Objective To observe and explore the effect of bupivacaine (BUP)single use or combined with sufentanil (SUF)for pregnant woman in caesarean operation with chills and pain.Methods 96 pregnant women with caesarean section were selected,they were randomly divided into observation group and control group by random num-ber method,each group with 48 cases.Patients in the observation group accepted BUP combined with SUF treatment, while the control group only received BUP treatment.The intraoperative and postoperative data of maternal chills and dragging pain,and the incidence of adverse reactions were compared between the two groups.Results The sensory block onset time and duration of the observation group were (1 .7 ±0.5)min and (1 26.2 ±9.5)min,which in the control group were (2.0 ±0.4)min and (9.1 ±1 1 .0)min,the differences between the two groups were statistically significant (t =2.295,1 5.88,all P <0.05).For chills and stretch of pregnant women,the number of the observation group were 2 casesand 3cases,which in the control group were 9cases and 1 0cases,the differences between the two groups were statistically significant (χ2 =5.031 ,4.360,all P <0.05).No patient had toxicity of local anesthetics between two groups.Total anesthesia effective rate of the observation group was 97.9%,which of the control group was 83.3%,the total anesthesia effect of the observation group was better than the control group (χ2 =4.41 4,P <0.01 ). Conclusion BUP combined with SUF treatment has significant effect for pregnant women in caesarean operation,as well as can significantly relieve the pregnant women'chills and pain.

Objective To evaluate the effects of ulinastatin(UTI)on liver and renal function and portal vein thrombosis(PVT)in patients undergoing portal azygous disconnection.Methods Thirty patients undergoing selective portal azygous disconnection were randomly divided into two groups.Group U:UTI 2?105 U was given after anesthesis and followed six days after operation.Group C:The same amount of normal saline instead of UTI.The liver and renal function and PVT were measured.Results There was significant difference in PT%,CHE,ALT at 1st day after operation between two groups,and so was CHE at 5th day and PT%、INR、ALB at 15th day after operation.There was no statistical difference in renal function and PVT between two groups.Conclusions UTI can protect liver function,but no effect on renal function and PVT during portal azygous disconnection.

Objective:To explore the microbiological and disease distribution characteristics of multidrug-resistant bacteria in patients hospitalized in a critical care rehabilitation ward, and to analyze the risk factors leading to multidrug-resistant bacterial infections.Methods:Microbiology screening data describing 679 patients admitted to a critical care rehabilitation ward were retrospectively analyzed to divide the subjects into a multidrug-resistant group (positive for multidrug-resistant bacterial infections, n=166) and a non-multidrug-resistant group (negative for multidrug-resistant bacterial infections, n=513). The risk factors were then analyzed using logistic regression. Results:Among 369 strains of multidrug-resistant bacteria observed, 329 were gram-negative bacteria (89.2%), mainly Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli. They were distributed in sputum (56.9%) and mid-epidemic urine (28.2%) specimens. Patients whose primary disease was hemorrhagic or ischemic cerebrovascular disease accounted for 40.96% and 23.49% of the multidrug-resistant bacterial infections, respectively. Logistic regression analysis showed that albumin level, dependence on mechanical ventilation, central venous cannulation, or an indwelling urinary catheter or cystostomy tube were significant independent predictors of such infections.Conclusion:The multidrug-resistant bacterial infections of patients admitted to the critically ill rehabilitation unit are mainly caused by gram-negative bacteria. Their occurrence is closely related to low albumin levels and mechanical ventilation, as well as to bearing an indwelling central venous catheter, a urinary catheter or a cystostomy catheter.