.The kidney stone burden ranged from 0 to 37mm [mean (15.4 ±9.7)mm].and ureter stone burden ranged from 0 to 34 mm [mean (8.2 ±7.2)mm].Total stone number was 109,including 78 stones in kidney and 31 stones in ureter.23 (71.9％) patients had stents placed before the surgery.All the patients were treated with FURL and(or) URL by the same surgeon under general anesthesia,and C arm was used routinely to monitor the position of the guide wire,sheath and residual stones.The stents were placed for 2 to 4 weeks post-operatively.The ureteral catheters were placed for 24 to 48 hours.Stone-free rates(SFRs) were judged by KUB and(or)NCCT on the first day after the surgery and one month after withdraw the stent.The number of procedures,operative duration,hospital stay,SFRs in different time phase,serum creatinine,stone composition and complications were evaluated.All patients were divided into low burden group and high burden group,based on the borderline of stone burden (20mm).The SFR and complication was compared among those group.Results Among 32 cases,30 cases underwent the one stage procedure and 2 cases underwent two stage procedure.Operative time was (99.2 ± 32.5) mins.There was no significant difference of serum creatinines before and after the surgery.[(78.3 ± 15.0) μmoL/L vs.(77.9 ± 15.3) μmol/L,P =0.711].The overall SFRs aftcr 1,2 procedures were 84.0％ (27/32) and 91.0％ (29/32),respectively.The immediate SFRs for patients with a preoperative stone burden ≤20 and ＞20 mm showed significant difference(100％ vs.50％,P =0.002).Only 5 minor postoperative complications,including fever in 4 patients,hematuria in 1 were recorded.Longterm complication,such as ureteral stricture,was not noticed.Conclusions For selected cases with bilateral upper urinary stones,bilateral same-session ureteroscopy is effective and safe with little influence on the kidney function.For those whose stone burden less than 20mm,the immediate SFRs are much higher.

AIM:To investigate the role of JAK-STAT pathway , IL-1βand IL-6 in the PC12 cells with X-ray irradiation.METHODS:The PC12 cells were irradiated with X-ray at doses of 2, 4 and 8 Gy.After 24 h, the levels of IL-1βand IL-6 were detected by ELISA .The protein levels of p-JAK1, p-JAK2, p-STAT1, p-STAT3 and p-STAT5 were measured by Western blot .RESULTS:Compared with control group , the levels of IL-1βand IL-6 increased .The protein levels of p-JAK1, p-JAK2, p-STAT1, p-STAT3 and p-STAT5 increased with the doses of X-ray exposed.CONCLUSION:JAK-STAT signaling pathway , IL-1βand IL-6 play a role in the injury of PC12 cells with X-ray irradiation.

Objective To measure 95% effective doses (ED95) of propofol and etomidate by using up-down intravenous administration method, and compare the potency ratio and the anesthesia duration of them. Methods Twenty eight male SD rats were divided into two groups randomly: the propofol group and the etomidate group. Loss of righting reflex was regarded as the judgment index of unconsciousness. The dose-response curve was made according to the formula of Y=Ymin+(Ymax-Ymin)/ [1+10log(ED50-X)× m]. Values of ED95 of propofol and etomidate were calculated, and the anesthesia duration periods after administration of the two equivalent dose drugs were measured respectively. Results The values of ED95 were 9 mg/kg and 1.5 mg/kg for propofol and etomidate. The ED95 ratio for propofol and etomidate was 6. There was a significant difference in anesthesia duration between propofol group (465.6±18.5)s and etomidate group (233.7±9.3)s (P<0.05). Conclusion The anesthesia duration of propofol is longer than that of etomidate, taking the ED95 as equivalent dose.

