Objective To study the sedation efficacy of propofol combined with midazolam and /or fentanyl in fibreoptic choledochoscope. Methods Ninty outpatients were randomly divided into three groups. Group PF (n=31)was given fentanyl 0. 05 m.g plus propofol 1 mg/kg intravenously, group PM (n=29) midazolam 2 mg plus propofol 1 mg/kg, and group PMF(n=30) fentanyl 0. 05 mg, midazolam 2 mg and propofol 1 mg/kg. Propofol 20 mg was used when needed. HR,MAP,SpO_2,sedation scores and amnesia were recorded. Results All patients were awakened in 20 minutes after procedures. The recovery time was shorter in group PF than that in the other two groups. There were 21(67. 70%) patients in group PF, who were aware of surgery. Fifteen(48. 4%) patients were satisfied in group PF. Conclusion Propofol combined with midazolam and /or fentanyl in fibreoptic choledochoscope has better sedation without any obvious side effects.

Objective To investigate the changes in cerebral cAMP and PKA levels during development of acute opioid tolerance induced by remifentanil and to determine whether post-receptor cAMP/PKA signaling pathway is involved in the process. Methods Fifty-six male Kunming mice weighing 25-35 g were randomly divided into 5 groups: group Ⅰ control (C) (n=8); group Ⅱ received morphine infused intraperitoneally (IP) at 0.6 μg'kg-1·min-1 for 120min(M) (n=8); group Ⅲ,Ⅳ,Ⅴ received remifentnil infused IP at 0.4, 0.8 and 1.6 μg·kg-1·min-1 for 120 min(R1=8, R2n=8; R3 n=24).Control group received IP infusion of normal saline. Tail-flick test was performed td measure the response of animals to a thermal nociceptive stimulus before IP infusion, at 30, 60, 90 and 120 min after beginning of IP infusion and at 15, 30, 45 and 60 min after termination of IP infusion. Eight animals were decapitated at 60 min after termination of IP infusion in all 5 groups and the other 16 animals in group R3 were decapitated at 30 and 45 min after termination of IP infusion (n=8 each) for determination of intracellular contents of cAMP and activities of PKA in cerebral cortex and inferior colliculus-striatum by ELISA or radioactive isotope [32p,] ATP-catalyzing assay. Results The tail-flick latency was significantly prolonged during IP infusion as compared with the baseline before infusion in group M, R1 , R2 and R3 but became significantly shorter at 30 and 45 min after infusion than the baseline values in group R1, R2 and R3indicating hyperalgesia after remifentauil infusion. The cerebral contents of cAMP and PKA activities at 60 min after termination of infusion were comparable or decreased in group M, R1, R2 and R3 as compared with group C. There was no significant difference in cerebral cAMP contents and PKA activities at 30, 60 and 45 min after IP remifentanil infusion in group R3. Conclusion Remifentanil can induce acute hyperalgesic effect on mice, and there is no up-regulation of post-receptor cAMP/PKA signaling pathway in the acute opioid tolerance, which is not similar to that chronic opioid tolerance.

Objective: To study the effects of the different doses of midazolam in fibreoptic gastroscopy on sedation, respiratory and circulatory function. Method: One hundred and four outpatients undergoing fibreoptic gastroscopy were randomly divided into four groups. The control group(N)was not given drugs, the other groups were intravenously given midazolam 0.07mg/kg(MS),0.05mg/kg(M),diazepam 10mg(D)respectively. The sedative scores, symptom, amnesia,HR,MAP and blood gases were observed. Result: The sedative scores of MS,M and D groups were much better than that of control group. There were significant differences in sedative scores,amnesia and sedative period between MS group and D group or M group. MAP decreased one minute after administering the drugs in MS,D and M groups significantly. The results of blood gases analysis of all groups were in normal ranges. Conclusion: Midazolam 0.07mg/kg can produce safe and effective sedation for fibreoptic gastroscopy.

Laparoscopic anatomical hepatectomy of segment 7 is recognized as one of the most difficult hepatectomies. Because of its location and anatomic characteristics, the resection of hepatic segment 7 has the difficulties of poor surgical view, instrumental accessibility, hepatic pedicle anatomy, confirmation of dividing line and secure hemostasis. When performing laparoscopic anatomical hepatectomy of segment 7, the authors routinely put patient at left semi-decubitus position, set all trocars at the right upper quadrant of the abdomen, and select proper approach for hepatic pedicle anatomy according to the results of individualized preoperative three-dimensional reconstruction. The authors use to transect the liver parenchyma at the plane between hepatic segment 6 and segment 7, with the direction perpendicular to the right hepatic vein, and then finish parenchymal dissection using right hepatic vein as the intrahepatic landmark. According to the authors experiences, choosing appropriate tactics can effectively reduce the difficulty of laparoscopic anatomical hepatectomy of segment 7, improve the safety and controllability of operation, and ensure the oncological radical effects.

