Objective To evaluate the advantages and disadvantages of Narcotrend(NT)in monitoring the depth of anesthesia when compared with the bispectral index.Methods Eighty ASA Ⅰ or Ⅱ patients of both sexes,aged 19-60 yr,undergoing elective surgery,were enrolled in this clinical study.Propofol was given by target-controlled infusion(TCI).After the initial target plasma concentration of 2.1 μg/ml was achieved,the concentration was increased by 0.3 μg/ml every 30 s until the patients lost consciousness.Then the effect-site concentralion of propofol was increased by 0.5μg/ml to maintain anesthesia and rocuronium 0.8 mg /kg was injected intravenously 30 s later.Tracheal intubation was performed 3 min after rocuronium injection.Mean arterial pressure (MAP),HR,NT value and BIS value were measured before TCI of propofol(baseline),al loss of consciousness,immediately before rocuronium administration,2 min after rocuronium administration,during intubation,and at 1 and 3 min after intubation.Results NT and BIS values were significantly decreased at loss of consciousness as compared with the baseline value(P ＜ 0.01).NT and BIS values were significantly lower at 2 min after rcuronium administration than before rocuronium administration(P ＜ 0.05).Compared with that before intubalion,HR and MAP were significantly increased during intuhation,and at 1 and 3 min after intubation,while no significant change was found in NT and BIS values(P ＞ 0.05).Conctusion NT can monitor the sedative effecl induced with TCI of propofol accuralely,the myoelectric activity exerts an obvious effect,and the accuracy of NT for monitoring the analgesic effect is lower.NT and BIS are comparable with respect to the advantages and disadvantages.

Objective To study the operative methods and surgical technique of arthroscopical meniscal suture in treatment of meniscal tears under local anesthesia. Methods From February 1999 to November 2003, we cure 32 patients (22 males and 10 females) with this method. The patients' average age is 29. Results All of the patients accept the operation through arthroscopy under local anesthesia. The procedure last 50 minutes on an average. 92% of the patients gain good results, no severe complications. Conclusion This method has the advantages of less pain, time saving(save time), quick recovery and less complications.

Definiting the workflow and key link of the risk management in medical laboratory by FMEA.Identifying risk factors of the workflow and key link of blood coagulation test by the criteria for laboratory accreditation , such as ISO15189 recognition criteria and CAP laboratory accreditation inspection . Through the evaluation of the blood coagulation test , effective corrective actions and examining performance data periodically , the quality of the blood coagulation test can be improved continuously.

Objective To assess the diagnostic value of dynamic contrast enhanced MR imaging in predicting the efficacy of distinguishing benign from malignant soft tissue tumor Methods Dynamic contrast enhanced MR imaging was performed in 30 patients with pathologically confirmed soft tissue tumors The MR signal intensity of the ROI was plotted The slope value of the time intensity curve was analyzed Results There was significant difference between the slope value of benign and malignant lesions Based on the slope value of half minute, differentiation of benign from malignant lesions was possible with 90 9% of the sensitivity, 89 4% of the specificity, 83 3% of the positive predictive value and 94 4% of the negative predictive value Conclusion Dynamic contrast enhance MR imaging can correctly predict benignity or malignance of soft tissue tumors

Objective To investigate inhibitory effect of Telmisartan on carotid arterial intima-media thickness in patients with essential hypertension. Methods 104 patients with mild or mid essential hypertension were randomly divided into three groups, which include telmisartan group( telmisartan 80 mg/d PO), ramipril group( ramipril 5 mg/d PO), and control group( other anti-hypertension agents). Blood pressure was monitored during treatment. Carotid arterial intima-media thickness(CIMT) were measured in all patients at beginning and patients who had the 12 months course. Results There were 91 patients who had the 12 months course,which include telmisartan group33 cases,ramipril group28 cases, and control 30 cases. The CIMT was significantly decreased in telmisartan group and ramipril group ( all P < 0. 05 ), and not changed in control while blood pressure fall effectively. In ramipril, group5 cases were ceased the course because of severe cough. Conclusion Both telmisartan and ramipril could decrease blood pressure and CIMT effectively, and there were less side effects in telmisartan group.

Objective To research the 50% effective anesthetic volume ( EAV50) of 0.5% ropivacaine in nerve stimulator-guided vertical infraclavicular brachial plexus block. Methods Thirty patients scheduled for forearm or hand surgery were blocked using 0. 5% ropivacaine in nerve stimulator-guided vertical infraclavicular brachial plexus block. The EAV50, which is the anesthetic volume corresponding to 50% success and 50% failure was determined by up-and-down sequential test. The starting dose of 0. 5% ropivacaine was 0. 55ml/kg. Block failure resulted in a dose increase 110% , and block success in a reduction 110%. The sensory and motor blockade were accessed at 5- min intervals (up to 60 min). Results In nerve stimulator-guided vertical infraclavicular brachial plexus block, EAV50 for 0.5% ropivacaine was 0.417ml/kg. In up-and-down sequential test, there were significantly different in the block success rates of lateral, medial and posterior cord ( P <0.01). Conclusion In nerve stimulator-guided vertical infraclavicular brachial plexus block, enough anesthetic volume must be given to increase block success rates of all the cords of brachial plexus, and EAV50 for 0. 5% ropivacaine was 0.417ml/kg.

