As a core element of the Confucianism,mind-nature theory is full of the essence of Confucian mor-al education and has a profound influence on the Chinese national morality education.Confucianism mind-nature theory which takes Confucius and Mencius as representatives,after the continuous development of the future genera-tions,has been formed a complete ideological system.Confucianism mind-nature theory highly affirms the values of moral and unifies the values of life and moral.This article,by exploring the moral resources of Confucianism mind-nature theory,rethinks the ideas of contemporary ethics education and expounds how to enhance the effect of medical ethics education.

Objective To investigate the effect of parecoxib on intrapulmonary shunt during one-lung yentilation in patients undergoing esophageal cancer operation. Methods Forty-five ASA Ⅰ orⅡ patients of both sexes aged 47-57 yr weighing 42-59 kg undergoing esophageal cancer resection were randomly divided into 2 groups:control group (group C,n = 23) and parecoxib group (group P,n = 22). Left radial artery and right internal jugular vein were cannulated for MAP and CVP monitoring and blood sampling. Parecoxib 40 mg in 10 ml of normal saline was injected iv slowly before induction of anesthesia in group P while in group C normal saline 10 ml was injected instead of parecoxib. Anesthesia was induced with TCI of propofol (Ce 4 μg/ml) and sufentanil (Ce 0.3 ng/ml). Insertion of double lumen tube was facilitated with rocuronium 0.9 mg/kg. Correct position of the double lumen tube was verified by fiberoptic bronchoscopy. Anesthesia was maintained with TCI of propofol and sufentanil and intermittent iv boluses of cis-atracurium. BIS was maintained at 50-55 during operation. MAP, HR, CVP,mean airway pressure were monitored and recorded after induction of anesthesia (To), at 15, 30 min and 1 h of OLV (T1.2.3) and 30 min and 1 h after re-expansion of the collapsed lung (T4.5). Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis. Intrapulmonary shunt (Qs/Qt) was calculated.Results There was no significant difference in MAP, HR, CVP, mean airway pressure and Qs/Qt during onelung ventilation between the two groups. Conclusion Parecoxib has no effect on hypoxic pulmonary vasoconstriction during one-lung ventilation in patients undergoing esophageal cancer resection.

Objective To determine the half-effective target effect-site concentration (EC50 ) of sufentanil inhibiting the urethroscope insertion response when combined with propofol by target-controlled infusion (TCI) in the elderly patients undergoing transurethral resection of prostate (TURP) . Methods Twenty-two ASA Ⅰ- Ⅲ patients, aged 65 -79 yr, weighing 47-81 kg, undergoing TURP, were enrolled in the study. Anesthesia was performed with TCI of propofol and sufentanil. The target plasma concentration of propofol was 4 μg/ml. The target effect-site concentration of sufentanil was determined by up-and-down sequential trial. The initial target effect-site concentration of sufentanil was 0.3 ng/ml and the ratio of the target concentrations between the two consecutive patients was 1.1. The ECW and 95% confidence interval of sufentanil required to inhibit the response to urethroscope insertion were calculated. Results The EC50 of sufentanil required to inhibit the urethroscope insertion response was 0.23 ng/ml (95% confidence interval 0.12-0.44 ng/ml). Conclusion When combined with propofol by TCI (target plasma concentration 4 μg/ml), the EC50 of sufentanil inhibiting the response to urethroscope insertion is 0,23 ng/ml in the elderly patients undergoing TURP.

Objective To evaluate the feasibility of using corrected body weight to set the tide volume for mechanical ventilation during general anesthesia in obese patients.Methods Ninety-six ASA physical status Ⅰ or Ⅱ obese patients,with a body mass index of 28-44 kg/m2,scheduled for elective extremity surgery under general anesthesia,were divided into 3 groups (32 cases of each group) by random digits table method:tide volume based on actual body weight group (group A),tide volume based on ideal body weight group(group B),and tide volume based on corrected body weight group(group C).The pulmonary function of all patients was normal.The patients were endotracheally intubated and mechanically ventilated after induction of anesthesia.According to the corresponding body weight,the initial tide volume was set based on 8 ml/kg in each group(respiratory rate:15 bpm).At 10 min after start of mechanical ventilation,peak airway pressure (Ppeak),airway plateau pressure (Pplat),airwayresistance (Raw) were recorded.Arterial blood samples were collected at 30 min of mechanical ventilation for blood gas analysis and arterial blood oxygen partial pressure (PaO2),arterial blood carbon dioxide partial pressure (PaCO2) and the patients requiring readjustment of tide volume were also recorded.Results The level of Ppeak,Pplat,Raw in group B and group C were significantly lower than those in group A[(15.3 ± 1.8),(18.5 ± 2.6) cmH2O (1 cmH2O =0.098 kPa) vs.(23.2 ±3.3) cmH2O; (11.5 ± 1.6),(14.3 ± 1.4) cmH2O vs.(17.6 ±2.7) cmH2O; (10.8 ± 1.7),(12.5 ± 2.6) cmH2O/ (L·s) vs.(16.8 ± 3.0) cmH2O/ (L·s)],and the level of PaCO2 in group B and group C was significantly higher than that in group A [(48.8 ± 3.1),(40.2 ± 2.3) mmHg (1 mmHg =0.133 kPa) vs.(28.6 ± 3.8) mmHg],there was significant difference(P ＜ 0.01).The level of PaO2 and oxygenation index in three groups had no significant difference (P ＞ 0.05).There were no patients requiring readjustment of tide volume in group C,however,93.8％ (30/32) patients required readjustment of tide volume in group A and 81.2 ％ (26/32) in group B,there was significant difference (P ＜ 0.01).Conclusion Corrected body weight based on 8 ml/kg can be used to set the tide volume for mechanical ventilation during general anesthesia in obese patients with normal pulmonary function.

