Objective To study the effect of sevoflurane or propofol/remifentanil general anesthesia undergoing gynecological surgery.Methods A total of 80 patients scheduled for selected gynecological surgery were divided into sevoflurane group or propofol/remifentanil group by random digits table method and 40 cases in each group.The induction of anesthesia was conducted with midazolam,propofol,sulfentanil,and rocuronium.After tracheal intubation,anesthesia was maintained with sevoflurane in sevoflurane group,and with propofol/remifentanyl target-controlled infusion in propofol/remifentanil group.Bispectral index was monitored in each group,and which was maintained 40-60.Blood pressure and heart rate was observed.At the end of operation,all anesthetics were discontinued,and the time of consciousness recovery,tracheal extubation,orientation was recorded.The incidence of agitation,nausea and vomiting within 24 h after surgery and the use of rescue drugs such as epinephrine,atropine or urapidil was recorded.Results No statistically significant difference was observed with respect to the time of consciousness recovery,tracheal extubation,orientation between two groups (P ＞ 0.05).The use of atropine and epinephrine in sevoflurane group was lower than that in propofol/remifentanil group [7.5％(3/40) vs.22.5％(9/40),20.0％(8/40) vs.32.5％(13/40)],and there was significant difference(P ＜ 0.05),and the use of urapidil in sevoflurane group was higher than that in pmpofol/remifentanil group [22.5％ (9/40) vs.2.5％ (1/40)],and there was significant difference (P ＜ 0.01).There was no statistically significant differences with respect to the incidence of agitation,nausea and vomiting within 24 h after surgery between two groups (P ＞0.05).Conclusion Propofol/remifcntanil and sevoflurane both provide satisfactory anesthesia for gynecological surgery.

Maxillary first molar with twin-root canal in palatal side is rare. This article described two cases of maxillary first molar with twin-root canal. A properly designed and prepared access of the cavity is helpful for the diagnosis and negotiation of the root canal morphology.
Dental Pulp Cavity ; Humans ; Maxilla ; Molar ; Root Canal Therapy

Objective To learn the gene mutation type and prevalence of thalassemia in the Taishan area and to provide basis for the prevention and treatment of local thalassemia .Methods 1 383 patients who visited the hospital for thalassemia genetic test from January to December 2014 were enrolled for this study .α‐andβ‐genes were determined by using PCR and membrane hybridization methods .Results Of the 1 383 patients ,595 were diagnosed with thalassemia (positive rate was 43 .02% ) ,including 386 cases (27 .91% ) of α‐thalassemia ,183 cases(13 .23% ) of β‐thalassemia and 26 cases(1 .88% ) of αβ‐thalassemia .- -SEA/αα(accounted for 64 .25% ) was the major genotype of α‐thalassemia ,the major genotype of β‐thalassemia wasβ41 -42/β(accounted for 28 .42% ) , and - -SEA/αα,β41 -42/βwas the major genotype of αβ‐thalassemia (accounted for 19 .23% ) .Conclusion Taishan is located in a high risk area of thalassemia ,it is of great significance to perform genetic diagnosis of thalassemia among reproductive population so as to reduce the birth rate of children with thalassemia in the area .

Liver transplantation is a valid treatment option for select patients with Hepatocellular Carcinoma HCC and end-stage liver disease. However, in approximately 20% of patients, recurrent HCC is the rate-limiting factor for longterm survival. Despite identification of clinical parameters that may stratify patients at high risk and exhaustive preoperative staging, cancer recurrence is likely the result of microscopic extrahepatic disease. With a desperate donor organ shortage, locoregional ablation techniques and resection are being employed in patients on the waiting list to serve as a bridge to OLT. Further more, some have advocated aggressive surgical resection of isolated metastasis in both the liver and extrahepatic viscera. Whether these creative strategies confer a survival advantage is unknown, requiring longterm follow-up to determine their efficacy.

OBJECTIVE:To investigate the characteristics and regularity of adverse drug reaction (ADR) in a third grade class A hospital,and to provide reference for rational drug use in clinic. METHODS:A total of 813 cases of ADR reported to Na-tional ADR Monitoring by the hospital during 2013-2015 were summarized and analyzed retrospectively in terms of age,gender,route of administration,drug type,organs or systems involved in ADR,clinical manifestation and outcome. RESULTS:Among 813 cases of ADR,there were 391 male (48.09%) and 422 female (51.91%). Patients aged more than 60 were with high inci-dence of ADR,involving 347 cases(42.68%). Among routes of administration,most ADR cases were caused by intravenous ad-ministration,involving 747 cases (91.88%). Among all drug types,the number of ADR cases caused by anti-infective drugs was the most,involving 382 cases(46.99%);cephalosporins took up the highest proportion,being 38.22%(146 cases). Organs or sys-tems involved in ADR were mainly skin and its appendants,involving 434 cases (53.38%). CONCLUSIONS:ADR monitoring should be strengthened for elderly patients receiving anti-infective drugs intravenously so as to reduce the occurrence of ADR and guarantee medication safety.

