Objective To discuss the safety of using etomidate combined with remifentanil by target controlled infusion ( TCI) for painless bronchofibroscopy. Methods Sixty patients were divided into two groups: painless bronchoscopy group (treatment group, 24 patients) and the routine bronchoscopy group (control group, 36 patients). Treatment group received TCI of remifentanil and intravenous injection of etomidate fat emulsion. Control group was subjected to surface anesthesia with 2%lidocaine. SpO2 , blood pressure, heart rate and breath changes during examination and complete awakening were continuously monitored. Bronchofiberscopy time, body movement during examination, bucking and satisfaction degree after examination were also recorded. Results Treatment group patients felt senseless and painless during bronchoscopy, without memory of bronchoscopy and pain. Patients in control group had discomfort, body movement and acute bucking, and most of them had painful memory. There were significant differences between the two groups (P<0. 01). In treatment group, after examination, blood pressure, respiratory frequency, heart rate and SpO2 were significantly decreased (P<0. 01). During examination, the blood pressure, respiratory frequency and heart rate were increased, and SpO2 decreased in control group compared to the baseline (P<0. 01). There was no significant difference in SpO2 between treatment group and control group during examination (P>0. 05). Conclusion TCI etomidate combined with remifentanil during bronchoscopy achieved satisfying anesthetic effect.

OBJECTIVE: To analyze the basic data of adverse drug reactions(ADR) and assess the quality of ADR reports submitted in 2006 in Shenzhen,and to provide bases for ADR monitoring.METHOD: The electronic forms of ADR cases reported in 2006 by different units in Shenzhen that had been subjected to the evaluation of Guangdong provincial center were downloaded,and the related data were subjected to frequency analysis.The three time points(duration of medication,onset time of ADR,turnover time) were used to evaluate the integrity of ADR process recording,and the relevance was evaluated by means of contrast.RESULTS: 19 drug categories and total 465 kinds of medicines were involved in 3 303 ADR cases.The categories of antimicrobials and Chinese herbal preparations and ADR cases induced by these drugs ranked at the first and second among all the drugs.The lesions of ADR involved primarily skin and its accessories,followed by gastrointestinal system.Most ADR cases were caused thorough intravenous route of administration.The majority ADR cases had a favorable turnover.New and severe ADR reports were few.The qualities of most reports were poor.CONCLUSION: The training program for ADR reporters should be strengthened;ADR reporters' reporting awareness and responsibility should be strengthened to enhance ADR reporting quality,and physicians' prescribing behavior should be intervened properly so as to reduce the incidence of ADR.

Objective To observe the application effect of wuhuangyou in the prevention of radiodermatitis for tumor patients undergoing chemotherapy and evaluate its applicability. Methods We divided 203 tumor patients undergoing chemotherapy into 3 groups.Application of wuhuangyou,meibao and routine health education were used in each group. Results Statistical difference existed in the incidence rate and degree of radio-dermatitis between the three groups,among which wuhuangyou proved to possess the best effect,P ＜ 0.01. Conclusion The application of wuhuangyou was safe,effective,economical in the prevention of radio-dermatitis.It could relieve the pain of patients and guarantee the smooth process of chemotherapy.

Objective To evaluate the clinical and imaging characteristics of osteoid osteoma in femoral neck and to improve diagnostic accuracy of this disease.Methods Twenty-one patients (18 males and 3 females,age,7-26 years,median age,13 years) with pathologically proven osteoid osteoma of the femoral neck were retrospectively analyzed for their clinical profile and radiologic features.CT and X-ray examinations were performed in all patients,10 of them pefformed post-contrast CT scan and 4 of them performed MRI examinations.Results Nineteen patients had hip pain (pain worse at night in 11,and 8 received salicylates treatment with good response),and 2 patients only with intermittent claudication.The duration ranged from 2 months to 54 months (median duration 12 months).X-ray: Nidus was seen on plain film in 10 cases,18 cases showed different degrees of bone sclerosis of the nidus.CT: Nidus was demonstrated in all cases.Among them,8 were intracortical,6 were subperiosteal,7 were endosteal.Twenty cases showed different degrees of bone sclerosis of the nidus-extra-articular anteromedial cortical surface of the femur neck.Nineteen cases showed vascular groove sign.MRI: Nidus was seen in 4 cases.Bone sclerosis was low signal on all sequences.Three cases had joint effusion,4 cases had bone marrow edema,and 2 cases had synovial thickening.Conclusions Although osteoid osteoma of femoral neck has non-specific clinical features,the radiographic findings are usually typical.The nidus of osteoid osteoma is often located within the joint.Bony sclerosis occurs at the area of extra-articular anteromedial cortical surface of the femur neck.CT examination remains an optimal method to identify the nidus.

Objective To observe the effect of Juli Sanjie Pill(JSP) on estrogen receptor(ER)? and ER? expression in the myometrium and hysteromyoma tissue,and to explore the correlation of ER? and ER? expression levels with the incidence of hysteromyoma. Methods Forty hysteromyoma patients were divided into two groups: 20 patients with operative indications after oral use of JSP and asking for operation,were enrolled in the treatment group,and other 20 patiens without mediation of medicine but asking for operation were in the control group.The ER? and ER? expression levels in hysteromyoma tissue and the surrounding normal myometrium of the two groups were detected by radioimmunoassay.Results There presented the expression of ER? and ER? in the hysteromyoma tissue and the surrounding normal myometrium of the two groups,and the levels in the hysteromyoma tissue were higher than that in the myometrium(P0.05).Conclusion The incidence of hysteromyoma is correlated with the local expression of ER? and ER? in the uterus.The therapeutic mechanism of JSP for hysteromyoma is probably related with the decrease of ER? and ER? expression levels in hysteromyoma tissue and with the decrease of ER? level in the surrounding normal myometrium.

