Objective To investigate the influence of autologous blood transfusion on oxygen metabolism in patients undergoing orthopedics surgery. Methods Forty patients 28-65 yr weighing 55-80 kg scheduled for internal fixation of spine were randomly divided into two groups with 20 patients in each group. Anesthesia was induced with intravenous fentanyl , propofol and vecuronium and maintained with inhalation of isoflurane. Patients bleeding less than 600 ml or more than 1 200 ml were excluded. When the loss blood volume was more than 600 ml, the autologous blood of 600 ml obtained from the autotransfusion device was remfused to the patients in group A, the heterogenous blood of 600 ml was transfused in group B, The radial and pulmonary arteries were cannulated for measurement of hemodynamics and blood gas analysis. The cardiac index, oxygen delivery, oxygen consumption, oxygen extraction ratio were calculated and blood lactate concentration was measured immediately before anesthesia , after infusion of autologous or heterogenous blood, at the end of the operation and one day after the operation respectively. Results Compared with the baseline, only oxygen delivery increased significantly after infusion autologous blood or heterogenous blood, at the end of the operation in both groups ( P 0.05) . As compared with that in group B, oxygen extraction ratio decreased significantly in group A ( P 0.05). Conclusion Upon condition that bleeding volumes is limited (600-1 200 ml) in patient undergoing orthopedic surgery, autologous blood transfusion technique can provide enough oxygen for tissue metabolism.

The term "a green hospital", meaning "a safe, dependable and harmless hospital", epitomizes the harmony between the hospital's intrinsic quality and extrinsic surroundings. Thus, the construction of a green hospital possesses rich connotations, viz. powerful guarantee, of medical safety, dependable guarantee of quality, delivery of civilized services and harmonious doctor-patient relationship, and comfortable and humanized surroundings for medical care. It is imperative to formulate comprehensive assessment standards for green hospitals or incorporate such standards into the conditions for hospital appraisal so as to render the idea of green hospital a target of hospital development.

Objective To investigate effects and complications of medline and paramedian approaches for intravertebral anesthesia in knee arthroscopy.Methods A total of 120 ASA I or II patients scheduled for knee arthroscopy were randomly assigned into 2 groups: either receiving midline approach intravertebral block(Medline Group) or paramedian approach block(Paramedian Group).A combined spinal-epidural anesthesia was performed with the single-segment needle-through-needle technique in both groups.The anesthetic response time,successful puncture rate,incidence of paresthesia,incidence of difficult epidural catheterization,incidence of traumatic needle placement,and backache rate and duration of both groups were observed respectively.Values of SBP,DBP,HR,and SpO2 at 1,5,10,30 minutes after anesthesia respectively were recorded.Results There were no significant differences(P

Objective To evaluate the safety and efficacy of the general anesthesia for laparoscopy-assisted surgery in aged patients (≥80years). Methods The effects of general anesthesia in 39 patients who underwent laparoscopy-assisted surgery during the period from May 2000 to February 2007 were analyzed retrospectively. All the patients were 80 years old or above, with a mean of 83.3 years old. Among the patients 38 cases had systemic diseases, and some of them had more than one concomitant disease. The systemic diseases included diabetes mellitus in 6 cases, coronary atherosclerotic heart disease in 10 cases, hypertension in 18 cases, arrhythmia in 15 cases, cerebral vascular disease in 8 cases and anemia in 1 case. The laparoscopy-assisted surgery included cholecystectomy in 14 cases, radical resection for rectal cancer in 6 cases, for colon carcinoma in 8 cases, and for kidney cancer in 6 cases, and resection for colonic benign tumor, hernioplasty, gastro-jejunal anastomosis and fenestration of hepatic or renal cysts in 1 patient each. Results During the peri-narcosis period cerebral infarction occurred in 1 patient, and 20 patients were transferred to Intensity Care Unit. After operation 33 patients (84.6%) were cured and 6 patients (15.4%) had the illness condition improved. Conclusions The general anesthesia in laparoscopy-assisted surgery is safe and feasible for the elderly patients over 80 years old. The elderly patients may safely tide over the peri-narcosis period with good prognosis with effective control of complications and concomitant diseases. So the general anesthesia should not be categorically forbidden in laparoscopy-assisted surgery for the elderly patients with complications.

Objective To summarize the experience of anesthesia management of retroperitoneoscopic surgery in aged patients(aged more than 70 years old).Methods The clinical data of 81 aged patients(ranged from 70 to 86 years old,mean:74.2 years old)receiving retroperioneoscopic surgery from October 2002 to January 2007 was reviewed retrospectively in our hospital.Of whom,77 patients had concomitant diseases.81 patients were operated on under general anesthesia.Results Hypercarbia,acidosis and hypertension occurred in 35(43.2%),35(43.2%) and 41(50.6%) cases,respectively,after pneumoperitoneum.Tracheal catheters were pulled out in 66 patients in operation room,with the decannulation time being 5-50 minutes(mean,15.1 minutes).14 patients(17.3%) were transferred to ICU postoperatively.1 patient(1.2%) died from acute myocardial infarction.Sever delirious state was found in 1 patient.Conclusions On the basis of cautious perianesthesia management,aged patients can tolerate hypercapnia,acidosis and elevation of blood pressure induced by pneumoperitoneum,but the management of perianesthesia period should be prudent.

