Objecttve To investigate the effects of snfentanil and ropivacaine used in labor combined spinalepidural analgesia(CSEA)and its influence on labor course and infants and its side effects.Methods 160 primiparas who chose deliver analgesia were randomly divided into two groups:group A intrathecal 5μg sufentanil plus saline up to 2.5ml,extradural 0.2μg/ml sufentanll plus 0.1% ropivacaine and saline up to 100 ml;group B extradural ropivacaine 1.5mg plus glucose 100g/L up to 2ml;group C have no analgesia.Then to investigate the effects of analgesia VAS scores,labor course duration,caesarean section rate,flooding volume,neonatal Apgar scores and its side effects.Results Compared with group C,the analgesia effects of group A and B were definitely(P＜0.05,P＜0.01);visual analogue score(VAS)at 5min,10min and 30min in group A were(3.4±1.2),(1.6 ±0.7)and(0.7 ±0.5)respectively,while in group B were(5.3±1.5),(4.3±1.8)and(3.1±1.7),which had significant difference in two groups(all P＜0.01);they all could reduce the first labor course duration,caesarean section rate,and there were no difference with group C(P＞0.05);and the flooding volume and neonatal Apgar scores had no differences(P＞0.05).Conclusion Sufentanil and ropivacaine combined used in CSEA has stronger effect and longer duration without prolonged labor coulee and poor side effects,which would be a more perfect analgesia worth clinical application in obstetrics.

Objective This investigation was launched to characterize the relationship between some popular sports and the meniscus injury as well as the impairment extent due to practice duration.Methods The overall 819 women aged 20-49 years from clinic service,hospital,community and gymnasium were selected to join the investigation.The participants practice yoga or any other popular sports including badminton,jogging,climbing hills for at least one hour per day.The subjects were diagnosed with meniscus injury by means of physical examination and MR imaging.All of the subjects were therefore divided into the case(273)and the control(546)pools.The nested case-control model was applied to assess the relative risk of the meniscus.The 181 yoga subjects had been further divided into three sub-groups of 3-6 months,6-12 months and over 12 months,and they were accordingly analyzed with the variables of the age,body mass index(BMI)and Lysholm score.Results The study showed that yoga was associated with higher risk(OR=1.621,P=0.008)of meniscus injury,but the other sports showed no statistically significant risk (badminton 0R=1.028,jogging OR=1.116,climbing hills OR=1.259).The trainees appeared to be statistically different between the groups of 3-6 months and over 12 months on the items of the Lysholm score(P=0.006)and BMI(P=0.003).Conclusion Yoga plays a risky role on the issue of meniscus injury comparing some other popular sports among young women.The yoga players who exercise longer got lower Lysholm scores and lighter weight.

Objective To evaluate the effect of the endotracheal tube (ETT) depth on the efficacy of bronchial blocker when used for one-lung ventilation.Methods Sixty patients of both sexes,aged 46-78 yr,weighing 48-85 kg,with body mass index＜30 kg/m2,scheduled for elective thoracotomy requiring one-lung ventilation,were divided into 2 groups (n =30 each) using a random number table:the distance between the tip of ETT and the carina was 3 cm group (group Ⅰ) and the ETT cuff was placed at 2 cm below the glottis group (group Ⅱ).The bronchial blocker was inserted under the guidance of a fiberoptic bronchoscope.The ETT depth,time to bronchial blocker position,development of bronchial blocker displacement and increase in airway peak pressure,degree of lung collapse,severity of postoperative tracheal mucous membrane injury and development of sore throat and hoarseness were recorded.Results Compared with group Ⅰ,the ETT depth was significantly shallower,the time to bronchial blocker position was shortened,postoperative tracheal mucous membrane injury was attenuated (P＜0.05 or 0.01),and no significant change was found in the incidence of bronchial blocker displacement and increase in airway peak pressure,degree of lung collapse or incidence of sore throat and hoarseness in group Ⅱ (P＞0.05).Conclusion The ETT depth the ETT cuff placed at 2 cm below the glottis can improve the efficacy of bronchial blocker when used for one-lung ventilation.

