Objective To investigate the impact of propofol and midazolam on the time course of extubation in patients with mechanical ventilation.Methods The patients were randomly divided into the propofol group(n=37)and the midazolam group(n=52),which were further divided into three sedation stratums.The administration of two drugs were stoped immediately while weaning from the ventilator.The awakening time and extubation time of the two groups were recorded and compared with each other.Results Both awakening time and extubation time of the propofol groups were shorter than those of the midazolam group(P

Adult ; Aged ; Blood Cell Count ; Caffeic Acids ; therapeutic use ; Female ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; Male ; Middle Aged ; Tablets ; Treatment Outcome ; Young Adult

Enteral Nutrition ; Humans ; Pancreatitis ; therapy ; Parenteral Nutrition

AIM: The impaired function of vascular endothelial cells occurs popularly in hypertensive patients. Hepatocyte growth factor (HGF) plays a crucial role on impaired function, and is related to prevalence, severity and target organ damages of hypertension. This study explored the relationship between HGF gene C57488A polymorphism and essential hypertension (EH). METHODS: ①Between June and December in 2006, totally 107 EH patients with an average age of (61?9) years, in them 47 cases with family history of hypertension, were recruited in this study. Informed consents were obtained from the patients who were all the Han residents of Hefei area, and the experiment was approved by the hospital ethical committee. The hypertension criteria formulated by Chinese Medical Association included the systolic pressure ≥140 mm Hg or diastolic pressure ≥ 90 mm Hg (1 mm Hg=0.133 kPa), or having received drug therapy for hypertension over one year. The patients were administrated with hypotensive drugs with one month. Meanwhile 110 normotensives without family history of hypertension and drug therapy were served as controls, with an average age of (60?8) years. Inclusion criteria: systolic pressure 0.05).②The distributions of HGF gene C57488A polymorphism were in agreement with Hardy-Weinberg equilibrium, indicating population representativeness. The frequencies of three genotypes CC, CA, AA were 0.809, 0.170, 0.021 and C, A alleles were 0.894, 0.106 in the EH group with family history respectively. Correspondingly, the frequencies were 0.733, 0.233, 0.033 and 0.850, 0.150 respectively in the EH patients without family history. Meanwhile, the frequencies were 0.527, 0.355, 0.060 and 0.705, 0.295 respectively in the controls.③The frequencies of genotype CC and allele C were both significant higher in EH with or without family history compared with the controls (P 0.05). CONCLUSION: HGF gene C57488A polymorphism is possibly associated with EH, and genotype CC and allele C may be the factors of genetic predisposition of EH in Han population of Hefei area.

Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.

ObjectiveTo prospectively investigate whether any of the perfusion parameters would predict early tumor response to chemotherapy and/or radiotherapy and prognosis in non-small cell lung cancer (NSCLC). MethodsIn a prospective series, Perfusion CT were performed in 152 patients suspected lung cancer with 16-slice or 8-slice multislice CT. Contrast medium (50 ml) was injected at a rate of 4 ml/s with a power injector.The scanning delay was 10 seconds and the scanning time was 50 seconds.Among 152 patients,123 patients were proved lung cancer by pathology.With the perfusion 3.0 software, the parameters including blood flow (BF), blood volume (BV), mean transit time (MTT) and capillary permeability surface area product (PS) were calculated. The perfusion image quality was evaluated on a 4-1eveal scale. The treatment response after chemotherapy and(or) radiotherapy was assessed with Response Evaluation Criteria in Solid Tumors (RECIST) ,and then the relationship between perfusion parameters with early tumor response to chemotherapy and(or) radiotherapy was evaluated. Student t test and Kaplan-Meier estimates were used for data analysis. ResultsIn 84 patients (68.3%), the perfusion image quality was staged level 2 (moderate) and level 3 (good). Among them, 35 patients with NSCLC were assessed with RECIST after chemotherapy and (or) radiotherapy.In these 35 patients, The BF of responders and nonresponders was (81.0±33.6)and (56.3±23.1) ml·min~(-1)·100 g~(-1),respectively, which was significantly different(t=2.393, P=0.023). The median PFS of low-BF group (BF≤80 ml·min~(-1)· 100 g~(-1)) and high-BF group (BF>80 ml·min~(-1)·100 g~(-1)) was 11.8 and 8.0 months respectively (P>0.05), and the median PFS of low-BV group (BF≤6 ml/100 g~(-1)) and high-BV group (BF>6 ml/100 g~(-1)) was 9.2 and 8.0 months respectively(P>0.05), both of them were not significantly different.ConclusionNSCLC in high perfusion are relatively sensitive to chemotherapy and/or radiotherapy, and the response rate is relatively higher, but the progress time is relatively shorter.

