Objective To evaluate the efficacy of epidural block combined with general anesthesia for elderly upper abdominal surgery Methods Thirty-four elderly patients ,scheduled for elective upper abdominal surgery, ASA grade Ⅰ-Ⅱ, were divided randomly into study group (groupⅠ) and control group (group Ⅱ) In both groups anesthesia was induced with introvenous diazepam 0 1mg?kg -1, fentanyl 5?g?kg -1, etomidate 3mg?kg -1, atracurium 0 2 mg?kg -1 and succinylcholine 2 mg?kg -1, and was maintained with intravenous infusion of propofol 4-10ml/h and/or inhalation of 1% isoflurane and intermittent bolus of atracurium In groupⅠ epidural block was performed before induction Hemodynamics was measured with impendence cardiography and electroencephagram were monitored and intraoperative awareness, postoperative restlessness and anesthetic dosage were recorded, also the concentrations of plasma vasopressin and blood glucose were determined at pre-operation, incision and the end of surgery Results In group Ⅰ MAP,CO,HR incresed slightly during intubation, incision and extubation, and systemic vascular resistance (SVR) decreased during operation , but SVR was increased abruptly after extubation in group Ⅱ There were unsignificant changes in thoracic fluid index(TFI), stroke volume(SV), ejection volume index(EVI), EVI/TFI ratio in both groups during whole procedures SEF was recovered more earlier in group Ⅰthan that of in group Ⅱ after extubation The vasopressin and glucose levels increased significantly after-extubation compared with those before operation in group Ⅱ Conclusions The epidural block combined with general anesthesia can be more effectvely and safely applied to elderly upper abdominal surgery

Objective: To study an epidemiological methodology for domestic violence. Methods:A program was drawn,the epidemiological instruments were developed, investigators were trained, not only according to the principles of epidemiology but also being suited to Chinese condition. Then,We win over the support of government bodies, arouse the messes to action, and all clues from investigation were confirmed by interview with persons concerned.Spot check randomly was used for control of quality.Results:The reliability of the epidemiological instruments was 97%, the sensitivity was 95%, the specificity was 100%. The prevalence of domestic violence in life-time and past year was 16.2% and 11.6% respectively.Conclusion:This was a practical methodology in epidemiological survey for domestic violence in China.

Objective To study atrioventricular conduction during right coronary artery infarction and its correlation with sympathetic nerve.Method AIMI model by ligating the fight coronary artery of denervated autonomic nervous cats was used.The A,H and V-wave were measured from the His electrode by template matching.The AA,AH,HV intervals with and without sympathetic nerve stimulation were measured respectivelv.Results The decreased percentage of AH intervals was (7±5)% vs.(14±5)% (without pacing) and (12±2)% vs.(23±7)% (with pacing) respectively in ischemia and normal after sympathetic nerve stimulation,and the decreasing amplitude were 50% and 48% respectively.Conclusion The regulating function of sympathetic nerve on atrioventricular conduction decreased after ischemia related to the right coronary artery.This decrease may be one of the mechanisms that lead to atrioventficular block after acute inferior myocardial infarction.

Objective To investigate the influence of bloody cervical cell samples on human papillomavirus(HPV) genotyping detection using flowcytometry fluorescence hybridization kit.Methods According to the concentration of hemoglobin(Hb),cervical cell samples were divided into five groups,including group A with Hb of 0 g/L(10 cases),group B with 0 g/L100 g/L.In each group,50% samples were with initial positive results of HPV genotyping detection.Every sample was detected using sample volume of 50,100,200,500 and 1 000 μL different volumes for testing and analysis results.Results For all samples with initial negative results,five samples with initial positive results in group A and five samples with initial positive results,the detected results of different sample volume were without differences.In the 10 samples,with initial positive results of group C,D and E,there were four,four and nine samples respectively,were with false negative detected results of different sample volumes.Conclusion Bloody cervical cell samples could cause false negative results of HPV genotyping detection using flowcytometry fluorescence hybridization kit.It might be necessary to set optimal sample volume according to the concentration of Hb for ensuring the accuracy of genotyping detection.

