ObjectiveTo analyze the influence of different anesthesia methods on the stress response and hemodynamic of elderly patients undergoing laparoscopic cholecystectomy(LC).Methods Fifty-eight elderly patients who needed LC were selected and divided by random digits table method into GAEA group received general anesthesia combined with epidural anesthesia and GA group received general anesthesia with 29 cases each.The stress response and changes of hemodynamic were observed.Results Blood pressure and heart rate (HR) were elevated during pneumoperitoneum in both groups.Blood pressure and HR returned to normal at 30 minutes after pneumoperitoneum in GAEA group,which were recovered more slowly in GA group.There was no significant difference in systolic blood pressure (SBP),diastolic blood pressure (DBP),HR between two groups before and after anesthesia (P＞0.05).SBP,DBP,HR of GAEA group were ( 123.8 ± 25.9) mm Hg ( 1 mm Hg =0.133 kPa),(85.9 ± 8.4) mm Hg,(83.2 ± 7.4) times/min during pneumoperitoneum,respectively,(118.2 ±21.1) mm Hg,(84.4 ±8.3) mm Hg,(82.8 ±7.5)times/min at 10 min after pneumoperitoneum,( 114.9 ± 20.7) mm Hg,(80.2 ± 7.6) mm Hg,(78.5 ± 10.4)times/min at 30 min after pneumoperitoneum.SBP,DBP,HR of GA group were (138.3 ±26.7) mm Hg,(91.2 ± 8.8) mm Hg,(89.3 ± 10.1 ) times/min during pneumoperitoneum,( 130.3 ± 21.3) mm Hg,(89.2 ±8.6) mm Hg,(88.2 ± 9.7) times/min at 10 min after pneumoperitoneum,( 126.2 ± 20.7) mm Hg,(85.2 ±8.4) mm Hg,(84.9 ± 9.6 ) times/min at 30 min after pneumoperitoneum,respectively.SBP,DBP,HR during pneumoperitoneum,at 10 min and 30 min after pneumoperitoneum in two groups had significant differences (P ＜0.05).The anesthesia onset time in GAEA group was(73.2 ±24.9) s,and the awake time after operation was (31.6 ± 10.2) min,while those in GA group were (78.1 ± 22.4) s and (35.9 ± 14.3) min.The anesthesia onset time and awake time after operation in GAEA group were shorter than those in GA group,but had no significant difference (P＞ 0.05 ).Postoperative visual analogue score of GAEA group [ ( 13.4 ± 8.2)scores] was obviously lower than that of GA group[(26.3 ± 10.1) scores] (P ＜0.05).The incidence of adverse reactions between GAEA group [27.59％(8/29)] and GA group [6.90％(2/29)] had statistical difference (P ＜ 0.05).ConclusionsCompared with general anesthesia,general anesthesia combined with epidural anesthesia during LC for elderly patients can reduce the occurrence of intraoperative stress responses and have more steady hemodynamic,better anesthetic effect and faster recovery.But it may cause the incidence of nausea,headache and other postoperative adverse reactions increase.

Objective To analyze the performance of adsorbing CO2 with zeolite 5A molecular sieve in crew module. Methods Fitting analysis was based on experimental data of adsorbing CO2,O2 and N2 with zeolite 5A molecular sieve and the suitability of isotherm adsorbing equation of Langmuir,Freundlich and BET models to be conducted with Origin software. Then using obtained equations and competitive adsorbing theory,the adsorbed amounts of these three kinds of gas under competitive condition were calculated. Results The constants in equations for adsorbing CO2,O2 and N2 with zeolite 5A molecular sieve were determined,and adsorbed amounts for above three kinds of gases under competitive condition were calculated. Conclusion The adsorbed CO2 amount is affected by high fraction of N2. Therefore zeolite 5A molecular sieve should be modified technically so that its adsorption in N2 might be reduced to an ignored amount.

[Summary] Thoracic paravertebral block ( TPVB) can offer intra-postoperative analgesia for thoracic , cardiac, and breast operations .In recent years , the development of ultrasonic technology provides a platform for real-time and visual never block , which can further improve the success rate and reduce the incidence of complications .In this article, we reviewed the various approaches of ultrasound guidance for thoracic paravertebral blockade , and explored the latest progress of different technologies .

