Objective To investigate the effects of three different effect-site concentration (Ce) of sufentanil given by TCI on the minimum alveolar concentration of sevoflurane for blunting adrenergic responses to skin incision(MAC_(BAR))in patients undergoing abdominal surgery.Methods Eighty ASAⅠ orⅡ patients,aged 20-60 yr,body mass index<30 kg/m~2,undergoing elective abdominal surgery,were randomly divided into 4 groups(n=20 each):control group(group so)and 3 sufentanil groups(group S_1,S_2,S_3).The patients were unpremedicated.Anesthesia was induced with TCI of propofol(target plasma concentration 3.5 μg/ml)and TCI of remifentanil(Ce 4 ng/ml).nacheal intubation was facilitated with rocuronium 0.6 mg/kg after the patients lost consciousness.The patients were mechanically ventilated.And then propofol and remifentanil were immediately stopped and anesthesia was maintained with inhalation of sevoflurane and a mixture of nitrous oxide and oxygen,fresh gas flow set at 10 L/min maintaining for at least 20 min.In group S_0,sufentanil was not given after intubation.In group S_1,S_2 and S_3,TCI of sufentamil was started after intubation at Ce of 0.12,0.18 and 0.24 ng/ml respectively.In group S_0,S_1,S_2 and S_3,sevoflurane inhalation was started with the initial end-tidal concentration of 3.0%,1.8%,1.3% and 1.1% respectively.The patients'response to skin incision was described as positive if MAP or HR increased by≥25%,or negative(MAP or HR increased by<25%).If the response was positive,the end-tidal concentration of sevoflurane for the next patient was increased by 1.2 times,while if negative,decreased by 1.2 times.The sevoflurane MAC_(BAR) was determined by up-and-down sequential trial.Results Compared with group S_0,the MAC_(BAR) of sevotlurane was significantly decreased in group S_1,S_2 and S_3(P<0.05).Compared with group S_1,the MACB_(BAR) of sevoflurane was significantly decreased in group S_2 and S_3(P<0.05).No significant difference was found in the MACB_(BAR) of sevoflurane between group S_2 and S_3 (P<0.05).Conclusion TCI of sufentanil at Ce of 0.12,0.18 and 0.24 ng/ml can significantly reduce MAC_(BAR) of sevoflurane and enhance the inhibitory effect of sevoflurane on stress response in a concentration-dependent manner.

Current resource of medical morality is in shortage.When emphasizing the exterior supervision of the government,we should put more emphasis on the exterior restricting factors which are more profound,such as the excursion of the norm to the experts,the excessive market-orientation of medical innovation,the shortage of financial devotion,the deficiency of hospital management system.To solve the above problems,a fair medical surrounding is to be built,a patients association be established,and the social honesty and credit mechanism be rebuilt.

The current pharmacotherapy is inadequate in preventing the progression of ventricular remodeling and congestive heart failure. Cellular cardiomyoplasty, through cell transplantation or regeneration of cardiomyocytes is a potential therapeutic approach to prevent left ventricular remodeling and the development of congestive heart failure after myocardial infarction. Recent research has focused on stem cells, which are undifferentiated pluripotent cells and can differentiate into a wide variety of cells including cardiac myocytes and endothelial cells. The majority data on stem cell transplantation were preclinical animal studies, all showing that stem cell therapy may replace lost heart muscle (myogenesis) and enhance cardiovascular revascularization (angiogenesis and vasculogenesis). These findings have been rapidly applied to human trials, but there were many questions remain to be solved. Although the results are interesting and safe, early phase Ⅰ clinical studies are small in scale and very preliminary. Data from large, randomized controlled trials are needed to confirm the short- and long-term effects of cellular cardiomyoplasty.

Humans ; Mucocutaneous Lymph Node Syndrome ; etiology ; immunology ; metabolism ; physiopathology

Objective To study the nursing effect of evidence-based nursing in perioperativc period of gynecological laparoscopy operation and prevention of postoperative complications.Methods 238 cases of patients undergoing laparoscopic operation were setas the study group,the evidence-based nursing method was used in this group.Another 212 cases of patients undergoing laparoscopic operation were named as the control group,they were given conventional nursing care.The improvement of complications and anxiety emotion were compared between the two groups.Results The complication rate was 10.92% in the study group,and 29.24% in the control group,the difference between the two groups was significant.The decreased degree of total score of HAMA and psychic anxiety,somatic anxiety score in the study group was higher than those of the control group at discharge.The difference had statistical significance.Conclusions Evidence-based nursing plays an important role in decreasing the postoperative complications and improving the anxiety emotion of patients,which is worthy of clinical popularization.

Based on some European universities the author wants to analyse their education system and find some enlightenment on our post-graduate education construction of medical laboratory science.

Skin flaps from rabbit thighs were raised. The saphenous veins of the flaps were anastomosed with the femoral arteries.The valves in the veins were studied histologically. Fibrous tissue of the venous valve at the site of its junction with the venous wall underwent "fatigue" injury resulting in fracture of the valve.Theraby the valve opened according to the direction of blood flow, and the valvular tissue began to adhere to the venous wall.The results suggested that rapid blood flow with high pressure might remodel the venous valve in an arterialized venous skin flap.

Objective To study the relationship between the operative programs and curative effects in treating non-reflex pubovesical muscle neurogenic bladder by transurethral division of internal sphincter. Methods Bilateral or one laternal division of internal sphincter were performed separately,followed-up for 3 months to 5 years in postoperation,and analysed data obtained .Results Bilateral division had a much higher improving rate(92%) than that of one laternal(60%)(P

OBJECTIVE:To establish a cluster analysis method applied in plant classification and the identification and assessment of traditional Chinese medicine.METHODS:The raw data of the shape,the chemical composition and the UV-spectra data of plants were collected,and these data were assigned with values in accordance with the binary assignment then subjected to a cluster analysis.RESULTS:The 11 species of plants under study were accurately classified into the proper categories by the new method.CONCLUSION:By this method,the analytic data are comprehensive and the conclusion is detailed and reliable,which serves as the supplement and development for traditional cluster analysis method.

Objective To investigate the correlation and clinical significance between CTGF of fibrosis marker and coronary heart disease .Methods Totally 102 cases of coronary heart disease patients by coronary artery angiography ensured were used as coronary heart disease group ,98 cases with age and sex strict matching of coronary heart disease were normal and were used as con-trol group;T test was used to analysis the difference with disease group and control group at base clinical data ,serum CTGF and TGF-β1 ,the correlation between coronary heart disease and serum CTGF level was evaluated by logistic regression analysis ,and clinical diagnosed value was evaluated .Results Triglyceride ,total cholesterol ,apolipoprotein A1 ,high density lipoprotein ,lipopro-tein alpha ,low density lipoprotein ,TGF-β1 and CTGF in coronary heart disease group were significantly higher than those in control group(P<0 .05) .Spearman correlation analysis showed that CTGF and TGF-β1 were positively correlated (r=0 .773 ,P=0 .002) . Serum CTGF can play positive role in the evaluation of the risk stratification of coronary heart disease .Conclusion Age ,smoking , hypertension ,total cholesterol ,apolipoprotein A1 ,high density lipoprotein ,low density lipoprotein ,lipoprotein alpha ,CTGF and TGF-β1 were influencing factors for coronary heart disease .Detection of CTGF in clinical work can be used as assessment coronary artery stenosis and severity index .