0.05). PetCO 2 was a reliable index reflecting PaCO 2. There was a significant difference between PetCO 2 and PaCO 2 in the Group Ⅲ (P

Objective To determine the median effective target effect-site concentration (EC50) of sufentanil when intraoperative wake-up test was successful in patients undergoing scoliosis surgery.Methods Ninety ASA Ⅰ or Ⅱ patients,aged 18-64 yr,with body mass index ＜ 30 kg/m2,scheduled for scoliosis surgery under sevoflurane and sufentanil anesthesia,were randomly divided into Ⅰ-Ⅵ groups (n =15 each).Anesthesia was induced with sufentanil,etomidate and cisatracurium,and maintained with sevoflurane,sufentanil and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Before the wake-up test,infusion of cisatracurium was stopped and the end-tidal concentration of sevoflurane was adjusted to 0.The EC50 was determined by the K(a)rber method.The target effect-site concentration of sufentanil was set at 0.19 ng/ml in group Ⅰ,0.18 ng/ml in group Ⅱ and gradually decreased in decrements of 0.01 ng/ml.The wake-up test was performed 5 min later.The EC50 and 95 ％ confidence interval of sufentanil were calculated by the K(a)rber method.Results EC50 of sufentanil obtained was 0.164 ng/ml and 95％ confidence interval of sufentanil obtained was 0.157-0.172 ng/ml when the wake-up test was successful.Conclusion The EC50 of sufentanil is 0.164 ng/ml when the intraoperative wake-up test is successful in the patients undergoing scoliosis surgery.

Objective To study wether dezocine (DZ) can attenuate neuropathic pain in rats and to investigate its mechanism.Methods Neuropathic pain was induced by tight ligation of the left L5 spinal nerve of the male SD rats. 24 Spinal nerve ligation (SNL) model rats were randomly divided into three groups:the first group (saline group, n=8), rats were given intraperitoneal injection of 1ml of saline 14 days after SNL surgery; the second group (dezocine group, n=8), rats were given intraperitoneal injection of 5mg/kg of dezocine in 1ml saline 14 days after SNL surgery;the third group (morphine group,n=8),rats were given intraperitoneal injection of 5 mg/kg of morphine 14 days after SNL surgery. Results Intraperitoneal injection dezocine and morphine had significant analgesic effect in neuropathic pain rats. This analgesic effect lasted for 4-6 hours.Continuous injection of morphine for 3 days produced significant tolerance, while continuous injection of dezocine for 7 days still had significant analgesic effect on neuropathic pain. Conclusion Intraperitoneal injection of dezocine and morphine can attenuate SNL neuropathic pain, continuous injection of morphine for 3 days can produce significant tolerance, while continuous injection of dezocine for 7 days still has significant analgesic effect on neuropathic pain.

Objective To monitor the resistance of Streptococcus pneumoniae following the 2004 in Qingdao area, and to provide a reasonable basis for clinical application of antimicrobial agents. Methods Collecting respiratory tract, blood, cerebrospinal fluid and other specimens from out-patient and in-patients of some hospital in Qingdao from January 2005 to December 2008. According to the recommendation of NCCLS, antibiotic resistance analysis of 11 kinds of antibiotic to the isolated 231 Streptococcus pneumoniae by micro-agar dilution method, and analysis resistance trends and age differences. Results The results showed that the rate of Streptococcus pneumoniae not sensitive to penicillin is 23. 38% (PRSP: 9.52% , PISP: 13. 85% ) , resistant to cefotaxime is 9. 96% (23/231), resistant to amoxicillin is 12. 55% , resistant to erythromycin is 90. 48% (209/231). PRSP rate of patients younger than 14 years of age 27. 91% (12/43), significantly higher than that of the PRSP rate of adults 5. 38% (10/186). Conclusion The rate of resistant to penicillin Streptococcus pneumoniae increased significantly from 2004, and an increasing trend year by year, the resistance of Streptococcus pneumoniae is also a rising trend year by year. For patients infected low penicillin-resistant Streptococcus pneumoniae in this region, cefotaxime, amoxicillin are preferred drugs.

