Objective To determine the plasma concentrations and pharmacodynamics of fentanyl and nerphine used in postoperative epidural or intravenous patient-controlled analgesia (PCEA,PCIA) .Methods Sixty ASA Ⅰ - Ⅱ patients (36 male, 24 female), aged 18-25 yr undergoing elective major operation were randomly divided into 3 groups : group Ⅰ received PCEA with 0.13 % bupivacaine + fentanyl 2?g?ml-1 (n = 20) ; groupⅡ received PCEA with 0.13 % bupivacaine + morphine 0.08 mg? ml-1 ( n = 20); group Ⅲ received PCIA with morphine 0.5 mg ? ml-1 ( n = 20). In group Ⅰ and Ⅱ the background infusion rate was 4 ml ? h-1 , PCA bolus dose 2 ml and lock-out interval 20 min, while in group Ⅲ the back ground infusion rate was 1 ml?h-1 , PCA bolus dose 2 ml and lock-out interval 6 min. PCA was maintained for 48 h in all three groups. The vital signs, analgesic effect (VAS, VRS) and side-effects were recorded and venous blood samples were taken for determination of plasma fentanyl and morphine concentrations at 4 h, 24 h and 48 h after PCA was commenced. Results The demographic data were comparable among the three groups. There was no significant difference in MAP, HR and RR during PCA among the three groups. The analgesia was satisfactory in all three groups and no other analgesic was used during PCA. The rate of excellent analgesia ranged between 80%-85 % . The incidences of side-effects were higher in group Ⅱ and Ⅲ as compared with those in group Ⅰ . The volume of epidural PCA solution administered in 48 h was significantly larger in group Ⅰ than that in group Ⅱ( P

Objective To investigate the application of the mini nutritional assessment (MNA)in the malnutrition risk eval-uation of elderly inpatients with cardiovascular disease(CVD).Methods The MNA method was adopted to detect the MNA scores in 316 elderly inpatients with CVD.The inpatient′s nutritional status was evaluated according to the MNA scores.Results Among 316 cases,52 cases(16.46%)were malnutrition,60 cases (18.99%)had the malnutrition risk and 204 cases (64.56%)were in a good nutritional status;the occurrence rate of malnutrition and malnutrition risk in the female elderly patients were higher than those in the male patients,the differences were statistically significant(P <0.01);the occurrence rate of malnutrition and malnutri-tion risk in the elderly inpatients(≥80 years old)were higher than those in the low age patients(60~<80 years old),but the differ-ences had no statistical significance(P >0.05);the occurrence rate of malnutrition and malnutrition risk in the rural patients were higher than those in the patients lived in city,the differences were statistically significant(P <0.05).Conclusion Elderly inpatients with CVD have the higher prevalence of the malnutrition risk,the MNA can be applied in elderly inpatients with CVD for conduc-ting the nutritional status monitoring and early screening the malnutrition risk.

In order to evaluate the changes in T cell subsets after acute irradiation injury, and investigate the mechanism of deficiency of cellular immunity in acute irradiation syndrome, Balb/c mice were exposed to a single total body irradiation of 5Gy gamma rays from a 60 Co source. On days 10, 28 and 120, the amounts of CD4 + and CD8 + subsets in spleen cells were evaluated by flow cytometry (FCM), and expression of IL 4 gene in ConA stimulated spleen cells was evaluated by reverse transcription linked polymerase chain reaction, in which ?-actin gene was used as an internal control. It was found that after irradiation, the ratio of CD4 + /CD8 + became significantly higher than that of the controls, and then the ratio lowered gradually until day 120. However, it still did not return to the level of the controls. On day 10, expression of IL 4 gene at mRNA level increased significantly. The results indicated that CD8 + subset was more radiosensitive than CD4 + , and the pattern of cytokine seeretion shifted to that of Th2 soon after irradiation.

Objective To compare the effects of different dose aprotinin on cardiopulmonary bypass induced inflammation and myocardial injury Methods Eighteen adult patients undergoing cardiopulmonary bypass (CPB) were divided into three groups (n=6): control,low dose aprotinin and full dose aprotinin Plasma levels of tumor necrosis factor ?(TNF?), interleukin 6(IL 6), interleukin 10(IL 10), intercellular adhesion molecule 1(ICAM 1), troponin T(TnT) and neutrophil integrin cluster of differentiation 11b(CD11b) were measured at following points: before CPB(T1);1 h of CPB (T2) ;30 min after weaning from CPB (T3); 4 h after weaning from CPB (T4) ; and 24 h after weaning from CPB(T5) Results TNF?: the values in two aprotinin using groups were lower than the control levels at T2, T3 and T4 , furthermore, in full dose group was lower than in low dose group at T4 , and lower than two other groups at T5 (P

Objective To observe the changes of calcitonin gene related peptide (CGRP) in rat spinal motoneuron after upper motoneuron injury. Methods Thirty six adult male Wistar rats were selected. Spinal cord transection was made at the lower thoracic segment. The lumbar regions of spinal cord were removed immediately, 1, 2, 4, 7 and 14 days after surgery to be divided into dorsal and ventral sections. The content of CGRP in ventral section was detected using radioimmunoassay method.Results The level of CGRP in spinal motoneuron of the lumbar region was decreased significantly after transection of spinal cord, reached the lowest level on the 2nd day after surgery and then maintained at the low level.Conclusions The upper motoneuron injury can result in the decrease of CGRP content in spinal motoneuron.