Objective To study the diagnostic value of cavernosography in the venous leakage impotence.Methods Cavernosography were performed for 25 patients with the venous leakage impotence who had been diagnosed by the clinic just after the contrast agent had been injected.The appearance of cavernosography were analysed.Results Different degree venous leakage had been shown in 25 cases.The diagnostic accordance rate of the cavernosography,clinic impotence for the venous leakage was 100%(25/25).The accordance rate of the degree of the venous leakage shown by the cavernosography and pointed out by the clinical impotence was 36%(9/25).Conclusion Cavernosography not only can show the venous leakage and its location,but also can know the degree of the venous leakage.

Objective To study the relationship of epithelial nitric oxide synthase (eNOS) expression with the germ cell development and apoptosis in the rat cryptorchid. Methods Germ cell apoptosis was detected by terminal deoxynucleotidyl transferase mediated d UTP nick end labeling (TUNEL) in the unilateral cryptorchid.Expression of eNOS was detected by immunohistochemical S P method. The dispersion characteristics of expression of eNOS mRNA was investigated by in situ hybridization. Results On the 7th day after the operation,as compared to the control,the number of apoptotic germ cell in the cryptorchid was increased significantly,but its testis weight was decreased predominantly,and expression of eNOS gene was localized to the cytoplasm of Legdig cell,Sertoli cell and germ cell in both testes.On the 40th day,expression of eNOS gene was localized to the cytoplasm of lengthened spermid.On the 3rd day and 7th day,expression of eNOS mRNA had no apparent change in the cryptorchid as compared to the control. Conclusions In adolescence,expression of eNOS regulates secretion of hormone and germ cell development;whereas after adulthood,expression of eNOS is only related to the mature and activity of sperm.Expression of eNOS has no apparent relationship with germ cell apoptosis.

Objective To sum up the diagnosis and treatment of airway complication after heart-lung transplantation. Methods One patient who occurred dyspnea, cough and wheeze at the 200th day after heart-lung transplantation, was diagnosed suffering from anastomosis stenosis. Comprehensive multimodality approach such as rigid bronchoscopic debridement and laser photoresection were performed. Eventually, this case was surgically managed with sleeve resection of stenotic bronchial segment. Results Surgical operation by sleeve resection of stenotic segment was successful, and the patient's symptoms disappeared. Till now the patient has been living more than 14 months after transplant, and CT scanning and fibrous bronchoscopy examination showed that the anastomasis healed well. Conclusion Airway complication's early recognition and proper management could improve the patients symptoms and survival rate.

Objective To evaluate the therapeutic effect of Yin-Huang pills combined with Banlangen granule therapy on upper respiratory infection.Methods 120 cases of acute upper respiratory infection were randomly separated into an experiment group and a control group.The experiment group was treated by Yin-Huang pills combined with Banlangen granule;while the control group was treated by Yin-Huang pills.Results There was significant difference of cure rate between the experiment group(75%)and the control group(51.6%),with P＜0.01.There was no significant difference of total effective rate between the experiment group(96.6%)and the control group(88.3%),with P＞0.05.Conclusion Yin-Huang pills combined with Banlangen granule therapy was more effective in controlling acute upper respiratory infection,and this therapy caused few adverse effects.

Objective To evaluate the correlation between the dynamic enhanced CT signs of hepatocellual carcinoma(HCC),MVD and VEGF expressions in hepatocellular carcinoma.Methods The MVD and VEGF expression were examined by means of SP immunohistochemical technique in 45 cases of HCC proved by pathology.All patients were examined by plain and contrast-enhanced CT.Results(1)The relation of pathologic grade,MVD and VEGF:the MVD in HCC of grade Ⅰ,Ⅱ,Ⅲ,Ⅳ were 22.9 ± 12.6,36.7 ±16.2,51.1±17.3,67.8±21.4,VEGF positive rates in HCC of grade Ⅰ,Ⅱ,Ⅲ and Ⅳ were 28.6%(2/7),53.3%(8/15),90.9%(10/11)and 100.0%(12/12).The pathologic grading of HCC was positively correlated with MVD and VEGF expression,in grade Ⅰ and grade Ⅲ～Ⅳ,Ⅱ and grade Ⅳ(P＜0.05).There were no statistical correlation between Ⅰ and Ⅱ,Ⅱ and Ⅲ or between Ⅲ and Ⅳ(P＞0.05).(2)There were three blood supply types in HCC at contrast-enhanced CT,the MVD ad VEGF positive rates were 70.6±22.9 and 85.l%(23/27)in tumors with arterial blood,65.7±21.6 and 63.6%(7/11)in those with double blood supply,and 25.1±13.5 and 28.6%(2/7)in those with poor blood supply.There was statistical difference(P＞0.05)in VEGF expression between the tumors with arterial blood,arterial combining with double blood supply and poorly blood supply.In HCC with arterial and double blood supply,MVD expression level was higher than that with poor blood supplies(P＜0.01).Conclusion MVD and VEGF expression can reflect the tumor's cell differentiation of HCC in a certain degree.

In the paper, the effect of Xin Ji Rong liquer for oral on the plasm membrane fluidity of cultured cardiac myocytes in neonatal rats was observed with 1,6-dipheny-1,3,5-hexatriene (DPH) as a fluorescence probe. The result showed that adding isoprenaline to the cultured medium could make the membmne fluidity reduce signalicantly as compared with the control (P