Objective: To investigate the effect of different concentrations of dextrose transfusion on cerebral glucose metabolism in pediatric neurosurgical operations. Methods: Sixty anesthetized children undergoing selective cerebral tumor resection were randomly divided into three groups: Ringer lactate solution group (A, n = 20), 2.5% dextrose lactated Ringer's solution group(B, n = 20), 1% dextrose lactated Ringer's solution group (C, n = 20). All the hemodynamic data were recorded during anesthesia. The values of blood glucose and lactic acid were collected before intubation(T_a), 2 hours after opening cerebral dura mater (T_b) and the end of operation (T_c). The catheters for microdialysis were punctured into normal brain tissue. The contents of glucose and lactic acid were determined in the collected intercellular fluid by biochemical analysis instruments at T_A and T_B respectively. Results: There were no differences in heart rate(HR), mean arterial pressure(MAP) and arterial oxygen saturation (SpO_2) among three groups(P > 0.05). There were no differences in blood glucose at T_a between three groups(P > 0.05). The values of blood glucose at T_b and T_c were B group＞C group＞A group(P < 0.05). The values of blood glucose were higher at T_b and T_c than that of T_a in three groups(P < 0.05). There were no differences in blood lactic acid among three groups(P > 0.05). There were no significant differences in values of glucose and lactic acid in the collected intercellular fluid among three groups(P > 0.05). Conclusion: Transfusion of Ringer lactate solution or low concentration dextrose solution will increase blood glucose in pediatric neurosurgical operations, but still in the normal range, which has a little influence on blood lactic acid, glucose and lactic acid in brain intercellular fluid. It is a safe choice during neurosurgical operation.

ObjectiveTo assess the degree of pain in elderly patients with mechanical ventilation in ICU using critical-care pain observation tool(CPOT) and to choose the correct sedative and analgesic method.Methods 110 elderly patients in ICU after neurosurgery were divided into three assessment stages,every stage had two record points and total six points (T1-T6):the first stage (intubation and unconsciousness,T1-T2),the second stage (intubation and consciousness,T3T4 ) and the third stage(extubation and consciousness,T5-T6 ).Among them T1,T3and T5were nonnocuity assessment points of every stage,while T2,T4 and T6 were nocuity assessment points of every stage.The assessment time was one minute at every point.After recorded at every point in second and third stages,patients were asked to use the pain intensity descriptive scale (PIDS) themselves.CPOT,heart rate and mean arterial pressure (MAP) from T1 to T6 were recorded as well as PIDS from T3 to T6 in second and third stages.Results In the three stages,CPOT〔(26.8 vs.0.54,3.36 vs.1.20,2.78 vs.0.68) scores〕,HR〔(95 vs.85,94 vs.82,94 vs.84)beat/min〕 and MAP〔(95 vs.85,95 vs.87,94 vs.87)mm Hg〕 at T2,T4and T6 were higher than T1 (t=-42.89,-55.95,-55.38),T3 (t =- 5.52,- 11.33,- 11.78) and T5 ( t =- 5.54,- 9.95,- 11.33 ) ( P＜ 0.05 ).The PIDS at T4 and T6were higher than at T3and T5in the second and third stages 〔(2.52 vs.1.69,2.12 vs.1.44)scores〕 (P＜0.05).The correlation coefficient between CPOT and PIDS at T3 and T4 in the second stage were 0.49 and 0.58,respectively (P＜0.05),and between CPOT and PIDS at T5 and T6 were 0.52 and 0.59 in the third stage,respectively (P ＜ 0.05),and they both reached moderate correlation.ConclusionsCPOT may be an effective way to assess the degree of pain in elderly patients with mechanical ventilation at present.

