Objective To compare the anesthetic effect of different inserting time on patients under propofol combined sufentanil anesthesia in gastroscopy.Methods A total of 120 out-patients aged 18-60 years underwent gastroscopy were randomly divided into two groups (A and B,60 cases each).They received sufentanil 0.1μg/kg combined with propofol 1.5 mg/kg intravenously.Gastros-copy was inserted into patients’mouth immediately when the patients’consciousness lost and eyelash reflex disappeared (group A)or 30 s later (group B).When necessary (cough or movement),addi-tional propofol 0.5 mg/kg was added to enhance and maintain anesthesia.HR,BP and SpO2 were re-corded before induction (T0 ),before inserting (T1 ),gastroscopy passing through throat (T2 )and after procedure (T3 ).We observed and recorded cough,hiccup,body movement,recovery time and total dosage of propofol.Results Compared with T0 ,MAP (T1 )of both groups were lower (P <0.05).There was no statistic different in MAP on T2 and T3 .There was no statistic different in HR, MAP and SpO2 on T0-T3 between two groups.The incidence of cough and body movement were lower in group B than in group A (P <0.05).Group B had shorter recovery time and less propofol usage than group A (P <0.05).Conclusion Inserting gastroscopy 30 s after consciousness and eyelash re-flex disappear in propofol combined sufentanil anesthesia can reduce the incidence of cough and move-ment,reduce propofol consumption,and shorten recovery time but without respiratory and haemody-namic adverse effects.

Objective:To introduce our experience on extra-operating room anesthesia of children with grave congenital heart diseases during cardiac catheterization an d ventriculography. 　　Methods:Three hundred and sixty-nine children with grave congenital heart d iseases undergoing cardiac catheterization or ventriculography were selected for this study,among whom 86 are presented with left to right shunt and pulmonary a rtery hypertention,11 with pulmonic stenosis and primary pulmonary artery hypert ention,and 272 with right to left shunt.They were routinely fasted before the pr ocedure.O2 Saturation(SpO2) and electrocardiogram were monitored and blood p ressure were recorded.With oxygen inhalated by mask and venous route established ,the children were injected with scolapamine (0.02 mg/kg) and ketamine (1-2 mg /kg) for anesthesia induction.When patients lost conciousness,ketamine (6-8 mg/ kg) and droperidol (0.15-0.30 mg/kg) were given intromascularly for maintaine nce.During the procedure,ketamine (1-2 mg/kg) were given to deepen anethesia. 　　Results:The procedures were fufiled steadily.Eighteen patients presented wit h different kinds of complications such as abdomen distention,vomitting,arrhymia and refractory anoxia to defferent degrees.One patient died,and the mortality w as 0.27%. 　　Conclusions:Anesthesia of children with grave heart diseases during cardiac catheterization and ventriculography is particular.It is important for the anest hesiologists to be familiar with the pathophysiology of heart diseases,and suppl y sufficiant oxygen,keep airway open and unobstructed,avoid stomach regurgitatio n and inhalation and maintain sufficient sedation during the procedure.Oxygen sh ould be given continuously and SpO2 monitored posoperatively to avoid any comp lication.

Objective To explore the difference of the tremor of Parkinson's disease(PD) in early stage and physiological tremor by tremor analysis.Methods 14 patients with PD(group PD) and 9 cases of physiological tremor(group physiological tremor) were studied.The surface electrode of the accelerometry(Acc) was pasted at the end of certer-metacarpal of back of hand.At the same time,surface electrodes of electromyography(EMG) were pasted on the forearm flexors and extensors.The tremor graphices and myoelectric activities were recorded in 30 s with and without 1000 g bearing respectively.Tremor frequency and related myoelectric activities were analysed.Results Acc record: The main manifestations were static tremor and tremor frequency was no significant difference when with and without loading in group PD.In group physiological tremor,the main manifestations were posture or active tremor.With loading,the tremor frequency was significant reduced(P

To evaluate the feasibility of delivering NO through N_2O path in anesthesia machine,NO at 800 ppm was delivered through nitrous oxide path in anesthesia machine SIEMENS Ventilator 710 or NARKOMED 2B,to ventilate a test lung. The minute volume of ventilation (MV) was set from 2 to 6L/min, and NO concentration from 10 to 80 ppm. NO and NO_2 concentrations were measured by hemiluminescence and electro-chemical fuel cell technique. SIEMENS Ventilator 710:Non-rebreathing model,its inspiratory limb was prolonged to 7 meters,the NO level was adjusted at 80ppm before passing through soda lime, NO and NO_2 samples were taken before absorber,after absorber, 1, 2,4 and 6 meter site in inspiratory limb. NARKOMED 2B:Oxygen flows were at the rates epual to the MV mentioned above, NO concentration was at 10,20,40,60 and 80 ppm,the inspiratory gas mixture was sampled immediately passing through absorber, NO_2 levels were less than 5.0ppm in all conditions listed above. With SIEMENS Ventilator 710, the highest level of NO_2 was 3.45 ppm before absorber and 2.43 ppm after absorber,with NARKOMED 2B,that was 3.6 ppm. As MV increased,NO_2 level before absorber decreased (P