OBJECTIVE To study and evaluate the value of the antibiotic-neutralized culture bottle applied by manual operations.METHODS A total of 711 blood samples were collected from clinical high fever patients in Qingdao Central Hospital from 2002 to 2005.To compare the bacteria detected rates,cultural time and bacteria types in 399 samples cultured in manual blood-culture bottles with those in 312 samples cultured in antibiotic-neutralized culture bottles applied by manual operations.RESULTS The bacteria detected rates were 10.28% in manual blood-culture bottles and 20.83% in antibiotic-neutralized culture bottles applied by manual operations.There was significant difference between both of them(P72h were no statistical difference between manual blood-culture bottles and antibiotic-neutralized culture bottles.Twenty species of bacteria were detected in manual blood-culture bottles and 29 species of bacteria in antibiotic-neutralized culture bottles applied by manual operations.CONCLUSIONS The bacteria detected rate and species of bacteria were more obviously raised in antibiotic-neutralized culture bottles applied by manual operations than in manual blood-culture bottles.

Double-blind randomized controlled trial design is the most recognized scheme of therapeutic experimental design.On the assessment of the efficacy of traditional medicine, randomized controlled clinical trial design also has the same value.Only when using the research method towards epidemiology to perform the rigorous design on the clinical trial of traditional medicine and make the objective evaluation of its effect, can it get the real understanding and approval from modern medicine.When making the therapeutic clinical trial under the traditional medicine, due to the characteristics of the subject, therapeutic measures usually need to be changed so they cannot be standardized, and the modification may result in the share of multiple intervention components, which leads to the inaccurateness of results under the effect of confounding bias.According to the characteristics of traditional medicine, a new method was proposed for therapeutic clinical trial.Firstly do the randomization with the inclusion criteria made by the same symptom arise in a certain stage of disease, secondly adopt the standardized intervention measures for processing.Eventually confirm whether there is significant statistical difference.The symptom directing standardized interventions have provided the experimental design of the traditional medical clinical therapy with a feasible scheme, which can solve several problems existing in this design.

Objective To investigate the effect of propofol anesthesia on stress response and immune function of laproscopic cholecystectomy.Methods Corticosterone,glucose,complement concentrations in plasma of 20 ASAⅠ～Ⅱ patients under propofol combined anesthesia undergoing elective laproscopic cholecystectomy,were respectively determined before anesthesia,operation,gallbladder ablation and after de-intubation.Results After anesthesia,blood glucose increased while C3 and CH50 decreased gradually(P

Objective To evaluate the effect of dexmedetomidine on intraoperative wake-up test in patients undergoing scoliosis surgery.Methods Sixty ASA Ⅰ patients,aged 13-18 yr,scheduled for elective scoliosis surgery,were randomly divided into 2 groups (n =30 each) ∶ sufentanil group (group S) and dexmedetomidine combined with sufentanil group (group DS).Anesthesia was induced with sufentanil,etomidate and cisatracurium,and maintained with target-controlled inhalation of sevoflurane combined with target-controlled infusion of sufentanil in both groups.In group DS,dexmedetomidine 0.2 μg·kg-1 · h-1 was infused during operation,while the equal volume of normal saline was given instead in group S.Before the wake-up test,cisatracurium infusion was stopped,the end-tidal concentration of sevoflurane was adjusted to 0,and the target effect-site concentration of sufentanil was adjusted to 0.1 and 0.08 ng/ml in groups S and DS,respectively.The wake-up test was performed 5 min later.The wake-up time and bucking/restlessness and cardiovascular events during the wake-up test were recorded.The occurrence of intraoperative awareness was recorded in the patients who were followed up after operation.Results No cardiovascular events occurred during the wake-up test in group DS.The wake-up time was significantly shorter and the incidences of cardiovascular events and bucking/restlessness were significantly lower in group DS than in group S (P ＜ 0.05).No intraoperative awareness occurred in the patients.Conclusion Dexme-detomidine can be used for intraoperative wake-up test in patients undergoing scoliosis surgery,with shorter wakeup time,stable hemodymamics and fewer adverse reactions.