Objective: To investigate the difference in behavioral characteristics among different phenotypes of attention deficit hyperactivity disorder (ADHD) using amplitude of low-frequency fluctuation (ALFF), so as to provide insights into clinical differentiation of behavioral characteristics among different phenotypes of ADHD. Methods: The children with ADHD admitted to The Affiliated Hospital of Hangzhou Normal University were enrolled and classified into the inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI) and combined type (ADHD-C). The reaction time (RT) was measured using integrated visual and auditory continuous performance test, and the mean (RT-mean) and standard deviation of RT (RT-SD) were estimated. In addition, the ALFF was calculated at 0.010 to 0.027, 0.027 to 0.073, 0.073 to 0.167 Hz, and the difference of ALFF was compared among children with different types of ADHD. Results: A total of 107 children with ADHD were enrolled, including 95 boys and 12 girls, with a mean age of (8.89±1.93) years. There were 69 children with ADHD-I, 8 children with ADHD-HI and 30 children with ADHD-C. The RT-SD was significantly higher among children with ADHD-C than among children with ADHD-I [(126.003±51.619) ms vs. (97.720±45.302) ms; P=0.007]; however, there was no significant difference in RT-mean among children with various ADHD phenotypes (F=1.386, P=0.255). There was an interaction between frequency and ADHD phenotypes (F=2.754, P=0.032), and the ALFF was significantly higher among children with ADHD-C than among children with ADHD-I at 0.010 to 0.027 [(5 590.567±231.595) ms vs. (4 694.001±154.397) ms; P=0.002] and 0.073 to 0.167 Hz [(4 312.609±174.709) ms vs. (3 690.805±116.473) ms; P=0.005]. Conclusions The ALFF varies in ADHD phenotypes, and there is a frequency-specific difference.

Humans ; Liver Neoplasms

This study was aimed to identify and distinguish Metacordyceps liangshanensis recorded by the Sichuan Province Traditional Chinese Medicine Standard from its adulterants and its relative species by combining ITS and COI barcode sequences in order to study the feasibility of this new method. After extracting DNA of 28 species of Cordyceps samples, DNA were amplified and sequenced. And then, ITS and COI sequences were received. Codon-Code Aligner V3.7.1 and Mega 5.0 were used to analyze the variable site and construct the N-J tree. The results showed that the minimum ITS inter-specific K-2P distance was relatively higher than the maximum intra-specific K-2P distance. The inter-specific sequence divergence between M. liangshanensis and its adulterants exhibited high while intra-specific sequence divergence exhibited low. And COI one was the same case. N-J tree of both ITS and COI indicated that same genus belonged together and each species belonged to relatively independent branch. It was concluded that based on the ITS and COI gene, the technology of DNA barcode can be an excellent identification of M. liangshanensis, its adulterants and its relative species. It provided technical support for the further research on species molecular identification and phylogenetics of Cordyceps .

Objective This study aimed to explore clinical characteristics of four types of obesity based on metabolic classification. Methods Forty-eight obese patients were divided according to their clinical characteristics into 4 groups including metabolic healthy obesity (MHO), hypometabolic obesity (LMO), hypermetabolic obesity (HMO), and metabolic obesity with inflammation (IMO). 20 normal weight individuals were also recruited as a control group. Body fat, body weight, visceral index, and basal metabolism were measured by Omron body fat meter. Fat content and its distribution were measured by dual energy X-ray absorptiometry. All participating patients underwent various tests for 75 g oral glucose tolerance, blood glucose, insulin, C peptide. Lipid profile, thyroid function and sex hormones levels, and inflammation factors were also measured. Results (1)Patients in MHO group had higher body fat content, but had no metabolic disorder and inflammation. Their hormones levels were normal. (2) Lower metabolic rate and lower hormones levels were found in the patients in LMO group with increasing visceral fat. Trunk/subcutaneous fat mass was significantly higher than that in MHO group(1. 19 ± 0. 25 vs 0. 97 ± 0. 32, P<0. 05). There were abnormal lipid and glucose metabolism in LMO group. The insulin action index was significantly lower than that in MHO group(0. 006 6 ± 0. 002 7 vs 0. 012 1 ± 0. 009 5, P<0. 05). The area under the curve of glucoseconcentrationwassignificantlyhigherinLMOgroupthanthatinMHOgroup[(18.71±8.68vs12.70±4.63) mmol/L, P<0. 05]. (3)Heart rate and blood pressure were higher in HMO group. The heart rate was significantly increased compared with that in MHO group [(90. 50 ± 8. 24 vs 73. 20 ± 14. 11) beat/min, P<0. 05]. The waist circumference was significantly larger than that in MHO group [(111. 88 ± 10. 54 vs 98. 05 ± 15. 56) cm, P<0. 05]. (4) In IMO group, insulin action index was significantly lower than MHO group (0. 007 0 ± 0. 003 3 vs 0.0121±0.0095,P<0.05). ThetrunkfatmassanduricacidlevelsweresignificantlyhigherthanMHOgroup [(17236.38±4610.60vs15816.10±5453.42)gand(468.28±121.32vs376.84±97.14) μmol/L,bothP<0. 05]. Patients in IMO group had acanthosis nigricans, but their glucose level was relatively normal. Conclusion The metabolic-based obese diagnosis is essential for understanding the obesity etiology and providing individualized treatment.

