Oblective To define the median effective dose (ED50) and 95%effective dose of fentanyl for inhibition of emergence agitation after sevoflurane-remifentanil anesthesia in children.Methods Twenty six ASA ⅠorⅡchildren aged 5-8 yr weighing 15-30 kg undergoing adenoidectomy under general anesthesia were studied.The patients were unpremedicated.Anesthesia was induced with inhalation of 8%sevoflurane (fresh gas flow=6 L/min)and iv remifentanil 1μg/kg.The patients were mechanically ventilated after tracheal intubation.Fentanyl was injected iv to inhibit emergence agitation.The dose of fentanyl was determined by using modified Dixon's upand-down method (increment or decrement of 0.5μg/kg).The initial dose of fentanyl was 4 μg/kg.Anesthesia Sevoflurane inhalation and remifentanil infusion were terminated at the end of operation.The patients were transferred to the PACU.No alteration in the ventilatory settings was made.Stimulation of the patients was avoided during emergence.The emergence time and the occurrence of agitation,nausea and vomiting and respiratory depression within 4h after operation were recorded.ED50,ED95 and 95%confidence interval (CI) of fentanyl for inhibition of emergence agitation were calculated.Results ED50 was 3.01μg/kg (95%CI 2.52-3.40μg/kg) and ED95 3.81μg/kg(95%CI 3.41-6.22μg/kg).No nsusea and vomiting and respiratory depression occurred within 4h after operation.The emergence time was (11.3±2.6) min.Conclusion The ED50 and ED95 of fentanyl for inhibition of emergence agitation after sevoflurane-remifentanyl anesthesia were 3.01 and 3.81μg/kg respectively in children.

Objective To compare the hemodynamics and respiratory mechanics between flexible reinforced laryngeal mask airway (FRLMA) and tracheal intubation (TI) in functional endoscopic sinus surgery. Methods Forty-six patients (ASA) scheduled for selective functional endoscopic sinus surgery under general anesthesia were allocated randomly to either flexible reinforced laryngeal mask airway group (FRLMA, n=23) or tracheal intubation group (TI, n=23) with mechanical ventilation. MAP and HR were recorded before anesthesia induction, before intubation, after intubation immediately, before extubation and after extubation immediately. Parameters for respiratory mechanics included peak inspiratory pressure (PIP), plateau airway pressure (P_(plateau)), mean airway pressure (P_(mean)), positive end expiratory pressure (PEEP), peak inspiratory flow (FI_(max)), peak expiratory flow (FE_(max)), and end tidal CO_2 (P_(Et)CO_2). All of the above indicators were recorded 5, 10 and 15 minutes after intubation. Meanwhile, arterial gas analysis was examined. Complications such as aspiration, coughing, pharyngeal pain, hoarseness, muscular soreness and unseal of FRLMA were followed up 24 hours after extubation. Results MAP and HR were significantly higher in group TI than those in group FRLMA after intubation and extubation (P<0.05). PIP, P_(plateau), P_(mean) and VD/VT were significantly higher in group TI than those in group FRLMA (P<0.05). Complications such as coughing, pharyngeal pain and muscular soreness were significantly lower in FRLMA group than that in TI group (P<0.05). Conclusions The application of FRLMA on functional endoscopic sinus surgery is a simply handling method, with minor laryngeal stimulation during intubation and extubation, more stable hemodynamics, reliable respiratory mechanics and low incidence of postoperative upper airway complications.