Objective To investigate the effect of the intraoperative wake-up test on the postoperative delirium in patients undergoing scoliosis operation under analgesia with sufentanil. Methods Sixty ASA Ⅰ or Ⅱ patients , aged 12-60 yr, scheduled for scoliosis surgery, were randomly divided into 2 groups ( n = 30 each) : control group (group C) and intraoperative wake-up test group (group W) . The intraoperative wake-up test was not performed during operation in group C. Anesthesia was induced with target-controlled infusion of sufentanil with the target effect-site concentration set at 0.5 ng/ml and iv injection of propofol 1-2 nig/kg. As soon as the patients lost consciousness, tracheal intubation was facilitated with 0.15 mg/kg cisatracurium besylate. The patients were mechanically ventilated. Anesthesia was maintained with target-controlled inhalation of sevoflurane (target end-tidal concentration 0. 8%-1. 5%), target-controlled infusion of sufentanil (target effect-site concentration 0.2-0.3 ng/ml) and iv infusion of cisatracurium besylate 0.1 mg- kg-1·h-1 . In group W, the patients underwent the intraoperative wake-up test. Postoperative analgesia was provided with sufentanil. The occurrence of intraoperative awareness and postoperative delirium was recorded. Results No significant difference was found in the incidences of intraoperative awareness and postoperative delirium between the two groups. Conclusion The intraoperative wake-up test is not the risk factor for postoperative delirium in patients undergoing scoliosis surgery under analgesia with sufentanil, and inhibition of perioperative pain and intraoperative awareness by analgesia with sufentanil may be involved in the mechanism.

ObjectiveTo compare the intraoperative wake-up test in patients undergoing scoliosis surgery with different anesthesia methods.MethodsForty ASA Ⅰ patients aged 13-18 yr with body mass index ＜ 30 kg/m2 scheduled for scoliosis surgery were randomly divided into 2 groups ( n =20 each): propofol combined sufentanil anesthesia group (group P) and sevoflurane combined sufentanil anesthesia group (group S).Anesthesia was induced with target-controlled infusion of sufentanil(target effect-site concentration 0.5 ng/ml),and iv injection of etomidate 0.3 mg/kg in both groups.Tracheal intubation was facilitated with 0.15 mg/kg cisatracurium when patients lost consciousness.The patients were mechanically ventilated.Anesthesia was maintained with target-controlled inhalation of sevoflurane (target end-tidal concentration 0.8％-1.5％ ) in group S,and target-controlled infusion of propofol (target plasma concentration 3-5 μg/ml) in group P,and target-controlled infusion of sufentanil (target effect-site concentration 0.2-0.3 ng/ml),and iv infusion of cisatracurium 0.1 mg· kg-1· h-1 in both groups.BIS value was maintained at 40-60.Cisatracurium administration was terminated and target effect-site concentration of sufentanil decreased to 0.1 ng/ml before wake-up test,5 min later,sevoflurane and propofol administration were terminated,and 5 min later wake-up test was performed.MAP and HR were recoreded during wake-up test.The wake-up time and advers effect (bucking,restlessness and awareness)were recorded.Results The wake-up time was significantly shorter in group S than in group P( P ＜ 0.05).MAP and HR were in normal range during wake-up test in both groups,and bucking,restlessness and awareness were not found in both groups.ConclusionTarget-controlled inhalation of ssvoflurane combined with sufentanil can be safely and effectively used for intraoperative wake-up test in patients undergoing scoliosis surgery,and the wake-up time is shorter than that with propofol combined sufentanil,and it is an apporiate anesthetic technique for the intraoperative wake-up test.