Objective To investigate the clinical values of dexmedetomidine in general anesthetic for laparo-scopic cholecystectomy.Methods One hundred patients admitted to our center with cholelithes were prospectively studied.According to the principle of completely random digital table,all patients were randomly signed to dexmedeto-midine group or control group.The primary outcomes were hemodynamic changes and postoperative complications. Results There was no significant differences at t0,t1,t2,t3,t4 and t5 in mean arterial pressure (P >0.05).There was no significant difference in heart rate at t0 (P =0.503),however,compared with the control group,patients in the dexmedetomidine group got a significant reduction in t1,t2,t3,t4 and t5 in heart rate(all P <0.05).Compared with the control group,the operation time of the dexmedetomidine group was significantly shorten[(1 18.52 ±15.42)min vs.(127.24 ±19.14)min,t = -5.673,P =0.021 ],the rate of movement of the center of the operation was significantly decreased (36% vs.64%,χ2 =7.840,P <0.001),the incidence rate decreased significantly (0% vs. 10%,χ2 =5.263,P =0.022).There was no difference between the two groups in intra -operative bleeding volume, hypertension,hypotension,tachycardia,postoperative drainage volume,postoperative bleeding,infection and vomiting (all P >0.05 ).Conclusion Dexmedetomidine contributed to maintaining the hemodynamic stable in general anesthetic for laparoscopic cholecystectomy,and reducing the rate of shivering.

The centrosome plays a crucial role in the maintaining of cell conformation,mitosis and chromosome seg-regation.It responds to the DNA damage and keeps the genome stability via cross-talking with the intranuclear DNA damage repair system.The apoptosis of tumor cells can be induced through inhibition of the duplication of centro-some.So the inhibitors of centrosomal proteins will be a potential anti-tumor therapy.

Intravesical instillation after transurethral resection of bladder tumor (TURBT) has been considered as the most important and effective method for the prevention and treatment of non-muscle invasive bladder cancer (NMIBC).Nowadays, the main choices of intravesical instillation are chemical drugs and Bacillus Calmette-Guerin (BCG).For all pa-tients with NMIBC, intravesical instillation should be admistered as soon as possible after TURBT.For patients of G_(1-2)T, an immediate single postoperative instillation of chemotherapy as standard therapy for low-risk disease is enough.For interme-diate-risk patients, it is recommended to use an immediate single postoperative instillation of chemotherapy plus an induc-tion course or maintenance treatment, but the scheme of intravesical instillation should be based on the specific circum-stances of the patients.For high-risk patients, maintenance therapy with BCG should be the first chioce.The combination of intravesical BCG and chemotherapy has certain advantages in treating NMIBC, but its efficacy needs further verifica-tion.Although there is a long history of intravesical instillation after TURBT, the choice of drugs, the time of instillation, and the corresponding dosages are still inconclusive.This article summarizes the strategies of the treatment for NMIBC after TURBT.

As a method of financial management and control,the implementation of cost accounting has a significant influence on management of sicentific research projects.The model patterns of cost accounting in the United Kingdom,the United States and European Union,respectively can be served as practical frameworks to guide Chinese scientific research project funds in terms of accounting forms,methods and contents.Based on the understanding of current domestic development and problrms of cost accounting experiences learned from internation practices are signifcant for improving cost accounting system in scientific research projects of China.

[Objective] To evaluate the curative effect of anterior cruciate ligament(ACL)reconstruction for remaining anteromedial or posterolateral bundle and ruptured fiber.[Method]Among 89 cases of ACL rupture,there were 32 cases of sports injury,24 cases training injury,23 cases traffic accidents and 10 cases sprained in daily life.ACL ruptured at the notch of the femur in 24 cases,and at the intercondyle of the tibial in 28 cases.Thirty-two cases were reconstructed with quadri-bundle Hamstring tendon knot press-fit technique and 20 cases were reconstructed with quadriceps tendon press-fit technique with autogenetic patellar bone.ACL anteromedial bundle(AMB)ruptured in 14 cases and posterolateral bundle(PLB)ruptured in 23 cases.The intact bundle and the remnants of ACL were preserved.AMB and PLB were reconstructed with double-bundle Hamstring tendon knot press-fit technique in 37 cases.Absorbable interference screws were used at the tibial tunnel and sutured tendon was knotted across the tibial bone bridge.[Result]The average duration of follow-up were 25 months(14-37 months).Lysholm knee function score increased by 27.7 scores,from average 67.5 scores of pre-operation to average 95.2 scores at the end of the follow-up.Rulermetr examination tibial translation was 4 mm?2 mm in 72 cases and 6 mm?3 mm in 17 cases.Lachman test was negative in 79 case,weakly positive in 8 cases and positive in 2 cases.The function of the knees were improved and the stabilization was strengthened after operation.According to knee therapeutic effect evaluation criterion,76 cases were excellent and 13 cases were good.[Conclusion]To keep the remaining of anteromedial or posterolateral bundle and ruptured fiber for ACL reconstruction is beneficial for the graft revascularization or healing,and is helpful for the position sense or rehabilitation.

