Objective To observe the clinical sedativelefficacy of Tianwang-Buxin Dan treating chronic obstructive pulmonary disease patients undergoing mechanical ventilation.Methods 97 patients with chronic obstructive pulmonary disease undergoing mechanical ventilation were randomly recruited into a treatment group (47 cases) and a control group (50 cases).The control group was treated with midazolam and fentanyl,and the treatment group were treated by Tianwang-Buxin Dan on the basis of the control group.The amount of medazolam and fentanyl,duration of MV,and incidence of side-effects such as hypotension,bradycardia,delirium,nausea,etc were observed in both groups.Results The expected sedative and analgesia scores were obtained in patients of both groups.Compared with the control group,the patients in the treatment group were easier to be aroused and be kept in sedation and analgesia state,besides the dose of midazolam (μg/kg·h-1) (9.51 ±5.87 vs 20.01 ±6.24,P＜0.01)and fentanyl (μg/kg·h-1) was significantly fewer (0.22 ±0.13 vs 0.32±0.12,P＜0.05),duration of MV (days) was shorter(7.13±6.25 vs 12.85±9.13,P＜0.01),duration of disable sedatives for extubating (hours)was shorter (4.35 ± 2.57 vs 8.79±4.02,P＜0.01),the rates of hypotensionand brdycarcardia were significantly lower,the rates of delirium and nausea were clearly lower(both P＜0.05)in the treatment group.Conclusion Sedative effect of Tianwang-Buxin Dan is satisfactory for patients with chronic obstructive pulmonary disease undergoing mechanical ventilation,with the property of easier arousal,lower hypotension rates,lower brdycarcardia rates,lower delirium rates nausea rates,and fewer dosage of midazolam (by 50％) and fentanyl (by 30％) administration.

Objective To investigate the relationship between the different deep venous drainage patterns in the brain and the perimesencephalic subarachnoid hemorrhage (PMSAH).Methods From January 2014 to January 2017,the clinical data of 90 patients with subarachnoid hemorrhage (SAH) diagnosed and treated in the Second Affiliated Hospital of Anhui Medical University were analyzed retrospectively.Thirty patients with PMSAH were in a PMSAH group and 60 patients with aneurismal SAH were in a control group.Unilateral cerebral hemisphere venous drainage was divided into type A (normal continuous):the basilar vein had deep middle cerebral vein drainage and was drained into the great cerebral vein of Galen;type B (normal discontinuous):there was discontinuous venous drainage between the basal vein and the anterior uncal vein and the posterior Galen vein;type C (primitive variant):did not drained into great cerebral vein of Galen,perimesencephalic vein was drained into the superior petrosal sinus or basal vein was directly drained into the transverse sinus or straight sinus.The different combinations of bilateral cerebral hemisphere venous drainage were divided into normal type drainage (typeⅠ:AA),discontinuous type drainage (types Ⅱ:AB or BB),and primitive type drainage (types Ⅲ:AC,BC,or CC).The differences of venous drainage between the two groups were compared.Results In the PMSAH group,both types Ⅰ and Ⅱ drainages accounted for 26.7％ (n=8 in each type) and type Ⅲ accounted for 46.7％ (n=14).In the control group,typeⅠaccounted for 48.3％ (n=29),type Ⅱ accounted for 28.3％ (n=17),and type Ⅲ accounted for 23.3％ (n=14).There were no significant differences in the distribution of three venous drainage patterns between the two groups (χ2=5.804,P=0.055).However,there was significant difference in the types Ⅲ venous drainage between the two groups (χ2=5.081,P=0.024).Conclusion Most of the deep cerebral venous drainage in patients with PMSAH showed basilar venous drainage into the venous sinuses of dura mater,but not to the large cerebral vein drainage,suggesting the way of primitive drainage into the dural sinus was more prone to rupture compared with that of drainage into large cerebral veins.

