Complications in CRF-CAPD were treated by TCM during the past 17 years. Loss of appetite and hypoproteinemia were treated with modified Renshen Yangrong Decoction, for abdominal pain and distention, modified Xiangsha Liujunzi Decoction; for peritonitis, modified Dacaihu Decoction; for diarrhea due to hypofunction of spleen with exuberant dampness, modified Shenling Baizhu Powder; for Yang-deficiency of the Spleen and Kidney, modified Lizhong Decoction plus Sishen Pill; for skin pruritus, Siwu Decoction with additives; for renal -ortheopathy, treated by principles of tonifying the liver - kidney, strengthening the bones and tendons and blood - activating and stasis - relieving; for hyperlipidemia, by principles of tonifying the liver -kidney, phlegm and turbidity - eliminating and blood - activating stasis - relieving; for renalanemia, Guishao Sijunzi Decoction with additives. To improve patient'sliving quality and nutrition, self- formulated Shentekang capsule was given to improve renal function, decrease the frequencies and duration of dialysis, self - formulated Shenshuai Recipe was administered.

Objective To study the characteristics of CT images of myocardial bridge(MB)in patients with atherosclerosis.Methods CTA images of MB in 129 patients with atherosclerosis were studied.Another 109 patients without atherosclerosis,in the diagnosis of MB were used as control.The type,age,thickness of MB,length of mural coronary artery and end systolic diameter of mural coronary artery were compared between the two groups.Results In the study group,78 cases (60.5%)were superficial type,51(39.5%) were deep type.While in the control group,70(64%)cases were superficial type and 39(36%)were deep type.There was no significant difference between the two groups.The age,thickness of MB,length of mural coronary artery and end systolic diameter of mural coronary artery in each group were 57.01±10.17 years old,(3.15±1.66)mm,(20.43±7.38)mm,(1.16±0.25)mm and 48.36±9.11 years old,(1.95±1.77)mm,(21.07±6.69)mm,(2.07±0.81)mm.These parameters had significant differences between the two groups except the length of mural coronary artery (P>0.05).Conclusion The MB of the study group is thicker than the control group,and the mural coronary artery diameter of the former is narrower than that of the latter.

Objective To investigate the effects of different methods of volume therapy on the inflammatory response in patients undergoing liver cancer resection.Methods Forty ASA Ⅰ or Ⅱ patients,aged 40-60 yr,with body mass index 20-25 kg/m2,undergoing liver cancer resection,were randomly divided into 2 groups ( n =20 each):routine fluid replacement group (group Ⅰ ) and goal-directed fluid replacement group (group Ⅱ ).The fluid replacement regime in group Ⅰ =compensatory volume expansion (CVE) + physiological requirements + cumulative loss + confinued loss + the third space losses.CVE was replaced with lactated Ringer's (LR) solution 5 mg/kg before anesthesia induction.The physiological requirements and cumulative loss were replaced with LR solution according to the principle of 4-2-1.The continued loss equal to the intraoperative blood loss was replaced with the equal volume of 6％ hydroxyethyl s tarch ( HES 130/0.4).The 3rd space losses were replaced with LR solution 5 ml·kg-1 ·h-1.In group Ⅱ,CVE was replaced with LR sol6ution as in group Ⅰ.LR solution was infused after anesthesia induction at 5 ml·kg-1 ·h-1.6％ HES was infused to maintain left ventricular ejection time (LVETc) between 350-400 ms.When 350 ms ＜ LVETc ＜ 400 ms and the amplitude of stroke volume ( SV ) increased by ＞ 10％,6％ HES was infused continuously until the amplitude of SV increased by ≤ 10％.Blood samples were taken before anesthesia induction and at the end of operation for measurement of serum TNF-α,IL-2,IL-4,IL-6 and IL-8 concentrations.The adverse cardiovascular reactions were recorded.Results Compared with group Ⅰ,the serum TNF-α,IL-6,IL-8 concentrations were significantly decreased,the serum IL-2 and IL-4 concentrations were significantly increase,and the incidence of hypotension and tachycardia was significantly decreased in group Ⅱ ( P ＜ 0.05).No adverse cardiovascular reactions were found in both groups.Conclusion LVETc and SV-guided volume therapy can maintain the blood volume and inhibit the inflammatory response and is suitable for the patients undergoing liver cancer resection.

