To evaluate the items of critical values and alert limits of the test results , to optimize the critical values report procedure , to modify the laboratory information system ( LIS ) and the hospital information system ( HIS ) , the critical values monitoring platform was designed .Through the monitoring platform,the critical value report rate and critical value report timely rate could be calculated , so reduce medical risks and improve the level of hospital management .

ObjectiveTo investigate the effects of dexmedetomidine on postoperative cognitive dysfunction (POCD) in the elderly patients undergoing laparoscopic radical trachelectomy.MethodsSixty ASA Ⅰ or Ⅱ patients (aged 65-80 yr and weighing 55-74 kg) undergoing elective laparoscopic radical trachelectomy were randomly divided into two groups:30 patients received intravenous injection of dexmedetomidine 0.2 μg · kg - 1 ·h- 1 ( group D EX) and 30 received same volume of normal saline (control group,group NS) after induction of anesthesia.Cognitive function was assessed at 1 day before operation and on the 7th day after operation using a battery of nine cognitive dysfunction tests.ResultsCompared with group NS,on the 7th postoperative day,the incidence of POCD was decreased in group DEX ( P ＜ 0.05 ).ConclusionDexmedetomidine can improve POCD in the elderly patients undergoing laparoscopic radicaltrachelectomy.

To observe the expression of cyclooxygenase (COX)-1 and COX-2 in brain after spared nerve injury (SNI) and compare the analgesic effects of COX inhibitors with different selectivity. Radioimmunoassay, RT-PCR and Western blotting techniques were used to evaluate the change of brain COX expression at different time points( before SNI, 1 h, 12 h, 1 d, 3 d, 7 d, 14 d, 30 d and 60 d after SNI); By exploring hot plate test, we observed the reacting time of animals after injection of saline, NS-398, SC-560 and indomethacin at different time points. The results showed that: ( 1 ) The expression of brain COX-1 didn't increase significantly until 14 d after SNI, while that of COX-2 increased significantly and rapidly after SNI and reached peak at the time point of 1 d ( all P ＜0.05 ); (2) NS-398 showed significant analgesic effect on neuropathic pain after SNI at the early phase ( P ＜ 0.05 ), but didn't persist for over 30 d; ( 3 ) Indomethacin and SC-560 didn't show significant analgesic effects until 14 d. These results suggest that brain COX-1 is involved in the late phase of neuropathic pain and may play a role in the persistence of pain, while brain COX-2 is involved in the early phase of neuropathic pain and may play a role in the pain origination.

Objective To investigate whether I198T gene polymorphisms and Lp-PLA2 activity were the risk factors of CAD.Methods A case-control study was conducted in 398 people with coronary heart disease and 396 controls whose ages and sex were matched with coronary heart disease from Peking University People's Hospital in October 2009 to May 2010.The Il98T gene polymorphisms were detected by the amplification refractory mutation system (ARMS-PCR) using TaqMan probe.Lp-PLA2 activity,CHO,GLU,TG,HDL,LDL,hs-CRP,Lp (a) were investigated at the same time.The data were analyzed by Independent-samples T Test,Chi-square test,One-Way ANOVA,Binary Logistic Regression.Results LpPLA2 activity was significant higer in CAD group than that in the control group (31.51 nmol · ml-1 · min-1＞21.31 nmol · ml-1 · min-1,F =16.40,P ＜0.05).Adjustment for various traditional cardiovascular risk factors,including ages,sex,CHO,TG,Hs-CRP,Lp(a),and GLU,quartiles of Lp-PLA2 activity were associated with risk of CVD with a OR of 7.5 (95％ CI:2.34-24.05) for comparison of the top to bottom quartile.Lp-PLA2 activity was the highest (22.68 nmol · ml-1 · min-1,P ＜ 0.05) in genotype Ⅱ and the lowest (11.35 nmol · ml-1 · min-1,P ＜ 0.05) in genotype TT,the association between I198T and coronary artery disease was not significant (P ＞ 0.05).Conclusions Lp-PLA2 activity was significantly higher in CAD group and was a risk factor for CAD.There was no significant association between I198T polymorphism and CAD.

Objective This study is to understand the interpersonal conflict management styles of head nurses and its related factors. Methods A cross- sectional survey was conducted in 440 head nurses in Shanghai Hospital, using"personal information table"and the "Rahim Organizational Conflict Inventory- Ⅱ"as the tools for data collection. Results When dealing with conflicts, "integrating"is the most commonly used approach of head nurses, while "dominating"the least used one. Age, education, work experience and other factors were statistically significant with the conflict management styles head nurses used. Conclusions The most commonly used conflict management style of head nurses tends to a winwin way. Age, education, work experience and other factors can affect the ways of managing conflict.

OBJECTIVE To compare the results of plasma scalpel assisted uvulopalatopharyngoplasty(UP PP) under local anesthesia(PS)with radiofrequency volumetric tissue reduction(RF)in the treatment of obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS Sixty-nine and 79 patients were treated with PS and RF respectively. They were followed-up for 6 and 12 months after operation and the outcomes of the 2 surgical methods were compared. RESULTS The improvement rates at 6 months after PS and RF were 85.5 % and 83.5 % respectively. There was no significant difference between the 2 methods. The improvement rates at 12 months after PS and RF were 78.3 % and 49.3 % respectively. The difference was significant. No major complication was found. CONCLUSION The long-term outcome of PS is better than that of RF. PS surgery may be comparable with surgery under general anesthesia in some special cases.

