Objective To compare the difference of ultrasound-guided anterior sciatic nerve block by multiple injection and single injection.Methods Among 90 patients undergoing lower limb operation,aged 18-68 years old,47 patients were males and 43 patients were females,all falling into ASA Ⅰ-Ⅲ.The patients were randomized to ultrasound-guided anterior sciatic nerve block by multiple injection (group M,n=45) single injection (group S,n=45).Local anesthetic of 0.5% ropivacaine hydrochloride 20 ml was used.The width,thickness and depth of sciatic nerve and blocking performance time were recorded.Sensory and motor blockade on the operated limb were evaluated every 10 minutes after injection of local anesthetic for 30 minutes and complications were observed in two groups.Results The width,thinkness and depth of sciatic nerve on the ultrasound screen were not statistically significant in the two groups.The performance time of group M was longer than that of group S (P<0.05).The proportion of patients with sensory blockade of each nerve significantly differed between the two groups: for superficial peroneal nerve at 10,20,and 30 minutes,for the sural nerve at 20,30 minutes,for the tibial nerve at 30 minutes,that of group M was higher than that of group S (P<0.05).A significantly greater rate of motor blockade was observed for the dorsal flexion of foot and toes extension in group M than that of group S at 30 minutes (P<0.05).The complications of nausea,vomitting and tinnitus were not different in two groups.Conclusion Multiple injection needs more operation time compared with single injection,but its onset time of sensory and motor blockade is quicker,the complications were not different.

AIM: To investigate the effect of angiotensinⅡon Cx43 gap junction in cultured neonatal rat cardiac myocytes and its mechanism. METHODS: The cardiomyocytes were treated with AngⅡ for 24 h, which were pretreated with valsartan or PD98059 for 60 min before AngⅡ treatment. The controls were treated with equal amount of DMSO. The Cx43 expression, synthesis and gap junction in cardiomyocytes were characterized by Western blotting, metabolic labeling and immunoprecipitation assay, and electron microscope. RESULTS: Western blotting analysis revealed that Cx43 content concentration-dependently increased in cells treated with 10 -9-10 -6 mol/L AngⅡfor 24 h. Phosphorylated extracellular signal regulated kinase (P-ERK) 1/2 activity increased in cells treated with 0.1 ?mol/L AngⅡ for 24 h (P

Objective To evaluate the value of the TIMI risk index in predicting 30-day and one-yosr mortality and incidence of heart failure in patients with ST-elevation myocardial infarction (STEMI).Method Data of 229 patients with STEM1 from August 1999 to March 2006 in the First Affiliated Hospital,Sun Yat-sen University,were retrospeclively collected,analyzed and scored with TIMI risk index.When categorized into quintiles(≤12.5,12.5～17.5,17.5～22.5,22.5～30,>30) and modeled as a continuous variable,difference of prediction of 30day and one-year mortality and 30-day incidence of heart failure of patients were compared respectively.Results When categorized into quintilos and modeled as a continuous variable,30-day and one-year mortality and 30-day incidence of heart failure were increasing with increasing score of risk index (P<0.05).The area under the recewer operating characteristic curve were 0.65,0.68,0.67 and 0.70,0.72,0.70,respectively.Conclusions The TIM1 risk index can be used as a simple,rapid and practical tool to risk-stratify patients with STEMI.

Objective To identify the prevalence and profile of psychological difficulties in a sample of women seeking the breast reconstruction, and to study the effect of the reconstructive surgery on their psychology. Methods Before and after the breast reconstruction, 50 breast-loss women were tested with the self-rating anxiety scale (SAS), the self-rating depression scale (SDS), the self-esteem scale (SES),the self- rating body dysmorphic disorder scale (SBDDS), and the Eysenck personality questionnaire (EPQ), respectively. The proportion of the abnormally psychological patients was counted, their personality characters were analyzed, and the postoperative psychological changes were obverved. Results It was found that the 64 percent of the breast-loss patients were in anxiety, 30 percent were in depression, and 18 percent were in body dysmorphic disorder. The characteristics of their personality were more extravert, sociable and easily emotional agitation. The scores in SES of the preoperative patients were 27.46±8.95, and those of the postoperative patients were 33.05±6.12 (P＜0.05). The scores in SBDDS of the preoperative patients were 25.74±13.23, and those of the postoperative patients were 18.22±8.08 (P＜0.05).Conclusion The proportion of the anxiety, depression and BDD is high in the breast-loss women, and the postoperative psychology of esteem and body dysmorphic disorder is improved effectively.

Objective To observe the difference of quadratus lumborum block (QLB)and transversus abdominis plane (TAP)block combined with patient controlled intravenous analgesia with sufentanil in analgesia after appendectomy.Methods Seventy-seven patients undergoing appendecto-my,including 44 patients males and 33 patients females,all falling into ASA Ⅰ or Ⅱ,were random-ized into group QLB (n =39)and group TAP block (n =38).Ultrasound-guided QLB and TAP block was performed at the end of operation and 0.25% ropivacaine hydrochloride 20 ml was used.Postop-erative VAS score and the consumption of sufentanil at 4,8,12,24 and 48 h was recorded.Postoper-ative nausea and vomiting,dizziness,skin itching were recorded.Results Patients in group QLB used significantly less sufentanil than that of group TAP (P <0.05 )at 12,24,48 h and VAS score has no differences after operation.Side effects like postoperative nausea and vomiting [2(5.1%)vs 8(21.0%)], and dizziness [4(10.2%)vs 11(28.9%)]were significantly less (P <0.05).Conclusion QLB can more effectively reduce postoperative sufentanil consumption and side effect than TAP block.