OBJECTIVE:To investigate the effects of Dexmedetomidine hydrochloride injection on elderly patients underwent thoracic surgery during anesthesia recovery period. METHODS:Totally 60 elderly patients underwent thoracic surgery in our hospi-tal during Jun. 2014-Feb. 2016 were selected as research objects and then divided into control group and observation group ac-cording to even and odd-numbered admission order,with 30 cases in each group. Control group was given Propofol injection 0.5-1 mg/kg intravenously 5 min after mask oxygen inhalation. Observation group was given Dexmedetomidine hydrochloride injec-tion 0.5-1.0 μg/kg intravenously. Both group were successively given Etomidate emulsion injection 0.1-0.2 mg/kg,Sufentanil citrate injection 0.3 μg/kg and Cisatracurium besilate for injection 0.2 mg/kg intravenously for anesthesia induction;tracheal intubation was performed and ventilator was used to assist ventilation after anesthesia induction. And then control group was given continuous intravenous dripping of propofol 3-6 mg/kg·h;observation group was given continuous intravenous dripping of Dexmedetomidine hydrochloride injection 0.2-0.5 μg/(kg·h). At the same time,both group were given continuous intravenous dripping of sufentanil 0.1-0.2 μg/(kg·min)and cis-atracurium 1.5-2 μg/(kg·min),and continuously inhaled 1%-2% sevoflurane for anesthesia mainte-nance. Hemodynamic index(HR,MAP,SpO2),postoperative recovery,the occurrence of delirium,restlessness,cough and involun-tary movement were observed in 2 groups before surgery (T0),after anesthesia induction (T1),at the moment of sputum suction and extubation(T2),5 min after extubation(T3),30 min after extubation(T4). RESULTS:At T2 and T3,HR and MAP of control group were increased significantly compared to at T0,T1,and higher than those of observation group,with statistical significance (P<0.05). At T0,T1,T4,there was no statistical significance in HR and MAP between 2 groups (P>0.05). At T0,T1,T2,T3, T4,there was no statistical significance in SpO2 level between 2 groups(P>0.05). The breathing recovery time,eye openning time and extubation time of observation group were significantly shorter than those of control group,with statistical significance (P<0.05). The incidence of postoperative restlessness,delirium,cough and involuntary movement in observation group were signifi-cantly lower than control group,with statistical significance (P<0.05). CONCLUSIONS:Dexmedetomidine hydrochloride injec-tion can keep hemodynamics stable in elderly patients underwent thoracic surgery during anesthesia recovery period.,shorten recov-ery time and reduce the occurrence of stress response as postoperative delirium,restlessness,cough,involuntary movement.

Screening and diagnosis of early colorectal cancer(CRC)can reduce CRC mortality and improve overall survival. Currently,the major screening methods for early CRC include fecal occult blood test(FOBT)and colonoscopy. FOBT exhibits low sensitivity with high false positive rate,while the gold standard -- colonoscopy is invasive and with low compliance. Therefore,a convenient and effective screening and diagnostic method for early CRC is urgently needed. Plasma SEPT9 gene methylation assay is a new non-invasive screening and diagnostic method for early CRC used clinically in recent years,it exhibits high accuracy,and is convenient for mass screening and diagnosis of early CRC. This article reviewed the research progress and diagnostic value of plasma SEPT9 gene methylation assay for CRC.

Objective To investigate the duration of the first-fundus-examination and the status of diabetic retinopathy in patients with type 2 diabetes mellitus. Design Questionnaire. Participants 956 patients (1905 eyes) with type 2 diabetes in Tongren Eye Center of Beijing Tongren Hospital. Method Self-designed questionnaire was carried out. Patients were divided into different groups by the du-ration of the first-fundus-examination, degree of diabetic retinopathy, duration of diabetes, education background and living area in the data analysis. Main Outcome Measurements Duration of the first- fundus-examination, degree of diabetic retinopathy. Results Dia-betes patients in shorter duration groups finished the first-fundus-examination earlier than in longer duration groups (all P <0.05). Dif-ferent education background didn't show significant influence on duration of the first fundus examination. Urban patients received earli-er first-fundus-examination than rural patients (all P <0.05). The incidences of vitreous hemorrhage, retinal detachment and retinal pho-tocoagulation were rising with the duration of diabetes. The proportions of vitreous hemorrhage and retinal photocoagulation were higher in primary-school education group than in middle-school and college education groups (all P<0.05). Difference of the incidences of vit-reous hemorrhage and retinal detachment weren't found between in Beijing and non-Beijing patients. The incidences of vitreous hemor-rhage and retinal detachment in urban patients were higher than in rural patients (all P<0.05). Conclusion The most diabetic patients finish the first-fundus-examination much later than requested. Diabetic patients in lower-education-level groups and in rural group are even later, and their conditions are more serious.(Ophthalmol CHN, 2009, 18: 279-282)

Antiviral Agents ; therapeutic use ; China ; Hepatitis B ; drug therapy ; epidemiology ; immunology ; prevention & control ; therapy ; Hepatitis B Vaccines ; immunology ; Humans

Diabetes Complications ; drug therapy ; surgery ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Ischemia ; drug therapy ; etiology ; surgery ; therapy ; Lower Extremity ; blood supply

China ; epidemiology ; Hepatitis, Viral, Human ; epidemiology ; Humans

In recent years,antiviral therapy for chronic hepatitis B infected patients has achieved great development along with the invention of nucleos (t) ide,nucleos (t) ide analogues,interferon α and pegylated interferon α.The development of antiviral medicine also proposes new demands for the clinical diagnosis and therefore promotes the development of laboratory diagnostic techniques in the detection of chronic hepatitis B.In this review,we focused on the clinical application in the quantitive detection of HBV DNA,and its significance on clinical evaluation,treatment options,follow-up and prognosis in antiviral therapy.

