Objective To compare the clinical effect of different doses of oxycodone on endotracheal intubation during general anesthesia induction period.Methods Ninety-five patients with endotracheal intubation general anesthesia were selected as the research subjects,and the patients were randomly divided into group A,group B and group C.31 patients in group A received intravenous administration of oxycodone 0.20mg/kg,32 patients in group B received intravenous administration of oxycodone 0.25mg/kg,and 32 patients in group C received intravenous administration of oxycodone 0.30mg/kg.The adrenaline,norepinephrine,dopamine concentration,as well as mean arterial pressure and heart rate at different time points were compared among the three groups.Results The mean arterial pressure and heart rate at T0 time point were decreased to varying extent compared with those at T1 time point(t =23.618,7.412;22.928,9.063;32.636,9.422,P =0.000,0.000;0.000,0.000;0.000,0.000).The heart rate,mean arterial pressure at T2,T3 and T4 time points in group A were increased compared with T0 time point (t =13.834,6.506,7.015;17.604,14.796,16.323,P =0.000,0.000,0.000;0.000,0.000,0.000).The adrenaline,norepinephrine and dopamine at T2,T3 and T4 time points in group A were increased compared witb T0 time point (t =121.662,64.533,15.687;31.498,16.933,9.286;39.712,116.049,147.102,P =0.000,0.000,0.000;0.000,0.000,0.000;0.000,0.000,0.000).The heart rate,mean arterial pressure,adrenaline,norepinephrine and dopamine at T2,T3 and T4 time points in group B and group C were decreased significantly compared with those in group A (t =19.586,31.972,16.844,27.087;14.046,14.822,15.377,23.826;7.756,14.396,13.268,23.342,100.573,1 04.010,37.612,38.892,107.377,117.969;56.135,56.757,24.223,25.300,95.057,82.088;22.878,25.731,5.532,5.934,134.763,83.628,P =0.000,0.000,0.000,0.000,0.000,0.000;0.000,0.000,0.000,0.000,0.000,0.000;0.000,0.000,0.000,0.000,0.000,0.000;0.000,0.000,0.000,0.000;0.000,0.000,0.000,0.000;0.000,0.000,0.000,0.000),and the differences were statistically significant (all P ＜ 0.05).Conclusion During the induction of general anesthesia,the appropriate dose of oxycodone in patients with endotracheal intubation was 0.25mg/kg,which could effectively maintain the hemodynamic stability,such as mean arterial pressure,and could reduce the stress response.

Objective To investigate the relationship between plasma P substance(SP),atrial natriuretic peptide(ANP) and renal function in chronic renal failure(CRF).Methods SP and ANP were measured by radioi m munoassay in normal control and CRF before and after hemodialysis(HD),serum creatinine(Cr) was determined simultaneously.Results SP before HD was significantly higher than that of control(P

Objective To evaluate the effect of oral levothyroxine plus intrathyroidal injection of dexamethasone on conversion of subclinical hypothroidism caused by Hashimoto's thyroiditis.Methods 80 subjects with Hashimoto thyroiditis were randomly divided into 2 groups.Subjects in levothyroxine group(40 cases) were treated with oral levothyroxine sodium,subjects in dexamethasone group(40 cases) were treated with oral levothyroxine plus intrathyroidal injection of dexamethasone.Serum free triiodothyronine(FT_3),free thyroxine(FT_4),sentient thyrotropin(sTSH) and other parameters were evaluated before treatment and after treatment in patients with Hashimoto's thyroiditis.Results The content of FT_3,FT_4 after treatment were obviously higher than that before treatment(t=2.123,P

