Objective To evaluate the effects of different rates of remifentanil infusion on cardiovascular response to tracheal intubation in older patients. Methods Thirty ASA Ⅰ-Ⅲ patients aged 65-75 yrs weighing 50-80 kg scheduled for elective abdominal operation were randomly divided into 3 groups (n = 10 each) according to the remifentanil infusion rate: group A 0.05 ?g?kg-1?min-1; group B 0.1 ?g?kg-1?min-1 and group C 0.15 ?g ?kg-1?min-1. The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg. Radial artery and subclavian vein were cannulated for BP and CVP monitoring and blood sampling. ECG, BP, HR and SpO2 were monitored during anesthesia. After 10 min stabilization induction of anesthesia was commenced with remifentanil infusion for 10 min. Midazolam 0.1 mg?kg-1 was then given Ⅳ. Succinylcholine 1.5 mg?kg-1 was given to facilitate intubation after the patients lost consciousness. BP and HR were recorded immediately before induction of anesthesia (T0, baseline), immediately after intubation (T1 ) and at 2, 5 and 10 min after intubation (T2 ,T3 ,T4 ) . Cardiovascular intubation response was defined as increase in SP or HR by 15% of the baseline value within 2 min after intubation. Blood samples were taken at T0-4 for determination of plasma concentration of norepinephrine (NE) and epinephrine (E) by HPLC. Side effects such as chest wall rigidity and hypotension were also recorded. Results The cardiovascular intubation response rate was significantly higher in group A (80%) than in group B (10% ) and C (10% ) . The incidence of side effects was significantly higher in group C (70% ) than in group B (20%) and A. Plasma NE and E concentrations were significantly increased after intubation in group A (at T2-4) and B (at T2,3) as compared with baseline values at T0; while in group C only plasma NE concentration was significantly increased at T2 and T3 and there was no significant change in plasma E concentration after intubation. The plasma NE and E concentrations were significantly higher in group A (T2-4) and B (T2,3) than in group C. Conclusion The appropriate infusion rate of remifentanil for tracheal intubation is 0.10 ?g?kg-1 ?min-1 in older patients.

Objective To investigate the diagnosis of hepatic tumors by contrast-enhanced color Doppler ultrasonography. Methods Thirty-two patients with known focal liver lesions(diameter 11-112 mm,mean 43 mm) were studied with color Doppler flow imaging(CDFI) before and after injection of 2.4 ml SonoVue at the concentration of 5 mg/ml. The pathological diagnosis included 13 benign lesions and 19 malignant ones. Analysis was performed on signal intensity of intratumoral vascularity,time of enhancement duration,resistant index and maximum velocity of intratumoral arterial blood flow. The data were compared between benign and malignant lesions. Results Before injection of SonoVue,intratumoral blood flow could be detected among 53.8 %(7/13) benign lesions and 78.9 %(15/19) malignant tumors. However these detection rates went up to 76.9 %(10/13) and 100%(19/19) respectively after administration of SonoVue. Significant difference between benign and malignant tumors was observed in time of enhancement duration. Furthermore RI showed significant difference between benign and malignant lesions.Diagnostic accuracy of hepatic tumors increased from 75.0 %( 24/32 ) to 90.6 %(29/32) after enhancement. Conclusions The clinical results showed the ability of contrast-enhanced CDFI in reflecting the blood supply of the hepatic tumors,demonstrating the high sensitivity and specificity of the technique,which could be of great value to the diagnosis of hepatic tumors.

0.05), respectively. ICU stay time was shorter in protocol-directed group than in non-protocol-directed group (20?11 vs. 44?33 days, P