Objective: To study the characteristics of coronary CT angiography (CTA) in patients with myocardial bridge (MB) with arrhythmia. Methods: Our study included 2 groups: MB+arrhythmia group,n=31, clinical information as medical record, electrocardiogram (ECG), myocardial enzyme, echocardiography and coronary CTA findings were collected; MB group, n=30, the MB patients were without arrhythmia. Results: In MB+arrhythmia group, all patients were with mere MB, coronary artery disease, valve-structural heart diseases and other systemic diseases were excluded. There were 2/31 patients with ventricular fibrillation, 1 with atrial fibrillation, 5 with supraventricular tachycardia and 23 with ventricular tachycardia; 17/31 patients having deep type MB and 14 having superficial type MB. The myocardial systolic end diameter, diastolic end diameter by retrospective ECG gating and the stenosis at cross section of mural coronary MB by CTA were similar between 2 groups,P>0.05. Conclusion: MB+arrhythmia patients had no specific characteristics in coronary CTA; anatomical CTA feature may partly explain the myocardial ischemic symptom while couldn't clarify arrhythmia occurrence in relevant patients.

Objective To analyze the CTA features of asymptomatic myocardial bridge.Methods The CTA images of 69 cases with asymptomatic solitary myocardial bridge were studied retrospectively, and CTA images of 60 cases with symptoms as the contrast group.The type, age, thickness of myocardial bridge, mural coronary artery length and diameter changes of each cases of two groups were analyzed.Results In the study group, 51 cases of 69 (74%) were superficial style, while 18 cases were deep type (26%).In the contrast group, the superficial and deep style were 13 (22%) and 47 (78%) respectively.The mean age,thickness of myocardial bridge,mural coronary artery length and the diameter of mural coronary artery were (53.01±11.17) years old,(1.25±1.16) mm,(21.33±7.32) mm,(2.86±0.45) mm and (51.36±9.31) years old,(1.45±1.87) mm,(20.07±6.60) mm and (1.37±0.41) mm.The rate of type and diameter of mural coronary artery had significant differences between two groups (P<0.05), while other data had no significant differences (P>0.05).Conclusion The CTA features of asymptomatic myocardial bridge are mostly superficial type.The diameter of mural coronary artery on the end systolic is a factor to judge the rate on the occurrence of clinical symptom.

Objective To evaluate the predictive performance of propofol target-controlled infusion (TCI) system incorporating the Schnider pharmacokinetic parameters in Chinese patients. Methods Forty ASA Ⅰ or Ⅱ patients, aged 25-45 yr, with body mass index 20-25 kg/m2 , scheduled for gynecological laparoscopic surgery un der general anesthesia, were enrolled in this study. Anesthesia was induced with TCI of propofol (target plasma concentration (Cp) 3 μg/ml) and remifentanil (Cp 4 ng/ml) . Propofol was infused by Orchestra TCI system incorporating the Schnider pharmacokinetic parameters. Tracheal intubation was facilitated with rocuronium 0.6 mg/kgafter the patients lost consciousness. The patients were mechanically ventilated. PETCO2 was maintained at 30-40 mm Hg. Anesthesia was maintained with TCI of remifentanil (Cp 4 ng/ml) and propofol (Cp 3-5 μg/ml) and intermittent iv boluses of atracurium 0.2 mg/kg. BIS value was maintained at 40-45. Venous blood samples were obtained at 15, 30, 45 and 60 min after pneumoperitoneum for measurement of blood propofol concentrations by high performance liquid chromatography with fluorescence detector. Performance error, median prediction performance error, median absolute performance error, wobble and divergence of propofol TCI system were calculated. Results The value for performance error was 21 % (13%), for median prediction performance error 6.7 % (37.4%),for median absolute performance error 19% (18%), for divergence - 0.65%/h (0.82%/h) and for wobble 16.3% (15.2% ) . Conclusion The accuracy of propofol TCI system incorporating the Schnider pharmacokinetic parameters is high in Chinese patients and its predictive performance is acceptable clinically.

