Objective: To evaluate the feasibility and safety of postoperative patient-controlled epidural analgesia (PCEA)in children. Methods: Forty postoperative pediatric patients(5-11 years old)were divided into two groups. A and B. Both wereinstituted with postoperative PCEA with LCP model (loading dose 2.05 + 0.13ml), continuos infusion rate 0.82 + 0.15mi/h, PCA dose 0.81 + 0.16ml)by Graseby-9300 PCA pump. The PCEA solution of group A was 0.075% bupivacaine plus0.0012 % buprenorphine, that of group B was same while 0. 005% droperidol was added as an adjuvant. Results:The volumeof PCEA sdution consumption in group B was significantly less than that in group A on the first and second postoperative day (P< 0.01-0.05). Good analgesic efficiency with little side effects was obtained, as evaluated by the VASF emasay or D/D score and complications in two groups, but the analgesic effect of group B was better than that of group A. Conclusion: Thepediatric PCEA with low concentration of bupivaeaine plus buprenorphine is feasible and safe. Droperidol may enhance theanalgesic effects of PCEA.

Objective:To evaluate the safety of patient controlled epidural analgesia (PCEA)for elderly patient. Method: Forty two adult patients after operation were divided into control group(44.4?7.8a)and old group(70.9?5.la) according to their ages. All patients reeeived epidural 0.125% bupivacaine and 0.01% morphine mixture for PCEA. BP,HR, RR and SpO_2 were monitored for the first 24 hours following PCEA. Result: The dosage of the mixture was 33.3?6.8ml in control group and 31.6?8.7ml in old group. BP,HR didn't alter markedly in both groups throughout the whole period. RR and SpO_2 remined normal levels. Conclusion: With adequate dosage PCEA can be used safely for elderly postoperative analgesia

Objective To investigate the effect of flurbiprofen axetil on perioperative plasma levels of prostaglandin E2 (PGE2) and β-endorphine (β-EP) in patients after remifentanil-based anesthesia.Methods Sixty ASA Ⅱ patients of both sexes,aged 40-64 yr,weighing 50-75 kg,undergoing resection of esophageal cancer,were randomly divided into 3 groups (n =20 each):intralipid group (group A),flurbiprofen axetil pretreatment + postoperative analgesia with flurbiprofen axetil group (group B) and flurbiprofen axetil pretreatment group (group C).Anesthesia was induced with propofol,remifentanil and rocuronium and maintained with propofol,remifentanil and intermittent iv boluses of rocuronium.In group A,intralipid 0.2 ml/kg was injected intravenously at 30 min before operation and patient-controlled intravenous analgesia (PCIA) with fentanyl 15μg/kg + intralipid 0.2 ml/kg was used for postoperative analgesia.In group B,flurbiprofen axetil 2 mg/kg was injected intravenously at 30 min before operation and PCIA with fentanyl 15 μg/kg + flurbiprofen axetil 2 mg/kg was used for postoperative analgesia.In group C,flurbiprofen axetil 2 mg/kg was injected intravenously at 30 min before operation and PCIA with fentanyl 15 μg/kg + intralipid 0.2 ml/kg was used for postoperative analgesia.PCIA solution contained fentanyl 15 μg/kg,flurbiprofen axetil 2 mg/kg and intralipid 0.2 ml/kg in 100 ml of normal saline.The PCA pump was set up with a 0.5 ml bolus dose,a 10 min lockout interval and background infusion at a rate of 2 ml/h after a loading dose of 5 ml starting from 30 min before the end of operation.VAS score was maintained ＜ 3 after operation,and tramadol 50 mg was injected intravenously when VAS ≥ 4 after operation.The amount of remifentanil used during operation and the number of successfully delivered doses and the number of attempts,requirement for tramadol,apnea and severer hypotension were recorded within 48 h after operation.Blood samples were taken immediately before induction of anesthesia,at the end of operation,24 and 48 h after operation (T1-4) for determination of plasma β-EP and PGE2 concentrations.Results There was no significant difference in the amount of remifentanil used among the three groups (P ＞ 0.05).Compared with group A,the number of successfully delivered doses,the number of attempts and the requirement for tramadol were decreased,and the concentration of plasma PGE2 at T2,3 were significantly decreased in groups B and C,and the concentrations of plasma β-EP at T3,4 in group B and at T4 in group C were significantly increased (P ＜ 0.05).Compared with group B,the number of successfully delivered doses,the number of attempts and requirement for tramadol were significantly increased,and the concentration of plasma β-EP at T3,4 wassignificantly decreased in group C (P ＜ 0.05).Compared with the baseline value at T1,the concentrations of PGE2 were significantly increased at T2,3,and the concentration of plasma β-EP was significantly increased at T2,but decreased at T4 in group A,and the concentrations of β-EP at T3,4 were significantly increased in group B (P ＜ 0.05).There was no significant difference in the concentrations of PGE2 and β-EP between the four time points in group C (P ＞ 0.05).Apnea and severer hypotension were not found in the three groups.Conclusion The mechanism by which flurbiprofen axetil reduces postoperative opioid tolerance in patients after remifentanil-based anesthesia may be related to the decrease in PGE2 levels and increase in β-EP levels.

