0.05). Conclusion The rapid paper strip method could be applied as the rapid method for monitoring the fecal colifom group in surface water.

Objective To investigate the incidence of autoimmune and nonautoimmune thyroid diseases in patients with breast cancer.Methods Clinical and ultrasound evaluation of thyroid gland,detection of serum thyroid hormone and related antibodies,and fine-needle aspiration of thyroid gland were performed in 100 breast cancer patients and 100 control individuals during the period from 2004 to 2008.Results The mean values of anti-thyroid peroxidase antibodies were significantly higher in breast cancer patients than that in control individuals [(104.56±21.54) U/ml vs (22.16±4.65) U/ml,(P=0.030)].The incidence rates of autoimmune and nonautoimmune thyroid diseases were higher in breast cancer patients than that in control individuals[38 ％ (38/100) vs 17 ％ (17/100),P=0.0009,26 ％ (26/100) vs 9 ％ (9/100),P =0.0016,respectively].Conclusion The results indicate an increased incidence of autoimmune and nonautoimmune thyroid diseases in breast cancer patients.

Objective To compare the effects of equivalent dose of sufentanil and fentanyl on wake-up test and recovery profile in scoliosis surgery. Methods Forty ASAⅠ-Ⅱadolescents undergoing scoliosis surgery were randomly divided into fentanyl group (group F,n=20) and sufentanil group(group S,n=20). Anesthesia was maintained with low-flow(1 L/min) inhalation of isoflurane and nitrous oxide (O2∶N2O=1∶1) in both groups. Intermittent i.v. boluses (1～1.5 ?g/kg) of fentanyl was used for analgesia in group F, and total dosage was not more than 5?g/kg when the wake-up test was started. Continuous infusion of sufentanil [0.1～0.2 ?g/(kg?h)] was maintained in group S, and total dosage was less than 1 ?g/kg when the wake-up test was started. The wake-up test time, postoperative recovery time, end-tidal isoflurane concentration(ETiso) and other hemodynamic variables during operation were recorded. Results There was no significant difference in the wake-up test time, postoperative recovery time, bucking and/or restlessness during the wake-up test, PCA morphine dosage and PONV between the two groups. Conclusion Properly administration of sufentanil does not prolong the intraoperative wake-up test time so that it can safely be used in scoliosis surgery.

Objective: To compare the efficacy and side effects of patient-controlled intravenous morphine with epidural single bolus morphine in postoperative pain relief. Method: Sixty patients undergoing gynecological procedures under epidural anesthesia were randomly assigned to epidural morphine(EPI)group or patient-controlled intravenous analgesia (PCIA) group. In the EPI group,2 mg of morphine was injected into epidural space at the end of operation. In PCIA group, 1 mg of morphine as a demand dose would be injected intravenously by the patient through a patientcontrolled analgesic delivery system until the pain relieved. The patients were followed up at 4, 8, 12, 24 h after operation,and the degree of pain,sedation, nausea and vomiting were assessed. Result: The total dosage of morphine was higher in the PCIA group(19.08?5.0 mg)than that in the EPI group(2mg,P

Objective To compare the efficacy of interscalene brachial plexus block using an ultrasound-guided method with nerostimulator-guided method.Methods Ninety ASAⅠ～Ⅱ patients scheduled for surgery of the upper extremity were randomly allocated into three groups(n=30),Control group: nerve stimulator-guided and single-injection group;US group: ultrasound-guided with nerve stimulator confirmation and single-injection group;UD group: ultrasound-guided with nerve stimulator confirmation and double-injection group.Thirty mL 0.5% ropivocaine was injected in each group.The patient in group UD received half the volume of ropivocaine injected around the two target nerves.Results The average onset time of sensory blockade in the UD group was significantly shorter than in the US group and Control group.The rate of satisfactory sensory blockade in the UD group was significantly higher than in the US group and Control group.Conclusion Ultrasound-guided interscalene brachial plexus block may shorten the onset time with fewer adverse events.The ultrasound-guided double-injection method may significantly improve the quality of blockade.

0.05) in the presence of ApoE ?4 allele.In all four ApoE ?4/4 homozygote patients,one female patient presented a transient delirium status three days before surgery,another male patient presented serious fluctuated delirium symptoms from the second to 17th days after operation.Conclusion The presence of ApoE ?4 allele seems not a predictator of postoperative delirium.ApoE ?4/4 homozygote patients may be more indulgent to delirium than others.

Objective To investigate whether apolipoprotein E (ApoE) genotypes is associated with postoperative delirium in aged noncardiac surgical patients. Methods Two hundreds and twelve inpatients over 65y, undergoing selective noncardiac surgeries were enrolled in the study. The patients were frequently interviewed and evaluated prospectively for delirium with the Confusion Assessment Method (CAM) during the first three postoperative days. APOE genotype was determined using multiplex amplification refractory mutation system pelymerase chain reaction (multi-ARMS PCR) technique. Results Delirium occurred in 45 patients during the first three postoperative days. Of the 212 patients, 18 (8.5%) possessed one or two ApoE 84 allele. There was no significant difference between delirious patients and non-delirious patients(6.7% : 9.0%, P >0.05) in the presence of ApoE ε4 allele. In all four ApoE ε4/4 homozygote patients, one female patient presented a transient delirium status three days be-fore surgery, another male patient presented serious fluctuated delirium symptoms from the second to 17th days after operation. Conclusion The presence of ApoE ε4 allele seems not a predictator of postoperative delirium. ApoE ε4/4 homozygote patients may be more indulgent to delirium than others.

