To observe the time-dependent course of potentiation of vecuronium produced by 1MAC of end-tidal sevoflurane and isoflurane. Method: At the beginning, a steady infusion rate of vecuronium to maintain 90 of neuromuscular block was established in 40 patient undergoing neurosurgical procedures under propofol fentanyl nitrous oxide oxygen anesthesia. The patients were randomly assigned to receiving IMAC end-tidal concentration of either sevoflurane (Group Sev) or isoflurane(Group Iso). Vecuronium infusion rate was adjusted to maintain 90%, neuromuscular block. The change of infusion rate of vecuronium with time was observed after inhalation of Sev or Iso. Result: Sev and Iso decreased the infusion dosage of vecuronium in an exponential manner, maximal potentiation occurred 90 min after inhalation. Maximal reduction in infusion rate was 67.87% in group Sev and 69.87% in group Iso without the significant difference between them. Conclusion: Sev and Iso can potentate the muscular relaxation of vecuronium at similar degree in strong time-dependent way.

Objective To observe the clinical effectiveness and prognostic factors of autologous hemopoietie stem cell transplantation on diabetic peripheral angiopathy patients under different degrees of vascular lesions. Methods Thirty-six patients with diabetic were divided into mild vascular stenosis group (group A: 20 lower extremities, vascular stenosis less than 50% ), moderate vascular stenosis group(group B :26 lower extremities, vascular stenosis of 50%-70% ) and severe vascular stenosis group (group C: 25 lower extremities, vascular stenosis greater than 70% ) according to the degree of vascular lesions. All patients were given the stem cell mobilization for 5 days, then peripheral hemopoietic stem cells were gathered on the last day and transplanted to ischemic limb by using monoeyte stem cell suspend liquid with 3 cm × 3 cm intervals.Each index of three groups was regularly observed ( 1th,12th and 18th month respectively after the operation)and comprehensive evaluated. Meanwhile,the transplantation prognostic factors (age, disease duration, post-prandial 2 hours blood glucose, glycated hemoglobin, blood pressure, triglycerides) were analyzed by multiple regression. Results Twelve months after transplantation, the ankle brachial index (ABI) and percutaneous oxygen pressure (TcPO2) of all three groups increased compared with that before the transplantation (P<0.05). In the 18th month after transplantation, the ABI still increased in group A and B (P< 0.05), and no significant changes were found in group C compared with that in the 12th month. Eighteenth month after transplantation, lower extremities of 8 patients (40%) in group A, 8 patients (31%) in group B and 6 patients (24%) in group C were examined to have neovascularizatian. Age, disease duration, blood pressure, post-prandial 2 hours blood glucose, glycated hemoglobin and triglycerides were all the important factors that affected diabetic peripheral angiopathy recurrence after transplantation. Conclusions The long-term effica-cy of stem cell transplantation on diabetic peripheral angiopathy patients at a mild to moderate degree is superior to that with severe vascular lesions. Close monitoring of blood glucose, blood pressure and triglycerides in the operation perinatal stage is required.They are the important prognostic indicators.

Objective: To study temporomandibular joint function after mandibular fracture. Methods: According to the methods of Helkimo, the questionnaire and clinical examination were administered in 36 cases with mandibular fracture and 32 health controls. Results:There were statistically significant difference between the fracture group and control group in anamnestic dysfunction and clinical dysfunction index(P0.05).Conclusion: People with mandibular fracture have more symptoms and sign of temporomandibular dysfunction in the time ranged.

Objective To evaluate clinical effects of the treatment of tibial fractures through compression reduction and osteosynthesis with common plate. Methods From March 2001 to September 2003, 48 cases of tibial fractures were treated through compression reduction and osteosynthesis with common plate. Results All the cases were followed up for 6 to 24 weeks (averaging 14 weeks). The healing time was 12 to 16 weeks (averaging 5 weeks). No delayed union, non union, infection, or ineffective internal fixation occurred. Conclusion Compression reduction and osteosynthesis with common plate to treat tibial fractures is a kind of biomechanical fixation that facilitates fracture healing.

Objective To evaluate the effect of lipoic acid on endothelial microparticles (EMP) in diabetic patients with peripheral artery disease (PAD) of the lower limbs. Methods Forty eight diabetic patients with PAD of the lower limbs were randomly divided into two groups: the therapeutic group and control group (each group has 24 cases). Patients of control group only received internal comprehensive medicine therapies for 3 weeks. Patients of therapeutic group were treated with both lipoic acid (600 mg lipoic acid injection in normal saline solution for intravenous drip, once daily for 3 weeks) and internal comprehensive medicine therapies at the same time. The levels of EMP in venous blood and Ankle-brachial index (ABI) were estimated before and after treatment by flow cytometry. Results Compared to the control group after treatment [(1 179. 8± 120. 1) per μL], EMP value showed a significant reduction in therapeutic group [(1 032. 4±117. 2) per μL] (P<0. 01). The levels of ABI of therapeutic group (0. 68 ±0. 10) was increased obviously as compared that before lipoic acid treatment (P<0. 01). Patients treated with lipoic acid showed the higher levels of ABI than the control group after treatment (0. 58±0. 11) (P<0. 01). Conclusion Lipoic acid injection significantly decreased the level of EMP in diabetic patients with PAD of lower limbs. Lipoic acid might be an effective drug for diabetic patients with PAD.

