Objective:To analyze the clinical application effects of different anesthesia maintenance methods in daytime pediatric sur-gery in oral maxillofacial surgery.Methods:80 children underwent anethesia for daytime surgery in oral maxillofacial region were en-rolled and divided into 2 groups(n=40).The maintenance dose of propofol was 2-3(mg·kg)/h in venous group,that was 3％to 4％sevofluranenas in opharyngeal airway-assisted inhalation group.The heart rate,mean arterial pressure,oxygen saturation,postoperative wake-up time and incidence of adverse reactions after the local anesthesia(T1),intraoperative(T2)and end-of-surgery(T3)were re-corded and compared between the 2 groups.Results:No statistical difference in heart rate change between the 2 groups at different time points(P＞0.05).The average arterial pressure decrease and the decrease of oxygen saturationin in the inhalation group were lower than those of the venous group(P＜0.01).The incidence of adverse events in the inhalation group were lower than that of the intravenous group(P＜0.05).Conclusion:Nasopharyngeal airway-assisted inhalation anesthesia has definite sedative effect in daytime pediatric pa-tients in oral maxillofacial surgery with less influence on the circulatory system and fewer adverse events.

Objective: To analyze the effects of different doses of flurbiprofen and other analgesic drugs on the postoperative analgesia in the Enhanced Recovery After Surgery (ERAS) . Methods: 98 patients with jaw cysts or multiple impact teeth were retrospectively analyzed. Patients were divided into 3 groups by the drug scheme: flurbiprofen 250 mg + 0. 9％ NS to 100 ml (group Ⅰ, n =32), sulfentanil 100 μg + azasetron 20 mg + 0. 9％ NS to 100 ml (group Ⅱ, n = 34), flurbiprofen 200 mg + sulfentanil 50 μg + azasetron 20 mg + 0. 9％ NS to 100 ml (group Ⅲ, n = 32) . Analgesic effects were evaluated at 3 h, 1 d and 2 d after surgery with Wong-Baker expression scale and numeric rating scale (NRS) . Questionnaire survey was also used to evaluate degree of satisfaction on analgesia. Results: Analgesia effective rate of group Ⅰ, Ⅱ and Ⅲ was 40. 62％, 67. 65％ and 68. 75％ respectively (P ＜0. 05) . Degree of satisfaction on analgesia of group Ⅰ, Ⅱ and Ⅲ was 71. 87％, 58. 82％ and 93. 75％ respectively (P ＜ 0. 05) .Conclusion: Flurbiprofen combined with sulfentanil has good analgesic effects and low side effects in the maxillofacial surgery of jaw cysts and multiple impact teeth.

"Si Sheng",including postgraduates,advanced study students,standardized training students and interns,is the main part of teaching work in hospital and department.This article is for meeting the requirement of students and emphasizing all-round preparation of the teaching work and teaching in accordance with their aptitude;pays attention to the combination of various teaching methods,such as training of new technology and new affairs,case discussion,multidisciplinary discussion,standardized teaching rounds and so on;pays attention to collect feedback from students.Those practical works effectively improve teaching quality and standard.

The accuracy of preoperative staging diagnosis of colorectal cancer directly determines the accuracy of treatment and prognosis.Endoscopic ultrasonography,CT,MRI and positron emission tomography/computed tomography (PET/CT) imaging have their own advantages and disadvantages in preoperative staging of colorectal cancer.According to the actual situation of patients,choosing the best method of examination,when necessary,several effective methods combined,can improve the accuracy of preoperative staging diagnosis of colorectal cancer.