Objective To evaluate three compartments of mediastinal anatomy in the diagnosis of space occupying lesions. Methods CT images of 78 mediastinal lesions confirmed by surgery or/and pathology were retrospectively studied. Results According to the occurrence ratio of occupying lesions, anterio superior mediastinal lesions were lymphadenovarix, thymoma, teratoblastoma, and intrathyroma, etc. In anterio inferior mediastinum, heart tumors, teratoblastoma, fatty tumor were found successively. Posterior mediastinal lesions were lymphadenovarix, neurogenic tumors, esophageal tumors, tracheo broncheal tumors, aneurysms, diaphrageal herniation and so on. Conclusion The results suggested that the mediastinal three compartments protocol was more terse and practical than others in the diagnosis of space occupying lesions before operation.

Objective To evaluate the effects of dexmedetomidine on the expression of tumor necrosis factor-α(TNF-α) and intercellular adhesion molecule-1 (ICAM-1 ) during cerebral ischemia-reperfusion (I/R ) in rats .Methods Thirty-six male Sprague-Dawley rats , aged 8-12 weeks ,weighing 280-320 g ,were randomly divided into 3 groups ( n= 12 each ):sham operation group (group S ) , cerebral I/R group (group I/R ) and dexmedetomidine group (group D ) .The animals were anesthetized with 10% chloral hydrate 3.5 ml/kg .The focal cerebral ischemia was induced by middle cerebral artery occlusion using a nylon thread with rounded tip inserted into internal carotid artery and advanced cranially until resistance was met .In group D ,dexmedetomidine 3μg/kg was injected intravenously immediately after beginning of ischemia ,followed by infusion at 3μg·kg-1 ·h-1 for 120 min ,while the equal volume of normal saline was given in group I/R .Four rats from each group were chosen at 24 ,48 and 72 h of reperfusion , and blood samples were taken from the left ventricle to determine the concentrations of serum S100B protein .The rats were then sacrificed and the brains were removed to determine the expression of TNF-αand ICAM-1 in brain tissues .Results Compared with group S ,the concentrations of serum S100B protein were significantly increased , and the expression of TNF-α and ICAM-1 in brain tissues was up-regulated in I/R and D groups ( P<0.05) .Compared with group I/R ,the concentrations of serum S100B protein were significantly decreased , and the expression of TNF-α and ICAM-1 in brain tissues was down-regulated in group D ( P<0.05 ) .Conclusion The mechanism by which dexmedetomidine reduces the cerebral I/R injury is related to down-regulation of TNF-αand ICAM-1 expression in rats .

AIM:To explore the fingerprint method for quality control of Danhong sterile powder for injection (Radix et Rhizoma salviae mihiorrhizae,Flos carthami).METHODS:The samples were determined by Agilent 1100 DAD-HPLC with SinoChrom ODS-BP column(250 mm×4.6 mm,5 μm),by gradient elution using methanol-0.1% phosphoric acid,as mobile phase 30 ℃ column temperature.flow rate of 1.0 mL/min,detection wavelength was set at 280 nm,and inject volume 20 μL.RESULTS:Its fingerprint exhibited better separation for each peak,revealing amount of finger information,Based on the ten batches of Danhong sterile powder for injection,according to the technical requirements of fingerprint on injection of Chinese traditional medicine.CONCLUSION:Proposed HPLC fingerprint can be used as the important evidences for the quality control of Danhong Injection.

AIM:To explore the fingerprint method for quality control of Danhong sterile powder for injection(Radix et Rhizoma salviae miltiorrhizae,Flos carthami).METHODS:The samples were determined by Agilent 1100 DAD-HPLC with SinoChrom ODS-BP column(250 mm?4.6 mm,5 ?m),by gradient elution using methanol-0.1% phosphoric acid,as mobile phase 30 ℃ column temperature,flow rate of 1.0 mL/min,detection wavelength was set at 280 nm,and inject volume 20 ?L.RESULTS:Its fingerprint exhibited better separation for each peak,revealing amount of finger information,Based on the ten batches of Danhong sterile powder for injection,according to the technical requirements of fingerprint on injection of Chinese traditional medicine.CONCLUSION:Proposed HPLC fingerprint can be used as the important evidences for the quality control of Danhong Injection.

Endoscopy ; Equipment Failure ; Female ; Foreign Bodies ; surgery ; Humans ; Intubation, Intratracheal ; instrumentation ; Middle Aged ; Trachea

Objective To evaluate the effectiveness of three neurological assessments in experimental autoim?mune encephalomyelitis. Methods Thirty-two female C57BL/6 mice (18-20g) were randomly divided into normal group (n=15) and immune group (n=17). Immune group were induced subcutaneously in the flank by emulsion consisted of MOG33-35 and complete Freund’s adjuvant. Mice were assessed by two investigators for 35 days after immunization in a blinded manner using Kono’s 5-point criterion, Weaver’s 15-point criterion and improved 15-point criterion. Based on H&E staining, we analyzed the accuracy, sensibility and dependency of three assessments. Results 35-day clini?cal-score plots revealed that the fluctuation of symptoms was more obvious in improved 15-point criterion compared with the other two criteria. 15-point criterion and improved 15-point criterion are more accurate than 5-point criterion in atypical-onset EAE. 15-point criterion and improved 15-point criterion could detect the neurological deficits much earli?er than 5-point criterion (P<0.001). Neurological scores assessed by improved 15-point were well correlated with the pathological findings during the peak and remission stage. Conclusion Improved 15-point criterion is better neurological score system than Kono’s 5-point criterion and Weaver’s 15-point criterion because of its accurate assessment of the neurological deficits in experimental autoimmune encephalomyelitis.