Based on the performance status quo of the deficiency of medical informing duty,this paper analyzed the causes,from the respects of system,management,medical side,patient side,legal,cultural and ethical factors.

Objective To investigate the effects of ultrarapid opiate detoxification during general anesthesia on the plasma morphine concentration and brain ?-endorphin content in rats addicted to morphine. Methods Ninety male Wistar rats aged 12-15 weeks weighing 180-220 g were randomized into 6 groups: group I normal animal ( n = 5); group II morphine addiction ( n = 5); group III natural withdrawal ( n = 20); group IV general anesthesia ( n = 20); group V general anesthesia + naloxone ( n = 20) and group VI clonidine pretreatment ( n = 20). Morphine addiction was induced by subcutaneous injection of increasing doses of morphine sulphate for 5 days (5, 10, 20, 40 and 50 mg? kg-1 t.i.d. ? 5 days) . Morphine detoxification was started on the 6th day. General anesthesia was induced and maintained with ?-OH and midazolam i.m. supplemented with intermittent isoflurane inhalation to maintain loss of righting reflex. Spontaneous breathing was kept during general anesthesia. In group V naloxone 0.05, 0.1 and 0.2 mg was injected subcutaneously at 5, 30 and 60 min after loss of righting reflex. Successful detoxification was defined as no withdrawal symptoms after subcutaneous injection of naloxone 0.1 mg. In group VI clonidine 0.05 mg ? kg-1 was given i. v. 1 hour before induction of anesthesia. Blood samples and brain tissue were obtained before detoxification in group I (normal animal) and II (morphine addiction) while in the other 4 groups they were obtained immediately and 1,2,3 day after detoxification.Results The plasma morphine concentration was 224 ? 164 ng?ml-1 in group II (morphine addiction), significantly higher than in all the detoxification groups ( P V ) (P

objective: The aim of this study was to investigate effects of desflurane and sevoflurane on coronary circulation in dogs and to compare its effects with those of isoflurane. Method:Eighteen mongrel dogs were anesthetized with sodium pentothal 20mg/kg and atracurium 0.8mg/kg. After intubation, thoracotomy was performed and a 3.0 or 3.5mm pulsed Doppler flow probe was placed around the left anterior descending coronary artery. The dogs were randomly assigned to receive desflurane,sevoflurane or isoflurane with the values of MAC being 7.2%, 2.3% and 1.28%,respectively. Coronary blood flow(CBF)were recorded 20 min after the period of equilibration at the desired endtidal concentration. Result:CBF was significantly increased in desflurane and isoflurane group at giving concentrations. Unlike isoflurane,CBF in sevoflurane group decreased slightly at low concentration,but increased significantly at high concentration. Conclusion: The effects of desflurane and isoflurane on coronary circulation are similar, but those of sevoflurane and isoflurane are different.

Objective To investigate the effect and safety of combined spinal-epidural analgesia (CSEA) with different doses of ropivacaine during labor. Methods One hundred ASA Ⅰ -Ⅱ full term primigravidae were randomly divided into 5 groups: group Rl (n =20), R2 (n =21), R3 (n = 21), group Y ( n = 19) and group C ( n = 20) . When the external cervical os was dilated to 3-4cm lumbar puncture was performed at L2-3 or L3-4 with a special CSE needle. 0.75% ropivacaine 0.33ml (2.5mg), 0.5ml (3.75mg) or 0.67ml (5mg) was added to 5% glucose with a total volume of 2.5ml and injected into subarachnoid space in group R1, R2 and R3 respectively. When subarachnoid block was wearing off, patient controlled-epidural analgesia (PCEA) with 0.175% ropivacaine was started (background infusion 6ml/h, bolus 2ml, lock-out time 15min) . In group Y patients received only PCEA with 0.175% ropivacaine and in group C patients received neither CSEA nor PCEA and served as control. Level of pain (VAS scores), degree of motor block (modified Bromage scores), Apgar scores and neurological and adaptive capacity scores (NACS), the progress of labor, the amount of ropivacaine used and side effects were recorded and compared. Blood samples were taken from umbilical vein for blood gas analysis immediately after delivery. Results Demographic data were comparable between groups and there were no significant differences in the progress of labor, Apgar score, NACS and blood gases of umbilical venous blood between groups. The onset of analgesia was significantly faster in group R1, R2 and R3 than that ingroup Y(P

Objcetive To evaluate tumor necrosis factor-alpha(TNF-?) in differentiating diagnosis of tuberculous and non-small cell lung cancer with cytology-positive pleural effusion.Methods We measured TNF-? of serum in 25 patients with tuberculous effusion,26 cases of lung adenocarcinoma,21 cases of lung squamous cell carcinoma with pleural effusion and controls by enzyme-linked immunosorbant assays.Results Serum TNF-? levels in patients with tuberculous pleural effusion were lower than that in patienrts with lung adenocarcinoma and lung squamous cell carcinoma(P