Objective To investigate the clinical application and curative effect of Carbon Nano-particles in curative resection of mid-low rectal cancer .Methods 26 patients with mid-low rectal cancer were divided equally into carbon nano-particle group and routine group .The labeling group were injected with carbon nano-particles 20~24 hours before operation and treated with TME laparoscopic radical resection .The data of lymph nodes detected in the two groups were compared .Results (1)Total number of lymph nodes detected in the labeling group was higher than that of the routine group (287 vs .124 ,P<0 .05) .(2)The labeling group had higher average lymph nodes detected per patient (22 .12 ± 3 .50 vs .9 .56 ± 1 .50 ,P< 0 .05) ,as well as higher average lymph nodes smaller than 5mm per patient(9 .18 ± 1 .41 vs .3 .50 ± 0 .82 ,P<0 .05) .(3)The metastasis rate of lymph nodes detected in la-beling group lacked statistical significance as compared with that of the routine group (3 .10 ± 0 .37 vs .2 .62 ± 0 .25 ,P>0 .05) .Con-clusion Adoption of carbon nano-particle in curative resection of rectal cancer can increase the number of lymph nodes detected ,re-veal more accurately the metastasis situation of lymph nodes ,facilitate the resection of lymph nodes and rectal cancer during the op-eration ,and provide guidance for postoperative clinical staging and treatment .

OBJECTIVE To evaluate the prevention of antibiotic-associated diarrhea(AAD) in surgical critical illness patients and strengthen the usage of antibacterials to AAD in hospital.METHODS Using prediction and retrospection to analyze the factors of AAD.RESULTS The main factors for AAD are changing antibiotics frequently,the age of patient,complicated disease of patient.CONCLUSIONS Rational use and rigorous control of antibiotics are the keys to prevent AAD in hospital.

Microcalcifications are among the most common imaging findings of breast cancer. This article reviews the recent liter-ature regarding the foci of microcalcifications in breast cancer. In particular, we summarize the composition, formation mechanism, and biopsy method of the microcalcifications;the relationship between the foci and clinicopathologic indicators;and the influence of neoad-juvant chemotherapy on the foci.

OBJECTIVE To ensure safe operation of medical equipment through raising procurement staffs′ awareness of safety and quality control in the process of purchasing medical equipment and exerting fine control of safety and quality throughout procurement. METHODS To sum up regulations,rules and ways on the safety and quality control at all links in the process of purchasing.RESULTS The acceptance rate of quality inspection of introduced medical equipment was 100% and the operating rate of equipment for the annual working hours was 95%.In 2002,our work together with other departments work in our hospital passed the proof of ISO9000. CONCLUSIONS They can not keep hidden safety perils of medical equipment outside the gate of the purchasing and can not ensure the safe operation of medical equipment and its vital role in every medical activity,unless purchasing staffs observe all purchasing regulations and rules and exert fine control of safety and quality of the purchasing.

Objective To evaluate the prognostic value of plasma D dimer level in cancer thrombosis and vascular invasion assessment and to analyze the correlation between plasma D dimer level and the Pittsburgh modified TNM staging in patients with hepatocellular carcinoma for orthotopic liver transplantation. Methods The plasma D dimer level was quantitated using Golden method in 120 patients with hepatocellular carcinoma for orthotopic liver transplantation. Cancer thrombosis in trunk vein and microvascular invasion was diagnosed by pathology. The relationship between plasma D dimer level in different Child pugh’s classification patients and vascular invasion as well as the Pittsburgh modified TNM staging was analyzed with ? 2 test, factorial analysis of variance and q test by microsoft SPSS 9.0.Results In Child Pugh’s A, B and C patients, the difference of plasma D dimer level between patients with trunk vein cancer thrombosis and patients without vascular invasion was significant ( P 0.05). The differences of plasma D dimer level between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅲ tumor, and between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅳ tumor were significant ( P 0.05). Conclusion Plasma D dimer level, which increasing as upgrade of the Pittsburgh TNM staging, is useful in the vascular invasion and cancer thrombosis assessment in patients with hepatocellular carcinoma for liver transplantation, and the correlation was more significant as progression of vascular invasion and upgrade of Child pugh’s classification.