Objective In recent years,as people have attached importance to the application of regional chemotherapy in the surgery of advanced gastric cancer,the research of fluorouracil sustained release implant,a regional chemotherapeutic drug,is on the increase.Fluorouracil sustained release implant is a new anti-carcinogen combined with fluorouracil,a conventional chemotherapeutic drug,through polymeric scaffolds and rete technology.It can be implanted into cancerous lesion area,as its slow-releasing potential and targeting property will give full play to the antitumor effect of fluorouracil,which can decrease the rate of local recurrence and metastasis of gastric cancer and prolong the life span of the patients.Based on the study of the researches on fluorouracil sustained release implant,a summary was made from different perspectives: basic medicine,pharmacy and clinical medicine.It may have reference value for clinical application and further study.

Objective:To investigate the open method(OC) and laparoscopic cholecystectomy (LC) after bile duct dilation incidence of contrast.Methods:collected from 2006 December to 2014 December in the department of hepatobiliary surgery requires 412 patients underwent cholecystectomypatients hospitalized with cholecystolithiasis,chronic cholecystitis,gallbladderpolyps,were randomly divided into LC group and OC group,LC group of 207 cases,205 cases in OC group,and were respectively treated with LC and OC.Start regular follow-up after a month,the comparison of 2 surgical operation time,blood loss and postoperative application of antibiotics time,anus exhaust time,eating time and hospitalization time.And to observe the two groups the incidence of patients after bile duct dilatation in follow-up after operation.Results:207 cases of LC patients were 89 patients had bile duct dilation,205 cases of OC patients were 41 patients had bile ductdilation,statistically significant differences between the two groups (P＜0.05).In group LC,the diameter of common bile duct in operation half months began to increase,the increase continued until 3 months after operation.After 3 months of little change in the diameter of common bile duct.The averagepreoperative bile duct diameter is 5.3 mm,after 6.1 mm,there was significant difference(P＜0.01).Conclusion:LC is a safe and reliable operation method,Identifying cause dilatation of common bile duct after LC operation and attention as soon as possible to give the corresponding prevention and treatment,further can reduce complications occur.

Objective To generate data on the current medical rehabilitation resources in Hubei province so as to improve the management of rehabilitation quality.Methods Medical institutions on the second level and above were investigated using a questionnaire which covered installations,personnel,equipment and field of operations.Results A total of 176 questionnaires were recovered.Among them,166 (94.3％) of the hospitals had established a department of rehabilitation medicine,and 122 (69.3％) had set up an independent rehabilitation ward,accounting for a total of 3,359 beds.Altogether,there were 1,260 rehabilitation physicians (36.7％ of the assigned personnel),904 therapists (26.3％) and 1,272 nurses (37％).Senior physicians,therapists and nurses were 26％,3.1％ and 28.3％ of the respective totals.Conclusion Rehabilitation medicine in Hubei Province remains relatively poorly developed.It is weak in terms of building the discipline,management and devices,especially in a serious lack of professionals and rehabilitation therapists.

Objective: To clarify the predictive value for long-term prognosis of GRACE score and SYNTAX score in patients with non-ST elevation acute coronary syndrome (NSTE-ACS).
Methods: A total of 784 NSTE-ACS patients treated in our hospital from 2009-01 to 2014-01 were retrospectively studied. According to the treatment, the patients were divided into 3 groups: Medication group,n=410, Stent group,n=325 and CABG group,n=49. Based on 2 scoring systems, the patients were divided into another 3 groups: Low risk group, Medium risk group and High-risk group. The relationship between GRACE score and SYNTAX score was studied by Pearson correlation analysis, survival analysis was conducted by Kaplan-Meier method, univariate and multivariate analysis were performed by Cox proportional hazard model, and the area under curve (AUC) of ROC analysis was used to compare two methods.
Results: All 784 patients completed the follow-up study at the median of 47.7 months. Pearson correlation analysis showed that there was a weak positive correlation between GRACE score and SYNTAX score (r=0.40,P<0.01). Survival analysis presented that by GRACE score system, the MACE occurrence rates in Low risk group, Medium risk group and High-risk group were elevated accordingly as 13.81%, 23.64% and 36.55% respectively. And by SYNTAX system, MACE occurrence rates in Medium risk group and High-risk group were 39.29% and 37.93%, which were both higher than that in Low risk group (23.99%), while the scores between Medium and High risk groups were similar,P>0.05. Cox proportional hazard model and ROC analysis indicated that GRACE and SYNTAX scores had the important predictive value for lone term prognosis of NSTE-ACS. ROC analysis of GRACE score, SYNTAX score, the combination of GRACE and SYNTAX scores showed that 3 of them all had good predictive value for MACE occurrence, three of 95% CI had signiifcant overlapping without statistic differences.
Conclusion: GRACE score and SYNTAX score are related, both of them have important while similar predictive value for long term prognosis in NSTE-ACS patients, the combination of 2 scores cannot increase the predictive value. GRACE score is appropriate for the risk stratiifcation in NSTE-ACS patients.

