Objective To investigate the characteristics of the pharmacodynamics of rocuronium bromide in patients with hepatobiliary disease. Methods Forty-eight patients undergoing abdominal surgery were divided into four groups, group A: patients with liver cirrhosis and portal hypertension (n = 12); group B1 : patients with cholelithiasis and obstructive jaundice (n = 12); group B2 : patients with cholelithiasis but no obstructive jaundice ( n=12);group C: patients without hepatobiliary disease ( n = 12) . Their renal function was normal. Patients with cardiovascular and neurological diseases were excluded. Premedication consisted of intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with midazolam 0.05 mg?kg-1 , fentanyl 2?g?kg-1 , propofol 2 mg?kg-1 and rocuronium 0.6 mg?kg-1 . The patients were intubated and mechanically ventilated. PETCO2 was maintained at 30-35 mm Hg. Anesthesia was maintained with iv infusion of propofol and fentanyl. Additional bolus dose of rocuronium 0.15 mg?kg-1 was given when T, recovered to 25% and each patient received six additional doses irrespective of duration of operation. Neuromuscular function was monitored using Datex-Ohmeda NMT mechanosensor. Onset time (from the end of injection to maximum depression of muscle twitch), clinical duration of intubating and additional dose (25 % recovery of T1 ) and recovery index (T1 from 25 % -75 %) were recorded. Results The demographic data were comparable among the four groups. The onset time was significantly longer in group A than that in group B, , B2 and C ( P

Objective To study the effects of three anesthetic techniques on the neuroendocrine and immune responses to surgical stress Methods Thirty patients undergoing elective upper abdominal surgery, were allocated randomly to epidural anesthesia group(groupⅠ), general anesthesia group (groupⅡ)and combination of epidural and general anesthesia group(group Ⅲ ) The serum concentrations of IL 6 and cortisol, and T cell subsections were measured respectively before induction, before incision, 1 h following the operation, at the operative end , on the first and fifth postoperative day Results Serum IL 6 concentrations increased significantly in groupⅠand Ⅱ(P0 05) during and after the operation, and serum IL 6 concentrations of all patients at the operative end were correlated positively to the operative duration (r=0 61, P

Objective To evaluate the myocardial protective effects of thoracic epidural anesthesia (TEA) with 0 5% ropivacaine during acute myocardial ischemia reperfusion Methods Eighteen healthy hybrid dogs were randomly divided into three groups: ropivacaine group (group Ⅰ), bupivacaine group (group Ⅱa) and normal saline group (group Ⅱb) Anesthesia was induced and maintained with intravenous anesthesia and ventilation was mechanically controlled Epidural catheter was placed at T 6 7 and 0 5% ropivacaine, 0 5% bupivacaine or normal saline 12ml was administered epidurally 15min after epidural administration of local anesthetics or normal saline, the anterior descending branch of left coronary artery was temporarilly occluded for 45min Blood samples were taken from right atrium and assayed for cardiac troponin T (cTnT) before epidural administration and 6h after reperfusion Myocardial tissues of left ventricular infarction area were examined by electron microscopy Results Plasma cTnT levels were comparable (P

Myasthenia gravis is an autoimmune disease resulting from the production of antibodies against acetylcholine receptors of the endplate. These antibodies impair postjunctional membrane and reduce the number of functional acetylcholine receptors of endplate. Thymectomy is an effective therapeutic method for adult myasthenic patients. In this paper, the author reviewed the pathophysiological characteristics and problems related to anesthesia, such as preoperative evaluation, the effect of preoperative medical treatment on the anesthesia, patients'response to muscle relaxants and postoperative management.

Objective To investigate the sedative effect of propofol combined with different doses of midazolam in patients undergoing long-time microsurgeries.Methods Forty ASA(American Society of Anesthesiologists)Ⅰ～Ⅱ patients were randomly divided into 4 groups.Normal saline(NS) 2 mL was administered in groupⅠ,while midazolam 0.01,0.02 and 0.04 mg/kg was administered in groupⅡ,Ⅲ,Ⅳ respectively.one min later,propofol was infused at a rate of 5～10 mg/kg?h combined with midazolam based on the abovementioned dosage per hour for groupⅡ,Ⅲ,Ⅳ respectively.Taking auditory evoked potential index(AAI) as a parameter,after it decreased to 40,the infusion rate of propofol was adjusted to keep AAI at the level of 30～45,and maintained the level by infusing propofol and midazolam for 5 hours.The dosage of propofol required for induction and maintenance was recorded.The emergence time and whether patients had awareness during the operation were recorded after the infusion stopped.Results At the target sedative level of AAI 30～45,the Observer's Assessment of alertness/sedation(OAA/S) score of all patients in the four groups reached 0～1.The induction period was obviously shortened and the propofol dosage was dramatically reduced in group Ⅱ～Ⅳ as compared with groupⅠ.At the stage of maintenance of sedation,the dosages of propofol in both groupⅠandⅡ were larger than those in group Ⅲ and Ⅳ.The emergence time in group Ⅳ was dramatically longer than the other groups(P

Objective To evaluate the clinical effect in prevention of intravenous catheter-related infection(CRI) using antiseptic impregnated central venous catheter.Methods Intravenous catheter-related infection was retrospectively analyzed between 440 cases performed with general centrol venous catheter and 420 cases performed with antiseptic impregnated central venous catheter in ICU.Results There were 34 cases of CRI in 860 cases,28 cases were inserted general central venous catheter and 6 cases inserted antiseptic impregnated central venous catheter,the group of antiseptic impregnated was lower singificantly than the group of general in infection rate(P=0.0002).Conclusion Using antiseptic impregnated central venous catheter can reduce CRI,which has clinical effect in prevention of CRI.

