Objective To investigate the discriminatory power of Auditory Evoked Potential and Bispectral Index devices on consciousness or consciousless state of patients during intraoperative wake-up test and recovery from scoliosis surgery with sevoflurane-remifentanil anesthesia.Methods Thirty ASA Class I or II adolescents undergoing scoliosis surgery under sevoflurane-remifentanil anesthesia were randomly divided into three groups: standard clinical practice (control), AEP-guided, and BIS-guided. After induction of general anesthesia remifentanil was infused at the rate of 0.3 ?g/(kg?min). At the beginning of wake-up test, the circuit was opened while the vaporizer was turned off , and the rate of remifentanil infusion was decreased to 0.05 ?g/(kg?min). Anesthesia was started again as soon as the patients had movements to command. The AAI, BIS, and end-tidal sevoflurane concentration at the time of before induction (T0), circuit opened(T1), spontaneously breathing recovered (T2), patients movement to command (T3), tracheal extubation (T4) and emergence from anesthesia (T5), as well as the time of spontaneously breathing recovered, patients movement to command during wake-up test, tracheal extubation and emergence from anesthesia were recorded.Results Comparing with control group, AAI and BIS increased at T1 both in AEP-guided and BIS-guided group (P

Objective To evaluate the right ventricular function using volumetric pulmonary artery catheter (VPAC) in patients undergoing off-pump coronary artery bypass grafting (CABG) .Methods Thirty-two patients (18 males, 14 females) aged 45-63 yrs weighing 58-74 kg undergoing CABG were studied. Their cardiac functions were graded according to NYHA classification as Ⅰ or Ⅱ. Radial artery was cannulated before induction of anesthesia for BP monitoring. Anesthesia was induced with midazolam 0.03-0.05 mg?kg-1, fentanyl 10-15 ?g?kg-1 and pipecuronium 0.1-0.15 mg?kg-1 and maintained with 1.0-1.5% isoflurane. The probe (7 MHz) of the transesophageal echocardiography (TEE, Sonos 2500, HP) was placed in esophagus after tracheal intubation for measurement of both right and left ventricular end-diastolic, end-systolic volume and ejection fraction (LVEDV, LVESV, LVEF, RVEDV, RVESV, RVEF). VPAC (type 774HF75, Edwards Life Science Co) was placed via right internal jugular vein for measurement of RVEDV, RVESV and RVEF. 6% HAES 10 ml?kg-1 was infused over 10 min. The cardiovascular parameters mentioned above were measured before and immediately after 6% HAES infusion using both TEE and VPAC, and compared.Results The RVEDV and RVESV (measured by TEE and VPAC) and LVEDV, LVESV (by TEE) were significantly increased after HAES infusion as compared with the baseline values (P

Objective To study the changes in cerebral cortex glutamate (G) content induced by isoflurane inhalation alone or combined with 2-amino-5-phosphonovalerate (AP5),a NMDA receptor competitive antagonist.Methods Six adult male SD rats were anesthetized with isoflurane. Dialysis probe (internal diameter=0.05mm) which was connected to a micro-infusion pump filled with artifical cerebrospinal fluid(ACSF) was inserted into cerebral cortex. The dialysate was collected for determination of G concentration. After the baseline MAC for isoflurane was measured, the study was carried out in 4 groups based on the concentration of isoflurane inhalation: group Ⅰ:1%; group Ⅱ:1MAC; group Ⅲ:2% and group Ⅳ: the effect of AP5 on isoflurane MAC value. In group Ⅳ AP5 was continuously infused at a rate of 100 ?g?kg -1?h -1 via the vein in the tail and the MAC for isoflurane was measured again. G concentration of dialysate was measured and EEG and SEP were monitored in every group.Results G concentration of cerebral cortex dialysate was decreasing with increasing concentration of isoflurane from group Ⅰ to group Ⅲ. Concentration of isoflurane was negatively correlated with cerebral G content (r=-0.839,P

Objective To observe the changes of heart rate variability(HRV) following intravenous esmolol and surface anesthesia during tracheal intubation Methods One hundred and twenty adult patients were randomly divided into three groups (n=40), group Ⅰ (Esmolol), group Ⅱ (laryngotracheal surface anesthesia), group Ⅲ (oropharynx and laryngotracheal surface anesthesia group) Tracheal intubation was induced with fentanyl 2?g kg -1 , propforl 2mg kg -1 and vecuronium 0 1 mg kg -1 Group Ⅰ : intravenous administration of esmolol 2mg kg -1 2min before endotracheal intubation Group Ⅱ: laryngotracheal spray with 1% tetracaine 2 5ml 2min before endotracheal intubation Group Ⅲ : spraying the back of tongue, soft palate, pharynx and larynx with 1% tetracaine 0 5ml, with other manipulation being similar to group Ⅱ In each group BP,HR, HRV, LF, HF and LF/HF and BIS parameters were recorded before induction, during intubation and 1,3,5 and 10min after intubation respectively Results In three groups BP remained unchanged Compared with that in group Ⅱ and Ⅲ, HR in group Ⅰ decreased significantly(P

