Objective To investigate the effects of different doses of dexmedetomidine used in SEP and MEP monitoring in patients undergoing neurosurgery. Methods Eighty patients undergoing neurosurgery receiving SEP and MEP monitoring were randomly divided into 4 groups(n = 20 each):group C,group D1,group D2 and group D3. In groups D1 ,D2 and D3 ,dexmedetomidine 0.5 μg/kg was infused over 10 minutes before anesthesia induction,and then was infused at a rate of 0.1,0.3 and 0.5μg/(kg·h)respectively toward the end of operation. Group C received the equal volume of normal saline. HR ,MAP and BIS were recorded at admission to the operating room(T1),skin incision(T2),when the muscle relaxants were stopped(T3)and 50 minutes later(T4). The current intensity and the time when first MEP was induced after muscle relaxant was stopped ,the amplitudes and latencies of SEP(N20-P25,N20)and MEP on thenar muscle at T4,the total consumption of propofol,and development of adverse affects were also recorded. Results Compared with groups C and D1,HR and MAP were decreased at T2-T4 in groups D2 and D3(P<0.05). The amount of propofol consumed were lower in groups D2 and D3 than in groups C and D1(P < 0.05). The current intensity inducing MEP was lower and the amplitude of MEP at T4 was higher in group D2 than in groups C,D1 and D3,and the situation was same in group D3 than in group C (P<0.05). No significant change was found in the other parameters in groups C ,D1 ,D2 and D3(P>0.05). Conclusion Dexmedetomidine infused at 0.3 μg/(kg · h) after infusion of a loading dose of 0.5 μg/kg could improve monitoring quality of MEP through reducing the amount of propofol consumed ,have less inhibition on MEP than other groups,have no obvious effects on SEP,andmaintain hemodynamic stability.

Seventy-two endophytic fungi isolated from Cephalotaxus hainanensis Li were screened for antitumor and antimicrobial activities. The results showed that 9 strains presented cytotoxic activities to at least one of the tested tumor cells, five strains exhibited strong antimicrobial activity against Staphylococcus aureus, one strain had inhibitory effect on Phytophthora parasitica. It was evidently that the endophytic fungi of C. hainanensis are potential resources to find valuable bioactive components.

Objective: To compare the efficacy of moxibustion with different doses for knee osteoarthritis (KOA), and explore the correlation between moxibustion dose and clinical efficacy. Methods: Sixty-eight patients with KOA who met the inclusion criteria were randomly divided into a 20-minute moxibustion group and a 40-minute moxibustion group by the random number table method, with 34 cases in each group. Dubi (ST 35), Neixiyan (EX-LE 4) and Heding (EX-LE 2) were used for moxibustion in the two groups. Each treatment lasted 20 min or 40 min for each point in the 20-minute moxibustion group and 40-minute moxibustion group, separately; the treatment was given 3 times a week and lasted for 4 weeks. The visual analog scale (VAS), Western Ontario and McMaster University osteoarthritis index (WOMAC) and traditional Chinese medicine (TCM) symptom scores were evaluated before and after treatment to compare the efficacy between different moxibustion doses for KOA. Results: After treatment, the total effective rate was 87.5％ in the 40-minute moxibustion group, versus 70.0％ in the 20-minute moxibustion group, and the difference in the total effective rate between the two groups was statistically significant (P<0.05). After treatment, the VAS scores, the total WOMAC scores and the component scores of pain, stiffness and dysfunction, and the TCM symptom scores in both groups all changed significantly when compared with those before treatment (all P<0.05). After treatment, the between-group differences in the VAS score, the total WOMAC score and the component scores of pain and dysfunction, and the TCM symptom score were statistically significant (all P<0.05), while the difference in the stiffness score in WOMAC showed no statistical significance (P>0.05). Conclusion: Either 20-minute moxibustion or 40-minute moxibustion can relieve pain, improve stiffness, dysfunction, and TCM symptoms for KOA; and 40-minute moxibustion is better in relieving pain, improving dysfunction and TCM symptoms.

Objective To investigate the role of opioid receptors and vagus and sympathetic nerves in the remifentanil-induced cardiovascular depression in rabbits. Methods Forty 2-6 months old New Zealand white rebbits of both sexes weighing 1.5-2.5 kg were randomly divided into 5 groups (n = 8 each): group Ⅰ remifentanil (group R); group Ⅱ naloxone + remifentanil (group N+ R); group Ⅲ vagus nerve cut-off +remifentanil (group V+ R); group Ⅳ epidural block + remifentanil (group S+ R) and group V vagus nerve cutoff + epidural block + remifentanil (group V + S + R). The animals were anesthetized, tracheostomized and mechanically ventilated. PaCO2 was maintained at 35-45 mm Hg. Vecuronium 0.3 mg/kg was given iv every 40 min to keep muscle relaxed. Right carotid artery was cannulated for continuous MAP monitoring. ECG was continuously monitored. A bolus of remifentanil 5.0 μg/kg was administered iv in all 5 groups. In group N + R naloxone 40μg was given iv about 2 min before remifentanil. In group V + R bilateral vagus nerves were cut off through neck incision. After HR and MAP had stabilized for 30 min, remifentanil was given iv. In group S + R epidural block was performed at L6.7 interspace with 2% lidocaine to block cardiac sympathetic nerves. When HR and MAP decreased by 20% of the baseline values and stabilized for 30 min remifentanil was given iv. In group V + S + R bilateral vagus nerves were cut off first. Then epidural block was performed before remifentanil administration. MAP and HR were recorded at 1 min before iv remifentanil administration (T0 ), at 30 s (T1), 1,2, 3, 4, 5, 10, 15 and 20 min (T2-9 ) after remifentanil administration. Results Intravenous remifentanil 5.0 μg/kg significantly decreased HR at T1 and MAP at T1-7 as compared with those at T0 in group R. Pretreatmentwith naloxone 40 μg prevented remifentanil-induced decrease in MAP but did not affect remifentanil-induced decrease in HR in group N + R. Vagus nerve cut-off and sympathetic block induced by epidural anesthesia performed before iv remifentanil did not affect remifentanil-induced cardiac depression in group V + R, S + R and V + S + R. Conclusion Opioid receptors and vagus and sympathetic nerves are not related to remifentanil-induced decrease in HR. Remifentanil induces decrease in MAP by activating opioid receptors.

