Objective To explore the effect of PCEA on intestinal peristalsis.Methods 120 patients with ASA Ⅰ～Ⅱ lower abdominal or lower limbs surgery were randomly divided into four groups with 30 cases each and received PCEA at the end of operation sespectively.Group A were given 0.0002% fentanyl,0.2% Ropivacaine and 0.005 % Droperidol;0.01% morphine,0.2% Ropivacaine and 0.005% droperidol in group B;0.2% Ropivacaine in group C;0.9% saline in group D.Postoperative analgesia was provided by PCA pump with LCP model.Results Satisfactory analgesia in group A was 93%,97% in group B 47% in group C and 13% in group D.Both group A and B did not show any significant difference in the analgesic effects(P＞ 0.05).Satisfactory analgesia in group A and B were significantly better than in group C and D(P＜0.05).The renewal of intestinal peristalsis were significantly faster in lower limbs surgery patients than lower abdominal patients(P＜ 0.01),but it did not show any significant difference in the same kinds of surgery in four groups (P＞0.05).Conclusion Both group A and B can get a satisfied analgesia effect;intestinal peristalsis of lower limbs surgery patients renewed were shorter than in lower abdominal patients.

Objective To observe the pathological changes of hippocampus and myelin in rats with frontal cereberal ischemia and reperfusion after treated with methylcobalamine and to discuss the mechanism of the cerebral protective effect of methylcobalamine.Methods Cerebral ischemia and reperfusion models were made by clamping bilateral carotid arteries.Forty-five male Wistar rats were randomly allocated to sham-operation group,ischemia-reperfusion group and methylcobalamine group(n=15).1,2,4 weeks after reperfusion the rats in each group were divided into three groups(n=5).The pathological changes of hippocampus and myelin were observed by using light microscope,HE staining,LFB staining and electron microscope.Results The pyramidal neurons in hippocampus in ischemia and reperfusion groups expressed putrescence and myelin necrosis or demyelination at 1st week,and the histomorphological changes at 4th week were significant than that at 2nd week.The followings were observed in electron microscope: dimness,partly solubilization and collapsablity in myelin.The pyramidal neurons in hippocampus of therapy groups were similar to normal one and myelin expressed compaction and shipshape.The changes were more obvious at 4th week.Conclusion Methylcobalamine can obviously decrease the ischemia lesion of hippocampus and myelin and protect the brain function.

Objective To investigate the association between HbA1c status,arterial stiffness and endothelial function in subjects with type 2 diabetes mellitus(DM).Methods The study group consisted of 338 DM patients,including 74 subjects with normal HbA1c(≤ 6.0％)(Group A),102 subjects with mildly increased HbA1c(HbA1C increased by less than 6.5％)(Group B)and 162 patients with high HbA1c level (HbA1c increased by more than 6.5％)(Group C).All patients were evaluated for glucose,HbA1c,TC and TG.Pulse wave velocity(PWV)and flow-mediated dialation(FMD)were performed simultaneously.Results Compared with Group A,Group B and C had higher baPWV([1734 ± 343]cm/s vs.[1537 ± 313]cm/s and [1853 ± 364]cm/s vs.[1537 ± 313]cm/s).Patients in Group C had a higher baPWV than those in Group B ([1853 ± 364]cm/s vs.[1734 ± 343]cm/s,P =0.006).The patients in group A had a lower level of FMD than that of group B and C([4.20±3.13]％ vs[5.29±3.92]％,[4.09±2.79]％ vs.[5.29±3.92]％,P＜0.01).Leaner association analysis showed a positive correlation between baPWV and HbAlc(r =0.53,P ＜0.01).baPWV was negatively correlated with FMD(r =-0.25,P ＜0.01).Logistic regression analysis showed that HbA1c(OR32.19％,CI 11.26 ～53.12,P＜0.001),age(OR 14.21,95％ CI 11.43 ～ 17.00,P＜0.001),systolic blood pressure(OR 7.36,95％ CI 6.12-8.59)and TC(OR:0.31,95％ CI:9.97-70.64)were independent predictors for the increased arterial stiffness(baPWV).Conclusion Arterial stiffness parameters varied significantly across subgroups of patients with different levels of HbA1c and the arterial stiffness was positively associated with deranged glucose homeostasis.

