0.05). Conclusion Noninvasive anesthesia level determinator has similar quality compared to pinprick method in measuring the levels of block. Moreover, noninvasive anesthesia level determinator is safer and its energy of stimulation can be controlled easily.

Objective To explore the effect of compound lidocaine cream and/or psychotherapy in preventing the catheter-related bladder discomfort (CRBD) of male patients with operation under general anesthesia. Methods Eighty male patients undergoing selective upper abdomen operation were selected, and the patients were divided into 4 groups by random digits table method with 20 cases each:control group (C group), compound lidocaine cream group (L group), psychotherapy group (B group) and compound lidocaine cream combined with psychotherapy group (LB group). The incidence of CRBD after extubation, dosage of fentanyl and the number of patients who need flurbiprofen axetil to relief the pain of CRBD were compared among the 4 groups. Results The incidence of no CRBD after operation in LB group was significantly higher than that in C, L and B group: 90%(18/20) vs. 15%(3/20), 60%(12/20) and 50% (10/20), and there were statistical differences (P<0.05). The incidence of mild CRBD in LB group was significantly lower than that in C, L and B group:10%(2/20) vs. 45%(9/20), 35%(7/20) and 40% (8/20), and there were statistical differences (P<0.05). There were no statistical differences in dosage of fentanyl among the 4 groups (P>0.05). The rate of patients who need flurbiprofen axetil to relief the pain of CRBD in C group was significantly higher than that in L, B and LB group: 40%(8/20) vs. 5%(1/20), 10%(2/20) and 0, and there were statistical differences (P<0.05). Conclusions Both the means of compound lidocaine cream and psychotherapy can reduce the incidence of CRBD. However, the method of compound lidocaine cream combined with psychotherapy is able to basically avoid the occurrence of CRBD, and it is worth spreading in clinic.

Objective To evaluate the clinical curative effect and safety of application of Jiegu pill in the conservative treatment of patients with middle clavicle fracture.Methods Fifty-four cases of patients with middle clavicle fracture were randomly divided into the control group and treatment group,27 cases in each group.Two groups of patients were treated with conservative treatment,the control group was given Jiegu Qili Pian1.5g,bid,oral; the experimental group was treated with Jiegu pill 3.0g,bid,oral.Before and after treatment,compared between the two groups of patients with serum Osteocalcin(BGP),total type I collagen amino terminal peptide(TPINP),alkaline phosphatase(ALP)levels,efficiency of treatment and incidence of adverse reactions.Results After treatment,compared with the control group,the serum levels of BGP、TPINP and ALP were higher in the experimental group(P<0.05).The treatment efficiency of the experimental group(96.29％)was significantly higher than that of the control group(77.78％)(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The Jiegu pill can significantly improve the serum levels of BGP、TPINP and ALP in patients with middle clavicle fracture,promote fracture healing,the clinical efficacy and safety were high.

Objective To explore the feasibility of reducing induction dose of remifentanil,deepening anesthesia and intubation after umbilical removal and its effect on maternal,neonatal and anesthesiologists during cesarean section.Methods Thirty cases of ASA Ⅰ-Ⅱ scheduled for elective cesarean section were divided into three groups according random digits table method with 10 cases each.The induction dose of remifentanil was 1.0,1.5,1.0 μ g/kg in group Ⅰ,group Ⅱ,group Ⅲ.Group Ⅰ and group 11 received routine procedure after induction of anesthesia,intubation,while group Ⅲ received anesthesia umbilical removal.Systolic pressure (SBP),diastolic pressure (DBP) and heart rate (HR) were recorded before induction of anesthesia,skin incision and immediately intubation.And the fetal childbirth time,intubation time and neonatal Apgar score at 1,5,10 min were recorded.Results Three anesthesia procedures could meet the requirements of cesarean section.The SBP,DBP and HR at skin incision in group Ⅰ and group Ⅲ were significantly higher than those at before induction of anesthesia [group Ⅰ:(136.5 ±9.7) mm Hg (1 mm Hg=0.133 kPa) vs.(113.5 ±7.8) mm Hg,(96.5 ±9.1) mm Hg vs.(74.2 ±6.0)mm Hg,(98.5 ± 8.7) times/min vs.(81.2 ± 8.4) times/min; group Ⅲ:(138.1 ± 11.4) mm Hg vs.(118.7 ±9.9) mm Hg,(90.1 ±9.9) mm Hg vs.(77.3 ±7.9) mm Hg,(100.3 ±9.0) times/min vs.(81.7 ±9.2)times/min],there were statistical differences (P ＜ 0.05).The SBP,DBP and HR at immediately intubation in group Ⅲ were significantly lower than those in group Ⅰ andgroup Ⅱ [(97.6±10.1)mmHgvs.(138.9±11.2) and (130.1 ± 4.5) mm Hg,(80.1 ± 5.5) mm Hg vs.(97.7 ± 8.9) and (82.0 ± 8.6) mm Hg,(80.4 ±7.8) times/min vs.(99.3 ± 12.2) and (95.9 ± 9.6) times/min],there were statstical differences (P ＜ 0.05).There was no statistical difference in fetal childbirth time among the 3 groups (P＞ 0.05).The neonatal Apgar score at 1 min in group Ⅱ was significantly lower than that in group Ⅰ and group Ⅲ [(7.4 ± 0.9) scores vs.(8.8 ± 0.6),(8.9 ± 0.6) scores],there was statistical difference (P ＜ 0.05).The intubation time in group Ⅲ was significantly longer than that in group Ⅰ andgroup Ⅱ [(8.5±l.8) min vs.(3.0±0.5),(2.8±0.6)min],there was statistical difference (P＜ 0.05),but the intubation time in group Ⅲ was completed within 10 min.Conclusions Using the protocol of remifentanil 1.0 p g/kg induction,midazolam 2 mg,fentanyl 0.2 mg deepening after the umbilical removal can effectively avoid the effect of remifentanil on neonatal 1 min Apgar score,decrease the intubation stress with no effect on anesthesiologists.This method is simple,method of anesthesia for elective cesarean section.

