Objective: To observe the effects of total intravenous anesthesia(TIVA)and spontaneous respiration on brain oxygen balance status in patients undergoing brain stem neoplasm resection. Method: Thirty patients,ASA grade Ⅰ-Ⅱ, received endotracheal intubation with spontaneous respiration and TIVA. TIVA was maintained with intravenous 0.2% lidocaine 2-3mg?kg~(-1). h~(-1),0.4% propofol 4-6mg?kg~(-1),h~(-1)and 1% ketamine 1-1.5mg?kg~(-1). h~(-1). Arterial and jugular bulb blood samples were taken before and after induction,sawing skull and removing trmor seperately to analyse blood gas. According to Fick principle, the level of CaO_2,CjvO_2 and C (a-jv)O_2 were calculated. Result:The hymodynamics, SaO_2 and CaO_2 remained stable during whole procedure. In comparison with the baselines. respiratory rate, minute volume, arterial blood pH and C(a-jv)O_2 were decreased, and PaCO_2.SjvO_2, and CjvO_2 were increased significantly (P

Objective To investigate the effect of isoflurane at different concentration on the quantitative electroencephalogram(SEF and BIS) , intracranial pressure(ICP) and hemodynamics during neurosurgery Methods Thirty ASA grade Ⅰ Ⅱ patients with saddle tumor ,scheduled for selective operation, were randomly divided into three groups after induction with fentanyl propofol vecuronium and intubation Anesthesia was maintained with inhalation of 0 5,1 0 or 1 5 MAC of isoflurane in each group respectively MAP,HR,ICP,SEF and BIS were recorded before induction,reaching the designed MAC, at incision ,sawing bones and opening dura Results SEF and BIS decreased significantly with increases in concentration of isoflurane MAP decreased markedly at1 5 MAC compared with that at 0 5 MAC (P

Objective To evaluate the influencing factors for postoperative odynophagia in elderly patients undergoing intraoperative transesophageal echocardiography (TEE) examination for cardiac surgery.Methods A total of 96 patients with intraoperative TEE examination for cardiac surgery was divided into two groups:the elderly group (patients aged ≥65 years,n=60) and the young group (patients aged ＜ 65 years,n =36).Clinical data were retrospectively analyzed.Postoperative odynophagia was assessed by number rating scale (NRS) scores.Characteristics of postoperative odynophagia were compared between the two groups.Influencing factors for postoperative odynophagia were analyzed by multivariable logistic regression analysis.Results The incidence of postoperative odynophagia and the average NRS score were higher in the elderly group thanin the young group [88.3％ vs.66.7％,(2.6±1.7) vs.(1.4±0.9),P＜0.05 or 0.01].Multivariate logistic regression analysis showed that preoperative oral lidocaine plasmagel,oropharyngeal mucosal injury and duration of TEE insertion were independent influencing factors for postoperative odynophagia (all P＜0.01).Conclusions The incidence of postoperative odynophagia is higher and the degree of odynophagia is more serious in elderly patients undergoing intraoperative TEE examination for cardiac surgery.Postoperative odynophagia can be relieved by applying the preoperative oral lidocaine plasmagel,reducing oropharyngeal mucosal injury and shortening the duration of TEE insertion.

Objective:To study the epidemiology of inpatients with fractures and discuss its effect on health education.Methods:Therer were 6290 inpatie nts with fracture investigated retrospectively.FoxPro and SPSS were used for statistical analysis.Results:The mean age of the patients was 41.03±20.05 years.The fraction male to female patients was 2.39:1.The mean hospitalized days were 24.11±22.73 days (±s).A majority(63.5%) of the patients were admitted to the hospital by emerg ency.Fractures in 15 parts accounted for 70% of total fractures in 6 hospital, 7 of which accounted for more than 50% of total fractures in each hospital.Discussion:Health education should be carried out according to risk factors as well as age and gender.The devel opment of the model,which combines prevention,first-aid and rehabilitation,is t he trend of health education for fractures.The basic knowledge of fractures in these 15 parts should be learned by orthopedic nurses.Patient education should be carried out individually.The hospital's situation should also be considered.

