Objective To evaluate the barium meal radiography and CT scans in diagnosing malignant gastrointestinal stromal tumors (GIST) of small intestine. Methods The clinical and imaging data of 16 patients with GISTs of small intestine which were diagnosed surgically and pathologically were analyzed and summarized. In this group CT scan and gastrointestinal barium exam(GI) was performed. Results The tumors included 6 low-malignant GISTs of small intestine and 10 high-malignants. The diameter varied from 3.2 cm to 7.2 cm, the average size was 5.6 cm. The main signs of barium meal of malignant GIST of small intestine included flattened or destroyed mucosa runae, partial lumen stenosis, and barium fleck and fistula in the tumor. On CT scans, the main manifestation was an extraluminal mass with multiple necrosis areas of low density. Conclusion Barium examination and helical CT scan are the major imaging techniques in the determination of the location of GIST of small intestine. The appearance of imperfect lumen and the irregular tumor with multiulcerations or low density regions and inhomoneneous enhancement may lead to the correct diagnosis of malignant GIST.

Objective To determine the population pharmacokinetics of intravenous etomidate infusion in adult patients.Methods Twenty-nine ASA Ⅰ or Ⅱ patients of both sexes aged 25-82 yr weighing 45-80 kg received contant-rate infusion of etomidate at 60 μg· kg-1 · min-1 until BIS value dropped to ≤ 40.Arterial blood samples were obtained from radial artery for determination of plasma etomidate concentration before,at 1,3,5 min of continuous etomidate infusion and at 1,3,5,7,10,20,30,45,75,120,180,240,300 and 360 min after termination of etomidate infusion.Population pharmacokinetic model was established by using the software package NONMEM.Population pharmacokinetic parameters were calculated according to etomidate concentrations and covariates including age,height,bodyweight,sex,liver-kidney function etc.using software package NONMEM.Results Pharmacokinetics of etomidate was best described by a three-compartment pharmacokinetic model with age as a covariate affecting systemic clearance (CL1).The typical parameters were:V1 =4.7 L,V2 =11 L,V3 =123L,CL1 =1.28-0.0119 × (Age (yr)-55) L/min,CL2 =1.25 L/min and CL3 =1.08 L/min respectively.Context-sensitive half-time increased with age and steady-state infusion time.Conclusion Pharmacokinetics of etomidate is best described by a three-compartment pharmacokinetic model with age as a covariate affecting systemic clearance (CL1).

Objective To assess the changes in blood coagulation after infusion of hydroxyethyl starch 45/ 0.7(molecular weight = 450000 Dalton, 70% of glucose units have been substituted) ,200/0.62, 200/0.5 and 130/0.4.Methods Forty rabbits weighing (2.6 ?0.5)kg were randomly divided into 5 groups of 8 animals each: group I HES450/0.7; group II HES 200/0.62; group III HES200/0.5; group IV HES 130/0.4; group V 0.9% NaCl. The animals were anesthetized with intramuscular seconal and ketamine. Hydroxyethyl starch or normal saline was infused at 10 ml?kg-1?h-1 for 3 h. Blood samples were taken before and 1,2,3 h after staring the infusion for determination of prothrombin time ( PT), activated partial thromboplastin time (APTT) and fibrinogen level (FIb) and thromboelastograph examination (TEG) .Results (1) After infusion of 30 ml?kg-1 HES 450/0.7 or 200/0.62 (in group I and II ) R time (representing the rate of initial fibrin formation) and K time (coagulation time) were significantly prolonged (P