Objective To explore the efficacy and safety of Linagliptin in combination with Metformin in newly diagnosed T2DM patients. Methods A total of 140 newly diagnosed T2DM patients were enrolled in this study. All the patients were admitted in the Endocrinology and Metabolism department of our hospital from January 2013 to October 2013. Random number table method was used in patients’ selection. All the patients were divided into two groups :Linagliptin plus Metformin group (Linagliptin group ,n=70) and Glipizide plus Metformin group (Glipizide group ,n=70) ,and followed up for 12 weeks. Efficacy and safety of treatment were compared between the two groups. Results The difference of FPG ,2 hPG and HbA1 c did not reach the statistical significance between the two groups at baseline treatment (P>0.05). FPG ,2 hPG and HbA1 c were significantly lower after treatment compared with baseline in both groups (P<0.05). FC-P ,2 hC-P ,HOMA-β,HOMA-IR ,IAI and adiponectin level at baseline were similar between the two groups ( P> 0.05 ). All these indicators were improved after treatment in both groups (P< 0.05) ,and were significant better in Linagliptin group than in Glipizide group. Adverse events rate were significantly higher in Glipizide group than in Linagliptin group (18.57%vs 5.71% ,χ2 = 5.423 ,P= 0.020 ). Conclusion The efficacy of Linagliptin in combination with Metformin in newly diagnosed T2DM patients was similar with Glipizide plus Metformin. The β cell function improvement was better and APN level was higher after Linagliptin treatment.

Objective To summarize 5 otospongiosis cases with profound sensory hearing loss who received cochlear implante(CI) in routine way.To analyze their characteristics in audiology and temporal CT,and the effects after CI.Methods 5 cases of profound sensorineural hearing loss with otospongiosis received pure tone test,otoacoustic emission,auditory brainstem evoked potential and temporal CT before operation.One of the patients received binaural CIs.Mapping was done one month after operation.Follow-up tests were provided 6 months after operation to assess the effects.Results 5 cases showed clinical characteristics of gradual binaural hearing reduction,PTA greater than 90 dB HL,mixed or sensorineural deafness,normal tympanic membranes,reduced peaks in acoustic impedance,and typical CT findings.5 patients(6 ears) were implanted in routine manner.It was difficult to open the cochlea scala tympani.The scala tympani was filled with loose bony tissues.It was about 7～9 mm between the round window and the normal scala tympani.All patients showed the standard wave from in nerves reaction remote monitoring.The patients were followed up from 8 months to 3.1years.The average PTA was 20～37dB HL.The speech discrimination score was 95%～99% for open Chinese audiometry.Conclusion CI was an effective way to help patients with profound sensory hearing loss and otospongiosis.

Objective:To investigate the feasibility,effectiveness and safety in the treatment of symptomatic middle cerebral artery stenosis with stenting.Methods:Twelve patients with middle cerebral artery stenosis were treated with stenting from August 2005 to December 2006.Among these patients,9 were male and 3 were female.The meam(SD)age was 69(5.3)years(range 56 to 81 years).The mean(SD)stenosis degree was 84.2%(3.7)(range 50% to 99%).All patients were successfully treated with balloon-expanded stents.and there was not any severe complications.Results:The rate of residual stenosis after the procedures was≤20%.No cerebral ischemic symptoms recurred in the patients over a 6-to 18-month follow-up period.Conclusions:Endovascular stenting is a safe and effective approach in the treatment of symptomatic middle cerebral artery stenosis,and its short-term effect is significant.

Objective To explore the anxious condition and the influencing factors of chronic hepatitis B patients, and to take appropriate care measures. Methods Self-designed questionnaire for general information of patients, a comprehensive Zung self-rating depression scale(SDS)and Zung self-rating anxiety scale(SAS)were used to investigate 100 patients with chronic hepatitis B patients(the study group), and the results were compared with 80 normal persons(the control group). Results The SDS and SAS score of the study group was significantly higher than the control group. The negative emotion factors of the study group included social context, family, education, self- respect. Conclusions Patients with chronic hepatitis B has obvious negative mood, and are influenced by many kinds of factors. Strengthening the comprehensive psychological intervention can improve the negative emotional state, and promote rehabilitation of patients.