Objective To compare the efficacy of sevoflurane combined anesthesia and propofol combined anesthesia in elderly patients undergoing abdominal surgery.Methods Sixty patients aged 65-80 yr scheduled for elective abdominal surgery under general anesthesia were randomly divided into 2 groups (n = 30 each): sevoflurane group (group S) and propofol group (group P).Anesthesia was induced with TCI of sufentanil and propofol.The initial target effect-site concentration (Ce) of sufentanil was set at 0.25 ng/ml and initial target plasma concentration (Cp) of propofol set at 2.0 μg/ml,and then both concentrations were increased in 0.5 μg/ml increment when they reached the balance until loss of consciousness.Tracheal intubation was facilitated with rocuromitm 0.6 mg/kg and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration set at 1.0%-2.0%) in group S,TCI of prepofol (Cp set at 2-4 μg/ml) in groups P, and sufentanil by TCI ( Ce set at 0.15 ng/ml) and iv infusion of vecurenium 0.15 mg·g-1·h-1 in both groups. .BIS value was maintained at 40-60,and changes of MAP and HR were less than 30% of the baseline value in both groups.The use of vasoactive drugs during perioperative peried,time of awakening,extubation and consciousness were recorded and compared between the 2 groups.Results The usage rate of urapidil was significantly decreased,and the awakening time,extubation time and consciousness time shortened in group S compared with group P.Conclusion Sevoflurane-sufentanil combined anesthesia provides better hemodynamic stability and faster recovery than propofol-sufentanil combined anesthesia in elderly patients.

Objective To explore the mechanism of Xiao Chaihu decoction in t he treatment of endometriosis in rats.Methods The rat model of endometriosis w as established. Fas and Caspase- 3 protein expression in the eutopic endometriu m and eutopic endometrium were observed by immunohistochemical method.Results The protein expression of Fas and Caspase- 3 in ectopic endometrium of Xiao Cha ihu decoction group was higher than that in the eutopic endometrium, while the r esult in the control group was just the opposite. No significant difference was shown in Danazol group. Conclusion The therapeutic mechanism of Xiao Chaihu de coction for endometriosis may be related to the promotion the apoptosis of ectop ic endometrium tissue by increasing Fas protein expression.

Objective To evaluate the influencing factors for postoperative odynophagia in elderly patients undergoing intraoperative transesophageal echocardiography (TEE) examination for cardiac surgery.Methods A total of 96 patients with intraoperative TEE examination for cardiac surgery was divided into two groups:the elderly group (patients aged ≥65 years,n=60) and the young group (patients aged ＜ 65 years,n =36).Clinical data were retrospectively analyzed.Postoperative odynophagia was assessed by number rating scale (NRS) scores.Characteristics of postoperative odynophagia were compared between the two groups.Influencing factors for postoperative odynophagia were analyzed by multivariable logistic regression analysis.Results The incidence of postoperative odynophagia and the average NRS score were higher in the elderly group thanin the young group [88.3％ vs.66.7％,(2.6±1.7) vs.(1.4±0.9),P＜0.05 or 0.01].Multivariate logistic regression analysis showed that preoperative oral lidocaine plasmagel,oropharyngeal mucosal injury and duration of TEE insertion were independent influencing factors for postoperative odynophagia (all P＜0.01).Conclusions The incidence of postoperative odynophagia is higher and the degree of odynophagia is more serious in elderly patients undergoing intraoperative TEE examination for cardiac surgery.Postoperative odynophagia can be relieved by applying the preoperative oral lidocaine plasmagel,reducing oropharyngeal mucosal injury and shortening the duration of TEE insertion.

Adult ; Female ; Hematologic Tests ; Hexanes ; adverse effects ; Humans ; Male ; Occupational Exposure ; adverse effects ; Young Adult

Objective To study the effect of Taohongsiwu decoction(THSWD) on the VEGF expression and the micrangium regeneration of callus tissue in bone stump. Methods 65 Japanese rabbits were divided into four groups randomly, three groups were given orally with THSWD, Yandining tablet, distilled water respectively after the right radial bone fracture model was established by operation, and the other group served as control. At the 7th,15th,21th and 35th day after fracture, immunohistochemical method was used to detect the expression of VEGF, and the histochemical staining was used to detect the micrangium change of callus tissue in bone stump. Then the data were compared and analysed. Results VEGF expression level was higher in THSWD intvervening group than that in the other groups, and the decrease of VEGF expression was not obvious after the peak value at 15th day. The callus micrangium regeneration and the remodeling of callus in THSWD intervening group were better in all phase than those in the other groups. Conclusion THSWD could improve the VEGF expression of callus tissue, accelerate the micrangium regeneration in bone stump and promote the healing of fracture.