Objective To investigate the correlation between macular structural changes and functional outcomes in idiopathic macular epiretinal membranes (IMEM).Methods Clinical data of 85 patients with monocular IMEM admitted from April 2013 to April 2014 were retrospectively analyzed.The diseased eyes(85 eyes)were studied as observation group and the normal eyes (85 eyes)served as control group.The results of routine eye examinations,optical coherence tomography (OCT) and multifocal electroretinography (mfERG) were compared between observation and control groups.Results The preoperative best corrected visual acuity (BCVA) in observation group was lower than that in control group (0.55-± 0.17 vs.0.92 ± 0.14,P ＜ 0.05);the eyes with BCVA ＜ 0.1 in observation group were more than those in control group (P ＜ 0.05).The central retinal thickness (CRT) of observation group was higher than that of control group[(322.1 ±54.3) μm vs.(210.3 ±47.5) μm,t =14.29,P ＜0.05].The average response density of N1 wave and P1 wave in observation group were (36.7 ± 19.7) and (95.2 ±24.0) nV/ deg2,which were lower than those in control group [(42.9 ± 16.3) and (134.8 ± 20.1) nV/deg2;t =-2.23 and-11.66,respectively,P ＜0.05].The latent period of N1 wave and P1 wave in observation group were (22.0 ±4.1) and (39.5 ± 4.7) ms,which were lower than those in control group [(18.7 ± 3.0) and (38.0 ± 3.2) ms;t =5.99 and 2.43,respectively,all P ＜ 0.05].The CRT in observation group was not correlated with average response density of macular center N1,P1 wave and latent period (r =-0.23,-0.35,0.06,-0.04,all P ＞ 0.05).BCVA in observation group was negatively correlated with CRT(r =-2.16,P ＜ 0.05).Conclusions The central retinal thickness is negatively correlated with the best corrected visual acuity,but not correlated with center mfERG in patients with IMEM.

Objective To investigate deanxit clinical efficacy of depression in elderly patients with acute coronary syndrome(ACS).Methods 88 elderly patients with ACS and depression were randomly divided into Deanxit (2 tablets daily ; Deanxit,n =43) or placebo (control,n =45) treatment in addition to standard therapy.SDA score,SDS score,MACE and cardiac autonomic nerve function were performed at 12 weeks follow-up.Results In deanxit group,SDA score and SDS score were significantly reduced (34.28 ± 6.35 vs 52.68 ± 5.74,41.19 ±4.63 vs 54.68 ± 4.32,P ＜ 0.05),MACE were also decreased (4.6％ vs 28.9 ％,P ＜ 0.05).SDNN were significantly higher than control (109.03 ± 23.08 vs 98.29 ± 27.44,P ＜ 0.05),but LF was reduced (152.89 ± 92.75vs 249.21 ± 64.17,P＜ 0.05).Conclusion Deanxit can improve the depression and clinical symptoms in elderly patients with ACS and depression.By improving the cardiac autonomic nerve function,deanxit possible reduce the onset of severe arrhythmia and improve the short-term prognosis.