Objective To compare the influences between bronchial blocker (BB) and double lumen tube (DLT) in respiratory mechanics and blood gas in one lung ventilation. Methods Thirty-six patients undergoing pulmonary lobectomy or radical operation of esophageal carcinoma were randomized into group BB (17 cases) and group DLT (19 cases). In group BB,BB was intubated under the guidance of a fibreoptic bronchoscope after intubation of single lumen tube; while in group DLT, the position of the tube was confirmed using fibreoptic bronchoscopy after intubation. The peek airway pressure (Pmax) and pulmonary dynamic compliance (CLdyn) during double lung ventilation and one lung ventilation were recorded in recumbent position. Blood samples were taken from, radial artery 20 min after one lung ventilation for blood gas analysis,partial pressure of oxygen in artery(PaO2), partial pressure of carbon dioxide in artery(PaCO2), saturation of arterial blood oxygen (SaO2) were recorded. Results No significant difference was found in Pmax and CLdyn between two groups during double lung ventilation,but Pmax was significantly lower in group BB [(21.00 ± 3.59) cm H2O,1 cm H2O = 0.098 kPa] than that in group DLT [(26.89 ±4.21) cm H2O] (P＜0.05), and CLdyn was greater in group BB [(28.10 ±6.24) ml/cm H2O] than that in group DLT [(24.00±7.13) ml/cm H2O ] (P ＜ 0.05); there were no significant differences in PaO2, PaCO2, SaO2 betweentwo groups during one lung ventilation (P＞ 0.05). Conclusion The influence to respiratory mechanics in one lung ventilation is smaller using BB than using DLT, BB has blocker well applicable value in clinics.

Objective:To optimize the storage placement of drug in automatic dispensing machine so as to increase the dispensing speed and work efficiency.Methods: The drugs were dispensed on the up and down side of the center of axle wire from high to low according to the dispensed frequency. The application regularity of various drugs was analyzed by using a number of prescription information and the relevant drugs were stored in nearest tank aroundthe drug outlet as the principle of minimum time algorithm. Through optimizing the storage placement of automatic dispensing machine and applying average dispensing time as evaluation index, the change of average dispensing time between before and after 3 months of the optimization of storage placement was analyzed.Results: After the storage placement was optimized, average dispensing time was shortened 2.0s. And the difference of the time between before and after optimization was statistically significant (t=11.92,P<0.05). Conclusion: Through applying minimum time algorithm, the optimized storage placement of automatic dispensing machine shortens the dispensing time of prescription and increases work efficiency.

Objective To evaluate the value of quantized diffusion-weighted imaging (DWI)in diagnosis of focal liver lesions. Methods A retrospective analysis was performed in 120 patients with focal liver lesions and in 12 healthy controls who underwent DWI and routine non-enhanced MRI at 3.0T.In 120 patients,there were 1 79 focal liver lesions including 53 hepatocellular carcinomas (HCC),61 metastatic tumors,32 hemangiomas and 33 cysts.The DWI and apparent diffusion coefficient (ADC)maps and ADC val-ues of the lesions and the normal liver were analyzed and measured with a b value of 800 s/mm2 ,and the statistical differences be-tween two groups were compared.Results DWI showed 33 hepatic cysts with low signal,and 5 1 hepatocellular carcinomas,61 he-patic metastases and 32 hepatic hemangiomas with high signal,thus the signal difference between hepatic cyst and other lesions was significant (P <0.05).The ADC images of HCC and metastatic tumors were cold colour,and those of hepatic cysts and hemangio-mas were hot colour.The ADC value between HCC,liver metastatic tumors,hepatic hemangioma and cysts were significant different (P <0.05).However,there were no significant differences in ADC value between HCC and metastatic tumors (P >0.05).In addit-on,the ratios of the ADC values of lesion to background liver between hepatocellular carcinoma and metastases were significantly dif-ferent (P <0.05).Conclusion DWI and ADC maps,and ADC value can provide importantly additional information for the diagnosis and differential diagnosis of focal liver lesions.

Objective To evaluate the clinical efficacy and complications of the covered stents in the treatment of malignant upper gastrointestinal tract stricture.Methods 53 cases with malignant upper gastrointestinal tract obstruction underwent treatment with covered stents.The therapeutic efficiency and the complications were observed.Results The procedures were successful in 50 cases in one time,the successful rate was 94.3%.The complications included chest pain and foreign body sensation,diarrhea,restenosis,stent migration,esophagus reflux,bleeding.Conclusion The treatment with covered stents was a safe,simple and effective management for the patients with malignant upper gastrointestinal tract obstruction who had lost the chance of surgical resection or refused to undergo operation.

