Objective:To observe the influence of sevoflurane and propofol anesthesia on hemodynamics in laparoscopic cholecys-tectomy. Methods:Totally 98 patients with laparoscopic cholecystectomy were randomly divided into P group and S group. P group was with propofol for anesthesia, and S group was with sevoflurane for anesthesia. Before anesthesia, 2min after intubation, 10 min af-ter intubation, 5min and 30min after pneumoperitoneum, and after the surgery, the levels of blood glucose and cortisol, and hemody-namic changes in the two groups were observed, and the incidence of adverse reactions was also studied. Results:2 min and 10 min af-ter the anesthesia, the blood glucose levels in the two groups were significantly lower than those before the anesthesia(P<0.05 or 0. 01), while 30 min after pneumoperitoneum and after the operation, the blood glucose levels were increased(P<0. 01). The blood glucose levels in S group after the operation were much lower than those in P group (P<0. 01). 2 min after intubation, cortisol was decreased in the two groups (P<0. 05 or 0. 01). 5 min after pneumoperitoneum and after the operation, cortisol levels were higher than those before the anesthesia in P group(P<0. 01), and 5 min and 30 min after pneumoperitoneum and after the operation, cortisol levels in S group were lower than those in P group (P<0. 01). HR and SPO2 showed no significant changes in the two groups during the whole process (P>0. 05). 2 min and 10 min after intubation, SBP in the two groups was decreased (P<0. 01), and 5 min and 30 min after pneumoperitoneum, there was notable difference in SBP between the groups (P<0. 01). 2 min and 10 min after intuba-tion, DBP was decreased in the two groups (P<0. 01), and the difference was significant between the groups (P<0. 01). 5 min and 30 min after pneumoperitoneum, DBP in P group had notable difference with that in S group (P<0. 05). The incidence of adverse re-actions in the two groups showed no significant difference (P>0. 05). Conclusion: Sevoflurane anesthesia in laparoscopic cholecys-tectomy can keep stable hemodynamics in the patients, and the anesthetic effect is better than propofol.

Objective:To study the effect of priming technique combined with time limit on shortening the onset time of cisatra-curium besilate. Methods:Totally 112 adult patients undergoing selective operation with general anesthesia were randomly divided into group A, B and C. Fentanyl with the dose of 4 μg·kg-1 and propofol with the dose of 2 mg·kg-1 were used in the three groups as the inducing agents. Group A was first with intravenous injection of cisatracurium besilate 20 μg·kg-1 , and 3 minutes later, the in-ducing agents and cisatracurium besilate with the dose of 80 μg·kg-1 were respectively injected. Group B was first with intravenous injection of cisatracurium besilate with the dose of l00 μg·kg-1 , and 1. 5 minutes later, the inducing agents were injected. Group C was respectively injected with the inducing drugs and cisatracurium besilate with the dose of l00 μg·kg-1 . The T1 percentage before the induction, the time of 90% and 100% inhibition of muscle twitching, the rating of trachea cannula and adverse drug reactions in the three groups were observed and compared. Results:There was no significant difference in the excellent rate of trachea cannula a-mong the three groups (P>0. 05). Compared with group A and B, group C showed no T1 suppression before the induction, while group B with T1 of (9. 8 ± 2. 6) was higher than group A with T1 of (3. 2 ± 1. 5) (P<0. 01). The time of 90% and 100% inhibition of muscle twitching in group C was the longest (P<0. 01), and the incidence of adverse drug reactions in group C was also the highest (P<0. 05). Conclusion:The application of priming principle and time limit can effectively shorten the onset time of cisatracurium be-silate with significant effect and high safety.

