Objective To study the effect of seven sevoflurane or propofol combined with remifentanil anesthesia on patients undergoing laparoscopic surgery.Methods In Taizhou Tumor Hospital from January 2015 to December 2016 were 100 cases of patients with laparoscopic surgery as the research object in the course of the study, were randomly divided into control group and experimental group two were 50 cases each.Patients in the control group were treated with propofol and remifentanil anesthesia.The experimental group was given seven sevoflurane and remifentanil anesthesia.Comparative analysis of the experimental group and the control group of patients with anesthesia effect.Results After the corresponding anesthesia, patients in the experimental group extubation time, recovery time was significantly better than the control group, with statistical difference(P<0.05).In the experimental group, 15 minutes after extubation, the Steward recovery score was(5.04±0.65), while the control group score was(4.12±0.54).Can be obtained, the quality of patients' recovery was significantly higher than that of the control group, with statistical difference(P<0.05).The cognitive function scores of the experimental group were significantly higher than those of the control group after extubation(2 h), and the difference was statistically significant(P<0.05).Conclusion Compared with propofol remifentanil anesthesia, seven sevoflurane remifentanil anesthesia effect is good, can improve the patient's recovery quality, to help with the recovery of cognitive function, with further clinical promotion and application significance.

Objective To study the effect of different doses of dexmedetomidine combined with propofol and remifentanil in patients undergoing abdominal surgery. Methods 200 cases of abdominal operation in our hospital from January 2015 to August 2016 were selected as the subjects, and were randomly divided into the experimental group and the control group, with 100 patients in each group. Patients in the control group received 0.4μg/kg, dexmedetomidine hydrochloride injection combined with propofol and remifentanil anesthesia, and the experimental group received 0.8μg/kg, Dexmedetomidine Hydrochloride Injection anesthesia. The adverse reactions, extubation time and recovery time of the experimental group and the control group were compared and analyzed. Results After the corresponding dose of dexmedetomidine, the patients in the experimental group were 6 cases of nausea and vomiting, 7 patients with chills, 13 cases of adverse reactions, the total incidence was 13%. In the control group, shivering occurred in 23 cases, nausea and vomiting occurred in 12 patients, and the number of adverse reactions in 35 cases, the incidence of adverse reactions was 35%. The probability of adverse reactions in the control group was significantly higher than that in the control group, with statistical difference (P<0.05). The recovery time and extubation time of the experimental group were significantly lower than those of the control group, with statistical difference (P<0.05). Conclusion 0.8μg / kg dexmedetomidine hydrochloride Iinjection combined with propofol and remifentanil anesthesia in abdominal surgery is better anesthesia effect, can significantly shorten the time of patients with tube drawing, high safety, reduce the pain and risk of surgery patients has clinical significance in the further promotion and application.

With the change in the modes of medicine, the traditional educational mode of clinical medicine is unable to meet the development demands of modern medicine. Evidence based medicine, a new mode of medical treatment, reflects the development trends of modern medicine and represents the direction of modern medical advancement. Judging from the perspective of medical education, evidence based medicine is a learning method which differs from the traditional educational mode and represents a new concept of education in clinical medicine. The rise of evidence based medicine demonstrates the direction of reform in medical education in the world today and will also bring about great changes in the mode of medical education in China. It is imperative for us to follow the trend in clinical medical education, update concepts on medical education in line with the basic ideas of evidence based medicine, and push forward reform in the mode of medical education.

Objective To observe the effects of improving tumor cell hypoxia on radiotherapy in non-small cell lung cancer(NSCLC). Methods Forty-two patients with NSCLC on stage II to stage IV were enrolled randomly, of whom 38 patients were well documented. All patients were treated with oxygenator by intravenous oxygen delivery within thirty minutes before radiotherapy to increase partial pressure of blood oxygen and improve tumor cell hypoxia. The arterial blood gas was analysed for each patients before and after oxygen infusion. All patients receive radiotherapy at a dosage of 2 Gy each time per day, five times per week. The total dosage was 60 to 70 Gy. Another 37 NSCLC patients selected randomly in control group were treated by conventional radiotherapy. The therapeutic effects were analysed statistically according to WHO categorized standard. Results The mean PO2 was (85.6?7.5) mm Hg, (103?9.7) mm Hg, and SaO2 was (89.5?6.1) %, (94.4?5.2) % before and after oxygen infusion respectively in study group. The efficacy of radiotherapy was 63.16 %(24/38), which was higher than that in control group 43.24 % (16/37) (0.05

