ObjectiveTo investigate the effects of induction with Dezocine to prevent the agitation of the patient after remifentanil anesthesia.Methods60 patients of upper abdominal surgery,ASA Ⅰ ～ Ⅱ class,were randomly divided into 3 groups,20 patients in each group,anesthesia was induced with the midazolam 0.05 mg/kg,propofol 1 ～2mg/kg,vecuronium 0.12mg/kg.Analgesic drugs were administer as follow:control group,remifentanil ( group Rmf )1 μg/kg; fentanyl group ( group F) 4 μg/kg; Dezocine group ( group D) 0.2mg/kg.Remifentanil、propofol are used to maintain anesthesia.The time of recovery and extubation,the VAS pain score,the Ramsay score and adverse reactions such as vomiting,respiratory depression after extubation were recorded.ResultsCompared with group Rmf,the hemodynamic parameters was more stable in group F and group D.Compared with group F ( 1 μg/kg),the VAS pain score,the Ramsay score and adverse reactions significantly decreased in group D ( P ＜ 0.05 ),and the time of extubation in group F was longer than group D(P ＜ 0.05).Conclusion0.2mg/kg of Dezocine could be used for the induction of anesthesia to reduce the incidence of agitation and adverse reactions during recovery period.

ObjectiveTo observe the pathogenic relationship and the mechanisms between the first molars and the temporomandibular disorders(TMD) by getting epidemiology data.MethodsThe oral examinational people during 2007 to 2011 as investigating objects were selected and epidemiological study was carried out with standard clinical diagnostic criteria for dental caries TMD.ResultsThe people with dysfunctional first molars showed that TMD positive rate was 51.48％,and normal molars was 23.47％.The results had significant difference( x2 =54.34,P ＜ 0.01 ).ConclusionThe people with dvsfunction of first molars mav be liable to TMD.

ObjectiveTo compare the clinical effect of video-assisted thoracoscopic surgery (VATS) and median sternotomy in treatment of myasthenia gravis(MG).Methods48 patients received extended thymectomy for MG were divided into two groups by operative approach,23 cases in VATS group and 25 cases in control group.The operative time,operative blood loss,postoperative drainage quantity,patients' length of stay,the incidence of crisis and curative effect after follow-up were analyzed.ResultsThe operative blood loss,postoperative drainage quantity,patients' length of stay of the VATS group were significantly less than those of the control group.There was no significant difference of the operative time.During a follow-up of 6 ～ 32 months,symptom was improved in 82.6％ of patients in VATS group and 80.0％ in the control group (P ＞ 0.05 ).One case complicated with MG crisis was found in the VATS group and three cases in the control group.ConclusionVATS for MG was safe and effective with the advantages of less invasive,fewer complications and quick recovery.It was the first choice for the surgical treatment of MG.

ObjectiveTo investigate the clinical significance of transforming growth factor β1 (TGF-β1)and vascular endothelial growth factor (VEGF) expression in tissues of nasal inverted papilloma (NIP).MethodsThe clinical data of patients with NIP underwent surgical resection were retrospectively analyzed.The TGF-β1 and VEGF expression in NIP tissues and nasal polyps tissues were detected by immunohistochemistry method.100 patients with NIP were divided into benign lesions,atypical hyperplasia and malignant group according to result of pathological diagnosis,the nasal polyps was used as the control group.ResultsThe positive expression rate of TGF-β1 and VEGF in the NIP group were 46.0％ and 32.0％,compared with the control group the differences were significant(all P ＜ 0.05 ).In different pathological groups,the results of TGF-β1 and VEGF expression were malignant group ＞ atypical hyperplasia ＞ benign lesions.The positive expression rate of TGF-β1 and VEGF in the NIP group had significantly positive correlation(P ＜ 0.05).ConclusionThe TGF-β1 and VEGF expression were closely related to the the occurrence,development and malignant of NIP.TGF-β1 was highly expressed in the NIP tissues,and could increase the expression of VEGF and promote the formation of neovascularization of NIP.

ObjectiveTo investigate the risk factors of upper gastrointestinal hemorrhage in elder patients with lung cancer after operation,providing the basis for clinical prophylaxis and treatment of complications.Methods360 elder patients with lung cancer in department of thoracic surgery of our hospital were enrolled from Jun 2005 to Dec 2010,the complications after operation were reviewed retrospectively.ResultsAfter investigation,we found that only 10 patients(2.8％ ) had upper gastrointestinal hemorrhage.6 cases of them were fluid and electrolyte imbalance,8 cases of them were hyoxemia,3 cases of them was hypotension after operation.8 cases of them were older than 70 years old.There was significant difference between older and smaller than 70 years old.ConclusionThe incidence of postoperative upper gastrointestinal bleeding in elderly patients with lung cancer was 2.8％,which was a relatively uncommon condition in clinic.Its major risk factors were age,fluid and electrolyte imbalance,hypotension and hyoxemia caused by operation.

