Objective To investigate the efficacy of anesthesia with propofol-remifentanil given by targetcontrolled infusion (TCI) for thymectomy in patients with myasthenia gravis ( MG). Methods Forty-five ASA Ⅰ or Ⅱ MG patients aged 16-64 yr weighing 45-95 kg undergoing thymectomy were studied. Anesthesia was induced with TCI of propofol (target plasma concentration 4 μg/ml) and remifentanil (target effect-site concentration 4 ng/ml). Thracheal intubation was performed after topical anesthesia with 2% lidocaine 2-3 ml and then the patients were mechanically ventilated. Anesthesia was maintained with TCI of propofol ( target plasma concentration 3-5 μg/ml) and remifentail (target effect-site concentration 3-6 ng/ml). Sufentanil 0.15 μg/kg was injected intravenously for analgesia 30 min before operation. The success rate of intubationat at first attempt, body movement in response to skin incision, recovery time, extubation time, extubation condition at the end of operation and cardiovascular events were recorded. Results Thracheal intubation was performed successfully in all patients. The success rate of intubation at first attempt was 100%. No body movement occurred during skin incision in the patients.Recovery time was 1.0-3.2 min and extubation time 2.6-7.0 min. All patients were successfully extubated at the end of operation. Bradycardia developed in 3 patients and hypotension in 4 patients during induction, but they all returned to normal after symptomatic treatment. Bradycardia developed in 3 patients during operation, but returned to normal after symptomatic treatment. Conclusion Anesthesia with TCI of propofol and remifentanil can be used safely and effectively in MG patients undergoing thymectomy.

Inductive chemotherapy and concurrent chemoradiotherapy have been a focus on the clinical research in the treatment of nasopharyngeal carcinoma.Cisplatin,as a kind of representative platinum drug,can improve the curative effect,but it also brings a lot of side effects to nasopharyngeal carcinoma patients.The new kind of platinum drug-nedaplatin,can not only guarantee the curative effect but also reduce the side effects of chemotherapy.

The reversed-phase high-performance chromatography was developed for determing the content of berberine, palmatine, emodin and chlorogenic acid in Xiaoerniuhuang Powder on ODS column. The powder samples extracted with methanol were determined separatly at their particular absorption points using external standard method.This method had advantages of perfect separatin, high sensitivity, good reproducibility and simple operation.

Bone Resorption ; China ; Cytokines ; physiology ; Diphosphonates ; pharmacology ; Estrogens ; pharmacology ; Humans ; Jaw ; drug effects ; metabolism

Objective To observe the bleeding risk of short-term intensive statin therapy after coronary artery bypass grafting. Methods A total of 240 patients treated with coronary artery bypass grafting were randomly divided into group A(experimental group)and group B(control group). All pa-tients were normalized to conventional treatment and they were given low molecular weight heparin for an-ticoagulant therapy during the perioperative period. Patients in group A were given 40 mg of atorvastatin before surgery,and 40 mg of atorvastatin every night for one month after the surgery. Patients in group B were given 10 mg of atorvastatin every night during the treatment. One month after the operation,platelet aggregation rate and bleeding events of patients were compared. Results There were significant differ-ences in maximum platelet aggregation rate[(14. 5 ± 3. 7)% vs(38. 1 ± 7. 4)% ,P < 0. 05],inhibition rate of platelet aggregation[(79. 5 ± 4. 3)% vs(50. 8 ± 10. 2)% ,P < 0. 05],and incidence of postopera-tive bleeding[27. 5% vs 12. 5% ,P < 0. 05]between group A and B,respectively. Conclusion Short-term intensive statin therapy can increase the bleeding risk after coronary artery bypass grafting.