[Objective] To study the aeroallergens in the patients with allergic rhinitis in Guangzhou.[Methods] Using the German screen allergens quantitative detection system to determinate serum aeroallergen specific IgE and total IgE levels of 625 cases with allergic rhinitis diagnosed in The Third Hospital of SUN Yat-sen University.The samples were stratified on two age groups:the juvenile and the adult.Difference of serum aeroallergen specific IgE of the two groups was investigated.[Results]Aeroallergen specific IgE antibody in the serum of 625 patients with allergic rhinitis were positive.Total IgE in serum was positive in 413 cases,accounting for 66.1%.The positive rate of total IgE was less than that of aeroallergen specific IgE.The positive rate of aeroallergen specific IgE in order were mite mixture (84.32%),cockroach (19.04%),cypress (15.20%),cat-dog epithelia (13.12%),tree mixture (7.20%),ragweed (5.12%),humulus lupulus (1.76%),mugwort (1.76%),mould mixture (1.44%).In the two groups,the positive rate of aeroallergen specific IgE in order were similar.There were significantly higher sensitivity and positive rate of mite mixture in the juvenile group than the adult group (P ＜ 0.01).[Conclusion] The most important aeroallergens are mite mixture,cockroach,cypress,cat-dog epithelia,which could be referenced as Guangzhou patients .The juvenile is more sensitive to mite than the adult.

Objective To analyze the separation and displacement of bone fragments in sagittal fracture of the mandibular condyle (SFMC),understand the motion type and guide clinical treatment and development of related surgical instruments.Methods Forty-five patients (52 sides) with SFMC treated between October 2008 and October 2012 were enrolled; 32 patients (36 sides) were males and 13 patients (16 sides) were females.According to the Neff classification,there were 20 sides with type A,28 sides type B and 4 sides type M.All the patients underwent CT scan and were classified based on measurements of distance and angle of displaced bone fragments.Results Patients were categorized into type Ⅰ on 20 sides (type Ⅰ A on 14 sides and type Ⅰ B on 6 sides),type Ⅱ on 27 sides (type Ⅱ A on 11 sides and type ⅡB on 16 sides),type ⅢB in 1 side and type Ⅳ in4 sides.Mean displacement of bone fragments was 12 mm (range,4-16 mm) ; mean deviation angle was 34°(range,11°-43°) ; mean descending distance was 13 mm (range,6-18 mm).Conclusion CT analysis results show that,mast bone fragments in SFMC move slightly.

Objective To develop a suitable forcep for reduction and internal fixation of sagittal fracture of mandibular condyle (SFMC) and evaluate its role in clinical practice.Methods Twenty patients with SFMC diagnosed by three-dimensional CT undergone open surgery were divided into experimental group and control group with 10 patients per group,according to the random number table.Patients in experimental group were reduced and fixed using the new reduction forcep,while in control group by the classical vascular clamp and nerve retractor.Operation time,three-dimensional CT before operation and 2 weeks after operation,and occlusion,maximum mouth opening (MMO),visual analogue scale (VAS),joint clicking as well as noise before operation and 1 and 6 months after operation were recorded.Results Operation time was obviously lower in experimental group than in control group [(0.90 ± O.11)hours vs (1.34 ±0.10)hours,t =-10.8,P ＜0.01].MMO in experimental group revealed significant improvements compared to control group at postoperative 1 month [(32.6 ± 1.6) mm vs (29.7 ±1.6)mm,t =-10.1,P＜0.01] and at postoperative 6 months [(34.3 ± 1.2)mm vs (33.3 ± 1.1)mm,t =3.4,P ＜0.01].VAS between experimental group and control group also differed significantly at postoperative 1 month [(3.6 ± 0.7) mm vs (5.1 ± 0.7) mm,t =-12.5,P ＜ 0.01] and at 6 months [(3.5±0.9) points vs (4.8±0.6) points,t=-3.3,P＜0.01].Conclusion The new reduction forcep can shorten operative time and improve mouth opening and pai for SFMC.