Objective To realize compliance actuality, discuss effect factor and institute correspond countermeasure for diabete integration treatment. Method Investigate 251 patients with diabete who did colligate treatment and community with correlation factor. Results The rate of mostly complication of diabetes was higher (66.53%), and the rate of colligate treatment was lower (only 29.08%). The compliance of treatment had relation with the rate of knowing diabete, symptom and complication, economy factors, medicine insurance, and lever of doctor closely. Conclusion We should intensify diabetes knowledge education, increase medical treatment specialty level, associate with community intervene, supervise and direction, establish consummate medical treatment insurance system to increase colligate treatment of diabetes sufferer.

Objective To establish and stabilize a new HLA-B locus typing strategy, reference strand mediated conformation analysis(RSCA)system and to conform its advantages.Methods Of 27 hematopoitic stem cell transplant patients and 63 potential donors DNA samples were extracted from peripheral blood cells and HLA-B loci were both typed by RSCA and PCR-SSP methods. The (ambi)-(guous) results were identified by using DNA sequencing. Results Among 90 samples, 87/90 ((96.7) %) cases could be designated definitely, but one of them was disagreement with the SSP result which was confirmed by sequencing, and 67/90 ((74.4) %) cases could be typed to allelic level. 1/90 ((1.1) %) case could not be identified by RSCA for its bad PCR results. Only one allele of each 2 samples could be designated and the other could not be identified by RSCA, which were further confirmed by sequencing method, and the results confessed which were known as alleles, but there were no corresponding data in RSCA database. Twenty samples were randomly selected to identify the replication rate of RSCA, and the results demonstrated that the replication rate was 100 %. Among PCR-SSP typing results, about 10 % samples might be typed for 1-3 times to confirm their types. Conclusion RSCA had some advantages such as high resolution, high sensitivity, high accuracy, high replication, finding new alleles, large scale and low cost, and was especially suitable for unrelated donor-recipient (screening).

Objective:To evaluate pathogenesis of nasal polypsis.Method:To detect HPV in 26 pathological samples of 13 cases by polymerase chain reaction(PCR).Ten cases of normal nasal mucous were used as control.Result:HPV-DNA was positive 12 cases(92.3%) in 13 cases of the first surgical operation by PCR.HPV-DNA was positive 5 cases(38.5%)in 13 cases of the second surgical operation by PCR.The most HPV type was HPV6.HPV-DNA was negative in 10 cases of control.Conclusion:The results showed that HPV plays an etiologic role in the development of nasal polypsis.

BACKGROUND: Preliminary experimental study found that the human amniotic mesenchymal stem cells (hAMSCs)transplantation can improve nerve injury symptoms of rats with cerebral infarction.OBJECTIVE: To observe the survival, colonization and differentiation of hAMSCs in the infarct area of cerebralinfarction rats.METHODS: Sixty Sprague-Dawley rats were randomly assigned into hAMSCs transplantation, model or shamoperation groups (n=20/group). Animal models of middle cerebral artery occlusion were produced in the model andtransplantation groups by Zea-Longa method. One day after modeling, rats in the hAMSCs transplantation groupwere given in situ transplantation of 10 μL of hAMSCs (2×106) into the damaged striatum and cortex, while those inthe model and sham operation group were given the same volume of PBS. Within 1 week after transplantation, ratneurological defects were assessed and changes in their body mass were continuously monitored. Two weeks aftertransplantation, TTC staining was used to observe cerebral infarct size, hematoxylin-eosin staining was used forpathological observation of brain tissues, and immunofluorescent staining was used to detect expression ofneuron-specific nuclear protein.RESULTS AND CONCLUSION: With time, weight loss was increased while neurologic deficit scores were graduallyreduced in the hAMSCs and model groups. Compared with the model group, the weight loss and neurologic deficitscores were lower in the hAMSCs group,; however, there was a significant difference in the neurologic deficit scoresbut not in the weight loss between the two groups. Additionally, the hAMSCs significantly reduced infarct size,attenuated pathologic injury, and decreased the number of inflammatory cells. Immunofluorescence stainingshowed that the hAMSCs were observed at 1 week after transplantation under inverted luorescence microscope,and gradually differentiated into nerve cells at 2 weeks after transplantation. In conclusion, transplanted hAMSCsmay migrate to and survive in the cerebral infarct region, and differentiate into nerve cells in situ in rats with cerebralinfarction.