Objective To investigate the changes of plasma carbon monoxide (CO) concentration in patients undergoing cardiac surgical procedures Methods Arterial blood samples were obtained via the radial artery catheter ,before incision, CPB30min, before cardioversion,before weaning from CPB, 20 min after weaning from CPB,4h,24h after surgery, respectively, to measure the plasma CO concentration with ultraviolet spectrophotometry Results Plasm CO concentration increased significantly after the commencement of CPB(P

Objective To reduce unreasonable use of antibiotics in acute suppurative tonsillitis cases. Methods Retrospective analyses of 1107 acute suppurative tonsillitis cases from the pediatric outpatient department were conducted.According to course of antibiotic treatment, these cases were divided into the group of full course of treatment and the group of insufficient course of treatment.According to the types of antibiotic, the subjects were di-vided into azithromycin group and non-azithromycin group.Three months after the onset of illness, the occurrence of complications and illness relapse between full course of treatment group and insufficient course group, azithromycin group and non-azithromycin group were analyzed.Meanwhile, the cases were divided into Chinese mainland group, Macao and Taiwan group, and foreign group according to their native places and nationalities.We compared the num-ber of cases used insufficient course in these three groups and analyzed their reasons.Results The relapse rate was significantly lower in the full course treatment group compared with insufficient course treatment group ( P<0.05 ) , and significantly higher in non-azithromycin group compared with azithromycin group ( P<0.05 ) .The occurrence rate of insufficient course treatment in the Chinese mainland group was obviously higher than the Macao group, Tai-wan group and foreign group (P<0.05).The main reasons for insufficient course of treatment were the insufficient patients′obedience and some doctors′poor understanding of the disease course.Conclusion A full course treatment with antibiotics on acute suppurative tonsillitis are strongly suggested.It may be of great significant to strengthen the awareness of reasonable use of antibiotics among the inland citizens.

To evaluate the effects of tetramethylpyraze (TPZ) on the collapsed lung during one lung ventilation (OLV), 2.4 adult patients with esophageal cancer,ASA grade Ⅰ-Ⅱ,undergoing esopha-goesophagostomy, were randomly allocated to receiving intravenous infusion with TPZ 4mg?kg~(-1) (group T,n=12) or equivalent volume of normal saline (group C,n=12) in 5 mins before onset of OLV respectively. The ultrastracture of collapsed lungat 90th min following OLV showed that in group C mitochondia swelled, the cristae disappeared, and large vecule appeared, but in group T those remained normal. As compared with those in group C,the Ca~(2+) content in erythrocyte decreased significantly 30 and 60 mins following OLV (P

ve When a new drug is introduced for intrathecal (IT) administration, its effect on spinal cord should be studied for safety reason. The aim of this study was to determine the ultra-microstructure of spinal cord and Ca2+ content in spinal cord after IT administration of ropivacaine in dogs. Methods Eighteen mongrel dogs of either sex weighing about 10kg were randomly assigned to one of three groups according to the dose of ropivacaine administered IT: group A received normal saline 2ml IT and served as control; group B received 0.5% ropivacaine 2ml(10mg) IT; group C received 1% ropivacaine 2ml(20mg) IT. Anesthesia was induced with intramuscular ketamine 20mg.kg-1 and atropine 0.05mg?kg-1 and maintained with intermittent iv boluses of ketamine 3mg?kg-1 and fentanyl 5?g?kg-1 Left internal jugular artery was cannulated for intra-arterial pressure monitoring. An incision was made in the back at L3-4 and lumbar puncture was confirmed by aspiration of cerebral-spinal fluid (CSF). Normal saline or ropivacaine was then injected over 20 seconds. 3 hours after IT administration the animals were sacrificed and L1-2 segment of spinal cord and nerve roots were immediately removed for Ca content determination and electron microscopic examination. Results The Ca2+ content of spinal cord was significantly higher in group C than that in group A and B. Electron microscope revealed that in group A and B neurolemma of the nerve root and mitochondria and endoplasmic reticulum of the neurons in spinal cord were intact, while in group C neurolemma was stratified and partly disrupted and mitochondria and endoplasmic reticulum underwent swelling and there was vacuole degeneration. Conclusions Ropivacaine of high concentration or at high dose may be injurious to spinal cord.

ve To determine the most approprite hypoxic concentration and duration for prenatal hypoxic adaptation animal experiment by exposing pregnant rats to the hypoxic air of different oxygen concentration.Methods Full-term pregnant rats( gestation time 22 days) were placed in an airtight cabin specially designed for hypoxic adaptation experiment. The rats were divided into 7 groups. The Q2 concentration in the airtight cabin was decreased from 21% (group Ⅰ as control) to 18% (group Ⅱ), 17% (group Ⅲ), 16% (group Ⅳ), 15% (group Ⅴ), 14% (group Ⅵ) and 13% (group Ⅶ) respectively. The animals were exposed to short duration of hypoxic air twice with a break of 5min breathing fresh air. The duration of the first hypoxic episode lasted 10 min (group Ⅰ ) , 5 min (group Ⅱ), 7.5min (group Ⅲ), 9.83 min (group Ⅳ), 11.5 min (group Ⅴ), 13.17 min (group Ⅵ) and 14 min (group Ⅶ) respectively. The second hypoxic episode lasted 10min, 9.33 min, 11 min, 15.17 min, 13.33 min, 17 min and 18 min respectively. Ten newborn rats (1 day after birth) randomly selected from each group were placed in a 100ml airtight bottle and the duration from the start to the time when the newborn rat stopped breathing was recorded as hypoxia surviving time. Another 10 newborn rats randomly selected from each group were decapitated and brain was removed for light and electron microscopic examination to determine the degree of neuronal damages. Results In group Ⅰ-Ⅴ the newborn rats were normal (pink skin color and good extremity movement) . In group VI 10/55 (18%) newborn rats were cyanotic with diminished extremity movement, the others were normal. In group VIII 11/52(21% ) newborn rats died, 14/ 52(27%) were cyanotic with diminished extremity movement. Neuronal damages could be seen in cyanoticnewborn rats including decreased number, swelling, apoptosis of neurons and expanded mitochondria. The hypoxia surviving time was significantly longer in group Ⅳ, Ⅴ and Ⅵ than that in control group. Conclusions Hypoxic air containing 15% O2 is appropriate for animal experiment of prenatal hypoxic adaptation. It is better to divide prenatal hypoxia into two episodes lasting 11.5 min and 13.33 min with a break of 5 min between them when animals breathe fresh air.