Objective To evaluate the correlation between stroke volume variation (SVV) and blood volume during one-lung ventilation (OLV).Methods Forty ASA Ⅱ male patients,aged 50-60 yr,with body mass index 20-25 kg/m2,scheduled for elective resection of esophageal cancer,were studied.Anesthesia was induced with fentanyl 4 μg/kg,propofol 2 mg/kg,and rocuronium 0.6 mg/kg.Double-lumen tube was inserted.Correct position was verified by fiberoptic bronchoscopy.The patients were mechanically ventilated (VT 8 ml/kg,RR 15 bpm,Ⅰ ∶ E 1 ∶ 2).6％ hydroxyethyl statch (HES) 130/0.4 was infused intravenously at a rate of 0.67 ml· kg-1 · min-1 starting from 30 min of OLV.SVV,cardiac output (CO),SV and cardiac index (CI) were monitored and recorded using the FloTrac/Vigileo (Edwards Lifesciences,USA) system before HES was infused and when the dose of HES reached 2,4,6,8,10 and 12 ml/kg.Spearman rank sum correlation coefficient was used to analyze the data.Results SVV was negatively correlated with the blood volume during OLV and the correlation coefficient was rSVV =-0.249.CI,CO and SV were positively correlated with the blood volume during OLV and the correlation coefficients were rCO =0.570,rSV =0.552 and rCI =0.550,respectively.Conclusion SVV is poorly correlated with the blood volume during OLV and can not reflect the blood volume accurately.

ObjectiveTo observe the difference in analgesia effects of ropivacaine with fentanyl used intraarticularly after the single knee arthroscopy procedure.Methods40 patients performed knee arthroscopy under combined spinal-epidural anaesthesia( CSEA),were randomly divided into 4 groups (n =10),at the end of operation 10mlof different drug at the group F,R,FR and N(fentanyl 10μg,0.5％ ropivacaine,fentanyl 10μg +0.5％ ropivacaine,normal saline)were injected intra-articularly.The antalgic effects of four groups based on standard of VAS were observed at the 2,4,8,12 and 24h after operation.ResultsThe 2h postoperative VAS scores were lower in four groups,the differences in four groups were not significant.The 4,8,12,24h postoperative VAS scores of F,R and FR group were much lower than that of N group ( all P ＜ 0.05 ).Moreover,VAS scores of FR group were much lower than that of F and R group( all P ＜ 0.05 ).No other adverse effects were observed.ConclusionIntra-articular administration of ropivacaine with fentanyl could provide superior postoperative analgesia without side effects.It was an excellent regimen for analgesia after knee arthroscopy.

Objective To evaluate the protective effects of different modes of ventilation on the lungs on the operated side during one-lung ventilation (OLV ) in patients undergoing thoracic surgery .Methods Forty-five ASA physical status Ⅰ or Ⅱ patients of both sexes ,aged 45-64 yr ,weighing 65-80 kg ,were randomly divided into 3 groups (n=15 each) using a random number table :group A ,group B and group C .After induction of anesthesia ,the patients were intubated with double-lumen tube and OLV was performed .During OLV ,the lung on the operated side was collapsed naturally in group A ,positive pressure ventilation (FGF 2 L/min) was applied in the lung on the operated side in group B ,and high-frequency jet ventilation (frequency 100 beats/min ,driving pressure 0.5 kg/cm2 ) was used in the lung on the operated side in group C .Immediately after intubation (T0 ) , and at 1.5 h (T1 ) and 2 h (T2 ) of OLV ,blood samples were taken from the central vein and radial artery for determination of the serum interleukin-6 (IL-6 ) and IL-8 concentrations .The net release of IL-6 and IL-8 was calculated .Blood samples were taken from the radial artery at T0-2 for blood gas analysis and for determination of surfactant protein A (SP-A) concentration in the serum .Respiratory index (RI) was calculated .The non-cancer tissues 1.0 cm × 1.0 cm × 1.0 cm which were extracted from the lung cancer specimens were used for microscopic examination of the pathological changes of lungs which were scored .Results Compared with group A ,the net release of IL-6 and IL-8 ,serum SP-A concentration ,RI and pathological scores were significantly decreased at T1 ,2 in B and C groups ( P<0.05) .Compared with group B ,the serum SP-A concentration and RI were significantly decreased at T1 ,2 , and the net release of IL-6 was increased at T2 in group C ( P< 0.05 ) .Conclusion Continuous positive ventilation and high-frequency jet ventilation both can effectively protect the lungs on the operated side during OLV in patients undergoing thoracic surgery ,and the efficacy of high-frequency jet ventilation is better .

In this paper, the authors analyzed the clinical features and the psychological characteristics of pa-tients with vitiligo: nervousness and inferiority, urgent treatment, high expectation , disappointed feelings of the failtreatment. Aimed at these psychological problems, the medical ethics requirements in the process of diagnosis and treatment were proposed:respect for the patient, protect of the patient′s privacy, patient communication and regular follow-up and health education.