Objective To assess the efficacy of ropivacaine in combination with different doses of sufentanil for epidural anesthesia in patients undergoing hysterectomy. Methods Eighty ASA Ⅰ or Ⅱ patients aged 30-55 yrs weighing 40-70 kg undergoing elective hysterectomy were randomly divided into 4 groups ( n = 20 each) : ropivacaine group (R) and 3 ropivacaine-sufentanil groups (R-S1-3). The patients were unpremedicated. ECG, BP, HR and SpO2 were monitored during ansthesia. Each patient received an epidural catheter placed at L2,3 interspace. After correct placement of epidural catheter was confirmed 0.75% ropivacaine 13 ml and normal saline (NS) 2 ml were given through epidural catheter in group R whereas in the 3 R-S groups 0.75% ropivacaine 13 ml and sufentanil 10 (R-S1), 20 (R-S2) or 30 (R-S3) ?g in NS 2 ml were injected into epidural space. BP, HR and SpO2 were recorded every 3 min. The onset time, upper spread and duration of sensory block; onset and duration of motor block (Bromage scale); degree of abdominal muscle relaxation; level of sedation (OAA/S scale); anesthetic efficacy and side-effects were recorded. The dose-response curve constructed by probit regression analysis was established to calculate ED50 and ED95. Results The onset time, the time needed to reach the highest sensory level were significantly shorter and the duration of sensory block was significantly longer in the 3 R-S groups than in R group ( P

AIM:To investigate the safety and complications of femtosecond laser corneal small incision lenticule extraction(SMILE) procedure and discuss the prevention and treatment.METHODS: We retrospectively studied the complications of 403 patients(799 eyes) with myopia and myopic astigmatism treated by SMILE.RESULTS: All the patients underwent the operation successfully.Only 1 case(1 eye)suffered from dark spot and changed to femtosecond laser-assisted LASIK(FS-LASIK), 5 cases(5 eyes, 0.6%) suffered from the suction loss, 11 cases (17 eyes, 2.1%) developed opaque bubble layer.All patients gained perfect uncorrected visual acuity(UCVA) (20/20).The best corrected visual acuity(BCVA) did not decrease after operations.The incidence of haze and diffuse lamellar keratitis was low (0.3% and 0.4%, respectively)and no other complications were observed.There was 9 eyes in 6 patients (1.1%) found regression of refraction at 6mo after surgery, while the UCVA of rest patients reached 1.0 at 3mo after surgery.CONCLUSION: The SMILE procedure has high safety for myopia and myopic astigmatism.Effective prevention and management of the complications is the key to achieve the satisfactory visual acuity.

Adult ; Bronchoalveolar Lavage ; nursing ; Female ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; nursing ; therapy ; Retrospective Studies

Objective To compare the time-course of relaxant effect of rocuronium between patients of Uygur and Han nationalities.Methods Thirty ASA Ⅰ or Ⅱ patients (15 Uygur nationality,15 Han nationality) of both sexes,aged 20-55 yr weighing 45-73 kg were divided into 2 groups (n=15 each):group U Uygur nationality and group H Han nationality.Anesthesia was induced with midazolam,propofol,fentanyl and suxamethonium chloride.Tracheal intubation was performed and the patients were mechanically ventilated.Recuronium 0.6mg/kg was then given iv.Neuromuscular function was monitored with acceleromyograph using single stimulation of the ulna nerve.The onset time (time from injection of recuronium to maximal paralysis),nonresponse time (duration of maximal twitch depression),clinical duration (time required for the twitch to return to 25% of control height after injection of initial dose),75%recovery time (time for twitch to return to 75%of control height after injection of initial dose) and recovery index (time for twitch height to return from 25% to 75% of control height) were recorded.Results There was no significant difference in the onset time between the two nationalities.The time of nonresponse period,clinical duration and 75% recovery time were significantly shorter in Uygur patients than in Han patients.Recovery index was significantly shorter in Uygur patients.Conclusion There is a significant difference in the time-course of muscle relaxant effect of recuronium between Uygur and Han nationalities.The influence of nationality on recommended dosage of recuronimn should be considered.

