Objective To investigate the effects of inhalation of different concentrations of nitrous oxide on intracuff pressure (ICP) of the laryngeal mask airway (LMA) in patients during general anesthesia. Methods Forty-right ASA Ⅰ or Ⅱ patients aged 25-64 yr undergoing elective operations under general anesthesia were randomly divided into 4 groups (n=12 each): group C (100 %O2, group N2 (65 % O2 + 35%N2O), group N2 (50%O2 + 50 % N2O), and group N3 (35%O2 + 65%N2O). A suitable model of the LMA was selected according to height and weight. Anesthesia was induced with Ⅳ propofol 1.5-2.0 mg/kg, fentanyl 2-3 μg/kg, lidocaine 1-2 mg/kg and vecuronium 0.08-0.1 mg/kg and maintained with intravenous infusion of propofol and intermittent boluses of fentanyl and vecuronium. After the successful placement of LMA, the air was injected into the cuff to make intracuff pressure (ICP) reach 40 cm H2O (baseline). The ICP were recorded at 15, 30, 45, 60, 75 and 90 min (T1-6) following inhalation of N2O. Results The ICP grandually increased with the increase in the concentration of N2O (P<0.05). The ICP decreased at T2-6 in group C, but increased at T2-6 in group N1 and at T1-6 in group N2,3 as compared with baseline(P<0.05). There was a positive correlation between the ICP and inhalation time in group N1-3(r1-3=0.968,0.987,0.973 respectively, P<0.05). Conclusion The inhalation of N2O can increase the ICP in concentration- and time-dependent manners,

Objective To investigate the mental health status of adults with human immunodeficiency virus (HIV)infection or acquired immune deficiency syndrome(AIDS).Methods Ninety-four patients with HIV infection or AIDS and 38 healthy subjects were enrolled and filled in the Symptom Checklist 90(SCL-90),Coping Styles Questionnaire(CSQ)and Eysenck Personality Questionnaire(EPQ).Resultsin SCL-90,the scores of compulsion ,depression,anxiety and psychoticism factor were significantly increased in the patient group(all P＜0.05).In the study group,the scores of depression and paranoid ideation factors of male patients were higher than those of female patients.For the participants with HIV infection or AIDS,several factors of SCL-90 were correlative with CSQ and EPQ(r=0.21 to 0.70).ConclusionEmotional disorders may be the most common mental problem of patients with HIV infection or AIDS,and social and psychological supports should be needed.

Objective To investigate the changes of serum C-reactive protein(CRP)and neu-ron-specific enolase(NSE)levels in patients with acute cerebral infarction(ACI)and their relations with in farct size,severity of neurological impairment.Methods The levels of serum CRP,NSE were measured in 60 patients(ACI group)within 72 hours after infarction and 40 normal controls(control group).The severity of neurological impairment of patients with ACl was assessed by National Institutes of Health Stroke Scale (NIHSS)at admission.Results The mean levels of serum CRP and NSE in ACI group were higher than those in control group, (6.95±2.34)mg/L vs(2.21±1.05)mg/L,P＜0.01, (22.39±4.72)μg/L vs(7.16±2.63)μg/L,P＜0.01,respectively.Higher levels of CRP and NSE were obviously associated with larger infarct size and more severe neurological impairment.The changes of CRP and NSE levels correlated with scores of NIHSS(r=0.51,r=0.44,all P＜0.01)significantly.CRP levels were positively correlated with those of NSE(r=0.57,P＜0.01).Conclusion The levels of serum CRP and NSE can be used as an important biological marker to estimate the size of infarct and the severity of neurological impairment in ACI.

The "Wu Chang" thought is a core idea in Chinese Confucian morality system,which plays a critical role in establishing and further developing traditional Chinese medical ethical principles,doctors′ professional obligations,behavioral regulations,professional requirements,and physician-patient relationship.Therefore,it is also of positive referencing and revealing significance for fully understanding the modern doctors′ professionalism and responsibilities raised by the "Doctors′ Declaration of Doctors′ Professionalism in the New Century".

Metabolic syndrome, whose incidence is higher than that we have thought, has done great harm to people's health. This review is to introduce the recent advance in the defination,epidemiology,etiology,major risk factors,clinical diagnosis and treatment, etc . of metabolic syndrome.

