Objective To compare the laryngeal mask insertion conditions at different plasma target concentrations (Cp) during the induction of anesthesia with target-controlled infusion (TCI) of propofol.Methods Forty-five ASA I - II patients of both sexes aged 18-60 yr, weighing 50-80 kg undergoing minor surgery in which the use of laryngeal mask (LM) was indicated were randomly divided into 3 groups ( n = 15) according to Cp of propofol set during induction of anesthesia: 4, 6 and 8 ?g ? ml-1 . The patients were premedicated with intramuscular scopolamine 0.3 mg. Fentanyl 3 ?g?kg-1 was given i.v. . TCI of propofol was started 3 min later with Diprifusor (Graseby 3500 infusion pump). LM was inserted when the effect-site concentration (EC) of propofol reached 2.5 ?g ? ml -1 as displayed on the infusion pump. LM insertion conditions (mouth opening, gagling, coughing, head and limb movement, overall ease of insertion) were assessed. The total dose of propofol, insertion time, the time needed to reach EC 2.5 ?g?ml-1 were recorded. SP, DP, HR and BIS value were recorded at 6 time points: baseline before induction (T1 ) , at the loss of consciousness (T2), at EC 2.5 ?g ? ml-1 (T3), immediately (T4), 3 min (T5) after insertion of LM. Results The SP, DP, HR and BIS value were decreasing with increasing depth of anesthesia in the 3 groups. The decrease in BP and BIS value after insertion of LM was significantly larger in group 3 (8 ?g ?ml-1) than in group 1 and 2 (P

Objective To evaluate the effectiveness and safety of terazosin in the treatment of benign prostatic hyperplasia (BPH)patients with concomitant hypertension.Methods A singlecenter prospective clinical observational study was conducted from March,2006 to March,2010 in our center.The main endpoints were the changes of IPSS total score,diastolic and systolic blood pressures at the end of 4 weeks and 3 monthes compared with the baseline,The second endpoints were Qmax value at the end of 4 weeks and 3 monthes compared with the baseline,Safety was assessed by adverse events.Results There were 212 patients in the study recruited,and 189 patients completed the study.All patients had BPH combined with hepertension.All patients were randomly devided into two statistical analysis group,blood pressure well controled and not well controled group,In the well controlled group,the IPSS socre reduced from 22.31 ± 5.18 at baseline to 15.64 ±3.91 at the end of the 4th weeks and 13.16 ± 3.53 at the end of 3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).The Qmax were improved significantly from (7.87 ± 2.41 ) ％ at baseline to (14.19 ±2.64)％ at the end of the 4th weeks and (15.69 ±2.77)％ at the end of3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).Terazosin had moderate effect in blood pressure decreasing (P ＜ 0.05 ),and all patients were within normal blood pressure range.In the uncontrolled group,the IPSS socre reduced from 21.55 ± 4.82 at baseline to 15.44 ± 3.66 at the end of the 4th weeks and 12.96 ± 3.11 at the end of 3rd monthes in the blood pressure well controled group populatin (P ＜ 0.01 ).The Qmax were improved significantly from ( 8.27 ± 2.27 ) ％ at baseline to ( 14.26 ± 2.87) ％ at the end of the 4th weeks and ( 15.51 ±2.92) ％ at the end of 3rd monthes in the blood pressure well controled group populatin( P ＜ 0.01 ).Terazosin decreased BPH patient blood pressure with controlled patients and unctrolled patients additionaly to other blood pressure medicine (P ＜ 0.05 ),and no severe side effect occured.At the end of the study,all patients were taking drug continuously and were followed.Conclnsion Terazosin can significantly improve the symptoms and quality of life in BPH patients with hypertension with good safety and compliance.

Objective To investigate the mechanism of acute lung injury after hepatic ischemia / reperfusion and the protective effect of propofol.Method s Forty-eight male SD rats were randomly divided into Sham2 group,Sham6 group; IR2 group (IR2),IR6 group (IR6); P2 group (P2),P6 group (P6).The 1 mg·kg-1·min-1 propofol was infused from 30min before ischemia in P groups,and the same volume sodium lactate Ringer's solution was infused in Sham and IR groups.The concentration of TNF-α,superoxidedimutase(SOD),malondialdehyde(MDA),myeloperosidase(MPO),lung wet/dry weight ratio and lung histological scores were measured at the points of 2 and 6 hour after reperfusion.Results TNF-α levels were higher in IR and P groups than those in sham groups but the values in P groups were lower than those in IR groups.SOD levels decreased greatly in IR groups,there were great difference between P and IR groups.MDA levels increased greatly in IR groups and reached the peak value at 6 hour after reperfusion.MDA levels in P groups were lower than those in IR groups and there were no difference between P and sham groups.The ratio of Wet/dry levels,MPO and lung histological scores were increased greatly after reperfusion in IR and P groups.But the value in P groups was lower than those in IR groups.Conclusions Acute lung injury after hepatic ischemia / reperfusion is mainly induced by the oxidant stress and neutrophil infiltration in lung tissues.Propofol may have effects of antioxidation and decrease neutrophil infiltration which attenuate lung injury induced by hepatic ischemia/reperfusion.