Cestode Infections ; parasitology ; Humans ; Infant ; Male

Objective:To analyse the degree of equality of New Rural Cooperative Medical Scheme (NRCMS) in different economic regions. We provide a reference for equal development of the NRCMS and the reform of the political system and mechanism under the provincial-controlled county fiscal system. Methods:A typical province was chosen with provincial-controlled county fiscal system was fully implemented several years. We collected data on coverage, financing and compensation for the NRCMS from 2005 to 2011. We used the variable coefficient, uniformity coefficient, Theil Index for comprehensive evaluation. Results:Per capita financing has not reached the bottom line. From 2005 to 2011, inter-re-gional and intra-regional variation coefficient, Theil index of service coverage, financing level and hospital actual compen-sation has declined year by year. The degree of inequality in economically developed regions was greater than in less eco-nomically developed regions and economic medium region. Conclusion:The degree of equalization of the NRCMS in the province continuously improved. Innovation of provincial-controlled county fiscal system and mechanism provides a favora-ble environment and forming conditions for equalizing the development of the NRCMS. The paper suggested exploring and building fiscal classification step transfer payment institution and dynamic prediction model of the NRCMS, further optimi-zing financing mechanism, promoting the provincial management system of the NRCMS as soon as possible in order to pro-mote the equalization development.

Objective: To explore the relevant factors of acquired swallowing disorders in adult patients after cardiac surgery. Methods: A Jiatian water swallowing screening test was conducted for adult patients after cardiac surgery in our hospital from 2015-03 to 2015-09. There were 32 patients with acquired swallowing disorder deifned as Case group and meanwhile 420 patients without swallowing disorder at the same word deifned as Control group. Non-conditional Logistic regression analysis was applied to study the relevant factors for acquired swallowing disorders. Results: The overall incidence of acquired swallowing disorders was 7.08%. Multi Logistic regression analysis presented that duration of endotracheal intubation (OR=1.060,P<0.001), pre-operative arrhythmia (OR=2.780,P=0.019), NYHA grade (OR=1.789, P=0.033) and Euroscore (OR=1.216,P=0.040) were the relevant factors for the occurrence of acquired swallowing disorders in adult patients after cardiac surgery. Conclusion: Medical professionals should pay special attention to patients with above mentioned risk features at post-operative drinking to reduce the complications of acquired swallowing disorders.

Objective To study the anti-oxidative stress effects of benazepril and candesartan.Methods SHRs of 12 weeks old were given benazepril(10 mg/kg?d,n=9)or candesartan(4 mg/kg?d,n=9)or combina- tion(Ben:10 mg/kg?d+Can:4 mg/kg?d)for 12 weeks.The tail arterial pressure was measured every two weeks.At end of study,pathological changes in the thoracic aorta,activity of SOD,serum contents of NO and hydroxy radicals,plasma Ang Ⅱ and cGMP,eNOS and P22~(phox)protein expressions in aortic tunica intima were de- termined.Results The thoracic aorta wall was thickened markedly in SHRs,and blood pressure,hydroxy radi- cal,Ang Ⅱ and P22~(phox)protein expression were increased significantly,while the serum NO,level of cGMP and eNOS expression were decreased.Benazepril(Ben)or Candesartan(Can)inhibit the thickening of vessel wall, enhance the activity of SOD(Ben:68.7?2.1,Can:65.6?4.2 vs SHR:48.8?3.2 U/mL,P

A.Conclusion The inhalation of yellow phosphorus and its compounds in rats may induce intoxication of rats with manifestations of ALI/ARDS.Xuebijing injection and decadron have therapeutic effects on such intoxication,then Xuebijing injection combined with both decadron can decrease decadron dosage.

