Objective Research of chromosome’s influence and curative effect on first and second generation tyrosine kinase inhibitor therapy to CML patients.Methods Giving conventional genetic analysis to 80 Ph+ CML patients,and contrast CML patients’chromosome changing situation with first and second generation tyrosine kinase inhibitor therapy.Results There were 1 1 cases with other abnormalities of chromosome number and structure in 80 cases of Ph+ CML patients,and 10 cases were resistant or intolerant to imatinib.35 patients (87.5%)achieve sustained complete cytogenetic remission (CCyR)who treated with imatinib (TKI-Ⅰ)in the total 40 cases,in these 35 patients,7 cases (17.5%)got CCyR in 3 months;10 cases (25%)got CCyR in 6 months,13 cases (32.5%)got CCyR in 12 months,and 5 cases (12.5%)got CCyR in 18 months.33 patients (82.5%)achieve sustained completecytogenetic remission (CCyR)who treated with dasatinib/nilotinib (TKI-Ⅱ)in the total 40 cases,in these 33 cases,16 cases (40%)got CCyR in 3 months;9 cases (22.5%)got CCyR in 6 months,5 cases (1 2.5%)got CCyR in 1 2 months,and 3 cases (7.5%)got CCyR in 1 8 months.Conclusion Ph+ CML patients combined with other chromosome abnormity were more easily to be resistant or intolerant to imatinib,espe-cially in acceleratd phase and blastic phase.First and second generation tyrosine kinase inhibitor have little difference to treat with CML patients in long time efficacy,but the second generation effect is better than first generation in short time effica-cy.

Objective To analysis the relationship between blood homocysteine concentration in diabetic retinopathy patients with vascular endothelial cell damage and platelet activation.Methods 80 type 2 diabetes mellitus(T2DM)patients,including 50 no diabetic retinopathy(NDR group)and 30 diabetic retinopathy(DR group)and 30 normal controls were selected to measure the concentration of Hcy as well as circulating endothelial cells(CEC),Endothelin(ET),Yon Willebrand(vWF)and platelet activation markers CD62p and CD63.Results The level of CEC,ET,vWF,CD62p,CD63 and Hcy in T2DM group were,distinctly higher than those of control(P＜0.01),furthermore,the level of these markers in DR group were also higher than that in NDR group(P＜0.01).Blood CEC level Was positively related with ET(r=0.839,P＜0.05),and the same relationship was found in Hcy and CEC(r=0.615,P＜0.05),ET(r=0.642,P＜0.05),CD62p(r=0.623,P＜0.05)and CD63(r=0.542,P＜0.05).Conclusions High blood Hcy,CEC,ET,vWF,CD62p and CD63 level were tighdy related with DR.High level of Hcy,vascular endMermis cell damage and platelet activation maybe play an important role in the pathogenesis of DR.

Primary biliary cirrhosis (PBC) is considered to be an autoimmune liver disease. Its etiology is unknown. Pathogenesis of PBC is associated with many aspects such as genetic factors, environmental factors, independent activity of target antigen, T-cell autoreactive immune responses and so on. Recently, new materials that involved in the morbidity of PBC have been identified constantly. Antimitochondrial antibodies (AMA) are characteristic of PBC. In particular, AMA-M2 is highly positive for the serological diagnosis mark of PBC. At present, treatment still cannot be for the etiology of PBC. Symptomatic treatment and support treatment are main measures. Ursodeoxycholic acid (UDCA)is the only one recognized medication with specific effect on the PBC. At present, the liver transplant can increase the survival rate and extend their survival time for end-stage of patients with PBC. This article emphasis on the progress of pathogenesis and treatment of the PBC are reviewed to explore research.

Objective To investigate the efficacy of patient-controlled epidural analgesia(PCEA)with ropivacaine plus fentanyl for postoperative analgesia after suprapubic prostatectomy(SPP).Methods Thirty-six ASAⅡorⅢpatients aged 62-78 yrs weighing 52-84 kg undergoing SPP were randomly divided into 3 groups with 12 patients in each group:groupⅠreceived PCEA with 0.12% ropivacaine and fentanyl 1?g?ml~(-1);groupⅡreceived PCEA with 2% ropivacaine and fentanyl 1?g?ml~(-1) and groupⅢreceived patient-controlled intravenous analgesia(PCIA)with morphine 0.2 mg?ml~(-1).Postoperative pain was assessed using VAS(0=no pain,10= worst pain).The degree of motor blockade(modified Bromage scale)was evaluated at 6,24,48 and 72 h after operation(T_(1-4)).Bladder spasm episodes were recorded.Side effects including nausea,vomiting and pruritus and the total number of RBC in rinse solution were also recorded.Results(1)Bromage score(0=no motor block,3 =inability to flex ankle joint)was significantly higher in groupⅠandⅡthan in groupⅢat T1(6 h after op.), but significantly lower in groupⅠandⅢthan in groupⅡat T_(2-4)(24-72 h after operation).(2)VAS score(0= no pain,10=worst pain)was not significantly different among the 3 groups without bladder spasm but significantly higher in groupⅢthan in other 2 groups during episodes of bladder spasm.(3)The number of bladder spasm episodes was not significantly different among the 3 groups within 6h after operation,but was significant larger in groupⅢthan in the other two groups during 6-72 h after operation.During 6-24 h after operation more bladder spasm attacks occurred in groupⅠthan in groupⅡ.(4)The incidence of side effects was significantly lower and the total number of RBC in rinse solution was significantly smaller in groupⅠandⅡthan in groupⅢConclusion PCEA with 0.12% or 2% ropivacaine plus fentanyl can effectively reduce the number of bladder spasm attack and postoperative bladder bleeding.Different concentrations of ropivacaine should be used for PCEA during different postoperative periods.

