Objective To study the influence of carbamazepine on the neuromuscular block induced by rocuronium. Methods Thirty-two ASA Ⅰ- Ⅱ patients scheduled for neurosurgical operations were studied: 16 cases suffered from epilepsy were treated with carbamazepine for 24 to 180 months (carbamazepine group); the others suffered from intracranial tumors without antiepileptic treatment (noncarbamazepine group). Anesthesia was induced and maintained with target controlled with propofol 5 μ g/ml was monitored using train-of-four (TOF) stimulation. The onset time and times of muscle relaxation recovery 25%,50%,75% was recorded. Results The onset time was no difference between two groups (P＞0.05),but the times of muscle relaxation recovery 25%, 50%, 75% in carbamazepine group [(23.9±3.8 ), ( 29.2 ±4.5 ), ( 36.0 ± 5.4 ) min] were shorter than those in non-carbamazepine group [( 34.0 ± 2.8 ), (40.5 ± 4.6),( 49.9 ± 5.3 ) min] ( P ＜ 0.01 ). The recovery index in carbamazepine group [( 12.1 ± 2.9 ) min] was shorter than that in non-carbamazepine group [(15.8 ± 3.1) min](P＜0.05 ). Conclusion The duration of the rocuronium-induced neuromuscular block is significantly shortened by preceding chronic carbamazepine therapy.

Objective To compare the efficacy and safety of combined epidural/general anesthesia (CEGA) versus total intravenous anesthesia (TIVA) for laparoscopic cholecystectomy. Methods Forty patients were assigned to group TIVA and group CEGA by random digits table with 20 cases in each. The systolic and diastolic arterial pressure,heart rate, oxygen saturation,Steward score, visual analogue scale (VAS) score and adverse reaction were monitored. Results Steward score 4,6 min after operation in group CEGA [(4.5 ±0.6), (5.7 ±0.2) scores] was higher than that in group TIVA [(2.8 ±0.4), (4.1 ±0.5)scores](P ＜ 0.05 ). The VAS score 2,3,4 h after operation in group CEGA [( 1.8 ± 0.3 ), (1.5 ± 0.4), (1.7±0.3 ) scores] was lower than that in group TIVA [( 3.2 ± 0.5 ), ( 3.7 ± 0.4), (4.2 ± 0.6) scores] (P＜0.05 ).There was no significant difference in abdomen pain, shoulder pain and adverse reaction between two groups.The incidence of postoperative side effects was lower in both groups (P ＞ 0.05). Conclusions The use of CEGA for laparoscopic cholecystectomy seems to be effective and safe, and to offer some advantages as compared to TIVA alone. CEGA can control pain due to CO2-induced peritoneal irritation, provide excellent infra-operative and postoperative analgesia. CEGA does not require the use of intraoperative intravenous opioids and shortens recovery time, without increasing the incidence of adverse reaction.

Objective To evaluate the efficacy of levonorgestrel-releasing intrauterine system(LNGIUS) in the treatment of endometriosis. Methods Fifty-three patients suffering from endometriosis were placed LNG-IUS in uterine cavity after menstruation. The efficacy 3,6,12 months after LNG-IUS placement was observed and compared. Results The scores of dysmenorrhea, deep dyspareunia, menstrual anus pain 3,6,12 months after LNG-IUS placement were lower than those before LNG-IUS placement (P ＜ 0.05 ).CA125 [(21.8±12.5) kU/L]and destradiol [(78.8±45.5)ng/L] 12 months after LNG-IUS placement were improved than those before LNG-IUS placement and 3,6 months after LNG-IUS placement [CA 125:(36.3±17.5), (33.5±15.6), (28.2 ± 11.7) kU/L,destradiol: (40.4 ± 28.6), (42.5 ± 31.5), (56.5 ± 36.2) ng/L](P ＜ 0.05 ). The menstrual blood volume was less 6,12 months after LNG-IUS placement than that before LNG-IUS placement (P＜0.05), and the quality of life was improved( P ＜ 0.05 ). Conclusion LNG-IUS can be safe and effective treatment of patients with endometriosis, and less side effects.

Objective To study the changes of interferon ( IFN )- γ ,interleukin(IL)-4 and IL-6 in endometriosis. Method The levels of peripheral blood IFN-γ ,IL-4 and IL-6 in 25 patients with endometriosis (EM group) and 20 normal adults (control group) were detected by enzyme linked immunosorbent assay (ELISA). Results The level of peripheral blood IFN- γ in EM group [(109.64±26.79 ) ng/L] was lower than that in control group [(155.17±30.36) ng/L] (P ＜ 0.05 ), IL-4[(33.52 ± 8.69)ng/L]and IL-6 [(44.12 ± 3.57) ng/L] were higher than those in control group [(22.52 ± 6.54), ( 15.12 ±2.63 )ng/L](P＜0.05 ).The ratio of IFN-γ/II-4(3.27±1.45 ) and IFN- γ/IL-6 ( 1.15 ± 0.56 ) in EM group were significantly lower than those in control group (6.89 ±1.68,2.54 ±1.03)(P ＜0.01 or ＜0.05).Conclusions Th1 cells shift toward Th2 cells in patients with endometriosis. Th1/Th2 ratio may be correlated with the pathogenesis of endometriosis.

