Objective To study the effects of lidocaine on inflammatory mediators and myocardial enzymes in patients undergoing off-pump coronary artery bypass grafting (OPCAB).Methods Twenty patients underging OPCAB were randomly divided into 2 groups of L and C with 10 cases each. After anesthesia induction, group L was given a bolus of lidocaine 2 mg/kg, which was followed by an infusion of lidocaine 2 mg·kg~(-1)·h~(-1) till the end of operation. Group C was given normal saline instead of lidocaine as the control. Blood samples were taken for the measurements of TNF-a, IL-8, SOD, MDA, cTnⅠ, CK-MB and MYO. The hemodynamics, early postoperative clinical informations and ICU and hospital stay were recorded. Results The increases of TNF-α and IL-8 were significiently less in group L than those in group C(P<0.01 or P<0.05). MDA at 24 h after operation was higher in group C than that in group L(P<0.05). The increases of CK-MB and cTnⅠ at 24 h and 48 h after operation were significiently less in group L than those in group C(P<0. 01 or P <0. 05). The ICU and hospital stays were shorter in group L than those in group C(P<0. 05). Conclusion Continuous infusion of lidocaine during OPCAB can decrease the inflammatory mediators and myocardial enzymes and protect the myocardium.

When auditory organ is stimulated by some tones,there will be a series of electric activities in our auditory systems,we call them auditory evoked potentials.we can divide them short,middle and long latency response by their latencies.Different potentials can reflect brain function activities in different pathes of auditory nerve.In forensic medicine expertise,they can be objective evaluation in audition function and handicap of pathes of auditory nerve brain function.In this article,we summarized the mechanism and characters of different auditory evoked potentials,sumed up their application value in forensic medicine.

OBJECTIVE To investigate the current situation and epidemiological features of syphilis among inpatients in our hospital since 2003.METHODS This study was retrospective.The data were obtained from the inpatients′ files from Jan 2003 to May 2006,All patients with syphilis were analyzed with epidemiological methods.RESULTS Of the 127 586 inpatients screened for syphilis,740(0.58%) were positive,in which 13 were congenital syphilis,371 were latent syphilis and 356 were dominant syphilis.The yearly syphilis positive rate steadily increased,especially the proportion of latent syphilis,being higher among male(0.70%) than female(0.49%)(OR=1.47).The syphilis positive rate of the elder was higher than that of the younger.The syphilis occurred in all departments and all age groups.CONCLUSIONS There is a need for a routine syphilis screening among all inpatients in order to prevent the misdiagnosis of syphilis among them,especially for the latent syphilis.This could be benefit for the latent syphilis patients to get treatment earlier and minimize the spreading of syphilis.

We mainly disscused hearing impedimemt due to damage tothe tympanic membrane which is no more than 50 decibel of hearing loss with describing the signs of traumatic hearing loss, characteristics of its pathology and hearing tests on the basis of 40 eases with traumatic deafness coming to the forensic identification and the forensic identification of hearing Loss with objective data, What ABR audiometry is of great significance has been luther demonstrated in determining hearing Loss whith is supeuior to other hearing tests in distinguishing exaggeration and simulated desfness. We also analyzed rules for seriors hearing loss in Standard for Identifying serious Injury to Human Body(trial draft)from point of classification of hearing loss degree in clinics.

Event-related potentials (ERP) is some kind of brain potentials that recorded from cranial surface when human cognitive processing an object(pay attention, memorize, thinking, etc). ERP consists of a variety of cognitive function and related components. Including early composition, mismatch negativity (MMN), N2 family, P3 family, and other related components of language processing. These components are closely related to human cognitive function,the research of ERP can lead to a deeper understanding of cognitive function of human brains and has important application value of forensic medicine.

ObjectiveTo report the clinical results of applying free second toe hemiarthrosis to repair finger hemiarthrosis injury,and discussed the countermeasures of relative problems.MethodsFrom June 2005 to January 2010, thirteen fingers of 13 patients with traumatic finger joint injury had repaired by using vascularized second toe hemiarthrosis graft.ResultsAll 13 grafted fingers survived,and all wounds were primary healing.The time of follow-up was between 1.5 and 4.5 years,average of 3.2 years.All grafted joints were healed and the remaining joints were normal in morphology and structure,except for 1 patient subluxation with dorsal slightly convex.No degenerative changes happened to the grafted joints.No pain and no joint instability phenomenon.Nonunion and re-fracture phenomenon did not appear.The average extension of joint motion was 0°.The average flexion was 80°.Healing of the foot donate areas were satisfactory,and did not affect walking function.Using TAM assessment method of the hand joint function,the excellent rate was 90％.ConclusionThe way of using free second toe hemiarthrosis to repair finger hemiarthrosis injury could achieve satisfactory clinical efficacy.To completed set-up of transplanted joint structure and function units,a delicate surgery were improved to be important factors of the surgical treatment.

