Objective To investigate the effect of ultrashortwave diathermy on pulmonary hypertension in patients with chronic cor pulmonale(CCP), and its mechanism. Methods Eighty-seven cases of acute phase CCP were divided into 2 groups: an ultrashortwave treatment group, in which 45 patients were treated with both ultrashortwave diathermy and conventional treatment; and a control group, in which 42 patients received regular treatment. The plasma levels of VEGF, ET-1 and the PaO_2, mPAP and FEV1.0 in the two groups were measured before and after treatment. Results In contrast to the control group, the FEV1.0 and PaO_2 of the experimental group were remar-kably increased, while their VEGF, ET-1 and mPAP were significantly decreased after treatment. VEGF and ET-1 were negatively related to PaO_2, and positively related to mPAP. Conclusions Ultrashortwave therapy is effective in treating pulmonary hypertension in patients with CCP. The mechanism for this may involve the synthesis and release of VEGF and ET-1.

Objective To investigate the pathological changes of local airway tissue after inserting Y-shaped titanium-nickel memory alloy stent in carina, and to evaluate CT three-dimensional reconstruction technique in postoperative and follow-up observation. Methods Twelve healthy adult canines were enrolled in this study. Based on the information of the carina obtained from CT three-dimensional reconstruction images, the preparation of Y-shape netlike stent was made by knitting method with single Ni-Ti memory alloy wire. The stent was then inserted in canine's carina with the help of a releasing system. After the operation fiberbronchoscopy and CT three-dimensional reconstruction were performed. The animals were sacrificed 12 weeks after the procedure and the bronchus of the stenting segment was removed and sent for histopathologic examination. Results Technical success was achieved in all canines with the stent fight in the carina. The airway remained unobstructed 12 weeks after the procedure. Histopathologic examination revealed that the stent became partial epithelialization. Conclusion The Y-shaped titanium-nickel memory alloy stent has good histecompatibility and physicochemical stability and no re-stenosis of the airway develops in the follow-up period of three months. The stent-releasing technique is easy and simple. As a non-invasive and convenient exam, CT three-dimensional reconstruction technique is of great value in postoperative follow-up observation.

Objective To study the clinical effect ofprednisone combined with Shuxuening injection on pulmonary interstitial fibrosis. Methods 120 cases were randomly recruited into a treatment group and a control group. The control group was treated with prednisone, and the treatment group was additionally given Shuxuening injection on the basis of the control group. The changes of vital capacity (VC), PO_2, PCO_2 and imaging were observed. Results The total effective rate was 81.67% and 66.67% in the treatment group and the control group Respectively, showing significant difference (P<0.05). VC and PO_2 were raised in both groups after the treatment (P<0.05), while the treatment group showed better results than the control group (P<0.05). PCO2 were also raised in both groups after the treatment (P<0.05), while there was no significant diference between the two groups (P > 0.05). There were 27 cases (45.00%) and 19 cases (31.67%) showed improvement in imaging in the treatment group and the control group respectively, manifesting a significant difference (P<0.05) . Conclusion Treatment of prednisone with Shuxuening injection is better than prednisone on pulmonary interstitial fibrosis. This method is worthy of clinic promotion.

Objective To assess the efficacy of laryngeal mask airway Supreme (LMA Supreme) used in patients undergoing gynecological laparoscopic surgery. Methods Eighty ASA Ⅰ or Ⅱ patients, aged 40-64 yr,weighing 50-70 kg, undergoing elective gynecological laparoscopic surgery, were randomized into 2 groups ( n = 40 each): LMA Supreme group (group S) and LMA ProSeal group (group P). Mallampati test was performed before operation in both groups. The patients were classified as Ⅰ or Ⅱ . LMA Supreme and LMA ProSeal were inserted in group S and P respectively after induction of anesthesia with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 3 μg/kg and vecuronium 0.1 mg/kg. A gastric tube was inserted through the drain tube of the LMA. The number of attempt, success rate, LMA placement time, success rate of gastric tube placement, cuff volume, peak airway pressure, and airway seal pressure, BP, HR, ECG, SpO2, PET CO2 and complications were recorded. The duration of surgery and pneumoperitoneum, and emergence time were also recorded. The fiberoptic bronchoscope scores were assessed after successful LMA placement. Results There were no significant differences in the duration of operation and pneumoperitoneum, emergence time between the two groups (P ＞ 0.05). The BP, HR,SpO2, PET CO2 and peak pressure were within the normal range during operation in both groups. The first attempt success rates of LMA placement and gastric tube placement were significantly higher, the LMA placement time was significantly shorter, and the fiberoptic bronchoscopic scores were significantly higher in group S than in group P ( P ＜ 0.05). Conclusion LMA Supreme is helpful for ventilation during operation with less complications and can be used effectively for gynecological laparoscopic surgery.