Objective To evaluate the effect of neuromuscular block on the airway sealing pressure of laryngeal mask airway (LMA) i-gel in patients undergoing general anesthesia.Methods Sixty patients scheduled for elective surgery under general anesthesia with LMA i-gel were randomly allocated to one of three groups (n =20 each):control group (group C),rocuronium 0.3 mg/kg group (group R1) and rocuronium 0.6 mg/kg group (group R2).Anesthesia was induced with target-controlled infusion of propofol and remifentanil.The target plasma concentration of propofol was 3.5 μg/ml,and the target effect-site concentration of remifentanil was 3.0 ng/ml.When the patients lost consciousness and after the target plasma and effect-site concentrations were balanced,LMA i-gel was inserted to perform mechanical ventilation.After insertion of LMA i-gel,rocuronium 0.3 and 0.6 mg/kg were injected in R1 and R2 groups,respectively.The airway sealing pressure of LMA i-gel was detected immediately after insertion of LMA i-gel and at 1 min after administration of rocuronium.Results There was no significant difference in the airway sealing pressure of LMA i-gel between groups and within groups(P ＞ 0.05).Conclusion Neuromuscular block has no significant effect on the airway sealing pressure of LMA i-gel in patients undergoing general anesthesia.

A sample investigation is conducted among 109 political affairs staff from different scales of hospitals in Yancheng city.By analyzing the investigation data,this paper points out there is a lack of humanities qualification among hospital political affairs staff.Some countermeasures are also come up with as follows.The enhancement of humanities knowledge should be the first step to improve qualification of political affairs staff.Political affairs staff should take a positive role in adapting to the challenges of information economics.The political affairs work should be initiated with humanities culture in order to keep pace with social progress.The mutual improvement in humanities education and political affairs work lies a solid foundation for the construction of a harmonious physician-patient relationship.

Objective To summarize the experience of surgical techniques and prevention of postoperative complications of giant intracranial meningiomas.Methods The clinical data of 32 patients with giant intracranial meningiomas were analyzed retrospectively.The cause of operative complications was analyzed and the experience was summarized.Results The meningiomas Simpson grade Ⅰ resection was 16 is.cases,grade Ⅱ resection was 9 cases,grade Ⅲ resection was 5 cases,grade Ⅳ resection was 2 cases.The postoperative complications included anemia was 14 cases,intracranial hemorrhage was 2 cases,severe cerebral edema was 4 cases,epilepsy was 3 cases,cerebral infarction was 2 cases,and recovered well after treatment.Conclusion Good surgical technique,advanced prevention of surgical complications,early diagnosis and treatment can significantly improve the prognosis.

Objective To establish nude mice xenograft tumor models of human endometrial carcinoma for basic and clinical study. Methods Fourteen samples of human endometrial carcinoma were subcutaneously heterotransplanted to nude mice (BALB/C, nu/nu),3～4 mice were transplanted for every sample. Results The initial take rate was 42.8%,then it increased to 100.0% after the 5th passage. Five of 14 samples were transplanted for 48～63 passages.The characteristics of histology,ultrastructure and chromosome were identical to those of human donour tumors. The DNA ploidy was consistent for SL-1,SL-2 and SL-3,but changed for SL-4 and SL-5 by cytometric analysis. The expression of estrogen receptor and progesterone receptor for 5 models was all negative. The expression of p53 was positive for SL-1,SL-2 and SL-4,but negative for SL-3 and SL-5.The expression of c-erbB-2 was positive for SL-1,SL-2 and SL-4,negative for SL-3 and SL-5.The expression of p16 was positive for SL-2 and SL-3,negative for SL-1,SL-4 and SL-5. Conclusions Five nude mice xenograft tumor models of human endometrial carcinoma were established successfully. It will be helpful for the basic and clinical study of human endometrial carcinoma.

