Objective: To investigate the changes of oxygen metabolic parameters and blood glucose concentrations during perioperative period of orthotopic liver transplantation. Methods: The blood gas, cardiac index (CI), mixed venous oxygen saturation (SvO2), oxygen delivery (DO2), oxygen consumption (VO2), oxygen extraction rate (O2ER), and arterial blood glucose were measured at defined time points (before anesthesia induction, 30 min before anhepatic period, 5 min after anhepatic period, 30 min after anhepatic period, 5 min of neohepatic period, 30 min of neohepatic period, and postoperation) in 50 patients receiving liver transplantation. Results: Compared with those before anesthesia induction, no significant changes in CI, SvO2, DO2, VO2, and O2ER were found in pre-anhepatic period. CI, VO2, and DO2 decreased significantly at the early 5 min of the anhepatic period (P<0.05); VO2, DO2, and O2ER decreased significantly at the 30 min of the anhepatic stage (P<0.05). SvO2, DO2, and VO2 increased, but O2ER decreased significantly at the early 5 min of the neohepatic stage (P<0.05). DO2, VO2, and O2ER increased significantly at the 30 min of the neohepatic stage (P<0.05). During preanhepatic stage the blood glucose levels increased progressively but were lower than those during anhepatic stage. During neohepatic stage, blood glucose decreased abruptly but was still higher than the normal level (P<0.05). Conclusion: It suggests that serious imbalance of oxygen metabolism exists during liver transplantation, especially in anhepatic and early neohepatic stages. Blood glucose increases during the preanhepatic stage, reaches the peak during the anhepatic stage, and then decreases gradually.

Objective To compare the efficacy of postoperative noninvasive positive pressure ventilation ( NPPV ) plus standard medical therapy ( SMT) with SMT alone in patients with moderate to severe chronic obstructive pulmonary disease ( COPD )Methods Twenty-four patients, after upper abdominal or thoracic surgery, who suffered from COPD and moderate to severe respiratory insufficiency, were randomly allocated to receiving SMT alone (oxygen, aminophylline infusion, nebulized beta-2 agonists and anticholinergics, antibiotics administration and chest physiotherapy; control group ,n=12) or NPPV in addition to SMT(NPPV group ,n=12) NPPV was intermittently given with an air-cushioned face mask under the continuous positive airway pressure of 3 cmH 2O and FiO2 of 35%Results There were not significant differences in baselines between both groups 8 patients in control group ( 667%) and all patients in NPPV group recovered with initial therapy with statistically significant difference (P

Objective To study the methods of clinic diagnosis and treatment for chronic lumbar pain induced by lumbo-sacral compartment syndrome. Methods Thirty-three patients with chronic lumbar pain induced by lumbo-sacral compartment syndrome were diagnosed by physical, radiological examination and intra lumbo-sacral muscle compartmental pressure measurement. 33 patients consisted of 15 men and 18 women, with the mean age 42.3 years, and mean duration of chronic lumbar pain was 27 years. Lumbar erector spinae osteo-facial compartment was decompressed using mini-invasive surgery. Lumbar and abdomen muscles were rehabilitated extensively after operation. Results After operation, symptoms of low back pain were alleviated significantly, and walking distance were promoted as well. Post operative flexion and extension of lumbar spine were increased to (15??0.5?) and (7??0.7?) respectively. Intramuscular pressure in rest state, during movement and no more than 6 min after movement was (6.8?0.8), (162.3?12.35) and (7.1?0.6) mm Hg respectively [before operation was(10.4?0.9), (187.1?11.16) and (13.2?1.3) mm Hg respectively, P

Objective To explore the effect of endoscopic sinus surgery on inverted papilloma of nasal cavity and paranasal sinuses in 30 cases.Methods 30 patients with inverted papilloma of nasal cavity and paranasal sinuses were operated on by endoscopic sinus surgery.Results During a follow-up of 2～3 years,only four cases recurred, Conclusion Endoscopic sinus surgery had advantsges of clear field and little injury,and therefore it was effective for inverted papilloma of nasal cavity and paranasal sinuses.

In the past,it is always believed that routine drainage after pancreaticoduodenectomy (PD) is one of the most crucial methods to prevent and detect postoperative complications and to reduce mortality.However,in more recent years,with the development of fast track surgery,scholars in pancreatic surgery have investigated the necessity of drainage after PD together with its merits and faults.Therefore,this paper gives a brief review on this topic.

Objective:To study the inhibitory effect of clarithromycin on angiogenesis induced by b-FGF. Methods:TheMatrigel implant assay was used. Matrigel (500?l) containing b-FGF and heparin were injected subcutaneously into the ab-domen of mice and were harvested 5 d later. The amount of hemoglobin and micro-vascular area present in the implant weremeasured and cotnpared. The mice were given either CAM (study group) or the same volume of glucose (vehicle group) oncea day by gastric intubation. Treatmen started 3 d before Matrigel implant and continued until the end of study. Results:Clar-ithromycin reduced hemoglobin content and micro-vascular area in Matrigel implant at high dosage(≥40 mg/(kg?d). Con-clusion:These data demonstrate that clarithromycin is a potent inhibitor of angiogenesis and may has possible therapeutic value in controlling pathologic angiogenesis.

