Objective To evaluate the clinical effects of continuous spinal anesthesia (CSA) with sufentanil for labor analgesia when compared with the effects of combined spinal-epidural analgesia (CSEA) and continuous epidural analgesia (CEA).Methods One hundred ASA Ⅰ or Ⅱ nulliparous patients who were at full term and who requested labor epidural analgesia,were randomly divided into 3 groups (n =40 each):continuous spinal analgesia group (group S),combined spinal-epidural analgesia group (group C) and continuous epidural analgesia group (group E).Labor analgesia was performed when the cervical dilation was 2-3 cm.In group S,the spinal catheter was placed at L3,4 interspace,and patient-controlled analgesia (PCA) with sufentanil was performed after a loading dose of sufentarnil 8 μg.PCA solution contained sufentanil 100 μg in 100 ml of normal saline.The PCA pump was set up with a 2 ml bolus dose,a 10 min lockout interval (volume was limited to 14 ml/h) and background infusion at a rate of 2 ml/h.In group C,CSEA was performed at L2,3 interspace,the patients received intrathecal sufentanil 8 μg via a spinal needle,the PCA solution contained 0.1％ ropivacaine 200 mg and 0.5 μg/ml sufentanil 100 μg in 200 ml of normal saline.The CSEA pump was set up with a 6 ml bolus dose,a 10 min lockout interval (volume was limited to 40 ml/h) and background infusion at a rate of 6 ml/h.In group E,CEA was performed at L2,3 interspace and the method was the same as in group C.The systolic pressure,diastolic pressure,HR,fetal heart rate (FHR) and intensity of uterine contraction were recorded beforeanalgesia and 5,10,15,30,60 and 120 min after beginning of analgesia,when the cervical dilation was 7-8 cm,and when the uterine cervix dilated absolutely.The side effects were recorded.Bromage scale was assessed at 10 min of analgesia.Apgar scores of the neonates were recorded at 1,5 and 10 min after birth.The analgesic effect was evaluated 24 h after birth.Results In group S,the hemodynamic parameters,FHR and intensity of uterine contraction were within the normal range,the analgesic effect was excellent or good,Bromage scale was 0,two cases had post-dural puncture headache,the incidence of pruritus was 42 ％ and pruritus was mild,Apgar scores of the neonates were 9.1 ± 0.4,9.6 ± 0.4 and 10 at 1,5 and 10 min after birth,respectively,no cardiovascular events occurred.There was no significant difference in the parameters mentioned above between groups C and S and between groups E and S (P ＞ 0.05).Conclusion CSA with sufentail is effective and suitable for labor analgesia and the efficacy is comparable with that of CSEA and CEA.

Hypersensitivity reactions ( HSRs) are the serious problems of taxanes in the clinical appli- cation. These reactions range in severity from mild flushing and itching to bronchospasm, dyspnea and signifi-cant alterations in blood pressure with loss of consciousness or not, and death in some rare cases. Nevertheless, HSRs are often reported only sporadically in clinical trials or as case reports. The vague or inconsistent termi-nology used to describe these reactions may reflect our poor understanding of their pathophysiology. This article will reviews the advancement of taxanes HSRs.

group A)(P0.05).In all the 3 groups,the BIS decreased to the lowest level at T2,and then increased at T3 and T4,and the BISs at T2,T3,and T4 were significantly different from that at T1(P

Objective To evaluate the effects of the domestic wire-reinforced epidural catheter on complications related to anesthesia during labor analgesia.Methods A total of 2 407 parturients,aged 18-40 yr,weighing 50-100 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective operations under combined spinal-epidural anesthesia for labor analgesia,were divided into 2 groups using a random number table:comnon epidural catheter group (group Ⅰ,n=1 203) and wirereinforced epidural catheter group (group Ⅱ,n=1 204).After successful epidural puncture,the appropriate amount of local anesthetics was injected into the subarachnoid space,and the corresponding epidural catheter was then inserted,and the depth was 3 em.Paresthesia during catheterization,unexpected catheter displacement,difficult extubation,catheter bending,epidural bleeding,successful insertion at first attempt,successful insertion time,the number of successfully delivered doses and consumption of patientcontrolled analgesia solution were recorded.The patients were followed up after operation for nerve damage.Results Compared with group Ⅰ,the incidence of paresthesia during catheterization,unexpected catheter displacement and catheter bending was significantly decreased,the occurrence of epidural bleeding was reduced,the success rate of insertion at first attempt was increased,successful insertion time was shortened,the incidence of difficult extubation was increased (P＜0.05 or 0.01),and no significant change was found in the number of successfully delivered doses,consumption of patient-controlled analgesia solution or incidence of nerve damage after operation in group Ⅱ (P＞0.05).Conclusion Complications related to anesthesia are reduced when the domestic wire-reinforced epidural catheter is used for labor analgesia.

