Objective To compare the BIS values in patients under anesthesia with minimum alveolar concentration (MAC) of sevoflurane and median effective concentration (EC50) of propofol at loss of consciousness.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 18-60 yr,undergoing elective surgery under general anesthesia,were equally and randomly divided into 2 groups:inhalational anesthesia with sevoflurane group (group Sev) and intravenous anesthesia with propofol ( group Pro).The end-tidal concentration of sevoflurane was monitored using Aestiva anesthesia machine (Datex Ohmeda) in group Sev.Anesthesia was induced with intravenous injection of etomidate 0.3 mg/kg,rocuronium 1 mg/kg,and remifentanil 0.2 μg/kg.The patients were mechanically ventilated after tracheal intubafion.Sevoflurane inhalation was started 12.5 min after intubation in group Sev.Propofol was given by target-controlled infusion with the target plasma concentration set at 3.8 μg/ml 12.5 min after intubation in group Pro.When the effect-site concentrations of propofol reached EC50 of propofol at loss of consciousness (2.2 μg/ml),1.3 EC50(2.86 μg/ml) and 1.5 EC50 (3.3μg/ml) and when the end-tidal concentrations of sevoflurane reached 1.0,1.3 and 1.5 MAC,BIS value,MAP and HR were recorded.Results HR was significantly higher at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 in group Pro than in group Sev ( P ＜0.05).BIS value was significantly decreased at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 compared with that at 1.0 MAC or EC50(P ＜0.05).There was no significant difference in MAP and BIS value at each time point between the two groups ( P ＞ 0.05).Conclusion No significant change in BIS values is found in patients under anesthesia with 1.0,1.3 and 1.5 MAC of sevoflurane and with 1.0,1.3 and 1.5 EC50 of propofol.

ObjectiveTo investigate the effects of ederavone on oxidative stress response during one-lung ventilation (OLV).MetihodsThirty ASAⅠ or Ⅱ patients of both sexes aged40-64 yr,weighing50-85 kg undergoing elective esophageal cancer resection were randomly divided into 2 groups ( n =15 each):control group (group C) and edaravone group (group E).In group E edavavone was infused immediately after tracheal intubation at 60.0 mg/h for 30 min.Then the infusion rate was reduced to7.5 mg/h and maintained until the end of operation.In group C equal volume of normal saline was infused instead of edaravone.Arterial and venous blood samplea were taken immediately before skin incision,at 30 min of OLV and 30 min after re-expansion of the collapsed lung for blood gas analysis and determination of serum MDA and 8-iso-PGF2a concentrations.PaO2/FiO2,PA-aDO2 and respiratory index (RI) (RI =PA-aDO2/PaO2 ) were calculated.ResultsPA-a DO2,RI and serum concentrations of MDA and 8-iso-PGF2a were significantly lower at 30 min after re-expansion of the collapsed lung in group E than in group C( P ＜ 0.05).ConclusionEdaravone can attenuate oxidative stress response during OLV.

Objective:To explore the application effect of Roy adaptation model combined situational teaching method in pediatric nursing teaching.Methods:A total of 108 nursing students interned in our hospital in 2019 were selected and randomly divided into two groups, among which, 54 nurses who accepted the traditional teaching method were taken as the control group, and 54 ones who adopted Roy adaptation model combined situational teaching method were taken as the research group. The scores of theory and operation skills of the two groups were evaluated before and after teaching, at the same time, the comprehensive ability was assessed and the satisfaction survey was conducted among the students after the teaching. SPSS 20.0 was used for data processing, the scores of theory and operation skills comprehensive ability and nursing students' satisfaction with teaching were described with ( ± s) and t test was performed. Results:After the teaching, the theoretical knowledge and operational skills scores of the two groups were significantly improved than those before the teaching ( P<0.05), and those of all students in the research group were significantly higher than those in the control group ( P<0.05). The scores of ability to integrate theory with practice, self-learning ability, communication ability, teamwork ability, independent thinking and problem solving ability, clinical thinking ability in the research group were higher than those in the control group, with statistical differences ( P<0.05). And students in research group had significantly higher overall satisfaction scores on the teaching than those in control group had ( P<0.05). Conclusion:Application of Roy adaptation model combined situational teaching method in pediatric practice teaching can improve the theoretical knowledge and operational level of nursing students, enhance their communication ability and other abilities, and help to improve their satisfaction with teaching.