Objective To explore the diagnostic value of dual syringe and dual-channel direct multi-slice computed tomography venography(MSCTV) for lower extremity deep venous obstructive disease.Methods 100 patients highly suspected deep vein thrombosis by clinic wereunderwent dual syringe and dual-channel direct MSCTV.The original data processed with technology of subtraction,and put into workstation and reconstructed with maximum intensity projection(MIP),multiplanar reformation(MPR) and volume rendering (VR).Images of deep venous obstructive lesions were analysed and graded.All patients were underwent DSA in one week.Results Direct MSCTV showed that the reconstructed images and the vascular contrast were very clear.In the evaluation of deep venous,excellent proportion was 95 ％ for the inferior vena cava,94 ％ for the common iliac vein,95 ％ for the external iliac vein,95.5 ％ for the femoral vein,96.5％ for the popliteal vein and 92 ％ for the low leg vein.Direct MSCTV displayed complete and regular vein in 8 normal patients,92 cases displayed different parts and different degrees of thrombosis.On original axial images,eccentric filling defect of vascular were showed (there were 64 multiple vein occlusion cases and 28 solitary obstruction cases).The occlusion locations in deep venous were as following:3 in the inferior vena cava,67 in the common iliac vein,28 in the external iliac vein,50 in the femoral vein,26 in the popliteal vein,89 in the anterior tibial vein,35 in the posterior tibial vein and 5 in the peroneal vein.There were 7 normal patients and 93 patients with different parts and different degrees of thrombosis.Conclusion Direct MSCTV can accurately show deep vein thrombosis,which image is clear and reliable for displaying the scope and extent of lesions of the vascular and whether the collateral circulation established.Direct MSCTV has a significant clinical value in diagnosing the thrombotic disease of deep vein obstructive lesions.

Objective To explore the correlation between the time course of disease and bone metabolism changes in patients with spinal cord injury. Methods Data on serum osteocalcin(SO)measured by radioimmunoassay(RIA)from a database on 167 patients with spinal cord injury(SCI)were analyzed retrospectively.The patients were divided into four groups according to the time post-injury:group A(＜3 months post-injury,n=44),group B(3-6 months post-injury,n=42),group C(7-12 months post-injury,n=37)and group D(＞12 months post-injury,n=44). Results The mean SO value in all 4 groups of patients was significantly higher than normal.The mean SO value of group B was significantly higher than that of group A,but not significantly different from that of group C.The mean SO value of group D was significantly lower than that of group C,but not significantly different from that of group A.Conclusion Serum osteocalcin is elevated in the early stages of SCI,and its subsequent de-cline is closely correlated with the time post-injury.

Objective To investigate the therapeutic efficacy of combining Kangfuxin solution with compound Bingpengsan on patients with diabetes mellitus complicated with pressure sores. Methods Fifty-two diabetes mellitus patients complicated with pressure sores admitted in Department of Emergency in the PLA 155th Central Hospital were divided into observation group and control group by lot method,26 cases in each group. Observation group was treated by combining Kangfuxin solution with compound Bingpengsan,the control group was given Mepliex application therapy,they all had change of dressing once a day. After treatment for 20 days,the therapeutic efficacy of pressure sore,healing time and frequency of changing dressing were observed. Results The total effective rate in observation group was significantly higher than that of control group〔96.1%(25/26)vs. 80.6%(21/26),P<0.05〕, in the observation group,the pressure sore healing time was significantly shorter than that of the control group(day:Ⅱstage:9.5±1.7 vs. 13.0±2.1,Ⅲstage:13.1±3.1 vs. 18.1±5.1,Ⅳstage:15.3±3.7 vs. 19.6±5.9,all P<0.05)and the number of times of changing dressing was significantly reduced compared with that of control group (times:Ⅱ stage:16.39±1.89 vs. 19.32±2.26,Ⅲ stage:19.56±2.52 vs. 22.36±2.69,Ⅳ stage:23.54±2.86 vs. 26.47±3.96,all P<0.05). Conclusion The Kangfuxin solution combined with compound Bingpengsan for treatment of deep pressure ulcers in patients with diabetes mellitus has significant effect,its cure rate is relatively high,the pressure sore healing time is reduced and the patients' suffering is alleviated.