BACKGROUND:High liquid-absorbing property, high-capacity imbibition property and high antibacterial property of chitosan dressings can be promoted by chemical modification.
OBJECTIVE:To observe the effect of high-absorbing chitosan dressings on hemostasis and wound healing.
METHODS: (1) Venule bleeding experiment: symmetry oozing wounds were produced on the rabbit skin, which were respectively covered by high-absorbing chitosan dressings and sterile gauze. Then, hemostatic time and bleeding volume were recorded. (2) Deep II degree burn wound healing experiment: 40 Sprague-Dawley rats were selected to prepare deep II degree burn wounds on the back, and then model rats were randomly divided into two groups: experimental group with high-absorbing chitosan dressings and control group with vaseline gauze. After 3, 7, 14, 21 days, wound tissues were taken and analyzed histopathologicaly.
RESULTS AND CONCLUSION: (1) Venule bleeding experiment: The bleeding amount and hemostatic time were significantly lower in the high-absorbing chitosan dressing group than the sterile gauze group (P < 0.05,P < 0.01). (2) Deep II degree burn wound healing experiment: the unhealed wound areas were significantly lower in the experimental group than the control group at days 7, 14, 21 after repair (P < 0.05). After 3 days of wound repair, necrosis of the squamous epithelial layer and the structural damage of the hair folicle in the corium layer and skin appendages were found in both two groups. Meanwhile, the infiltration caused by varying numbers of neutrophils and lymphocytes inside the damaged skin tissues was visible. After 21 days of repair, the epithelium healed wel in the control group, with a little lymphocyte infiltration and formation of crust on the skin surface; while in the experimental group, the epithelium healed wel, with complete squamous epithelial layer and no inflammatory cel infiltration. Thus, these experimental findings reveal that the high-absorbing chitosan dressing has an excelent effect on hemostasis and wound healing.

Objective To observe the effect of lnng-term in vitro culture on the biological properties of adipose-derived stem cells(ADSCs)as seeding cells of tissue engineering.Methods The surface makers and apoptosis of primary and passaged human ADSCs were identified by flow cytometric analysis.Osteogenic differentiation of ADSCs at different passages were identified by alkaline phosphatase(ALP),Von Kossa staining and RT-PCR respectively.Results The surface marker expression of mesenchymal stem cells on ADSCs was high and did not change with passages of the cells.The early apoptosis rate of the cells was 1% to 2%,and increased insignificantly from passage one to passage nine.The osteogenic potential of ADSCs confirmed by ALP,Von Kossa staining and RT-PCR was maintained to as late as passage eight.Conclusion Since the biological properties of ADSCs are stable,they can be served as optimal seeding cells for tissue engineering and regenerative research.

Objective To explore clinical application of coronary artery imaging with 64-slice spiral CT.Methods 46 patients with coronary heart disease were undergone both coronary artery imaging with 64-slice spiral CT and coronary angiography,and the effects on coronary display respectively were compared Results Coronary display in coronary artery imaging with 64-slice spiral CT was better than that of the coronary angiography, which was a inspection pattern of noninvasive coronary display. Conclusion Coronary artery imaging with 64-slice spiral CT can accurately evaluate coronary artery stenosis, which was worth to application.

Objective To investigate the technique and method of MSCT in examination of laryngeal. Methods MSCT data of 28 patients with laryngeal carcinoma confirmed pathologically were analyzed retrospectively. Images quality was evaluated and the results obtained with various windows and CT virtual larynscopy were compared. Results All images had good quality,20 cases(69% ) could be displayed with conventional soft tissue windows,24 cases(81% ) could be demonstrated with lung windows,and 27 cases(93% ) could be demonstrated with CT virtual larynscopy. Conclusion The multislice CT could effectively demonstrate laryngeal carcinoma, and could be applied routinely in examination of laryngeal carcinoma.