Objective To understand the overall development of TCM technique patent in Guangdong Province through the analysis on the patent application and authorization status of TCM technique patent in Guangdong Province from 2006 to 2015. Methods CNIPR and State Intellectual Property Office platform was searched, and 2006-2015 TCM technique patent application literature in Guangdong Province were obtained, the patent application and authorization status were analyzed. Results The number of application for TCM technique patent in Guangdong Province was 1434 during 2006-2015, and the number of application and authorization rates were increasing. The number of application in the Pearl River Delta (PRD) region of Guangdong Province was greater than that of the non-PRD regions, with individual application of 65.9% and enterprise application of 25.9%; A61K36 accounted for 98.7% in TCM technique patent classification statistics. Conclusion The quantity of patent application of TCM technique in Guangdong Province is large, but the number of application of non-individuals, the rate of authorization, technology statistical classification and innovation ability of TCM technique are low.

Objective To assess the changes in heart geometry and function during off-pump coronary artery bypass grafting(CABG).Methods Thirty ASAⅡorⅢpatients(24 males,6 females)aged 50-78 undergoing elective off-pump CABG were studied.After induction of anesthesia and tracheal intubation a catheter which was connected to the monitor measuring continuous cardiac output(CCO),mixed venous blood oxygen saturation(S(?)O_2)and CEDV was placed via right internal jugular vein and the probe of multi-phase transesophageal echocardiograph(TEE)(Sonos HP 2500)was inserted in the esophagus.The distance between the probe and the incisors was between 34-45 cm.The hemodynamic variables and TEE parameters were recorded when epicardium was opened(T_1,baseline)when the octopus tissue stabilizer was placed during anastomosis between the graft vessel and left anterior descending artery(LAD)(T_2)left circumflex artery(LCX)(T_3)and right coronary artery(RCA)(T_4)and when the anastomoses between the vessel grafts and aorta was completed (T_5).Results At T_2 the mitral valve deceleration time(DT_1)and the blood flow through the mitral valve(Q_1) were decreased significantly as compared with the baseline(T_1);MAP was significantly decreased while HR and CVP were increased(P＜0.05).At T_3 the left and right ventricular end-diastolic diameter(LVEDD,RVEDD), tricuspid valve diameter(TVD)and the blood flow through Q_1 and tricuspid valve(Q_2)were significantly decreased as compared to the baseline values at T_1.The mitral valve E/A ratio was increased while the tricuspid valve E/A ratio was decreased(P＜0.05).The MAP,S(?)O_2,right ventricular end-systolic and end-diastolic volume(RVESV,RVEDV)and right ventricular ejection fraction were significantly decreased while HR and CVP were increased at T_3 as compared to the baseline at T_1.At T_4 LVESD,LVEDD,MVD,tricuspid valve E/A ratio and Q_1 were significantly decreased as compared to the baseline at T_1(P＜0.05).MAP,MPAP,SV,S(?)O_2, RVEF,RVESV and RVEDV were significantly decreased while HR and CVP were increased(P＜0.05).At T_5 all the TEE and hemodynamic parameters returned to the baseline valves at T_1.Conclusion During anastomoses between graft vessels and LAD,LCX and RCA,both left and right ventricles are compared to some extent and the heart function is impaired temporarily but returns to the baseline after the anastomoses are completed.

Objective To describe the analgesic effect of low-flow rate oxygen inhalation with intravenous mannitol injection for patients after nasal operation and seek for effective method for allevia-tion of pain.Methods 160 patients were divided into group A,B,C and D with 40 cases in each group.Group A received intravenous injection of 125 ml of 20%mannitol and group B got low-flow rate oxygen inhalation through nasal canulas.While group C were given the combination of treatment in that of group A and group B.Group D was named the control group and only adopted routine nursing.The pain alleviation effect was observed by McGill pain evaluation method.Results The score of pain in group C was lower than those in group A and B.While the scores of pain in group A and B were lower than that in group D(P<0.01).Conclusion The nasal swelling in group C lightened compared with those of group B (P<0.01)and group A(P<0.05).The nasal swelling in group A was lighter than that of group D but no difference Was seen between group B and group D

