AIM: To study the effectiveness of urapidil and nitroglycerine on controlling the cardiovascular responses to tracheal intubation/extubation in patients with essential hypertension. METHODS: 45 patients with essential hypertension undergoing general anesthesia were divided randomly into control (C, without depressor, n=15), urapidil (U, 0.5 mg?kg -1 , n=15), and nitroglycerine (N, 1 ?g?kg -1 , n=15) groups. The SBP, DBP, MAP, HR and RPP were measured during intubation and extubation and at the induction of anesthesia and the end of operation respectively. RESULTS: The SBP, DBP, MAP, HR and RPP increased markedly (P

Objective:To explore the changes of serum cholinesterase(ChE)and its clinical significance in patients with sepsis.Methods:Serum cholinesterase concentration,acute physiology and chronic health evaluation(APACHE)Ⅱ scores were estimated in patients.The patients in this study were divided into the sepsis group and the non-sepsis group.The patients with sepsis were further divided into the death group and the survival group.The influence of altered serum ChE levels on prognosis was compared between the groups.Results:(1)Serum ChE was significantly lower in patients of sepsis group than that of control group(P ＜ 0.01).(2)In patients with sepsis,the serum ChE level was significantly lower in the death group compared with that of survival group(P ＜ 0.05).(3)In patients with sepsis the serum ChE levels were significantly negatively correlated with APACHE Ⅱ scores(r=-0.280,P ＜ 0.05),positively correlated with serum albumin and body mass index(r=0.458 and 0.287,P ＜ 0.05).Conclusion:Serum ChE levels can be used to determine the prognosis and severity of illness in patients with sepsis.

The new round of medical and health system reform proposed the need to explore effective ways to gradually reform the mechanism of “using medicine costs to supply medical care”, through the implementation of “medical separation”, solve patients’ problem of “difficult and expensive”. While implementing the mode of the “medical separation”, according to exploring and practicing the actual situation of the region, it describes on the main mode of “medical separation”, analyzes the advantages and disadvantages, and proposes policy recommendations of “medical separeation” according to analysis of different modes.

Objective To investigate the risks and anesthetic management of scar uterus undergoing cesarean section.MethodsOne hundred pregnant women(aged 24-43 years old)with scar uterus underwent cesarean section.Epidural anesthesia was used in 90 cases(group A)and general anesthesia in 10 cases(group B).The monitorings included ECG,BP,HR and SpO_2.CVP was measured in the high risk cases.The time from skin incision tO neonatal delivery(I-D).the time from uterine incision to delivery(U-D),and Apgar scores of neonates were recorded.Results Incomplete blockade was seen in 20 cases(22％).The I-D time was shorter in group B than that in group A[(7.5±2.0)min vs.(12.3±2.6)min](P<0.01).Intraoperative hypotension occurred in 32 cases (32％).Neonatal asphyxia happened in 21 cases(21%).Apgar scores of 11 neonatals werc less than 3,of whom 5 neonates died.Apgar scores were 4 to 7 in 10 cases,8 to 10 in 79 cases.Subtotal uterectomy was performed in 2 cases.Repair of injuried bladder had to be done in one case.Intraoperative huge bleeding took place in 15 cases.Conclusion The scar uterus undergoing cesarean section has a high risk for mothers and neonates.The incidence of incomplete epidural blockade is higher.Effectively preventing and managing the risk factors are the keys for reducing maternal and neonatal complications and mortality.

