Objective To investigate the effects of different ventilations during the induction of anesthesia on postoperative nausea and vomiting in patients undergoning laparoscopic cholecystectomy. Methods One hundred and twenty patients undergoing laparoscopic cholecystectomy were randomly divided into M group and V group according to random number table, 60 patients each group. The patients in M group performed manual ventilation and the patients in V group performed mechanical ventilation. According to different tidal volume, V group were randomly divided into three groups (20 patients each group:V1,V2 and V3 group, respectively recieved body weight × 4, 6 and 8 ml/kg. After tracheal intubation,the operations were completed by maintaining the end of CO2 partial pressure (PETCO2)from 35 to 45 mmHg, 1 mmHg = 0.133 kPa. Tidal volume, peak airway pressure (Ppeak) and PETCO2 in anesthesia induction,and intraoperative gastric insufflation and postoperative nausea and vomiting were recorded and compared. Results The incidence rate of gastric insufflation, postoperative nausea and vomiting in V group were significantly higher than those in M group:50.0%(30/60) vs. 21.7%(13/60), 45.0%(27/60) vs. 18.3%(11/60), 26.7%(16/60) vs. 10.0%(6/60), P<0.05. The level of Ppeak in M group, V2 group and V3 group were signicantly higher than that in V1 group: (13.55 ± 1.95), (12.05 ± 1.23), (18.35 ± 3.71) cmH2O vs. (13.55 ± 1.95) cmH2O, 1 cmH2O = 0.098 kPa, P<0.05. The level of PETCO2 in M group, V2 group and V3 group were signicantly lower than that in V1 group:(19.60 ± 4.31), (27.75 ± 1.94), (23.60 ± 4.45) mmHg vs. (29.90 ± 2.40) mmHg, P<0.05. Conclusions Manual ventilation during the induction of anesthesia in patients undergoning laparoscopic cholecystectomy is better than mechanical ventilation . Proper manual positive pressure ventilation and volume mechanical ventilation with low tidal (4 ml/kg) may allow for decreasing intraoperative gastric insufflation and postoperative nausea and vomiting.

Objective To evaluate the clinical characteristics and long-term results of elective coronary stenting in octogenarians with coronary artery disease. Methods From Jan 2000 to Dec 2003, 84 octogenarians with coronary artery disease documented agiographically were divided into stent group (n=45) and medicine group (n=39). The clinical characteristics, in-hospital and long-term results were analyzed between the two groups. Results There were no difference between the two groups at the respect of basic clinical characteristics but the percentage of AMI was higher in the stent group (40.0% vs 17.9%, P

The purpose of the National Competition in Basic Medicine Innovation Forum & Ex-perimental Design in colleges is to boost Excellent-doctor Education Training Plan, cultivating students' scientific research ability and other comprehensive capacity. In practice, the originality and the scientific nature of the selected topic were emphasized through the provision of scientific research funding. The teachers changed their traditional instructional concept and teaching models. They guided the students to select the scientific subjects and took various measures to change students ' learning mode, resulting in gradually pro-moting the students' scientific research level and comprehensive ability. The results showed that these novel strategies are feasible and effective, which may provide a new way for improvement of the excellent doctor program.

Objective To study the cytoprotective effect of prostaglandin E1(PGE1)in the imme- diate period after orthotopic liver transplantation (OLT).Methods Ten patients undergoing OLT were divided into 2 groups: group P (n=6) was administered with PGE1 and group C (n=4) served as control group. Serum ALT, AST, TBIL, DBIL, bile output and the period of intensive care unit (ICU) in both groups were observed in the first 3 weeks after OLT. Results Postoperative increases in serum ALT, AST, TBIL and DBIL levels were significantly suppressed by PGE1. In addition, PGE1 contributed distinctly to an increase of bile output (P

Objective To evaluate the clinical features in patients with pre- or post-operation epilepsy, and to explore the relationship of secondary epilepsy and craniocerebral operations. Methods The patients involved in present study were admitted and underwent the craniocerebral operations in the General Hospital of PLA from Jun.1999 to Feb.2008. The clinical data of epilepsy occurred at pre- or post-operation were retrospectively analyzed. All the 186 patients were divided into the pre-operation epilepsy group(Group A, n=90 ) and the post-operation epilepsy group(Group B, n=96). Based on a standardized questionnaire, a database was established with Microsoft Access 2007 including the primary etiological factor, the location of epileptogenic focus, the seizure frequency, the seizure type, and the abnormal electroencephalogram (EEG). Results Intracranial tumor and cerebrovascular malformation were the main primary etiological factors in group A, and intracranial tumor, cerebral trauma, cerebrovascular malformation and acute cerebral apoplexy were the main primary etiological factors in group B. The four main primary etiological factors for seizures were discovered in significant difference between group A and group B(?2=45.857 3,P=0.000 0). Cranial computed tomography(CT) or nuclear magnetic resonance imaging(MRI) detected that the most locations of epileptogenic focus were in frontal lobe(31.8% in group A and 29.5% in group B), temporal lobe(30.7% in group A and 26.3% in group B), and parietal lobe(17.0% in group A and 24.2% in group B). The frequency of seizure was significantly decreased in group A(?2=11.313 3,P=0.010 1), and was increased in group B(?2=77.080 3,P=0.000 0). The quantity of abnormal EEG for focal epilepsy was significantly decreased in group A(?2=9.773 4,P=0.007 5), but the increasing quantity of abnormal EEG was not significant in group B(?2=4.366 0,P=0.112 7). No significant difference in seizure type was proved after the craniocerebral operations in group A(?2=0.214 3,P=0.643 4). Campared with the post-operation epilepsy group, the location of epileptogenic focus did not show significant distinction in the pre-operation epilepsy group(?2=1.772 2,P=0.777 6). Conclusions Craniocerebral operation is an effective therapy for the secondary epilepsy with certain epileptogenic focus, and it is one of the definite causes of secondary epilepsy.

