Objective To explore the effect of propofol-remifentanil total intravenous anesthesia in cosmetic surgery and the controllability of anesthesia.Methods According to the American Society of Anesthesiologists (ASA),levels Ⅰ-Ⅱ hospitalized patients for elective cosmetic surgery (100 cases) were randomly divided into two groups,namely propofol-remifentanil total intravenous anesthesia group (Group T) and combined intravenous inhalational anesthesia group (Group C),50 cases each.Observatory items of patients included intraoperative cardiovascular drug use,body movement,waking-up time,extubation time,leaving time from operation theatre,postoperative adverse reaction,hypoxemia (SpO2＜95％) and anesthesia satisfaction.Results In Group C,waking-up time,extubation time and leaving time from operation theatre were (12.2 ± 3.6),(13.8± 4.6) and (4.6 ±5.8) min,respectively,which were longer than those (6.7±2.6),(7.8±3.3) and (3.3±3.8) min in Group T (P＜0.05).In Group T,intraoperative ephedrine usage (6/50,12.0％) and body moving rates (4/50,8.0％) were higher than those (1/50,2.0％) and (1/50,2.0％) in the Group C (P＜0.05).The Group T had lower incidence of postoperative adverse reactions,including lethargy (2/50,4.0％),irritability (1/50,2.0％),nausea and vomiting (8/50,16.0％),which were lower than those (8/50,16.0％),(7/50,14.0％) and (17/50,34.0％) in the Group C (P＜0.05).The incidence of postoperative chill was similar between the two groups with no statistical significance (P＞0.05).Satisfactory rate with anesthesia was 84.0％ (42/50) in Group T that was higher than 52.0％ (26/50) in Group C (P＜0.05).Conclusions Propofol-remifentanil intravenous anesthesia has definite effects with faster postoperative recovery,less adverse reaction and complications,safety and operablity.

OBJECTIVE:To explore the effects of Xinnaoxin pills on CAT score,cardiopulmonary function and hemorheology of patients with pulmonary heart disease complicating with coronary heart disease. METHODS:In retrospective study,80 cases of pulmonary heart disease complicating with coronary heart disease were randomly divided into control group and observation group with 40 cases in each group. Control group was given routine treatment as relieving asthma,eliminating phlegm and oxygen inhala-tion,anti-infective treatment,correcting acid-base balance,cardiotonic and diuretic treatment. Observation group was additionally given Xinnaoxin pills 1.0 g/time,bid after meal,on the basis of control group. CAT score,cardiopulmonary function and hemorhe-ology index were compared between 2 groups before and after treatment as well as ischemic ECG improvement effect and the occur-rence of ADR after treatment. RESULTS:After treatment,hematocrit hematocrit had changed slightly among hemorheology index-es,and CAT score,other hemorheology indexes and cardiopulmonary function indexes were improved significantly;the improve-ment of observation group was better than that of control group,with statistical significance(P<0.05). Total effective rate of isch-emic ECG was 90.0% in control group and 92.5% in observation group,there was no statistical significance(P>0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Xinnaoxin pills can effectively improve CAT score and cardiopulmonary function of patients with pulmonary heart disease complicating with coronary heart dis-ease. It also can improve hemorheology and shows good clinical efficacy,but great importance should be attached to the safety of drug use in the clinic.

Objective To investigate the morphological changes of peritoneum during peritoneal dialysis (PD) and elucidate the possible mechanism of its functional deterioration. Methods Peritoneal biopsies were obtained from normal subjects( n = 10), uremic predialysis patients( n = 12) at catheter insertion and PD patients ( n = 10) at the time of catheter remove or reinsertion or renal transplantation, peritoneal morphology was studied by light microscopy, scanning electron microscopy and transmission electron microscopy. Results Normal peritoneal membrane consisted of a monolayer of mesothelial cells on a basement membrane, and a layer of connective tissue containing cells, blood vessels, lymphatic vessels and so on. Mesothelial cells were polygonal, often elongated, and had numerous microvilli on their luminal surface. Sometimes the microvilli ended with roundish formation or resembled a corona. There were lots of oval or roundish pinocytotic vesicles in the cytoplasm of mesothelial cell. Submesothelial connective tissue contained many collagen and elastic fibers. The peritoneal morphology of uremic predialysis patients was similar to that of normal subjects. But significant abnormalities of peritoneal morphology were observed in PD patients and the changes were progressive. Microvilli were the first site of damage, including microvilli shortening, gradual reduction in number and following total disappearance. Then mesolhelial cell detachment from basement membrane and total disappearances were found. Finally the peritoneal membrane only consisted of submesothelial connective tissue denudation of cells. Conclusions PD can modify peritoneal morphology and structure. The morphological change is progressive and might be one of the important causes of peritoneal failure. Peritoneal biopsy can provide lots of valuable informations about the impact of PD, and thus further study on the relationship between peritoneal structure and its function is very useful for understanding of the physiopathology of peritoneum during PD.