Objective To study the effects of Irinotecan (CPT-11) on human colorectal cancer HCT-116 and HT-29 cells and investigate the potential mechanisms.Methods The effect of Irinotecan on the proliferation of HCT-116 and HT-29 cells was determined by MTT assays.The invasive capacity was measured by transwell assays,and the apoptosis of the tumor cells was detected by flow cytometry after stained with Annexin-V and PI.The difference between the current of ATP-sensitive potassium ion of HCT-116 and HT-29 was examined by patch clamp.Results It was found that 1.0-64.0 μg/ml CPT-11 could inhibit the proliferation and the invasive capacity of HCT-116 and HT-29 cells at both dose-and time-dependent manner.The IC_(50) of HCT-116 and HT-29 were 39.3 and 19.5 μg/ml respectively.Cytometry showed that the apoptotic rates were increased from 14.8% and 9.3% to 36.9% and 27.9% after the treatment of 32.0 μg/ml and 16.0 μg/ ml CPT-11,which were close to their IC_(50).The proportion of G_0/G_1 and S of HCT-116 and HT-29 was enhanced from 27.4% and 17.4% to 95.9% and 98.2%.Transwell assay indicated that the invasiveness of HCT-116 and HT-29 was reduced by 40.8% and 47.5%.The patch clamp showed that CPT-11 reduced the I_(KATP) of cell membrane at a negative dose-dependent manner.Conclusion CPT-11 could have a significant impact on the proliferation,invasiveness,cell cycle,and the apoptosis of human colorectal cancer cell HCT-116 and HT-29.HT-29 was more sensitive to CPT-11 than HCT-116.The inhibitory effect of CPT-11 on cell proliferation might be linked to its inhibition of ATPsensitive potassium channel.

Objective To investigate the effects and potential mechanism of irinotecan (CPT-11), an antitumor drug, on human colorectal cancer cell line HT-29 and its impact on 4-amion pyridine (4-AP), a kalium ion channel blocker. Methods The effects of CPT-11, 4-AP and combination of two drugs on proliferation and invasion of HT-29 cells were measured by MTT and Transwell assay respectively. The impact of CPT-11 or 4-AP on cell apoptosis was determined by flow cytometry with Annexin-V and PI staining. The current of ATP sensitive potassium ion (IKATP) was measured by patch clamp. Results The CPT-11 could inhibit proliferation of HT-29 cells at dose from 1.0 to 64.0 μg/ml in dose-and time-dependent manners. Whereas the above effect was enhanced when CPT-11 combined with 4-AP (1.0 mmol/L). The administration of CPT-11 (16.0 μg/ml) or 4-AP (1.0 mmol/L) significantly induced the cell apoptosis and inhibited the invasion of HT-29 cells, furthermore, these effects could be enhanced by combination of two drugs. And the different concentrations of CPT-11 reduced the IKATP of cell membrane in negative dose-dependent manner. Conclusions The effects of CPT-11 on HT-29 cells, such as reducing proliferation and invasion as well as inducing the apoptosis, can be enhanced by 4-AP, which may be related to inhibition of ATP-sensitive potassium channels.

This study was aimed to observe the effect of Sang-Ji (SJ) mixture in the treatment of Toll-like receptor 4 (TLR-4) expression on peripheral blood monocytes (PBMCs) in hypertensive patients. A total of 60 cases of hyper-tensive cases with overabundant liver-fire and phlegm syndrome were randomly divided into the treatment group and the control group with 30 cases in each group. Both groups received Felodipine and/or Benazapril treat-ment. The treatment group was added with SJ mixture. The observation duration was 28 days. The detection was made on indicators such as blood pressure , traditional Chinese medicine ( TCM ) syndrome scores and TLR-4 ex-pression on PBMCs before and after treatment. The results showed that after treatment, the blood pressure, TCM syndrome scores and TLR-4 expression on PBMCs of both groups decreased compared with that of the pretreat-ment . Changes on TCM syndrome scores and TLR-4 expression of the treatment group were more significant than that of the control group ( P < 0 . 05 ) . It was concluded that SJ mixture improved clinical symptoms in pa-tients with overabundant liver-fire and phlegm syndrome , decreased TLR-4 expression on PBMCs , in order to inhibit the immune response to a certain extent .

Objective To evaluate the value of transcatheter arterial embolization(TAE) in the treatment of intractable epistaxis.Methods TAE using gelform or polyvinyl alcohol(PVA) particles of forty-one patients with intractable epistaxis were undertaken by the femoral artery approach,through selective catheterization of involved maxillary artery or the bleeding arteries for the stopage of bleeding..Results Of the forty-one patient,39 cases were cured by once TAE and the other 2 with recurrent bleeding on the next day after the TAE,to whom a second interventional treatment fullfilled the requirement.Conclusions Transcatheter arterial embolization is a simple,safe and effective treatment for the intractable epistaxis.

Objective:To establish a new method to detect Amp C?-lactamase by PCR. Methods:The amp C and amp D gene fragments of E. cloacae were amplified by the amp C and amp D primers to detect Amp C ?-lactamase, especially the enduring and highly productive enzymes. Results:Totally 193 of 214 strains of E. cloacae were positive for amp C gene , implicating most strains of E. cloacae had the ability to produce the enzyme. Sixteen of the 193 strains (amp C positive) were negative for amp D genes, implicating these 16 strains could produce the enduring and highly productive enzymes. The results were confirmed by cefoxitin three-dimensional test. Conclusion:The new method to detect Amp C ?-lactamase, especially the enduring and highly productive enzymes,by amp C and amp D primers is a rapid and accurate method.

Objective To compare the influences of peridural and general anesthesia on respiration and circulation in gynecological laparoscopic operation. Methods Fifty-six patients, underwent gynecological laparoscopic operation during June to October, 2003, are divided into two groups. The items of respiration and circulation recorded before and 10, 20, 30, 40min after pneumoperitoneum as well as 5 min after deflation abdomen were as follows: blood pressure (BP), heart rate (HR), sphygmus oxygen saturation (SpO_2), end-expiratory pressure of CO_2 (P_ ETCO_2), tidal volume, frequency of respiration, minute ventilation volume and airway pressure. Results The re-consciousness time after the operation in the peridural anesthesia group is significantly less than that in the general anesthesia group (P0.05). Conclusion In gynecological laparoscopic operation, no significant difference was found concerning the influence of the two anesthesia manners on respiration and circulation.