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 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 value of Univent tube in the airway management during one-lung ventilation. Methods A total of 40 patients with pneumothorax undergoing video-assisted thoracoscopic surgery (VATS) were randomly divided into Univent (U) and double-lumen tube (Robertshaw) (D) groups (20 in each). In U group, intubation was performed under the guidance of a fibreoptic bronchoscope; while in D group, the position of the tube was confirmed using fibreoptic bronchoscopy after intubation. The time of intubation, number of secondary dislodgements, quality of lung deflation, peak airway pressure during one-lung ventilation, and blood artery gas analysis data in the two groups were recorded 30 minutes after one-lung ventilation. Results The intubation time in U group was significantly longer than that in D group [(6.18?1.26) min vs (3.26?0.82) min, t=8.654, P=0.000]. The number of secondary dislodgements was 7 in U group, and 5 in D group(U=187.500, P=0.663). No significant difference was detected in the quality of lung deflation between the two groups, (U group: 15 excellent, 3 fair, and 2 poor; D group: 17 excellent, 2 fair, and 1 poor;U=179.500, P=0.583). The peak airway pressure during one-lung ventilation in U group was significantly lower than that in D group [(15.3?3.5) cm H2O vs (21.4?6.6) cm H2O, t=-3.649, P=0.001]; and the oxygen pressure in group U was significantly higher than that in group D [(303.8?65.7) mm Hg vs (258.4?72.9) mm Hg, t=2.066, P=0.046]. No significant difference was found in carbon dioxide pressure and oxygen saturation between the two groups. Conclusion During VATS, univent tube showed the same effectiveness and safety as DLT for one-lung ventilation.

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.

A series of 6 novel 2-amino-4, 5-diarylpyrimidines were synthesized by the reaction of isoflavones with guanidine. They were identified by the spectra of IR, 1H NMR, 13C NMR and elemental analysis. The protective effects of 2-amino-4, 5-diarylpyrimidines against oxygen-glucose deprivation leading by sodium hydrosulfite in PC12 cells were studied by MTT method. It was shown that 2-amino-4, 5-diarylpyrimidines exhibited neuroprotective effects against oxygen-glucose deprivation injury in PC12 cells, which could increase the amount of survival PC12 cells and reduce their injured degree in the model.

Objective To design a method for detecting multileaf collimator (MLC) leaf position accuracy in implementing a static intensity-modulated plan and to analyze the impacts of leaf errors on dose of targets and normal organs.Methods Static intensity-modulated planning for twenty lung cancer cases through dose verification was sorted in an ascending order according to the number of segment,and then the first and the last 10 plans were sorted as the simple plan group and the complex plan group,respectively.These plans were transmitted to a Varian 600CD accelerator and implemented by it.Photos were taken with PV aS500 electronic portal imaging device (EPID) and actual position of leafs was determined by gradient algorithm to calculate the pass rate for leaf verification.MLC files were modified according to examination results and the plans were re-calculated while keeping other parameters unchanged.Thus,difference of targets and normal organs dose distribution before and after the appearance of leaf errors were obtained.Results The dose distribution of most organs after leaf errors were increased or decreased,and the maximum dose of spinal cord in the sixth and thirteen cases exceeded the limit of 45 Gy.In the group of simple plan only the changes of maximum dose to the spinal cord were statistically significant(t =-3.08,P ＜ 0.05),while in the group of the complex plan all changes of D95％ of PGTV and PTV,maximum dose of the spinal cord,V20 of lung and V40 of heart were statistically significant(t =-1.89,-1.99,-2.36,-2.55,-1.85,P ＜ 0.05).Conclusions To ensure the safety and effects,it was necessary to detect leaf position,particularly the complex intensity-modulated planning.Electronic portal imaging devices and treatment planning system could detect leaf positions during the implementation of a plan and obtain the actual dose of targets and normal organs.

Objective To compare and observe the effect of GASMAN software computer aided and traditional teaching method in the teaching of inhalation anesthesia. Methods 48 members of interns who need to enter the inhalation anesthesia department to study the theory of inhalation anesthesia were ran-domly divided into either GASMAN software group or traditional group with 24 people in each group, using the above two methods to carry on the study of inhalation anesthesia. After the end of the teaching course, the study effect and the satisfaction degree of the two groups of students were investigated by the written exam and questionnaire. SPSS 11.5 was used for statistical analysis, using±s to express measurement data. The results of the examination were compared with the independent sample t test, and the satisfaction survey feedback was compared with chi square test, The difference was statistically significant (P<0.05 ). Result The mean score of GASMAN software group (95.4 ±2.7) was significantly higher than that of tra-ditional group (85.0 ±3.5) (t=11.5,P=0.000). Satisfaction survey results showed that GASMAN computer assisted instruction software learning was easier for students to accept, and there were significant difference between two groups (P=0.001). Conclusion Teaching mode of GASMAN software is a good learning technique of inhalation anesthesia, which is worthy of promotion.

Objective: To study the chemical constituents of Bletilla striata (Thunb. ) Reichb. f. Methods: The con-stituents were separated and purified by column chromatography with silica gel and Sephadex LH-20,and were identified byspectral analysis. Results: Five compounds were identified as: 2, 7-dihydroxy-4-methoxy-9, 10-dihydrophenanthrene (1), 2, 7-dihydroxy-3, 4-dimethoxyphenanthrene (2), 3, 7-dihydroxy-2, 4-dimethoxyphenanthrene (3 ), 3', 3--dihydroxy--5-methoxybiben-zyl(4), p-hydroxybenzaldehyde (5), Conclusion: Compound 2, 3, 4 are isolated from this plant for the first time.

It’s still controversial whether there is specificity of acupoints, because numerous studies showed that stimulation to acupoints and sham acupoints produced parallel clinical efficacies. For example, acupoint specificity was not detected when Visual Analogue Scale was adopted to evaluate pain, while hemodynamic and neuroimaging studies suggested the existence of acupoint specificity. This article reviewed and summarized relevant studies that supported or didn’t support acupoint specificity. Further researches are required to prove the existence of specificity of acupoints.