Objective The study was designed to compare the effects of desflurane and isoflurane on the vecuronium-induced neuromuscular block in the elderly patients. Methods Thirty ASA class I - II elderly patients aged over 70 yr undergoing elective surgery under general anesthesia were randomly divided into 3 groups: desflurane group ( I , n = 10) ; isoflurane group ( II , n = 10) and 3 control group ( III , n = 10). Anesthesia was induced with midazolam 0.02-0.05 mg? kg-1 , propofol 0.5-2.0 mg ? kg-1 and fentanyl 2-5?g? kg-1 maintained with inhalation of 6% desflurane(1 MAC) +50% N2O in oxygen (group I ) or 1.15% isoflurane + 50% N2O in oxygen(group II ) or 50% N2O in oxygen (group III ) supplemented with intermittent iv boluses of propofol and fentanyl when necessary. Neuromuscular block was monitored using accelograph (TOF GUARD , Denmark) .A total dose of vecuronium 40 mg ?kg-1 was divided with 4 equal doses of 10?g ? kg-1 , which was administered accumulatively in each patient. The next dose was given when the effect of the previous dose had reached its peak (T1 was no longer depressed in the height of 3 successive stimuli) .The cumulative dose-response curves of the 3 groups were established. The onset time and maximum depression of T1 of the initial dose and 3 incremental doses were recorded. After the last increment of 10 ?g?kg-1, the time for T1 to returned to 25% ,75% ,90% and TOF ratio(T4/T1) to 70% were recorded. The recovery index was also calculated.Results The demographic data were comparable between the 3 groups. The ED50 and ED95 were significantly lower in desflurane and isoflurane groups than those in control group(P 0.05 ) . The time for T1 to return to 25 % , 75 % and 90 % was significantly longer in desflurane and isoflurane group than that in the control group. The recovery from vecuronium-induced neuromuscular block was slower in desflurane group than that in isoflurane group( P

Objective To assess the effects of gelatine and 6% hydroxyethyl starch 200/0.5 (HES 200 / 0.5) on phagocytic activity of human neutrophils and monocytes using flow cytometry.Methods Thirty-three ASA Ⅰ - Ⅱ patients aged 18-70 years scheduled for urological minor surgery were randomly divided into three equal groups of eleven patients :group I gelatine;group II HES 200 / 0.5 and group Ⅲ lactated Ringer's solution (LR) . 10 ml?kg-1 of gelatine, HES or LR was infused over 60 min and venous blood samples were taken before infusion and 1 h after the start of infusion for determination of phagocytes with ingested FITC-labeled E coli by flow cytometry. Results In gelatine group the percentage of neutrophils and monocytes with phagocytic activity decreased significantly after infusion ( P

Gelofusine is a plasma substitute made from modified fluid gelatin,it's hemodynamic and biochemical effects on organism were studied in 6 anesthetized dogs and 20 patients scheduled for undergoing open heart surgery(OHS). Different degree of isovolemic acute hemodilution was achieved by supplying the gelofusion at the same amount of blood withdrawn. The results showed,in patients group, after hemodilution, no significant changs were observed in HR, MAP, DO_2 and CaO_2, wherease, CO, CI, and VO_2 increased. In dog group, HR and MAP remained, CaO_2 and SVRI decreased, CO, CI, DO_2 and VO_2 increased at the degree of isovolemic hemodilution less than 20 ml/kg, DO_2 began to decrease at the degree of hemodilution greater than 20ml/kg. In both groups, there's no significant changes in the concentration of K~+, Na~+ ,CI~- and pH value after hemodilution. Our findings supports previous observation about gelofusion's effect to maintain the blood volume and reserve the hemostasis,in addition,it has no deterious effect on coagulation

Objective To investigate the relationship among the depth of midazolam induced sedation, the plasma midazolam concentration and quantified electroencephalogram(EEG) and determine the appropriate depth of sedation during regional anesthesia Methods Twenty adult ASA I II patients(male 7,female 13)scheduled for thyroid adenoma or cyst operation under cervical plexus blockade were studied The age ranged from 19 57 years [mean (46 4?9 5)yr] and weight from 40 83kg[mean (63 1?10 3)kg] Patients with liver or kidney disorders or habitually taking benzodiazepine were excluded The patients were premedicated with phenobarbital sodium 0 1g Dorsalis pedis artery was cannulated for blood sampling Besides blood pressure, heart rate and SpO 2, quantified EEG (BIS and 95%SEF) were continuously monitored and recorded Level of sedation was assessed using the modified observer's assessment of alertness/sedation (OAA/S) scale The BIS, 95%SEF and plasma midazolam concentration (Cm)were correlated with the OAA/S scores using nonparametric Spearman's rank correlation analysis Results As depth of sedation deepened from an OAA/S score of 4 to 1, BIS value decreased from 91 5?2 6 to 63 1?5 7, 95%SEF from 21 4?2 0 to 15 2?2 9 and plasma midazolam concentration increased from (120 8?55 2)ng/ml to (533 0?139 4)ng/ml BIS, 95%SEF and Cm were all well correlated with the OAA/S score The coefficients of correlation between BIS, 95%SEF, Cm and OAA/S score were 0 952,0 674 and -0 856 respectively Conclusions Cm, BIS and 95% SEF are all well correlated with the depth of midazolam induced sedation and can all be used to monitor the depth of midazolam induced sedation, but BIS is the best among them BIS value 75 82 and OAA/S score 2 3 are the most appropriate level of sedation during regional anesthesia