Objective To investigate the prevalence of latent tuberculosis infection(LTBI),and to identify the risk factors in primary schoolchildren from Shanghai through the population-based field investigation combined with the tuberculosis infection enzyme-linked immunospot assay(T-SPOT.TB)assay.Methods The children in grade 4 and 5 were enrolled from four primary schools in Pudong new district and Yangpu district of Shanghai.Questionnaire interview was applied to investigate the soeiodemographic and clinical information related to LTBI.The T-SPOT.TB assay was used to detect LTBI in the enrolled subjects.Univaitate and multivariate analyses were used to identify the risk factors associated with LTBI among the primary schoolchildren.Results Totally 472 schoolchildren were enrolled in the present study,with 439(93.0%)being vaccinated with bacillus calmette-guerin (BCG) and ten (2.1%) having contact history with tuberculosis (TB) patients.Among the 472 eligible subjects,16(3.4%) children were T-SPOT.TB positive,who had no clinical symptoms andsigns relevant to TB and were defined as LTBI.The LTBI prevalence in BCG vaccinated and unvaccinated children were 2.7% and 12.1%,respectively (OR:6.972;95%CI:1.834-26.500);those in TB contacts and children without TB contact history were 30.0% and 2.8%, respectively (OR: 16. 38; 95% CI: 3. 692-72. 700). Conclusions The prevalence of LTBI among senior schoolchildren in Shanghai is 3.4%. BCG vaccination is protective for children from LTBI, while daily contacts with TB patients increases the risk of LTBI in schoolchildren.

AIM: To establish a RP-HPLC method to determine the fingerprint of Shentong granules. METHODS: Chromatographic conditions consisted of Alltech ODS column and the mobile phase composed of a mixture of acetonitrile-water(gradient elution),detection wavelength at 270 nm.The flow rate was 1.0 mL/min. RESULTS: A HPLC fingerprint determination with a good reproducibility was established,which could separate main principles of Shentong granules. CONCLUSION: The method can provide more information for the quality control of Shentong granules.

Postoperative ileus( POI)is a temporary impairment of coordinated gastrointestinal motility that develops as a consequence of abdominal or non-abdominal surgery and is a major factor contributing to the prolonged hospitalization of patient. In recent years,because of the widespread use of opioid analgesics,morphine induced POI is common. This article reviewed the progress in study on mechanism and management of POI caused by morphine.

Objective To assess the clinical outcomes about the visual qulitity of toric implantable contact lens ( TICL) implantation for high myopia with astigmatism. Methods Fifty-two eyes of 27 patients that underwent TICL implantation were examined. Uncorrected visual acuity( UCVA) ,best corrected visual acuity( BCVA) ,refraction,contrast sensitivity ( CS) with and without glare were evaluated before and after the treatment. Results Significant improvement in UCVA and BCVA were found at 1 month and 6 months after treatment (P<0. 05). The refraction at 1 month ( -0. 56 ± 0. 42)D and 6 months ( -0. 58 ± 0. 22)D after treatment were of no significant difference (P>0. 05), and the astigmatism at 1 month ( -0. 35 ± 0. 60)D and 6 months ( -0. 31 ± 0. 42)D after treatment were of no significant difference either (P>0. 05). The CS with and without glare were all significantly better than results before operation for 6. 0,12. 0 and 18. 0 cycles/degree (P<0. 05),but there were no significant difference between 1 month and 6 months after treatment (P>0. 05). No significant difference were found preoperatively,1 month after treatment and 6 months after treatment in terms of CS with and without glare (P>0. 05). The satisfaction of this investigation was 100%. Conclusion The TICL performed well in correcting high myopia with astigmatism,and it is a good surgical option for the treatment.

Objective To explore the effect of emergency pre-hospital care intervention procedures on patients with acute cerebral hemorrhage treatment. Methods One hundred and eighty patients with acute cerebral hemorrhage rescued in the ambulance of our hospital from June 2011 to June 2014 were selected as the observation group , and another 120 patients of acute cerebral hemorrhage escorted by family members to our hospital during the same period were set as a control group. The patients in the observation group were given guidance nursing, on-site emergency care, emergency care and hospital transit emergency care, and the patients in the control group were given rescue in the hospital. The two groups were compared in terms of effective transit time. Results The effective transit time for the patients in the observation group was (0.87 ± 0.19)h, significantly shorter than the control group (1.26 ± 0.35) h (P<0.05). The complication rate in the observation group was 22.22%, significantly lower than that of the control group (54.17%) (P<0.05). Conclusion Pre-hospital emergency care intervention for patients with acute cerebral hemorrhage can effectively shorten transit time, reduce complications and improve outcome and improve survival, worthy of promotion.

