OBJECTIVE:To investigate the analgesia effect of low-dose ketamine combined with sufentanil after radical sur-gery of esophageal cancer. METHODS:Totally 153 patients of pre-implementation esophageal cancer surgery were randomly divid-ed into group A,B and C. After induction of anesthesia in patients in each group,patients in group A administered sufentanil 2 μg/kg;group B were treated with sufentanil 2.5 μg/kg;group C were treated with sufentanil 2 μg/kg + ketamine 85 μg/(kg·h). Visual analog(VAS)score and Ramsay score before and after anesthesia 4,8,16,24 and 48 h,analgesia pump pressing times and inci-dence of adverse reactions in each group were observed. RESULTS:Ramsay score in 4,8 and 16 h in each group were significant-ly higher than before anesthesia,the differences were statistically significant(P<0.05),however,compared with before,there was no significant difference in the Ramsay score in 48 h among each group(P<0.05);VAS scores in each group(except for group C in 48 h) at each time point were significantly higher than before,group C

OBJECTIVE:To compare mental state and drug safety of puerperant underwent propofol and etomidate painless abortion after regain of consciousness. METHODS:102 puerperant underwent painless abortion were selected and randomly divided into control group and trial groups with 51 cases in each group. The control group received Propofol injection 2 mg/kg intravenous-ly,and the trial group received Etomidate fat emulsion injection 0.2 mg/kg intravenously. The changes of patient’s mental state were evaluated with Positive and Negative Emotions Scale (PANAS) before anesthesia and after regain of consciousness. The changes of HR,BP,MAP and SpO2 were observed and compared between 2 groups before anesthesia and 1,2,3 and 5 min after anesthesia. The anesthetic effect and ADR were compared between 2 groups. RESULTS:Compared to before anesthesia,positive mood scores of the trial group were increased slightly after regain of consciousness,while that of the control group were increased significantly;there was statistical significance before anesthesia and after regain of consciousness (t=9.023,P<0.05);there was statistical significance between 2 groups(t=8.367,P<0.05). Negative mood scores of 2 groups were decreased significantly af-ter regain of consciousness;there was statistical significance before anesthesia and after regain of consciousness(t=8.672,9.895, P<0.05). HR,BP MAP and SpO2 of 2 groups had no statistical significance within 5 min after anesthesia(P>0.05). The total effective rate of anesthesia in control group was 80.4%,while that of trial group was 78.4%;there was no statistical signifi-cance between 2 groups (χ2=1.273,P>0.05). The incidence of nausea,vomiting,dizziness and other ADR were similar in 2 groups,but the incidence of fantasy(39.2%)in control group was significantly higher in trial group(11.8%);there was statistical significance between 2 groups(χ2=10.120,P<0.05). CONCLUSIONS:Propofol and etomidate have good stability on the respira-tory and circulatory system,anesthetic effects are correspond to the incidence of ADR. Etomidate has a better safety. But the psy-chological status of patients in the propofol group is preceding than etomidate group.

Objective To investigate the necessity and tolerance of operation for hip fracture in patients aged 75 years and over. Methods The general tolerance including the self-care ability, comorbidities and postoperative complications was retrospectively analyzed in 70 elderly patients with hip fracture. Then the relationship between operation and survival status was estimated. Results The average tolerance score was significantly higher in 46 patients who accepted the operation than in 24 patients who didn't C(76. 1±12. 2) vs. (65. 5±13. 9), P<0. 01]. The median survival period was significantly higher in operation group than in non-operation group ( 97 mouths vs. 48 mouths, P< 0. 05). Kaplan Meier analysis showed that the survival status was better in operation group than in non-operation group. Conclusions For elderly patients over 75 years old with hip fracture, comprehensive evaluations of surgical tolerance before operation are very important for assessing the perioperative risk and feasibility of surgery. The operative treatment is a reasonable choice, as long as the operation is well tolerated by the patients.

Objective To evaluate the short-term clinical effect of 125Ⅰ seeds interstitial braehytherapy for recurrent malignant tumor after radiotherapy. Methods 21 patients with recurrent gynecologic tumors after radiotherapy received 125Ⅰ seeds interstitial braehytherapy through TPS, ultrasound. 125Ⅰ seeds radiotherapy per grain was for 20.72-29.60 MBq. The distribution of seeds was checked by X-my after treatment. The clinical therapeutic efficacy was observed by chest CT, ultrasound. Results The overall effective rate was 100 %, CR 85.71%(18/21), PR 14.29 %(3/21). Conclusion 125Ⅰ seeds interstitial brachytherapy is minimally invasive, convenient, safe, utility and feasible in clinical practice. The radioactive protection is easy. It is a new and high technology of malignant tumor treatment. Colligation treatment method is increased by this technique. But this technology cannot replace routine method.

Objective To evaluate the prevalence of depression and anxiety in the middle and elderly patients with chest pain from department of emergency.Methods Totally 1200 patients suffering from chest pain were enrolled from July 2009 to August 2009.All patients were scored by self-rating depression scale (SDS) and self evaluation anxious scale (SAS).Results 383 cases of 912 patients(42.0％) with coronary heart disease (CAD) and 58 of 288 patients (20.1％) without CAD had depression,with a statistically significant difference (x2 =44.98,P=0.002).Odds ratio (OR) for CAD in patients with depression was 2.5,with 95 ％ confidence interval (CI) of 1.0-5.0 (P ＜0.05).Conclusions There is high prevalence of depression and anxiety as independent risk factors for CAD.