The AC impedance of human hepatoma SMMC-7721 cells were measured in our laboratory by Agilent 4294A impedance analyzer in the frequency range of 0.01-100 MHz. And then the effect of hematocrit on electrical impedance characteristics of hepatoma cells was observed by electrical impedance spectroscopy, Bode diagram, Nyquist diagram and Nichols diagram. The results showed that firstly, there is a frequency dependence, i.e., the increment of real part and the imaginary part of complex electrical impedance (δZ', δZ"), the increment of the amplitude modulus of complex electrical impedance (δ[Z *]) and phase angle (δθ) were all changed with the increasing frequency. Secondly, it showed cell volume fraction (CVF) dependence, i. e. , the increment of low-frequency limit (δZ'0, δ[Z*] 0), peak (δZ"(p), δθ(p)), area and radius (Nyquist diagram, Nichols diagram) were all increased along with the electric field frequency. Thirdly, there was the presence of two characteristic frequencies: the first characteristic frequency (f(c1)) and the second characteristic frequency (f(c2)), which were originated respectively in the polarization effects of two interfaces that the cell membrane and extracellular fluid, cell membrane and cytoplasm. A conclusion can be drawn that the electrical impedance spectroscopy is able to be used to observe the electrical characteristics of human hepatoma cells, and therefore this method can be used to investigate the electrophysiological mechanisms of liver cancer cells, and provide research tools and observation parameters, and it also has important theoretical value and potential applications for screening anticancer drugs.
Carcinoma, Hepatocellular ; Cell Line, Tumor ; Cell Membrane ; Cytoplasm ; Electric Impedance ; Electrophysiological Phenomena ; Humans ; Liver Neoplasms ; Membrane Potentials

Objective To investigate the pharmacodynamics of remifentanil required to prevent laryngeal mask airway (LMA) insertion response in patients anesthetized with propofol by TCI. Methods Thirty-six ASA Ⅰor Ⅱ patients aged 18-59 yr with body mass index ＜ 30 kg/m2 undergoing elective breast operation were enrolled in the study. Propofol was administered by TCI at an effect-site concentration of 4.0 μg/ml. When the patients lost conciousness, TCI of remifentanil was started. The initial target plasma concentration of remifentanil was set at 2.9 ng/ml, and the ratio of two consecutive effect-site concentrations was 1.2. LMA was inserted at 3 min after the target effect-site concentration and the plasma concentration achieved the balance. Criteria of successful insertion were defined as Muzi score≤2 and the increase in MAP and HR≤ 15% of the baseline values within 3 min after insertion. EC50 was determined by modified Dixon's up-and-down sequential trial and the 95 % confidence interval was calculated. Results The EC50 of remifentanil was 2.75 ng/ml. The 95% confidence interval was 2.51-3.01 ng/ml. Conclusion The EC50 of remifentanil for suppression of cardiovascular response to LMA insertion is 2.75 ng/ml in patients anesthetized with propofol by TCI.

Objective To investigate the effects of preconditioning with different concentrations of sevoflurane on the expression of Toll-like receptor 4 (TLR4) in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS).Methods Thirty adult male Sprague-Dawlcy rats,wcighing 200-250 g,were randomly divided into 5 groups (n =6 each):normal saline group (group NS),group ALI,and preconditioning with different concentrations of sevoflurane groups (groups S1-3).ALI was induced by intratracheal instillation of LPS 5 mg/kg.Groups S1-3 inhaled 1.2％,2.4 ％ and 4.8 ％ sevoflurane for 30 min respectively,and ALI was induced 30 min later.The rats were sacrificed at 12 h after administration of LPS or normal saline and lungs were removed for microscopic examination and for determination of TLR4 mRNA and protein expression in lung tissues and concentrations of TNF-α and IL-1β in broncho-alveolar lavage fluid (BALF).W/D lung weight ratio was calculated.Results Compared with group NS,W/D lung weight ratio and concentrations of TNF-a and IL-1β in BALF were significantly increased and the expression of TLR4 mRNA and protein was up-regulated in groups ALI and S1-3 (P ＜ 0.01).Compared with group ALI,the parameters mentioned above were significantly decreased in groups S2 and S3,and the concentrations of TNF-α and IL-1 β in BALF were significantly decreased and the expression of TLR4 mRNA was down-regulated in group S1 (P ＜ 0.05 or 0.01).The parameters mentioned above were significantly lower in groups S2 and S3 than in group S1 (P ＜ 0.05).The pathologic changes were significantly attenuated in groups S1-3 compared with group ALI.Conclusion Preconditioning with sevoflurane can concentration-dependently reduce LPS-induced ALI in rats through inhibiting the up-regulation of TLR4 expression in lung tissues and reducing the inflammatory response.