Objective To study the status of telomerase activity during the development of thyroid tumors,and to determine whether telomerase activity can be used clinically as a molecular marker in the differential diagnosis of thyroid cancer.Methods Telomerase activity was measured in 37 thyroid carcinomas,33 benign thyroid lesions and 30 normal thyroid tissue samples by means of telomerase repeat amplification procedure-polymerase chain reaction(TRAP-PCR).The assay was also applied to 15 fine needle aspirates(FNAs) of thyroid carcinomas to test its sensitivity.Results Thirty-one of 37 thyroid carcinomas(83.8%),7 of 33 benign thyroid lesions(21.2%),and 4 of 30 adjacent normal thyroid tissue asmples expressed telomerase activity,15 FNAs also had positive telomerase activity,just as their corresponding tissue specimens.The quantitative analysis showed that the telomerase activity was significantly higher in thyroid carcinomas than that in benign thyroid tissue samples.And medullary carcinomas and anaplastic carcinomas had higher levels of telomerase activity than papillary carcinomas.Conclusion Telomerase activity is a good marker for thyroid carcinomas.The quantitative TRAP-PCR might have more potential application in the differential diagnosis of tumors and the estimation of tumor progression and prognosis.And this sensitive assay could become a useful new modality for supplementing microscopic cytopathology in the detection of cancer cells in small tissue samples and FNAs.

Evidence-based practice advocated that clinical decisions should based on the most relevant and valid evidence. The medical postgraduates in our university were investigated with questionnaires about their influencing factors of the evidence-based practice. The countermeasures were found to improve the competence of evidence-based practice.

Objective To explore clinical efficacy of Shenlingbaizhu decoction on immune status in patients with ulcerative colitis(UC).Methods 60 patients with UC were selected and divided into control group and experiment group evenly and randomly.Control group received treatment of salazosulfapyridine,while experiment group received treatment of Shenlingbaizhu decoction based on treatments of control group.Clinical efficacy,serum levels of IL-6 and IL-8,percentage of Treg cells in peripheral blood were observed and compared between two groups before and after treatments.Results Total clinical efficacy of experiment group was significantly higher than that of control group(P＜0.05)(90.00％ vs 76.67％);Serum level of IL-6 was decreased significantly in all patients(P＜0.05),more significantly in experiment group(P＜0.05)after treatment;Serum level of IL-10 increased significantly in experiment group after treatment(P＜0.05);Percentage of Treg cells increased significantly in experiment group after treatment(P＜0.05).Conclusion Combination therapy of salazosulfapyridine and Shenlingbaizhu decoction shows significantly better clinical effects than salazosulfapyridine alone,probably via regulating immune status.

Objective To investigate the effect of intravenous lidocaine on the efficacy of sevoflurane combined with remifentanil for tracheal intubation without neuromuscular relaxants. Methods Seventy-five ASA Ⅰor Ⅱ patients, aged 18-64 yr, scheduled for elective surgery, needing tracheal intubation under general anesthesia, were randomly divided into 3 groups ( n = 25 each) : sevoflurane + remifentanil 1 μg/kg group (group A) ;sevoflurane + remifentanil 1 μg/kg + lidocaine 1 mg/kg group (group B); sevoflurane + remifentanil 2 μg/kg group (group C) . Two minutes after inhalation of 8% sevoflurane for anesthesia induction, remifentanil 1 μg/kg, remifentanil 1 μg/kg + lidocaine 1 mg/kg, and remifentanil 2 μg/kg were injected intravenously in groups A, B and C respectively. Tracheal intubation was performed after completion of remifentanil injection. Intubating conditions were assessed based on ease of laryngoscopy, position of vocal cords, activity of vocal cords, degree of coughing and limb movement. MAP and HR were also recorded before induction and immediately before and after intubation. Results Tracheal intubations were successful in all patients. The satisfactory rates of coughing were significantly higher in groups B and C, and MAP and HR were significantly lower immediately before and after intubation in group C than in group A ( P ＜ 0.05) . The satisfactory rate of coughing was significantly higher in group B than in group C ( P ＜ 0.05) . During intubation, 3 cases developed hypotension and 1 case bradycardia in group C. Conclusion When sevoflurane combined with remifentanil is used for tracheal intubation without neuromuscular relaxants, intravenous lidocaine 1 mg/kg can not only improve intubating conditions, but also decrease the consumption of remifentanil.