Objective To evaluate a new computer-aided technique applicable for myocardial contrast echocardiography(MCE) to quantitate automatically calibrated myocardial contrast intensity(CD and to test the feasibility of calibrated CI in assessing myocardial perfusion. To analyze the relationship on myocardial perfusion,regional contractile function and cell apoptosis in stunned myocardium. Methods According to coronary occlusion and reperfusion at different times, rabbits were divided into three groups: 15 min occlusion/30min reperfusion (group Ⅰ ),30 min occlusion / 60min reperfusion (group Ⅱ ) and 120 min occlusion / 60min reperfusion (group Ⅲ ). MCE was performed on all rabbits at baseline,occlusion and after reperfusion,and its images were analyzed by a new computer-aided technique. Myocardial calibrated CI of each segment was measured automatically by software. Percentage wall thickening (WT) of each risk segment at each stage were also measured by echocardiography. The apoptotic index(AI) in regional left myocardial dysfunction was calculated by terminal deoxynucleotidyl transferease-mediated biotinylated deoxyuridine triphosphate nick end labeling(TUNEL ). Results (1) During occlusion, WT in the areas at risk decreased to zero or negative and the calibrated CI values were significantly lower than those at baseline ( P ＜0.01 ). After reperfusion, WT in all risk segment remained depressed, but calibrated CI significantly improved in group Ⅰ and Ⅱ while those remained unchanged in group Ⅲ. (2)AI in risk myocytes were (13. 70 ± 5.48 ) %, (36.25 ± 5.55 ) % and ( 62.06 ± 6. 70 ) %, respectively, both statistically significant difference between the two groups ( P ＜0.05 or P ＜ 0.01 ). AI were negatively correlated to WT and calibrated CI ( r = - 0. 87 and r = - 0. 77, P ＜0.05). Conclusions MCE with computer-aided technique can assess quantitatively myocardial perfusion and regional contractile function. Short-term ischemiareperfusion does not cause myocardial necrosis, but it will lead to myocardial cell apoptosis and the phenomenon of myocardial stunning. Prolonged ischemia, even if given sufficient reperfusion, can lead to apoptosis and necrosis simultaneously.

Objective To introduce the method and experience of the setting of psychological care nurses,to discuss its effect on high-quality nursing and on amelioration of the patients' negative moods.Methods Psychological care nurses were set up in all the clinical departments,after systemic training of psychological knowledge and became qualified psychological consultant via national certification examination.We took psychological care nurses as the leading role,assisted with other nursing modes.By the means of mental status scale in non-psychiatric settings (MSSNS) and the satisfaction questionnaire of psychological care to evaluate the patients' mental status and satisfaction degrees before and after the intervention in 297 cases.Results Patients'scores of anxiety scale,depression,anger,loneliness factor and the total score of the MSSNS after the psychological nursing intervention were significant differences than those before the psychological nursing intervention,[(39.66±4.70)vs (45.59±6.45),(23.31±2.28)vs (26.59±3.35),(13.91 ±3.01) vs (15.12±2.58),(17.58±3.74)vs (20.29 ±4.67),(92.09±6.85)vs (106.66±8.58),t values was 14.376,15.213,23.992,13.974,13.641 respectively,P＜0.05].The satisfaction rate of patients for psychological nursing intervention after the intervention was 96.97％(288/297),which was significant higher than that before the intervention,69.70％(207/297),x2=79.53,P＜0.05.Conclusions Psychological care demands professional qualities.Only through systemic training,can grasp the nurses master professional psychological knowledge and skill,so as to apply scientific psychological care to the patients and help them to solve their psychological perplexities and maintain physical and psychological well-beings.

Objective To study the clinical effect of sevoflurane combined with remifentanil in laparoscopic cholecystectomy (LC).Methods50 cases of laparoscopic cholecystectomy in Tianjin Haihe Hospital from February 2015 to September 2016 were selected as the research object, and randomly divided into the control group and the experimental group, each group had a total of 25 cases.The patients in control group were treated with continuous intravenous infusion of propofol.The experimental group received sevoflurane.Patients in the experimental group and the control group were given remifentanil after surgery.Compared with the experimental group and control group of patients with the degree of recovery and related Linchuan indicators.ResultsAfter the corresponding anesthesia, the control group of patients with recovery time was (13.4±3.1) minutes, the score was (4.1±1.2) points, extubation time was (14.6±3.7) minutes.However, the extubation time and recovery time of the control group were significantly longer than those of the experimental group, and the recovery score was lower than that of the experimental group, with statistical difference (P<0.05).There was no obvious adverse reaction in the experimental group and the control group, and there was no significant difference in the changes of cardiovascular factors.ConclusionSevoflurane combined with remifentanil for laparoscopic cholecystectomy can improve the anesthetic effect to a great extent, stable operation and postoperative patients with cardiovascular function, recovery time is short, the clinical significance of only one step promotion and application.