Objective To study the effects of treating herpes zoster with the combination of Chinese and western medicine.Methods 160 cases of herpes zoster were randomly recruited into a treatment group(n=80),and a control group (n=80).The control group was treated with westem medicine(acyclovir,ethacridine solvents,and vitamin B6 and B12).The treatment group was administrated with Chinese medicines,acupuncture and cupping on the basis of treats in the control group Results The total effective rate was 100%in the treatment group and 72.5%in the control group.There was significant difference between the two groups(χ~2=23.85,P＜0.05).Conclusion The combination of Chinese and western medicine is effective in treating herpes zoster and worthy of generalization.

OBJECTIVE To investigate the distribution of bacteria in general ICU then discuss the susceptible factors and the treatment.METHODS A retrospective analysis of clinical information was performed on 123 patients diagnosed infection who stayed in ICU from May 2002 to May 2004.RESULTS Most of bacteria resulted in infection of general ICU were Gram-negative(62.88%) and then Gram-positive(19.65%). Fungal infection accounted for 17.47%.Pseudomonas aeruginosa occupied the highest percentage among Gram-negative bacteria.Most of Gram-positive bacteria were Staphylococcus aureus and all of them were MRS.The infection site in ICU focused on lower respiratory tract(89.09%).The second was urinary tract(11.79%).CONCLUSIONS Most of the bacteria causing infection in general ICU locate in respiratory tract.They are mainly Gram-negative.All of the Gram-positive bacteria are MRS.The risk factors of hospital-acquired infection are related with patient′s age,underlying disease,intensive care time,ventilation time and invasive operation.

OBJECTIVE To investigate the characteristic of Gram-positive bacteria in general ICU then discuss the susceptible factors and the treatment.METHODS A retrospective analysis of clinical information was performed on patients with Gram-positive infection in ICU from May 2002 to May 2004.RESULTS Most of Gram-positive bacteria resulted in infection in general ICU were Staphylococcus aureus and all of them were MRSA.The infective site focused on lower respiratory tract(84.44%).The second was catheter(8.89%).CONCLUSIONS The risk factors of hospital-acquired infection are relative with patient's age,underlying diseases,stay time in ICU,ventilated time and invasive operation.

Objective To evaluate the clinical value of adriamycin injection via the foramen ovale and around peripheral trigeminal branches under the guidance of X-ray for treatment of primary trigeminal neuralgia by comparison with the three-dimensional computed tomography (CT).Methods A total of 91 patients with primary trigeminal neuralgia of both sexes,aged 33-76 yr,with the course of disease 6 months-24 yr,with visual analogue scale score of 6-9,were divided into 2 groups using a random number table:X-ray group (n =43) and CT group (n =48).Hartel anterior approach was used to puncture the foramen ovale in 2 groups.One point five percent adriamycin 0.2,0.3 and 0.5 ml were injected via the supraorbital foramen,infraorbital foramen and oval foramen.When pain relief was poor (visual analogue scalc scorc≥ 4) within 1 yr after treatment,oxcarbazepine and adjuncts (tramadol,flupentixol and melitracen tablets,etc.) were taken orally.The requirement for oxcarbazepine and adjuncts was recorded during 1 day-1 week,1 week-1 month,1-3 months,3-6 months and 6 months-1 yr after treatment periods.The operation time,the nuinber of puncture,and developinent and recurrence of complications during treatment and within 1 yr after treatment were recorded.Results Compared with CT group,the number of puncture and incidence of facial hematoma during treatment were significantly increased (P ＜ 0.05 or 0.01),and no significant change was found in the operation time,requirement for oxcarbazepine and adjuncts,incidence of dizziness,nausea and vomiting during treatment,or the incidence and recurrence rate of masticatory muscle weakness and facial numbness after treatment in X-ray group (P＞0.05).Conclusion Compared with the three dimensional CT,X-ray provides similar efficacy and safety when used to guide adriamycin injection via the foramen ovale and around peripheral trigeminal branches for treatment of primary trigeminal neuralgia,showing that X-ray guidance has significant clinical value.