[Objective]The purpose of this study was to investigate the effect of severe aortic valve incompetence on the pharmacodynamics of cisatracurium.[Methods]Thirty patients were enrolled in this study:15 patients with severe aortic valve incompetence scheduled for aortic valve replacement were included in the study group(AI-group)and 15 patients without heart disease undergoing general surgical operations were allocated into the control group(C-group).Anesthesia was induced with fentanyl 5 μg/kg.propofol 1.5～2 mg/kg and cisatracurium 0.1 mg/kg and maintained by total intravenous anesthesia with propofol-remifentanil infusion.Degree of neuromuscular block was measured by train-of-four ratio using TOF-WATCH acceleragraph monitor.Onset time(from administration of cisatracurium to T1=0),total twitch suppression time,the time for spontaneous recovery of T1 to 25%and 75%.and the recovery index were recorded respectively.[Results]The onset time of cisatracurium was significantly longer in the AI group compared to the control group(5.6±0.8 min vs 3.4 ±0.4 min.P＜0.001.However.there was no difference in the recovery time between the two groups.[Conclusion]We demonstrated that the onset of cisatracurium was delayed in the patients with severe aortic regurgitation in comparison to those without heart disease.

Objective To evaluate the efficacy of laparoscopic and open operation combined with endoscopic nasobiliary drainage(ENBD) in the management of choledocholith. Methods 44 cases treated by laparoscopic common bile duct exploration (LCBDE) and 34 ones by open common bile duct exploration(OCBDE) combined with ENBD and primary suture of common bile duct were retrospectively analyzed from January 1997 to July 2001. Results All cases were operated on successfully. The clearance rate of stones was 100%(78/78). No postoperative complications such as bile leakage, hemobilia, cholangitis, etc occurred. Postoperative hospital stay was (6 2?1 3)days in group LCBDE and (7 4?2 1)days in group OCBDE. 57 cases had been followed up for (1～4 5)years with an average of 2 6 years, and ultrasoundgraphy showed no bile duct stricture and recurrent stones. Conclusions LCBDE or OCBDE combined with ENBD and primary suture of common bile duct is safe and reliable.

Objective To study the method of combined laparoscopy and endoscopy ( duodenosco-py and choledochoscopy) in the treatment of Csendes's II, III Mirizzi Syndrome. Methods Twenty one patients with Mirizzi Syndrome were admitted for the procedures. These patients received endoscopic nasobiliary drainage first, followed by laparoscopic subtotal cholecystectomy plus common bile duct(CBD) exploration. Results Satisfactory out come was realized except conversion to open surgery occurred in 2 for failure in repairing due to the extensive adhesions of Calot's triangle and anatomical abnormalities of cystic duct. In the course of operation ,removal of incarcerated stones in neck of gallbladder was performed in 14 cases, extraction of CBD stones by intraoperative choledochoscopy in 5 cases, and all cases received primary suture on the defect of CBD. There was neither residual stones left nor serious after - effect including biliary fistula and he-mobilia. Mean postoperative stay was 9.4 days. Follow - up observations on 19 patients did not show recurrence of stones, nor bile duct stricture during 18-41 months. Conclusion The combined procedures is feasible and safe alternative but can be technically demanding. This management is able to substitute some conventional procedure of T - tube insertion, however, primary suture on the defect bile duct is especially difficult.

Objective To study on the method of applying laparoseopy for the treatment of choledo cholithiasis after biliary tract operation, and to evaluate its therapeutic efficacy. Methods Thirty-seven cases of common bile duct stones after operation from October 1999 to December 2003, received laparoscopic common bile duct exploration (LCBDE) were retrospectively analyzed. Results Satisfactory results were accepted in 35 cases and the rest two cases converted to laparotomy. Thirty cases had got primary healing by the help of employing endoscopic nasobiliary drainage (ENBD) , 7 cases received T-tube drainage. There was neither residual stones left nor serious after-effect including biliary fistula and hemobilia happened. Mean operative time was ( 168 ?30. 2) min. Mean postoperative stay in hospital was (11.5?1.3) d. Recurrences of calculi and bile duct stricture never happened within 6-48 m follow-up study. Conclusion The laparoscopic procedure is technically feasible and safe alternative, however, the technique in lyses of adhesions, dissection and suture of choledochus are quite difficult, therefore it is recommended to be performed in experienced hands expected to minimize the occurrence of complications, and firmly mastered the indications of conversion to laparotomy as far as possible.