ObjectiveTo investigate the clinical features and ultrasound imaging characteristics of retroperitoneal fibrosis (RPF),and to find out the value of ultrasound in monitoring the outcome of this disease.MethodsTwelve patients with retroperitoneal fibrosis proven by operation or biopsy were analyzed retrospectively.Their abdominal ultrasound images before and after treatments were studied,especially the severity of renal collecting system separation,the abnormal echo group around the retroperitoneal organs which including the abdominal aorta,the mesenteric artery and vein,the iliac vessels,the inferior vena cava,the bilateral ureters,renal arteries and veins.ResultsAll patients had abnormal separation in renal and ten patients were detected corresponding dilatation in unilateral or bilateral ureters.Seven patients were detected hypoechoic and heterogeneous clumps located in retroperitoneal area,which were around retroperitoneal blood vessels,kidneys or ureters.Three patients received resection to rule out cancer,two patients had ultrasound-guided biopsy and took hormone therapy after diagnosis,seven patients undertook ureteral release surgery and inserted double J stent combined with hormone therapy.Two months later,ultrasound showed the lesions significantly disappeared or reduced size compared with before treatments.It was also found that the majority of patients had hydronephrosis relieved and renal function recovered.Conclusions Ultrasound can help diagnosing retroperitoneal fibrosis,and monitor the outcome of this disease.

Lack of domestic medical humanistic education in medical schools leads to the low humanistic quali-ty of medical students, but humanistic quality of medical personnel is essential to medical activities. Taking into ac-count the actual domestic medical schools, for medical students, humanistic quality education in social practice should be the only way, which encompasses guiding medical students to pay attention to people′s livelihood, build-ing a social practice brand combined medicine and humanities, and implementing dynamic observation of humanis-tic education.

Objective To find the effect of chronic renal failure on the development of neointimal hyperplasia and the role of monocyte chemokine-1 (MCP-1) after arteriovenous fistula in mice.Methods We created AVF (common carotid artery to jugular vein in an end-to-end anastomosis) in mice with or without chronic renal failure (renal ablation or sham operation).The outflow of AVF was harvested at 3 weeks postoperative the vascular tissue.The pathological changes were examined.The level of blood urea nitrogen (BUN) and the degree of intimal hyperplasia were analysed.The protein and mRNA expression of alpha smooth muscle actin (SMA), Ki-67,NF-κB and MCP-1 were detected by immunohistochemistry, RT-PCR and Western blot.Results 1)Compared with the control group, the blood BUN level of the experimental group was significantly higher and the intimal hyperplasia was more serious, meanwhile, the lumen was more narrow (P<0.05).2)In the experimental group, the expression of α-SMA, Ki-67, NF-κB and MCP-1 was significantly increased (P<0.05).3)MCP-1 promoted the proliferation of vascular smooth muscle cells.Conclusions Chronic renal failure promote the development of neointimal hyperplasia, which may be related to the increase of MCP-1 expression.

AIM: To explore the oxidant-antioxidant status and levels of mononuclear cells (PBMCs) oxdative DNA damage in patients with type 2 diabetes mellitus (T2DM), and to value the effect of resveratrol on peripheral blood mononuclear cells oxidative DNA damage in T2DM patients in vitro. METHODS: The DNA damages in PBMCs of 39 T2DM patients with vascular complication, and 29 T2DM patients without complication were detected by single cell gel electrophoresis (the comet percentage). The levels of plasma total antioxidative capacity (TAC), the contents of plasma malondialdehyde (MDA) and plasma thiol group (SH) were measured. The effect of resveratrol on DNA damage of T2DM patients were investigated in vitro. In addition, 26 healthy subjects were studied as a control group. RESULTS: The comet percentage of PBMCs and the contents of plasma MDA in T2DM patients without complication were all significantly higher than that in healthy controls (P

Objective To introduce the clinical application of Tono-Pen tonometer.Methods The intraocular pressure was detected with Tono-Pen XL tonometer at different time points for sixteen patients went through laparoscopic gynecologic operation,then the statistical analysis of the results was performed.Results In processes of artificial pneumoperitoneum and low position,the intraocular pressure escalated gradually,and after artificial pneumoperitoneum,the intraocular pressure descended rapidly.Conclusion Tono-Pen tonometer is the only tonometer can be used for the patient of general anesthesia until now.

Intracoronary stent implantation is a safe and effective treatment for coronary artery disease.In-stent restenosis has been significantly reduced by utilization of drug eluting stents.This article reviews the results of long-term follow-up after intracoronary stent implantation and their implication.