Objective To discuss the feasibility and safety of continuous spinal anesthesia (CSA) in renal transplantation through comparing the effects of combined spinal and epidural anesthesia (CSEA) and CSA renal transplantation. Methods Sixty patients undertaking renal transplantation were divided into two groups randomly. Group A, 30 patients, undertaking operation with CSEA; Group B, 30 patients, undertaking operation with CSA. The patients in group A were injected 2 mL 0.75% ropivacaine, then epidural catheter was inserted, 0. 75% ropivacaine 10 mL was administered when needed. The patients in group B were injected 2 mL 0.75% ropivacaine into spinal through Spinocath catheter, and 0.75% ropivacaine 1ml was administered through Spinocath catheter when needed. We observed the effects of the two anesthesia methods and the changes of the patients' vital signs. Results The patients in group A and B all completed the operation smoothly; there were no significant differences in the circulatory function before and during operation; there were no complications related to anesthesia in all the patients; group B was superior to group A in the aspects of the control and maintaining of anesthesia. Conclusion Continuous spinal anesthesia applied to renal transplantation is safe and feasible.

Objective To evaluate and verify the preventive and therapeutic effects of electroacupuncture (EA) plus pelvic floor muscle training (PFMT) in treating mild-moderate female stress urinary incontinence (SUI). Method By adopting a single-blind randomized controlled design, eighty-two SUI patients were randomized into an observation group of 40 cases and a control group of 42 cases. The observation group was intervened by EA plus PFMT, while the control group only received PFMT. Before the treatment and after 4-week treatment, the 1 h urine leakage amount, Incontinence Questionnaire Short Form (ICI-Q-SF) and improvement rate were evaluated in the two groups, to analyze the effects of the two methods in improving mild-moderate SUI. Result For mild SUI patients, the 1 h urine leakage amount and ICI-Q-SF score dropped significantly after the treatment in the observation group (P<0.05), and the observation group was significantly lower than the control group (P<0.05). For moderate SUI patients, the 1 h urine leakage amount and ICI-QSF score dropped significantly in both groups after the intervention (P<0.05), the observation group was significantly lower than the control group (P<0.05), and the improvement rate in the observation group was markedly higher than that in the control group (P<0.01). Conclusion EA plus PFMT caneffectively improve the urine leakage and urination in mild-moderate SUI patients. EA plus PFMT can effectively prevent the aggravation of moderate female SUI, and its effect is better than PFMT alone.

Because many patients in rehabilitation hospitals still require advanced surgical treatments and chronic pain managements, therefore, anesthesiologists in these hospitals are very important in clinical practice. To use experience of training for anesthesiologists in general hospitals and to consider characters of patients and operations in rehabilitation hospitals are essential to educate anesthesiologists who are qualified in rehabilitation hospitals. The concrete measures include consummating the evaluation system, using available advantages and improving the quality of training, establishing special training programs suitable for characters of rehabilitation, and integrating rehabilitation medicine to other medical fields.

Objective To explore the relationship between post-operative cognitive dysfunction (POCD) and the dose of general anesthetic propofol in the elderly. Methods 96 patients undergoing thoracic operation were selected and randomly assigned to high bispectral index (BIS) value (HIBIS 50~60, low dose of propofol) and low BIS value (LOBIS 30~40, high dose of propofol). Remifentanyl was infused in both group with the dose of 0.2 μg/kg ⋅ min. The dose of propofol was adjusted with target-controlled infuse (TCI) according to the different ranges of BIS value in different groups. The mean arterial pressure was maintained in a certain level. The dose of propofol was recorded during the operation. Cognitive function was assessed by 12 neurophysiological tests recommended by International Study of Post Operative Cognitive Dysfunction (ISPOCD) on the day before operation and the 7th day after operation. And the D-value of the tests before and after the operation was calculated. Results 47 cases in the HIBIS group and 45 cases in the LOBIS group were included in the end. The incidences of POCD were 6.3%(3 cases) and 2.2%(1 case) respectively in HIBIS group and LOBIS group according to Mini-Mental State Examination (MMSE) score, and 12.8% (6 cases) and 6.7% (3 cases) according to combination judgment, but there was no significantly difference (P>0.05). The post-operative scores were significantly lower than pre-operative scores (P<0.01) on Hopkins Verbal Learning Test-Revised (HVLT-R) in HIBIS group. and HVLT-R dealyed Recall Test, Hvlt- r Recognition Discrimination Index and Verbal Fluency Test in both groups (P<0.01), including verbal and words. The D-values of 4 neurophysiological tests were higher in the HIBIS group than in the LOBIS group. The dose of propofol was significantly lower in the HIBIS group than in the LOBIS group (P<0.01). Conclusion As the same level of analgisia and hemodynamics, the more the dose of propofol is, the better the post-operative function is in the elderly.