Objective To study the effect of different dose of propofol compounding with epidural anesthesia on oxygenation and shunt fraction during one-lung ventilation(OVL).Methods Forty patients with esophageal carcinoma undergoing thoracotomy were randomly divided into group Ⅰ and Ⅱ.After placing epidural tube at T_(6～7) for epidural anesthesia,the patients group Ⅰ were received propofol 5mg?kg~(-1)?h~(-1) and 10mg?kg~(-1)?h~(-1) in group Ⅱ.Taking the blood sample from arter for blood-gases measurement at beginning of operation,30min after OVL and 60min after OVL.Results At 30min after OVL,the shunt fraction(Qs/Qt) value of group Ⅰ and Ⅱ was(11.35?3.6) and(15.6?5.41);PaO_2 was (36.12?10.23) and(31.05?9.36).At 60min,the Qs/Qt was(13.9?3.7) and(18.5?2.1);PaO_2 was(34.87?15.42) and(26.97?11.35).There was significantly difference between two groups(P

Objective To establish a determination method of phthalates in the drinking water used to monitor the pollution level of phthalates in the drinking water of Beijing. Methods 23 samples from drinking water plants in Beijing were determinated by GC-MS, using selective ion mode (SIM)with high sensitivity and internal standard quantitation method with high accuracy. Results In all samples, di(2-ethylhexyl) phthalate (DEHP) was detected out and the highest concentration was 24.5 ?g/L, dibutyl phthalate (DBP) was detected out in 7 samples and the highest concentration was 11.1 ?g/L, The other 3 kinds of phthalate were not detected out. The detection limit of DEHP and DOP was 8.0 ?g/L, DMP, DEP, DBP was 0.3 ?g/L, The recovery rate were 71.7%-96.0%, RSD were 2.8%-9.0%. Conclusion The main pollutants of phthalates are DEHP and DBP in drinking water of Beijing, GC-MS is suitable for determination of phthalates in drinking water.

OBJECTIVE To explore the relationship between intubation of general anesthesia and lower respiratory tract infection.METHODS Totally 947 cases were divided into bronchial intubation group(groupⅠ,541 cases) and(tracheal) intubation group(groupⅡ,406 cases) for a retrospective analysis about lower respiratory tract(infection).The(sputum) samples of(infected) patients were took germiculture and antibiotic susceptibility.RESULTS There were 26 cases arisen lower respiratory tract infection in group Ⅰ and there were 18 in group Ⅱ.The(incidence) was 4.81% and 4.43%,respectively.86.36% pathogens of sputum samples were non-zymophytes,it was a direct proportion between high(antimicrobial) resistance rate and lower respiratory tract infection rate.The infection rate of 60-70 years old and under 49 years patients was 9.56% and 2.04%,respectively.The infection rate of(patients) undergoing anesthesia less 3h and over 3h was 3.26% and 6.14%,respectively,with significant(differences)(P

Objective To observe the therapeutic effect of tramadol combined with fentanyl in patient controlled intravenous analgesia after nucleotomy of intervertebral disc.Methods 60 patients under general anesthesia,scheduled for nucleotomy of intervertebral disc,were randomly divided into three group(n=20):group tramadol(group T),group fentanyl(group F) and group tramadol+fentanyl(group TF).All patients were received patient controlled intravenous analgesia by loading dose+background dose+PCA bolus dose.The BP,HR,RR,VAS at 6,12,24,48h of postoperation were observed.The sedation score in 24h,average effective-press times and drug dose in 48h of postoperation were recorded.The incidence of nausea and vomiting during 24h of postoperation were observed.Results It had no significantly difference of BP,HR,RR,VAS among three groups.The average effective-press times of group TF (8?2) were significantly less than those of group T (14?3) and group F (12?3).The drug dose of 48h was tramadol (17.9?1.5)mg/kg(group T),fentanyl (16.8?1.5)?g/kg(group F) and tramadol (11.5?0.7)mg/kg+fentanyl (9.1?0.7)?g/kg(group TF).The drug dose of group TF showed significant difference compared with others.The sedation score in group F was the highest,it had significant difference compared with the other two group.The frequency of nausea and vomiting in group T was significantly more than that in others.Conclusion Tramadol or fentanyl gived alone can afford the same satisfied analgesic effect on nucleotomy of intervertebral disc.But there is high nausea-vomiting frequency in tramadol and strong sedation frequency in fentanyl.Tramadol combined with a little opioid fentanyl can afford more satisfying analgesic effect,and is provided with advantage in less drug and side-effect.

Objective To investigate the association of endothelial nitric oxide synthase (eNOS) polymorphisms and avascular necrosis of femoral head (ANFH),to explore possible relationship between the ANFH incidence and 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7.Methods Totally 125 atraumatic ANFH patients and 126 healthy controls without hip trauma history were enrolled.Gene polymorphisms in 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7 were determined.Medical history was collected for etiology analysis.Results In between-group comparison,the frequency of b/a genotype intron 4 in ANFH group was significantly higher than that in healthy control group [19/125 (15.2％) vs 6/126 (4.8％),P =0.0001,OR =4.501],and the result of G/T genotype exon 7 in the ANFH group also indicated a statistical significance with the healthy control group [30/125 (24.0％) vs 17/126 (13.5％),P =0.0094,OR =3.804].In subgroup analysis,genotype b/a and G/T were especially higher in the idiopathic group than that in the healthy control group.Conclusions eNOS gene polymorphisms might be a risk factor of ANFH,there is underlying relevance of eNOS and the disease.Both 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7 are associated with ANFH incidence.