Objective To explore the effects of glargine combined metformin and repaglinide combined metformin treatment on metabolism of free radicals in elderly patients with type 2 diabetes(T2DM ) .Methods Selected 90 cases of elderly T2DM pa‐tients were divided into 2 groups:group A (glargine combined metformin treatment group) ,group B (repaglinide combined met‐formin treatment group) .Each group had 45 patients ,they were all treated for four weeks in antidiabetic therapy ,select 40 healthy people in physical examination center of hospital as controls .They were measured in patients with fasting plasma glucose (FPG) ,2h postprandial blood glucose(2hPG) ,malondialdehyde (MDA) ,glutathione peroxidase (GSH‐PX) ,8‐iso‐prostane (8‐iso‐PGF2a) , Hcy and so on ,before and after treatment .Results (1)Before treatment ,the FPG ,2hPG ,HbA1c ,MDA ,8‐iso‐PGF2a ,Hcy of group A and B were higher than the control group ,while the level of GSH‐PX was lower than the control group ,the difference was statis‐tically significant(P<0 .05);(2)After treatment ,the levels of FPG ,2hPG ,MDA ,8‐iso‐PGF2a ,Hcy were significantly reduced and the levels of GSH‐PX was significantly elevated in group A ,the differences were statistically significant (P<0 .05);(3)There were no obvious difference in reduce the levels of FPG ,2hPG and HbA1c between group A than group B(P>0 .05) ,While 8‐iso‐PGF2a , MDA ,Hcy of group A had a bigger decline rate than group B ,the GSH‐PX in group A increased more compared with group B ,the difference was statistically significant (P<0 .05) .Conclusion (1)There is a high oxidative stress state in elderly patients with T2DM ;(2)Both treatments could improve diabetics oxidative stress levels ,but glarginecombined metformin to reduce diabetics oxi‐dative stress is superior to repaglinide combined metformin .

Tumor markers have been of vital importance in cancer diagnosis and treatment.However,the sensitivity of tumor markers for early diagnosis is low and can not be widely used.Quantum dots are new fluorescent nanoparticles with unique photophysical and chemical properties,thus having a great potential impact on cancer pathogenesis,early diagnosis,targeted therapy,prognosis and monitoring by combining with tumor marker.The current research is focused on the detection of specific tumor markers or molecules based on tangible carriers such as cells and tissues.One of the most promising clinical applications would be to explore the potential of this highly sensitive labeling technique for the detecting and imagining of tumor markers in serum and other body fluids,where some progress has already been made recently.How to detect early cancer based solely on invisible carriers would be the next step of quantum dots bio-probes in clinical use,so as to develop a new detection technique with greater sensitivity,specificity,rapidity and convenience.

OBJECTIVE To discuss the function of sustaining quality improvement in preventing perineum wound infection.METHODS The perineum wound infection situation in 2003 was retrospectively analyzed,and since then the measures for sustaining quality improvement were implemented.RESULTS In 2004 and in 2005 the perineum wound infection percentage and the stitch inflammation rate were obviously reduced than in 2003.The difference was statisticaly significant.CONCLUSIONS Sustaining quality improvement is an unceasing,gradually advancing and long-term process.The prevention of perineum wound infection is a long time work for obstetrics workers.To carry out strictly the aseptic technical operation,grasp skilled suture technology,choose easily absorbable suture,maintain suitable cleanliness and nursing and use the antibiotic could be effectively to prevent the perineum wound infection and the stitch inflammation occurrence.