Objective To investigate the association between the expression of heparanase(Hpa) and the invasion of choriocarcinoma by studying the expression of Hpa in human choriocarcinoma cell lines JEG-3 and JAR and human chorionic villous tissues.Methods(1)Matrigcl invasion assays were used to detect in vitro invasive ability of JEG-3 cells and JAR cells.(2)Expression of Hpa protein in the human chorionic villous tissues and choriocarcinoma cell lines(JEG-3 cells and JAR cells)were detected by immunocytochemistry and western blot.Results(1)The invasive cell number was significantly larger in JEG-3 cells than in JAR cells(191?17 vs 106?13,P

ObjectiveTo explore the effective way of first aid skill standard training in regional central hospital.Methods60 residents from different regional central hospitals were received aid skills training based on two ways:namely OSCE ( multi-station structured skills test ) which lay particular em phasis on skills and traditional face to face way; and were assessed by uniform standards.ResultsThe scores of residents who received OSCE training were significantly better than those which received traditional face to face training ( P＜0.05 ),including.ECG,cardiopulmonary resuscitation,endotracheal intubation and doctor examination.ConclusionFirst aid skills standard training used by OSCE approach in regional central hospital can improve their first aid skills and should be promoted.

Objective To promote preventive and therapeutic measures for osteoporosis by investigating the prevalence of low bone mineral density (BMD) in connective tissue disease patients who were taking corticosteroid and identify the associated risk factors of osteoporosis.Methods Thirty-eight female patients who had connective tissue diseases and were taking corticosteroid in PU MCH rheumatology outpatient clinic were studied and followed up from Oct 2006 to April 2007.Lumber spine and right femoral bone mineral density were determined bv dual energy X ray absortiometry (DEXA).Clinical information was obtained from a questionnaire of history and medical records.Duration and accumulative dosage of glucocorticoid intaking.menopause time were obtained retrospectively.Correlation analysis between BMD and clinical information was conducted.Results ① In 38 patients,23 (61%) patients showed a normal BMD,10 (26%) were osteopenia,3 (8%) were iu the osteoporotic range,while 2 patienLs (53%) had fragile fracture.② Compared with patients with normal BMD,subjects with low BMD had significantly older age,longer period after menopause and higher accumulated dose of corticosteroids.③ Postmenopausal women had significantly lower BMD in lumber and hip than premenopausal women.④ Either of vertebral and right hip BMD correlated negatively with the accumulated dosage of cortieosteroids by simple linear regression.⑤ The correlation between BMD and accumulated dosage of corticosteroids improved after correcting for the effect of age by partial correlation analysis (Pearson partial vertebral r=-0.8,P=0.009;right hip r=-0.3,P=0.010).⑥ A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinicsl factors studied and a low BMD.Two statistically significant variables were menopause status (P=0.0000) and a higher steroid accumulated dosage (P=0.008).Conclusion Low BMD is common in connective tissue disease patients receiving corticosteroid.Risk factors for low BMD are postmenopause.duration and the accumulated dosage of glucocorticosteroid.The high prevalence of low BMD implies that more attention should be paid to the prevention and treatment of osteoporosis and fractures in connective tissue disease patients who are taking corticosteroids.

Objective To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on sedative efficacy during induction of anesthesia with propofol.Methods Patients,of ASA physical status Ⅰ or Ⅱ,aged 21-69 yr,scheduled for elective thyroid surgery,were randomly divided into 2 groups using a random number table:control group (group C) and TEAS group.TEAS was applied to bilateral Hegu and Neiguan acupoints for 30 min.The frequency was 2/100 Hz,wave length was 0.2-0.6 ms and the intensity was maintained at about 8-12 mA according to the current that could be tolerated.Induction of anesthesia was started at the end of TEAS.Sequential method was used to determine the median effective target plasma concentration (EC50) of propofol causing loss of consciousness in each group.The initial target plasma concentration of propofol was 3 μg/ml.BIS value was recorded every 30 s within 5-8 min after loss of consciousness and the average BIS value was calculated.It was considered to be positive response when the average BIS value was below 50.The target concentration of propofol was decreased/increased by 0.3 μg/ml in the next patient.Results EC50 of propofol causing loss of consciousness was 3.08 μg/ml in group TEAS,and 3.70 μg/ml in group C,and there was significant difference between the two groups.Conclusion TEAS can enhance the sedative efficacy during induction of anesthesia with propofol in the patients.

With the rapid development of computer technology and informatization of the society,hospital network security and reliability becomes more and more important.According to HIS maintenance in our hospital,this paper discusses security measures in hospital from such aspects as system security,data security,network security,and security management.