Studies on NaCl concentration, pH tolerance and selectivity to different concent rations of Na +, K +, Mg 2+ and Ca 2+ of 43 isolates from th e saline soils in XinJiang, HeBei and QingHai Provinces of China and 4 type stra ins were performed in this paper Results showed that halotolerant actinomycete s have extensiv e adaptability to Na +, K + and Mg 2+ and only a few of them can grow in low CaCl 2 concentration Halophilic actinomycetes have extensive adaptability to Na +, and for most halophilic actinomycetes, Na + can be substituted by K + , Mg 2+ , but not for Ca 2+ For some halophilic actinomycetes , it is necessary to have Na + for their growth It also showed that the growth of al l halophilic actinomycetes had se lectivity with different concentration of Na +, K +, Mg 2+ So it is pre sumed that only Kaliumphilic or Magnesiumphilic Actinomycetes maybe exist in hig h salt environments In addition, the growth pH range were 6 0～9 0 and the o ptimum pH were 7 0～8 0 not only for halophilic but also for halotolerant acti nomycetes The dis tribution of halophilic actinomycetes also have some relativity to isolation sit es

Disasters are traumatic events that are always incongruent with our existing cognitive structures. Immediate negative psychological impact and traumatic related psychiatric disorders are popular among survivals involving the disasters. Super-half of survivals involving the "5" 12" Wenchuan earthquake experienced the symptoms of anxiety or increased arousal. 12.59% of survivals were met with the ASD diagnosis. 21.29% of adults and 10.21% of adolescents were met with the PTSD diagnosis 5 months after the major earthquake. Immediately negative psychological impact and high prevalence of traumatic related psychiatric disorders among survivals were confirmed.More effort should be paid on the disaster related patients in emergency department with psychiatric issues. Also, the long-term psychological service is necessary for Sichuan Pest-Disaster Reconstruction Projects.

Objective To summarize the puncture indications and the pathological type features of renal allografts biopsies in our center for evaluating its safety and diagnostic value .Methods The data of 773 percutaneous renal allograft biopsies in 629 kid‐ney transplants in the Pearl River Hospital of Southern Medical University from January 2005 to June 2014 were retrospectively an‐alyzed .Results The success rate of renal biopsy was 100% ,9 cases(1 .2% ) were complicated postoperative perirenal small hemato‐ma ,33 cases(4 .3% ) with gross hematuria and 1 case(0 .13% )with abdominal pain .Among the indications of 773 biopsies ,protein urine occured 205 cases(26 .5% ) of patient ,blood Cr increased in 187 cases(24 .2% )of patients ,protein urine simultaneously com‐plicating blood Cr increased ,in 313 cases of patients ,53 cases(6 .9% )had postoperative oliguria urinary ,and 15 cases(1 .9% )were get procedural biopsy .In the pathological types ,21 cases(2 .7% ) were normal ,179 cases (23 .2% ) were acute T cell‐mediated rejec‐tion after transplantation ,51 cases (6 .6% )were acute antibody‐mediated rejection ,205 cases (26 .5% ) were chronic T cell‐mediated rejection and 43 cases(5 .6% ) were chronic antibody‐mediated rejection;41 cases(5 .3% ) were drug toxicity ,29 cases(3 .7% ) were acute tubular necrosis(ATN) ,11 cases(1 .4% ) were relapsed or new nephropathy ;9 cases(1 .2% )were HBV related renal disease;39 cases (5 .0% ) were critical lesion and 145 cases(18 .8% )were others .Conclusion Rrenal allograft biopsy is safe ,it is important to the etiological diagnosis of renal disease after renal transplant ,which can guide the clinical treatment and improve the long term survival of renal graft and should be routinely carried out in clinic .

Objective To evaluate the effect of evidence- based nursing for patients receiving percutaneous coronary intervention and stent implantation. Methods A total of 136 patients with coronary heart disease were randomly divided into the intervention group (n = 68) and the control group (n = 68). Traditional nursing measures were employed for the patients of the control group , while evidence-based nursing intervention was adopted for the patients of the intervention group. The patient’s comfortableness, satisfaction and the occurrence of complications were determined at 24, 48 and 72 hours after the operation, and the results were compared between the two groups. Results At 24, 48 and 72 h after percutaneous coronary intervention, the each dimension score of GCQ and the total score of the intervention group were significantly higher than those of the control group (P<0.05). The occurrence of back pain, urinary retention and hypotension in the intervention group was significantly lower than those of the control group (P < 0.05). Patient’s satisfaction extent of the intervention group was significantly better than that of the control group (P < 0.05). Conclusion Evidence-based nursing intervention can effectively enhance the nursing skill and orientation, and reduce the occurrence of back pain, urinary retention and hypotension, thus improve patient’s comfortableness and satisfaction. Therefore, evidence - based nursing intervention should be recommended in clinical practice.