Objective To evaluate the effect of desflurane on emergency in patients undergoing suspension microlaryngoscopy surgery.Methods Forty adult patients with ASA Ⅰ-Ⅱ who underwent elective microlaryngoscopy surgery were randomly divided into desflurane group (group D,n =20) and sevoflurane group (group S,n =20).Time from end of the surgery to resume of spontaneous breathing,extubation,and discharge from postanesthesia care unit (PACU) were recorded.The extent of cough reflex during extubation and cough episode after extubation were recorded.Perioperative mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T0),on suspension laryngoscope instrument (Ttary),the gas concentration reached 1.3 MAC (T1.3mac),1 min after 1.3 MAC (T1.3 1),on arrival at PACU (Tpacu),on extubation (Textu),1 min after extubation (T 1),5 min after extubation (T 5),and on discharge from PACU (Tdis).Results Time from end of the surgery to resume of spontaneous breathing was not significantly different between the two groups.Time to extubation in group D was 4.6 min,which was shorter than it was in group S (P＜0.05).Time to discharge from PACU was 5.0 min in group D,which was shorter than it was in group S (P＜0.05).Incidence of cough was 100％ in group D and 55％ in group S during extubation (P＜0.05).The episode of coughing after extubation was not significantly different between the two groups.Perioperatively,changes of MAP and HR between the two groups were not significantly different (P ＞ 0.05).Conclusions Desflurane for adult patients undergoing suspension microlaryngoscopy surgery was associated with fast emergence.The incidence of cough was higher in group D than it was in group S during extubation,but it continued a short duration.

Objects To analysis the research status of epidemiology.Methods According to SCI database,a statistical analysis was made for the amount and distribution of published original studies in epidemiological methods in SCI from 1998 to 2007.Some characteristic index,such as the subject areas,countries distribution,study designs and research status in china were evaluated.Results The number of articles of epidemiological methods showed an increasing tendency annually.These articles are mainly from public,environmental & occupational health and analytical epidemiology.America is core country in this field.Shanghai cancer institution showed higher productive in papers in China.Most of papers were mainly published in "CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION",which ranked at the first place in China.Conclusion With the development of epidemiology,epidemiological study methods have also been continuously improved and have played an important role.In addition,Cancer Epidemiology is a focus subject in China.

Objective To diagnose the intrauterine occupational disease by vaginal ultrasonography or hysteroscopy, and to evaluate the diagnostic values of these two methods. Methods One hundred and fifty patients were detected by vaginal ultrasonography and hysteroscopy from Jan 2004 to Dec 2004, and a total of 71 cases were confirmed intrauterine occupational disease. Tissue hysteroscopy or bioposy were performed during the hysterosocopy in order to analyse the tissue pathology. Results In these 71 patients, 47 were no less than 46 years old. Most of them had abnormal uterine bleeding.Thirty-three cases (46.48%) were suggested by vaginal ultrasonography, and 49 (69.01%) by hysteroscopy. Thirty-eight cases (53.52%) were in line with the pathological result.There were significant differences between vaginal ulterasonography and hysteroscopy in diagnosing the intrauterine occupational disease (P

opping drinking. They were not influenced by gender, smoking and drinking histories. They could serve as monitoring indexes for recent drinking status on healthy individuals.

Objective Comparison the coincidence rate in the colloidal gold method and the passive agglu-tination method to detect mycoplasma pneumoniae (MP) infection, discuss the clinical value in rapid diagnosis of MP infection in the two methods. Methods Two-hundred patients with MP infection, including 100 cases in the the children group, and 100 cases in the adult group, were detected in MP-IgM antibody in serum with the colloidal gold method and the passive agglutination method. Results The positive rate of MP-IgM antibody with the passive agglutination method were slightly higher than that of the colloidal gold method in the children group (P > 0.05), While the positive rate of MP-IgM antibody with the passive agglutination method in the adult group were signifi-cantly higher than that of the colloidal gold method (P<0.05). When the antibody titer of MP-IgM antibody were 1:60, ≥1:320 in the children group, the coincidence rate of the positive results with the colloidal gold method and the passive agglutination method were 95.40%, 95.30%;When the antibody titer of MP-IgM antibody were 1:80, 1:160,≥1:320 in the adult group, the coincidence rate of the positive results with the colloidal gold method and the passive agglutination method were 0, 61.90%, 63.80%. Conclusions In the pediatric MP infection, for the high an-tibody titer of MP-IgM antibody, the positive coincidence rate with the colloidal gold method can reach clinical diag-nostic requirements. Clinical physicians according to the age and disease process of patients choose the appropriate method in order to realize the simple, rapid and accurate diagnosis of mycoplasma pneumoniae infection.