Aiming to solve the problems in traditional classroom mode PBL teaching during clinical practice of oral and maxillofacial surgery,this paper investigated multi-pattern PBL teaching basing on Weblog,daily ward round and classroom discussion in the clinical practice,and focused on the practice methods,advantages and feature of this multi-pattern PBL teaching.

Objective To investigate the influence of arsenic trioxide (AS2 O3 )in the vasculogenic mimicry (VM ) of HepG2 cells, and to preliminary clarify the possible mechanism of inhibition of AS2 O3 on the VM. Methods Themean inhibitory concentration (IC50 )of AS2 O3 72 h after treatment of HepG2 cells was calculated by CCK-8 assay.The HepG2 cells were cultured on 3-D Matrigel and randomly divided into control group, 1/2 IC50 AS2 O3 group and IC50 AS2 O3 group.IPP software was used to calculate the number,length and area of VM,and the expression levels of VM-related proteins VE-cadherin and MMP-2, apoptotic-related protein caspase-3 and proliferation-related protein PCNA were detected by Western blotting method.Results The IC50 of AS2 O3 was 10μmol·L-1 72 h after treatment of HepG2 cells.The number,length and area of VM in 1/2 IC50 and IC50 AS2 O3 groups were significantly lower than those in control group (P<0.01);the number,length and area of VM in IC50 AS2 O3 group were also lower than those in 1/2 IC50 AS2 O3 group (P<0.05).Compared with control group,the expression levels of VE-cadherin and MMP-2 in 1/2 IC50 and IC50 AS2 O3 groups were decreased (P<0.05),and the expression levels of caspase-3 and PCNA had no significant change (P>0.05).Conclusion AS2 O3 can inhibit the forming of VM of HepG2 cells,which indicated that its mechanism may be related to inhibiting the expressions of VE-cadherin and MMP-2 .

OBJECTIVE To observe the effect of vacuum-assisted closure in clinical persistent infection patients.METHODS Thirty two sufferers infected in soft tissue,bones and joints were treated by general methods but without durable concrescence.It lasted averagely 138 days.In our department it treated by vacuum-assisted closure in 23 days.Thereby a comparison of self-control came into being.RESULTS Thirty two cases were cured after following at least one year except for one case with recrudescence.CONCLUSIONS Vaccum-assisted closure is the most effective surgery therapy measurement and is a kind of unidirectional drainage.If we can use it felicitously then we can treat infection in orthopedics′ effectively.

AIM:Researches have shown that musculocutaneous flap or fascial flap could well treat refractory bedsore in a long term. This study observed the clinical experience in the treatment of sacrococcygeal ulcers. METHODS:From January 2000 to January 2006,19 patients with sacrococcygeal ulcers,who received myocutaneous flap transposition in Department of Burns and Plastic Surgery,West China Hospital of Sichuan University,were selected. The informed consent was obtained from all patients. The surgery included two stages. At the first stage,debridement and eschar excision were performed. At the second stage,the surgery was undergone after selecting the myocutaneous flap type according to the patients' age,ulcer position,and ulcer extent. Twenty-one wounds were repaired by gluteus maximus myocutaneous flaps,and the flap size was 13 cm ?11 cm-17 cm?14 cm;8 by long-head of biceps femoris flaps of 10 cm?6 cm-13 cm?6 cm. After operation,the patients were placed on turn-over bed for 14 days and followed regularly. RESULTS:All flaps survived and the wounds in 18 cases healed at the first stage. Hematocele underlying flap occurred in one patient with urinemia,and healed by dressing exchange. After a follow-up of 5 months to 3 years,no patient had a recurrence;the color and texture of the flaps were good,and he appearance was satisfactory. CONCLUSION:The technique of two period operation treatment of myocutaneous flap transposition can accelerate the healing of sacrococcygeal ulcers and improves the success rate of operation.