ABSTRACT]OBJECTIVETo study the compliance to sublingual immunotherapy(SLIT) in patients with allergic rhinitis(AR) in Guangzhou city.METHODSFrom January 2014 to May 2014, 202 patients with AR received SLIT were followed up by telephone. According to age, the patients were divided into group A(age<14 years) and group B(age≥14 years). The compliance to SLIT was analyzed and the reasons of poor compliance were investigated.RESULTSAmong 202 patients, only 93 cases(46.04%) were successfully followed up by telephone, 109 cases(53.96%) were lost to visit. Among the 93 cases of successful follow-up, the good compliance rate was 29.03%(n=27), the poor compliance rate was 70.97%(n=66). compliance to SLIT was not affected by age and gender(P>0.05). Main reasons for poor compliance included poor efficacy (48.48%), insufficient education about SLIT (16.67%), inconvenience (15.15%), and adverse reactions(10.61%).CONCLUSION In Guangzhou city, lost follow-up rate in AR patients receiving SLIT is high. Compliance to SLIT is relatively low and improvements shall be made.

Objective:To study the evaluation of left ventricular myocardial function in patients with chronic renal failure by cardiac magnetic resonance feature tracking technique.Methods:Thirty patients with chronic renal failure (chronic renal failure group) who were treated in Jinhua Central Hospital of Zhejiang Province from June 2018 to June 2019 and 30 adult volunteers (healthy control group) who were examined at the same period were enrolled. The cardiac movie sequence was obtained by using Phillips Acheva 3.0 T CMR imaging equipment. The tissue tracking tool in CVI42 software was used to analyze the myocardial strain of the subjects, and the levels of left ventricular ejection fraction (LVEF), end diastolic volume (EDV), end systolic volume (ESV), apoptotic volume (AV), global longitudinal strain (GL), global circumferential strain (GC) and global radial strain (GR) were detected and compared between two groups.Results:The level of EDV in chronic renal failure group was higher than that in healthy control group: (132.3 ± 18.5) ml vs. (111.5 ± 15.1) ml, the level of LVEF in chronic renal failure group was lower than that in healthy control group: (62.41 ± 2.10)% vs. (67.30 ± 3.92)%, and the differences were statistically significant ( P<0.01). The levels of GL, GC and GR in chronic renal failure group were lower than those in healthy control group: (-16.3 ± 3.1)% vs. (-11.1 ± 4.1)%,(-17.5 ± 2.9)% vs. (-13.7 ± 4.7)% and (36.5 ± 9.5)% vs. (46.3 ± 8.4)%, and the differences were statistically significant ( P<0.01). When b = 300, 500 and 800 s/mm 2, the apparent diffusion coefficient (ADC) value of different clinical stages in healthy control group and chronic renal failure group were compared, and the differences were statistically significant ( P<0.01). When the clinical stage of chronic renal failure was higher, its ADC value was lower gradually. Conclusions:Cardiac magnetic resonance feature tracking technology can accurately and effectively evaluate the changes of left ventricular myocardial function in patients with chronic renal failure.

Objective To investigate the sources and transmission routes of clustered cases of healthcare-associated infection(HAI) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) in the intensive care unit (ICU) of a hospital,and provide evidence for the prevention and control of HAI.Methods Clustered cases of MDR-AB HAI in ICU were investigated,specimens of patients and environment were collected and cultured,the isolated strains were performed antimicrobial susceptibility testing.Results Five strains of pathogenic bacteria were isolated from sputum of patients with HAI,5 infected patients were at adjacent beds from the same ICU;the onset time was on January 2-7,2016.A total of 21 strains of pathogenic bacteria were isolated from environmental specimens during the same period,these strains were from quilt,bedside cabinet,treatment trolley,faucet,bedrail,breathing tube,and hands of health care worker(HCWs).Antimicrobial susceptibility testing results showed that strains from patients and environment were all MDR AB,and had the similar antimicrobial resistance pattern.Conclusion The occurrence of clustered HAI cases is due to contamination of HCWs' hands and hospital environment by MDR-AB.