Objective To investigate nasomaxlllary complex facial soft tissue changes after the treatment with maxillary protraction appliance with skeletal Class Ⅲ malocclusion with a retruded maxilla.Methods Thirty growing subjects with skeletal Class Ⅲ malocclusions with maxillary retrognathism were selected and treated by facial mask(male 15,female 15,with an average age of 10.5).They were given a maxillary protraction treatment with face mask for 6-8 months.Cephalometric measurements about nasomaxillary complex soft tissue changes were analyzed to draw the statistic conclusion.Results After maxillary protraction treatment,PraY,nasofrontal angle,As-Y,UL-Y,UL-E,S-Ns-Sn increased (P ＜ 0.01) ; M-Y increased (P ＜ 0.05) ; LL-E,PosY,nasolabial angle decreased (P ＜ 0.05).There were no significant differences in the Ns-Y and columella-tip angle.Conclusion After maxillary protraction treatment,nasomaxillary complex area becomes more marked.Both the nasomaxillary complex soft tissue and lower facial profile are dramatically improved.The combining effect of these two changes results in a more harmony profile.

Objective To explore the effect of duraphat varnish on reducing orthodontic tooth enamel demineralization around brackets.Methods We Selected 30 patients aged 12 to 14 years old in orthodontic Departrnent of Shenyang Stomatological Hospital from Jan 2011 to Dec 2013 and carried out rectification scheme to pull out the first premolar after test.The full mouth dental were divided into four parts by the quadrant and the first premolars of different groups were coated with Tooth Mousse,Fluor Protector and saline (as control group),duraphat varnish (as experimental group) respectively.Every group included 30 teeth.Three months later,We observed the demineralization of the teeth.The enamel decalcification of all quarters were detected by DI-AGNOdent.Results The rate of enamel demineralization in the experimental group was 10.0％,that in the Tooth Mousse group was 13.3％,the 0.1％ Fluor Protector group 23.3％,the saline group 53.3％.There were significant statistical difference of the rate of enamel demineralization between the Duraphat varnish group and 0.1％ Fluor Protector group,and that between the Duraphat varnish group and the saline group (P ＜ 0.01).There was no statistical difference of that between the Duraphat varnish group and the Tooth Mousse group (P ＞0.05).There were no statistical difference of DIAGNOdent reading between the experimental group and the control groups before bonding(P ＞ 0.05).After bonding,one month later and three months later,there was no statistical difference of DIAGNOdent reading between the Duraphat varnish group and the Tooth Mousse group (P ＞ 0.05).There was significant statistical difference of that between the Duraphat varnish group and 0.1％ Fluor Protector group(P ＜ 0.01).Conclusion Duraphat varnish can reduce the tooth enamel demineralization more effectively than 0.1％ Fluor Protector and saline in orthodontic treatment,and also can be used for children who were wearing fixed orthodontic appliances.

OBJECTIVE To investigate the pathogens of hospital acquired pneumonia(HAP) in the general ward of our hospital to provide the basis for clinical experiential medication.METHODS The bacteria of the 62 patients with HAP whithout organ dysfunction in the general ward of our hospital between Jan 2005 and Apr 2008 was analyzed.RESULTS The main pathogens followed by Klebsiella pneumoniae(29.03%),Escherichia coli(22.58%),Staphylococcus haemolyticus(16.13%),S.epidermidis(12.90%),Pseudomonas aeruginosa(8.06%) and S.aureus(4.84%).Gram-negative bacilli showed better sensitivity to imipenem,piperacillin/tazobactam and cefepime(91.89-81.08%);Gram-positive cocci had lower resistance to vancomycin and rifampin(100.00-92.00%).CONCLUSIONS Hospital-acquired pneumonia in the general ward can be cured by appropriate commonly used antibiotics.

Objective To investigate the impact of pelvic muscle training (PFMT) on the quality of life (QOL) and incidence of postoperative complications in stress urinary incontinence (SUI) patients after tension-free vaginal tape surgery (TVT). In order to provide evidence for clinical nurses taking measures to promote rehabilitation of postoperative patients. Methods A total of 101 female SUI patients who underwent TVT surgery were included in this study. 50 patients in the trial group received pelvic muscle training guidance by one-to-one for 3months while 51 patients in the control group were instructed to the routine discharge guidance. All patients were asked to finish the Incontinence-specific Quality of Life questionnaire (I-QOL) at the day before surgery and 3 months after the surgery, respectively. And incidence of postoperative complications were evaluated at 3 months after the surgery. Results A total of 94 participants completed all questionnaires, including 48 patients of the trial group and 46 patients of the control group. The postoperative score of I-QOL in the trial group were higher than that of control group (94.32 vs. 90.34, Z=3.863, P<0.01). Further analysis found that avoidance and limiting behaviors domain score (90.63 vs.87.50, Z=3.227, P<0.01) and psychosocial impacts domain score (97.22 vs. 90.28, Z=4.186, P<0.01) in the trial group were higher than that of control group. The incidence of postoperative urgency urinary incontinence was significantly difference between the two groups (χ2=4.953,P=0.026), the proportion were 16.67% (8/48) in the trial group and 36.96% (17/46) in the control group, respectively. According to the results, the patients′overall quality of life of the trial group was better than that of control group after surgery. Conclusions Postoperative SUI patients′implementation of pelvic muscle training can significantly increase their quality of life and can decrease the incidence of urgency urinary incontinence.