Objective To compare the renal function after neurosurgery performed under closed-circuit anesthesia with sevoflurane and desflurane and determine the safety of the closed-circuit sevoflurane anesthesia. Methods 36 ASA Ⅰ or Ⅱ patients aged 18-60 years were randomly divided into 2 groups to receive either sevoflurane (group S, n = 18) or desflurane (group D, n = 18) . The duration of surgery was expected to be ≥90 min. The patients were premedicated with intramuscular midazolam 0.07 mg?kg-1 . Anesthesia was induced with midazolam 0.1 mg?kg-1, fentanyl 1.5-2.0 ?g?kg-1 , propofol 1-2 mg?kg-1 and vecuronium 0.1-0.15 mg? kg-1. The patients were mechanically ventilated (VT = 8-12 ml?kg-1) after tracheal intubation. PET CO2 was maintained a 35-45 mm Hg. Fresh gas flow (FGF) was first set at 1-5 L?min-1 for 2-3 min, then reduced to 0.18-0.3 L?min-1. In group D end-tidal desflurane concentration was maintained at 6%-10% ; whereas in group S the end-tidal sevoflurane concentration was maintained at 2.7%-4.0% . BP, HR, ECG, SpO2 PET CO2, inspiratory and expiratory O2 , desflurane and sevoflurane concentrations and the temperature in the center of soda-lime canister were continuously monitored during the operation. Gases were collected from breathing circuit for determination of compound A concentration (by gas chromatography) before anesthesia, at the end of 2-3 min wash-in, every 30 min during maintenance of anesthesia and at the end of anesthesia. Venous blood samples were taken before anesthesia (baseline) , at the end of surgery (T1) and at 2, 24 and 72 h after operation (T2-4) for determination of serum F-, creatinine (Cr) and blood urea nitrogen (BUN) concentrations. Urine specimens were taken for determination of total protein (TP), ?2-microglobulin (?2-MG) and ?-N-acetyl-glucuronidase (NAG) levels, before operation (baseline) at the end of operation and at 24, 48 and 72 h after operation. TP/Cr, ?2-MG/ Grand NAG/Cr were calculated to eliminate the influence of the volume of urine.Results There were no significant differences between the two groups with respect to age, sex, body weight, height, duration of anesthesia and temperature in the center of soda-lime canister. The inspiratory O2 concentration was ≥ 75% during anesthesia. There was no significant difference in serum Cr and BUN concentrations and NAG/Cr in urine before and after operation as well as between the two groups. TP/Cr and ?2-MG/Cr in urine were significantly increased after operation compared to the baseline values but there was no significant difference between the two groups. There was no significant correlation between postoperative TP/Cr, ?-MG/Cr and compound A. Conclusion Closed-circuit sevoflurane ansthesia does not affect postoperative renal function.

Objective To investigate the protective effect of penehyclidine hydrochloride pretreatment on focal cerebral ischemia/reperfusion injury and expression of caspase-3 in rats.Methods Sixty male Sprague-Dawley rats weighing 250-300 g were randomly divided into 3 groups(n=20): control (C) group in which sham operation was performed; ischemia-reperfusion (I-R)group, in which saline (2.0 mg?kg-1)was administered for intraperitoneal injection 30 min before anesthesia,then the ischemia model was made by occlusion of the left middle cerebral artery for 120 min; penehyclidine hydrochloride pretreatment (P) group, in which penehyclidine hydrochloride(2.0 mg?kg-1)was administered for intraperitoneal injection 30 min before anesthesia,then the same 120 min focal cerebral ischemia was performed as described in I-R group.At the end of 24 h reperfusion the animals were decapitated and the brains were removed.The volume of cerebral infarction was detected with TTC staining;Coronal sections including hippocampal tissue were obtained for HE staining.The levels of caspase-3 mRNA expression in hippocampus were detected by using semi-quantitative RT-PCR technique.Results Compared with group I-R,the volume of cerebral infarction in group P were reduced significantly(P

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.