OBJECTIVETo assess patients' knowledge, attitudes, and concerns regarding anesthetic management.

METHODA survey of 55 items was developed and administered preoperatively to 500 patients including 190 men and 310 women in our hospital. Patients were interviewed on their knowledge of the role of anesthesiologists, their preferences regarding anesthetic management, and also their concern about potential anesthetic complications.

RESULTSPatients' perceptions of anesthesiologists' training and role have reached a certain level. Most significant preoperative concerns regarding the anesthesiologists focused on experience, qualifications, and presence or absence during the anesthesia. Patients' concerns also included the possibility of not being waken up following anesthesia, experiencing postoperative pain, and becoming paralyzed. The variations of concerns depended partially on patients' sex, type of anesthesia, and proposed surgical procedure, partially on their education and living environments.

CONCLUSIONIt is suggested that anesthesiologist address significant patient concerns during the preoperative visit to enhance their effectiveness in patient care. Efforts to educate the public on the anesthesiologists' role in preoperative care would improve patients' confidence.

Adolescent ; Adult ; Anesthesia ; psychology ; Attitude to Health ; Educational Status ; Elective Surgical Procedures ; psychology ; Female ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Surveys and Questionnaires

Objective To discuss the clinical characteristics and prognosis of 15 children with hand foot and mouth disease (HFMD) and acute flaccid paralysis (AFP) who were admitted to Beijing Ditan Hospital during the outbreak of HFMD in 2008. Method The epidemiology, clinical manifestations, cerebrospinal fluid (CSF),magnetic resonance imaging and prognosis of 15 children with HFMD and AFP were retrospectively reviewed. The recovery of the patients' affected extremities were monitored for 4 weeks. Results The mean age of these patients was (22.47 ± 20.68) months (range: 5～72 months). Acute paralysis developed (3.47 ± 1.68) days after the onset of fever and progressed to maximum severity within (1～2) days. Poliomyelitis-like syndrome was observed in all cases. Of the 15 cases, 10 had monoplegia of lower limbs, two had paraplegia, one had monoplegia of upper limbs and two had quadriplegia. In these cases, the muscle power varied from level 0 to level 4, and six even showed no muscle power in their affected extremities. Thirteen cases developed neurologic complications (encephalitis, meningitis or ataxia) and three had transient urinary retention. Cerebrospinal MRI examination in eight cases showed hyperintense lesions on T2-weighted images, predominantly in the impaired anterior horn regions of the spinal cord (C2～C7 for cases with upper extremity impairments and T12～L1 for cases with lower extremity impairments), and displayed long T1 signals and long T2 signals. In addition, the midbrain, brain-stem or medulla was also involved in four cases who also contracted encephalitis or meningitis. The muscle strength in 11 patients with single lower extremity impairment showed improvements in the distal limb muscles within 4～8 days, and the other cases showed recovery 2～3 weeks later. Conclusions HFMD in combination with AFP most commonly occurs in children aged less than 2 years old. Acute paralysis develops during the early stage of infection and progresses to a maximum severity within 2 days. In most cases described here, paralysis occurred in a single lower extremity and recovered more rapidly than those with all four limbs affected or with single upper extremity impairment . MRI examination is particularly valuable for the diagnosis and prognosis of AFP because of its high sensitivity and accuracy.

OBJECTIVETo investigate the efficacy and safety of tetracaine hydrochloride in patient-controlled epidural analgesia (PCEA) after pulmonary lobectomy.

METHODSForty-three patients scheduled for elective pulmonary lobectomy under general anesthesia were randomly allocated into either tetracaine group (22 patients) or ropivacaine group (21 patients). In the tetracaine group, 0.15% tetracaine was used for postoperative PCEA, while 0.3% ropivacaine was used in the ropivacaine group. The duration of postoperative analgesia was 48 h. The PCEA included a bolus of 6 ml with a lockout time of 1 h. Postoperative pain score was measured by visa analogue scale (VAS). Forced expired volume at the 1st second (FEV1.0), forced vital capacity (FVC), FEV1.0/FVC and peak expired flow (PEF) were measured preoperatively and daily after surgery. Hemodynamics were monitored and recorded before and after each administration of local anesthetics during the period of the study.

RESULTSVAS scores in both groups decreased significantly after a bolus injection of local anesthetics. There was no significant difference between the two groups in VAS either before or after the administration of PCEA. On the 1st and 2nd days after the operation, pulmonary function was reduced in both groups. However, there were no significant differences between the percentage of the changes of FEV1.0, FEV1.0/FVC and PEF in the two groups. There were also significant differences between the percentage of the changes of heart rate, mean arterial blood pressure and SpO2 after administration of local anesthetics. There was no significant difference in overall satisfaction with pain relief.

CONCLUSIONSThe analgesic effect of 0.15% tetracaine is similar to that of 0.3% ropivacaine used in patient-controlled epidural analgesia after thoracotomy. No serious side effects were observed.

Adolescent ; Adult ; Amides ; therapeutic use ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; methods ; Anesthetics, Local ; therapeutic use ; Humans ; Middle Aged ; Pain Measurement ; Pain, Postoperative ; drug therapy ; Pneumonectomy ; Tetracaine ; therapeutic use