Objective To compare the anesthesia effect and adverse effect of subarachnoid block anesthesia with different doses of sufentanil combined with bupivacaine 7.5 mg in aged patients,and explore the suitable dosage of sufentanil.Methods Eighty aged patients with ASA grade Ⅰ-Ⅲ undergoing elective lower limb surgery were divided into 4 groups by random digits table and each group was in 20 cases:group Ⅰ received bupivacaine 7.5 mg,group Ⅱ received bupivacaine 7.5 mg+sufentanil 2.5 μg,group Ⅲ received bupivacaine 7.5 mg+ sufentanil 5.0 μg,group Ⅳ received bupivacaine 7.5 mg+ sufentanil 7.5 μg.The vital signs,degree of motor and sensory nerve blockade and adverse effect were observed.Results Compared with base blood pressure,systolic blood pressure(SBP)and diastolic blood pressure(DBP)in group Ⅰ was significantly decreased after intrathecal injecton 15,30,45,60 minutes(P ＜0.05).There were no significant differences in the degree of motor nerve blockade in four groups(P ＞ 0.05).The time of sensory nerve blockade in group Ⅰ[(194 ± 58)min]was significantly shorter than that in group Ⅱ,Ⅲ,Ⅳ[(255 ±44),(242 ±58),(308 ± 123)min](P ＜0.05).The time of sensory nerve blockade in group Ⅳ was significantly longer compared with group Ⅱ and Ⅲ(P ＜ 0.05).The number of pruritus in group Ⅳ(10 cases)was significantly more than that in group Ⅰ and Ⅱ(0,4 cases)(P＜0.05).Conclusion Subarachnoid block anesthesia with sufentanil 2.5 or 5.0 μg combined with bupivacaine 7.5 mg in aged patients is safe and effective.

In present,clinical laboratory is required to continuously improve the quality management system for providing almost perfect reports and services.The new conception and methodology of quality management in clinical laboratory should be constantly updated in order to ensure the patient safety.The article focuses on the integration of risk management and six sigma,into the quality management system for clinical laboratory.

Severe acute pancreatitis( SAP),especially with secondary infection of pancreatic necrotic tissue,is clinically a very severe and critical condition. The mortality rate can be as high as 40% . Intestinal barrier dysfunction and translocation of enteric bacteria contribute to the infection of pancreatic necrotic tissue and peripancreatic accumulated fluid,promote systemic inflammatory response syndrome( SIRS)and multiple organ dysfunction syndrome( MODS). Because there is no specific and objective assessment criteria for intestinal function and the function is diversity,intestinal dysfunction is not included in the modified Marshall organ dysfunction scoring system in 2012 revision of the Atlanta International Consensus on Classification and Definitions of Acute Pancreatitis. Paying emphasis to prevention and treatment of intestinal dysfunction may reduce the infection of pancreatic necrotic tissue,preventing the progress of MODS and reducing the mortality rate of SAP. This article reviewed the pathogenic mechanism as well as prevention and treatment of intestinal dysfunction in SAP.

Objective To study the ultrasonographic changes and blood flow characteristic ofthromboangiitis obliterans (TAO) by two-dimensional ultrasound and color Doppler imaging MethodForty-seven vessels of 40 patients with clinically suspected TAO vascular detected with two-dimensionalultrasound and color Doppler,and comparison with CT imagmg.Results Color Doppler imaging couldvisualize the arterial wall and blood flow echo filling case,and the spectrum showed the hemodynamicchanges.Conclusions Color Doppler is the first choice for the secondary check to the noninvasivethromboangiitis obliterans,close to the result by an angiography that is usually regarded as a sensitive,accurate and convenient diagnostic method.

The incidence rate of erectile dysfunction (ED) is reportedly as high as 30-90% after radical prostatectomy for prostate cancer, which seriously affects the patients' quality of life. Penile rehabilitation is defined as the use of any drug or device at or after radical prostatectomy to maximize erectile function recovery. A variety of treatment options are available for post-prostatectomy ED patients, including oral phosphodiesterase 5 inhibitors (PDE5I) , intracorporal injections, vacuum erection device, and penile prosthesis. This article presents an overview of the currently used methods for the drug treatment and penile rehabilitation of the ED patients after radical prostatectomy. It seems proper to recommend daily use of a vacuum erection device plus oral PDE5I in the early postoperative period. For those who fail to respond to this therapy, intraurethral alprostadil, intracorporal injections, or a penile prosthesis could be considered.
Alprostadil ; administration & dosage ; Combined Modality Therapy ; Erectile Dysfunction ; etiology ; therapy ; Humans ; Male ; Penile Erection ; Penile Prosthesis ; Phosphodiesterase 5 Inhibitors ; administration & dosage ; Prostatectomy ; adverse effects ; Quality of Life ; Recovery of Function ; Vacuum

Objective:To determinate the substances with high molecular weight in porcine anterior pituitary and adrenal cortex extracts injection. Methods:The HPLC analysis was performed on a TSK-GEL G2000SWXL(7. 8 mm × 300 mm,5 μm) column with the mobile phase of trifluoroacetic acid-acetonitrile-water(0. 05:35:65). The flow rate was 0. 5 ml·min-1, and the detection wave-length was 214 nm. Results:The substances with high molecular weight in porcine anterior pituitary and adrenal cortex extracts injec-tion was below 1%. Conclusion:The method is simple and repeatable, which can be used for the control of the substances with high molecular weight in porcine anterior pituitary and adrenal cortex extracts injection.

