Objective To investigate the effect of propofol used in mechanical ventilation patients in the exacerbation of chronic obstructive pulmonary disease(COPD). Methods 35 patients who received mechanical ventilation and sedated by propofol were observed in the exacerbation of COPD. The time to get Ramsay sedation level Ⅲ～Ⅳ was observed. The parameters of pneusis and eirculation before ,after giving propofol and withdrawl were compared.Results The sedative time of propofol was (51.3±3. 80) seconds. In the most time(85% ) ,the level of Ramsay sedation was maintained at Ⅲ～Ⅳ after the usage of propofol. The time of awake from anesthesia was (5.8±4. 9) minutes, and the patients had no adverse reactions. The blood pressure, heart rate of patients were stable. And the parameters of respiratory rate,SaO2 ,arterial partial pressure of oxygen and partial pressure of carbon dioxide in artery were improved significantly( P＜0. 05 ). Conclusion The sedative effect of propofol is safe and effective in patients required mechanical ventilation in the exacerbation of COPD.

Objective To explore the availability,feasibility and securiy of the pain-free fiberoptic brenchoscopy in clinical application.Methods The blood pressure,heart rate,respiratory rate and saturation of blood oxygen were measured before,middle and after pain-free fiberoptic bronchoscopy under the propofol induced intravenous anesthesia in a cohort of 30 patients.The time of from anesthesia to completely conscious was recorded.Results In 30 paitents,the blood pressure were descended.The heart rate,respiratory rate and saturation of blood oxygen had no significant change.Every patient had no discomfortableness and no pain.The time of leaving examination room was average 25minutes after completely conscious.Conclusion The pain-free fiberoptic bronchoscopy under propofol was safe and painless in the patients have mental stress,no cooperation,hypertension and advanced age.It is a good curative means especially to the people who need repeatedly.

This paper is aimed to evaluate the CT manifestation of congenital pectus excavatum and its effect on the cardiac morphology. CT features of 34 children with pectus excavatum were retrospectively reviewed. The Haller index (HI), CT depression index (CTDI), cardiac rotation angle (CRA), pulmonary vein angle (PVA), cardiac compression index (CCI) and cardiac asymmetry index (CAI) were measured from the images on the PACS system. The relationships among these indexes were evaluated. The HI was 4.12 +/- 1.48, the CTDI was 2.39+/- 0.70, CRA was (53.52 +/- 7.68) degrees, PVA was (66.51 +/- 11.02) degrees, CCI was 2.43 +/- 0.95, and CAI was 1.55 +/- 0.56. There was statistical significance of CCI and CAI between children with severe or slight pectus excavatum. The HI and CTDI were positively related with CCI and CAI respectively, whereas there was no statistical significance of CRA and PVA between children with severe or slight pectus excavatum. There was no statistical significance of HI, CTDI, CRA, PVA, CCI and CAI among different age groups. The morphological change of the heart compressed in children with pectus excavatum can be accurately evaluated by multislice helical CT.
Child ; Funnel Chest ; pathology ; Humans ; Myocardium ; pathology ; Retrospective Studies ; Tomography, Spiral Computed

Objective As a special type of chronic pancreatitis, autoimmune pancreatitis ( AIP ) is gradually being recognized?In 2001,researchers found that serum IgG4 levels were significantly increased in AIP patients,2% of chronic pancreatitis was 1?AIP; 1?AIP was considered a systemic disease associated with IgG4?So far,a number of autoimmune antigens associated with 1?AIP have been identified,but the role of IgG4 in the disease is certain,because the pathogenesis of the disease is not sure,the diagnosis and treatment of AIP is not optimistic.

Objective To investigate the correlation between anatomical structure and recurrence of common bile duct stones.Methods The clinical data of 195 patients with common bile duct stones were studied,including 37 patients with recurrent bile duct stones.The correlation between anatomical structure and the recurrence of common bile duct stones were analyzed by univariate and multivariate analysis.Results Univariate analysis revealed that history of cholecystectomy,choledocholithotomy,periampullar diverticu-lum,papilla hypertrophy or stenosis,intramural duodenal bile duct abnormalities,common bile duct stric-ture,choledochectasia and angulated common bile dust were risk factors of recurrence.Multivariate logistic regression analysis showed that past history of cholecystectomy,periampullary diverticulum,angulated com-mon bile dust,choledochectasia were independent risk factors for the recurrence of common bile duct stones. Conclusion Patients with anatomical structure of past cholecystectom,periampullary diverticulum,choledo-chectasia,angulated common bile dust are prone to recurrence of common bile duct stones.