Objective To explore the effects of silybin-phosphatidylcholine compound (SPC )on lipopolysaccharide (LPS)-induced activation of nuclear factor-?B (NF-?B) and phosphorylation and degradation of inhibitors of NF-?B?(I?B?).Methods Phagocyte were collected in abdominal cavity of Kunming mousse aged 6 to 8 weeks,cultured phagocyte(2?105 mL-1) were divided into control, LPS and SPC groups randomly, phagocyte in control group were added into the same volume of 9 g/L sodium chloride.Phagocyte in LPS group were added into a single bolus of LPS(10 ?g/mL LPS) for 24 hours, phagocyte in SPC groups were preincubated with different concentration of SPC for 2 hours followed by a 24 hours incubation with 10 ?g/mL LPS. Immunocytochemistry were used to measure the contents of NF-?B, phosphorylated I?B? in phagocyte.Results The content of NF-?B p65 located in the nuclear in control group was little. The content of NF-?B p65 located in the nuclear in LPS group markly higher than that in control group(P

Objective To evaluate the clinical efficacy of “Shamrock” ultrasound images?guided lumbar sympathetic ganglion blockade ( LSGB) . Methods Sixty patients of both sexes, aged 18-60 yr, weighing 50-70 kg, of American Society of Anesthesiologists physical statusⅠorⅡ, undergoing unilater?al LSGB, were divided into groupⅠ ( n=30) and group Ⅱ ( n=30) using a random number table. In group Ⅰ, unilateral LSGB was performed at the L2 level under ultrasound guidance with paramedian trans?verse scanning. In groupⅡ, unilateral LSGB was performed at the L2 level under ultrasound guidance with“Shamrock” ultrasound images. After final needle position was confirmed, 2% lidocaine 6?0 ml was ad?ministered in each patient. At 20 min before and after LSGB, the visual analogue scale scores and skin temperature of the big toe of the affected foot were recorded, and the successful blockade and visibility of important paravertebral structures on ultrasound images were recorded during puncture. Results The visu?al analogue scale scores were significantly lower, and the skin temperature on the affected side was signifi?cantly higher after LSGB than before LSGB in both groups ( P<0?05) . The important paravertebral struc?tures such as erector spinae, quadratus lumborum, psoas major, transverse process of L2 vertebrae, and the curved edge of L2 vertebrae were visible in both groups. The visibility rate of the inferior vena cava or ab?dominal aorta on ultrasound images and the success rate of blockade were significantly lower in group Ⅰthan in group Ⅱ (P<0?01). Conclusion Compared with paramedian transverse scanning, LSGB has some advantages such as real?time monitoring, higher success rate of blockade, better efficacy and avoiding damage to great vessels when performed under “Shamrock” ultrasound image guidance.

Objective To assess the values of automated breast volume scanner (ABVS) for differentiating of benign and malignant breast masses.Methods A total 174 breast masses in 148 patients were subjected both to conventional handheld B-mode ultrasound (HHUS) and ABVS examinations.The masses were defined as five categories of benign,probably benign,equivocal,probably malignant,and malignant with each method.The results of ABVS and HHUS were compared with pathology.By using the definitive diagnosis and the five levels of suspicion categories,receiver operating characteristic (ROC) curves were drawn to evaluate their diagnostic results.In addition,the diagnostic accuracy for breast masses of futures including retraction phenomenon and hyperechoic rim in coronal plane of ABVS was evaluated.Results The area under the ROC curve of ABVS (0.927) was larger than that of HHUS (0.903) (Z =2.256,P =0.024).The specificity and the positive predictive values both reached to 100％ and false positive rate was 0 with retraction phenomenon,and the specificity and the negative predictive value were 88.89％ and 94.51％ respectively with hyperechoic rim in coronal plane of ABVS.Conclusions ABVS plays an important role in the clinical practice.The retraction phenomenon and hyperechoic rim of breast masses in coronal plane of this new modality have high specialty for differentiating malignant from benign breast masses.

Objective To provide reference for anti-infection drugs in Zunyi area by analyzing the etiological characteristics of children with severe pneumonia.Methods The sputum, throat swabs and serum of children with severe pneumonia in pediatric intensive care unit of our hospital from January 2014 to December 2015 were collected in this study.The pathogen species which caused severe pneumonia were detected and identified by the method of pathogen culture,and typical pathogens were detected by RT-PCR and indirect immunofluorescence.Results A total of 337 children with severe pneumonia were included,the pathogen positive rate was 86.65%(292/337).The rate of viral infection(37.32%)was the highest,followed by bacterial infection accounting for 28.42%,then the mixed infection accounting for 27.74%,and the mycoplasma pneumoniae infection accounting for 6.50%.The respiratory syncytial virus type B accounting for 28.44% was the most common in viral infection,and there were significant differences in age distribution(P<0.05),the children under 3-years-old,especially the infants under 1-year-old had the highest susceptibility.Viral infection had certain seasonality,compared with spring and winter,autumn and winter(November to April) had higher viral detection rate and the difference was statistically significant(x2=29.28,P=0.001).The escherichia coli was the most common in bacterial infection,accounting for 21.69%.Klebsiella pneumoniae,Escherichia coli were more common in neonates and infants under 1-year-old,Haemophilus influenzae occured in 1~3 years old children,Streptococcus pneumoniae infection could occur in any age.Conclusion Viral infection is the most common pathogen in children with severe pneumonia in Zunyi area followed by bacterial infection,which is more common in children under 1-year-old,and with the high incidence in autumn and winter.Bacterial infection is more common in children over 3 years of age.Bacterial and viral mixed infection is common in children under 3 years of age,especially in children under 1-year-old.