Objective To evaluate the efficacy and safety of sunitinib as first line treatment in patients with metastatic renal cell carcinoma (RCC). Methods This study included 46 Chinese patients who were diagnosed with metastatic RCC after radical nephrectomy. The patients received oral sunitinib (50 mg once daily on a 4 weeks on, 2 weeks off) on a 6 weeks cycle dose schedule until disease progression or intolerable toxicities occurred. Results The overall objective response rate was 32.6% (95% confidence interval [CI, 19.1% to 46. 1%]), and the disease control rate was 86.9%,with complete response (CR) 0 (0%), partial responses (PRs) 15 (32.6%), stable disease (SD) 25(54.3 %), and progression disease (PD) 6 ( 13. 1%). The median progression-free survival was 11 months, and the 1-year survival rate was 65.2%, while the median overall survival (mOS) has not been reached. The main adverse events included fatigue 33 (71.7%), skin discoloration 29 (63.0 %),anorexia 28 (60.9%), hand-foot syndrome 26 (56.5%), oral mucositis 25 (54.3%), hypertension 19 (41.3%), facial edema 18 (39.1%), diarrhea 17 (37.0%), hemorrhage 17 (37.0%), nausea 15 (32.6%), and hematological toxicity: leukopenia 32 (69.6%), neutropenia 30 (65.2%), thrombocytopenia 28 (60.9%), anemia 21 (45.7%). Most of grade 3/4 serious adverse events were thrombocytopenia in 15 (32. 6%) patients. Conclusions Sunitinib has a prominent effect in metastatic renal cell cancer in a Chinese population with mostly mild to moderate adverse reactions. More attention should be paid to grade 3/4 adverse reaction of thrombocytopenia.

AIM: To compare the expression of three cyclooxygenase (COX) isoforms in the process of inflammatory pain and evaluate the analgesic effects of different protocols about usage of COX inhibitors on inflammatory pain. METHODS: Formalin was injected subplantarly to mice to induce inflammatory pain. The expression of COX-1, COX-2 and COX-3 was evaluated by radioimmunoassay and RT-PCR, respectively. For the analgesic effect assay, animals were divided into 5 groups including control, SC, NS, IN and NS + SC group. The former 4 spectively. In the NS + SC group, animals received NS398 during the first 1 month and SC-560 during the second month in the NS + SC group. RESULTS: The expression of COX-1 was higher at the late phase while that of COX-2 was higher at the early phase of inflammatory pain. The expression of COX-3 did not significantly change in the process of inflammatory pain. Additionally,behavioral assessment showed that using COX-2 inhibitors at the early phase followed by COX-1 inhibitors at the late phase could get better analgesic effect on inflammatory pain compared with single using COX-1 selective or COX-2 selective inhibitors. CONCLUSION: In brain, the expression of COX-2 increases rapidly in the inflammatory pain process while COX-1 expression does not increase till the late phase. Brain COX-3 is poorly involved in the inflammatory process. Combined use of COX-1 and COX-2 selective inhibitors may be a better protocol in inflammatory pain treatment.

Objective To study the expression of CD27 and CD28 in antigen-specific CD4~+T cells in patients with pulmonary tuberculosis and healthy people, and understand the role of differentiated stages of CD4~+T cells in the pathogenesis of tuberculosis. Methods The expression of CD27 and CD28 was analyzed by CD4, CD154, CD27 and CD28 staining and flow cytometry. The distributions of CD27 and CD28 in antigen-specific CD4~+T cells were compared between patients with pulmonary tuberculosis and healthy controls. Results In patients of pulmonary tuberculosis, the frequencies of CD27 + CD28 + (early differentiated stage), CD27~- CD28~+ and CD27~+ CD28~- (intermediate differentiated stage), CD27~- CD28~-(fully differentiated stage) T cell subsets in antigen specific CD4~+T cells were (49. 55 ±6. 15)%, (26. 85 ±3. 87)% ,(7. 2 ± 1.37)% and ( 16. 35 ±3.97)%, respectively. In healthy controls, the frequencies of the four subsets in antigen-specific CD4~+T cells were ( 51.81 ± 4. 94 ) %, ( 29. 83 ± 5.33 ) %, ( 12. 65 ±4. 48)% and (5.7±2)%, respectively. The early differentiated CD4~+T cell was the major subset both in patients and healthy people, however, which had significant difference compared with the fully differentiated subset ( t = 2. 26, P < 0. 05 ). Conclusion The population frequency of the fully differentiated CD4~+T cells in patients with pulmonary tuberculosis was significantly higher than that in healthy people. This suggested that the differentiation degree of the antigen-specific CD4~+T cell might be related with pulmonary tuberculosis.

Objective To study population frequencies of CD4+,CD154+ T cell subset in patients with pulmonary tuberculosis and controls with positive PPD reaction. Methods Flow cytometry was used to detect the CD4+,CD154+ T cell subset, the population frequen-cies in patients with pulmonary tuberculosis and controls were compared. Results The expression level of CD154 was higher when PE-la-beled CD154 antibody was added during stimulation period, compared with CD154 labeling after stimulation(1.51±0. 36/0. 40±0. 13, P <0.05). The CD154+ cells were not detectable in fresh isolated CD4+ T cells, but significantly increased after stimulation with specific anti-gens. The population of CD4+, CD154+ T cell subset was significantly reduced in patients with active pulmonary tuberculosis, compared with healthy controls with PPD positive reaction(0. 72±0. 32/1.65±0. 76, P <0. 01). Conclusions The population of CD4± ,CD154± T cell subset was significantly reduced in patients with active pulmonary tuberculosis, which indicated that it may play an important role in the de-velopment of tuberculosis.