Objective: To study the effect of controlled hypotention on the prevention and treatment of cerebral swellingafter removal of giant arteriovenous malformation(AVM). Methods:8 cases with AVM( > 6cm) were selected. When Laser-Dopple flowmetry showed an increase of cerebral blood flow after excision arteriovenous malformation (AVM), intraoperativ-ely, 2.5 % thiopental 5-10mg/kg was injected. Results: The basic mean blood pressure of all cases was 77.63 + 4.27mmHgand basic cerebral blood flow value was 35-134PU. After AVM resection, cerebral blood flow was increased obviously. Thechange value 1 was 125-434PU and the increasing amplitude was 223.48% + 0.62% (P < 0. 001). With thiopental injec-tion, mean artery blood pressure was reduced by 23.00 % + 0.02 %. The cerebral blood flow value was reduced too. Thechange value 2 was 89-236PU and the decreasing amplitude was 35 % + 7.35% (P < 0.01) eampared with that beforethiopental injection. Conclusion:Controlled hypotension can decrease the increasing amplitude of cerebral blood flow and thecerebral perfusion after the giant AVM removal.

AIM: To compare domestic and imported vecuronium bromide on the effects of muscular relaxation and cardiovascular system.　METHODS: Thirty patients undergoing elective surgery were divided into domestic one group and exotic one group. The onset time, T1 recovery to 10% of control, clinical duration, T1 recovery to 75% of control and recovery index of each group were measured by train-of-four stimulation and recorded. The changes of arterial pressure and heart rate of each group were recorded before induction, before intubation, intubation, and 1,2,5 min after intubation.　RESULTS: The changes of arterial pressure and heart rate were not obvious diffecance between two groups. The effect of muscular relaxation did not differ after administration either.　CONCLUSION: The significant different changes between domestic and imported vecuronium bromide are not noticed. Both on the effects of muscular relaxation and cardiovascular system are similar.

OBJECTIVE:To guarantee that the medical institutions to purchase qualified drugs from legal suppliers of drug.METHODS:The qualification documents of the pharmaceutical manufacturers and management enterprises were collected,examined and verified,numbered and filed.RESULTS & CONCLUSIONS:Strict examination of the qualification documents of the drug suppliers contributed to scientific and normalized management of drug purchase of medical institutions so as to guarantee the drug quality.

Objective To evaluate the efficacy of dexmedetomidine combined with sufentanil for patientcontrolled intravenous analgesia (PCIA) after caeserean section. Methods One hundred and twenty parturients aged 18-40 yr undergoing caeserean section under spinal-epidural anesthesia were randomly assigned to one of 3 groups( n=40 each):group Ⅰ , group Ⅱ and group Ⅲ . During operation as soon as the baby was bom a bolus of dexmedetomidine 0.5 μg/kg was given iv in Ⅱ and Ⅲ groups while in group Ⅰ normal saline (NS) was given instead. Ⅰ and Ⅱ groups received PCIA with sufentanil (background infusion 0.015 μg·kg-1·h-1;bolus dose 0.023 μg/kg;lockout interval 8 min). Group Ⅲ received PCIA with sufentanil + dexmedetomidine (background infusion sufentanil 0.015 μg·kg-1 ·h-1 + dexmedetomidine 0.045 μg·kg· h-1;bolus dose sufentanil 0.023 μg/kg + dexmedetomidine 0.07 μg/kg;lockout interval 8 min) . Pain threshold and pain tolerance threshold were measured before caeserean section and 1 h after bolus dose of dexmedetomidine or NS. VAS, OAA/S and satisfaction scores and sufentanil consumption were recorded at 4, 8 and 24 h after operation.Blood samples were obtained before anesthesia,1 h after bolus injection of dexmedetomidine, and 24 h after operation for determination of serumcortisol concentration. Results Pain threshold and pain tolerance threshold at 1 h after bolus injection of dexmedetomidine were significantly increased as compared with the baseline before anesthesia in Ⅱ and Ⅲ groups and were significantly higher in Ⅱ and Ⅲ groups than in group Ⅰ . VAS scores and the consumption of sufentanil were significantly lower while the satisfactory score was significantly higher in group Ⅲ than in Ⅰ and Ⅱ groups. Serum cortisol concentrations were significantly increased at 1 h after iv dexmedetomidine or NS injection as compared with the baseline before anesthesia in all 3 groups, but there was no significant difference in serum cortisol levels among the 3 groups. Conclusion Addition of dexmedetomidine to sufentanil for PCIA can significantly reduce the consumption of sufentanil and improve parturient's satisfaction.

Objective To investigate the effects of 3% hypertonic saline (HTS) on cerebrospinal fluid pressure (CSFP), hemodynamics and electrolytes and the feasibility of reducing intracranial pressure (ICP) with 3% HTS in patients with brain tumor. Methods This study was approved by our institutional ethics committee. Forty consenting ASA Ⅰ or Ⅱ patients of both sexes (23 males, 17 females) undergoing elective surgical excision of supratentorial glioma were randomly divided into 2 groups (n =20 each):3% HTS group and 20% mannitol group. The patients were fasted for 12 h before operation and premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with midazolam 1.5-2.0 mg, fentanyl 3 ?g?kg-1,2.5% sodium pentothal 4-6 mg?kg-1 and vecuronium 0.1 mg?kg-1. The patients were mechanically ventilated (VT= 8-10 ml?kg-1, RR = 12 bpm, PETCO2 = 30-35 mm Hg) after tracheal intubation. Anesthesia was maintained with isoflurane inhalation and vecuronium infusion at 0.05 mg?kg-1?h-1. A bolus of fentanyl 4 ?g?kg-1 was given i.v. 5 min before incision. Before induction of general anesthesia a 17 G catheter was inserted into subarachnoid space at L3,4 for measurement of CSFP. Left radial artery and right internal jugular vein were cannulated for BP and CVP monitoring and blood sampling. When end-tidal isoflurane concentration was maintained at 1 MAC and hemodynamics stabilized for 15 min,3% HTS 5.35 ml?kg-1 or 20% mannitol 1 g?kg-1 was infused i.v. over 15 min. MAP, HR, CVP and urine output were measured and recorded and arterial blood samples were taken for blood gas analysis and determination of plasma Na+ and K+ concentrations, pH and plasma osmotic pressure before infusion (T0 , baseline) and 15, 30, 60, 90 and 120 min after infusion (T1-5). CSFP was measured at T0-4 and cerebral perfusion pressure (CPP) was calculated (CPP = MAP - ICP).Results The two groups were comparable with regard to sex, age, body weight and the extent of cerebral midline deviation (

According to the requirement of the national assessment for achieving the infection control criteria, 42 villages (among them,25 villages belonged to the first stratum, and 17 villages belonged to the second stratum) in 14 counties from 5 provinces, including Hunnan, Hubei, Jiangxi, Anhui and Yunnan, were selected as sampling villages for the assessment.The results from the field assessment showed that 154 out of 9 067 people were found infected with Sckistosoma japonicum, with an average infection rate of 1.7% ranged from 0.31 % to 4.10% , and only Yongping Village from Weishan County and Tenglong Village from Eryuan County were not found any case. A total of 46 out of 3 323 head of cattle were infected with S. japonicum, with an average infection rate of 1.38% ranged from 0.26% to 3.79% , and no any infected individual detected in Nanling County. No outbreak occurred in those sampling villages. Therefore, it is indicated that the five sampling provinces have reached the national criteria on infection control of schistosomiasis.