Objective: Our purpose was to study the effect of anisodamine on the injury of myocardium after myocardial ischemia reperfusion. Methods: Eighteen patients (ASA grade Ⅱto Ⅲ) scheduled for valve replacement, were randomly divided into 2 groups during extracorporeal circulation. Anisodamine (0.25 mg/kg) was given intravenously in the anisodamine group before reperfusion. Equivalent volumes of normal saline were administered in the control group. The central venous blood samples were collected at different time after ischemia and reperfusion. We then measured the concentrations of lactic dehydrogenase (LDH), creatine kinase (CK), and malondiadehyde (MDA) with biochemical methods. Results: The levels of serum LDH, CK, and plasma MDA increased significantly in the control group during ischemia and reperfusion. In the anisodamine group, the levels of serum LDH and CK increased. But the values were lower at corresponding time than those in the control group (P<0.05) during reperfusion. The plasma level of MDA unchanged in the anisodamine group during ischemia and reperfusion. The postoperative cardiac function recovered much more better in the anisodamine group. Conclusion: Anisodamine can reduce the degree of reperfusion injury. A certain protective effect on myocardial ischemia reperfusion injury exsists during valve replacement.

The assessments of oocyte quality were usually needed in assisted reproductive technology and reproduction science.Based upon the changes of structure and biochemistry in the development of oocyte,assessments of oocyte quality mainly comprised the oocyte morphology and its maturity.The assessment method of oocyte quality from nondestructive manner and invasive technique to provide multi-pathway for evaluating the oocyte quality reasonable was discussed.

Objective:To analyze the clinical features of the recurrence of febrile seizures(FS), and observe the efficacy of levetiracetam(LEV)in preventing FS recurrence.Methods:We retrospectively analyzed the clinical data of 101 cases of FS recurrence who were admitted to the Department of Neurology of our hospital from May 2017 to May 2020, and collected the information of the recurrence after discharge and adverse effects of LEV application.Cox proportional hazards model regression was applied to explore the relationship between FS recurrence and LEV prophylaxis.Results:Among 101 cases of recurrent FS, the section of 18-60 months(63/101)composed the dominant proportion, of which the episode of 18-36 months(40/101)took the biggest recurrence rate.All 101 recurrent FS cases occurred within 24 hours of fever-beginning time, and 74.3%(75/101)occurred within 3 hours of fever onset.39.6% cases(40/101)were non-high febrile seizures, of which 30.0%(12/40)even had a temperature ≤38°C at the onset.Ninty-five cases of FS were included in the retrospective cohort study.Thirty-eight cases(4 lost to follow-up)were treated with LEV, while 57 cases(7 lost to follow-up)were not treated with any anticonvulsant drugs.The recurrence rate in the prophylactic group was 17.6%(6/34), compared with 44.0%(22/50)in the control group.The recurrence rate of the prophylactic group was statistically lower than that of the control group( χ2=6.325, P=0.012). Cox regression analysis was used to explore the relationship between FS recurrence and various factors, suggesting LEV prophylaxis( OR=0.325, 95% CI 0.129-0.821)and family history of FS( OR=3.060, 95% CI 1.427-6.560)affect the recurrence of FS.Then FS family history was stratified, LEV prophylaxis still statistically reduced the recurrence of FS( OR=0.316, 95% CI 0.124-0.802). Conclusion:The risk of recurrence increases significantly after 18 months of the age.Besides, FS recurrence is relatively common in the initial episode of fever and in the stage of low fever.For children at months of high probability of recurrence, prophylactic drugs should be used in the initial episode of fever and in the stage of low fever.LEV prophylaxis therapy is effective, with mild adverse reactions.

Items of design and signature from clinical trial drugs were made , the occurrence ratio of every item in 2265 informed consent form ( ICF) from 63 clinical trial drugs in Beijing Youan Hospital affiliated to Capital U-niversity of Medical Sciences were analyzed , and items with lower occurrence ratio were explored .Generally , the design and signature of ICF met the requirement of GCP .However , there were some defects of ICF and antonym of signature .Based on the analysis on the problems , some measures were put forward:formulate relevant standard op-erating procedures , strengthening the management of informed consent , and strengthen the system construction and education training , promote the hospital ethics construction , to protect the rights and interests of the subjects .

Objective To evaluate the efficacy and safety of endoscopic submucosal excavation in the treatment of suhmucosal tumor.Methods From 2010 to 2013,a total of 108 cases of suhmucosal tumor detected by endoscopic,endoscopic ultrasonography and computed tomography (CT) scan,most of which grew toward the lumen,were treated by endoscopic suhmucosal excavation.After the lesions were completely excavated,pathological examination were performed.All the cases were followed up with endoscopic examination at one,three,six,12 and 24 months after operation.Results Among 108 cases of lesions,27 cases were located in esophagus,eight in cardia,59 in stomach,two in duodenum and 12 cases in rectum.The diameters of the lesions ranged from 0.5 to 5.5 cm (median 2.1 cm).Operation time was between 18 and 240 minutes (median 105 minutes).The endoscopic treatment was converted to laparoscopic operation in three cases because the submucosal tumors of gastric body growing towards outside the lumen,or adhesive to muscular layer tightly and or perforation too big to be sutured.Three cases of submucosal tumor of fundus were failed to excavate,the other 102 cases (94.44％) of lesions were completely removed.Perforation occurred in 19 cases (17.59％).The procedure was converted to laparoscopic operation in one case.Effective endoscopic suture was complered in 18 cases.The volume of haemorrhage during operation was about 0 to 50 mL and no post-operational bleeding was found.Eight cases had cervical subcutaneous emphysema.Nine cases had pneumoperitoneum.Left parotid gland swollen was found in one case.Nine cases were lost to follow up.The left 99 cases were followed up for one to 24 months and no recurrence.Conclusion ndoscopic submucosal excavation safety and effectively achieve once complete removed of the big submucosal tumor which grows towards inside the lumen,and provide complete pathologic data.