Contraindications ; Desensitization, Immunologic ; Humans

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 measure the distances among anatomic points of bony orbit of Chinese Han-nationality adults. Methods: Bony orbits were measured with the special measuring tools in 86 Chinese adults (62 males and 24 famales), and the results were statistically analysed. Results: Difference between the left and right obits was observed in orbital width, medial distance of superior orbital foramen a and inferior foramen a and c in males. Difference between bilateral orbits was also observed in orbital width and anterior distance of superior orbital fissure in females. Normal values of the distances of anatomic points of adult orbits were then calculated. Conclusion: Normal values of the distances of anatomic points of orbit of male and female adults are concluded.

AIM: To study the curative effect for patients with age related cataract and shallow anterior chamber after phacoemulsification.METHODS: Totally 38 patients (38 eyes) with age related cataract and shallow anterior chamber were selected and divided into two groups according to the depth of the anterior chamber, as mild shallow anterior chamber group (2-2.5mm) 23 eyes, high risk shallow anterior chamber group (<2.0mm) 15 eyes.Thirty-eight patients (38 eyes) with age related cataract with normal anterior chamber were as control group at the same period.All the patients received the operations by the same doctor and were followed up for 3mo.The observed items included visual acuity before and after operations, intraocular pressure, anterior chamber depth, corneal endothelial cell density and complications.RESULTS: There were no significant difference on visual acuity, intraocular pressure and corneal endothelial cell density between the two groups before operations (P>0.05).The visual acuity improved significantly after operation in both groups (P<0.05).Intraocular pressure after operation decreased significantly in both groups (P<0.05).Anterior chamber depth increased significantly after operation in both groups (P<0.05).Corneal endothelial cell density decreased significantly in both groups (P<0.05).There were no significant difference on anterior chamber depth, intraocular pressure and corneal endothelial cell density between the two groups at different time point after operations (P>0.05).Posterior capsular rupture occurred in shallow anterior chamber group in 1 eye, suspensory ligament rupture in 1 eye.Posterior capsular rupture and suspensory ligament rupture occurred none in normal anterior chamber group.Postoperative corneal edema occurred in 10 eyes (26%) in shallow anterior chamber group, which occurred in 3 eyes (8%) in normal anterior chamber group.The difference on the incidence was significant (P <0.05).CONCLUSION: Phacoemulsification should be taken timely for patients with age related cataract and shallow anterior chamber.The postoperative visual acuity can be improved and the anterior chamber depth can increase.The operation is safe and effective for those 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.

The migration of endothelial cell induced by fluid shear stress is related to many physiological and pathological responses in organism.The redistribution of membrane receptors and proteins,caused by shear stress,is a vital step for cell migration,followed by chemical reactions and signal transduction.Then cell morphological changes are induced,such as polarity,protrusion,and adhesion,which lead to the migration of endothelial cell at last.The goal of this paper is to review what is known about the mechanical models of endothelial cell migration and the responses of cells to fluid flow.It is helpful for better understanding the intrinsic mechanism of mechano-chemical signal pathway of the migration of endothelial cells induced by fluid shear stress.

Objective:To investigate cerebral angiography Features of patients with ischemic cerebrovascular disease.Methods:One hundred and twenty seven patients with ischemic cerebrovascular disease were selected in our hospital from March 2013 to April 2015, statistical analysis of their cerebral angiography differences at different ages, different types of ischemic cerebrovascular disease.Results: One hundred and twenty seven patients were found 97 patients(76.4%) had cerebral artery occlusion or stenosis, simple intracranial stenosis 40 cases, 31 cases of simple extracranial stenosis, 26 intracranial and extracranial stenosis cases; on the view of age, young patients with simple intracranial stenosis (69.2%), while the proportion of elderly patients in intracranial and extracranial stenosis was 40.5%, significantly higher than the proportion of old and middle-aged patients; patients with ischemic cerebrovascular disease at different types of stenosis and stenosis had no significant difference.Conclusion: Patients with ischemic cerebrovascular disease in different age have different distribution and different stenosis, especially in the largest proportion of young patients with occlusion, while parts of the brain in patients with vascular stenosis and stenosis and ischemic cerebrovascular disease the type was no significant association.

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.

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 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.