Objective To study the protective effects of propofol against ischemia-reperfusion injury in rat brains.Methods Modified Longa modle of focal cerebral ischemia-reperfusion injury was used. 200 healthy male SD rats, weighing 200-300g were anesthetized with intraperitoneal(I.P.) ketamine and propofol. When righting reflx was abolished, external carotid artery was exposed. A nylon thread with rounded end was inserted cranially until anterior cerebral artery was reached. After 3h ischemia nylon thread was withdrawn for reperfusion which lasted 3h. Bloos samples were obtained from orbit. Skull was opened and brain removed. In control group carotid artery was exposed but nylon thread was not inserted cranially. The animals were divided into four groups: (1)ischemia-reperfusion model group: normal saline 10 ml was administered I.P.,(2)operation control group: normal saline was given I.P.at the end of operation,(3)nimodipine group: nimodipine 1 mg?kg -1 was administered I.P. 10 min before ischemia,(4) propofol group: propofol 110 mg?kg -1 was given I.P. 10 min before ischemia. Brain infarction area, cerebral water content, serum lactate dehydrogenase(LDH) and creatine kinase(CK) levels,brain SOD activity and MDA and Ca 2+ levels were measured. Ultrastracture of brain tissue was examined by electron microscopy.Results Propofol 110 mg?kg -1 reduced mortality after brain ischemia/reperfusion injury. Infarction area of brain was significantly smaller in propofol and nimodipine groups than that in group 1. Propofol significantly inhibited the increases in serum LDH and CK levels induced by ischemia/reperfusion, increased SOD activity and decreased MDA content and Ca 2+ level in brain tissue. There was less brain tissue damage in propofol group.Conclusions Propofol 110 mg?kg -1 has protective effect against cerebral ischemia-reperfusion injury in rats.

Objective To summarize the causes and the prevention of bile duct injuries during laparoscopic cholecystectomy (LC). Methods Clinical records of 1 000 cases of LC were analyzed retrospectively. Results Conversions to open cholecystectomy were required in 15 cases(1.5%). Complications took place in 6 cases(0.6%), involving 3 cases of common bile duct injury, 1 case of stomach puncture, 1 case of port hemorrhage, and 1 case of bile leakage. No long-term complications were seen. Conclusions The most frequent cause leading to bile duct injuries is pulling the bile duct to be angulated.

AIM: To study the up-regulation of inducible nitric oxide synthase (iNOS) in lung of pulmonary fibrosis and its relationship with fibrosis. METHODS: The changes of amount of iNOS positive stain cells and type Ⅰ?Ⅲ collagen were examined on the day 7, 14 and 30 after intratracheal administration of bleomycin A_5. The contents of NO-_2/NO-_3 (nitrite/nitrate) in out-flowing pulmonary blood (OPB), hydroxyproline in lung and the histological changes were detected after iNOS was blocked by aminoguanidine (AG). RESULTS: (1) The number of iNOS-positive stain cells increased significantly in BLMA_5 7 d, 14 d and 30 d groups compared with that in control group (P

Objective To realize the distribution and change in antimicrobial resistance of common pathogens causing acute lower respiratory tract infection (LRTI)in children,and provide evidence for rational use of antimicrobial agents. Methods Data about pathogens from children with LRTI in a hospital between January 2011 and December 2013 were ana-lyzed statistically.Results Of 934 isoalted pathogenic strains,728 (77.94%)were gram-negative bacteria,the major were Klebsiella pneumoniae (n =278),Escherichia coli (n =216),Enterobacter cloacae (n =85 ),and Pseudomonas aeruginosa (n=63).The isolation rate of gram-positive bacteria was 20.87%(n=195),the major were Staphylococcus aureus (n=132)and Streptococcus pneumoniae (n=49).Antimicrobial susceptibility testing results revealed that sensitive rate of gram-negative bacteria to imipenem,meropenem,and amikacin were all 100.00%,to ceftazidime/clavulanic acid and piperacillin/tazobactam were relatively low,to cephalosporins increased year by year.Sensitive rates of the main gram-positive bacteria to vancomycin were both 100.00%, to erythromycin and clindamycin were relatively low. Conclusion The major pathogenic bacteria causing LRTI in pediatric department are gram-negative bacteria,antimicrobial resistance rates increased year by year,management of antimicrobial use in children should be strengthened to prevent the occurrence of multidrug-resistant organism infection.

Objective To investigate the statistical methods used in nursing papers for bachelor's degree. Method We collected 160 nursing theses for bachelor's degree in 2016 in our college and analyze the statistical methods. Results A total of 80 papers used statistical methods consisting of statistical table, statistical inference, single factor analysis, variance analysis and statistical description. Among them, the statistical methods in 66 papers (82.5%) were misused. About 139 misuses of statistical tables was found in papers, and about 23 misuses of statistical inference in papers, taking up 45.4%. Conclusions The nursing undergraduates are familiar with the application of statistical methods, but the methods tend to be simple and unitary. Therefore, it is a need to enhance their practice in using statistical methods.

The application of continuous quality improvement program in standardized residency training examination in the central Hospital of Shanghai Jiading was introduced to inquire into the way to improve the quality of standardized training of resident doctors. Through the steps of FOCUS-PDCA, we continuously improved the examination content and quality compliance training personnel, and developed the examination process including test, training, supervision, learning and using. After the implementation of the project, the percentage of the departments that meet the residency training examination requirements has been increased from 33.3%to 100%in our hospital. The percentage of the students that passed the licensed medical skills examination was 96.6%in that year. 100%of the students passed the graduation comprehen-sive examination. Year-end evaluation showed that the students' satisfaction degree to the teachers increased from 94.5%to 98.2%. Thus, through the implementation of CQI project, we achieved the goal of promoting teaching and promoting learning.

Objective:To investigate the knowledge level on AIDS among medical staff in Xianyang city and provide evidence for performing health education and training on occupational protection.Method:Medical staffs including doctors,nurses,laboratory workers and administrators from 17 different rank hospitals in Xianyang city were enrolled in the investigation.Result:1046 questionnaires were collected back.The average accurate response rates about basic knowledge,transmission,diagnosis and treatment were 52.5%,36.3% and 30.1%,respectively.Sex,age,education level,professional title,nature of work and the grades of units have showed correlation with the knowledge levels of AIDS(P

Objective To investigate the influence of the two-dimension computer-aided surgery navigation system to the concordance of lumbar spine pedicle screw fixation on both sides.Methods 1355 patients were undergone lumbar spinal pedicle screw fixation during January 2004 to December 2009.All patients were divided into tow groups:the navigation group (743cases) and the fluoroscopy assistant group (612 cases).All patients got standard A-P and lateral X-ray plate of lumbar spine within seven days after surgery.The X-ray images were analyzed by the software of Image-pro plus 5.0 to evaluate the concordance of lumbar spine pedicle screw fixation on both sides.The angle between axial line of pedicle screw and superior lamina terminals (α angle) and the angle between axial lines of pedicle screw on both sides (γangle) were measured.The position of the pedicle screw was checked weather it was in the lumbar pedicle partially.Results There were no significant differences (P＞0.05) between the α angle on both sides of L1-S5 vertebral body in navigation assistant group (L:3.89°±0.47°,R:3.94°±0.37°).The differences of the α angle on both sides of L2 (L:4.55°±1.27°,R:5.12°±1.87°) and L4 (L:4.22°±1.89°,R:6.62°±1.97°) vertebral body in the fluoroscopy assistant group had statistical significance (P＜0.05).There were no significant differences between the α angle on both sides of other bodies (L:4.32°±1.47°,R:4.37°±1.59°,P＞0.05).The γangle in navigation assistant group (2.32°± 0.27°) was obviously smaller than fluoroscopy assistant group (3.32°±1.51°),the differences had statistical significance (P＜0.05).Accuracy of pedicle screw in navigation assistant group was 91.5％ (3604/3938).Accuracy of pedicle screw in fluoroscopy assistant group was 87.6％ (2426/2768).The difference in accuracy of pedicle screw in both groups had statistical significance (x2=26.913,P＜0.0001).Conclusion The accuracy of pedicle screw and the concordance of pedicle screw on both sides can be significantly improved using the two-dimension perspective computer-aided surgery navigation system.