ObjectiveTo compare the clinical effect of 0.2% ropivacaine and bupivacaine combined with fentanyl respectively for postoperative continuous epidural analgesia(CEA).Methods50 patients of American Society of Anesthesiologists(ASA) grade Ⅰ~Ⅱ after abdomen operation were divided randomly into group ropivacaine + fentanyl(RF) and bupivacaine + fentanyl(BF). 5min before operation finished, group RF was given 0.2% ropivacaine plus 5 μg/ml fentanyl 5 ml, group BF was given 0.2% bupivacaine plus 5μg/ml fentanyl 5ml, and followed by a continuous infusion of 0.2% ropivacaine or bupivacaine plus 2 μg/ml fentanyl 2 ml/h at the end of operation respectively. The analgesic and paralytic effects expressed in VAS and modified Bromage degrees respectively were recorded 1h, 8h, 24h and 48h after operation.ResultsThere were no significant difference between group RF and group BF in VAS scales(P>0.05), but there were significant difference between group RF and group BF in modified Bromage degrees (P<0.05).ConclusionRopivacaine and bupivacaine combined with fentanyl could be safely and effectively used for postoperative analgesia. Because of the lower incidence of complications, ropivacaine combined with fentanyl will be more satisfactory.

ObjectiveTo investigate the clinical efficacy and safety of solifenacin for female overactive bladder (OAB) who failed in toherodine treatment. MethodsFrom Jan 2010 to Oct 2010,48 cases of female OAB were treated with 5 mg/d solifenacin for 4 weeks after the failure of tolterodine treatment.The improvement of the perception of bladder condition as well as the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were used as objective indexes for the evaluation of therapeutic effect. ResultsAfter 4-week solifenacin treatment,the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were respectively decreased from the baselines ( 8.7 ± 1.5),(3.4 ± 2.1 ),( 2.4 ± 1.8 ),(2.1 ± 1.8 ) and (2.2 ±1.6) to be (7.2 ±2.5),(2.0 ±1.8),(1.5 ±1.2),(1.2 ±0.8) and (1.4 ±0.8).The perception of bladder condition was improved in 42 cases.The withdrawal from the treatment was seen in 3 cases due to headache and dry mouth.No severe adverse event was found in the rest 45 patients. Conclusion Solifenacin might be an effective and safe alternative agent in the treatment of female OAB who failed in tolterodine treatment.

Objective To investigate the value of low-dose MDCT in the diagnosis of breast cancer using ROC analysis. Methods Retrospectively analyze the breast images of 105 cases that had performed both 64-row CT and pathological examinations. The case number that underwent CT examination with routinedose parameters was 48; and that with low-dose was 57. Two radiologists with clinical experiences more than 5 years evaluated the breast lesions, respectively. And ROC curve was used to test the diagnostic efficacy of breast cancer between the two groups. Results Compared with the routine-dose group, the quality of CT image was high enough to disclose the breast lesions while the exposure dose was significantly decreased. The areas under the ROC curve between the routine-dose group (0.943) and the low-dose group (0.908) did not show significant difference (P >0.05). Conclusion Low-dose thin-slice MDCT with contrast enhancement can efficiently and safely diagnose breast cancer.

Aim To explore the effect of nNOS specific inhibitor 7-nitrioindazole(7-NI) on the neurogenesis after focal cerebral ischemia in the adult mice dentate gyrus.Methods Focal cerebral ischemia was induced by middle cerebral artery occlusion(MCAO).A bromodeoxyuridine(BrdU) method was used to identify the proliferated cells in hippocampal dentate gyrus.Step-down test was performed to assay the learning and memory function.Results The number of BrdU~+ cells was increased in the ipsilateral but not contralateral dentate gyrus after focal cerebral ischemia.7-NI promoted the increment in the ipsilateral dentate gyrus significantly.7-NI also improved the survival of the new-born cells,as well as the learning and memory function of ischemic mice.Conclusion Our results indicate that nNOS down-regulates the neurogenesis after focal cerebral ischemia.

OBJECTIVE:To provide basis for rational use of verapamil in clinical practice.METHODS:53 patients with hypertension received oral verapamil.The concentrations of verapamil in plasma were determined by fluorespectrophotometry.The population pharmacokinetic parameters were estimated by iterative two stage method and compared with the results estimated by traditional standard two stage method.RESULTS:The population pharmacokinetic parameters in 53 patients were,CL(189.3?59.3)ml/(h?kg),Vd(1.420?0.231)L/kg,T1/2(5.74?190)h,the parameters had no significant difference as compared with the parameters estimated by traditional standard two stage method.CONCLUSION:Iterative two stage method is suitable for estimating population pharmacokinetic parameters,forecasting plasma concentration and optimizing individualized dosage regimen.

Objective To retrospectively review the experience of anesthesia for aortic valve insufficiency complicated with extremely dilated left ventricle.Methods The patients were premedieated with morphine 10 mg and scopolamine 0.3 mg IM.Anesthesia was induced with etomidate 0.1-0.2 ms/ks.sufentanil 1μ/kg and pipecuronium 0.1 mg/kg.After the patients were intubated,anesthesia wag maintained beween 1.0%and 1.5% isoflurane and intermittent Ⅳ boluses of sufentanil and pipecuronium.ECG,direct BP,SpO2,PET CO2,CVP and body temperature were monitored during anesthesia.Result All patients Were rehabilitated without ventricular fibrillation and arrhythmia.Conlusions Measures are taken before the surgery to maintain preload,increase heart rate,reduce afterload moderately and maintain myocardial contractility.After the surgery,maintenance of preload is helpful for ensuring adequate forward flow and benefcial to patients using dopamine and nitrolycerin.