Aim To establish a model of biphasic vasoconstriction induced by electrical stimulation, and analyze effects of 1～100 nmol?L~(-1) tetrodotoxin (TTX) on the biphasic vasoconstriction in the ring preparation of the rabbit saphenous artery. Methods Isometric vasoconstriction of the rabbit saphenous arterial rings was recorded, and the sympathetic nerves of the arterial rings were activated with electrical stimulation. Results The biphasic neurogenic vasoconstriction was consistently induced by electrical stimulation (15 V,1 ms pulse duration,2～16 Hz for 32 s) in a frequency-related manner in the rabbit saphenous artery. TTX (3 nmol?L~(-1)),a neuronally selective sodium channel blocker,did not affect the first phase of vasoconstriction,but it markedly inhibited the second phase of vasoconstrictive responses to 2～16 Hz stimulation by 44 %～67 %. Increasing the concentration of TTX to 10 nmol?L~(-1), TTX inhibited the first phase of the vasocontractive responses to 4～16 Hz stimulation by 40%～57%,whereas it inhibited more than 90% of the second phase of vasoconstriction. Concentration-response curves for NA(0.01～30 ?mol?L~(-1)) were not affected by TTX (0.1 ?mol?L~(-1)), but the same concentration of TTX completely inhibited the biphasic vascular responses to electrical stimulation. The biphasic contractile responses to electrical stimulation were all abolished by guanethidine (10 ?mol?L~(-1)), but the vasoconstrictive responses to exogenous NA were not affected by it. Conclusion Biphasic vasoconstriction can be induced by electrical stimulation,and the first and the second phases of vasoconstriction are mediated by neurotransmitters released from sympathetic nerves in the rabbit isolated saphenous arterial ring preparation.

0.05) at preoperatively and postoperatively the total knee score,preoperatively and postoperatively pain score,preoperatively and postoperatively patient function score,and preoperatively and postoperatively Patellar score.The postoperative maximum flexion of the fixed-bearing group and the mobile-bearing group was 108??9.3? and 99.5??10.1? respectively.There was significant difference between the 2 groups for the postoperative maximum flexion (P0.05) at the femoral valgus angle,the tibial angle,the tibial slope angle,and preoperatively and postoperatively the patellar height (Install-Salvati ratio).[Conclusion]The short-term results of the fixed-bearing posterior stabilized prosthesis and the mobile-bearing prosthesis TKA were successful.There was no significance difference between the two groups for the total knee score,function score,pain score,patellar score and radiographic results.The postoperative maximum flexion in fixed-bearing group was higher than that in mobile-bearing group.

Objective To compare the effects of equivalent dose sufentanil,remifentanil or fentanyl on hemodynamic and cardiac output in the elderly patients during induction of general anesthesia.Methods Ninety elderly patients(ASA Ⅰ ～ Ⅱ) undergoing elective abdominal surgery under general anesthesia were randomly divided into sufentanil group(group S),remifentanil group(group R) and fentanyl group(group F),30 patients in each group.Patients in group S,group R and group F received sufentanil 0.2μg/kg,remifentanil 2μg/kg and fentanyl 2μg/kg Ⅳ,respectively,using an blind method before intubation.SBP,DBP,MAP,HR,CO,CI and SVR were recorded before of anesthesia (T0),immediately after induction (T1),1,3 minutes after tracheal intubation (T2,T3).Changes of SBP and HR during observation were also recorded.Results The MAP and HR in three groups at T1 were significantly lower than those at T0 and decreased significantly in group R than those in group F and S(P ＜0.05).The MAP and HR in group F significantly increased at T1 than T0.The MAP and HR in group R were significantly decreased after tracheal intubation.Compared with the baseline,the MAP and HR in group S at T1,T2,remained unchanged.In group R,there were two patients whose HR were under 50 bpm.In group F,the MAP at T1,T2 were significantly higher than those at T.In group S,there were no significant changes in CO,CI,SVR which were all within normal range (P ＞ 0.05).Conclusion Both sufentanil and remifentanil effectively inhibit the stress response during induction of general anesthesia.At the same time,sufentanil has better hemodynamic stability.