A promising genetic marker, sag5b, was cloned and expressed and the difference of the genes between highly virulent strain (RH) and less virulent strain(Prugniaud) of Toxoplasma gondii was compared. The PCR-generated product of sag5b was subcloned into T easy vector and plasmid pET28a consecutively. The fusion expression was induced by IPTG and identified by SDS-PAGE and Western blotting. The immunoreactivity of recombinant SAG5B was identical to that of native SAG5B on the membrane of tachyzoites of RH strain. The brains of mice infected with Prugniaud strain of T. gondii were homogenated. Sag1 was successully cloned by PCR from both RH strain tachyzoites and the homogenized brain tissues of mice infected with low virulent strain of Prugniaud,whereas sag5b was only detected in RH strain but not in Prugniaud strain, indicating that sag5b could be used as a genetic marker for differentiation of strain virulence. Expression and vaccination of the virulence-associated gene into mice failed to induce obvious protective immunity against the challenge of RH strain.

OBJECTIVETo compare the therapeutic effect of Astragalus and Angelica Mixture (AAM) on treating CKD patients according to different CKD primary diseases, staging and TCM syndromes.

METHODSA multicentre, open-label, and self control clinical design was used, and thirty-two patients in line with inclusive criteria were recruited. Based on maintaining their previous basic CKD treatment, patients additionally took AAM (Astragalus and Angelica each 30 g), once a day, three months consisted of one therapeutic course. Serum creatinine (SCr), estimated glomerular filtration rate (eG- FR), 24 h urinary total protein (UTP), plasma albumin (ALB), hemoglobin (Hb), and changes of TCM syndrome factor integrals were compared before treatment, at the end of month 1, 2, and 3. The differences in the aforesaid indices were compared between CKD patients with different CKD primary diseases (chronic glomerulonephritis, chronic renal tubulointerstitial disease, hypertensive renal damage), different CKD stages (CKD 3 and CKD 4), and patients of qi-blood deficiency syndrome (QBDS) and non-QBDS.

RESULTSAAM could improve 78.12% (25/32) patients' renal function. Compared with before treatment, SCr decreased (12.08% +/- 10.11%), eGFR increased (21.14% +/- 18.55%), and ALB increased (2.76% +/- 1.97%) at the end of 3-month treatment (all P < 0.05). As for TCM syndrome factor integrals, compared with before treatment, the integrals for qi deficiency syndrome, blood deficiency syndrome, and yin deficiency syndrome decreased, while the integrals for dampness heat syndrome and turbid-toxin syndrome increased (all P < 0.05). There was no obvious difference in all indices except the integral for hypertensive renal damage patients of yin deficiency syndrome (P > 0.05). The SCr decreasing percent was 19.82% +/- 8.30% for patients of non-QBDS and 5.24% +/- 10.75% for patients of QBDS. The latter was higher with statistical difference (P < 0.05). As for TCM syndrome factor integrals, the integral differences of qi deficiency and blood deficiency were obviously higher in patients of QBDS, when compared with patients of non-QBDS (P < 0.05).

CONCLUSIONAAM could improve the renal function of CKD patients, elevate their ALB levels, and ameliorate associated qi deficiency syndrome, blood deficiency syndrome, and yin deficiency syndrome, especially for CKD patients of QBDS.

Adolescent ; Adult ; Aged ; Angelica ; Astragalus Plant ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Renal Insufficiency, Chronic ; drug therapy ; Treatment Outcome ; Yin Deficiency ; drug therapy ; Young Adult

Aged ; Diagnosis, Differential ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Lipoma ; pathology ; Liposarcoma ; metabolism ; pathology ; surgery ; Male ; S100 Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism