Objective To analyze the risk factors associated with respiratory dysfunction (ARD) in patients with DeBakey type Ⅰ aortic dissection after operation and provide the measures for prevention and treatment.Methods Retrospectively analyzed the clinical data of DeBakey Ⅰ type aortic dissection 18 patients under deep hypothermic cardiopulmonary bypass from September 2008 to March 2012 in the application of the three-branch type aortic arch endovascular stent.Recorded age,sex,preoperative complication,with or without perfusion badness syndrome,cardiopulmonary bypass time and aortic cross-clamping time.Monitoring preoperative and postoperative blood gas analysis,chest X-ray,ventilator parameters,intraoperative and postoperative blood transfusion.The single factor analysis of the risk factors associated with postoperative ARD was analyzed.Results No patient died in peroperative period.Five patients (27.8％) was in perfusion badness syndrome preoperative,8 patients (44.4％) was in ARD postoperative.Three patients (16.7％) occurred within 72 h and 5 patients (27.8％) occurred within 48 h.Three patients (16.7％) performed incision of tracheal for the duration of mechanical ventilation for more than 7 d.Correlation factor analysis showed that BMI (P =0.047),cireulatory arrest time (P =0.035) had correlation with postoperative ARD.Conclusions ARD is a common complication during perioperative.It can be correctable by pay full attention to the risk factors,and the prognosis is good.

This article analyzes the characteristics of lymph node metastasis in proximal advanced gastric cancer,in order to guide the extent of stomach resection (proximal or total gastrectomy) and the resection of spleen or splenic preservation. The metastasis of lymph node in proximal advanced gastric cancer has certain characteristics, which can provide a significant guidance for lymphadenectomy. Total gastrectomy plus splenectomy is a feasible radical surgery for proximal advanced gastric cancer, because of the requirement of lymphadenectomy.

Objective To investigate and analyze the reference ranges of the common parameters of venous blood cell analysis a ‐mong healthy adults in Kunshan City .Methods The analytical results of venous blood cells from 2 456 healthy adults were selected and the ten indicators of red blood cell ,hemoglobin ,mean corpuscular volume ,mean corpuscular hemoglobin concentration ,mean corpuscular hemoglobin ,hematocrit ,white blood cell ,lymphocytes percentage ,neatrophilic granulocyte percentage ,blood platelet were statistically analyzed by adopting the SPSS 19 .0 software .Results The commonly used 10 parameters of blood cells showed a skewed distribution ,the Mann‐Whitney U tests showed that the gender difference in 10 parameters was statistically significant (P<0 .05) ;the WBC count was slightly higher than that reported by other literature ,the other 9 parameters were close to those reported by the majority of related literature .Conclusion The commonly used parameters of blood cell analysis are influenced by the region , gender ,environment ,living condition and detection instrument ,and it is necessary to establish the reference ranges for each labora‐tory .

Objective To study the significance of serum IL-17 level in patients with acute coronary syndrome (ACS ) before and after rosuvastatin treatment .Methods Forty-eight ACS patients served as group A and 30 stable angina pectoris patients served as group B in this study .T heir blood-lipid level and serum hs-CRP and myocardial enzyme levels were measured and the number of coronary artery branches with lesions was calculated .Their association with serum IL-17 level was analyzed .Patients in group A were treated with rosuvastatin .The serum IL-17 levels were compared in two groups before and 4 weeks after rosuvastatin treatment .Results The serum IL-17 level was significantly higher in group A than in group B before rosuvastatin treatment (34.41 ± 6 .37 ng/L vs 15 .18 ± 3 .11 ng/L ,P<0 .05) and significantly lower in group A 4 weeks after rosuvastatin treatment than before rosuvastatin treatment (16 .71 ± 4 .72 ng/L vs 34 .41 ± 6.37 ng/L ,P<0 .05) .No significant difference was found in serum IL-17 level between the two groups after rosuvastatin treatment (P>0 .05) .Multivariate regression analysis showed that the serum hs-CRP and troponin level and the number of coronary artery branches with lesions were positively related with the serum IL-17 level (P=0 .012 ,0 .008 ,0 .000) .Conclusion Serum IL-17 level in ACS patients can partly reflect the severity of ACS .Early treatment of ACS with rosuvas-tatin can reduce the inflammatory reactions and serum IL-17 level ,and is of great significance in stabilizing the coronary plaques and reducing the incidence of ACS .

The per-diem payment is a unit packaged payment used for the medical cost of hospitalization. At present some areas in our country explored the per-diem payment in hospitalization and have received obvious effect. The experiences of different areas carrying out the per-diem payment in our country were compared to find the strengths and weaknesses, and provide references for other areas.

Morphology and microstructure of five herbal .medicines of the Bidens genus (Compositae )inChina were studied, and their resource utilization discussed. They are B. bipinnata, B.biternata, B. parviflora, B. tripartita and B. frondosa.

ObjectiveTo investigate the characteristics of three vaginal bacteria inspection methods of Amsel method,gram staining Nugent score method and bacterial vaginosis (BV) Blue methodMethods The leucorrhea specimen of 99 vaginal fluid abnormal patients were examined by Amsel method,gram staining Nugent score method and BV Blue method,then compared and analyzedResultsThe positive rate was 28.28％ (28/99) in Amsel method,47.47％(47/99) in gram staining Nugent score method and 16.16％ (16/99) in BV Blue method.There were significant differences among three methods(P＜ 0.01 ).The specificity and sensitivity of gram staining Nugent score method was higher.ConclusionThe three vaginal bacteria inspection methods have advantage and shortcoming individually,suspecting patients should be followed up to detect and diagnose in chnic,or detected by many methods.The specificity and sensitivity of gram staining Nugent score method is higher,but BV Blue method is simple,faster,which has higher value in detection and diagnosis in BV.

Interventional pulmonary procedures performed by flexible bronchoscopy has been widely used in the adult clinics.However,pediatric interventional pulmonary procedures are different from adult in anesthesia methods,equipment,technology and so on.At present.it is more limited.This review showed the experiences of pediatric bronchoscopy in Taipei Veterans General Hospital of Taiwan,China.

OBJECTIVE To check the defects of nosocomial infections reports,recording of the patient′s history,and antibiotics usage,so as to improve hospital management and reduce nosocomial infection.METHODS Patient′s records from Jan 1,2008 to Dec 31,2008 were reviewed to find out the defects and feedback to the physicians.RESULTS Some problems of 5995 cases were checked out and corrected,some suggestions were made.CONCLUSIONS Checking the patient′s records may supplement the defects of prospective monitor,direct the antibiotics therapy,and monitor occurrence of drug resistance.

Objective To explore the clinical significance of cytokines expression including CD11b,CD18,IL-8 and IFN-? in patients with psoriasis.Methods 55 patients with psoriases,including vulgaris,pustulosa,arthropathica and erthrodermic ones,were enrolled into the case group and 40 healthy persons as control.The expressions of CD11b,CD18 were detected by flow cytometry,while IL-8 and IFN-? with ELISA.Results The expression of CD11b,CD18,IL-8 and IFN-? in patients with psoriasis was significantly higher than those in control.Conclusions The ultra expression of CD11b,CD18,IL-8 and IFN-? might relate with the immunopathology of lymphocyte cell activation in psoriasis.This might provide the dependable basis for its treatment.