Objective To investigate the effect of sufentanil and midazolam assisted epidural anesthesia for cholecystectomy on sedative effects,visceral pulling reaction and the functions of respiratory and circulatory system.MethodsFourty patients underwent cholecystectomy received informed consent, were randomly allocated to two groups:group A and group B( n =20 each). When the level of epidural block is appropriate,auxiliary medicine infusion was given 5min before the skin incision. In group A,first injection was sufentanil 0. lμg · kg-1 and midazolam 0. 02mg · kg-1 in 1-2 min, then continuous infusion of sufentanil and midazolam was given at the rate of 0. 2μg ·kg-1 · h-1 and 0. 04μg · kg-1 · h-1 respectively,and the infusion was stopped at the time of wound closure. Group B received slow intravenous injection of pethidine 1mg · kg-1 and droperidol 0. 5mg · kg-1. We recorded the differences of SBP、DBP、SpO2 、HR、Ransay score and visceral pulling reaction classification. Results SBP、DBP、HR after anesthesis,were decreased in different degree in the above groups,but there was no statistically significant difference( P ＞0. 05). According to Ramsay score,in group A there were 3 cases in grade Ⅱ、8 cases in Ⅲ and 9 cases in Ⅳ ,while in group B there were respectively 4 cases in Ⅱ、13 cases in Ⅲ and 3 cases inⅣ. By comparision,the differences had statistical significance ( u = 3.75, P ＜ 0. 05 ); Group A according to visceral pulling reaction classification (0- Ⅲ ), were 9 cases in grade 0,9 cases in Ⅰ , 1 cases in Ⅱ and 1 cases in Ⅲ, while in group B there were respectively 4,5,7 and 4 cases. By comparision, the differences had statistical significance(u = 4. 01,P ＜ 0. 01 ). Conclusion In the cholecystectomy,sufentanil and midazolam assisted epidural anesthesia,could improve the level of sedation ,prevent visceral pulling reaction ,and had a minor interference to respiratory and circulatory function.

Objective To compare the efficacy and safety of Iamivudine-interferon sequential therapy and lamivudine monotherapy in HBeAg-positive chronic hepatitis B (CHB) patients.MethodsA total of 172 patients with HBeAg-positive CHB were randomized to sequential group (n=83) or lamivudine group (n=89).Sequential group were administrated with lamivudine 100 mg/d and 5 million units interferon alpha 2b subcutaneous injection every other day for 24 weeks were added since week 25 of treatment.Lamivudine group were administrated with lamivudine 100 mg/d for 48 weeks.All subjects were followed up for 24 weeks after drug withdrawal.Measurement data with homogeneity of variance were analyzed by using t test and data with heterogeneity of variance were analyzed by using rank sum test.The comparison of rates was done by chi square test or Fisher exact test.ResultsThe baseline hepatitis B virus (HBV) DNA levels of patients in sequential group and lamivudine group were (7.8±1.0) and (7.9±1.1) lg copy/mL,respectively (P＞0.05),and the baseline alanine aminotransferase (ALT) levels were (210.5 ± 150.1 ) and (211.9 ± 160.9) U/L,respectively (P＞0.05).At the end of treatment,higher ALT levels [(78.4±146.1) vs (36.1±32.4) U/L,P＜0.05)] and HBV DNA levels [(4.5±1.5) vs (3.8±1.3) lg copy/mL,P＜0.05)] levels,lower response rates (65.8％ vs 83.5％,P＜0.05),and similar HBeAg loss rates (31.6％ vs 22.2％,P＞0.05) and HBeAg seroconversion rates (27.6％ vs 16.0％,P＞0.05) were found in sequential group compared with lamivudine group.At the end of follow-up,higher ALT levels [(126.0±143.1) vs (82.7±83.0) U/L,P＜0.05)],similar HBV DNA levels [(5.3±1.5) vs (5.0±1.5) lg copy/mL,P＞0.05)],similar HBeAg loss rates (25.0％ vs 32.3％,P＞0.05) and HBeAg seroconversion rates (25.0 ％ vs 26.2 ％,P＞0.05) were found in sequential group compared with lamivudine group.YMDD motif mutation rate in sequential group was lower than lamivudine group at week 48 of treatment (10.5％ vs 26.9％,P＜0.05).ConclusionsLamivudine-interferon sequential therapy and lamivudine monotherapy are both effective in HBeAg-positive CHB patients,while HBV mutations are reduced in patients with sequential therapy.

Objective:To investigate the relationship between radiation mode and radiation-induced taste cell injury in mouse models.Methods:The head and neck of adult C57/bl mice were exposed to 8 Gy irradiation for 1, 2 and 3 times and sacrificed at 2, 4, 7 and 14 d after irradiation. Frozen sections of taste papilla tissues were treated with specific markers by immunohistochemical staining. The changes of proliferative cells and the number of type Ⅱtaste cells at different time points under different radiation modes were observed. The effect of different radiation dose patterns upon the taste cells was assessed.Results:The count of proliferative cells was decreased significantly on the 2 nd day after radiation, and rapidly recovered to normal level on the 4 th day after radiation, which was not correlated with the dose mode. The number of type Ⅱ taste cells was decreased on the 2 nd day of the first 8 Gy radiation, decreased to the lowest on the 4 th day of the second and third 8 Gy radiation, and rose slowly on the 7 th day. Conclusions:Radiation can initially decrease and subsequently increase the number of proliferative cells to normal range. Besides, it can gradually repair the type Ⅱ taste cell injury. After high-dose irradiation, the decrease of progenitor cells with proliferative function leads to a synchronous decrease in the number of taste function cells, which may be the reason why taste dysfunction cannot be recovered for a long time after radiotherapy.