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 evaluate the blood-saving effect of tranexamic acid in elderly patients undergoing total hip replacement.Methods One hundred and sixty ASA Ⅱ or Ⅲ patientss of both sexes,aged 65-70 yr,with a body mass index of 16-22kg/m2,undergoing total hip replacement,were randomly divided into 2 groups(n =80,each):control group(group C)and tranexamic acid group(group T).Anesthesia was induced with midazolam,fentanyl,etomidate and atracurium.The patients were tracheal intubated and mechanically ventilated.PEr CO2 was maintained at 35-45 mm Hg.Aneslhesia was maintained with propofol,remifentanil and atracurium.Before the skin incision,tranexamic acid 15 mg/kg was infused over 15 m in in group T,while the equal volume of normal saline was given instead in group C.Hemoglobin(Hb),platelet count(PLT),prothrombin time(PT),and activated partial thromboplastin time(APTT)were monitored during operation to guide blood transfusion.Intraoperative and postoperative blood loss and allogeneic blood transfusion were recorded.Postoperative complications were also recorded.Results There was no significant difference in the amount of intraoperative blood loss between the two groups(P ＞ 0.05).The amount of postoperative blood loss was significantly smaller and less allogeneic red blood cell was transfused in group T than in group C(P ＜ 0.05).No complications occurred after operation in either group.Conchusion Tranexamic acid has blood-saving effect in elderly patients undergoing total hip replacement,but the clinical value is limited.

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.

Matrix metalloproteinase (MMP)plays an important role in the degradation of extracellular matrix components,which is crucial for tumor growth,invasion and metastasis.As one with the largest relative molecular mass in MMP family,MMP-9 takes part in the generation and progression of colorectal cancer. Research shows that MMP-9 can be used for the early diagnosis of colorectal cancer.The expression levels of MMP-9 in tissue and plasma are negatively correlated with prognosis of the postoperative patients with colorectal cancer.In addition,targeted therapy drugs will be designed on the basis of MMP-9 expression increased in colorectal cancer.

Objective To explore the clinical value of video-assisted thoracoscopic mediastinal tumor resection.Methods The clinical data of 32 patients(observation group) who performed video-assisted thoracoscopic mediastinal tumor resection were retrospectively analyzed,compared them with 53 patients with mediastinal tumor who underwent traditional thoracotomy (control group).The clinical outcomes including operation time,intraoperative blood loss,chest drainage duration,postoperative hospital stay,postoperative complication and postoperative analgesia drug application were compared between two groups.Results No perioperative death was observed in two groups.There were no statistical difference in operation time between two groups [(121.9 ± 41.2) min vs.(141.7 ± 35.2) min] (P ＞ 0.05).The observation group was significantly better in the intraoperative blood loss [(116.0 ±53.2) ml],chest drainage duration [(5.2 ± 1.2) d],postoperative hospital stay [(8.5 ± 1.3) d],postoperative analgesia drug application [(0.8 ± 0.7) times],postoperative comolication (3 cases),than those of the control group [(147.2 ± 45.2) ml,(6.8 ± 2.2) d,(11.2 ± 2.4) d,(2.1 ± 0.9) times,15 cases].There were statistical differences between two groups (P ＜0.05).Conclusion Complete video-assisted thoracoscopic mediastinal tumor resection is a valuable way in the treatment of mediastinal tumor,rapidly recovery and less postoperative complication.

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.