Objective To evaluate the analgesic efficacy and safety of patient controlled intravenous analgesia (PCIA) with tramadol for labor analgesia as compared with combined spinal-epidural analgesia (CSEA) + patient controlled analgesia (PCEA) with ropivacaine and fentanyl. Methods Eighty ASA Ⅰ - Ⅱ full term primigravidae in active labor (at 2 ～ cm cervical dilation) who had a single fetus with vertex presentation and were expected to have a vaginal delivery were randomly divided into 3 groups: 1 control group received no analgesia ( n = 30), Ⅱ group A received CSEA + PCEA with ropivacaine and fentanyl ( n = 30) and Ⅲ group B received PCIA with tramadol (n = 20) . In group A CSEA was performed at L2-3. Ropivacaine 2.5 mg and fentanyl 5 mg were injected intrathecally. A catheter was then advanced 4 cm into epidural space cephalad for PCEA with a mixture of 0.1% ropivacaine with fentanyl 5?g?ml-1 (background infusion 4 ml?h-1 , demand bolus 4 ml with a 15 min lockout interval). In group B the loading dose of tramadol was 1 mg?kg-1 followed by background infusion of 0.75% tramadol at a rate of 2 ml?h-1 (demand bolus 2 ml with a 10 min lockout interval and a total dose limit of 500 mg) . The intensity of pain was evaluated by patients using VAS and motor function was assessed using modified Bromage score. The vital signs (BP, HR, SpO2), fetal heart rate, labor process, mode of delivery, Apgar score of neonates and side effects of analgesia were recorded. Results Good analgesia was achieved with high patient satisfaction in group A (96.7%) and B (95%) as compared with control group, but there was no significant difference in VAS score between group A and B. The onset time of analgesia was significantly shorter in group A (2.4 ? 1.2) min than that in group B (5.3 ? 2.7) min ( P

China ; epidemiology ; Disease Outbreaks ; prevention & control ; Humans ; Influenza, Human ; epidemiology ; Population Surveillance ; methods

Disease Outbreaks ; Humans ; Influenza A Virus, H1N1 Subtype ; physiology ; Influenza A Virus, H5N1 Subtype ; physiology ; Influenza, Human ; epidemiology ; prevention & control ; transmission ; virology

China ; epidemiology ; Humans ; Influenza Vaccines ; Influenza, Human ; epidemiology ; prevention & control ; therapy

Objective The study was designed to compare the pharmacodynamics of rocuronium administered by continuous infusion and intermittent bolus injection Methods Fifty ASAⅠ Ⅱ patients without any neuromuscular disease undergoing elective surgery under general anesthesia were randomly divided into two groups of 25 patients each In groupⅠ patients received rocuronium by intermittent bolus injection and in group Ⅱ by continuous infusion The responses of adductor pollicis to train of four (TOF) stimulation of ulnar nerve were monitored The onset time, the time of maximal neuromuscular blockade, the spontaneous recovery from paralysis and the total dose of rocuronium were recorded Intravenous anesthesia was used for both induction and maintenance of anesthesia, no patient received reversal of block Neuromuscular blockade monitoring ended when TOF ratio(T 4/T 1)≥70% The patients were extubated when ventilation was satisfactory Results The two groups were comparable with regard to age, sex, weight and duration of operation The mean onset time after rocuronium bolus(0 6mg/kg) was (78 18?15 44) s In group Ⅱ the mean infusion rate was (6 31?1 93)?g?kg -1 ?min -1 which was not significantly different from the amount of rocuronium administered per minute (5 43?1 46)?g?kg -1 ?min -1 in groupⅠ The mean interval between two bolus injection in group Ⅰwas (29 24?6 26) min, and no significant difference was seen between intervals The spontaneous recovery from neuromuscular block was significantly faster in group Ⅱ than that in group Ⅰ Conclusions Rocuronium has no cumulative effect There was no significant difference in the amount of rocuronium administered per unit time between the two groups The spontaneous recovery from neuromuscular block is faster by continuous infusion than that by intermittent bolus injection