Objective To observe the biochemical indicators and lifestyles of patients with non-alcoholic fatty liver disease (NAFLD),and analyse the risk factors of induced NAFLD.Methods A total of 258 in-and out-patients of NAFLD were included in the present study,the control group consisted of 213 examinationers with nonfatty liver disease.All samples were being blood biochemical indicator detection and lifestyle survey.Results Some blood biochemical index of NAFLD patients such as TC(5.48 ± 1.10) mmol/L,TG(2.31 ± 1.25) mmol/L,ALT (51.35 ± 26.18) U/L,AST (42.37 ± 28.32) U/L,FPG (5.62 ± 3.24) mmol/L,GGT (58.47 ± 43.25) U/L and UA (398.51 ± 96.85) μmol/L were higher than those of the control group (t =3.423,5.250,7.402,4.348,3.326,6.683,3.891,all P ＜ 0.01) ; and the incidence of hyperlipidemia,hypertension (21.71％),diabetes (22.09％),BMI(26.85 ± 3.45) or metabolic syndrome (44.57％) etc.Those indexes in NAFLD patients were significantly higher than those in the control group (x2 =8.14,10.55,58.48,t =10.73,all P ＜ 0.01).By multivariable Logistic regression analysis,TG,WI,BMI,HOMA-IR,lack of exercise,high-fat diet were independent risk factors for NAFLD (all P ＜ 0.05).Conclusion Patients with NAFLD is closely correlated to metabolic abnormalities,reasonable diet and a healthy lifestyle is an effective way of prevention and treatment of this disease.

Objective To evaluate the prophylactic effect of pancreatic duct stent (PPDS),NonSteroid Anti-Inflammtory Drugs (NSAIDs),and joint PPDS and NSAIDs on post endoscopic rectrograde cholangiopancreatography(ERCP) Pancreatitis(PEP) in choledocholithiasis patients.Methods A total of 200 choledocholithiasis patients were randomly divided into 4 groups,prophylactic pancreatic duct stent(PPDS) group (A),NSAIDs group (B),joint PPDS-NSAIDs group (C) and routine ERCP without prevention for PEP(group D).VAS score,levels of amylase in serum and CRP were measured before and 4 h,24 h,48 h after ERCP.Incidences of hyperamylasemia and PEP were observed.Results (1) Incidences of hyperamylasemia 48 h after ERCP were 6％ (3/50),6％ (3/50) and 4％ (2/50) in group A,group B and group C respectively,which were significantly lower than that of group D (11/55) (P ＜ 0.05).(2) Incidences of PEP 48 h after ERCP were both 2％ (1/50) in group A and group C,which were lower than that in group D (10％,5/50,P ＜ 0.05).Group B (4％,2/50) was lower than that of group D but there was no statistical significance(P ＞0.05).(3) VAS scores of all groups at 4 h,24 h and 48 h after the operation were significantly higher than before (P ＜ 0.05).Group B score was significantly lower than that of group D (P ＜ 0.05).Scores of group A and C at 4 h were lower than those of group D (P ＜ 0.05),and those at 24 h and 48 h were also lower but with no statistical significance (P ＞ 0.05).(4) Serum CRP levels at 4 h,24 h and 48 h were significantly higher than those before in each group.Serum CRP levels of group B and C were significantly lower than that of group D at 4 h,24 h and 48 h.Serum CRP level of group A was significantly lower than group D at 4 h,24 h.CRP level at 48 h of group A was lower than that of group D,but there was no statistical significance (P ＞ 0.05).Conclusion Both prophylactic pancreatic duct stent and NSAIDs (Parecoxib Sodium) can reduce incidence of hyperamylasemia after ERCP common bile duct lithotomy.Single or joint use of prophylactic pancreatic duct stent can prevent PEP.Furthermore,prophylactic pancreatic duct stent and NSAIDs (Parecoxib Sodium) can reduce pain and inflammation after ERCP common bile duct lithotomy.NSAIDs only (Parecoxib Sodium) is more effective than prophylactic pancreatic duct stent only and joint use of both.