[Objective]To evaluate the therapeutic effects of the operation of latero-anterior internal fixation by plate screw and vertebroplasty by calcium sulfate cement for treatment of thoracolumbar more vertebral compression fractures with osteoporosis.[Method]Twenty-two patients with osteoporosis and more vertebal compression fractures received latero-anterior internal fixation by plate screw and vertebroplasty by calcium sulfate cement.Functions of spinal cord nerve were damaged in different degrees.Preoperative auxiliary examination of X-ray,CT and MRI was used.The spinal stabilization,spinal cord function and the state of chronic lumbodynia were observed by postoperative photographs.[Result]All the patients were followed up,and the implants showed bone union.Sensation and motor function were improved in various degrees.The pain of chest and back or other complaints were obviously relieved.No recurrence occurred.Vertebral bodies by vertebroplasty had no leakage and the short-term effects were satisfactory.[Conclusion]The operation of latero-anterior internal fixation by plate screw combining vertebroplasty is profitable to simultaneously improve nerve compression of thoracolumbar kyphosis,spine instability,and other chronic pain caused by osteoporotic vertebral compression fractures.

Objective To study the character of transformation of H.pylori into coccoid form under oxidative stress, and the changes in the biological charasteristics after transformation. Methods The coccoid form of H.pylori was studied with bacteriological, enymological, and genetical methods to identify its differences from the original form. Animal experiment was conducted to determine its implantation capacity. Results Morphological transformation from spiral to coccoid form occurred with the prolongation of culture under oxygen stress. The metabolic activity was reduced gradually, finally maintained at a lower level. The activities of urease, alkaline phosphatase and acid phosphatase were decreased markedly. The mRNA levels of main virulence factors were declined. Both mRNA and activities of enzyme of Sod B and Kat retained high levels. A part of the coccoid forms showed reversion to helical form, and colonization in mice stomach could be found after being inoculated to mice. Conclusions The metabolism and virulence of H.pylori were all lowered under oxidative stress, but a part of the coccoid form may be viable. Sod B and Kat may play an important role in the oxygen metabolism of H.pylori.

Objective:To develop a modified rat laryngeal transplantation model to improve the survival rate of recipients.Methods: Eighty Class Ⅱ isogeneic F344 rats,weighing 250-350 g,were randomly divided into 2 groups(n=40).The control group adopted the Strome model.The allograft used for the experimental group preserved ascending pharyngeal artery,which formed a complex allograft together with tongue base,larynx and pharyngolarynx.End-to-end anastomosis was performed between both allograft common carotid arteries and anterior neck veins.The patency rate and survival rate of the allograft of the 2 groups were compared.Results: The artery,vein patency rate and survival rate were 30%,15%,and 30% in control group,and 75%,65%,and 80% in experimental group,respectively(P

Objective To study the changes in oxygen consumption ( VO2 ) and oxygen cost of breathing(OCB) in postoperative patients and the effects of various kinds of assisted ventilatory support on OCB.Methods Twenty patients (13 male, 7 female), aged 43-70 years, undergoing thoracic surgery were divided into two groups: (A) pulmonary disease(PD) group in which patients had chronic pulmonary disease and abnormal pulmonary function( n = 10); non-pulmonary disease (NPD) group in which patients had no chronic pulmonary disease and their pulmonary function was normal ( n = 10). Operation were performed under combined intravenous-inhalation anesthesia or general-epidural anesthesia. Metabolism of the patients was measured before anesthesia. After operation the patients were mechanically ventilated in ICU and PaCO2 was maintained between 4.6-6.0 kPa. Metabolism was measured 12h after operation when anesthesia had worn off, the patients were fully awake and breathing spontaneously. Their hemodynamics was stable. Body temperature was maintained at 37℃?0.5℃ . VO2 was measured using indirect colorimetry (Datex Deltatrac MBM-200). VO2, VCO2, energy expenditure(EE) and respiratory quotient (RQ) were recorded every minute for 30 min. OCB was calculated by deducting VO2 measured during controlled ventilation from VO2 measured during spontaneous breathing( OCB = VO2 spontaneous breathing - VO2 controlled ventilation) and expressed by OCB/VO2 spontaneous breathing ( % ) . During mechanical ventilation FiO2 was set