To investigate the dynamics of interleukin-21 (IL-21) cytokine in the Chinese HIV patients undergoing highly active antiretroviral therapy (HAAPT).Methods A total of 25 adults with chronic HIV infections,responding to combined highly active antiretroviral therapy (HAART) guideline criteria were enrolled for a 1-year follow-up.After signing an informed consent,20 mL blood was collected from each patient at the base line,6 month and 12 month,respectively.CD4 and CD8 cell count was quantified by flux cytometry,serum HIV RNA quantified by real time PCR and IL-21 concentrations by ELISA.Results IL-21 levels increased gradually during the follow-up but did not reach the healthy levels.IL-21 correlated positively with the CD4 cells but not with CD8 T cells.HIV RNA correlated negatively with CD4 cell count but did not show any relationship with the CD8 cells.Conclusion IL-21 has potential role in the immunopathogenesis of HIV,and might be an important factor in immune construction during HAART.

ObjectiveTo study the expression levels of YB-1 protein in hepatocellular carcinoma (HCC) tissues,tissues adjacent to tumour and normal liver tissues,and to explore the clinical significance.MethodsTo study the expression levels of YB-1 protein,immunochemistry was carried out on 58 HCC tissues and their corresponding adjacent tissues to tumour and on 20 normal liver tissues.The YB-1 protein with nuclear translocation was detected by Western blot in HCC tissues,tissues adjacent to tumour,normal liver tissues,HCC cell lines including QGY-7701 and SMMC-7721,and a normal hepatic cell line LO2.ResultsPositive signals of YB-1 protein were detected at a high level in HCC tissues (72.4％,42/58) when compared to tissues adjacent to tumour (41.4％,24/58) and to normal liver tissues (35 ％,7/20) (P＞0.05).The nuclear expression of YB-1 (31％,18/58) was significantly correlated with the pathologicalgrade,tumour size and portal venous invasion (P＜0.05).Using Western blot,the YB-1 protein with nuclear translocation was expressed at a higher level in HCC tissues (0.474±0.107) than in tissues adjacent to tumour and in normal liver tissues (P＜0.05).Similar results were obtained in HCC cell lines and the normal hepatic cell line (P＜0.05).ConclusionThe high expression of YB-1 in HCC and its nuclear translocation may be involved in human HCC progression.YB-1 may be a potential target for HCC treatment in the future.

Objective To investigate the clinical value of the echocardiography in the diagnosis of congenital mitral valve malformation and summarize its occurrence and type associated with other cardiac malformations.Methods The echocardiographic image data of 101 patients with congenital mitral valve malformation were retrospectively analyzed,the characteristics of different types were summarized and compared with operation results,CT,cardiac catheterization,transesophageal echocardiography,as well as the data of echocardiographic follow-up.Results Among 101 patients with echocardiographic examination showed mitral valve congenital malformation,63 cases were isolated valve set malformation (62.4％),and multiple valve set malformation were found in 38 cases (32.7％).In another side,39 cases were of single mitral valve malformation (38.6％),while 62 patients combined with other type cardiac malformations (61.4％).No significant difference of dynamic change was shown between patients with solitary and multiple malformation of mitral valve (P ＞0.05).Conclusions Echocardiography can display congenital mitral valve malformation in a fast,robust,real-time way.It has an important clinical value in the diagnosis of congenital mitral valve malformation.

Objective To probe into clinical value of real-time three-dimensional echocardiography (RT-3DE) in evaluating global and regional left ventricular function in patients with acute inferior, posterior and lateral myocardial infarction(MI).Methods The study consisted of 41 normal subjects and 23 patients with acute MI.RT-3DE was performed and three-dimensional image data was analyzed offline with software.A series of global and regional left ventricular volume curves were plotted.Regional and global diastolic volumes, regional and global systolic volumes, regional and global ejection fractions, regional stroke volume to global diastolic volume were compared respectively between control group and MI group.Results By contrast with control group, global left ventricle function and regional left ventricle function in the zones with infarction and part of the zones close to infarction had significant difference( P＜0.05),however,no effective statistic change was found in the most of the distal zones of infarction( P＞0.05).Conclusions RT-3DE can accurately evaluate measurement the left ventricular global and regional function in patients with acute MI.

Objective:To investigate the clinical features of placental thrombosis complicated with fetal growth restriction(FGR),and to analyze its diagnosis and treatment methods. Methods:Combined with reviewing the relevant literatures, the clinical data of a case of placental thrombosis complicated with FGR was retrospectively analyzed. The patient with 32 1/7 weeks of gestation was hospitalized due to placental blood sinus found one month ago;at the same time FGR was found by ultrasound examination. The patient was intravenously given nutritional support treatment such as amino acid and glucose.At the same time, the patient was continuously given low-flow oxygen. Results:The patient received cesarean section at 35 2/7 weeks of gestation and a baby girl with 1 280 g weight and 32 cm length was gained;many blood sinus in the maternal surface of placenta were seen with the largest diameter of 3-4cm;the placenta was hypertrophic, weighted 540 g .After operation,the newborn was transferred to Department of Neonatology and followed up for 1 month.1 month later, the infant could eat by herself, other physical examinations were finished without any obvious abnormal findings and the newbron discharged from hospital after recovery. Conclusion:Placental thrombosis complicated with FGR is very common in clinic and this disease severely endangers the neonatal health. Early diagnosis and reasonable treatment can improve the pregnancy outcomes.