Objective: To study temporomandibular joint function after mandibular fracture. Methods: According to the methods of Helkimo, the questionnaire and clinical examination were administered in 36 cases with mandibular fracture and 32 health controls. Results:There were statistically significant difference between the fracture group and control group in anamnestic dysfunction and clinical dysfunction index(P0.05).Conclusion: People with mandibular fracture have more symptoms and sign of temporomandibular dysfunction in the time ranged.

Objective:To analyze the influential factors, trend and equity of preventive care utilization in China from 1991 to 2011. Methods:Using China Health and Nutrition Survey ( CHNS) , logistic regression was applied to explore influential factors, study time trend of preventive care utilization, and examine its equity by Concentration In-dex. Results: Total preventive care services and physical examination utilization significantly increased. Significant inequity still exit in terms of general physical examination and blood text, however, disappeared with respect to blood pressure screening and gynecological examination. Main influential factors of preventive care utilization includes in-come, gender, education and insurance, etc. Conclusion:Preventive care utilization had significantly grown with de-creasing inequalities, but inequity still exit, particularly for general physical examination and blood test.

Objective To investigate the efficacy of precise hyperthermic intraperitoneal perfusion chemotherapy (HIPEC) in the treatment of advanced pancreatic cancer.Methods Thirty-six patients with advanced pancreatic cancer were analyzed retrospectively.Eighteen patients who received HIPEC combined with radiotherapy and chemotherapy were assigned as the treatment group and the other 18 patients who received chemotherapy and radiotherapy were assigned as the control group.Recent curative efficacy,Karnofsky Performance Status (KPS) score,postoperative complications and survivals between the two groups were analyzed,respectively.Results Significant differences were found between two groups in total short-term effective rate (P ＜ 0.05).The total short-term effective rate of treatment group and control group were 66.67％ (12/18) and 27.78％ (5/18),respectively.The increment of KPS score of treatment group was significantly higher than that of control group (P ＜ 0.05).There was no significant difference between two groups in postoperative complications (P ＞ 0.05).The median overall survival time (OS) of treatment group was 11 months (7 ～ 31 months),and the median OS of control group was 7 months (4 ～ 18 months).The survival of the treatment group was longer than the control group (P ＜ 0.05).Conclusions HIPEC treatment improved significantly the survival and life quality of advanced pancreatic cancer patients.With acceptable morbidity and mortality rates,HIPEC regime was an effective treatment modality for patients with advanced pancreatic cancer.

Objective The correlation and agreement of mycophenolic acid (MPA) plasma concentrations that detected by enzyme extended immunoassay (EMIT) and high performance liquid chromatography (HPLC) were studied using Pearson's correlation and Bland-Altman plots.METHODS 435 plasma samples were collected from 95 renal transplant patients who were treated with MPA from October 2014 to December 2015.The MPA plasma concentrations were simultaneously measured by EMIT and HPLC respectively,and the results were divided into two levels.Paired t test and Pearson's correlation were performed using SPSS13.0 to evaluate the relationships between the results in each level.The Bland-Altman plot was used to assess the agreement of the results of two methods.Results Higher concentrations were obtained with EMIT,there was a significant positive bias of EMIT for MPA(20.94％ ±14.42 ％,P＜0.001).Pearson's correlation analysis and Bland-Altman analysis showed that the results from different methods presented good correlation (r＞0.98) and agreement.Conclusion The results of EMIT were higher than that of HPLC.There were good correlation and agreement between the two methods.The differences between EMIT and HPLC suggest that different therapeutic window should be set up when the two methods are used for MPA therapeutic drug monitoring.