Objective To evaluate the application of the LMA CTrach for airway management during cervical spine surgery.Methods A total of 80 patients received cervical spine surgery under general anesthesia. During the operation, the LMA CTrach was used for ventilation and insertion of endotracheal tube. The authors recorded the time of laryngeal mask insertion, the success rate of ventilation, the success rate of the first attempt of endotracheal intubation, the number of attempts of endotracheal intubation, the time from insertion of the LMA CTrach to the completion of tracheal intubation. Results The LMA CTrach insertion was successfully completed in all but 2 patients. In 78 patients with good ventilation, the first attempt of endotracheal intubation failed in 5 patients. Except for unsuccessful ventilation in 2 patients and intubation failure for 3 times in 3 patients, the endotracheal intubation by using the LMA CTrach was accomplished in 75 patients. The mean time from insertion of the LMA CTrach to the completion of tracheal intubation was 192 s (range, 156～273 s). Conclusions The LMA CTrach system has the ability to align the LMA outlet with the larynx under direct view, and can increase the success rate of intubation and avoid some unnecessary injuries, giving certain advantages for airway management during cervical spine surgery.

0.05).Various degrees of pharyngalgia and hoarseness occurred in 2 patients in the Group Ⅰ,3 patients in the Group Ⅱ,and 2 in the Group Ⅲ,the incidence of complications being not statistically different(?2=0.323,P=0.851).Conclusions Compared with local anesthesia or endotracheal intubation,percutaneous dilational tracheostomy under laryngeal mask airway ventilation offers more stable circulation,higher reliability,and less influence to tracheostomy.This technique may give certain protection against cervical spinal cord injury during anesthetic induction.

Objective To compare the effect of allogeneic and autologous blood transfusion on postoperative immunoreaction in patients after spinal surgeries.Methods A total of 44 patients undergoing spinal operations were randomly divided into two groups.Allogeneic (n=22) or autologous (n=22) buffy-coat-depleted red cells were used in the patients during the operations.The serum levels of IL-6,IFN-?,and TNF-?were determined preoperatively and then re-measured 1 and 7 days after the operations. Results In theautologous group,both IFN-?and IL-6 increased after the oprerations,the level of IL-6 was significantly higher than that in the allogeneic group at days 1 and 7.The concentration of TNF-?did not change after the surgeries in the two groups. Conclusions By autologous blood transfusion,the serum levels of IFN-?and IL-6 can be increased significantly after spinal operation,meanwhile the concentration of TNF-?remains stable.The postoperative inhibitory effect of the procedure on immunocytokines is significantly weaker than that of allogeneic blood transfusion,indicating that autologous blood transfuion can protect or even increase immunofunction after spinal operation.

Objective To establish the quality standard of Zhimiling Suppository (Cortex Phellodendri, Radix Sophorae Flavescentis, Catechu, Borneolum Syntheticum, Alumen). Methods Catechu, Borneolum Syntheticum, Alumen in the preparation were identified by physics and chemstry method. Berberine Hydrochloride was determined by HPLC. Results The standard curve for Berberine Hydrochloride was linear in the range of 0.080 2～0.802 ?g, the average recovery was 100.4%, RSD was 0.85% (n=6). Conclusion The methods are simple, accurate and reproducible.

Objective To investigate the effect of tetrandrine (Tet) on experimental choroidal neovascularization and the effect of Tet on retinal structure and function. Methods Choroidal neovascularization was induced in 20 Brown Norway (BN) rats (40 eyes) by diode laser (wavelength: 810 nm; exposal time: 0.1 second; facular diameter:100 ?m; energy: 120 mW), and the rats were divided randomly into experimental and control group with 10 rats (20 eyes) in each group. In experimental group, 0.05 ml Tet with the concentration of 3.21 ?mol/L was injected intravitreously 0 and 3 days after laser photocoagulation; in the control group, the rats underwent an intravitreous injection with the same volume of sodium chloride solution. The incidence of CNV was evaluated by fundus fluorescein angiography (FFA) 14 days after laser photocoagulation. Five right eyes of another Five healthy BN rats underwent intravitreous injection with 0.05 ml Tet with the concentration of 3.21 ?mol/L, and an intravitreous injection with the same volume of sodium chloride solution was performed on the left eyes. Before injection, 1 hour, and 1 day after the first injection, and 1 hour, 1 day, 7 days, 14 days after the second injection the electroretinography (ERG) was performed on these 5 rats; 14 days after the second injection, the retinae were examined by light microscopy and transmission electron microscopy. Results The incidence of CNV was 23.26% in experimental group,which was obviously lower than that in the control group (63.33%) (P0.05). There were no structural changes of retinal tissues examined by light and electron microscopy. Conclusion Tet may inhibit choroidal neovascularization in rats; there isn′t any significant toxic effect of intravitreous injection with Tet on retina at the dosage of 3.21 ?mol/L.