Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Facial Injuries ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; therapy ; Retrospective Studies ; Wounds, Penetrating ; therapy ; Young Adult

Objective To assess the possible sequestration of remifentanil by the extracorporeal circuit.Methods Two types of extracorporeal circuits (ECCs) were used-Xijian type I (group A)and AFFINITY(R) NT(group B),while in control group (group C) a glass container was used.The ECC and glass container were filled with priming solution (6%hydroxyethyl starch 1000 ml + lactated Ringer's solution 500 ml).Remifentanil Wag then added to the priming solution with the final concentration of 100 ng/ml.The priming solution was circulated in the closed ECC or stirred the glass container.The concentration of remifentanil in the priming solution was determined at 2,5,10 and 15 min after addition of remifentanil.Results The remifentanil concentration in the priming solution decreased by 75.1%,57.9% and 18.3%at 2 min after addition of the drug in group A,B and C respectively as compared with the baseline value.The remifentanil absorption by ECC was significantly greater in group A than in group B.There was no significant difference in remifentanil concentration at the 4 time points in each group.Conclusion ECC can absorb remifentanil.The remifentanil absorption by Xijian type I is significantly greater than that by AFFINITY(R).

Cells, Cultured ; Comet Assay ; DNA Damage ; drug effects ; Female ; Humans ; Lymphocytes ; drug effects ; Male ; Micronucleus Tests ; Vincristine ; toxicity

Objective To analyze the effectiveness of doctor-patient communication course on improvement of doctor-patient communication ability.Methods Totally 360 eight-year program medical students of clinical medicine from Shanghai Jiaotong University School of Medicine were chosen as the research object and were divided into educational group(n＝l80) and control group(n＝180).Students in educational group study doctor-patient communication course while those in control group do not.SEGUE Framework was used to conduct exploratory research between educational group and control group.Accuracy of questionnaire database was examined by Excel software and logical test.KoImogorov-Smimov(K-S test) was applied to analyze the scores and (x ± s) was used to express the data through SPSS 16.0 statistical software.Comparison between group differences are statistically significant(P＜0.05).Results Overall score was higher in educational group than in control group.Concerning of communication initiation,infomation collection and understanding of patients,scores of educational group were significantly higher than those of control group(P=0.001,P=0.002 and P=0.007,respec-tively).Furthermnore,KoInogorov-Smimov(K-S test) and (x ± s) statistical results showed that scores of detailed items were higher in educational group than in control group as well.Conclusions Doctor-patient communication course is of great importance to help medical students practice physician-patient communication based on related knowledge learning,but course content setting remains to be further improved.

Objective To investigate the mechanism by which remifentanil decreases blood pressure during cardiopulmonary bypass (CPB).Methode Twenty-six ASA Ⅱ or Ⅲ patients (NYHA's classification grade Ⅱ or Ⅲ ) of both sexes and aged 20-55 years were randomized to receive remifentanil (group R, n = 13) or normal saline (group C, n = 13). Remifentanil 10 μg/kg or equal volume of normal saline was administered via a venous reservoir when cardiac arrest was induced with cardioplegic solution. The flow rate resistance (SVR) were measured and arterial blood samples were taken for determination of plasma concentrations of histamine,nitric oxide (NO) and 6-keta-prostaglandin F1α(PGF1α) before T0 and at 5, 10, 15 min (T5.10.15) after remifentanil administration.Results Remifentanil administration was associated with a significant decrease in MAP and SVR at T5 and T10 as compared with the baseline values at T0 ( P ＜ 0.05); whereas in control group, MAP and SVR were significantly increased at T5, T10 and T15 as compared with the baseline values at T0 . There were no significant differences in plasma histamine, NO and PGF1α concentrations between the two groups.Conclusion Remifentanil reduces SVR and causes a decrease in BP but without altering plasma concentrations of histamine, NO or PGl2.

Adult ; Bacteremia ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Nontuberculous Mycobacteria ; Postoperative Complications

Dermatomycoses ; drug therapy ; Drug Therapy, Combination ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Sexually Transmitted Diseases ; drug therapy ; Skin Diseases ; drug therapy ; Skin Diseases, Viral ; drug therapy

Objective To investigate change of chemokine mRNA and protein in the patients with diabetes mellitus(DM)complicated infection.Methods Fourty-eight patients with DM complicated infection were studied.Expression of mRNA and protein of monocyte chemoattractant protein-1(MCP-1)and interleukin 8 (IL-8)were measured by FQ-PCR,RT-PCR and ELISA.The relationship between hs-CRP,PMNL,IL-8 and MCP-1 were analyzed.Results Expression of mRNA and protein of MCP-1 and IL-8 were increased in the DM patients complicated infection.MCP-1 mRNA(mesured by FQ-PCR)was positively correlated with the protein(IL-8 r = 0.33;MCP-1 r = 0.88;P

Objective To explore a feasible and effective method of purse-string suture and traction in proce- dures for prolapse and hemorrhoids(PPH)with circular stapler.Methods Width of resected mucosal band and ex- tent of residual hemorrhoid mucosal lifting were compared between two groups of patients with hemorrhoids receiv- ing PPH with“two-point retraction”method(group one,110 cases)and other retraction methods(group two,40 cas- es).Results For group one of 110 cases with“two-point retraetion”,resected mucosal band of all cases were intact and and average width ranged from 3.5 to 5cm.There was a completely residual hemorrhoid mucosal lifting(com- plete return of prolapsed hemorrhoid into the anal canal)in 100 cases of group one(91%).But in group two with other retraction methods,average width of resected mucosal bands ranged from 0.2 to 3.5cm and there was an in- complete band in 10 cases(25%).The rate of mucosal lifting in this group was only 62.5%(19/40).Conclusion Two-point retraction is a feasible,effective and simple method in PPH,resulting in an intact resected mucosal band and sufficient hemorrhoid mucosal lifting.So the two-point retraction PPH is worth to be extended for application.

Objective To study the clinical result of the surgical treatment of upper cervical vertebra disease from high anterior cervical retropharyngeal approach.Methods Among 14 patients,there were 7 C_(2.3)disc hernia- rions combined with C_(2.3)dislocations,3 Hangman fractures,2 odontoid process fractures and 2 C_3 tumors.All patients underwent the high anterior cervical retropharyngeal approach.10 cases were given discectomy of C_(2.3)or focus clear- ance of C_3,iliac bone autograft or titanium cage filled and internal fixation with titanium plate.2 cases of odontoid process fractures were given anterior screw fixation.Results 14 cases got successful exposure.The decompression, reduction,lesion clearance and fusion with internal fixation were done in all patients.There were no important vascu- lar or nerve injuries.The surgical treatment could improve the spinal cord nerve function to a certain degree for the cases with compression of spinal cord.Conclusion Good exposure of upper cervical spine and effective surgical oper- ation could be achieved from high anterior cervical retropharyngeal approach,with minimal trauma and complication, and it was a favorable approach.