Objective: To observe the effect of electroacupuncture (EA) combined with Stretta radiofrequency treatment on contents of motilin (MTL) and gastrin (GAS) in gastroesophageal reflux disease (GERD) patients.
Methods: A total of 90 eligible GERD cases were randomly allocated into three groups, 30 in each group. Patients in the EA group were treated with EA, patients in the radiofrequency group were treated with Stretta radiofrequency, and patients in the observation group were treated with EA combined with Stretta radiofrequency. Assessment was made after a course of treatment.
Results: The recovery, improvement and failure cases and total effective rate in the EAgroup were 2, 18, 10 and 67.7% respectively, versus 13, 13, 4 and 86.7% in the radiofrequency group and 20, 9, 1 and 96.7% in the observation group. The therapeutic efficacy in the observation group was significantly better than that in the other two groups (P<0.01). After treatment, symptom scores of regurgitation, heartburn and substernal burning pain in all three groups were significantly reduced (P<0.05); the reduction in the observation group was more significant than that inthe other two groups (P<0.05),and the reduction in the radiofrequency group was more significant than that in the EA group (P<0.05). After treatment, the contents of MTL and GAS in all three groups were increased; and the increase in the observation group was more significant than that in the other two groups (P<0.05).
Conclusion: EA combined with Stretta radiofrequency treatment can significantly improve the clinical effect of GERD patients, improve regurgitation, heartburn and substernal burning pain and increase the contents of MTL and GAS.

Objective To investigate the effect of partial liquid ventilation(PLV) with perfluorocarbon(PFC) on pulmonary surfactant during beatment of acute lung injury(ALI) induced by oleic acid. MethodsTwenty-four male Japanese white rabbits weighing 2. 1-2.6 kg were randomly divided into three groups(n = 8 ineach group): groupl: normal animal + mechanical ventilation (MV); group 2: ALI + MV; group 3: ALI +PLV.The animals were anesthetized with intraperitoneal ketamine 100 mg/kg, trachectomized and mechanicallyventilated (FiO_2 = 1, RR = 35 bpm, I: E = 1: 2, PEEP = 5 cm H_2O, PaCO_2 was maintained at 35-45 mm Hg byadjustment of tidal volume) .In group 2 and 3 ALI was induced by infusion of oleic acid 150?g/kg via centralvenous catheter over 30 min period. ALI was considered established when PaO_2 /FiO_2 was

OBJECTIVE To explore the scientific and standardized experience of blood purification center of infectious diseases hospital in the hospital infection management.METHODS The development of its experience was summed up.RESULTS Sound system,wide range of focused training,as well as hospital infection in day-to-day management basis,and establishment and improvement of the incident management were carried out to control the nosocomial infection.CONCLUSIONS Correct system and norms,stringent measures and continuously updating the concept of nosocomial infection can effectively improve the management of hospital infection.

Objective To evaluate the effect of dexamethasone on lumbar plexus combined sciatic nerve block (CLPSNB). Methods Sixty patients were randomly allocated into three groups with 20 cases each. Guided by a nerve stimulator,CLPSNB was performed with 0. 5% ropivacaine 45 ml plus dexametbasone 10 mg in group A,0. 5% ropivacaine 45 ml plus normal saline(NS) 2 ml and dexametbasone 10 rng Ⅳ. in group B,or 0. 5% ropivacaine 45 ml plus NS 2 ml in group C. ResultsThe durations of sensory and motor blockade in group A were [(15. 2 ± 3. 3)h and (12. 6 ± 2. 8)h], respectively, which were significantly longer than [(10. 1 ± 2. 1)h and (7. 9 ± 1.6)h]in group B and [(10. 4±2. 5)h and (7. 6±2. 3)hi in group C(P<0. 05). Conclusion Dexarnetbasone added to 0. 5% ropivacaine significantly prolonges CLPSNB.

Objective To observe the effects of dexmedetomidine combined with propofol on the hemodynamics level in elderly patients undergoing gastroscopy.Methods 68 patients undergoing endoscopy from January 2014 to January 2015 in our hospital were selected and randomly divided into observation group and control group, 34 cases in each group.Propofol anesthesia combined with dexmedetomidine was used in the observation group and propofol anesthesia was used in the control group.The RR ( respiratory rate) and HR ( heart rate) of the two groups were observed before the administration (T0), after the administration (T1), when the gastroscope was inserted (T2), after the examination (T3), 5 min after the examination (T4), MAP (mean arterial pressure) and SpO2(pulse oxygen saturation) were measured.The postoperative consciousness, orientation recovery time and surgical tolerance were compared between the two groups.The anesthetic adverse reactions were recorded during the operation.Results The observation group in T1, T2, T3, T4 time point HR were lower than the control group, and the data remained relatively stable level, the difference was statistically significant (P<0.05).There was no significant difference in consciousness recovery time and recovery time of orientation force between observation group and control group.The tolerance of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05).The total adverse reaction rate of the observation group was 32.35% lower than that of the control group 88.24%, the difference was statistically significant ( P <0.05 ) .Conclusion Dexmedetomidine combined with propofol for the elderly patients with painless gastroscopy , analgesic effect is good, and can better maintain hemodynamic fluctuations, reduce propofol anesthesia adverse reactions, does not Affect the patient's awareness and ability to restore the direction.

Respiratory depression is a common adverse effect of opioids .Currently, the mechanisms and manage-ment of opioid-induced respiratory depression ( OIRD) are one of the research foci .OIRD arises from stimulation ofμ-opioid receptors in the pre-Botzinger complex and the Kolliker-Fuse neurons .Adenylyl cyclase , calcium chan-nels, and G-protein-gated inwardly rectifying potassium (GIRK) channels may be the key cellular signaling mecha-nisms of OIRD .