Objective:To measure the clivo-axial angle (CAA)and cervicomedullary angle (CMA)in upper cervical deformity patients who underwent computer-assisted posterior upper cervical reduction and fixation surgery,and analyze their correlation.Methods:In the study,25 patients with symptomatic upper cervical deformity were chosen for measurement of preoperative and postoperative CMA and CAA using magnetic resonance imaging (MRI)and intraoperative C-arm.The angle between the clivus plane and the straight line parallel to that of the posterior margin of the C2 vertebral body was defined as CAA;moreover,the angle between the straight line parallel to the ventral side of the cervical spinal cord and the straight line parallel to that of the ventral side of the medulla oblongata was defined as CMA.Two ex-perienced spinal surgeons performed the measurements.The CAA and CMA were measured three times, and the mean value was considered as the result.Results:Analyses of the CAA and CMA were per-formed with Wilcoxon rank test,which showed that there was consistency between the CAAs measured with MRI and intraoperative C-arm.The result showed that the postoperative CAA and CMA increased significantly compared with preoperation (P<0.001).Through Spearman rank correlation analysis,the preoperative CAA was positively correlative with the CMA (r=0.902,P<0.001),and so was the post-operative CAA (r=0.921,P<0.001).Conclusion:Preoperative and postoperative CAA in upper cer-vical deformity patients is significantly correlative with preoperative and postoperative CMA.CAA can be measured during surgery using intraoperative CT or C-arm based three-dimension navigation,and may predict the patient’s CMA,which cannot be measured during operation,but is essential for evaluating the decompression and reduction of the spinal cord.

0.05),APACHEⅡ score,and mortality were higher than those in negative group(P

The authors compared the purpose,and the main content of three international standards in medical education developed by the Institute for International Medical Education (IIME), World Health Organization Western Pacific Regional Office (WHO/WPRO), and World Federation for Medical Education (WFME) respectively. The IIME's standard is deferent from the others. The IIME's standard contains seven broad educational outcome domains and 60 items in the domains. The purpose of IIME's standard is to improve the common core competency of individual medical graduates of each medical school in the world, and the standard focuses the outcome of medical education and belongs to summative individual evaluation. The WHO/WPRO's and WFME's standards are quite similar. They define the standards across nine broad areas of medical schooling divided into 38 sub-areas. The ultimate goal of the WHO/WPRO's standard is to encourage national governments to adopt a quality assurance process in medical education. The aim of the two standards is to promote the quality assurance of medical schools. Both of the two standards focus the whole process of medical schooling and medical schools, and belong to formative evaluation.

Objective To design an experiment for method-comparison and bias estimation of multi tests on multi instruments.Methods According to the procedure described by the NCCLS approved guideline EP9-A and improving the method of sample collection,we took 8 patient mixing samples each day to analyze all comparison tests on 11 auto-chemistry analyzer within following 5 days.The duplicates were assessed within the same run.The coefficient of correlation and average bias% were calculated,and the system errors at medical decided levels were assessed.Results Taking ALT as an example,the coefficients of correlation were between 0.994-1.000,and the average bias% were between-0.460%-4.927%,SE at 40U/L was-1.510-1.834 and SE at 300 U/L was-3.101-9.188.Conclusion In all tests that joined the comparison among the different instruments,28 tests were acceptable,2 tests were acceptable after modifying the coefficients,and AMY and LIP were not acceptable.

OBJECTIVETo observe the therapeutic efficacy of Chinese medical syndrome typing and treatment combined cold needle puncture drainage operation or unipolar electrocoagulation drilling technique under laparoscope for treating clomiphene-resistant polycystic ovary syndrome (PCOS).

METHODSForty infertility patients with clomiphene-resistant PCOS were assigned to two groups using stratified random sampling method according to age, infertility time, and body mass index, 20 in each group. Patients in Group A were treated with Chinese medical syndrome typing and treatment combined cold needle puncture drainage operation, while those in Group B were treated with Chinese medical syndrome typing and treatment combined unipolar electrocoagulation drilling technique. After operation Chinese herbal treatment was administered to all patients according to syndrome typing. The serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), androgen (T), estradiol (E2), and prolactin (PRL) were determined before and after operation. The ovulation was monitored. The pregnancy rate and the pregnancy outcomes were recorded after operation.

RESULTSThere was no statistical difference in the 3-month spontaneous ovulation rate or the 1-year pregnancy rate (P > 0.05). The levels of LH, T, and PRL were significantly lower after operation than before operation in the two groups (P < 0.05). The menstruation and ovulation were obviously improved after operation. The total ovulation rate was 95% (19/20) in Group A. Successful pregnancy occurred in 15 cases of Group A. Ovarian hyperstimulation syndrome (OHSS) occurred in 1 case of Group A. The total ovulation rate was 90% (18/20) in Group B. Successful pregnancy occurred in 13 cases of Group B. Hypovaria occurred in 1 case of Group B. Luteinized unruptured follicle (LUFS) occurred in 2 cases of Group A and 1 case of Group B.

CONCLUSIONSChinese medical syndrome typing and treatment combined cold needle puncture drainage operation or unipolar electrocoagulation drilling technique could effectively promote the ovulation. The two methods showed similar therapeutic effects.

Adult ; Clomiphene ; pharmacology ; Drug Resistance ; Electrocoagulation ; Female ; Follicle Stimulating Hormone ; analysis ; Humans ; Integrative Medicine ; Laparoscopy ; Luteinizing Hormone ; analysis ; Medicine, Chinese Traditional ; methods ; Polycystic Ovary Syndrome ; therapy ; Pregnancy ; Prolactin ; analysis