ObjectiveTo investigate the effect of early fluid resuscitation on the prognosis of SAP patients.MethodsPatients who were admitted to our hospital within 72 h after the onset of the SAP were enrolled.The parameters for the fluid resuscitation were as follow: heart rate ＜120 beat/h,urine output ≥ 1 ml ·h-1 · kg-1,hematocrit ≤35％ and mean arterial pressure 65 ～ 85 mmHg ( 1 mmHg =0.133 kPa).The effects of different time of reaching fluid resuscitation ( ＜48 h,48 -72 h,＞72 h) and parameters achieved (0 ～ 1parameter,2 parameters,3 parameters,4 parameters) on the prognosis were analyzed.ResultsThere were 70 patient enrolled in this study and 41 ( 58.6％ ) developed complications,20 ( 28.6％ ) were referred to surgical operation and 10( 14.3％ ) died.The median hospital stay was 23.5 d,and the median medical cost was 71.9(5.7～567.4 thousands RMB).The rates of surgical intervention in ＜48 h,48 ～72 h,＞72 h groups were 20.0％,33.3％,75.0％,and the rates of acute kidney injury were 20.0％,25.0％,75.0％,while the rates of complications were 50.0％,83.3％,100％,and the difference among the 3 groups was statistically significant (P ＜ 0.05 ).The rates of surgical intervention in patients achieving 0 ～ 1,2,3,4parameters within 48h of SAP onset were 50.0％,26.3％,13.0％,25.0％,and the rates of acute kidney injury were 45.0％,31.6％,17.4％,0,while the rates of ARDS were 35.0％,31.6％,13.0％,0,which showing a significant decreasing trend.ConclusionsAn appropriate fluid resuscitation in the first 48 h after the onset of SAP was benefit for improving the treatment effects and patients' outcome.

ObjectiveTo study the effect of of oral powered microdedrider adenoidectomy with nasal endoscope in children with secretory otitis media. Methods74 children with secrctory otitis media treated with adenoidectomy with nasal endoscope randomly divided into group A 37 cases and group B 37 cases,the group A were treated with trans-oral adenoidectomy under endoscope, the group B were treated with trans-nasal adenoidectomy under endoscope,then the total effective rate,operation time, blood loss,incidence of complications and serum IgE, NO, IL-6,TNF-αand IL-2 of the two groups before and after the treatment were compared. ResultsThe cure, effective, and ineffective of group A were 34 cases ,3cases and 0 cases ,the total effective rate was 100.0％, the cure, effective,and ineffective of group B were 26 cases,7 cases and 4 cases,the total effective rate was 89.2％ ,the total effective rate of group A was significantly higher than that of group B( x2 =6. 869 ,P ＜0.05 ) ,the operation time of group A was( 8.6± 1.6) min, blood loss was( 12.3 ± 4. 1 ) ml, incidence of complications was 2.7％ ( 1 case postoperative hemorrhage), operation time of group B was ( 14.2 ± 2.1 ) min, blood loss was( 17.8 ± 3.5 ) ml, incidence of complications was 10.8％ (2 cases nasal adhesion and 2 cases postoperative hemorrhage) ,there were significant differences between the two groups ( t =5. 967,6.553, x2 =7. 142, all P ＜ 0.05 ), serum IgE, NO, IL-6,TNF-αand IL-2of the group A after the treatment were all lower than those of group B, ( t =5. 557,6. 348,5. 968,6. 976,5. 884, all P ＜ 0. 05 ).ConclusionThe effect of oral powered microdedrider adenoidectomy with nasal endoscope in children with secretory otitis media better,and it was worthy of popularization and application.

ObjectiveTo study the relationship between human papilloma virus(HPV) infections,p53 polymorphisms and esophageal cancer.MethodsA case-control study of 204 esophageal cancer cases (esophageal cancer group) and 102 healthy control cases (control group) biopsies were conducted to extract DNA,detected the HPV by PCR method and analyzed p53 polymorphisms by PCR-RFLP method,then analyzed the relationship between them and esophageal cancer incidence rate.ResultsThe positive rate of HPV16 in esophageal cancer group[59.3％(121/204)] was higher than that in control group [11.8％ ( 12/102 ) ] (P ＜ 0.05 ).And the frequency of Arg/Arg genttype of p53 in esophageal cancer group [ 51.5％ (105/204) ] was higher than that in control group [ 19.6％ (20/102) ] (P ＜ 0.05 ).The frequency of Arg/Arg genotypo in HPV16 positive patients [66.9％(81/121 )] was higher than that in HPV16 negative patients [ 28.9％ (24/83)] (P ＜ 0.05).ConclusionsHigh risk HPV phys an important role in development of esophageal cancer,p53 Arg/Arg genotype is one of high risk genetic factors for HPV-associated esophageal cancer.