Aqueous extract of Dracocephalum tanguticum Maxim. (DtM ),when given ig or ip to experimental hypoxia mice,markedly increased their tolerance to normobaric and hypobaric hypoxia. Erythrocyte superoxide dismutasc (SOD ) activity of mice or rats determined at high altitude (animaquing mountain 4700 m above sea level ) showed an elevated dismutation activity of peroxide anions. At an experimentally simulatcd altitude of 6000 m above sea level,determunation of MDA, Hb and Hct showed an obvious reduction of all the abnormally elevated criteria. It is suggested that the antihypoxia activity of DTM may be partly due to its free radical scavenging activity

Objective To evaluate whether it can prevent Frey's syndrome by reserving parotid fascia or reconstructing parotid fascia with sternocleidomastoid muscle and remaining of parotid fascia in parotidectomy. Methods Fifty-two patients undergoing parotidectomy with maintained and reconstructed parotid fascia were followed up. A test of chewing vitamin C slice guidance and iodine-amylum pilot was conducted for observing the incidence of postoperative Frey's syndrome. Results Flush with perspires was found only in 5 out of the 52 patients (9.61%), which was lower than the incidence after traditional parotidectomy. Conclusion The method of reserving and reconstructing parotid fascia with sternocleidomastoid muscle and remaining of parotid fascia in parotidectomy can efficiently prevent Frey's syndrome, and can also repair the hollow abnormity of the face.

AIM:To observe the effect of immune-activated platelets and low-density lipoprotein cholesterol (LDL) on the expression and activity of cyclooxygenase-2 (COX-2) and peroxisome proliferator activated receptor ? (PPAR-?) in human umbilical vein endothelial cells (HUVECs) treated with activated platelets and LDL.METHODS:The platelets were activated by ADP.The co-culture system of HUVECs with immune activated platelets and/or LDL were established.The activity of COX-2 and expression of PPAR-? at mRNA and protein levels in HUVECs were detected by RT-PCR and Western blotting.The concentration of PGE2 was measured by ELISA for representing the COX-2 activity.The PPAR-? activity was determined by a nuclear factor assay kit.RESULTS:The COX-2 activity and mRNA expression of PPAR-?,the protein levels of COX-2 and PPAR-? and PGE2 concentration in activated platelets group were significant higher than those in un-activated platelets group (all P

Objective:To report the results of neurocutaneous axial island flaps in the forearm in clinical application.Methods:12 patients with soft tissue defects around the elbow and the wrist were treated with proximally or distally based island flaps based on the lateral and medial forearm cutaneous nerves.The flaps measured 9cm?8cm to 4cm?3cm.Results:The flaps totally survived in 11 pa- tients,the other was patially survived.The color and texture of the flaps were good.Their appearance and function were satisfactory after 12～18 months follow—up.Conclusions:On the basis of the vascu- larization of the lateral and medial cutaneous nerves of the forearm,some reliable island flaps were raised successfully.These flaps are easy to dissection and have a large arc of rotaion.They were satisfac- tory in repairing the soft tissue defects around the elbow,the distalone of third of the forearm and the wrist.

Objective To report the improved operative technique and clinical results of sural nerve nutritional vessel axial flap Methods Based on anatomical studies,the sural nerve nutritional vessel flap pedicle with the lowest perforating branch of the peroneal artery were performed to repair the soft tissue defects of the lower leg,the ankle and the foot Results The modified flaps were applied in 7 cases,all flaps survived completely The size of the flap ranged from 30 cm?10 cm to 23 cm?8 cm The length of pedicles were 1 6～3 0 cm The colour and texture of flaps were excellent,the outline and functional results were satisfactory after 6～12 months follow up Conclusions This new procedure can enlarge the survival and repairing area of the flap,it can also solve the distortion problem of fasciocutaneous pedicle The blood supply of this flap is reliable Flap elevation is easy and quick It is very useful in repairing large skin defects of the lower leg,the ankle and the foot

Objective To report the improved operative technique and clinical results of posterior neurocutaneous vascular axial flap in the forearm Methods A reversed posterior neurocutaneous vascular flap in the forearm pedicle with dorsal branch of anterior interossea vessel were designed to repair the skin defects of hand and wrist Results The modified flaps were applied in 8 cases,all flaps survived completely The colour and texture of flaps were good,the outline and functional results were satisfactory after 6～12 months follow up Conclusion This type of flap is easy to dissect,blood supply is reliable,and major vessels in the forearm is preserved,It is suitable for repairing large skin and soft tissue defects of first web, dorsal aspects of wrist and palmar