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 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 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 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 observe the effect of Tongfu Xiere Recipe (TXP) combined with routine treatment on cytokine level in patients with acute lung injury due to surgery disease of chest. Methods Fifty eight patients with acute lung injury due to surgery disease of chest were randomized into two groups. The two groups received routine treatment subjecting to the Guideline (2006) for Diagnosis and Treatment of Acute Lung Injury/Acute Respiratory Distress Syndrome. The treatment group additionally received TXP (mainly composed of Radix et Rhizoma Rhei, Natrii Sulfas, Fructus Gardeniae, Caulis Lonicerae, Herba Taraxaci, Semen Raphani, Semen Lepidii seu Descurainiae, Rhizoma Polygoni Cuspidati, Radix Paeoniae Rubra, Fructus Aurantii Immaturus, and Cortex Magnoliae Officinalis) for 5 days or till oxygenation index recovered to the normal. The therapeutic effect was evaluated after treatment, and the changes of blood tumor necrosis factor ? (TNF-?), interleukin 6 (IL-6) and interleukin 8 (IL-8) levels were observed before and after treatment. Results The serum levels of TNF-?, IL-6 and IL-8 in the two groups after treatment were decreased (P0.05). Conclusion The therapeutic effect of traditional Chinese medicine integrated with western medicine is superior to the western medicine only for acute lung injury due to surgery disease of chest. TXP can regulate the immune function and relieve the pulmonary inflammation and injury by decreasing the blood levels of TNF-?, IL-6 and IL-8, thus enhance the therapeutic effect of western medicine.

Objective To compare the antioxidant activity between phenolic and nonphenolic alkaloids in Nelumbo Nucifera Gaertn.in vitro. Methods DPPH, ABTS, hydroxyl radical scavenging, super oxygen anion from oxidation, reducing power and beta carotene bleaching test methods were used to evaluate the antioxidant activity of the alkaloids. Results Half maximalinhibitory concentration ( IC50 ) of DPPH among total alkaloid, phenolic alkaloids and nonphenolic alkaloids was 21.89, 27.10 and 32.87 μg·mL-1 , respectively;IC50 of ABTS free radicals was 14.25, 20.55, 25.94μg·mL-1;The hydroxyl radical scavenging IC50 was 0.03, 0.03, 0.08 μg·mL-1; The auto-oxidation rate of super oxygen was 8.72×10-4, 5.87×10-4, 6.68× 10-4;The total alkaloid had the best reducing power, while the non-phennolic alakloids had the worst; Lipid inhibition rate of three alkaloids were 89.63%, 85.85% and 83.78% respectively. Conclusion Phenolic alkaloids are better than non-phenolic alkaloids in hydroxyl radical scavenging, reducing power and anti-lipid peroxidation, resulting in a promising prospect.

Objective To investigate the clinical effect of forced-air warming system combined with infusion heating technology on recovery quality and cellular immune.Methods Fifty patients scheduled for esophagus cancer resection randomized into two groups (n =25 each):the temperature protection group (group W)and the control group (group C).The intraoperative nasopharyngeal temperature was recorded before induction (T1 ),2 hours after operation (T2 ),the end of operation (T3 ),postoperative 2 hours (T4 ).The anesthesia wakening time,the occurrence of postoperative shivering and infection,hospitalization time were also recorded.Venous blood samples were taken at T1 ,T3 ,two days (T5 )and five days after the operation (T6 )for analysis of T-lymphocyte subsets by flow cytometry.Results Compared with T1 ,the nasopharyngeal temperature was significantly de-creased at T2 ,T3 and T4 in group C, and the nasopharyngeal temperature in group W was significantly higher than those in group C at T2 ,T3 and T4 (P <0.05).The anesthesia wakening time and the occurrence of postoperative shivering in group C was significantly more than those in group C (P <0.05).Compared with T1 ,the percentage of CD4 + cells and CD4 +/CD8 + ratio were significantly decreased and the percentage of CD8 + cells increased in both groups at T3 (P <0.05).Compared with group C at T3 ,the percentage of CD4 + cells and CD4 +/CD8 + ratio were significantly increased and the percentage of CD8 + cells decreased in group W (P <0.05).Conclusion The clinical use of forced-air warming system combined with infusion heating technology can protect the patient??s body tempera-ture,shorten the anesthesia wakening time,reduce the occurrence of postoperative shivering,which protects the patient??s immune function and accelerates recovery after surgery.

Objective To explore the effects of Shenfu injection combined with low-dose hydrocortisone on plasma lev?els of human leukocyte antigen (HLA)-DR and procalcitonin (PCT) in patients with septic multiple organ dysfunction syn?drome. Methods A total of 118 patients with septic multiple organ dysfunction syndrome were divided into three groups:control group (n=39), experimental group 1 (n=39) and experimental group 2 (n=40). The control group received conventioanl medicine therapy, while the experimental group 1 received Shenfu injection (100 mL, 2/d, for 7 d) combined with conventio?anl medicine therapy, and the experimental group 2 received Shenfu injection combined with low-dose hydrocortisone (200 mg/d, for 14 d) besides conventional medicine therapy. The peripheral blood samples were collected for the detection of HLA-DR, PCT and lipoperoxide (LPO) before treatment, 1 d, 3 d amd 7 d after treatment. The mortality in 14 d was record?ed. Results The mortality rates in 14 d were 61.5%(24/39), 41.0%(16/39) and 25.0%(10/40) for control group, experimen?tal group 1 and experimental group 2 (χ2=8.15, P<0.05). There were no significant differences in PCT, HLA-DR and LPO levels before treatment and 1 d after treatment between the three groups (P>0.05). The plasma levels of PCT and LPO were significantly decreased in control group, experimental group 1 and experimental group 2 after 3-d and 7-d treatment, but the levels of HLA-DR was significantly increased (P < 0.05). Conclusion The combination therapy of Shenfu injection and low-dose hydrocortisone can effectively reduce PCT level and increase HLA-DR level, which promotes the improve?ment of patients with septic multiple organ dysfunction syndrome.

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.