Objective To investigate the effect of repeated hyperbaric oxygen preconditioning (HOP) on the expression of hypoxia-inducible factor-1 alpha (HIF-1a) and erythropoietin (EPO) following spinal ischemiareperfusion (I/R) in rats. Methods Forty-eight male SD rats weighing 250-300 g were randomly divided into 3 groups (n = 16 each): sham operation group (S group); I/R group and repeated HOP group (HOP group). The animals in HOP group were pretreated with O2 ( ＞ 98 % ) at 2.5 ATA I h/d for 5 consecutive days at 24 h before spinal cord I/R. The animals were anesthetized with intraperitoneal pentobarbital sodium 35 mg/kg. Spinal cord ischemia was produced by cross-clamping of abdominal aorta distal to renal artery for 20 min in I/R and HOP groups. Hind-limb motor function was assessed and scored st 48 h of reperfusion. The animals were then sacrificed and the L5-7 segment of the spinal cord was removed for determination of the expression of HIF-1 α and EPO mRNA and protein and microscopic examination. Results Compared with group S, the hind-limb motor function scores and the number of normal motor neurons in the anterior horn of the spinal cord were significantly decreased, and the expression of HIF-1α and EPO mRNA and protein was up-regulated in I/R and HOP groups ( P ＜ 0.05). Compared with group I/R, the hind-limb motor function scores and the number of normal motor neurons in the anterior horn of the spinal cord were significantly increased, and the expression of HIF-1α and EPO mRNA and protein was up-regulated in group HOP ( P ＜ 0.05). The spinal cord injury was attenuated in group HOP compared with group I/R. Conclusion Repeated HOP can reduce the spinal cord I/R injury though up-regulating the expression of HIF1α and EPO in rats.

Objective To investigate the correlation between expression of vascular endothelial growth factor(VEGF) of serum and tumor tissues and the clinical prognosis in patients with breast cancer. Methods The expressions of VEGF level of serum and tumor tissues in 44 patients with invasive duct breast cancer, 13 with benign breast diseases and 40 healthy controls. Serum VEGF level was measured by ELISA method. The protein expression of tissue VEGF, ER and C-erbB-2 were evaluated by immunohistochemistry LSAB method. Results Serum VEGF level and tissue VEGF expression in breast cancer were higher than those in benign breast diseases (P0.05). VEGF expression was correlated with lymph node metastasis (P 0.05). Conclusion There is positively correlation between serum VEGF level and tissue VEGF expression, and between VEGF expression and clinic prognosis. Serum VEGF level may be one of important index of prognosis estimation in patients with breast cancer.

Objective:To observe the effects of soybean isoflavones(SI) on uteri and uterine Er?,ER? expression in perimenopausal rats. Method:Female SD rats in age of 7-month-old were used as control and 11-month-old SD rats were divided into 5 groups,model group,diethylstilbestrol group and 3 test groups exposed to three doses of SI(ig:30,12,4.6 mg/kg?d) respectively for 35 d. Serum concentrations of estradiol(E2) ,testosterone(T) ,follicle-stimulating hormone(FSH) and luteinizing hormone(LH) were determined. Ultrastructure of uterine luminal surface was observed by scanning electron microscopy and hematoxylin-eosin staining. Expression of ER? and ER? in the uteri were determined by immunohistochemistry. Results:Low dose SI significantly increased serum E2(P

Objective To explore the clinical significance of the brain natriuretic peptide(BNP) in evaluating the cardiotoxicity caused by daunorubicin(DNR) through studying the changes of the plasma BNP levels in children with acute leukemia who accepted the chemotherapy with DNR.Methods Thirty-one children with acute lymphoblastic leukemia(ALL) admitted in the year of 2002-2004 underwent the chemotherapy in DVLP project.The plasma level of BNP was measured by enzyme linked immunosorbent assay(ELISA) and the left ventricular end diastolic diameter(LVEDD) by color Doppler respectively before and after the administration of DNR.Simultaneously,electrocardiography(ECG) and cardiac muscle enzymes(LDH1,CK-MB) were measured as routine.Results The plasma level of BNP increased from(3.97?2.41) ng/L to(18.25?7.63) ng/L(P

OBJECTIVETo evaluate the effects of levonorgestrel-releasing intrauterine system (LNG-IUS) combined with GnRH analogue (GnRH-a) in the treatment of adenomyosis with uterine body enlargement.

METHODSTwelve women (mane age 40.3 years) with adenomyosis and uterine cavity depth over 11 cm received injections of GnRH-a every 4 weeks, and after the uterine cavity depth was reduced to below 10 cm, LNG-IUS was deployed. VAS pain score, PBAC bleeding score, uterine volume, and hemoglobin levels of the women were measured before the treatment and at 6 and 12 months after LNG-IUS placement.

RESULTSThe VAS pain score was significantly lowered at 6 and 12 month after LNG-IUS placement (P<0.05), and the PBAC bleeding score also showed significant reductions (P<0.05). The uterine volume decreased significantly at 6 and 12 months after LNG-IUS placement as compared with that before the treatment, but was significantly greater at 6 month in comparison with that at the time of LNG-IUS placement (P<0.05). Serum hemoglobin levels underwent significant increments after LNG-IUS placement (P<0.05).

CONCLUSIONLNG-IUS combined with GnRH analogue injection can be effective in the treatment of adenomyosis with dysmenorrhea and hypermenorrhea.

Adult ; Delayed-Action Preparations ; administration & dosage ; Drug Therapy, Combination ; Endometriosis ; drug therapy ; Female ; Gonadotropin-Releasing Hormone ; analogs & derivatives ; therapeutic use ; Humans ; Levonorgestrel ; administration & dosage ; Uterine Diseases ; drug therapy