Objective To study the early and mid-term outcome in terms of left ventricular(LV)geometry and function in patients with transposition of great arteries with intact ventricular septum (TGA/IVS) undergoing arterial switch operation.Methods Twenty patients were followed up and divided into 2 groups according to age:the earlier group and the later group.Age and sexual matched controls were also designed as control group 1 and control group 2.LV posterior wall thickness(PWTd),dimension(LVIDd)and length(L) at end diastolic phase,LV end-diastolic volume (EDV),end-systolic volume (ESV),ejection fraction (EF),mitral valve early (E) and late (A) inflow velocities and E/A,isovolumic relaxation time (IVRT) were obtained by two-dimensional echocardiography,normalized isovolumic relaxation time (IVRTn),wall thickness index (PWTd/LVIDd) and LV geometry index(LVIDd/L) were calculated,and these indexes between groups were compared.Results ①Compared with control group 1,PWTd in earlier group was higher [(0.41 + 0.06)cm vs (0.36 + 0.05)cm,P =0.022],but LVIDd had no significant statistical difference [(2.08 + 0.21)cm vs (2.21 + 0.23)cm,P =0.117],indicating PWTd/ LVIDd differed between groups(0.20 + 0.04 vs 0.16 + 0.01 P =0.001).②No abnormalities were observed in later group.③Compared with different age groups in TGA,EDV,ESV,L,LVIDd,PWTd were significantly higher in later group(P =0.000).There were obvious correlations between EDV,ESV,L,LVIDd and examined age (r =0.90,0.83,0.73,0.90,P =0.000,R2 =0.809,0.694,0.528,0.808) while there were no significant correlation between PWTd and examined age(r =0.56,P =0.000,R2 =0.309).Conclusions Early after operation,LV is undergoing hypertrophy or hyperplasia in TGA/IVS,but will recover in the mid-term period,and the function is normal all the time indicating that the LV myocardium may avoided irreversible pathological changes if operated in time.All in all,LV develops well in mid-term period.

Objective To investigate the clinical efficacy of ultrasound-guided and nerve stimu-lator-guided modified fascia iliaca compartment block combined with popliteal fossa sciatic nerve block in patients undergoing unilateral great saphenous varicose veins surgery.Methods Sixty patients, male 32 and female 28,aged 42-76 years,ASA Ⅰor Ⅱ,scheduled for unilateral great saphenous var-icose veins surgery were randomly divided into two groups (n =30 each):modified fascia iliaca com-partment block with popliteal fossa sciatic nerve block group(group N)and epidural anesthesia(group E).Firstly,popliteal fossa sciatic nerve block was performed in group N.Then confirmed iliac fascia and femoral nerve position on the ultrasonic image and the femoral nerve was blocked.The 1% lido-caine 10 milliliters and 0.5% ropivacaine 10 milliliters were injected in the fascia iliaca compartment block from medial border of sartorius to upward site of femoral artery.Meanwhile,the ultrasonic probe was moving inside in the level of inguinal ligament.The SBP,DBP and HR were recorded be-fore block(T0 ),10(T1 ),30(T2 )and 60 minutes(T3 )after block.The block working time and onset time of sensory block,use of ephedrine after anesthesia,anesthesia efficacy and the postoperative ad-verse reactions in the last 48 hours ,including nausea,vomiting,headache and urinary retention, were also recorded.Results Compared with T0 ,the SBP and DBP was significantly decreased at T2 in group E(P <0.05).Compared with group E at the same time,the SBP and DBP was significantly higher at T2 in group N(P <0.05).The onset time of sensory block was significantly shortened and the use of ephedrine after anesthesia was also less in group N(P <0.05 ).Group E was better than group N in the whole anesthesia efficacy (P <0.05),but there was no significant difference in the ex-cellent rate of anesthesia efficacy between the two groups.The incidence of postoperative urinary re-tention was significantly decreased in group N(P <0.05)and there was no significant difference of the rate of nausea,vomiting and headache.Conclusion Modified fascia iliaca compartment block with popliteal fossa sciatic nerve block has excellent anesthetic quality in patients undergoing unilateral great saphenous varicose veins surgery,which ensures more stable hemodynamics less side effects and more indications when compared with epidural anesthesia.

