Objective To evaluate the effects of intravenous anesthesia with propofol and fentanyl on flexible fiberoptic bronchoscopy (FFB).Methods Forty ASA Ⅰ - Ⅱ patients undergoing elective FFB were randomly divided into two groups (20 cases in each group): control group and intravenous anesthesia group.All patients received airway local topical anesthesia with 2% lidocaine before the procedure.The patients in intravenous anesthesia group received propofol 1.5 mg/kg and fentanyl 1 μ g/kg intravenous injection for induction while in control group normal saline was given instead.Supplemental oxygen was administered by the endoscopy face mask.The mean arterial pressure (MAP),heart rate (HR)and pulse oxygen saturation (SpO_2) were continuously monitored and recorded before induction of anesthesia (T_1, baseline), 1 min after intravenous injection (T_2) ,immediately and 3 min after intubation (T_3,T_4),after FFB (T_5).The persistence time of the procedure was noted.When the patients responded to commands exactly, the recovery time was recorded.All patients were interviewed for the global tolerance to the procedure, the acceptance of another fiberoptic bronchoscopy and the degree of amnesia.Results All of the 40 patients finished FFB successfully.VAS postoperation and dependence scores were lower in intravenous anesthesia group than those in contrel group[(1±2),(2±3) scores and (7±1),(7±3) scores](P< 0.05).MAP and HR at T_3, T_4 and T_5 were significantly increased compared with baseline values at T_1 in control group (P <0.05).MAP and HR at T_2 was lower than those at T_1,HR at T_3 was higher than that at T_1 in intravenous anesthesia group (P < 0.05 ).Compared with control group, MAP and HR at T_3, T_4 and Ts were lower, HB at T_2 was lower in intravenous anesthesia group (P < 0.05).There was no awareness during the FFB in intravenous anesthesia group.Conclusion Intravenous anesthesia with propofol and fentanyl is safe and effective for FFB.

Objective To assess the efficacy and safety of multimodal analgesia with different doses of nalbuphine combined with flurbiprofen on patients who received intravenous patient -controlled analgesia(PCIA) after thoracotomy.Methods Sixty patients underwent thoracotomy,ASA Ⅰ -Ⅱ,18 -65 years old,who underwent postoperative PCIA,were randomly divideded into three groups according to the digital table,nalbuphine 60 mg group (N60 group),nalbuphine 80 mg group(N80 group)and nalbuphine 100 mg group (N100 group),20 cases in each group.All patients were given 150mg flurbiprofen,a total of 100mL.PCIA solution:the background dose was 2mL/h, PCIA dose of 0.5mL,locking time of 15min.10min before surgery,each patient was intravenously given flurbiprofen 50mg,given a loading dose of 0.1mL/kg when closed chest.All patients were followed up for 48h.The incidence of adverse reactions such as vital signs,number of times,visual analog scale(VAS)score,sedation score,nausea and vomiting were recorded.Results There were no significant differences in the age,gender,body mass index and surgery duration among the three groups(all P >0.05).The vital signs were stable within 48h after operation.The VAS scores of N60 group were higher than the other two groups(N80 group:t =7.94,6.35,6.49,5.21,5.63,all P =0.00;N100 group:t =8.41,9.10,5.80,8.07,8.18,all P =0.00)at 4,6,8,24 and 48h after operation(all P <0.05).The VAS score of N80 group 48 h after operation was lower than that of N100 group(t =2.30,P =0.03),and the difference was not statistically significant in remaining(all P >0.05).The effective /actual compression ratio of PCIA of N80 group and N100 group were significantly higher than that of N60 group (t =7.30,8.35,all P <0.05). There were no differences in the incidence of adverse reaction among the three groups(group N80:χ2 =0.17,0.23, 1.03,all P >0.05;group N100:χ2 =3.14,0.23,1.03,all P >0.05).Conclusion Postoperative PCIA with nalbu-phine (80 mg)combined with flurbiprofen(150 mg)has significant analgesic effect and lower costs.

In resent years,brain parenchyma and cerebrovascular sonography have received considerable attention.Monitoring of cerebral vessels and their blood flow velocities and pulsation indexes may reflect the intracranial vascular lesions.However,there are a few studies about transcranial color-code duplex sonography (TCCD) in the monitoring of space-occupying stroke.This technology has the non-invasive,convenient,and economical advantages,and can timely provide clinical information.Using TCCD to monitor pace-occupying stroke may play a positive role in prevention of the diseases and prognosis.

