Objective To discuss the effect of treating tubal obstruction infertility through hydrotubation by hysteroscopy combined with Chinese traditional medicine. Methods Chose 308 patients with tubal obstruction infertility from October 2001 to December 2008 and used the hysteroseopy under which making tubal cannulation, then injected methylene blue and clear liquid to record cases of tubal patency.After the operation the patients would be given Chinese traditional medicine and followed up the case of pregnancy. Result The recanalization rate in 308 patients was 90.9% (280/308), and the rate ofre-pregnancy was 55.5%(161/290). Conclusion The effect of treatment through hysteroscopy to make tubal cannulation and have patients take medicine after operation is very satisfactory and it is worth promoting.

Acinetobacter baumannii, a glucose-nonfermentative gram-negative coccobacillus, is an important pathogen isolated in nosocomial infections, and the clinical detection rate has been increasing in recent years. Acinetobacter baumannii attracts widespread attention due to strong viability, broad resistance spectrum and high rate of drug resistance. The resistance mechanisms include the production of β-lactamases, alterations in penicillin-binding proteins, decreased outer membrane permeability and overexpression of active efflux pumps. The mechanisms of Acinetobacter baumannii resistance to β-lactarn antibiotics, especially those of the outer membrane porin and active efflux system are reviewed in this paper.

Objective To introduce the method, indications and the usage of abdominal double layer subcutaneous flap for the repair of late complicated hand injury. Methods A new type of flap was designed to repair the complicated hand injury. Sixteen cases were treated with this method since 1998. Results The duration of the follow up ranged from 3 to 24 months with an average of 13 months. All of the flaps survived well. After physiotherapy, the overall excellent and good rate of joint movement was 80%(TAM standard). No further surgery was required in all of the cases. Conclusion The abdominal double layer subcutaneous flap was especially indicated in those cases with bone nonunion, tendon and nerve defect and tendonous adhesions. This kind of flap not only provide a good skin covering, but also offer a soft bed for the tendons, nerves, and bones.

ObjectiveTo compare the preventive effects oftramadol and ketamine on the patients with postoperative hyperalgesia after remifentanil-induced neurosurgical anesthesia.MethodsOne hundred and fifty patients undergoing craniotomy were assigned to tramadol group,ketamine group and normal saline group with 50 cases each by random digits table.Anesthesia was maintained with infusion of remifentanil [0.1-0.2μ g/( kg· min ) ],propofol and sevoflurane.Tramadol ( 1.5 mg/kg),ketamine (0.5 mg/kg) or normal saline was given before skin closing.The emergence time,trachea extubation time,patients required analgesia and tramadol consumption,reverse effect were recorded.The visual analog scale (VAS),Ramsay scores at 15,30,60,120 minutes after emergence were performed.ResultsPatients required analgesia and tramadol consumption in tramadol group and ketamine group were significantly lower than those in normal saline group (P ＜0.01 or ＜0.05 ).The occurrence of shiver in tramadol group was lower than that in normal saline group (P ＜0.05).VAS scores in tramadol group at 15,30 minutes and in ketamine group at 30 minutes after emergence were significantly lower than those in normal saline group (P＜ 0.05).Ramsay score in ketamine group at 15 minutes after emergence was higher than that in tramadol group and normal saline group [ (2.9 ±0.6) scores vs.(2.3 ±0.7) scores and (2.3 ±0.9) scores](P＜0.01).ConclusionTramadol has a goodpreventive effect for postoperative hyperalgesia induced by remifentanil in neurosurgery compared with ketamine.

ObjectiveTo investigate the incidence of postoperative residual paralysis and respiratory function of patients undergoing neurosurgical anesthesia.Methods Three hundred andtwenty-eight patients undergoing neurosurgical anesthesia (ASA Ⅰ - Ⅱ ) were divided into vecuronium group (135 cases) and rocuronium group (193 cases) by random digits table.Anesthesia was maintained with propofol in combination with sevoflurane and intermittented intravenous infusion boluses of muscle relaxatant.Extubation of the intratracheal tube in operation room was performed under clinical criteria.The neuromuscular function were detected by acceleromyography with supramaximal train-of- four(TOF) stimulation of the ulnar nerve,and pulmonary function were measured in postanesthesia care unit(PACU).The TOF ratio and pulmonary function were compared between two groups.ResultsThe incidence of postoperative residual paralysis was 31.9％(43/135) in vecuronium group,and 14.5％(28/193) in rocuronium group.Hypoxemia and hypercapnia occurred in vecuronium group with TOF ＜ 0.9 were higher than in those with TOF ≥0.9[7.0％(3/43) vs.4.3％(4/92) and 44.2％(19/43) vs.18.5％(17/92),P ＜ 0.01 ],while in rocuronium group with TOF ＜ 0.9 were higher than in those with TOF ≥ 0.9 [ 3.6％( 1/28 ) vs.1.2％ (2/165) and 39.3％( 11/28 )vs.17.0％ (28/165),P ＜ 0.01 ].ConclusionsThere is a high incidence of postoperative residual paralysis according to the clinical criteria of recovery of neuromuscular function of patients undergoing neurosurgical anesthesia,which would impair respiratory function.