Objective To investigate the influence of C arm X- ray perspective computer auxiliary surgery navigation system on lumbar vertebral pedicle screw fixation in the elderly.Methods 286 patients(aged≥65 years) treated by lumbar spine post decompress and pedicle screw fixation for lumbar vertebral degeneration were divided into navigation (n=153) or non-navigation (n=133) groups.The amount of blood loss,surgery duration and time of beginning to walk after surgery were measured and compared, the improvement grading was determined by Oswestry disability index (ODI) before surgery and at the last follow-up. Results The surgery duration [(27.6+6.3)ain vs.(33.8±9.9)min],the volume of blood loss[(135.7±21.1)ml vs.(165.4±32.1)ml] and the time of beginning to walk after surgery[(134.6± 12.3)h vs.(169.0±23.9)h] were obviously reduced in navigation group as compared with non-navigation group (P ＜ 0.05). The grading improvement rate by ODI[(76.6±±3.7)％vs.(69.8+6.6)％] was higher in navigation group than in non navigation group (P＜0.05). Conclusions Using C arm X-ray perspective computer auxiliary surgery navigation system to lumbar pedicle screws fixation is helpful in the elderly for improving clinical efficacy.

BACKGROUND: In clinical, propofol can contract cerebral vessels, decrease cerebral blood flow, decrease brain metabolic oxygen consumption,which can decrease pressure in brain. Studies prove that propofol can protect endothelial cell that may be injuried by active oxygen injury and also decrease nerves injury of experimental rats with cerebral ischemia.OBJECTIVE: To investigate the protective effects of propofol on cerebral ischemia-reperfusion injury in rat and its mechanism.DESIGN: Randomized and controlled study.SETTING:Anesthesiological Department of the Second Affiliated Hospital of Xi'an Jiaotong University.PARTICIPANTS: The experiment was conducted at Pharmacological Laboratory of Medical College of Xi' an Jiaotong University in 2004. Totally 40 healthy male SD rats, aged 3-4 months, weighting 200-300 g, were divided randomly into four groups: Model group, control group, nimodipine group and propofol group, with 10 in each group.METHODS: The rats were anesthetized by intraperitoneal methods with ketamine and propofol separately. When righting reflex was abolished, external carotid artery was separated and ligated. A nylon thread was put at the stump site of external carotid artery without ligation. Model group: 10 mL normal saline was injected into intraperitone in 10 minutes before ischemia.Control group: 10 mL normal saline was injected into intraperitone at the end of operation. Nimodipine group: 10 g/L nimodipine (1 mg/kg) was injected into intraperitone in10 minutes before ischemia. Propofol group: 10 g/L propofol (110 mg/Kg) was injected into intraperitone in 10 minutes before ischemia. When ischemia was lasted for 3 hours, nylon thread was with drawed for reperfusion. When reperfusion was lasted for 3 hours, blood samples were obtained from orbit. Skulls were opened and brains were removed.Effect of propofol on cerebral ischemia-reperfusion injury was observed.MAIN OUTCOME MEASURES: Infarction area, cerebral water content,serum lactate dehydrogenase (LDH) and creatine kinase (CK) levels, brain superoxide dismutase (SOD) activity, malondialdehyde (MDA) and Ca2+levels were measured. Ultrastructure of brain tissue was examined under electron microscope.RESULTS: ①Infarct area in propofol group was significantly smaller than that in model group [(10.45±3.65, 19.68±4.03)%, (t=3.493,P ＜ 0.01)]. ② CK level was lower in propofol group than that in model group [(471±200,1 930±917) IU/L, (t=3.493, P ＜ 0.01)]; and LDH level in propofol group [(8 240±2 580) U/L] was significantly different from that in model group [(15 470±2 680) U/L, (t=3.441, P ＜ 0.01)]; And water content in brain tissue was lower in propofol group than that in model group [(78.2±2.4,82.9±2.9)%, (t=3.321, P ＜ 0.01)]. ③ The death rate of rats was 13.6%in propofol group, and 47.6% in model group, the former was decreased obviously as compared with the latter, and the difference was significant (t=6.21,P ＜ 0.05). ④ SOD activity was (1 690±780) U/g in propofol group and (830±110) U/g in model group, the difference was significant (t=3.420, P ＜ 0.01); but MDA content was obviously lower in propofol group than that in model group [(0.058±0.014, 0.115±0.047) μmol/g, (t=3.336, P ＜ 0.01)].CONCLUSION: Propofol has protective effect on cerebral ischemia-reper fusion injury in rats, and the mechanism is related with inhibition of Ca2+overloading and lipid peroxidation.