Objective To find the best level of transducer when continuous invasive arterial blood pressure monitoring using evidence-based approach. Methods Searched in three databases (Cochrane, PubMed,sinoMED), meanwhile the website of related academic societies,supplemented with Citation Index. Results There were 11 articles after selected. The majority of evidences (9 articles) suggested leveling with the heart, one suggested leveling with the catheter tip,and the other one regarded the matter as nothing important. Conclusions Transducer should be leveled to align the heart rather than the tip of arterial catheter when continuous invasive arterial blood pressure monitoring, but it doesn't matter which surface landmark of the heart. It was suggested that changing the level of transducer when changing the patient position or head of bed.

With the rapid development of information technology at present, application of personal digital assistant (PDA) is becoming more and more popular. It not only can be seen everywhere in daily life, but also infiltrates into the insurance, medicine, finance, public security, aviation, and so on. Along with the construction of the digital hospital and introduction of software, such as "Military I" project, picture archiving and communication systems (PACS), Hospital information System (HIS), as well as the popularity of management software of medical equipments, the hospital puts forward higher requirements for medical work information management. PDA was used for rehabilitation assessment in this hospital from March 2007 to March 2009, which had a good result. Application of PDA in rehabilitation assessment greatly optimized workflow, which is the core objective of rehabilitation medicine. PDA is the necessary way for rehabilitation assessment to the "digital rehabilitation ".

Objective To investigate the role of IL-12 in lung ischemia-reperfusion(L/R)injury in rats.Methods Twenty-four healthy male SD rats,8-10 weeks,weighing 250-280 g,were randomly divided into 3 groups(n =8 each):sham operation group(S),I/R group,IL-12 monoclonal antibody group(group IL-12).LungI/R was induced by clamping the left hilum of lung for 60 min followed by 120 min reperfusion in groupsI/R and IL-12.IL-12 monoclonal antibody 200tg/kg was injected via the caudal vein at I h before clamping the left hilum.The blood samples were collected at the end of reperfusion,the rats were then sacrificed and lungs removed for determination of the plasma TNF-α concentration,Th1 and Th2 levels,W/D lung weight ratio,MDA content,MPO activity,PaO2 and PaCO2 in lung tissues and for microscopic examination.Results Compared with group S,W/D ratio and the level of MPO,MDA and TNF-α were significantly increased in groups I/R and IL-12,and PaO2 was significantly decreased,and PaCO2,Th1 level and Th1/Th2 sere significantly increased in group I/R(P ＜0.01),and no significant change was found in PaO2,PaCO2,the level of Th1 and Th2,and Th1/Th2 in group IL-12(P ＞ 0.05).PaCO2,W/D ratio,the levels of MDA,MPO,plasma TNF-u,Th1 and Th1/Th2 were significantly lower,and Th2 level and PaCO2 were significantly higher in group IL-12 than in group I/R(P ＜ 0.01).The pathologic changes of the lung were attenuated in group IL.12.Conclusion IL-12 is involved in the lung I/R injury through inducing Th1/Th2 imbalance in rats.

Objective To investigate the effect of GSK-3β inhibitor TDZD-8 on activation of NF-κB during lung ischemia-reperfusion (I/R) in rats.Methods Thirty-two healthy male Sprague-Dawley rats,aged 8-10 weeks,weighing 250-280 g,were randomly divided into 4 groups (n=8 each): sham operation group (sham group) ; I/R group,I/R + dimethyl sulfoxide (DMSO) group and I/R + TDZD-8 group.Lung I/R was induced by clamping the left hilum of lung for 1 h followed by 2 h reperfusion.10％ DMSO and TDZD-8 1 mg/kg were injected intravenously at 5 min betore reperfusion in groups I/R + DMSO and I/R + TDZD-8,respectively.Blood samples were taken at 2 h of reperfusion for determination of arterial partial pressure of oxygen (PaO2) and concentrations of plasma interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α).The animals were then sacrificed and the left lung was removed for determination of W/D lung weight ratio,myeloperpxidase (MPO) activity,expression of phosphorylated glycogen synthase kinase-3 beta (p-GSK-3β) and phosphorylated nuclear factor-kappa B p65 (pNF-κB p65) and for microscopic examination.Results Compared with sham group,PaO2 and the expression of pGSK-3β were significantly decreased,and the concentrations of plasma IL-6 and TNF-α,W/D lung weight ratio,MPO activity and expression of p-NF-κB p65 were significantly increased in the other groups (P ＜ 0.05),and PaO2 and the expression of p-GSK-3β were significantly increased and the other parameters were significantly decreased in I/R+ TDZD-8 group (P＜ 0.05).There were no significant differences in the parameters mentioned above among groups I/R and I/R + DMSO (P ＞ 0.05).Microscopic examination showed that I/R-induced lung injury was ameliorated by TDZD-8.Conclusion GSK-3β inhibitor TDZD-8 can attenuate lung I/R injury by downregulating phosphorylation of NF-κB p65 and inhibiting inflammatory response.

