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 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 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 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.

Objectives To validate the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) in hospitalized pediatric patients, and to assess the nutritional status and nutritional risk using STAMP. Methods the nutritional status of hospitalized pediatric patients was investigated by adopting STAMP. The STAMP score≥4 was deifned as a high standard of nutritional risk. Results Among 1 506 hospitalized children, children with high nutritional risk accounted for 26.56%. The overall prevalence of malnutrition and stunting was 19.12%and 10.16%, respectively. There was signiifcant diffe-rence in stunting among each department (P<0.05), which was the highest in department of internal pediatrics. The proportion of patients receiving nutritional support was 10.09%. Among them, the rate of parenteral and enteral nutrition support was 7.84%and 2.92%, respectively. The ratio of parenteral nutrition to enteral nutrition was 2.68:1. After intervention to hospitalized pa-tients with high nutritional risk, the overall prevalence of high nutritional risk decreased from 26.56%at admission to 21.71%at discharge (P<0.05). Conclusions STAMP can objectively relfect the possible malnutritional risk in hospitalized pediatric patients. The nutrition condition of the pediatric patients can be improved through nutritional risk management.

Objective To investigate the effects of morphine on PTEN expression and NF-κB activity in human gastric carcinoma cell line MGC-803.Methods The human gastric cancer cell line MGC-803 was purchased from Cell Biology Research Institute,Chinese Academy of Sciences,and cultured in DMEM liquid culture medium.The cells were randomly divided into 2 groups(n = 6 each): control group and morphine group.The cells was exposed to 0.1 μmol/L morphine in morphine group.The apoptosis was assessed by flow cytometry after being incubated with morphine for 24 h.PTEN expression and NF-κB activity were detected using RT-PCR and Western blot.Results The apoptotic rate was significantly increased,PTEN expression was up-regulated and NF-κB activity was significantly decreased in morphine group compared with control group(P ＜ 0.05).Conclusion Morphine can promote the apoptosis in human gastric cancer cells by up-regulating PTEN expression and decreasing NF-κB activity.

Objective To explore the measures and methods to cope with the early stage epidemic struck of H7N9 avian influenza,as the head nurses of the department of infectious diseases.Methods The main work focus of the head nurses of the department of infectious diseases were analyzed during the early stage of H7N9 epidemic struck systematically by reference to the domestic literatures.Results At the early stage of H7N9 epidemic struck,the main work focus of the head nurses of the department of infectious diseases was to draw up every emergency plans,prepare necessary protective medical supplies,train medical staff,and be ready to the preview and triage.Conclusions The head nurses of the department of infectious diseases should pay close attention to the progress of H7N9 epidemic struck,and get ready for all related work in order to ensure smooth treatment during early stage of the epidemic struck.