Objective To observe the effects of standardized treatment to pregnancy and perinatal outcome of children gestational diabetes (GDM).Methods Forty-five cases of GDM glycemic control satisfied patients and 36 cases of GDM glycemic control dissatisfied patients were enrolled in this study who in the General Hospital of Jizhong Energy Feng Feng Group hospital from January 2010 to October 2012,and 50 cases of the same period of hospitalization single fetal blood sugar normal pregnant women were randomly selected as control group.Pregnancy outcome and perinatal outcome of three groups were analyzed and compared.Results (1) Pregnancy outcome of three groups:the incidence of concurrent gestational hypertension (27.8％),polyhydramnios(22.2％),premature delivery (16.7％),cesarean section rate (80.5％) and puerperalism (13.9％) in GDM glycemic control dissatisfied patients were higher than those of GDM glycemic control satisfied patients (8.9％,6.7％,2.2％,55.6％,2.2％) and control group (6.0％,4.0％,2.0％,46.0％,2.0％),and the differences were statistically significant (P＜ 0.05).(2) Perinatal outcome of three groups:the incidence of huge child (27.8％),neonatal hypoglycemia (41.7％),neonatal asphyxia rate (22.2％) of GDM glycemic control dissatisfied patients were higher than those of GDM glycemic control satisfied patients (4.4％,17.8％,6.7％) and control group (6.0％,2.0％,4.0％),and the differences were statistically significant (P＜0.05).Conclusion Gestational diabetes increases the incidence of infant and maternal complications,early diagnosis,standardized diagnosis and treatment can reduce infant and maternal complications,improve pregnancy outcomes.

Objective To investigate the clinical efficacy ofHejie Fenxiao Decoction on damp-heat patients with acute kidney injury (AKI).Methods Totally 68 patients were divided into the control group and the treatment group according to the patients’ willings. Both groups were given treatment, such as elimination of the incentives and symptomatic treatment. Besides, patients of the treatment group acceptedHejie Fenxiao Decoction for 30 days. The changes of renal function indexes, such as serum creatinine (SCr), blood urine nitrogen (BUN), uric acid (UA), albumin (ALB) and integral of TCM syndrome, were observed, and recovery ratio and clinical endpoints were compared.Results SCr and eGFR of both group were improved on day 14 (P<0.05). After treatment, the renal function recovery ratio and renal replacement ratio in the two groups showed obvious differences (P<0.05);although survival rate of treatment group was higher than control group, it showed no statistical significance (P>0.05);clinical endpoints analysis of the two groups showed statistical significance (P<0.05). The difference of integrals of TCM syndrome between the two groups showed statistical significance (P<0.05) on day 14.ConclusionHejie Fenxiao Decoction combined with basic regular Western medicine can better improve the clinical symptom, recover the renal function, and decrease the rate of renal replacement and death of AKI damp-heat patients.

Objective To investigate the role of fibroblast growth factor-23 (FGF23) in secondary hyperparathyroidism (SHPT). Methods (1)Serum FGF23 and intact parathyroid hormone (iPTH)from 38 maintenance hemodialysis (MHD) patients were measured by ELISA and chemiluminescence enzyme immunoassay respectively.(2) Parathyroid cells from six SHPT patients underwent parathyroidectomy with forearm autotrlansplantation were cultured for 24 h,then were induced by 0.1 mg/L FGF23.The supernatant was collected at 0.6,12,24 and 48 h respectively. The concentration of iPTH was measured by chemiluminescence enzyme immunoassay. (3)Protein expression of Klotho,FGFR1,FGFR3,GATA-3 and PCNA in parathyroid tissue from 33 SHPT eases and 3 healthy people were detected by immunohistochemistry SP and PV methods respectively. Positive cell rate and absorbance were calculated. Results (1) Serum FGF23 [(3901.85±2618.11) ng/L] was positively correlated with serum iPTH [(460.00±489.77) ng/L] in MHD patients. (2) 0.1 mg/L FGF23 suppressed iPTH secretion of parathyroid cells only at 24 h time point in vitro (P<0.05). (3) Expression of GATA-3, FGFR3, Klotho and PCNA was significantly increased and FGFRl was signiticantly decreased in parathyroid tissue of SHPT-patients as compared to healthy people. (4) Positive cell rate of GATA-3 was positively correlated with iPTH (r~2=0.1901, P=0.0425) and PCNA (r~2=0.2584, P=0.0025). Klotho was positively correlated with FGFRI and FGFR3 (r~2=0.2046, P=0.0082;r~2=0.2833, P=0.0014). PCNA was negatively correlated with FGFR1 (r~2=0.1292, P=0.0399) and positively correlated with FGFR3 (r~2=0.1226, P=0.0457). FGFR1 was negatively correlated with serum phosphate (r~2=0.2329, P=0.0044) and positively correlated with serum calcium (r~2=0.1422, P=0.0305). Conclusions FGF23 level is positively correlated with iPTH level in MHD patients. FGF23 can inhibit iPTH secretion of parathyroid cells in a weak and short way, which may be associated with the proliferation of GATA-3 positive cells and parathyroid cells, the up-regulation of FGFR3 and the down-regulation of FGFR1 expression.