OBJECTIVE:To build up a method of determining the concentration of midazolam in plasma by RPHPLC-UV detection.METHODS:The separation was carried out by a reversed-phase Hypersil ODS column(250mm?4.0mm,5?m) with a mobile phase consisting of methanol-acetonitrile-0.02mol/L potassium phosphate buffer(pH 7.4) (65∶25∶10,V/V).Mida_zolam was extracted from alkalinizing plasma and soluted in the mobile phase then detected at 221nm.RESULTS:The calibration curve had the fine linearity in the concentration range 50～1 600ng/ml(r=0.9 999).The detection limit was 2ng/ml.The absolute recovery was 90.8%～95.4%,the relative recovery was 99.3%～101.3%.The within-day and between-day precision(CV%) was 1.94%～5.16%,3.00%～6.39% respectively.CONCLUSION:The method is simple,stable and highly sensitive and could meet with the research of clinical pharmacokinetics.

0.05) . AEP index increased sharply from 42 to 67 when the patients regained consciousness (OAA/S increased from 2 to 3) but BIS increased gradually from 64 to 72 indicating that AEP index had better discriminatory performance. OAA/S correlated fairly well with BIS , AEP index and target-controlled concentration of propofol and r was 0.781, 0.684 and - 0.580 respectively. Conclusions Both AEP index and BIS can predict fairly well the level of sedation but AEP index prooes to be better in distinguishing conscious from unconscious.

Objective Auditory evoked potential index (AAI) has been proposed for monitoring anesthetic depth. The aim of this study was to compare tins new technique with hispectral index (BIS) and 95% spectral edge frequency (SKF) for assessing anesthetic depth during emergency from propofol-isoflurane anesthesia. The ability of these techniques in distinguishing consciousness from unconsciousness was also evaluated. Methods Thirty six ASA I - II patients ( 15 male, 21 female) undergoing elective surgery under propofol-isoflurane anesthesia were enrolled in the study. Age ranged from 18 to 75 years and body weight from 35 to 80 kg. Patients with psychoneural diseases or hearing disturbances were excluded. The patients were premedicaled with phenobarbitai sodium 0.1g and airopine 0.5mg. Anesthesia was induced with rnidazolam 0 .05-0.1 mg.kg1,fentanyl 5- 10ug.kg1 and vecuronium 0. 1-0.2mg.kg-1 and maintained with propofol infusion (8-16ml. h 1) and isoflurane inhalation (0.5% -1.0%). Intermittent IV boluses of vecuroniuni were given when needed. The patients were transported to recovery room after surgery. AAI, HIS, SKF and hemodynamic parameters were monitored and recorded on entering the recovery room, before extubation, during extubalion, 5, 10, 20 min after exlubation and before release from recovery room. Results AAI, BIS and SEF were 40.9?11.7,73.64?10.8 and 17.5?2.8 respectively on entering recovery room and increased to 72.6 ?11.0, 88.2?7.3 and 22.5?2.6 during exlubation. The increase in AAI was significantly greater. The mean values of AAI before and after responding to light glabellar tap or loud auditory stimulus were 36. 1?11.5 and 52.4?12.3 respectively, the mean values of BIS were 71.9?11.5 and 78 . 6?11.9 and of SKF 16.7?3.0 and 18. 6?3.2 .Only AAI demonstrated a significant difference detween consciousness and unconsciousness. Conclusion AAI, HIS and SKF all increase gradually during emergence from anesthesia. AAI is most sensitive among the three techniques and is most useful in detecting the transition from unconsciousness to consciousness.