Objective To observe the accuracy of abdominal ultrasound combined with transvaginal ultra-sound in the early diagnosis of ectopic pregnancy,thus to provide reference for clinical diagnosis of ectopic pregnancy. Methods The clinical data of 68 patients,who pathologically confirmed or conservative treatment with clinical diag-nosis of ectopic pregnancy,were retrospectively analyzed.All patients were treated with abdominal ultrasound,vaginal ultrasound examination.The accuracy and missed ectopic pregnancy rate of transvaginal ultrasound and abdominal B ultrasound and joint inspection were observed.And the presence or absence of abnormal ovarian uterus were recorded. Results By comparison with pathological diagnosis,joint diagnosis of 32 cases of ectopic pregnancy,the diagnosis rate was 94.1 %,missed 2cases,accounted for 5.9%;Transvaginal ultrasound diagnosis were 26 cases,accounted for 76.5%,missed by 8 cases,accounted for 23.5%;Abdominal ultrasound diagnosis were 24 cases,accounted for 70.6%,missed 1 0 cases,accounted for 29.4%.Joint inspection diagnosis rate was significantly higher than abdominal or vaginal ultrasound(χ2 =1 6.75,1 4.38,all P <0.05),and then compared transvaginal ultrasound and abdominal ultrasound diagnosis rate(P >0.05).Transvaginal ultrasound detected primitive heart tube pulse,mass,blood flow and gestational sac -like structures within the mass were significantly higher than the probability of abdominal ultra-sound(χ2 =26.71 ,7.1 8,1 0.25,50.28,25.69,6.39,all P <0.05).Conclusion United abdominal ultrasound and transvaginal ultrasound can significantly improve the early detection rate of ectopic pregnancy,which can provide refer-ence for clinical diagnosis and treatment.

At present, oncology medical student in our country has many communication problems, such as communication awareness is not strong,the lack of communication,communication is not enough self-confidence and other issues.To improve the communication ability between doctors and patients for the oncology professional medical students:it is the necessary premise for correct implementation of diagnosis and treatment, an effective way to reduce medical disputes, adapt to the demand of the development of higher medical education.And pointed out the effective ways to improve the ability of doctor-patient communication:to set up the doctor-patient communi-cation and tumor department before the internship training course;establishlisten with your heart and professional guidancemode;with teacher actively guiding; learn to empathymode; adhere to the concept of taking pa-tients as the center.

Our ancestor found that some of the Chinese herbal drugs were toxic during their clinical practice. They graded the toxicity of Chinese herbal drugs into three degrees and thought that the term "toxicity of the Chinese herbal drugs" could be used in a broad and a narrow sense. In modern times, toxic components of the Chinese herbal drugs and their toxic mechanisms, especially the toxicity on the kidney, were further revealed. The factors that affect the toxicity of the Chinese herbal drugs include the species, preparation, dose and environment. To prevent the toxicity of the Chinese herbal drugs, we must strengthen the management of the Chinese herbal drugs. On the other hand, doctors' recognition of the toxicity of Chinese herbal drugs should be enhanced. At the same time, patients should be told to decoct and take Chinese herbal drugs correctly.

Objective To investigate the bladder responses to different rates of bladder infusion in healthy and spinal cord injured rats.Methods Fourteen adult female Sprague-Dawley rats were used and divided into two groups:healthy group (n =7) and spinal transection injury group (n =7).The intravesical pressures induced by continuous infusion of saline with different rates under general anesthesia were recorded and compared between the two groups.Results In healthy group the responses of bladder contraction were dependent upon the rate of bladder infusion,and contraction time became shorter while increasing the infusion rate (P ＜ 0.05),i.e.contraction time was (401.0±132.4),(215.7 ±95.9),(108.3 ±59.1) and (52.5 ±32.8)s,respectively,when the infusion rate was 0.05,0.1,0.2 and 0.5 mL/min.Compared with healthy group,spinal transection injury group had significantly shorter bladder contraction time (P ＜ 0.05),however the relationship between bladder contraction time and infusion rate was much weakened.Spinal transaction injury rats had significantly lower peak of bladder pressure (P ＜ 0.05) compared with healthy rats.There was no significant difference for contraction durations between the two groups.Conclusions The infusion rates influenced the contraction periods for both healthy and spinal cord injured rats.During bladder infusions with a same rate,the contraction time and the peak of bladder pressure were determined by bladder conditions,i.e.healthy or neurogenic with spinal cord injury.