Objective To determine the risk factors for development of succinylcholine-induced postoperative myalgia.Methods One hundred and fifty-five patients,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 20-30 kg/m2,scheduled for elective craniofacial surgery,were included in the study.Total intravenous anesthesia with propofol or combined intravenous-inhalational anesthesia with sevoflurane was performed during surgery.The patients were divided into 2 groups according to whether or not myalgia occurred within 24.h after surgery:myalgia group and non-myalgia group.Factors including gender,age,body weight,duration of surgery,method of anesthesia,dose of succinylcholine,preinjection of lidocaine or nondepolarizing muscular relaxants during induction of anesthesia,use of hormone (dexamethasone or methylprednisolone) and nonsteroidal analgesics (parecoxib sodium) during surgery,and consumption of fentanyl were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for development of succinylcholine-induced postoperative myalgia.Results Forty-one patients developed postoperative myalgia,and the incidence of myalgia was 27.2％.The results of logistic analysis indicated that succinylcholine ＜ 1.5 mg/kg and no preinjection of lidocaine were closely correlated with the development of postoperative myalgia induced by succinylcholine.Conclusion Succinylcholine＜1.5 mg/kg and no preinjection of lidocaine are the risk factors for development of succinylcholine-induced postoperative myalgia in the patients.

Objective To compare the infusion outcome of the posterior interbody autogenous micromor-selized bone graft and structure bone graft ,which were used to cure single-segment spinal tuberculosis. Methods The posterior focus debridement and bone graft fusion were conducted on 35 single-segment spinal tuberculosis patients who were cured by micromorselized bone graft and structure bone graft in the hospital from January 2010 to June 2015. Sixteen patients received micromorselized bone graft cases and 19 patients received structure bone graft. According to JOA and VAS,the fusion effects were compared and analyzed in the following aspects,such as opera-tion time,blood loss volume during the operation,kyphosis distorted Cobb angles before and after the operation and fusion time. Results Follow-up visits were paid to all 35 patients and lasted for 12 to 24 months with an aver-age visit time of 18.5 months. Spinal grafted bones showed desirable fusion without invalid screws and grated bones in the spinal canal.(1)No statistical differences were observed between two groups in terms of post-operation JOA and VAS scores.(2)The operation time and blood loss amount during the operation were smaller in the micromor-selized bone graft than those in the structure bone graft ,with significant differences between 2 groups.(3)No sig-nificant differences were observed between the two groups in terms of kyphosis distortion angle ,but regarding to loss of Cobb angles in different intervals after the operation ,it′s greater in the former group than that in the latter one. (4)No significant differences between the two groups in terms of fusion time were observed. Conclusions The two fusion approaches demonstrated no prominent difference in alleviation of the clinical symptoms and the fu-sion time. The micromorselized bone grafting was superior to the structure bone graft in aspects such as operation time and blood loss amount. However ,it′s more likely for the former to lose Cobb angles in the follow-up visits. Both of the two grafting methods were effective in the single-segment spinal tuberculosis operation. All patients ex-cept those with severely unstable spines and osteoporosis and those were too old can adopt the micromorselized bone grafting approach.

Objective:To develop a list of basic and expanded medical laboratory tests in community health service centers in Shanghai.Methods:The status quo of human and equipment resource allocation, the test items and quality control currently performed, the perspectives of various stakeholders, the capacity building of community clinical laboratory in community health service centers in Shanghai were investigated by quantitative survey and qualitative interview; and the rating scores of each test item were assessed by expert consultation using Delphi method. The expert focus discussion was conducted, and each test item was rated and classified. Finally a list of the basic tests and expanded tests in clinical laboratories of community health service center was developed.Results:A total of 247 questionnaires were distributed and 192 (77.7%) were answered. A list of 94 laboratory test items was screened out based on the questionnaire survey of the laboratories of the community health centers. Thirty one experts in the relevant areas were invited to rate the test items, the average authority coefficient of experts was 0.90, with which the weighted average of the expert ratings was made. There were 45 (47.9%) items scored 7 or higher, 38 (40.4%) scored between 5 and 7, and 11 (11.7%) scored less than 5. Based on the results of the expert focus discussion, 48 items were recommended as the basic tests and 46 items as the extended tests.Conclusion:In this study a list of tests recommended to clinical laboratories in Shanghai community health service centers has been developed, which contains 48 basic tests and 46 extended tests.

Objective To evaluate the advantages about video-assisted thoracoscopic surgery (VATS) lobectomy with optimized management of surgical instruments package. Methods A total of 200 patients with lung cancer were enrolled, which included 78 males and 122 females, aged 24-83 years at median age of 56.8 years. All of them were divided into 2 groups including a routine group (n=100) and an optimized management of surgical instruments group (n=100). The total operation time, bleeding, instrument weights, utilization rate of instruments, counted and cleaning time in 2 groups were recorded and analyzed. Results The average operation time and average lost blood of the routine group was 117.62±42.52 min and 53.14±50.69 ml, respectively, and the one of the optimized instruments group was 120.48±40.62 min, 56.10±49.87 ml, respectively, with no significant difference between the two groups (P=0.112, P=0.231, respectively). The utilization rate of instruments in the routine group (58.02%±2.39%) was significantly lower than that of the optimized instruments group (94.00%±1.48%, P=0.014). The counted time, the loading and unloading time and the cleaning time of instruments in the routine group was 112.00±26.00 s, 70.00±15.00 s, 1 010.00±130.00 s, respectively, much longer than the time of the optimized instruments group, which was 65.00±23.00 s, 20.00±4.00 s, 665.00±69.00 s, respectively. There was a statistical difference between the two groups (P=0.028, P=0.011, P=0.039, respectively). The value of instruments in the routine group (177 574.00±14 438.00 yuan) was apparently higher than that of the optimized instruments group(132 027.00±10 311.00 yuan), with a statistical difference (P=0.032). Conclusion It is demonstrated that optimized management of surgical instruments package in VATS lobectomy can greatly improve the utilization rate of instruments and work efficiency, with no effects on the operation time and amount of bleeding in lobectomy.
Thoracoscopic surgery ; surgical instruments package ; lung cancer