Objective To evaluate the endothelial function in diabetic patients by high resolution sonography. Methods The intima-media thicknesses (IMT) of the bilateral carotid artery, femoral artery and the iliac artery of 22 elderly patients and 142 non-elderly patients with diabetes mellitus (DM) and 20 elderly and 20 non-elderly healthy persons were measured. The changes of the diameter of brachial artery were determined by measuring the diameter of brachial artery during reactive hyperemia and after sublingual nitroglycerin. Results The increased percentage of the brachial artery diameter under reactive hyperemia was significantly lower in elderly patients with DM (10. 03?6. 39)% than that in the elderly healthy control (15. 87?4. 79)% (P 0. 05). The IMT in elderly patients with early-stage DM incrassated significantly(P

Objective Establishing an employee satisfaction indicator system for tertiary hospitals in Beijing.Methods Evaluation indicators are built on theory research,and questionnaires are designed for survey.Such methods as principal component factor analysis,and verification factor analysis are called into play to test the construct validity and establish in the end the employee satisfaction indicators system.Results Such indicators comprise five grade-1 dimension and 34 grade-Ⅱ dimension,such as hospital management satisfaction indicator.Conclusion This self-designed scale ideally mirrors the employee satisfaction of tertiary hospitals in Beijing,proving the indicators to be objective and reasonable.

Objective To explore an effective method of isolating and culturing the vascular endothelial cells of rat thoracic aorta.MethodThe thoracic aorta was harvested under aseptic condition from the thorax of a Wistar rat.The peripheral connective tissue and fat of the thoracic aorta were stripped and disposed,and then the thoracic aorta was turned inside out to expose the intima.The thoracic aorta was ligated with silk and cauterized on both ends with heated forceps.Then the thoracic aorta was cultured in medium DMEM/F12 containing 20% newborn calf serum in a 50 ml culture bottle which was already blanketed with rat tail collagen.The thoracic aorta was discarded and the new culture medium was added into the culture bottle six days later.The migrating cells were differentially digested by 0.125% pancreatic enzyme for serial subcultivation.The cells were identified by immunohistochemical method with anti-Ⅷ factor antibody.ResultA small amount of cells were seen to migrate from the aorta and adhered to the bottom of culture bottle 6 days after cultivation;the migrating cells spread to cover most part of the bottom of culture bottle 12-14 days later.About 70% of the migrated cells were in a confluent monolayer.The confluent cells grew rapidly after being digested with pancreatic enzyme,and they showed a typical cobblestone appearance.The cells were identified as endothelial cells with 100% expression of Ⅷ factor,which was regarded as the marker of endothelial cells.ConclusionThe method established in the present study is simple and easy to handle,it does not need collagen enzyme and endothelial cell growth promoting substrate,and it is economical and applicable.It is especially suitable for isolation and cultivation of vascular endothelial cells of vessels of small caliber.

Objective An ideal small bowel transplantation model is the prerequisite and guarantee of small bowel transplan-tation-related researches.The aim of this study is to establish a pig model of orthotopic segmental small bowel transplantation by modifi-cation of blood vessel reconstruction and surgical techniques. Methods Twenty healthy pigs were equally assigned as donors and re-cipients.The superior mesenteric vessels were freed and the distal ileum harvested as grafts.After irrigation and preservation, the small bowel was transplanted by end-to-end anastomosis of the superior mesenteric arteries and veins, and then the small bowel was re-constructed simultaneously to restore intestinal continuity, with the proximal part of the graft brought out as a stoma for the purpose of graft monitoring. Results Transplantation was successfully performed in 9 of the 10 cases, with a success rate of 90%.The donor operations averaged 100 min, recipient operations 172 min, warm ischemia 1.3 min, cold ischemia 96 min, and vascular anastomosis 27.6 min.No postoperative anastomosis fistula occurred in any of the cases. Conclusion The pig model of orthotopic segmental small bowel transplantation is ideal for small bowel transplantation-related researches.

ObjectiveToestablisharatmodelofincreasedbloodflow-inducedpulmonaryarterialhypertension generatedbyanastomosisoftheleftcommoncarotidarterytoleftexternaljugularvein.Methods 45maleSDratswere divided into three groups:the shunt group , the ligation group and the sham group .At twelve weeks after the procedure , the general status of the rats was observed . Heart conditions , cardiac output and shunt patency were measured by echocardiography .Right ventricular systolic pressure ( RVSP ) and Qp/Qs were checked by catheterization . Right ventricular hypertrophy index ( RVHI) was calculated and lung tissues were examined by pathology using hematoxylin -eosin and elastin Van Gieson staining .All data were analyzed statistically by one-way ANOVA test using SPSS 16.0.Results There was no significant difference in body weight gains between the groups .The patency rate of shunt was 84.6%.The heart was enlarged in the group shunt .Cardiac output increased significantly in the shunt group than that in the other two groups [(309.8 ±33.1) mL/min?kg vs.(245.6 ±31.9) mL/min?kg, (240.8 ±30.9)mL/min?kg, respectively, P<0.05].In the shunt group Qp/Qs was 2.16 ±0.38 and RVSP increased to (35.8 ±4.9) mmHg, RVHI was 0.3263 ± 0.0342, significantly higher than that of the other groups .The pulmonary arteriolar wall was evidently thickened in contrast to that in the sham group [ ( 22.3 ±1.7 )% vs.( 10.6 ±1.7 )%, P <0.05 ) .Conclusions Anastomosis of the left common carotid artery to left external jugular vein can successfully establish pulmonary arterial hypertension model induced by high blood flow in rats .