Objective: To explore antitumor responses induced by recombinant vaccinia viruses expressing a p53 antigenic peptide (rVV-p53M) and enhanced effect of recombinant vaccinia viruses expressing costimulatory molecule B7 (rVVB7). Methods: A 135 Cys to Tyr point mutation p53-transduced P815 mastocytoma (P815-mp53) was used as an experimental tumor and the p53 protein as the model of tumor associated antigen． rVV-p53M and rVV-B7 were used as vaccine to test their induction of CTL and antitumor immunity. Results: Immunization of BABL/c mice with rVV-p53M could elicit specific CTLs, which could specifically lyse P815-mp53 cells. Immunization of mice with rVV-p53M could survive a part of mice challenged with 1×106 P815-mp53. Treatment with rVV-p53M could significantly prolong the survival oftumor-bearing mice. Admixture at 1:1 ratio of rVV-p53 M and rVV-B7 could enhance antitumor responses induced by rVV-p53M. Conclusion: Immunization with recombinant vaceinia virus expressing antigenic peptide is a useful alternative to peptide-based vaccine. Costimulatory molecule B7 can enhance antigenic peptide to induce antitumor responses.

Many gene therapy protocols can induce antitumor immunity, however, the ex vivo approach restricts their uses. This sutydy intended to induce antitumor immunity by direct transfer of MHC class Ⅱ gene in vivo. Methods: MHC class Ⅱ gene cDNA was introduced directly into two tumors: P815, (a murine weak immunogenic mas-tocytoma) and B16 (a murine nonirnmunogenic melanoma) to observe the survival rate of the mice. Results: Tumori-genicity of P815 was reduced when MHC class Ⅱ gene was introduced directly into tumors in vivo. Further more, most vaccinated mice could survive after second challenge of P815. Co-injection of MHC class Ⅱ and B7 genes in the B16 also resulted in the tumor grow slowly, while the injection of MHC class Ⅱ gene was not enough to induce effective antitumor responses. Conclusion: The results showed the potential applications of direct transfer of MHC class Ⅱ gene in the treatment of tumor.

Objective: To explore antitumor responses induced by recombinant vaccinia viruses expressing a p53 antigenic peptide (rVV p53 M) and enhanced effect of recombinant vaccinia viruses expressing costimulatory molecule B7 (rVV B7). Methods: A 135 Cys to Tyr point mutation p53 transduced P815 mastocytoma (P815 mp53) was used as an experimental tumor and the p53 protein as the model of tumor associated antigen. rVV p53 M and rVV B7 were used as vaccine to test their induction of CTL and antitumor immunity. Results: Immunization of BABL/c mice with rVV p53 M could elicit specific CTLs, which could specifically lyse P815 mp53 cells. Immunization of mice with rVV p53 M could survive a part of mice challenged with 1?10 6 P815 mp53. Treatment with rVV p53 M could significantly prolong the survival of tumor bearing mice. Admixture at 1∶1 ratio of rVV p53 M and rVV B7 could enhance antitumor responses induced by rVV p53 M. Conclusion: Immunization with recombinant vaccinia virus expressing antigenic peptide is a useful alternative to peptide based vaccine. Costimulatory molecule B7 can enhance antigenic peptide to induce antitumor responses.

ObjectiveTo observe the incidence and mechanism of postoperative hypoxemia in the patients after transsphenoidal pituitary tumor resection.Methods579 postoperative patients in postanesthesia care unit (PACU) in March, 2009～June, 2010 were investigated retrospectively using PACU databank. The incidence and mechanism of hypoxemia were analyzed.ResultsThe incidence of hypoxemia was 5.2%. Upper airway obstruction, change of breath mode, residual effects of anesthetics, bronchiospasm, aspiration, acute pulmonary edema and lung disease were the main reasons of postoperative hypoxemia after transsphenoidal pituitary tumor resection.ConclusionCareful monitor and treatment are the key to prevent hypoxemia after transsphenoidal pituitary tumor resection.

Objective To observe the clinical effect of Chuanxiong-Chatiao San in treatment hemicrania. Methods All patients were randomly recruited into a control group (75cases) and a treatment group (78 cases). The control group was treated with Gastrodin injection, Ligustrazine injection and Mailuoning injection; on this basis, the treatment group was treated with Chuanxiong-Chatiao powder. Both groups were treated for 14 days with a 7 days interval. Results The excellent rate and effective rate were 91.03% and 96.08% in the treatment group respectively; and 70.66% and 94.67% in the control group respectively. The difference between the two groups was significant (χ2= 12.7143,P<0.01) . Conclusion Chuanxiong-Chatiao powder combined with western medicine is effective in treating hemicrania.