Objective To discuss the safety of using etomidate combined with remifentanil by target controlled infusion ( TCI) for painless bronchofibroscopy. Methods Sixty patients were divided into two groups: painless bronchoscopy group (treatment group, 24 patients) and the routine bronchoscopy group (control group, 36 patients). Treatment group received TCI of remifentanil and intravenous injection of etomidate fat emulsion. Control group was subjected to surface anesthesia with 2%lidocaine. SpO2 , blood pressure, heart rate and breath changes during examination and complete awakening were continuously monitored. Bronchofiberscopy time, body movement during examination, bucking and satisfaction degree after examination were also recorded. Results Treatment group patients felt senseless and painless during bronchoscopy, without memory of bronchoscopy and pain. Patients in control group had discomfort, body movement and acute bucking, and most of them had painful memory. There were significant differences between the two groups (P<0. 01). In treatment group, after examination, blood pressure, respiratory frequency, heart rate and SpO2 were significantly decreased (P<0. 01). During examination, the blood pressure, respiratory frequency and heart rate were increased, and SpO2 decreased in control group compared to the baseline (P<0. 01). There was no significant difference in SpO2 between treatment group and control group during examination (P>0. 05). Conclusion TCI etomidate combined with remifentanil during bronchoscopy achieved satisfying anesthetic effect.

Objective To evaluate clinical effects of integrated traditional Chinese and western medicine therapy for epilepsy after stroke. Methods Literatures about the treatment of epilepsy after stroke with the combination of traditional Chinese medicine and western medicine which come from the database such as CNKI, VIP, WanFang and Pubmed, were studied and all the randomized controlled trials on comparing therapeutic effects of treating epilepsy between combined treatment of TCM and western medicine and western medicine were enrolled. The Cochrane Collaboration's software RevMan 5 was used for meta-analysis. Results 7 articles were included in the study, there is homogeneity among these articles(P>0.05), The fixed effect model was used for the meta analysis. the combined results were OR=5.17, 95%CI(3.02, 8.82), the overall effect of test Z=6.01, P<0.01, the difference between the treatment group and the control groups was significant, that means the overall effect of the combination of traditional Chinese medicine and Western medicine treatment was better than western medicine treatment; Funnel plot graphic displayed asymmetrically, which indicated the literatures publication bias. Conclusion The current data indicate that the curative effect of TCM and west medicine combined treatment is better than pure western medicine therapy for epilepsy after stroke, but as the literature publication bias, clinical studies need more high quality large samples to prove this conclusion.

Objective To explore the therapeutic effect,advantages and shortcomings of pleural effusion controlled by interrupted drainage via central venous catheter.Methods The research group had 52 cases with pleural effusion controHed by interrupted drainage via central venous catheter,and the control group had 50 cases with pleural effusion controlled by conventional pleuracentesis.Pleural effusion disappearing time,average hospitalization time,pleuracentesis frequency,related therapy expenses and complications of two groups were observed and compared.Results The pleuracentesis frequency,pleural effusion disappearing time,average hospitalization time,related therapy expenses and per capita incidence of complications of the research group were(1.06±1.30)times,(4.31±2.20)days,(9.87±2.30)days,(264.77±37.20)yuan and 9.62%and in the control group were(4.20±2.60)times,(9.92±3.70)days,(15.08±5.80)days,(487.62±55.56)yuan and 38.00%.The differences between two groups were particularly remarkable.Conclusion The method of pleural effusion controlled by interruptod drainage via central venous catheter is safe,eonvenient,economical and microtraumatic,and it is worth using more widely.

To investigate the effects of rennin angiotensin system blockade on the microvessel density in islets of diabetic rats and its relationship with islet function, diabetes model was created by feeding of high-caloric laboratory chow plus intraperitoneal injection of a small dose of streptozotocin (30 mg/kg). After 8 weeks intervention with perindopril (AE, n=10) or valsartan (AR, n=10), the islet function of the animals was evaluated by intravenous insulin release test (IVIRT). The pancreases were immunohistochemically stained to analyze the content of insulin and vascular endothelial growth factor (VEGF) in the islets. The microvessel density (MVD) of islets was detected by counting CD34 positive cells. The hypoxia inducible factor (HIF)-1alpha mRNA expression in the islets was detected by RT-PCR. Compared with normal control group (NC, n=10), the area under the curve for insulin from 0 to 30 min (AUCI(0-30)) of diabetes group (DM, n=8) was decreased by 66.3%; the insulin relative concentration (IRC) of betacell was decreased significantly; the relative content of VEGF was increased obviously [(-4.21+/-0.13) vs (-4.06+/-0.29)]; MVD in islets was decreased by 71.4%; the relative expression of HIF-1alpha mRNA was increased by 1.19 times (all P<0.01). Compared with DM group, the AUCI(0-30) of AE and AR group was increased by 44.6% and 34.9% respectively; IRC was also increased significantly; the relative content of VEGF was decreased by 21.2% and 21.7% respectively; MVD was increased by 62.5% and 75.0% respectively; the relative expression of HIF-1alpha was decreased by 27.2% and 29.0% respectively (all P<0.01 or P<0.05). There were no significant differences in the said indexes between group AE and AR. It is concluded that the blockade of RAS may ameliorate islets function of diabetic rats by increasing the MVD in islets.

To investigate the effects of rennin angiotensin system blockade on the microvessel density in islets of diabetic rats and its relationship with islet function,diabetes model was created by feeding of high-caloric laboratory chow plus intraperitoneal injection of a small dose of streptozotocin (30 mg/kg). After 8 weeks intervention with perindopril (AE,n=10) or valsartan (AR,n=10),the islet function of the animals was evaluated by intravenous insulin release test (IVIRT). The pancreases were immunohistochemically stained to analyze the content of insulin and vascular endothelial growth factor (VEGF) in the islets. The microvessel density (MVD) of islets was detected by counting CD34 positive cells. The hypoxia inducible factor (HIF)-1α mRNA expression in the islets was detected by RT-PCR. Compared with normal control group (NC,n=10),the area under the curve for insulin from 0 to 30 min (AUCI0-30) of diabetes group (DM,n=8) was decreased by 66.3%;the insulin relative concentration (IRC) of βcell was decreased significantly;the relative content of VEGF was increased obviously [(-4.21±0.13) vs (-4.06±0.29)];MVD in islets was decreased by 71.4%;the relative expression of HIF-1α mRNA was increased by 1.19 times (all P＜0.01). Compared with DM group,the AUCI0-30 of AE and AR group was increased by 44.6% and 34.9% respectively;IRC was also increased significantly;the relative content of VEGF was decreased by 21.2% and 21.7% respectively;MVD was increased by 62.5% and 75.0% respectively;the relative expression of HIF-1α was decreased by 27.2% and 29.0% respectively (all P＜0.01 or P＜0.05). There were no significant differences in the said indexes between group AE and AR. It is concluded that the blockade of RAS may ameliorate islets function of diabetic rats by increasing the MVD in islets.