Objective:To evaluate the diagnostic value of endobronchial ultrasonography(EUS)-guided fine-needle aspi-ration(FNA)in diagnosis of lung cancer.Methods:EUS-guided FNA was used in16patients suspected of lung cancer of sub-mucosal and parabronchial structures.Bronchoscopic methods failed to detect any abnormality in them.Results:Final diag-noses were made in15patients,including8cases of bronchopulmonary adenocarcinoma,4cases of bronchopulmonary squa-mous carcinoma and3cases of lymphatic metastasis of bronchral adenocarcinoma.The sensitivity of EUS-guided FNA was 93.8%. There was no severe complications associated with the use of EUS.No patients developed bleeding or pneumatotho rax.Conclusion:EUS is useful in detecting pathologic changes in the submucosal and parabronchial structures.EUS guided FNA is accurate and safe for diagnosis of lung cancer,especially in small nodes.

Objective To find out the influencing behavioral factors of antibiotics usage in population in Lanzhou. Methods Status of antibiotics usage was investigated in four hospitals in Lanzhou. Results The self-medicine pro portion among patients with respiratory system infection, infectious di arrhea, urinary system infection and choleic system infection were 44.22%, 31. 76%, 22.07% and 6.61% respectively. Patients having higher income used some antibiotics at a middle price, while patients having lower income used antibiot ics at a lower price. The educate d person applied some antibiotics at a lower price, but the illiterate person us ed some antibiotics at a higher price. The combined usage of antibio tics was affected by the disease program and distance of seeing doctor. The fart her distance away from hospital, the more proportion of antibiotics(two or thre e) used combinedly. Conclusions The antibiotics usage was affe cted by the disease variety, disease program, distance to hospital, average inco me and educ ated level.

Objective To investigate the effect of enteral nutrition (EN) on the T lymphocytes-mediated immune function in patients with acquired immune deficiency syndrome (AIDS). Methods Totally 79 AIDS patients were randomly divided into enteral nutrition ( EN ) group ( supported with EN daily in addition to conventional treatment; n = 46) and control group (underwent conventional treatment only; n = 33 ). T lymphocytes including CD3, CD4, and CD8 cells as well as blood biochemical parameters including alanine aminotransferase ( ALT), aspartate aminotransferase (AST), glucose ( Glu ), total protein (TP), albumin ( ALB ), blood urea nitrogen (BUN) , Cr, and prealbumin (PA) were determined immediately before management (T0) and on the 30th day(T1). Results ALT, AST, Glu, TP, ALB, BUN, Cr, and PA showed no significant differences between these two groups before management ( all P ＞ 0. 05 ). The levels of TP ( P = 0. 015), ALB ( P = 0. 007 ), and PA ( P =0. 022 ) were significantly higher in EN group than those in control group at T1. The cell counts of CD3, CD4, and CD8 were not significantly different at T0, while the cell count of CD4 was significantly higher in EN group than that in control group at T1 ( P ＜ 0. 05 ). Conclusion EN can improve the nutritional status and T lymphocytesmediated immune function in AIDS patients.

OBJECTIVE:To provide reference for the construction and development of hospital modernization pharmacy in Chi-na,and to promote the application of pharmacy automation system in hospital. METHODS:By introducing the change of pharma-cy management due to the debugging and application of outpatient pharmacy automation system(rapid dispensing machine,intelli-gent access machine)in our hospital,the problems of automation system and countermeasures were put forward,and the effects of automation system in our hospital were evaluated. RESULTS:With the application of automation system,the pharmacy layout was adjusted,the drugs in the machine was debugged and optimized,the procedure on adding drugs and stocktaking drugs were im-proved,the reasonable scheduling work in outpatient pharmacy was worked,the complete management plan on validity of drugs was established;referring to the problems of automation system,the procedures of adding drugs by rapid dispensing machine and intelligent access machine were formulated as well as related working guide. The adding and delivering drug failure emergency han-dling procedure of rapid dispensing machine,intelligent access machine failure emergency handling procedure were formulated ac-cording to the possible fault of automation system. Related index evaluation showed that automation system was applied and continu-ously improved,which reduced labor intensity(step count of pharmacists adding drug decreased from 5 634.6 steps/day to 4 087.8 steps/day);the work efficiency was improved greatly(the number of prescriptions increased from 226.55 sheets/h to 311.55 sheets/h during rush hours);the work error was reduced(the number of dispensing internal error decreased from 54.75 items/week to 21.50 items/week). CONCLUSIONS:After appling the automation system in outpatient pharmacy,the drug dispensing and staff manage-ment has been standardized,and it become the hospital pharmacy development inevitable trend. But it is suggested to adjust and op-timize the automation system continuously so as to exert its maximal efficacy.