Objective:Screening out NPC from susceptable crowd by serological test for EB virus.Methods:Checking antibody of EB virus by ELISA. At first, EBNA1 IgA was detected for susceptable crowd as a primary screening index, secondary , EBNA1 IgG and Zta IgG were detected in the EBNA1 IgA positive group.Results:The sensitivity and specificity of EBNA1 IgA were 91.8% and 91.4%, both were higher than those of EBNA1 IgG and Zta IgG; the sencondary detection of EBNA1 IgG and Zta IgG raised the specificity of NPC screening to 96.5% and also helped to divide the crowd into 3 groups as high, median, and low risk. And the high risk group accounted for 0.39%.Conclusion:Two-stage screening of NPC raise the sensitivity and specificity of NPC detection. It also helps to divide the crowd into 3 groups of risk.

Objective: To observe the effect of Ruxiankang (RXK) Capsule (Radix Bupleuri, Poria, Rhizoma Atractylodis macrocephalae, Radix Angelicae Sinensis, Radix Paeoniae Alba, Rhizoma Cyperi, etc.) on mammary gland and sex hormone of rat with mastoplasia. Methods: After benzoate estradiol and progestogen were injected into rats for 30 days the mastoplasia model was made, the model rats were treated with tamoxifen and RXK Capsule for 30days, and injected estradiol at the same time. Results: RXK Capsule and tamoxifen could significantly inhibit HMG rat's mammary gland swell, reduce quantity of lobule alveolus in mammary glands and secretion ( P

Objective To study the phonetic characteristics of patients with abnormal plosive consonant of functional articulation disorders (FAD) and the possible treatment approaches.Methods A total of patients of 4~26 years old with abnormal plosive consonant of FAD received speech assessment and the phonetic characteristics.Incorrect articulation patterns and forms of plosive consonant /b/,/p/,/d/,/t/,/g/ and /k/ were analysed.The targeted speech treatment was established to correct the erroneous places and types of pronunciation.Results The error rate of /t/ (82/87)was the highest,followed by /k/(77/87),/d/(67/87),/g/(60/87),/p/(59/87) and /b/(3/87) which was the lowest.The error rate of fricative was 65.52% as the highest among all the erroneous patterns,followed by unaspiration(63.22%),forward movement of the tongue(54.02%),distortion(33.33%),bilabial(32.18%),and backward movement of the tongue(18.39%).Seventy-one cases were completely cured,and 16 cases partially cured after 2 to 10 times of treatment.The number of incorrect words of plosives decreased to 4.03±2.71 after the speech therapy from 67.97±18.56 prior to that.The differences were statistically significant (t =34.301,P<0.001).Conclusion The articulation errors of plosives occur mainly on /t/,/k/,/d/,/g/and /p/,/b/.The incorrect types of pronunciation are fricatives,unaspiration,distortion and omission.The incorrect places of articulation are forward movement of the tongue,bilabial and backward movement of the tongue.The targeted speech therapy established according to the erroneous places and types of articulation is significantly effective.

Objective To study the phonological characteristics and rehabilitation methods of abnormal velar consonants in operated patients with cleft palate.Methods A total of 110 patients (60 males and 50 females, aged 4 to 27 years with the mean age as 9.01±4.12) with abnormal velar consonants after cleft palate treatment over one month were involved in this study.According to the severity of articulation disorders, the patients were divided into mild, moderate and severe groups who received 1 to 5 weeks of targeted rehabilitation training.The phonological characteristics of abnormal velar consonants and the correction between velar consonant misarticulation and age/gender were analyzed.Results The error rate of /g/ was 96.36%(106/110) which was the highest, then /k/ and /h/ was 74.55%(82/110) and 19.09%(21/110), respectively.Both /g/(80.19%, 85/106) and /h/(76.19%, 16/21) mainly showed omission while /k/ was mainly substituted by /h/(54.88%, 45/82) and /t/(29.27%, 24/82).95 cases were cured and 12 cases improved after specific rehabilitation.The overall cure rate was 86.36%.The cure rates for the mild, moderate and severe groups were 96.00%(24/25), 90.91%(30/33), and 78.85%(41/52),respectively.Males accounted for 51.76%(44/85) and females for 48.24%(41/85) among omission cases;males accounted for 51.47%(35/68) and females for 48.53%(33/68) among substitution cases.There was no significant correction among the number of incorrect words and age(r=-0.140, P>0.05) as well as gender(r=0.090, P>0.1).Conclusion Abnormal velar consonants in operated patients with cleft palate mainly had problems with /g/ and /k/./g/ showed mainly omission errors and /k/ mainly substitution.The targeted rehabilitation methods established in the study are significantly beneficial.