Objective To screen the potential biomarkers in plasma of rats with acute paraquat (PQ) poisoning using gas chromatography-mass spectrometry (GC-MS) based metabonomics technology,and to provide concrete evidence for early diagnosis.Methods Eight Sprague-Dawley (SD) rats were randomly divided into PQ poisoning group (intragastricly administrated with PQ solution 100 mg/kg) and control group (intragastricly administrated with the same volume of normal saline) according to the random number table,with 4 rats in each group.The general situation of rats was observed at 2,24 and 48 hours after administration.The blood of eye sockets was collected,the endogenous small molecule metabolites in plasma were determined with GC-MS method,and metabolic profile analysis and random forest analysis were performed to filter the potential biomarkers.Results ① The rats in PQ poisoning group gradually appeared lack movement,tachypnea,abdominal seizure and other symptoms of poisoning.In control group,the vital signs were stable.② The metabolites in plasma of rat were analyzed with GC-MS analysis,and the diagrammatic figure was plot as combined with principal component analysis (PCA) and partial least squares-discriminated analysis (PLS-DA) model,which showed that the distribution of plasma metabolism in PQ poisoning group was more diffuse but in the control group was more intensive,indicating that the metabolic patterns in two groups were different.From 2 hours after PQ administration,the metabolic trajectory in PQ poisoning group was significantly deflected compared with that of the control group,which was similar to control group until 48 hours,indicating that the metabolites in plasma of rat showed obvious difference in the early period.Five kinds of potential biomarkers with large weights were selected by random forest method which were serine,L-asparagine,hexadecanoic acid,octadecanoic acid,and arachidonic acid,the retention time was 15.259,24.345,33.334,37.695,and 40.254 minutes,respectively.The levels of serine,L-asparagine,arachidonic acid in PQ poisoning group were significantly higher than those of the control group,peaked at 48,48 and 24 hours,respectively (40.884-5.38 vs.28.85±2.32,6.61±1.31 vs.0.76±0.65,14.21±4.28 vs.4.42±1.19,all P ＜ 0.01),and the levels of hexadecanoic acid and octadecanoic acid were significantly lowered,reached tough at 48 hours (39.09 ± 10.23 vs.83.99 ± 20.49,44.03 ± 3.60 vs.140.76 ± 73.91,P ＜ 0.05 and P ＜ 0.01).The changes in these biomarkers were related to the toxicity of PQ,indicating that PQ could interfere the energy and lipid metabolism in rats.Conclusion Combine with the metabonomics analysis,screened plasma serine,L-asparagine,arachidonic acid content in PQ poisoning rats increased significantly,and hexadecanoic acid and octadecanoic acid content decreased significantly,which can preliminary diagnose acute PQ poisoning with animal general performance.

[ABSTRACT]OBJECTIVETo investigate the expression of cytokeratin (CK) 4 and 13 in sinonasal squamous cell carcinoma (SNSCC) and their pathobiological implications for tumor angiogenesis and metastasis. METHODSThe expression of CK4 and CK13 was detected by immunohistochemistry in normal and cancerous tissues in 42 cases of SNSCC, integral optical density (A) was measured by computer analysis of images and analyzed by SPSS13.0.RESULTSCK4 and CK13 were expressed significantly higher in normal tissues than in cancerous tissues of SNSCC. Moreover, the expression level of CK4 and CK13 was related to the differentiation of SNSCC, which was higher in the well/middle differentiated ones than in poor ones. The expression of CK4 was significantly associated with the tumor size, clinical stage and cervical lymphatic metastasis in SNSCC. While CK13 had no relationship with these three factors.CONCLUSIONThe detection of CK-4 and CK-13 might play an important role in the prognostic evaluation of SNSCC.

Background and purpose:18?-glycyrrhetinic acid(GA) is one of the important components of glycyrrhiza.Recent years,studies showed that GA has the effect of proliferation inhibition in human acute lymphoblastic leukemia cells,human liver carcinoma and lung cancer cells.We investigated the effects of GA on induction of apoptosis in human breast carcinoma(MCF7) cells.The previous studies have demonstrated that the dynamic change of intracellular free Ca~(2+) concentration([Ca~(2+)]i)plays important roles in many links of apoptosis-induced process.Therefore we also researched the relationship between GA-induced apoptosis and [Ca~(2+)]i in MCF-7 cells.Methods:After MCF-7 cells were treated with 50-250 ?mol/L GA for 24 h,cell viability for proliferation was assessed by MTT assay.MCF-7 cells treated with 100 ?mol/L and 150 ?mol/L GA for 24 h,the apoptotic rates in MCF7 cells were examined by terminal deoxynucleotide transferase mediated dUTP nick-end-labeling method,flow cytometry with Annexin V/ propidium iodide fluorescent stain and single cell gel electrophoresis assay(SCGE).For cells treated with 150 ?mol/L GA for 24 h,i was measured by Fure-2 fluorescein load method.For cells treated with 150 ?mol/L GA combined with 100 ?mol/L BAPTA-AM or 0.5 mmol/L EGTA for 24 h,cell apoptosis were examined by SCGE.Results:For cells treated with GA from 100 ?mol/L to 250 ?mol/L,the rate of proliferative inhibition was increased significantly(P