BACKGROUND:Conditioned medium from mesenchymal stem cels (MSC-CM) may represent a promising alternative to MSCs transplantation. Previous studies have shown that inflammatory activation can strengthen the multiple biological potencies of MSCs; however, normal MSCs with insufficiency of immunocompetence and migration ability are not effective for tissue damage repair. OBJECTIVE:To investigate differential effects of MSC-CM with and without inflammatory activation on radiation-induced intestinal injury.METHODS:MSCs from the bone marrow of SD rats were separated, cultured and identified, and then co-cultured with non-irradiated IEC-6 or irradiated IEC-6 in a transwel system for 24 hours. Then, MSCs with inflammatory activation were cultured alone for another 48 hours. After that, the supernatant was colected as non-activated MSC-CM (MSC-CMNOR) and MSC-CM under radiation-induced inflammatory condition (MSC-CMIR). Rats were exposed to 14 Gy whole abdominal irradiation and randomly divided into four groups: control group, radiation injury group (DMEM/F12), MSC-CMNOR group and MSC-CMIR group. Continuous administration was givenvia tail vein and intraperitoneal implantation of Alzet microosmotic pumps. Intestinal samples were colected at 1, 3, 7 days after radiation for analysis of short circuit variation, at 3 days after radiation for analysis of intestinal epithelium ultrastructure, and at 1, 3, 5, 7, 14 days after radiation for histological observation of the intestinal epithelium using hematoxylin-eosin staining. Blood samples were colected at 1, 3, 7 days after radiation for analysis of serum xylose levels. In addition, the survival state and survival time of rats were observed and recorded. RESULTS AND CONCLUSION: The short circuit variation responding to electrical field stimulation was significantly reduced at al frequencies, but it was significantly improved in the MSC-CMIR group. Similarly, the intestinal absorption (serum xylose levels) was also significantly impaired by irradiation, but improved by delivery of MSC-CMIR (P < 0.05). At 3 days after MSC-CMIR infusion, the intestinal epithelium exhibited an increase in crypt size and vilous length (P < 0.05). Under the electron microscope, a reduction in intestinal microvili and open tight junctions in irradiated intestinal epithelium was found, and the intestine from rats treated with MSC-CMIR had more obvious tight junctions. In addition, treatment with MSC-CMIR dramaticaly improved the survival rate and mean survival time of irradiated rats as compared to those treated with DMEM/F12 or MSC-CMNOR (P < 0.05). Taken together, the present study demonstrated that MSC-CMIR , but not non-activated MSC-CM, improves the structural and functional restoration of the smal intestine after radiation-induced intestinal injury.

ObjectiveTo analysis the epidemic tendency of the methicillin-resistant Staphylococcus aureus(MRSA).MethodsClinical data of patients from August 2004 to August 2005 were analyzed retrospectively.Results62 Staphylococcus aureus were isolated,and the MRSA isolated rate was 59%.The MRSA patients tended to complex infection.ConclusionThe infection caused by MRSA is serious.It is necessary to take effective measures to control the MRSA prevalence.

Objective To evaluate the characteristics of abdominal aorta wall motion in different stages of rats atherosclerosis with velocity vector imaging (VVI) technique. Methods Twenty-four healthy SD rats were on high-fat feeding after one week ordinary diet. Abdominal aortic intima-media thickness (IMT), end-systolic blood vessel diameter (Ds), peak systolic velocity (Vs), resistance index (RI), pulsatility index (PI) were measured before and at the end of 8th and 12nd week. Artery wall peak velocity (V_(max)), maximum tangential strain (S_(max)) and the maximum tangential strain rate (SR_(max)) were caculated with VVI. Results Abdominal aortic intima was rough and a small amount of foam cells were found under the light microscope at the end of 8 weeks of high-fat feeding. The values of Smax and SRmax measured at the end of 8th week of high-fat feeding decreased significantly than those of before high-fat feeding (P<0.05). At the end of 12nd week, abdominal aortic intimal was thicker and atherosclerotic plaque appeared somewhere. There were significant differences in artery IMT, Ds, Vs, RI, PI between before and the end of 2nd week of high-fat feeding (P<0.05);the values of V_(max), S_(max), SR_(max) decreased significantly than those of before and at the end of 8th week of high-fat feeding (P<0.05). Conclusion VVI can quantitatively evaluate the vessel wall elasticity in different stage of arteriosclerosis rats.