Objective To compare the effects oflightwand(LW) and direct laryngoscope(DL) in elderly patients undergoing surgery on hemodynamics and stress responses.Methods Forty elderly patients with ASA grade Ⅰ-Ⅱ grade who selective surgery were divided into LW group and DL group by random digits table method,each group with 20 cases.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate(HR) were recorded respectively before intubation,30 seconds and 5 minutes after intubation.Extracted patients with peripheral arterial 3 ml at the same time,measured by radioimmunoassay epinephrine and norepinephrine levels.Results The SBP,DBP,HR,epinephrine,norepinephrine 30 seconds after intubation in LW group were significantly lower than those in DL group [(140.50 ± 21.91) mm Hg(1 mm Hg =0.133 kPa) vs.(167.95 ± 17.85) mm Hg,(67.80 ± 6.76) mm Hg vs.(84.15 ±9.89) mm Hg,(85.10 ± 11.76) times/min vs.(96.30 ± 13.72) times/min,(49.47 ± 8.09) ng/L vs.(61.25 ± 9.43) ng/L,(171.27 ± 17.11) ng/L vs.(187.40 ± 16.13) ng/L,P ＜ 0.01].The SBP,epinephrine,norepinephrine 5 minutes after intubation in LW group were significantly lower than those in DL group [(120.75 ± 17.12) mm Hg vs.(136.65 ± 15.43) mm Hg,(39.80 ±7.38) ng/L vs.(47.63 ±8.48) ng/L,(155.93 ± 17.11) ng/L vs.(172.76 ± 13.45) ng/L,P ＜ 0.01].Conclusion Both LW and DL can be well done in elderly patients intubation,but LW can reduce stress responses during the intubation.

Objective:To study the effect of quality control circle(QCC)on the reasonable ratio of clinical prescriptions. Methods:The dispensed prescriptions in orthopedic emergency department were reviewed in our hospital,and the reasons of unreasonable prescriptions were analyzed. According to the QCC technique,the activities were implemented,the standardized work process was made out and the results were studied. Results:After the six-month QCC activities,the unreasonable ratio of emergency orthopedics prescriptions was reduced from 70% to 21% ,and the target yield rate was 140% and the improvement rate was 70% . Conclusion:The QCC has obvious effect on the improvement of reasonable ratio of emergency orthopedics prescriptions.

Background: Granular cell tumor (GCT) is an uncommon tumor, and gastrointestinal tract GCT is even more rare. Aims: To investigate the clinicopathological characteristics, treatment and prognosis of gastrointestinal tract GCT. Methods: Nine cases of gastrointestinal tract GCT from January 2017 to June 2021 at the 903rd Hospital of Joint Logistics Support Force, PLA and Jinhua Municipal Central Hospital Medical Group were retrieved. The clinical data, histopathological characteristics, treatment, and prognosis were retrospectively analyzed. Results: In the 9 patients with gastrointestinal tract GCT, ratio of male to female was 2:1, age at diagnosis was 19-60 years, with a median age of 52 years. Six GCT were found in esophagus, 2 in colorectum and 1 in anus. Endoscopic results showed submucosal protrusion or sessile polyps ranging in size from 2-12 mm with a median of 5 mm. Histology results showed that tumors were located in mucosa and/or submucosa, arranged in solid sheets or nests, with an infiltrative margin and inflammatory infiltrates. Tumor cells were mainly plump and polygonal with abundant cytoplasm and eosinophilic granules. Nuclei were small, the nuclear-cytoplasmic ratio was very low. Mitotic figure was rare. Immunohistochemistry results showed that S100 and CD68 proteins were positive in all patients, SOX10, CD56, Calretinin and Syn were positive in some patients, and CKp, Desmin, SMA, CD117, CD34, Dog1, and α-inhibin were negative in all patients. Esophageal and colorectal GCT patients received endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The anal GCT patient underwent local resection. Recurrence or metastasis were not observed during 9-53 months of follow-up. Conclusions: Gastrointestinal tract GCT is rare with non-specific clinical symptoms and submucosal protrusion or sessile polyps under endoscopy. Gastrointestinal tract GCT has special pathomorphology and immunophenotype. EMR or ESD is recommended for small and superficial lesions. Long-term follow-up should be performed.