Objective To observe the influence of Shenkang injection with Irbesartan on urinary albumin excretion rate(UAER)in 24 hours,serum lipid and blood rheology in early diabetic nephropathy.Methods One hundred and fifty normotensive early diabetic nephmpathy were randomly divided into control group,Shenkang injection group and Shenkang injection with Irbesartan group.Three groups were treated with diabetic education,dietary regimen,suitable physical activity and oral anti-hyperglycemic agents till their fasting blood glucose(FBG)was less than 7.0 mmol/L and postprandial blood glucose(PBG)was less than 10.0 mmol/L.The control group was treated with oral anti-hyperglycemic agents or/and insulin.Shenkang injection group was additionally treated with Shenkang solution.Shenkang solution was mixed by Shenkang injection 100 ml,5% glucose 250 ml and insulin 2-3 U.Shenkang solution was intravenously guttaed once a day.Shenkang injection with Irbesartan group was additionally treated with Irbesartan 0.15 g,once a day,taken orally.A course was taken for 3 weeks.The levels of UAER,serum lipid and blood rheology were detected immediately and 9 weeks after treatment.Results In the Shenkang injection group,compared with those before treatment,them were significant difference in UAER (87.44 ±10.06)μg/min vs.(116.55 ± 33.42)μg/min),serum lipid( (4.22 ± 0.70)mmol/L vs.(4.88 ± 0.69 )mmol/L)and blood rheology( (5.77 ±0.53)mPa·s vs.(7.38 ± 0.41)mPa·s)(P ＜ 0.05).In the Shenkang injection with Irbesartan group,compared to those before treatment,there were also significant difference in UAER ( (61.90 ±28.02)μg/min vs.(123.37 ± 29.98)μg/min),serum lipid( (4.00 ± 0.14)mmol/L vs.(4.90 ± 0.12)mmol/L)and blood rheology( (5.11 ±0.41)mPa·s vs.(7.27 ± 0.44)mpa·s)(P ＜ 0.05).Whearas in the control group,no significant difference were found compared with those before treatment.Furthermore,the improvements in the Shenkang injection with Irbesartan group were better than those in the Shenkang injection group(P ＜ 0.05).Conclusions Shenkang injection can reduce UAER,decrease serum lipid and improve renal blood rheology.Iteffectively prevents diabetic nephropathy in earlier period and maybe have synergy with Irbesartan.

A nested case-control study was carried out to assess the effectiveness of Chinese medicines in the treatment of diabetic nephropathy, so as to explore the feasibility of using nested case-control study on effect assessment of Chinese medicine.

Objective To study the impact of narrow band ultraviolet B (NB-UVB) irradiation on the expression of T helper 17 (Thl7) and CD4,CD25 and regulatory T (Treg) cells and their related cytokines transfor-ming growth factor beta 1 (TGF-β1) and interleukin-6 (IL-6) to further clarify how NB-UVB treatment helps patients with psoriasis vulgaris.Methods Ninety patients with active stage and stationary stage psoriasis vulgaris (45 cases each) were treated with NB-UVB for 8 weeks.Fifty healthy persons were used as normal controls.Peripheral blood levels of Th17 and Treg were measured by flow cytometry.An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of TGF-β1 and IL-6 before and after treatment.Clinical efficacy was evaluated in terms of the area of psoriasis and severity index (PASI) scores.Restlts Before treatment,the patients showed significantly higher levels of Thl7 cells in their peripheral blood than the controls.Their ratios of Th17 to Treg cells and their serum levels of IL-6 were also significantly higher.The percentage of Treg cells and the serum level of TGF-β1 were significantly lower in the patients.After the NB-UVB treatment,the Th17 cells,the ratio of Th17 to Treg cells and IL-6 had all decreased significantly.The percentage of Treg cells and TGF-β1 levels were significantly high-er compared with before phototherapy.The total effectiveness rate was 86.7％,and the average PASI scores had de-creased significantly.The PASI scores were positively correlated with the percentage of Th17,the Th17 to Treg ratio,and the serum level of IL-6,and negatively correlated with the percentage of Treg cells and TGF-β1.Conclusion The imbalance between Th17 and Treg cells and their cytokines may play an important role in the pathogenesis of pso-riasis.NB-UVB is able to significantly down-regulate the levels of Th17,IL-6 and the progression of Treg levels and TGF-β1 expression.It can regulate the balance between Thl7and Treg cells,which may be one of the mechanisms of NB-UVB treatment for psoriasis.The clinical data demonstrate that NB-UVB treatment is a safe and effective therapy for psoriasis vulgaris.

In order to meet the demand of higher medical education reform and to enhance the re-search capability among medical undergraduates , Capital Medical University carried out a project named undergraduate scientific research and innovation program. In the process of the project , several problems were found in both undergraduates and tutors including lack of document indexing skill , professional English ability , doctor-patient communication consciousness , data statistics and paper writing skills of undergraduates and limited time, insufficient funds and lacking experiences of tutors. Through establish-ing sound and standard training system, increasing scientific research funding, setting up incentive mech-anism and increasing scientific research ability training courses, scientific research ability of undergradu-ates and tutors were firmly strengthened.