Objective To summarize clinical characteristics, diagnosis and surgery of abnormally origination of left coronary artery from the pulmonary artery. Methods Clinical data of 10 patients with left coronary artery abnormally originating from pulmonary artery were analyzed, including 5 men and 5 women, aged from 13 to 40 years. Definite diagnosis was made by ultrasonic cardiogram (UCG) and cardiac catheter examination. Three cases were simply abnormal origination, six cases combined with MI, and one case combined with both MI and ventricular aneurysm of left ventricular apex. Ligation of the abnormal coronary artery was done in four patients, three were given pulmonary artery inner tunnel plasty under extrocorporeal circulation. Open implantation of left coronary artery to ascending aorta were done in 3 patients, while plasty of mitral valve were performed in 5 and ventricular aneurysm resection in 1. Results One patient died postoperatively. The follow-up ranged from 1 month to 11 years. One patient received replacement of mitral valve 16 months after first surgery due to severe MI. All the followed-up patients presented no myocardial ischemia or infarction, no residual shunt or late death. Cardiac function was rehabilitated to grade 1. Conclusion Obvious blood dynamics and cardiovascular morphology changes existed in patients with left coronary artery abnormally originating from pulmonary artery. Early diagnosis and surgery should be done. Proper surgical approach is the key to success.

Objective To investigate the clinical application and therapeutic effect of reservation cortical expand resection and reconstruction for extremities bone tumor. Method Twelve cases with extremities invasion bone tumor were reviewed,including 6 male and 6 female.The average age was 37.1 years old.According to the MRI,TypeⅠtumor located in metaphysic and growth eccentricity,and was treated with outside tumor osteotomy with reservation of one side as integumentale,the cut line was shape of "匚".Type Ⅱ tumor was with invasion part articular surface,and was operated with part joint osteotomy with reservation of one side as integumentale,the cut line was shape of"L".Type Ⅲ was with invasion total joint surface and as integmentale,all tumor segment including joint could be cut,but the shape of cut close to the diaphysis was echelonment. Result The operation time was 1~3 h,the operative bleeding quantity were 150~400 ml,all incisions were obtained primary healing.Twelve cases were followed up from 6 months to 8 years.The average extremity functional score according to the system of ISOLS(International Society of Limb Salvage):upper extremity was 22.3 and the lower was 25.3 The average bone healing time of returned deactivation bone graft and bone allograft healing with the osteotomy plane was 3 months,original tumor recurrence in local was 1,the recurrence rate was 7.69%,no malignant change and metabasis was found. Conclusion The reservation cortical expand resection and reconstruction could increase the treatment effect of extremities bone tumor,it is key to decrease the recurrence with strict indication,non-neoplasma and aseptic technique.Tumor shell and osteotomy plane should be deactivated thoroughly.

[Objective]To investigate the restoration of the axial alignment of the lower extremity during operation for fracture of tibia plateau and to assess the curative effect.[Method]A retrospective analysis of 45 cases of fracture of tibial plateau were conducted from May 2000 to June 2005,25 male cases and 20 female,mean age were 45.3.The type of fracture:3 cases were Schatzker I,10 were type Ⅰ,19 were type Ⅲ,6 were type Ⅳ,5 were type Ⅴ,2 were type Ⅵ.All cases were treated with open reduction,bone graft and internal-fixation with plate and screw under arthroscopy-assisted,and the normal axial alignment of the lower extremity was restored.The restoration standard was in accordance with the uninjured side limb.The way of measurement:the axial line from anterior superior iliac to interdigit of the first and second toe was done,then,the perpendicular distance from the center of patella to this line was calculated,and compared the data with uninjured side limb's.[Result]Forty cases were followed up,from 6 months to 24 months,average 15 months,according to the Rasmussen knee score standard,24 were excellent,11 were good,3 were fair and 2 were poor.The satisfactory rate was 87.5%,the restoration of knee function were close correlated with whether the line normal or not,there were abnormal lines recurrence in some cases,the main causes were:(1)Meniscus to be cut excessive to the loading redistribution in joint;(2)The reduced articular surface collapsed,again due to the affected limb weight loading too early;(3)Fractures were too complicated to be compress fixed with common buttress plate,resulted in displace fracture.[Conclusion]It is very important that the axial alignment of the lower extremity to be corrected during operation to the injured knee function restoration after operation,and the causes result in the axial line abnormal above-mentioned should be considered thoroughly,at the same time,the corresponding measures should be taken.