ObjectiveTo analyze the efficacy and safety of erythropoietin for anemia in patients with chronic heart failure.Methods66 cases with chronic heart failure were randomly divided into the observation group and the control group.The control group was treated with conventional anti-anemia iron treatment,and the observation group was taken erythropoietin therapy treatment on the basis of the control group.Both of the two groups were treated for 8 weeks continuously.ResultsThere were statistically significant differences between the two groups of patients after 8 weeks of treatment,cardiac function had improvement after treatment than before treatment (P ＜ 0.05 ).The observation group was significantly superior than the control group.The blood data in the two groups were compared,the Hb,RBC of the observation group were significantly increased compared with before treatment,the difference was significant (P ＜ 0.05).The RBC level did not change significantly in the control group before and after treatment.The electronic patient data in the two groups were compared,the LVEF,FS in the observation group and control group improved significantly compared with before treatment,but improvement of the observation group was significantly better than control group.The degree of improvement in the two groups were compared,the difference was significant( P ＜0.05).The SV,CO in the two groups were compared,it increasedsignificantly than before treatment,the difference was significant(P ＜ 0.05).The SV,CO before and after treatment in the control group didn't improve significantly.The E/A before and after treatment didn't improve significantly.The incidence of adverse drug reactions in the two groups showed no significant difference.ConclusionThe level of anemia had a direct impact on the degree of heart function classification.Following the usual treatment of heart failure,taking erythropoietin for anemia in patients with chronic heart treatment could significantly improve the treatment of patients with curative effect,with the advantages of safe,widely used for clinical application.

ObjectiveTo investigate the effect of endoscopic retrograde cholangiopancreatography(ERCP)combined with laparoscopic resection (LC) in the treatment of patients with cholecystic stone.Methods100 patients with cholecystic stone were randomly divided into observation group and control group.The patients in the control group (50 cases) received traditional open surgery,and the patients in observation group(50 cases) were given ERCP combined with LC.The effects of two groups were observed.ResultsThe operative time was (49.2 ± 8.5 ) min and intraoperative blood loss was(54.0 ± 12.2 )ml in the observation group.The operative time was (80.2 ± 15.7 )min and intraoperative blood loss was ( 114.5 ± 27.5 ) ml in control group.There were statistically significant differences between two groups(P ＜0.05 ).The hospital stay time and postoperative infection rate of the observation group was significantly lower than that of the control group ( all P ＜ 0.05 ).ConclusionIt was a safe and effective method to treat patients with cholecystic stone by ERCP combined with LC,which had the advantages of less trauma,faster recovery,less hospitalization time and could reduce the financial burden on patients,thereby it was worthy of clinical application.

ObjectiveTo evaluate the efficacy and safety of ibutilide for conversion of paroxysmal and persistent atrial fibrillation.Methods31 patients with atrial fibrillation duration less than 90 days were included into amiodrone or ibutilide group.16 patients were intravenously administer with amiodrone and 15 patients with ibutilide separately.Conversion rate,time needed to converse and adverse effects were compared between two groups.ResultsThe total conversion rate of ibutilide group was significantly higher than that of amiodrone group (66.7％ vs 37.5％,x2 =1.98,P ＜ 0.05 ).Time needed to converse was significantly shortened in ibutilide group compared with amiodrone group [ ( 31.75 ± 7.39 ) min vs ( 51.87 ± 9.26 ) min,t =3.67,P ＜ 0.05 ].No clinical significant adverse effects were observed in ibutilide group.ConclusionIntravenous administration of ibutilide in cardioversion of paroxysmal and persistent atrial fibrillation was more safe and effective than amiodrone.

ObjectiveTo investigate the change and significance of IL-8,IL-13 and IL-18 level in serum of patients with bronchial asthma.Methods45 patients with acute exacerbation of bronchial asthma were selected (acute group),and remission group 45 patients and 30 healthy persons (control group) were selected.The serum IL-8,IL-13 and IL-18 levels were measured respectively by ELISA.ResultsThe serum IL-8,IL-13 and IL-18 levels in acute group were significantly higher than that in control group and remission group ( t =5.21,5.13,4.99,5.32,5.48,5.59,P ＜ 0.05 ) ; The serum IL-8,IL-13 and IL-18 levels in remission group were significantly higher than that in control group(t =4.18,4.71,4.89,P ＜0.05).ConclusionThe levels of serum IL-8,IL-13 and IL-18 may be related to the severity of asthma attack.IL-8,IL-13 and IL-18 played important role in both pathogenesis and determination of asthma.

ObjectiveTo evaluate the fourth-generation ultrasonic lithotripsy system for treating the urinary tract stones.Methods243 cases of urinary tract stones who received treatment of fourth-generation EMS ultrasonic lithotripsy system were analyzed retrospectively.ResultsImmediate phase I lithotrotrisy was performed successfully in 227 cases and the successful rate of phase I was 93.3％ (227/243).Delayed phase Ⅱ lithotripsy was performed for 16 patients.Complications happened in 2 cases,one case occurred hydropneumothorax during operation,required indwelling thoracic drainage tube processing,the other had severe bleeding which conservative treatment was ineffective,cured by the intervention of super-selective renal artery embolization.Conclusion Fourth generation of ultrasonic lithotripsy for treating stones on different anatomical locations of urinary system was safe,practical and efficient,worthy of clinical application.