Objective To promote more understanding of bone metastasis and reduce the misdiag-nostic rate of bone metastatic tumor.Methods The mechanism of skeletal metastasis,the spreading pathway of tumor to bone,its frequency and distribution of skeletal metastasis,as well as relative frequency of primary malignant tumor,clinical features,diagnosis and differential diagnosis with bone metastastic tumor were re-viewed.Five misdiagnosed cases as bone metastasis were presented.Results Five cases of patients were ob-tained post-longer time of follow-up examination,ranging from24to96months(average57.6months).Case1was carcinoma of lung,and case2carcinoma of prostatic gland,both were living and well.Case4and case5were tuberculosis of lumbar spine,their conditions were stable and satisfied.A lesion of lum-bo sacral disc in case3was found and diagnosed as infection and kept stable without any back and extremities pain since first attack of disease.The causes of misdiagnosis were analyzed.Conclusion Meticulous review of the history and clinical features as well as proper explanation of the supplemental data from plain X-ray,bone scintigraphy,CT and MRI findings are essential for diagnosis of majority of bone metastatic tumor.Al -though such new imaging devices(as bone scintigraphy,CT and MRI )possess a high sensitivity for early detection of bone metastasis,yet with a poor specificity,hence orthopaedic surgeon have to catch hold of proper understanding about new imaging techniques.In difficult and doubtful cases,the bone biopsy under CT guiding may be needed,the radioisotopic Hawkeye system and diffusion weighted MR imaging are rec-ommended for differential diagnosis of senile acute benign(e.g.osteoporosis)and malignant (e.g.metastasis)vertebral body com pressive fracture.

There exists the contradiction between medical value and social ethics on human-body experiments,so the ethics requires that we should set a comprehesive appraise and choose the corresponding ethical principle to standardize the behavior of human-body experiments.

The diatom test has been used as a main diagnotic method of drowning.but itis doubful and even is considered valueless by some authors nowadays for it hasbeen proved by Niles Forged(1983)that the diatoms found in the internal organsof submerged corpses might be inspired into the body during fhe lifeWe believed that the diagnosis of drowning might be made by examining lungchlorophyll(a)of planktons with spectro-fluorophotometer qualitatively and quantitatively.According to our experimental stuudiesIt is confirmed that this method could be used for the diagnosis of drowning.Mean while two cases submerged in water were investigate.and the causesof deathwere diagnosed correctly.It is concluded that the examination of the lungchlorophyll(a)of planktoms could be used as a reliable diagnostic method infore nsic practice

Objective To observe the clinical curative effect of ankle chute tibia bone graft fusion treatment of late kaschin-beck disease.Methods Thirty-three patients with late kaschin-beek disease performed ankle arthrodesis,the ankle surgery in 5 cases,simple right ankle surgery in 13 eases and 15 cases of left ankle surgery.Intraoperative used tibial chute hollow screw internal fixation and bone graft plaster external fixation postoperatively.Followed up 0.5-6.0 years,compared the American orthopaedic food and ankle society (AOFAS) score before surgery to determine the efficacy of last follow-up,X ray film fusion situation assessment in the postoperative period.Results Thirty-three cases did not occur postoperative incision infection,vascular or nerve complications.Last follow-up,30 cases were no obvious discomfort,3 cases of mild ankle pain,accompanied by walking or standing for a long time after the foot heel had mild acid bilges feeling,did not affect the daily life.The AOFAS score before surgery was significantly lower than that last follow-up [(25.84 ± 16.81) scores vs.(87.32 ± 4.68) scores] (P ＜ 0.01).Clinical efficacy excellent in 25 cases,good in 5 cases,general in 2 cases,poor in 1 case.Follow-up X line piece was showed that in all cases to achieve bony fusion.Conclusion Using sliding kashin-beck terminal patients treated ankle bone graft fusion,simple operation,high bone graft fusion rate,less complications,curative effect is positive.

Objective To investigate the effect of cisplatin and 5-fluorouracil on endocrine Ishikawa cells in the treatment of endometrial cancer. Methods The human endometrial cancer cell line Ishikawa were selected, at the logarithmic growth period, the cells were divided into three groups of 5-fluorouracil (5 mg/L) group, cisplatin (5 mg/L) group and cisplatin (5 mg/L) combined with fluorouracil (5 mg/L) group ( combined group).After treated with corresponding drugs treatment, the cell viability was detected by MTT, the apoptosis was detected by flow cytometry, and the Bcl-2 and p65 expressions cells were detected by Western blot.Results The inhibitory rate of combined group, cisplatin group and 5-fluorouracil group were (41.45 ± 3.13)%, (25.20 ±3.09)% and (23.19 ±4.10)% respectively, and the inhibitory rate in the combined group was significantly higher than that of the other two groups (P<0.05).The apoptosis rate of the combined group, cisplatin group and 5-group were (29.44 ±4.35)%, (5.74 ±1.12)% and (5.82 ±1.78)% respectively, and the apoptosis rate in the combined group was significantly higher than that of the other two groups (P<0.05).The Bcl-2 relative expression in the combined group, cisplatin group and 5-fluorouracil group were (0.31 ±0.11), (1.23 ±0.49) and (1.28 ±0.59), the p65 expression were (0.67 ±0.23), (1.67 ±0.56) and (1.71 ±0.71), combined group of Bcl-2 and p65 relative expressions were obviously less than that of the other two groups ( P <0.05 ) .Conclusion Cisplatin combined with 5-fluorouracil on endocrine Ishikawa cells in the treatment of endometrial cancer could promote cell apoptosis, inhibit the cell proliferation, and its mechanism may be related to the inhibition of Bcl-2 and p65 protein expressions.