Objective To improve diagnosis effectiveness for patients with multiple endocrine neoplasia(MEN).Methods 68 patients with MEN were reviewed in this paper.The diagnosis,clnical features and principle of treatment were discussed.Results (1)MEN-Ⅰ 22.05%,MEN-Ⅱ 36.86%,MEN-Ⅲ 8.82% MEN-Ⅰ\,Ⅱ 33.72%.(2)The cases in female were more than male and ten years earlier than male.(3)Endocrinophathies involred in order were thyroid,adrenal medulla,parathroid and islet.Conclusion It is important that more than one endocrinopathy be examined in doubtful cases.

Objective To observe the effect and safety of different doses of sufentanil plus subarachnoid block during labor. Methods One hundred parturients (single birth) were divided into 5groups by random digits table with 20 cases in each, which sufentanil 3,4,5,6,7 μ g in group A, B, C, D, E plus ropivacaine 3 mg were injected respectively into subarachnoid space. The onset and duration of subarachnoid analgesia were observed; visual analogue scale (VAS) were recorded respectively before injection and 5,15,30,60 min after injection; the vital sign,labor stage,labor type,adverse reactions of parturients,fetal heart rate (FHR) and the Apgar score at 1,5 min of neonate were recorded respectively.Results The onset of subarachnoid analgesia in group A was higher than that in group B,C, D,E;the duration of subarachnoid analgesia in group A,B was shorter than that in group C,D,E.VAS declined gradually 5,15,30,60 min after injection compared with before injection in 5 groups (P ＜ 0.01 );VAS in group B, C, D, E was lower than that in group A at 5 min after injection (P ＜ 0.05 ), and VAS in group C, D, E was lower than that in group A,B at 60 min after injection (P＜ 0.05). There was no significant difference in vital sign,labor stage,labor type,FHR and the Apgar score of neonate among 5 groups (P ＞0.05). The occurrence of itch of skin and nausea in group D,E [25%(5/20), 15%(3/20) in group D,and 40%(8/20),20%(4/20) in group E] was higher than that in group A, B, C [5%(1/20), 0 in group A, 10%(2/20), 0 in group B, 10% (2/20), 0 in group C] (P ＜ 0.05 ). Conclusion Subarachnoid block (sufentanil 4-6 μ g +ropivacaine 3 mg) can offer safety and efficacy of labor analgesia; sufentanil 5 μg is the best dose with subarachnoid block during labor at present.

Objective Study on the clinical application valence of desensitization treatment bronchial asthma and the relationship of inhalation allergen and bronchial asthma.Method Using inhalation allergen,the patients of bronchial asthma were intradermal tested;80 asthmaic patients are randomly divided into 2 groups:1 of 2 desensitization treatment,the second as control group.The therapy endures 8～12 months.Clinical effects are observed.Results 80 cases in 80 cases bronchial asthma test were poisitive (100%);desensitization treatment for 8～12 months can achieve optimal symptom control.Recurrence rate of 2 years in 56 cases desensitization treatment were magnificently lower than control group (χ2=9.95,P<0.01).Conclusion Desensitization treatment is an effective method in the therapy of bronchial asthma.

Objective To analyze the cause of postmenopausal vaginal bleeding and diagnostic method. Methods The clinical and pathological data of 196 patients with postmenopausal vaginal bleeding were retrospectively analyzed. Results The benign diseases accounted for 46.94% (92/196), dysfunctional uterine bleeding accounted for 34.69% (68/196), malignant tumor accounted for 18.37% (36/196).Menopausal time 1--4 years, 5-9 years, 10-14 years, ≥ 15 years of malignant tumor incidence was 2.53%(2/79), 9.38% (6/64), 48.39% ( 15/31 ), 59.09 % (13/22). The age of onset in patients with malignant tumors was (61.28 ± 8.76) years old, menopausal time was (9.38 ±6.73) years, benign disease and dysfunctional uterine bleeding was (54.73 ± 6.72) years old and (4.12 ± 3.54) years, the differences were statistical significance (P ＜ 0.01 ). Conclusion The cause of postmenopausal vaginal bleeding bases mainlyon benign disease and dysfunctional uterine bleeding, but the older, longer menopausal time, which also increase the incidence of malignant tumors.

Objective To discuss the effect of treating tubal obstruction infertility through hydrotubation by hysteroscopy combined with Chinese traditional medicine. Methods Chose 308 patients with tubal obstruction infertility from October 2001 to December 2008 and used the hysteroseopy under which making tubal cannulation, then injected methylene blue and clear liquid to record cases of tubal patency.After the operation the patients would be given Chinese traditional medicine and followed up the case of pregnancy. Result The recanalization rate in 308 patients was 90.9% (280/308), and the rate ofre-pregnancy was 55.5%(161/290). Conclusion The effect of treatment through hysteroscopy to make tubal cannulation and have patients take medicine after operation is very satisfactory and it is worth promoting.

Objective To summarize the operative experience of transumbilical single-port laparoscopic cholecystectomy. Method The clinical data of 15 patients underwent transumbilical singleport laparoscopic cholecystectomy between May to October in 2010 was reviewed. Results The operative time was 30-85(45±16) min,hospitalization time was (2.5 ± 1.1 ) d. No surgical complications such as bile leak or uncontrolled hemorrhage occurred postoperatively. All the incision were healed well and the surgical scar was virtually concealed whithin the umbilicus. Conclusions Transumbilical single-port laparoscopic cholecystectomy is feasible and safe when patients are well selected. Comparing with conventional laparoscopic cholecystectomy, it's more manipulatively difficult.