On the basis of the summarization about some MPH education experience in Sun Yat-sen University,we make the assumption concerning construction of MPH training quality assurance system ,expound the content and operating mode of this training quality system,and then offer reference for improvement of MPH training quality.

Background and purpose:Esophageal cancer is one of the common malignant tumors in our country. Anastomotic stenosis is a common complication after resection of esophageal cancer, seriously affecting the quality of life of patients after operation. By changing anastomosis, this study explored the methods for prevention of anastomotic stenosis after esophageal cancer surgery.Methods:Patients were randomly divided into groups. Patients admitted on odd dates were placed in the control group whereas patients admitted on even dates were placed in the experimental group. Patients in the control group were treated with gastroesophageal anastomosis using anastomat for gastroesophageal anastomosis. Anastomotic stomach was contracted by purse string suture at first, and then treated with stapler gastroesophageal anastomosis, before the gastroesophageal anastomosis was carried out on patients in the experimental group. After 6 months’ follow-up, the incidences of anastomotic stenosis between the two groups were compared.Results:The postoperative anastomotic stenosis rate in the control group was 19.2%, while that in the exper-imental group was 0%. There were statistically signiifcant differences between them (χ2=22.8,P<0.005). The incidence of anastomotic stenosis in the control group was signiifcantly higher than that in the experimental group.Conclusion:Anastomotic stomach contracted by purse string suture before stapler gastroesophageal anastomosis can effectively reduce the occurrence of anastomotic stenosis after esophageal cancer surgery.

Objective: To study the influence of high cell incubating temperature on AMP-activated protein kinase(AMPK) activity and lipid metabolites of piglets hepatocytes in vitro.Method: Primary hepatocytes of piglets about age 55d were separated and cultured under 37 ℃(control) or 42 ℃(heat stress).The anabolic and catabolic products of [14C]-oleic acid were detected for hepatocytes and culture media at 60min,120min and 180min.There were 9 replicates per time point.Result: Heat stress activated AMPK activity and enhanced fatty acid oxidation.The production of [14C]-CO2 and [14C]-acid soluble metabolites(ASM) was higher in heat stress group than in the control.At the same time,heat stress depressed the incorporation of [14C]-oleate into phospholipids,monoglycerides,triglycerides,cholesterol and cholesteryl ester.Conclusion: Heat stress activated AMPK activity and enhanced the formation of anabolic products and depressed catabolic products in piglets hepatocytes in vitro.

Objective To explore the effection of four types of surgery for the treatment of adenoid hypertrophy . Methods 148 cases of with adenoid hypertrophy treated in our hospital between April 2012 and April 2015 were chose;they were randomly divided into 4 groups ,each group of 37 people .A group of patients with adenoid hypertrophy were taken traditional ade‐noidectomy curettage;Group B with nasal endoscopic adenoidectomy and cutting aspiration biopsy ;Group C by adenoidectomy shave their + residual endoscopic adenoidectomy bit cut method combined treatment ;Group D with nasal endoscopic adenoidectomy plas‐ma cutting treatment .The curative effect ,operation time ,blood loss were observed ;patients were followed‐up for half a year ,ade‐noidectomy residual rate and complications of each group were compared .Results The total effective rate of B ,C ,D three groups were significantly higher in group A patients (χ2 =7 .731 ,5 .045 ,7 .731 ,P<0 .05) ,the efficient between three groups was not sta‐tistically different (P>0 .05) .B ,C ,D three groups of operation time is significantly higher than A group of patients (t=5 .819 , 5 .829 ,2 .759 ,P<0 .05);B and C group had long operation time than group D (t=3 .555 ,3 .637 ,P<0 .05);But operation time of B and C had no significant difference between the two groups (t=0 .149 ,P>0 .149) .Bleeding of B and C group were significantly higher than group A (t=9 .305 ,4 .126 ,P<0 .05);Group D was significantly lower than A ,B ,C three group (t=8 .054 ,16 .559 , 12 .837 ,P<0 .05);Group C and group B was significantly higher than the bleeding (t=5 .739 ,P<0 .05) .Retention rate of group A is significantly higher than the other three groups (χ2 =31 .308 ,31 .308 ,24 .667 ,P<0 .05) ,the residual rate of B ,C ,B group were lower ,there was no statistically significant difference(P> 0 .05) .Complication rates between the four groups was no statistical difference(P>0 .05) .Conclusion we should choose the right means of surgical treatment according to patients condition and eco‐nomic situation to .

Seventy-two strains of endophytic fungi were isolated from the healthy bark, branches and leaves of Cephalotaxus hainanensis L.. Sixty-eight of them were morphologically classified into Fungi Imperfecti, thirty-three sporulated were identified to five genera. For those did not sporulate, one was identified to Rhizoctonia sp., the rest were tentatively classified into Mycelia Sterilia. Four were identified to Basidiomycetes. The result indicated the endophytic fungi of C. hainanensis show a degree of tissue specificity. There were significant differences about the quantity, genera and composition between the fungi isolated from bark and those from branches and leaves.

Anal Canal/surgery* ; Anorectal Malformations ; Constriction ; Fecal Incontinence ; Humans ; Rectal Prolapse