Objective To investigate the effects of three different effect-site concentration (Ce) of sufentanil given by TCI on the minimum alveolar concentration of sevoflurane for blunting adrenergic responses to skin incision(MAC_(BAR))in patients undergoing abdominal surgery.Methods Eighty ASAⅠ orⅡ patients,aged 20-60 yr,body mass index<30 kg/m~2,undergoing elective abdominal surgery,were randomly divided into 4 groups(n=20 each):control group(group so)and 3 sufentanil groups(group S_1,S_2,S_3).The patients were unpremedicated.Anesthesia was induced with TCI of propofol(target plasma concentration 3.5 μg/ml)and TCI of remifentanil(Ce 4 ng/ml).nacheal intubation was facilitated with rocuronium 0.6 mg/kg after the patients lost consciousness.The patients were mechanically ventilated.And then propofol and remifentanil were immediately stopped and anesthesia was maintained with inhalation of sevoflurane and a mixture of nitrous oxide and oxygen,fresh gas flow set at 10 L/min maintaining for at least 20 min.In group S_0,sufentanil was not given after intubation.In group S_1,S_2 and S_3,TCI of sufentamil was started after intubation at Ce of 0.12,0.18 and 0.24 ng/ml respectively.In group S_0,S_1,S_2 and S_3,sevoflurane inhalation was started with the initial end-tidal concentration of 3.0%,1.8%,1.3% and 1.1% respectively.The patients'response to skin incision was described as positive if MAP or HR increased by≥25%,or negative(MAP or HR increased by<25%).If the response was positive,the end-tidal concentration of sevoflurane for the next patient was increased by 1.2 times,while if negative,decreased by 1.2 times.The sevoflurane MAC_(BAR) was determined by up-and-down sequential trial.Results Compared with group S_0,the MAC_(BAR) of sevotlurane was significantly decreased in group S_1,S_2 and S_3(P<0.05).Compared with group S_1,the MACB_(BAR) of sevoflurane was significantly decreased in group S_2 and S_3(P<0.05).No significant difference was found in the MACB_(BAR) of sevoflurane between group S_2 and S_3 (P<0.05).Conclusion TCI of sufentanil at Ce of 0.12,0.18 and 0.24 ng/ml can significantly reduce MAC_(BAR) of sevoflurane and enhance the inhibitory effect of sevoflurane on stress response in a concentration-dependent manner.

The current pharmacotherapy is inadequate in preventing the progression of ventricular remodeling and congestive heart failure. Cellular cardiomyoplasty, through cell transplantation or regeneration of cardiomyocytes is a potential therapeutic approach to prevent left ventricular remodeling and the development of congestive heart failure after myocardial infarction. Recent research has focused on stem cells, which are undifferentiated pluripotent cells and can differentiate into a wide variety of cells including cardiac myocytes and endothelial cells. The majority data on stem cell transplantation were preclinical animal studies, all showing that stem cell therapy may replace lost heart muscle (myogenesis) and enhance cardiovascular revascularization (angiogenesis and vasculogenesis). These findings have been rapidly applied to human trials, but there were many questions remain to be solved. Although the results are interesting and safe, early phase Ⅰ clinical studies are small in scale and very preliminary. Data from large, randomized controlled trials are needed to confirm the short- and long-term effects of cellular cardiomyoplasty.

Current resource of medical morality is in shortage.When emphasizing the exterior supervision of the government,we should put more emphasis on the exterior restricting factors which are more profound,such as the excursion of the norm to the experts,the excessive market-orientation of medical innovation,the shortage of financial devotion,the deficiency of hospital management system.To solve the above problems,a fair medical surrounding is to be built,a patients association be established,and the social honesty and credit mechanism be rebuilt.

Humans ; Mucocutaneous Lymph Node Syndrome ; etiology ; immunology ; metabolism ; physiopathology

Objective To study the nursing effect of evidence-based nursing in perioperativc period of gynecological laparoscopy operation and prevention of postoperative complications.Methods 238 cases of patients undergoing laparoscopic operation were setas the study group,the evidence-based nursing method was used in this group.Another 212 cases of patients undergoing laparoscopic operation were named as the control group,they were given conventional nursing care.The improvement of complications and anxiety emotion were compared between the two groups.Results The complication rate was 10.92% in the study group,and 29.24% in the control group,the difference between the two groups was significant.The decreased degree of total score of HAMA and psychic anxiety,somatic anxiety score in the study group was higher than those of the control group at discharge.The difference had statistical significance.Conclusions Evidence-based nursing plays an important role in decreasing the postoperative complications and improving the anxiety emotion of patients,which is worthy of clinical popularization.

Objective To determine the prevalence of renal artery stenosis (RAS) and the efficacy of percutaneous transluminal renal angioplasty (PTRA) and stenting in patients with documented coronary artery disease.Methods Selective renal artery angiography or abdominal digital subtraction angiography was performed immediately after coronary angiography to detect and quantify RAS in 200 consecutive patients with known or suspected coronary artery disease. Eight severe stenotic renal arteries in 7 patients were treated with PTRA and stenting. All the lesions are considered to be atherosclerotic. Results RAS (defined as ≥50% diameter stenosis) was detected in 21 of 200 patients (10.5%) and 19 of 99 patients with coronary artery disease (19.2%) who had at least one coronary artery of ≥50% diameter stenosis. Procedure success rate was 100% in the 7 patients received PTRA and stenting. Blood pressure control improved in 74.1% patients with hypertension. Angiographic follow up was done in 3 patients in 3 to 9 months and no restenosis was found in the vessels.Conclusions It is necessary to routinely perform RAS for the patients with coronary artery discase undergoing coronary angiography to identify RAS, especially in those associated with hypertension, so as to diagnose and treat RAS in early stage. PTRA and stenting carries high success rate and appears to be an effective and safe treatment for RAS.

Objective: To investigate the association between the left ventricular hypertrophy (LVH) and blood pressure load (BPL) and circadian rhythm in hypertensive patients. Methods:Sixty patients with hypertension were studied by 24-hour ambulatory blood pressure monitoring ( ABPM) and colour Doppler echocardiography. Results: Daytime、 nighttime and 24-hour systolic blood pressure load (d-SBPL、n-SBPL、24h-SBPL) in hypertensive patients with LVH were significantly higher than those without LVH[(88.4?11.6) vs (79. 8?13. 4) ,P

Objective To investigate the change of anxiety in patients undergoing coronary angiography. Methods The Spielberger State-Trait Anxiety Inventory was carried out in hundred and forty five patients, 104 men, 41 women, mean age (63?9) years, before and after the coronary angiography procedure respectively. Results The state anxiety score after the procedure was significantly decreased from 35.8?10.2 to 31.7?9.9(P

Based on some European universities the author wants to analyse their education system and find some enlightenment on our post-graduate education construction of medical laboratory science.

Skin flaps from rabbit thighs were raised. The saphenous veins of the flaps were anastomosed with the femoral arteries.The valves in the veins were studied histologically. Fibrous tissue of the venous valve at the site of its junction with the venous wall underwent "fatigue" injury resulting in fracture of the valve.Theraby the valve opened according to the direction of blood flow, and the valvular tissue began to adhere to the venous wall.The results suggested that rapid blood flow with high pressure might remodel the venous valve in an arterialized venous skin flap.