Abstract?AIM: To determine the relation between each of the optical coherence tomography ( OCT) patterns, etiologies and visual acuity in patients with cystoid macular edema ( CME) .?METHODS:Fifty-seven eyes with CME from 52 patients were included in our study. The data of this cross sectional study was collected rfom p atient s wtih CME assessed by OCT, who also underwent fun dus photography and visual acuity test the same day. The best corrected visual acuity ( BCVA ) was assessed by using E chart a nd converted in logarithm of the minimum angle of resolution( logMAR ) . Thevisual acuity varied from 2.3 logMAR to 0 logMAR w ith a mean of 1.11±0.57. The etiology was determined from medical history and the fundus ph otograph of the patient. Four O CT grades established according to ratio between the vertical size of largest cyst and the maximum macular thickness (<30 %,≥30% <60%,≥60% <90%and≥90%) were considered. The correlation was established by calculating the Pearson's correlatio n coefficient “r” and the statistical significance was considered when P value was inferior to 0.05.?RESULTS: OCT grade I V was the most associated with very severe visual loss with the greatest mean VA of 1.96± 0.23 logMAR and the correlation between OCT grades and visual acuity was strongly statistically significant ( r =0.729, P <0.001 ). The central retinal vein occlusion ( CRVO) was the most underlying disease associated with worsev ision, with the gre atest mean VA of 2 logMAR and the correlation was statistically significant ( r=0.375, P=0.004).Another associated OCT pattern, the disruption of bot h inner segment/outer segment ( IS/OS) and external limiting membrane ( ELM) , was inversely associated with severe visual loss ( high mean VA=1.11 ±0.57 logMAR, with statistically significant correlation, r=-0.346, P=0.008 ) . The presence of both vitreoretinal traction components and outer retinal layers disruption were significantly associated with OCT grade IV ( r=0.390, P=0.003) and CRVO (r=0.362, P=0.006).?CONCLUSION:In this study, the OCT fourth grade and CRVO seem to be more significantly associated with the worse vision in patients with CME.

Objective This study was carried out to investigate the relationship among the partial plasma hormones associated with the stress,main indices of liver function as well as psychical status in the patients with viral hepatitis(VH).Methods Five indices of liver function,plasma cortisol(CT) and angiotensin Ⅱ(ATⅡ) were detected,the psychical tests were simultaneously carried out by survey item life events units(LEU),symptoms checklist 90(Scl-90).Results Both CT and ATⅡ ascended in the acute period of various types VH and correlated with many indices of liver function(P

OBJECTIVE To find out the main polluting bacteria in the medical establishments in Langfang city so as to direct the work of disinfecting and reduce the rate of the nosocomical infection in the medical establishments. METHODS The environment of the medical establishments was divided to five groups, including the air, the object surface , the medical workers hands, the using disinfectant and the medical equipment. RESULTS The main polluting bacteria in the air, on the object surface and the medical equipment were the Gram-positive cocci. The main polluting bacteria in the using disinfectant was the Gram-negative bacilli. The Gram-negative bacilli were more than the Gram-positive cocci on the hands of the medical worker. The main bacteria were Staphylococcus epidermidis, Escherichia coli and Acinetobacter. The using disinfectant was with the maximum qualified rate (98.8%), and with only 6 samples unqualified. The air was with the minimum qualified rate (58.22%). CONCLUSIONS No spores gemma which are difficult to be killed have been found and the unqualified samples in various environment are mainly due to the weak awareness of disinfection and the careless attitude.

AIM: To evaluate the clinical effects of modified hydroxyapatite implant in scleral shell.
METHODS: Thirty - four cases were performed eye evisceration, autogenous sclera shell anterior and posterior petaloid shape with posterior sclera fenestration, hydroxyapatite artificial eyeballs were implanted at stage I, and conjunctival wound, orbital activity and other complications were observed after surgery.
RESULTS:The follow-up was 6 ~12mo. There was no patients with implant exposure, sclera dissolution, conjunctival wound dehiscence, conjunctival sac constriction noted. All the patients got good activity of artificial globe, and the active range of side motion of the HA was 10o ~15o. The artificial eyes looked symmetrical, and the eyes socket were full.
CONCLUSION: The modified hydroxyapatite implant in scleral shell can maintain the normal anatomy of the orbital tissue, and also can get full eyes socket and good activity, It was an easy and simple surgery which could obtain satisfactory clinical effect and less complications.

Objective To clone, express and purify human PIF1 protein and analyze its ATPase activity. Methods The PIF1 cDNA was amplified by PCR from HeLa cell cDNA library and inserted to pET24b with histidine tag at its terminus to form pET24b-PIF1 plasmid. The recombinant pET24b-PIF1 plasmid was transformed to RosettaTM 2 (DE3) and the expression of PIF1 protein was monitored by SDS-PAGE analysis. By using fast protein liquid chromatograph (FPLC) system, the PIF1 protein was purified by affinity chromatograph and gel filtration. The ATPase activity of PIF1 was checked by thin layer chromatograph(TLC). Results The PIF1 protein was successfully cloned and expressed in E.coli. Conclusions The purification procedure of PIF1 protein was established using FPLC. The overexpressed and the purified PIF1 helicase has DNA and Mg2+ dependent ATPase activity.