Objective To investigate the risk factors and prevention of the ERCP-related upper gastrointestinal bleeding in patients with choledocholithiasis.Methods The clinical data of 678 patients who received ERCP in Yijishan Hospital of Wannan Medical College between January 2014 and December 2014 were reviewed.Univariate and multivariate analyses were performed to define the independent risk factor(s) for delayed hemorrhage following ERCP.Results A total of 383 patients,in whom 157 were males and 226 were females,the age ranged from 19 to 88 years,were recruited to the study.ERCP-related upper gastrointestinal bleeding occurred in 41 patients(10.7％),intraoperative bleeding occurred in 27(7.0％) and postoperative hemorrhage in 14 (3.7％).Twenty-eight cases were mild bleeding,9 moderate (4 caused by laceration of the cardiac mucosa) and 4 were severe bleeding.All patients recovered and were discharged,and no death occurred.No single case required surgical conversion.Univariate analysis revealed that cholangitis,medical history of aspirin/clopidogrel,giant diverticulum and the major papilla inside the diverticulum were risk factors for delayed hemorrhage following ERCP (P ＜ 0.05).Multivariate analysis indicated that independent risk factors were associated with cholangitis (OR =4.125,95％ CI:1.306-13.031,P ＜ 0.05),medical history of aspirin/clopidogrel (OR =10.220,95％ CI:2.997-34.853,P ＜ 0.01) and major papilla occurred inside the diverticulum(OR =14.064,95％ CI:1.888-104.762,P ＜ 0.05).Conclusion Cholangitis,medical history of aspirin/clopidogrel and major papilla at the diverticulum may increase the risks for upper gastrointestinal bleeding in ERCP in patients with choledocholithiasis.However,the hemorrhage should be actively managed,especially in endoscopy,once the bleeding occurs.

Antineoplastic agents-induced pulmonary toxicity is one of important reasons causing respiratory failure,which clinical manifestations are pulmonary inflammation,allergic reaction,vascular permeability reaction and pulmonary vascular disease.All of these may be caused by drug toxicity,immune response and increased capillary permeability and so on.Because of the nonspecific performance,it is important to exclude the other lung diseases.Once the diagnosis is clear,the antineoplastic gents should be immediately stopped and the patients should be timely administered high-dose eorticosteroid therapy.How to reduce the pulmonary toxicity induced by antineoplastic agents is becoming one of the future focuses about antineoplastic agents research.

OBJECTIVE:To develop an HPLC Method for the determination of the content of nilestriol in nilestriol vaginal gel.METHODS:The chromatographic separation was carried out on column Hypersil ODS,the mobile phase consisted of methanol-water (80∶20),the detection wavelength was 221 nm,the flow rate was 1.0 mL?min-1 and the injection volume was 20 ?L.RESULTS:The calibration curve was linear in the range of 20.06～200.6 ?g?mL-1 (r=0.999 9),the lowest detection limit was 3.41 ?g?mL-1 and the lowest quantitative limit was 5.92 ?g?mL-1.The average recovery rate was 100.8% (RSD=1.2%).CONCLUSION:The method is simple,accurate and applicable for the determination of the content of nilestroil in nilestroil vaginal gel.

PGE_2 reduced pulsation in concentration of 4 ng/ml and pause in 40 ng/ml for cultured rat heart muscle cells. Membrane and microfilament changes slightly in cultured heart muscle cells exposed to PGE_2 4 ng/ml for 6 min. But membrane presented marked distortion in cultured heart muscle cells exposed to PGE_2 4 ng/ml for 6 hr. These data indicated that effect of PGE_2 is time-dependent.

Objective This study was designed to investigate the exprssion of inducible NOS(iNOS) in human gastric carcinoma and its relation to angiogenesis in gastric carcinoma .Methods The expression of iNOS in 50 patients with gastric carcinoma was studied with immunohistochemistry SP method with iNOS. Microvessel density(MVD) of human gastric carcinoma was also determined with CD 34 as a marker. Results The expression rate of iNOS in 50 cases was 70%.There was a significant difference of MVD(P