Objective To investigate the effects of different concentrations of isoflurane on cerebral cortex content of acetylcholine and the underlying mechanism.Methods Six adult male SD rats weighing 300-350 g were used in this study. The guide needle was inserted and micro-electrodes were implanted 2 days before experiment. At the beginning of the experiment the micro-analysis needles were inserted into cerebral cortex and the micro-electrodes were connected to HXD-1 multi-function monitor. Micro-dialysis liquid was collected and BIS and 95% SEF were recorded before and during isoflurane anesthesia at 0.6% , 1% and 1.4% (each concentration was maintained for 30 min) and at 1 h after isoflurane inhalation was discontinued. Acetylcholine and choline concentrations in micro-dialysis liquid were determined. Results Isoflurane reduced acetylcholine and choline concentrations in cerebral cortex and decreased BIS and 95% SEF values in a dose-dependent manner. At 1 h after isoflurane inhalation was discontinued the concentrations of acetylcholine and choline didn' t return to the baseline values but the BIS and SEF returned to the baseline values. The BIS and SEF value at the disappearance of corneal reflex was 44.2 ? 2.2 and 11.6 ? 1.7 respectively.Conclusion Our study shows that the central cholinergic system is involved in the mechanism of isoflurane anesthesia.

In the thyroid surgery,parathyroid and laryngeal recurrent nerve injury is the most common complications.With the deepening understanding of the laryngeal recurrent nerve anatomy and surgical skills,laryngeal recurrent nerve injury incidence decline,and the prevention of complications of thyroid operation has turned to protect the parathyroid gland from laryngeal recurrent nerve protection.The technique of carbon nanoparticles labeled lymph nodes can effectively protect the parathyroid gland in thyroid surgery.

ve Cardiac output is traditional measured by thermodilution technique. Recent advance in catheter technique has allowed continuous monitoring of cardiac output, but it is invasive and expensive. The new transesophageal Doppler echocardiography (HemosonicTM 100) can measure aortic blood flow (ABF) and ABF is closely related to cardiac output (CO) (CO= ABF/70%). The purpose of this study was to compare cardiac output continuously measured with transesophageal Doppler echocardiography and modified Swan-Ganz catheter. Methods Forty ASA II - III patients aged 40-65 yr undergoing elective coronary artery bypass (CAB) were included in this study. Premedication consisted of intramuscular diazepam 10 mg, morphine 10 mg and scopolamine 0.3 mg. Anesthesia was induced with midazolam 0.08 mg?kg-1, fentanyl 10?g?kg-1 and pipecuronium 0.1 mg?kg-1 and maintained with isoflurane inhalation, continuous infusion of propofol and intermittent boluses of fentanyl, midazolam and pipecuronium. The sensor of transesophageal Doppler echocardiograph (TDEE) was placed in the esophagus at the level of T5-6 vertebra after induction and tracheal intubation. The sensor faced backward toward descending aorta. Swan-Ganz catheter (CCO/Sv()2) was placed via right internal jugular vein. In addition intra-arterial BP, ECG, SpO2, PET CO2 and nasal temperature were monitored.Results Continuous cardiac output measured with TDEE and Swan-Ganz catheter (CCO/SvO2) were highly correlated (R = 0.801, P

The paper introduces the development of hematology analysis technique in recent 10 years,and mainly concentrates in WBC differential technique,the extended functions and automation.The clinical application of red cell volume distribution width,reticulated platelets and reticulocyte subpopulation are also described in the paper.The common problems in the usage of hematology analyzer and correction methods are pointed out.

Objective To explore the teaching effect ofOrgan-system-based curriculum in-tegrated model on clinical graduation field work. Method 150 clinical medical undergraduates of Grade 2009 from Shenyang Medical College selected, were randomly divided into the experimental group (75 persons) and the control group (75 persons). The experimental group adopted the means of the Organ-system-based curriculum integrated model, namely practicing according to human organ-system and the control group accepted the traditional pattern of discipline centered practice during the clinical graduation internship. The two groups of students carried out questionnaire survey and comprehend examinations when the practice ended, and then statistics analysis (the chi square test, t test) was done by the SPSS 19.0 software between the two groups in order to explore the teaching effect. Result The students' satisfaction degree from six aspects of the questionnaire survey showed in the experimental group was significantly higher than that in the control group (the degree of recognition of practicing pattern: χ2=11.437, P=0.003; the architectonic integrality: χ2=9.881, P=0.007; the im-provement of the autonomic learning ability χ2=9.643, P=0.008; the teaching method and means: χ2=11.006, P=0.004; motivating learning interest: χ2=13.550, P=0.001; increasing the ability of clinical thinking: χ2=13.309, P=0.001), and the average test scores of students from three parts of examination results showed by comprehend examinations (speculative knowledge examination: t=2.768, P=0.006;technical skill examination: t=2.212, P=0.029; clinical capability examination: t=5.015, P=0.000) in the experimental group was obviously higher than that in the control group and the difference was sig-nificant. Conclusion Organ-system-based curriculum integrated model on clinical graduation in-ternship is generally approved by the students, which has significantly improved the students' clinical thinking ability, and the quality of graduation internship teaching.