Objective To study the nursing of totally endoscopic coronary artery bypass grafting (TECAB)using da Vinci robot.Methods 60 patients who accepted TECAB from January 2007 to December 2010 were selected.All patients underwent coronary arteriography,which showed severe stenosis in left anterior descending artery(LAD).8 of them complicated with right coronary artery stenosis or left circumflex coronary (LCX)stenosis.All patients were given education and nursing care from admission to discharge.Results After operation,angina pectoris alleviated in all cases,no surgery-related complications occurred.The bridge vessel was all cleared.All patients were discharged after rehabilitation.Conclusions Totally robotic TECAB is a new minimally-invasive surgery.Perioperative education is important.In early postoperative course,nurses should pay attention to bleeding condition of drainage and pulmonary nursing.Early postoperative exercise is a must,which can promote the recovery of all systems.

Objective To analyse the distribution characteristics of negative pattern of hepatitis B virus Markers (HBV‐M ) in healthy population in Hangzhou district in 2014 ,and provide strategy for the prevention and control of HBV infection in HBV‐M negative population .Methods The HBV‐M (HBsAg ,HBsAb ,HBeAg ,HBeAb and HBcAb) in blood specimens of health examina‐tion population were tested by using ELISA .For 300 cases preserved HBV‐M negative specimens ,HBsAg and HBsAb were detec‐ted by using chemiluminescence immunoassay and HBV‐DNA was detected by using PROCLEIX ULTRIO? Assay .The viral load of HBV‐DNA reactive sample was quantitatively determined .Results Among 9 143 blood samples ,2 213 samples were HBV‐M negative ,and the negative rate was 24 .20% .The negative rate of male to female was 1∶1 .21 .Using chemiluminescence immunoas‐says and PROCLEIX ULTRIO? Assay simultaneously ,we found one case of low concentration of HBsAg(both HBsAb and HBV DNA nonreactive) ,four cases of low concentration of HBsAb(both HBsAg and HBV DNA nonreactive) ,two cases of HBV‐DNA reactive(HBV‐M negative) .One HBV‐DNA reactive sample could be quantified as 560 IU/mL .Conclusion In HBV‐M (ELISA) negative population of health examination of Hangzhou district ,a few subjects had low concentrations of HBsAg or HBsAb or HBV‐DNA .For HBV‐M negative population ,quantitative detection of HBV‐M and HBV‐DNA before HBV vaccination is recom‐mended to determine w hether they need HBV vaccine and the HBV vaccination plan .

This review focuses on the current literatures on the therapeutic potential of non-renal derived adult stem cell transplantation for kidney disease.Although the therapeutic mechanism remains debatable,some reports suggest that hematopoietic stem cell transplantation holds potential for treatment of renal diseases such as renal ischemia reperfusion injury,IgA nephropathy and lupus nephritis.Mesenchymal stem cell(MSC) are capable of homing to injured kidney and contribute to activate intrinsic kidney cells,promote angiogenesis,inhibit oxidative stress and reduce apoptosis,inflammation and renal fibrosis.These renoprotective effects are likely mediated by paracrine/autocrine mechanism via cytokine and microvesicles from MSC.Pluripotent stem cells may be induced from fibroblast,mesangial cells,renal tubular epithelial cell and urine epithelial cell.Induced pluripotent stem cell(iPSC) can differentiate into renal lineage cells.The derivation of kidney disease-specific iPSC opens new avenues for the resolution to limited donor availability in kidney transplantation and for treating kidney diseases such as diabetic nephropathy and autosomal dominant polycystic kidney disease.

Objective To evaluate the effect of various rewarming regimes on rectal temperature and hemodynamic parameters of dogs after open abdominal injury and seawater immersion. Method 30 healthy dogs were subjected to open abdominal injury and 2-hour seawater immersion. Then dogs were divided into three groups: group A (n=10) received no special warming treatment, in group B(n=10) electric blanket was used to warm up to 42℃, in group C (n=10) animals were warmed by 1/3 saline solution in 42℃ for 20 minutes and continuous perfusion of the abdominal cavity with 1/2 saline solution for 2 hours. The changes in body temperature, heart rate, MAP, CVP and CO were observed before and after rescue. Results The results of group A were not satisfactory. The rectal temperature, MAP, HR and CO were not recovered to normal after 6 hours of treatment. and the rectal temperature was 34.8℃ after 6 hours. The rectal temperature rose to 36.9℃ after being rewarmed with an electric blanket in group B. The result was better than that of group A. But there was tachycardia. The effects of rewarming from hypothermia in group C was satisfied. All hemodynamic parameters and rectal temperature recovered after 4 hours treatment. Conclusion Cold seawater immersion after open abdominal injury would result to hypothermia, and intra-corporeal rewarming should be the optional treatment.