Objective To design the family support scale for adolescent patients with nephritic syndrome. Methods 192 adolescent patients with nephritic syndrome were selected in the pilot investigation, and then formed the first questionnaire. The reliability and the validity of the questionnaire were evaluated by the experts. Results The questionnaire involved 15 items and its reliability and the validity were satisfied. There was a positive correlation between the family support and the self-nursing degree. Conclusion The reliability and the validity of this questionnaire are both up to the demands, it can used to study the condition of family support for adolescent patients with nephrotic syndrome.

Aim To investigate the effects of glycyrrhizin on the proliferation of ASMC stimulated by fetal calf or histamine in rats. Methods Cell culture of rat ASMC, MTT assay, flow cytometry and cell growth counts were used in this study. Results ①In the culture medium containing 100g?L -1 fetal calf serum, Glycyrrhizin at low concentration(6?10 -5 mol?L -1 ) stimulated the increase of A 570 in ASMC. This effect descended with increasing glycyrrhizin concentration and changed to be inhibitory at high concentration (from 384?10 -5 mol?L -1 to 1 536 ?10 -5 mol?L -1 ). In the culture medium containing 10 -2 mol?L -1 histamine, Glycyrrhizin at both low and high concentration inhibited the increase of A 570 in ASMC. ②In the culture medium containing 100 g?L -1 fetal calf, Glycyrrhizin at low concentration(6?10 -5 mol?L -1 ) stimulated the proliferation of ASMC. This effect descended with increasing glycyrrhizin concentration and changed to be inhibitory at high concentration (from 384?10 -5 mol?L -1 to 1 536 ?10 -5 mol?L -1 ). In the culture medium containing 1 g?L -1 histamine, Glycyrrhizin at both low and high concentration inhibited the proliferation of ASMC. ③In the culture medium containing 100 g?L -1 fetal calf or 10 -2 mol?L -1 histamine, with increasing glycyrrhizin concentration, the cell count in G 1 phase increase, the cell count in G 2 and M phase decrease. Conclusion ①Glycyrrhizin accelerated the proliferation of ASMC stimulated by fetal calf at low concentration, inhibited the proliferation at high concentration. ②Glycyrrhizin inhibited the proliferation of ASMC stimulated by histamine at both low concentration and high concentration.

Objective To explore the epidemiological features of the metabolic syndrome in a cohort study of Xiangtan Mengkuang in China.Methods The prevalence rate,means and standard deviation of various risk factors associated with metabolic syndrome were analysed on the basis of base-line survey of risk factors of 5792 subjects(aged 25 years-old～) in 2004.Results (1)The prevalence rate of metabolic syndrome was 12.9%(12.4% in males,and 13.7% in females,P

Objective To explore the effect of morning nursing round and direction for key patients in geriatric comprehensive surgery department.Method Four hundred and twenty-six patients from January to December,2012 were assigned to control group,where routine morning nursing round was carried out.Another 453 patients from January to December in 2013 were assigned to observation group,where the morning nursing round and direction for key patients was carried out.The two groups were compared in terms of the general nursing quality,the rate of nurses knowing the disease condition and the rate of professional knowledge acquisition. Result After the application of morning nursing round for key patients,the general nursing quality,the rate of nurses knowing disease conditions and the rate of professional knowledge acquisition in the observation group were all significantly higher than those the control group(all P<0.05).Conclusion The morning nursing round and directions for key patients may remarkably improve the rate of nurses’knowing the disease conditions and professional knowledge acquisition and general nursing quality so that their professional skills and comprehensive quality can be further upgraded.