Objective This research attempted at prevention of steam contamination and protection of medical staff in periodontal scaling. Methods Thirty sample patients without oral cavity or upper res-piratory tract infection, chronic disease, infectious disease or other contraindication were randomly classified into the experimental group and the control group.The former gargled with chlorhexidine in the process of periodontal scaling while the latter rinsing only. Oral cavity bacteria of both groups were sampled before and after operation;air samples were got at five periods of time(before operation, 10 minutes in operation, 20 minutes in operation, 30 minutes in operation, and end of operation) and germicnltured.The entire data were analyzed.Results Air samphng in periodental scaling and oral sample germiculture after the scaling in the experimental group were lower than those of the control group, P<0.01. Conclusions With effective disinfection and sta-ble characteristics, chlorbexidine can be popularly utilized in skin mucous membrane disinfection. Gargling with chlorhexidine in periodontal scaling eliminates bacteria and microorganism in oral cavity and resulting steam,thus reducing environmental pollution and protecting the health of medical staff.

Objective To investigate the relationship between retinal vessel diameters and cerebral infarction of carotid artery stenosis patients.Methods Eighty seven patients (174 eyes) with carotid stenosis were included in this study.There were 49 males and 38 females,with an average age of (65.25±7.85) years.Thirty-four patients were suffered from cerebral infarction (cerebral infarction group),and the other 53 patients had no cerebral infarction (control group).There was no significant difference in age (t=1.916),male rate (x2=0.142) and carotid stenosis extent (x2=0.785) between the two groups (P=0.059,0.706,0.675).All patients underwent color fundus photography after mydriasis.Retinal vascular caliber measurements were performed using IVAN software.The main parameters were central retinal artery diameter (central retinal artery equivalent,CRAE),the diameter of the central retinal vein (central retinal vein equivalent,CRVE) and the retinal arteriole to venular ratio (AVR).The relationship between retinal vessel diameter and cerebral vascular disease were analyzed with logistic regression analysis.Results In cerebral infarction group,CRVE,CRAE and AVR ratios were (132.90 ± 20.67) μm,(243.47 ±43.92) μm and 0.56±0.10,while the control group was (145.26±21.59) μm,(224.99±32.35) μm and 0.68±0.13 respectively.There were significant differences between the two groups (t=-2.648,2.257,-4.631;P＜0.05).After correction for risk factors,such as age,smoking history,CRAE reduction and CRVE increases were significantly correlated with cerebral infarction.Conclusion CRAE reduction and CRVE increases are risk factors of cerebral infarction in patients with carotid stenosis,and it is useful in the prediction.

Objective To determine the factors contributing to the development of deep vein thrombosis (DVT) in the lower extremity in patients after hip or knee arthroplasty and hip fracture internal fixation.Methods One hundred and forty-seven consecutive patients receiving hip or knee arthroplasty and hip fracture internal fixation from 2004 to 2005 were included in this study. Their age ranged from 33 to 92 years. Duplex color ultrasonic inspection was performed on veins of the bilateral lower extremities before operation and 2 weeks after operation for detection of DVT. The patients were divided into a DVT group and a DVT-free group based on the development of DVT after operation. Detailed perioperative clinical information about the patients, surgery and anesthesia was collected.Results Lower extremity DVT was found in 42.2% of the patients after operation, while the incidence of proximal DVT was 2.7%. Compared with the DVT-free group, the usage rate and dosage of ephedrine increased significantly, the duration of anesthesia was significantly longer, and the white blood cell count (WBC) on the 1st postoperative day and the highest WBC count were significantly higher in the DVT group(P＜0.05). Logistic regression analysis indicated that the above factors were closely related to DVT.Conclusion Duration of anesthesia ＞ 3 h, ephedrine administration and a marked increase in WBC count after operation are the risk factors for DVT in the lower extremities in patients after hip or knee arthroplasty and hip fracture internal fixation.

Objective To evaluate the value of PCR molecular beacon assay. In detecting mycobacterium tuberculosis in clinical specimens. Methods The sputum specimens of 142 patients with pulmonary tuberculosis and 42 patients with respiratory system diseases other than tuberculosis were tested by smears, cultures and PCR molecular beacon assays. Results The sensitivities of smears. cultures and molecular beacon assay in detecting mycobacterium tuberculosis in sputum specimens of patients with pulmonary tuberulosis were 35.2%,35.9% and 44. 4%, respectively. The specificity of molecular beacon assay in testing clinical specimens was 100%. Conclusion PCR molecular beacon assay is in a hermetially sealed simple tube, rapid and anticontaminative. This assay is higher in sensitivity and specifity,than smears and cultures is one of the effective mothods for diagnosis of tuberculosis.

Objective To investigate the effectiveness of deep brain stimulation (DBS) treating Parkinson's disease.Methods Forty cases of Parkinson's disease were selected from March 2014 to August 2015.The clinical symptoms of these patients were described and quantitatively analyzed with Unified Parkinson's Disease Rating Scale (UPDRS) before and after the procedure of DBS surgery.Results After deep brain stimulation surgery,the symptoms including muscle stiffness,static tremor,bradykinesia were improved,UPDRS scores were significantly lower and the demanding dosage of Parkinson disease drugs such as L-dopa/benserazide and L-dopa/carbidopa were also reduced.Conclusion Deep brain stimulation for Parkinson's disease is safe and effective.It can obviously control the symptoms,reduce the dosage of oral drugs,and improve the quality of life.