Objective To investigate the prottective effect of ulinstatin on lung of rats with sepsis and its mechanism of ameliorating cell apoptosis. Method A total of 40 female SD rats were randomly (random number)divided into the control group and the therapy group (ulinastatin 300 000 u/kg). The rat models of sepsis were produced by the classical method of cecal ligature and puncture (CLP), and the designed doses ulinastatin were given intra-peritoneally to the rats of the ulinastatin group and the same amounts of PBS (phosphate buffered solution) instead of ulinastatin were administered intra-peritoneally to the rats of the control group when the sepsis symptoms appeared usually in 3 hours after modeling. In 12 hours after treatment, lung tissues of rats in two groups were taken for observation under the transmission electron microscopy and detecting the levels of Bcl-2 and Bax protein in lung tissues by using immunohistochemical technique. The levels of the integrated optical density(IOD)of Bcl-2 and Bax protein were detected by using Image-pro plus software and the ratio of Bcl-2/Bax was calculated. Results Transmission electron microscope showed that lung tissue in control group had inflmmatory changes such as severe congestion and consolidation, and those changes in ulinastatin treatment group (300 000 u/kg)were significantly slighter. There were significant differences in the levels of antiapoptotic protein Bcl-2 in lung tissue of rats between two groups(P＜0.01), and the level of protein Bcl-2 in ulinas tatin group were higher than those in control group. The level of pro-apoptotic protein Bax in control group were higher than that in ulinastatin group (P＜0.01). The ratio of Bcl-2/Bax in ulinas tatin group was higher than that in control group (P ＜ 0.05).Conclusions Ulinastatin has protective effect on lung tissue in septic rats, and it may inhibit the inflammatory response and in the same time plays a role in inhibiting cell apoptosis.

Objective To investigate the effect of sevoflurane postconditioning on oxidative stress responses during focal cerebral ischemia-reperfusion (I/R) in rats.Methods Twenty-four male Wistar rats,weighing 240-280 g,were randomly assigned into 3 groups:sham operation group (group S),focal cerebral I/R group (group I/R) and sevoflurane postconditioning group (group SP).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.Focal cerebral I/R was produced by middle cerebral artery occlusion.In group SP,3.9％ sevoflurane (1.5 MAC) was inhaled starting from 20 min before reperfusion until 10 min after reperfusion.While 100％ O2 and air were given instead of sevoflurane in groups I/R and S,respectively.Six rats chosen from each group at 24 h of reperfusion were sacrificed and brains were removed for determination of malondialdehyde (MDA),glutathione (GSH),superoxide dismutase (SOD),catalase (CAT),glutathione peroxidase (GSH-Px) and glutathione reductase (GR) levels and for microscopic examination.The cerebral infarct size was measured by TTC staining.Results Compared with group S,MDA level and cerebral infarct size were significantly increased in groups I/R and SP,and GSH,SOD,CAT,GSH-Px and GR levels were decreased in group I/R,and GSH-Px level was decreased in group SP (P ＜ 0.05).Compared with group I/R,cerebral infarct size and MDA level were decreased,and GSH,SOD,CAT,GSH-Px and GR levels were decreased in group SP (P ＜ 0.05).The pathological changes were significantly attenuated in group SP compared with group I/R.Conclusion The mechanism by which sevoflurane postconditioning mitigates focal cerebral I/R injury in rats is related to enhanced antioxidase activity and inhibition of oxidative stress responses.

Objective To evaluate the value of positive 99Tcm-MIBI tumor imaging for thyroid cancer diagnosis. Methods Fifty four suspected thyroid cancer patients underwent 99Tcm-O4 and 99Tcm-MIBI combined imaging procedure. The imaging data were confirmed by pathological findings. Results All the 54 cases had single throid nodules, and 25 of which were pathologically malignant. Fifty two cases of nodules were detected by the 99Tcm O4 thyroid static imaging, including 2 hot nodules,4 warm nodules, 10 cool nodules and 36 cold nodules;2 cases were negative by the imaging. Of the 25 malignant thyroid nodules, 16 nodules were visible by 99Tcm-MIBI uptake and were cold nodules;29 exhibited benign thyroid nodules,of which 15 could be seen by 99Tcm-MIBI uptake,including 1 warm nodules,2 cool nodules and 12 cold nodules. The sensitivity, specificity of the combined imaging of 99Tcm O4 and 99Tcm-MIBI were 64. 00% ( 16/25 ) and 48. 28% (14/29). No significant difference was found for the positivity between benign nodules and malignancy nodules by 99Tcm-MIBI tumor imaging ( χ2 = 0. 83, P ＞ 0. 05 ). Conclusion 99Tcm-MIBI tumor imaging is not specific for the diagnosis of thyroid malignancy.