Objective To investigate the gene expression change of TNF-α,IL-6 and IL-1β at different time points in brain tissues of rats with cerebral ischemia reperfusion injury.Methods A total of 24 adult male SD rats were randomly divided into four groups:sham group and 3 groups with brain ischemia reperfusion of 3h,6h and 12h.Real-Time PCR was used to analyze the gene expression ofTNF-α,IL-6 and IL-1 β at 3h,6h,and 12h after reperfusion.Results In the sham group,the mRNA expression levels of TNF-α,IL-6 and IL-1 β in were low,but increased immediately after brain ischemia injury and decreased gradually thereafter.The gene expression of TNF-α mRNA at 3h after reperfusion was significantly increased and reached the peak (P ＜0.01) then significantly decreased at 12h after reperfusion.The gene expression of IL-6 mRNA was notably increased at 3h after reperfusion and peaked at 6h (P＜0.01),and significantly decreased at 12h compared with 6h (P＜0.01).The gene expression of IL-1 β mRNA at 3h after reperfusion was significantly increased,peaked at 6h (P＜0.01) and significantly decreased at 12h (P ＜0.01).Conclusion The gene expression levels of TNF-α,IL-6 and IL-1β mRNA increased significantly in the early stage of reperfusion and decreased gradually after reaching the peak,which suggested that the gene expression change of TNF-α,IL-6 and IL-1β was involved in the mechanism of cerebral ischemia reperfusion injury.

Dysphagia is one of the most common and life-threatening complications in patients with stroke, and nutritional support plays an important role in rehabilitation. This article reviewed the progression of study on assessment for dysphagia and nutrition, and the timing, method and complication of enteral nutrition.

Disease bio-banks are an important strategic resource for medicine development. Such a bank with complete information and high information sharing enhances the competitiveness of medicine and promote the development of translational medicine. The present development of such banks is found with such setbacks as weak government leadership and standardization, as well as lack of a sharing mechanism. Therefore medical institutions should strengthen their standardization and informationization of disease bio-banks, which deserve sufficient government policy support and guidance. These efforts will help preserve our rich clinical resources, in addition to their integration and sharing for medicine advancement.

Objective To determine the value and reasonable application of slowly coated vicryl plus and albumin gel in primary suture after common BD exploration. Methods The operation was successfully performed in all 45 patients. The incision of common bile duct was directly sewed up by slowly coated vicryl plus and spurted by albumin gel after the exploration. Results There were no complications such as bile leakage and bile duct stricture etc.The mean payment of hospitalization was low 10.5%. Conclusion This method was safe,feasible and effective.

As the capital WaS invested increasingly to key disciplines,the university regarded the performance.Strengthening the evaluation on performance will help to the development of the disciplines.The omni directional performance evaluation iS a mode of all orientation.which will help the performance evaluation of disciplines go on well.At the same time.it should be paid attention to the design of the evaluation index,and the selection of the persons ioining in the evaluation team and the time of the evaluation.

Objective To explore the complication and its cause and treatment of pace markers implantation in older patient.Methods Among 205 older patients aged 70 to 90 years,103 were male,the others were female.Of these patients,162 were implanted with single chamber pace marker,43 with dual chamber pace markers.Results 21 patients happened complication(10.2%),the common complications related to operation were blood effusion and hematoma formation in pocket 12 cases,lead dislodgement 4 cases and infection with or without pocket rapture 2 cases.Occurrence of blood effusion was related to aspirin administration,lead dislodgement and infection with or without pocket rapture were related to operation.Conclusion To pay attention to ample preparation,close operation and strict observation can decrease the complication rate when pace marker is implanted.The serious result will be avoided by timely and effective treatment.The older patient with pace markers implantation is safe.

Aim To investigate whether Rhizoma curcumaecould induce pregnane X receptor(PXR)-mediated transcriptional expression of CYP3A4 and study the modulatory effects on the enzyme activity and mRNA expression of CYP3A in the rat liver.Methods Transient cotransfection reporter gene assays were performed in HepG2 cells;the rat liver microsomal cytochrome P450 and CYP3A isoenzyme-erythromycin N-demethylase(ERD)activities were determined by UV chromatography;the mRNA expression level of CYP3A was detected by reverse transcriptase-polymerase chain reaction(RT-PCR).Results In vitroinvestigation showed Rhizoma curcumaeand its four selected constituents could induce the CYP3A4 transcriptional expression by activating PXR.In vivoinvestigation showed the CYP450 content of liver microsomes and enzyme activity of CYP3A were markedly increased and induced by Rhizoma curcumaeextract;at the mRNA level, the expression of CYP3A1 and CYP3A2 gene were markedly induced by Rhizoma curcumaeextract.Conclusions Rhizoma curcumaeand its four selected constituents could induce the expression of the CYP3A4 gene transcriptional expression through activating PXR;Rhizoma curcumaeextract could increase and induce the enzyme activity and mRNA expression of CYP3A.