ObjectiveTo evaluate the feasibility and outcome of overnight laparoscopie cholecystectomy (OLC).MethodsThe clinical data of 149 patients with cholecystolithiasis or gallbladder polyps who were admitted to the Tianjin People's Hospital from October 2008 to December 2010 were retrospectively analyzed.All the patients underwent LC in the morning and were discharged 24 hours later.Modified Aldrete scoring was done 4-6hours after LC.Patients were contacted by telephone 3 days after LC and reexamined in the out-patient department 7 days after LC.The hospital cost of patients who underwent OLC or LC was compared using the t test.Results OLC was successfully performed on 149 patients,and the modified Aldrete scores of 130 patients were above 9.The visual analogue scale (VAS) of 118 patients were under 4,and the VAS of 31 patients were above 4.The condition of the 31 patients were closely monitered,and were administered morphine.Of the 149 patieuts,144were discharged 24 hours after operation,and the remaining 5 patients were admitted to general ward because of fever,peritoneal effusion or abdominal pain.The incidence of postoperative complication was 2.0％ (3/149) and the mortality was 0.All the patients were followed up,and none of the patients had an emergency readmission.The duration of incapacity was 5.2 days (range,2-7 days).The mean hospital cost of patients who received OLC was ( 7888 ± 396 ) yuan,which was significantly lower than ( 12121 ± 960) yuan of patients who received LC ( t =38.97,P ＜ 0.05 ).ConclusionOLC is effective and safe,and meets the requirement of health insurance policy.

Objective: To investigate the relationship of loss of P16 expression with biologlical behaviors and prognosis of gastrointestinal stromal tumors(GISTs). Methods: The expression of P16 protein and mRNA was detected in GISTs tissues by immunohistochemistry,Western blot and RT-PCR.The prognosis was evaluated through follow up. Results: The expression rates of P16 protein and mRNA in GISTs were 53.8%(21/39，Frozen tissue)，51.3%(20/39，Frozen tissues)and 51.4%(37/72，Paraffin-embedded tissues)，respectively.The expression of P16 was significantly different among GISTs of different aggressive risk(P<0.05).With the incease of aggressive risk，the expression of P16 was deceased.The expression of P16 was negtively correlated with Ki-67 and patient survival(P<0.05). Conclusion: The loss of P16 expression has a positive correlation with the infiltration and progression of GIST.Detection of P16 protein and mRNA is helpful for the evalutaion of biological behaviors and prognosis of gastrointestinal stromal tumors.

AIM: To investigate the effect of single immunoglobin IL-1 receptor related protein (SIGIRR) on damage of alveolar epithelial cells in acute lung injury induced by lipopolysaccharide. METHODS: The acute alveolar epithelial cell injury model was constructed by stimulation of A549 cells with LPS. In order to over-express SIGIRR, the A549 cells were transferred with eukaryotic expression vector containing full length SIGIRR cDNA. The transcriptional activity of NF-κB was measured by dual-luciferase reporter assay system. The concentrations of IL-1β, TNF- α and IL-6 were detected by ELISA. The levels of these inflammatory factors between the transfected cells and untransfected cells were compared. RESULTS: The over-expression of SIGIRR inhibited the transcriptional activity of NF-κB. The increases in IL-1β, TNF-α and IL-6 concentrations in alveolar epithelial cells induced by LPS were observed. CONCLUSION: SIGIRR in alveolar epithelial cells inhibits TLR4 signals triggered by LPS and attenuates the inflammatory reactions in alveolar epithelial cells, which plays a protective role against the acute damage of the alveolar epithelial cells.