Objective To evaluate the diagnostic value of computer-aided diagnosis with three-dimensional volumetric measurement in solid pulmonary nodules on follow-up CT. Methods Forty-six patients with 58 solid nodules were evaluated.Each patient underwent chest CT at least twice.The volume, doubling times(DTs) and volumetric growth rates(VGRs) of nodules were calculated with three-dimensional volumetric measurement software. If there were significant statistical differences in DTs between malignant and benign nodules, Nonparametric test was used to make the analysis.If there were significant statistical differences in upper DTs'values between malignant and benign nodules, X2 test was used to make the analysis.Final diagnosis of all nodule were confirmed by pathology or by response to diagnostic therapy or by clinical follow-up.Results The DTs of 13 malignant nodules were <400 days in 12 nodules, with a range from 45 to 465 days (median, 159 days) ; the VGRs ranged from 8% to 329% (median, 30.0%).The VGRs of 45 benign nodules ranged from -38% to 24% (median, 0%).The DTs of 24 benign nodules that increased or not changed in size were >400 days in 22 nodules, with a range from 302 days to 55 158 days (median, 2 704 days); the VGRs ranged from 0 to 24% (median, 6.5%. Twenty-one nodules that decreased in size had the VGRs ranging from -38% to -4% (median, - 16.0%), and the DTs of these nodules could not be calculated by software.There were significant statistical differences in DTs between malignant and benign nodules(P <0.05).Taking 500 days, 400 days and 300 days as the upper value for malignancies there were statistically significant differences in these values between malignant and benign nodules(P < 0.01).Their sensitivities were 100.0%, 92.3%, 76.9% respectively and specificities were 87.5%, 91.7%, 100.0% respectively.Accuracies were 91.9%, 94.6% ,91.9% respectively and positive predictive values were 8,11,0.Conclusions Taking 400 days as the upper DTs'value for malignancies has important diagnostic value. Computer-aided diagnosis with three-dimensional volumetric measurement is sensitive to the volume changes of solid pulmonary nodules on follow-up CT, and is useful in the differential diagnosis of pulmonary nodules.

Objective: To observe the clinical efficacy of warm needling plus tuina in treating senile functional constipation. ＜br> Methods: Ninety elderly patients with functional constipation were randomized into two groups. Forty-six patients in the treatment group were intervened by warm needling plus tuina; the other forty-four patients in the control group were intervened bySan Huang tablet. ＜br> Results: In the treatment group, 19 patients were cured, 24 cases showed improvement, 3 cases failed, and the total effective rate was 93.5%; in the control group, 16 patients were cured, 18 cases showed improvement, 10 cases failed, and the total effective rate was 77.3%. There was a significant difference in comparing the therapeutic efficacy (P＜0.05), and the therapeutic efficacy of the treatment group was higher than that of the control group. ＜br> Conclusion: Warm needling plus tuina can produce a higher therapeutic efficacy than takingSan Huang tablet in treating senile functional constipation.

Objective To explore and analyze the clinical curative effect and prognosis of enteric -coated aspirin combined with clopidogrel in the treatment of unstable angina pectoris of coronary heart disease.Methods 84 patients with unstable coronary heart disease angina pectoris were selected in the research,and they were divided into regular treatment group and combination group,42 cases in each group.The patients in conventional treatment group were given enteric -coated aspirin therapy,and the combined treatment group were given clopidogrel on the basis of routine treatment.The myocardial enzymology indexes of 24h before and after drug treatment,electrocardio-gram (ECG)recovery,curative effect and adverse reaction were compared between the two groups.Results After treatment,the myocardial enzymology indexes of the combined treatment group (AST,CK -MB,cTnT,cTnI)had sig-nificant differences compared with the general treatment group (t =3.98,P <0.05,t =0.05,P <0.05,t =0.05,P <0.05,t =0.05,P <0.05).After treatment,the ECG total recovery rate of the combination group increased obviously compared with the conventional treatment group,the difference between the two groups was significant (χ2 =5.49, P <0.05).The total effective rate of the combined treatment group increased obviously compared with the conventional treatment group,the difference between the two groups was significant (90.5% vs 64.3%,χ2 =4.48,P <0.05).The incidence rate of adverse reactions had no obvious difference between the two groups (83.3% vs 66.7%,χ2 =2.88, P >0.05).Conclusion Drug combination therapy in the treatment of unstable type of coronary heart disease angina pectoris can synergistically improve clinical symptoms and physical fitness,improve patients'quality of life,it is safe and reliable,which is worth popularization and application widely.

Up to now,there are 21 ministry of education innovation teams established by 37 independent medical colleges and universities,which has become an important part of the medical education system innovation team building.From the perspective of SWOT (strengths,weaknesses,opportunities,threats) analysis,in the process of ministry of education innovation team establishment in the independent medical colleges,there are unique advantages,followed by obvious disadvantages,and there are favorable outside opportunities,accompanied with unprecedented challenges.Independent medical colleges shall keep up with the development trend,leverage the national regional development policy,give full play to the advantages,endeavor to overcome weaknesses,seize the opportunities and face the challenges actively,make the right strategic decisions,in order to better play an irreplaceable role in higher medical education system.