BACKGROUND: The understanding about characteristics and variation trends of cerebral vascular hemodynamic indexes in high-risk stroke population,in prior and post-stroke period patients as well as in normal people,particularly the cerebral vascular hemodynamic index(CVHD) prior to stroke can improve diagnosis efficiency of stroke and increase sensitivity and specificity of stroke diagnosis.OBJECTIVE: To study the features of CVHD in acute stoke,in order to provide evidences for early evaluation and rehabilitation intervention.DESIGN: Case analysis and observational study based on patients.SETTING: A neurological department in a general hospital of military area command of Chinese PLA and a prevention and cure institute of cerebrovascular diseases.PARTICIPANTS: Totally 55 (male 38,female 17) inpatients in the Neurological Department of Fuzhou General Hospital of Chinese PLA from June to December 2001 were enrolled in the study.METHODS: CVHD was measured during the first week after onset and the data were analyzed.MAIN OUTCOME MEASURES: The CVHD,blood pressure and cerebral vascular hemodynamic parameters.RESULTS: The CVHD of each patient is below 75,median 32.5. The mean velocity,blood flow,maximum velocity,minimum velocity and difference between diastolic and critical pressures were lower than corresponding ones of healthy men in seventies( P ＜ 0.01 ). And the pulse wave velocity,peripheral resistance,specific impedance and critical pressure increased( P ＜ 0. 01).CONCLUSION: During the first week after stroke,the CVHD decreases and many hemodynamic parameters alters significantly. Examination of CVHD can reveal cerebral circulation insufficiency or predict an attack of cerebral stroke.

BACKGROUND: Endogenous opioid peptides are mainly mediated by μ receptor and produce inhibitory effect on breathing and heartbeat, and because of this, fetal distress happens and develops. Therefore, μ receptor mediation is the most important way that endogenous opioid peptides participate in the fetal distress and the pathological process of suffocation. Β-FNA (β-Funaltrexamine, μ-receptor antagonist) and ICI174864(δ-receptor antagonist) are helpful to reduce the happening of fetal distress.OBJECTIVE: To explore the roles of μ and δ receptors in the fetal distress based on the point of view that opioid peptides are involved.DESIGN: Completely randomized allocation and randomized and controlled trial using experimental animals as the subjects.MATERIALS: Twenty healthy white New Zealand purebred rabbits were randomly divided into 5 groups, and among them 16 rabbits were pregnant for 30 days and were put to death with the method of suffocation. The fetal rabbits were taken out immediately after cesarean section, with 6 - 8 fetal rabbits in each den. The fetal rabbits were classified into the following groups: untreated fetal distress group, (fetal distress group, 29 fetal rabbits), normal saline rabbits group(Normal saline group, 25 rabbits), rabbit distress β-FNA group(β-Funaltrexamine ) (FNA group, 28 rabbits), fetal rabbits ICI174864 treatment group(ICI174864 group, 31 rabbits).INTERVENTIONS: Pregnant rabbits in the saline group, FNA group , ICI group were intravenously given a bolus of normal saline or the opiate antagonist β-FNA or ICI174864 and were then asphyxiated. Another 4 rabbits that were pregnant for 30 days were put to death with the cut on the neck, and 28 fetal rabbits were taken out as the control group. After being delivered by cesarean section, all rabbit fetuses in the above five groups were assessed by Apgar scoring for respiration, heartbeat, skin color, muscle tension, and response to stimulation at 1, 5, 10, 15 and 30 minutes of age.MAIN OUTCOME MEASURES: Apgar scoring for respiration, heartbeat,skin color, muscle tension, and response to stimulation at 1, 5, 10, 15 and 30 minutes of age was made.RESULTS: The total Apgar score for respiration, heartbeat, skin color, muscle tension in the control group was the highest (8. 8 ± 1.1 ). And that of FNA group was 6. 8 ± 1.7, obviously higherthan that of the fetal distress group (2.1 ±1.0) and the saline-treated pups(2.5±1. 1) and(t=2.832 and 2. 795, P < 0.01 ). That of group ICI was 4.9 ± 0.7, markedly higher than that of the saline-treated pups and the fetal distress group( t = 2. 232 and 2. 195, P < 0.05) . There was no marked difference between the saline group and the distress group ( P > 0.05 ) and between the FNA group and the control group(P < 0.05) . The total Apgar scores of the ICI group,saline group, and distress group were significantly lower than that of the control group ( t = 2.913,2. 893, P < 0.01 and t = 2. 174, P < 0.05).CONCLUSION: Endogenous opioid peptides participates in the process of the happening and development of fetal rabbit distress that is mediated by opioid peptides receptor, the effect of μ receptor was much more than that of δ receptor. This study provides a basis for the evaluation of fetal distress and intervening at an earlier stage to enhance prognostic function.