BACKGROUND:Machinable bioglass-ceramics became a new inorganic biomaterial; moreover, strength, toughness and machinability are significantly studied.OBJECTIVE: To observe the effect of ZnO, Fe2O3 and ZrO2 additives on the microstructure and properties of machinable bioglass-ceramic in K2O-MgO-CaO-SiO2-P2O5-F system.DESIGN: Observational contrast study.SETTING: Department of Orthopaedics, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: The experiment was carried out in the Laboratory of Materials, Wuhan University of Technology from October 2003 to April 2004. K2O-MgO-CaO-SiO2-P2Os-F system, ZnO, Fe2O3 and ZrO2 additives, D/Max-ⅢA X-ray diffractometer (Japan), JSM-5610LV scanning electron microscope (SEM), HVS-1000 microhardnessmeter and 3257-35 magnetic testing device (Japan) were used in this study.METHODS: In the glass-ceramic of K2O-MgO-CaO-SiO2-P2O5-F system, three kinds of additives ZnO, ZnO-Fe2O3 and ZnO-Fe2O3-ZrO2 were added respectively. These three kinds of ceramics were prepared by being melted at 1 400 ℃ for 1 hour. After fire, crystal temperature was set based on differential thermal analysis curve. ① Physical properties: Microhardness was determined with microhardnessmeter (HVS-1000). The flexural strength and fracture toughness were established measured with ceramic mechanical test system (MTS) method and single edge notched beam (SENB) method, respectively. Saturation magnetic moment and Curie temperature were determined with 3257-35 magnetism test machine made in Japan. Holing method was used to measure machinability. ② Test of crystalline phase and microstructure: Crystalline phase analysis was carried out with X-ray diffraction (XRD: D/Max-ⅢA) and microstructure analysis were conducted on an etched fracture surface using SEM (JSM-5610LV,Japan). MAIN OUTCOME MEASURES: Effects of ZnO, Fe2O3 and ZrO2 additives on physical properties, mineral composition and crystalline phase.RESULTS: ① The addition of ZnO to the glass-ceramic in K2O-MgO-CaO-SiO2-P2O5-F system was beneficial to crystal growth, increasing aspect ratio of crystal, decreasing microhardness and improving toughness and machinability. ② The addition of ZnO-Fe2O3 to the glass-ceramic in K2O-MgO-CaO-SiO2-P2O5-F system can form minority Mg-Zn ferrite with magnetism. The main crystalline phase present in the glass- ceramic was diopside with small size and hardness was improved, which led to worse machinability. ③ Because of the addition of ZnO-Fe2O3-ZrO2, magnesia fluormica and fluorapatite became the main crystalline phases, and the minor phases including Mg-Zn ferrite, t-ZrO2 and m-ZrO2, etc.also presented in the glass-ceramic. This material possessed high strength and toughness, good machinability and magnetism, which could stimulate formation of new bone, and was good substitute of bone restorations. Bioassay and in vitro test indicated that the glass-ceramic in K2O-MgO-CaO-SiO2-P2O5-F system was bioactive and biocompatible. CONCLUSION: ZnO, Fe2O3 and ZrO2 additives play a significant role in changing crystalline structure, enhancing strength,toughness and machinability of machinable bioglass-ceramic and generating magnetism.

Objective To determine the relationship between neuronuscular block induced by cisatracurium for tracheal intubation during anesthesia induction and types of myasthenia gravis (MG).Methods Sixty-five patients of both sexes with MG,aged 20-75 yr,weighing 53-92 kg,with body height of 155-185 cm,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective videoassisted thoracoscopic thymectomy,were enrolled in the study.Among the 65 patients,there were 8 patients with ocular MG (type Ⅰ),19 patients with mild generalized MG (type]Ⅱ a),33 patients with subacute generalized MG (type Ⅱ b),2 patients with acute MG (type Ⅲ) and 3 patients with late severe MG (type Ⅳ).Neuromuscular monitoring was initiated when the patients lost consciousness after induction of anesthesia.Cisatracurium was administrated with the initial dose of 0.05 mg/kg,and if T1 depression was less than 95％ within 6 min,cisatracurium 0.015 mg/kg was intravenously injected until T1 depression was more than 95％.The patients were then tracheally intubated.The amount of cisatracurium consumed for intubation,onset time (from the beginning of cisatracurium injection to T1 depression ＞95％) and recovery time (recovery of T4/T1 to 25％ of control height) of neuromuscular block were recorded.T1 depression ＞ 95％ within 6 min after administration of 1-fold ED95 cistracuriun was defined as sensitivity to muscle relaxants.The requirement for cistracurium ＞ 1-fold ED95 when T1 depression ＞ 95％ was defined as insensitivity to muscle relaxants.The proportion of sensitivity/insensitivity was calculated.Results There was no significant difference in the amount of cisatracurium consumed for intubation and onset time and recovery time of neuromuscular block between patients with type Ⅰ and those with type Ⅱ a (P＞0.05).Compared with patients with type Ⅰ and type]Ⅱ a,the amount of cisatracurium consumed for intubation was significantly decreased,the proportion of sensitivity/insensitivity was increased,the onset time was shortened,and the recovery time was prolonged in patients with type Ⅱ b (P＜0.05).Conclusion With the severity of MG,the consumption of cisatracurium is gradually decreased when used for tracheal intubation during anesthesia induction,and the sensitivity is gradually increased in the patients with MG.