OBJECTIVE To analyze and review the antibiotics utilization for the perioperative inpatients in our orthopedics department,and to evaluate the rationality of the utilization.METHODS Totally 267 cases of inpatients receiving operations from Sep to Nov,2008 were selected in our orthopedics department,then the methods of drug use review and drug frequency analysis were applied to analyze and review the effects of antibiotics utilization with retrospective statistics.RESULTS All of the 267 inpatients have taken antibiotics,of which the cephalosporins were the most frequently used.The antibiotics commonly used were cefminox,cefmetazole,and cefuroxime.The antibiotics of the highest daily defined dose(DDD) costs and total costs were cefamandole,flomoxef,etc.The average days of antibiotics utilization for clean operations,clean-contaminated operations,and contaminated operations were 7 days,8 days,and 9 days,respectively and 86% of the patients were antibiotic combination usage.CONCLUSIONS There is inappropriateness in the antibiotics utilization during perioperations of orthopedics.Guidelines of drug use must be followed to improve the drug usage.

To adapt to the new medical enviroment and aiming at the problems existing in clinical teaching,the author explores the value and feasibility of new cultivation mode and its concrete methods to make clininal educatinon play more inportont role in medical education and medical elite cultivation

Objective To observe the changes of left ventricular diastole function in the old patients with paroxysmal atrial fibrillation(PAF)and probe the value of multiindexes to evaluate the left ventricular diastole function.Methods Us the ultrasonic color doppler to determinate the different indexes of left ventricular diastole function in the thirty-four older patients with PAF after converting who came to my hospital from September 2004 to February 2006,and the healthy elder were the controls.Results The index of isovolumic relaxation time(IVRT),flowing velocity E wave(EV),flowing velocity A wave(AV)and the ratio of EV and AV(EV/AV)of the group with PAF after converting were higher significantly in PAF group after converting(99?11 ms,75?13 ms),(0.65?0.14 m/s,0.84?0.15 m/s),(0.77?0.12 m/s,0.55?0.13 m/s)and(0.84?0.13〈1,1.52?0.16〉1)than those in control group.(P〈0.01).Conclusion A significant failure of left ventricular diastole function exists in the old patients with PAF and the multiindexes to evaluate the left ventricular diastole function are more objective.

Objective:To produce monoclonal antibodies(McAb) against aspergillus fumigatus and to establish rapid assay for the measurement of aspergillus fumigatus antigen.Methods:Recombinant galactomannoprotein of aspergillus fumigatus(AFMP1) was used to immune BALB/c mice.Monoclonal antibodies against AFMP1 were produced from hybridoma.Results:Three hybridomas producing antibodies against AFMP1 were obtained.IgG isotypes of three McAb were IgG1,IgG2a and IgG2b.The affinity constants(K) were 1.2?10 10 ,4.56?10 9 and 1.81?10 10 mol/L.The antibodies were proved to be specific for aspergillus fumigatus by Western blot and recognized different epitopes on AFMP1 by the additivity assay.An sandwich enzyme-linked immunosorbent assay(ELISA) to detect AFMP1 was established to produce standard curve which showed linearity between 0.1～60.0 ng/ml with a sensitivity of 0.1 ng/ml.Conclusion:These results show three hybridomas producing high specificity and affinity monoclonal antibodies against AFMP1 and can provide for rapid assay for the measurement of aspergillus fumigatus antigen.

Doctor-patient relationship has attracted increasing attention.In the light of modern model to study the related theory,a preliminary study of the ancient Chinese doctor-patient relationship model has been done.The doctor-patient relationship in ancient society is the same complex and multi-level.Therefore,doctor-patient model could not be lumped together.According to the social status of patients and the extent of their demand for medical services,and the social status of doctors and their medical technique,the doctor-patient relationship could be divided into three typies-equality type,authority type,and principal and subordinate type.With a view of doctor-patient relationship of traditional Chinese medicine,there draws an acquisition value of the current complex patient relationship.

Objective To investigate the effect of ultrasound-guided transverses abdominis plane (TAP)block on the efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy. Methods Sixty ASA Ⅰ - Ⅱ patients scheduled for abdominal hysterectomy under general anesthesia were randomly divided into 2groups (n = 30 each): ropivacaine group (group R) and normal saline (group NS). After induction of anesthesia,ultrasound-guided bilateral TAP block was performed, and 0.375% ropivacaine 40 ml was injected in group R,while the equal volume of normal saline was used instead in group NS. The patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after operation. The VAS score was maintained ≤ 3, the level of sedation was evaluated with Ramsay sedation score, and the comfort level was evaluated with Bruggrmann comfort scale (BCS) score at 2, 6, 8, 12 and 24 h after operation. The hemodynamic parameters were recorded. The consumption of sufentanil during operation and within 24 h after operation, the number of successfully delivered doses ( D1 )and the number of attempts ( D2 ) within 24 h after operation were recorded. D1/D2 was calculated. The adverse reactions were also recorded. Results SP, DP, HR, SpO2 and RR were in the normal range and there was no significant differences between the two groups ( P ＞ 0.05). The consumption of sufentanil were significantly lower,while the BCS score and D1/D2 higher in group R than in group NS (P ＜ 0.05). There were no adverse reactions in both groups. Conclusion Ultrasound-guided TAP block reduces the perioperative sufentanil consumption and enhances the efficacy of postoperative analgesia in patients undergoing abdominal hysterectomy.