Objective To investigate the relationship between coronary myocardial bridge and the symptoms of the patients and its related factors, and to provide evidence for rational treatment. Methods Sixty-one patients di-agnosed as myocardial bridge by coronary angiography and the examination of nuclide myocardial perfusion imaging were recruited and their clinical data was analyzed retrospectively. The patients were divided into ischemic group and non-ischemic group according to the nuclide imaging, and were followed up on the compliance of β-blocker taking and the symptoms. Results Among the 61 patients ,7 patients were ischemic,and the others were non-ischemic. There was no significant difference on symptoms between the two groups (P>0.05). The prevalence of Grade Ⅲ narrowing was higher in ischemic group (6/7) than that in the non-ischemic group (18/54) (χ~2=5. 009, P = 0.024) ,and the ischemic patients with Grade Ⅲ narrowing were older than those in the non-ischemic patients. Two patients in the ischemic group did not insist on taking β-blocker and their symptoms did not change,40 patients in the non-ischemia group did not insist on taking β-blocker,of which 33 patient's symptoms were improved. The symp-toms of all patients with good compliance of β-blocker taking were improved. Conclusions The symptoms of some patients are unrelated with myocardial bridge and treatment is not recommended.

This paper reviewed that high-intensity interval training (HIT) is effective on cardiorespiratory fitness and walking ability, but limited in quality of life in stroke paitents. More researches are needed to explore the differences from HIT to low and moderate intensi-ty continuous training .

[Summary] Malignant obstructive jaundice is the bile obstruction caused by the invasion of cholangiocarcinoma , pancreatic cancer or ampulla cancer .Due to lack of effective treatment , the prognosis is poor .In recent years , with the rapid development of medical technology and imaging technology , dual interventional treatment technology , such as percutaneous transhepatic cholangial drainage ( PTCD) or biliary stenting combined with radioactive seed implantation , ablation catheter lumen combined with biliary stent implantation , is applied in the treatment of malignant obstructive jaundice .This article is the summary of the clinical application of PTCD combined with radioactive seed implantation , biliary stent combined with radioactive seed implantation and intraluminal catheter radiofrequency ablation combined with biliary stent implantation technique .

Objective To evaluate the methods and efficacy of retroperitoneal laparoscopic nephron-sparing surgery for the treatment of renal tumor. Methods A total of 6 patients with renal tumors underwent retroperitoueal laparoscopie nephron-sparing surgery during warm ischacmia. Among the 6 eases, 2 had malignant tumor with the diameter of 2.5 cm and 2.2 cm,and 4 had renal angiomyolipoma with the diameter from 2.5 cm to 3.5 cm.The renal yes,Is were secured by a self-made equipment. Tumors were excised with a cold Endo-shear. Parenehymal edges were approximated using a absorbable hemostatic gauze. Results All procedures were successfully completed without open conversion. Mean surgical time was 150 minutes (range 120-210 minutes). Mean ischaemia time was 22 minutes (range 18-33 minutes) and the mean blood loss was 170 ml (range 150-200 ml). Surgical margins were negative in all patients.During a follow-up for 6-12 months, no patient had local or port site recurrence. Conclusions Betroperitoneal laparoscopic nephron-sparing surgery for renal tumor by using serf-made equipment is safe and effective. This procedure has the advantages of minimal invasion, less blood loss, good vision, and rapid convalescence and so on.

The vehicle-mounted wireless tele-consultation system involves computer network technology, satellite communication technology and multimedia video technique in, which is composed of GPS, vehicle -mounted satellite communication sub-system, automatic satellite-tracking sub-system and computer control system. The system can be applied to medical command, operation tele-instruction, tele-education, tele -consultation, uploading medical service data and searching electronic medical information,and thus the field medical treatment and medical service are both improved. This paper introduces such aspects of the system as its principle, components, functions and application to medical service support.

Objective To analyze the clinical efficacy of balloon occlusion of distal abdominal aorta for patients with pernicious placenta previa and placenta accreta.Methods Data of 72 patients with pernicious placenta previa and placenta accreta were retrospectively analyzed.There were 53 cases (occlusion group) reserved balloon occlusion in abdominal aorta before cesarean section,which can temporarily blocked abdominal aortic blood flow during operation.The other 19 cases (non-occlusion group) underwent cesarean section without balloon occlusion of abdominal aorta.The intraoperative,post operative situations and the birth state of newborn of the two groups were compared.Results The bleeding,blood transfusion and hysterectomy rate during the operation in occlusion group were less than those in non-occlusion group (all P＜ 0.05).Differences of the rate of postoperative transferring to intensive care unit (ICU) and the time in ICU were statistically significant between two groups (both P ＜0.05).No statistical difference of operation time,postoperative total hospital stay time and the rate of postoperative infection was found between two groups (both P＞0.05).There was no statistical difference of newborns weight and Apgar scores (5 min and 10 min after birth) between two groups (all P＞0.05).Conclusion The balloon occlusion of distal abdominal aorta in cesarean section for patients with pernicious placenta previa and placenta accreta is safe and feasible,which can effectively reduce the intraoperative bleeding,the blood transfusion and the risk of hysterectomy.