Objective To examine the differences in the level of sedation and adverse effects produced by equivalent analgesic doses of remifentanil,sufentanil and fentanyl.Methods Eighty ASA Ⅰ female patients aged 18-39 yr with BMI of 18-25 kg/m2 scheduled for laparoscopic surgery under general anesthesia were randomly divided into 4 groups ( n =20 each):group control (group C) ; group remifentanil ( group R) ; group sufentanil (group S) and group fentanyl (group F).Remifentanil 2 μg/kg,sufentanil 0.2 μg/kg and fentanyl 2 μg/kg in normal saline 10 ml were infused iv over 2 min in groups R,S and F respectively.Depth of sedation was assessed and scored using OAA/S scale (5 =alert,1 =no response to prodding) and wavele index (WLI),before (baseline) and at 2,4,6,8 and 10 min after drug administration.Besides RR,pulse oxygen saturation,BP,HR were also monitored.The incidences of apnea,muscle rigidity,nausea and vomiting,pruritus,vertigo,bradycardia,profuse sweating and skin rash were measured and calculated.Results The 4 groups were comparable with respect to age,BMI and height.The lowest values of OAA/S scores,WLI and RR were significantly lower in groups R,S and F than in group C.Sufentanil produced the deepest sedation among the 3 opioids.Remifentanil produced strongest respiratory depression and nausea and vomiting.Conclusion The equivalent analgesic dose of sufentanil produces deeper sedation than that of remifentanil and fentanyl while remifentanil has the greatest impact on RR.

The purpose of this study was to ascertain the usefullness of four mental health measures in their application to Chinese elderly subjects. These measures which included CES—D, GHQ—30, LSI, and MST were adapted to assess general symptoms of depression and minor psychiatic disorder, life satisfaction, and mental state of the elderly people. Results of these findings indicated that split—half and test—retest reliabilities of these measures were highly satisfactory. With respect to validity, test performace of a group of psychiatric patients (N=31) and normal elderly subjects (N=30) were found to be significantly differencetiated. Furthermore, the pattern of scores obtained by the psychiatric patients also matched well with the clinical diagnosis made by a consultant. Normative data in an old—old sample (N=554) revealed mild to moderate correlations between measures, reflecting favourably on their convergent validity. Significant sex differences were found, which necessitated the establishment of separate norms for males and females subjects.

Objective To investigate the distribution and duration of abnormal blood glucose level in SGA infants. Methods Blood glucose level was systemicly monitored in 37 SGA infants for (133?115) h(range 16～524 h, median 93 h), who were non NICU hospitalized and no feeding or IV infusion when admitted at (2 6?2 4) h (range 0.25~10.0 h, median 2.0 h) of age. Results During monitoring period, there was hypoglycemia in 19 cases (51%),hyperglycemia in 2 cases (5%), and both hypo and hyperglycemia in 3 cases (8%). The median of last time abnormal glucose level appeared was 10 hr after birth, its 95% confidence interval was 5~55hr after birth. Multiple regression analysis shown delivery models bad relationship with glucose level at admition (p= 0.013). The blood glucose level was higher in vaginal delivery babies. The lower the birth weight (BW)was, the longer the duration of abnormal glucose level lasted ( O

Abstract?AlM: To observe the anterior chamber angle shape of patients with diabetic retinopathy ( DR) at different stages using OCT, and to explore a more sensitive and accurate glaucoma preventing measure.?METHODS: A total of 613 cases of DR patients were divided into proliferation phase group ( 353 cases ) and background phase group ( 260 cases ) , another 100 cases of patients with only diabetes were selected as control group. OCT was used to detect the anterior chamber angle related parameters, including angle opening distance ( AOD) , trabecular-iris space area ( TlSA) , angle recess area ( ARA ) , anterior chamber depth ( ACD ) and anterior chamber angle ( ACA) .?RESULTS: There were significant difference among AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 were 0. 60 ± 0. 22mm, 0. 78 ± 0. 39mm, 0. 22 ± 0. 12mm2 , 0. 45 ± 0. 19mm2 , 0. 29 ± 0. 18mm and 0. 46 ± 0. 15mm, respectively. There were significant difference among ACA500, ACA750, ACD500 and ACD750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, ACA500, ACA750, ACD500 and ACD750 were 30. 29o ± 8. 19o, 21. 20o ± 7. 40o, 2. 32 ± 0. 23μm and 2. 52±0. 16μm, respectively. ln addition, ROC results indicated that all these indices exert significant difference on evaluating the stage of DR. ?CONCLUSlON: Anterior chamber angle shape detected using OCT can reflect the change of retinopathy. OCT is an accurate and simple technique for detecting DR staging.

Adolescent ; Humans ; Male ; Werner Syndrome

Colorimetry ; Coloring Agents ; Evaluation Studies as Topic ; Filtration ; methods ; Food ; Humans ; Image Interpretation, Computer-Assisted ; Mastication ; physiology ; Particle Size ; Time Factors

Objective To evaluate whether the prognosis of 6 months major adverse cardiac events(MACE)after acute myocardial infarction,and the reperfusion state of myocardial tissue are related to the white blood cell(WBC)count in elderly patients.Methods A total of 101 consecutive patients aged≥60 years(mean age 70?6 years)who had a primary percutaneous coronary intervention as their first-line therapy for ST-elevation myocardial infarction(STEMI)were enrolled, and both their WBC count on admission and ST-monitoring were available.A prospectively defined cut-off value of WBC count was 10,000/?l,a cut-off 50% measured after 60 min was used as ST -segment resolution(STR).Results The high WBC count group(n=48)showed the significantly higher(52.1% vs 22.6%,P＜0.01)incidence of 6 months major adverse cardiac events(MACE)than did the,low WBC count group(n=53).The low WBC count group had 45 patients with STR≥50%, high WBC count group had 23 patients with STR≥50%,STR after PCI was significantly different between the 2 groups(P＜0.01).Conclusions The WBC count is a predictor of the adverse outcome in elderly patients with STEMI.Furthermore,elevation in WBC count is associated with poor myocardial microcirculatory reperfusion.

The medical service payment system reform is one of core issues in medical and health system reform.The main content of diagnosis related groups-prospective payment system includes diagnosis coding standardization,medical records front sheet standardization,diagnosis grouping,medical information management.To successfully implement the payment system,it is important to implement clinical pathway,sign medical services agreement,accurately complete medical records from sheet,interdepartmentally cooperate.

Amikacin ; adverse effects ; Anti-Bacterial Agents ; adverse effects ; Child ; Drug Eruptions ; etiology ; Erythema Multiforme ; chemically induced ; Humans ; Male

Problem-based learning (PBL) was carried out in general practice residency training program.Interview was used to evaluate the teaching performance.A total of 22 teachers and 198 students participated in evaluations.Among the teachers,17 (77％) were quite satisfied and 5 (23％) relatively satisfied.The overall satisfaction rates of teachers,problems and problem solutions were 87％,75％ and 91％ respectively. PBL stimulated the interests of students and was conducive for the combination of theoretical and practical knowledge.And it might improve the thinking ability of students and would be a good teaching method in general medicine residency training.