Adult ; Aged ; Carcinoma, Hepatocellular ; surgery ; virology ; Female ; Follow-Up Studies ; Glutathione ; therapeutic use ; Hepatectomy ; methods ; Hepatitis B ; blood ; drug therapy ; Hepatitis B Surface Antigens ; blood ; Hepatitis C ; drug therapy ; Humans ; Liver Neoplasms ; surgery ; virology ; Male ; Middle Aged ; Prognosis

Objective To investigate the feedback of eight-year program students to problem-based learning ( PBL ),and find out the existing problems and solutions.MethodsThe questionnaire survey was made in the eight-year program students.ResultsApplication of PBL could achieve good feedback.It helped to enhance the self-directed learning,expressing ability,accessing resource skill,and team spirit.ConclusionAlthough there are some problems in the practice of PBL,PBL is a good teaching method in eight-year program education.

Objective To research the expression and clinical significance of SALL 4 gene in cervical cancer .Methods The ex-pression of SALL4 in 56 samples of cervical cancer and 35 samples of normal cervical tissues was detected by immunohistochemistry and RT-PCR ,and its relationship with the clinicopathological characteristics of cervical cancer was analyzed .Results The expres-sion of SALL4 mRNA was 2 .56 ± 0 .22 in cervical cancer tissues ,which was significantly higher than 0 .38 ± 0 .03 in the normal cer-vical tissues .the difference between them had statistical significance(t=58 .1 ,P<0 .01);the positive expression rate of SALL4 pro-tein was 80 .4% (45/56) in cervical cancer ,which was significantly higher than 11 .4% (4/35) in the normal cervical tissues (χ2 =41 .177 ,P<0 .01) .The positive expression of SALL4 in the cervical cancer tissues was correlated with the differentiation status of tumor ,which in the middle and high differentiation groups was lower than that in the low differentiation group (χ2 =4 .226 ,P=0 .039) ,but had no correlation with age ,International Federation of Gynecology and Obstetrics (FIGO) stage ,tumor size ,pathologi-cal type and lymph node metastasis(P>0 .05) .Conclusion SALL4 is highly expressed in the cervical cancer tissues and correlated with the tumor differentiation ,which might play an important role in the occurrence and development of cervical cancer .

Objective To investigate if glucose-insulin-potassium (GIK)would relieve the liver injury induced by endotoxemia in rats.Methods Sixty SD male rats,weight 200-250g,were randomly divided into three groups (n = 20):control group (group C),lipopolysaccharide group (group LPS,LPS 8 mg/kg)and Glucose-insulin-potassium group(group GIK,8 mg/kg LPS+GIK 4 ml·kg-1 ·h-1 ).All the rats were injected with 20 mg/kg ketamine intraperitonealy before trial. Erythrocin was daubed on the wound to avoid infection.The rats of group LPS and group GIK were injected LPS 8 mg/kg intraperitoneal,then,rats in group LPS and group GIK received saline(4 ml·kg-1 ·h-1 )or GIK(Glucose 200 g/L,Insulin 60 IU/L,KCL 60 mmol/L)infusion continuously. Liver and serum samples were collected on before injection,3 days after injection and 5 days after in-jection.Serum concentrations of ALT and AST were measured.TNF-αlpha of liver homogenate was detected by ELISA.The severity of liver damage was assessed by an approprite histopathological sco-ring system and apoptosis of parenchymal cells were assessed by TUNEL immunofluorescence assay. Results Compared with group control,the level of serum ALT and AST in group LPS and group GIK were significantly higher at 3 days after injection.The level of hepatic TNF-α,the hepatic damage score and the index of hepatic apoptosis in group LPS and group GIK were significantly higher on 3 days after injection and 5 days after injection.(P<0.05).Compared with group LPS,the level of hepatic TNF-αand the hepatocyte apoptosis rates decreased significantly in group GIK on 3 days after injection.The level of serum ALT and AST,hepatic TNF-α,the hepatic damage score and the hepatocyte apoptosis rates decreased significantly in group GIK at 5 days after injection(P <0.05).Conclusion Intraperitoneal injection of endotoxin can cause liver injury in rats,resulting in the liver hepatdysfunction and hepatocyte damage.GIK has protective effects on LPS induced liver injury in rats.

Objective: To study the diagnosis and treatment of primary hyperparathyroidism.Methods: The clinical data of 8 primary hyperparathyroidism patients(1992 2002) in our hospital were summarized and the references were reviewed.Results: It was found that primary hyperparathyroidism was liable to be misdiagnosed.Information on blood calcium,parathyroid hormone(PTH) and imaging may be helpful for diagnosis. Surgical resection(4 cases), anhydrous alcohol injection (2 cases), electron radiation (1 case) and internal medicine (1 case) were applied. Conclusion:Information on blood calcium,PTH and early imaging is helpful for diagnosis.Operation is the first choice of treatment, and for patients who can not tolerate surgery, anhydrous alcohol injection is an effective and safe treatment.