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OBJECTIVE To analyze the resistance of Pseudomonas aeruginosa (PAE) isolated from clinical specimen and provide the guidance for the clinical treatment. METHODS The P. aeruginosas infection status from Jun 2005 to Dec 2007 was reviewed retrospectively,and the results of susceptibility test in 286 strains of PAE were analyzed. RESULTS The drug-resistance rates to gentamicin,cefotaxime,and ceftriaxone in PAE were all above 60.0%,and that to cefoperazone/sulbactam,piperacillin/tazobactam sodium,amikacin and levofloxacin showing all higher sensitivity. The resistance rates to meropenem and imipenem were 17.1% and 18.5%,respectively. CONCLUSIONS P. aeruginosa is one of the main pathogenic bacteria in nosocomial infection. It's very important to strengthen the monitoring of drug-resistance of PAE and rationally antibiotics usage.

OBJECTIVE To investigate the resistance of meticillin-resistant Staphylococcus aureus(MRSA) and the occurrence of gene erm.METHODS ATB Staph and microdilute tests were performed to detect the susceptibility to 15 kinds of antibiotics in 50 strains of the S.aureus(SAU).Gene erm of these strains was detected by polymerase chain reaction(PCR).RESULTS There were no strains resistant to vancomycin,teicoplanin,fusidic acid and quinupristin-dalfopristin in 42 strains of MRSA detected.There were no strains sensitive to penicillin,oxacillin,gentamicin,tetracycline,ciprofloxacin and levofloxacin.Thirty-five strains habored gene erm in 42 strains of MRSA.The positive rate of gene erm was 83.3%.CONCLUSIONS The multiple-resistance of the MRSA is a serious issue.The resistance to erythromycin in MRSA is mediated by gene erm which encodes the methylase and changes the target site of drug action.

Objective To assess the efficacy and safety of nalbuphine in preventing the side effect of pruritus induced by intrathecal morphine after cesarean section. Methods Sixty patients aged 18- 35 years with ASAⅠ~Ⅱand undergoing cesarean section with combined spinal-epidural anesthesia were randomly and double blindly divided into two groups. Patients in Group N (30 patients) received nalbuphine 4 mg (2 ml) by intravenous route after clamping of the umbilical cord; Patients in Group P (30 patients) received 0.9% NaCl (2 ml) by intravenous route after clamping of the umbilical cord. The protocol of postoperative analgesia was intrathecal morphine 0.2 mg. The patients were followed up for 4 h , and the vital signs were detected at the time of returning to patient s room (T0), 1 h (T1), 2 h(T2), 3 h(T3) and 4 h(T4) after operation. The VAS scores, pruritus severity scores, time of pruritus onset, Ramsay sedation scores and and other adverse effects were recorded. Results The levels of MAP, SpO2, HR in two groups at T0, T1, T2, T3, T4 had no significant differences (P>0.05). The rate of pruritus severity score 0-1 score in group N was significantly higher than that in group P (χ2=17.4, P=0.00). The VAS scores and the rate of drowsiness, nausea, vomiting, shivering and dizziness in two groups had no significant difference (P>0.05). Conclusions Nalbuphine provides a significant reduction of morphine induced pruritus for patients who received intrathecal morphine analgesia after cesarean section.

Theacrine is one kind of natural purine alkaloids, which mainly exists in an unusual Chinese tea known as Kucha. It shows various biological activities, such as anti-depression, sedative and hypnotic effects and anti-inflammatory and analgesic activi-ties. The study on theacrine dates back to a few decades ago. According to the references published in recent years, the resource, preparation, characterization and pharmacological effects of theacrine were reviewed, and its application prospect was also explored.

OBJECTIVE: To develop RP-HPLC method for the rapid determination of resveratrol in serum and tissue homogenates (in some organs) of mice.METHODS:HPLC determination was performed using Kromasil C18 column,the mobile phase consisted of methanol - water (48∶ 52) with a flow rate of 1ml/min,the column was under room temperature with its pressure at 12kPa,the detection wavelength was 303nm and the sample size was 20?l. RESULTS: The linear range for resveratrol was 0.25～25?g/ml, with minimal detectable drug concentration at 0.1?g/ml (S/N=3). The average absolute rec_overy of the samples was above 88% and the methodological recovery rates of which ranged from 96% to 100%,RSD were below 10%. CONCLUSIONS: The established determination method is economical, reliable, simple and rapid, and suitable for the blood concentration determination of resveratrol and the study of its distribution in animal body.

Objective To investigate the clinical applications of the chain locking-type tension bands. Methods89 cases with patellar bone fractures,27 olecranal fractures patients,18 patients with fractures of surgical neck of humerus,16 patients with dislocation of the acromioclavicular joints and 12 patients with clavicular lateral fractures were treated with chain locking-type tension bands. ResultsTheResultsshowed that all patients wound were postoperative first intention.The healing time of the fractures were 6 ～ 18 months(average 10 months).The Kirschner's pins lapping,steel wire breaks and tension bands out of control were not found. ConclusionCompared with the traditional tension bands,the chain locking-type tension bands had stronger stability,stress distribution more even and less complications.