Objective To evaluate the effect of seawater immersion on hemodynamics and pathological changes in dogs with perforating injury of the intestine. Methods Thirty healthy adult dogs were subjected to perforating injury of the intestine. Ten injured dogs were immersed in artificial seawater after the injury. An equal number of injured dogs were immersed in normal saline solution. Control group dogs (n=10) were not subjected to salt water immersion. Hemodynamical and pathological changes were observed at different time intervals after injury. Results Obvious hemodynamic disorder and serious pathological changes were found after seawater immersion. Normal saline solution group and control group dogs did not show obvious disorders in hemodynamics and pathology. Conclusion Seawater immersion is one of the main factors leading to the disturbance in hemodynamic and pathological changes after perforating injury of the intestine.

Electron microscopic changes about the effect of gossypol acetic acid ongastrocnemius muscles of male monkeys,rats and guinea pigs were studied.The resultsare as follows:The ultrastructure of gastrocnemius muscles of adult male Rhesus monkeys afteradministration of gossypol orally with a daily dose of 4mg/kg for 2 years showedapparently normal in appearance,except some nuclear condensation and dissociationof nuclear membrance seen in individual animal.After oral aministration of gossypol in adult male Wistar rats with an antifertilitydosage,i.e 20mg or 30mg/kg/day for 30 days,no obvious difference was seen betweenthe experimented and control groups.Except mild distension of the smooth endoplasmicreticulum and dissociation of nuclear membrane sometimes seen in some of theexperiment animals.Similar results was obtained in the male guinea pigs.After a heavy dose(60mg/kg/day)of gossypol given to rats for 37 days,mostof the myofibrils still keep their normal periodic structures,each fiber is maintainingtheir transversly arranged pattern of dark A-bands and light I-bands alternativelyalong the whole length of the fiber.But some myofibrils had lost their normal striation.The width of the I-band increased and the breaking down or lysis precessesin few or even an individual myofibril had begun.There were no obvious pathologicalchanges seen in the mitochondria.Persistent oral administration of gossypol in ratewith a dosage of(60mg/kg/day)for 55 days,the pathological changes became moreobvious.The mitochondria became disordered in arrangement.Concomitant with thesschanges,the myofibrils appeared dystropic and fragmented.It indicated the presenceof myofibrillar degeneration.If the daily dose are increased to 60mg/kg for 25 days in guinea pigs.Theremight be no significant pathological changes in the myofibrils in them.Nevertheless,some mitochondria were swollen in various extents and the cristae became fragmentedor dissolved,which was known as mitochondrial necrosis.The relationship between hypokalemic paralysis and the present results inducedby toxic effect of gossypol were analysed and discussed.

Objective To investigate the value of serum α1 acid glycoprotein(AAG) and Homocysteine(Hcy) in different stage of renal damage in type 2 diabetes(T2DM ) .Methods a total of 128 patients with T2DM were recruited from January 2013 to Octo‐ber 2013 ,According to 24 h urinary albumin excretion rate (UAER) were divided into the first group ,the second and third groups , and choose 80 healthy cases over the same period as the normal control group .Serum AAG ,Hcy ,creatinine (Cr) and blood urea ni‐trogen (BUN) were detected ,the test results were analyzed statistically .Results There were significant differences in type 2 diabe‐tes mellitus group ,early diabetic nephropathy group ,clinical diabetic nephropathy group of the serum AAG ,Hcy levels(P<0 .05) , there were positively correlated (r=0 .673 ,P<0 .05) between UAER and serum AAG levels ,and were positively correlated (r=0 .35 ,P<0 .05) between UAER and Hcy levels .Conclusion Combined detection of serum AAG ,Hcy have a significant for early diagnosis of diabetic nephropathy and assessing the degree of renal injury in diabetes .