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.

Objective To explore the effect of jejunostomy in radical operation of esophageal cancer through right thoracotomy and abdominal incision. Methods A total of 90 esophageal cancer patients who had undergone radical resection through right thoracotomy and abdominal incision were retrospectively analyzed, among whom 50 cases used enteral nutrition via jejunostomy (jejunostomy group) and 40 cases via naso- intestinal tube (naso- intestinal tube group). The operation time, hospitalization time after operation, retention time of tube, complication and nutritional status after operation were compared between 2 groups. Results There were no statistical differences in the operation time and hospitalization time after operation between 2 groups (P>0.05). All the patients of 2 groups could tolerate the enteral nutrition. The retention time of tube in jejunostomy group was significantly longer than that in naso- intestinal tube group jejunostomy: (18.08 ± 9.28) d vs. (14.85 ± 4.59) d, and there was statistical difference (P<0.05). There was no statistical difference in the albumin before operation between 2 groups (P>0.05). The albumin after 1 week′s enteral nutrition in jejunostomy group was significantly higher than that in naso-intestinal tube group:(30.99 ± 2.79) g/L vs. (29.72 ± 3.16) g/L, and there was statistical difference (P<0.05). During the period of observation, the patients of naso-intestinal tube group had different degrees of nasopharyngeal region discomfort. The incidences of tube obstruction/ tube shedding and the complication in jejunostomy group were significantly lower than those in naso-intestinal tube group: 0 vs. 10% (4/40) and 18% (9/50) vs. 50%(20/40), and there were statistical differences (P<0.05). Conclusions Jejunostomy is a safer and more effective nutrient method in radical operation of esophageal cancer through right thoracotomy and abdominal incision.

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 discuss the concrete method and clinical effects of the wound refers to multiple fingers and fingerweb.Methods Twenty-six patients were used four different flaps to repair the wound refers to multiple fingers and fingerweb.Dorsalis pedis flap in 18 cases,2 cases were distal dorsal foot flap,anterolateral thigh flap,3 cases,toe web flap,4 cases,dorsal carpal branch of ulnar artery flap,1 case in this group.Results All of 25 flaps survived,the distal part of 1 case got necrosis and use skin grafting to treat.6 cases of dorsal foot flap and 1 case of anterolateral thigh flap use the operation of spliting fingers and finger web deepen operation.Conclusion According to the specific injury of the patients' hands refers fingerweb,using the suitable flap to repair the wound,can make a satisfactory results in the appearance and function of patients' hands.

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.

Objective To evaluate the role of nuclear factor kappa B (NF-κB) in sevofluraneinduced release of inflammatory factors in mouse microglias.Methods Microglial cells obtained from newborn C57BL/6 mice (aged 2-3 days) were seeded in 24-well plates (density 1 × 105 cells/ml, 1 ml/well) , a total of 80 wells.The cells were randomly divided into 4 groups using a random number table (n =20 each) : control group (group C);sevoflurane group (group S);NF-κB selective inhibitor pyrrolidine dithiocarbamate (PDTC) group (group P);PDTC + sevoflurane group (group P +S).In S and P+S groups, 4.1％ sevoflurane was inhaled for 6 h.In P+S group, 10 μmol/L PDTC was added at 1 h before sevoflurane inhalation.At 6 h of incubation with sevoflurane, NF-κB activity and expression and levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were determined.Results Compared with group C, the NF-κB activity and levels of IL-6 and TNF-α were significantly increased in group S, and no significant change in the above parameters was found in the other two groups.Compared with group S, the NF-κB activity and levels of IL-6 and TNF-α were significantly decreased in group P+S.There was no significant difference in NF-κB expression between the four groups.Conclusion NF-κB mediates sevoflurane-induced release of inflammatory factors in mouse microglias.

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.