PurposeTo investigate the image quality of Dual Source CT (DSCT) high pitch prospective scan in acute chest pain examination by using triple-rule-out (TRO) protocol and its responses to heart beat rate change.Materials and Methods Thirty-two consecutive patients who planned to undergo TRO acute chest pain examination were enrolled and randomly divided into research group and control group. The conventional retrospective spiral scanning protocol was applied to the patients in the control group, while the high pitch prospective spiral scanning mode was used in the research group. CT value, noise level, SNR, CNR and radiation dosage in aorta and pulmonary arteries were recorded and compared between the two groups, and the image quality of the coronary arteries was scored subjectively.Results No significant difference was found in the aspects such as CT value, noise level, SNR, CNR radiation dosage in aorta and pulmonary arteries (P>0.05); however, the subjective scoring for coronary artery in the research group (85.5%) was significantly lower than that in the control group (93.9%) (χ2=8.33,P<0.05). Considering the influence of severe heart rate changes, we excluded those patients whose heart rate variance was more than 5 beats/min (control group:n=5; research group:n=4) and then compared the image quality of the two groups again. The subsequent results showed no difference (χ2=0.12,P>0.05). In addition, the radiation dosage in the control group was significantly higher than that in the research group [(20.8±6.2) mSvvs. (2.3±0.4) mSv;t=17.142,P<0.01].Conclusion DSCT high pitch prospective scanning in TRO protocol shows high success rate in examining patients with acute chest pain whose heart beat rate is lower than 80 beats/min and heart beat variance is less than 5 beats/min. The image quality has no difference with that derived from retrospective scan but with far more less radiation dose (2.3±0.4) mSv. This method thus is promising and can be widely promoted clinically.

Objective:To observe volt-ampere characteristic of Acupoint Neiguan (PC 6) on patients with hyper-thyroidism for probing into the actions of acupoints and change of qi and blood of human body as well as the relationship between the action of acupoint and the metabolism of energy. Methods:A self-made high-sensitive apparatus was applied to detect volt-ampere curves of Acupoint Neiguan(PC 6)and its control point on 33 patients with hyperthyroidism and 30 healthy people.Results:In patients,the volt-ampere areas (VAA)of both ampere.Increasing scan(AIS)and ampere—decreasing Scan(ADS)as well as the inertia areas (IS) of both side Neiguan(PC 6)were significantly smaller than the control points(P<0.05 or P<0.0 1).In healthy people.The VAA of the AIS/ADS of both side and me IA of right Neiguan(PC 6)were significantly smaller than those of the comparison points (P<0.05 or P<0.01).The comparison on volt-ampere characteristicsof the acupoints having same names on right and left side showed that the inertia areas ofNeiguan(PC 6)on patients with hyperthyroidism on the right side were significantly larger than those on the left side (P<0.05).There was no significant difference between the patients and healthy people on the VAA of both AIS/ADS/IA of the right and left Neiguan(PC 6)(P>0.05).Conclusion:The volt-ampere characteristics of theright and left Neiguan(PC 61 on patients with hyperthyroidism are in imbalance.Hyperthyroidism exerts certaininfluenceontheheartfunction.

Objective To analyze and summarize the clinical , pathological features of 16 patients with centronuclear myopathy.Methods All of the 16 patients performed clinical examination and sporadic patients and a proband with family history ( n=6 ) performed serum creatine kinase , electromyography and open muscle biopsies , and the specimens were used for a standard series of histological and histochemical stainings.The clinical and pathological features of these patients were analyzed.Results The proportion of centronuclear myopathy in suspected myopathy cases was 0.127%(6/4 724) in our department.The onset time ranged from infancy to adulthood.The common initial symptoms included mild to moderate weakness of lower limbs and bilateral ptosis ( n =4 ).The other symptoms were facial weakness ( n =1 ) and ophthalmoplegia (n=1).There were 12 patients performing distal weakness exceeding proximal weakness . One family with autosomal dominant inheritance of 11 patients had a later age of onset than the sporadic ones and manifested bilateral ptosis , bilateral lower limbs weakness , especially in distal muscle.Muscle biopsies showed pronouncedly increased amount of fibers with centrally placed nuclei with predominant type Ⅰfibers and a clear perinuclear halo surrounding the centrally placed nuclei and an appearance of spoke of a wheel in some fibers.Conclusions This series of centronuclear myopathy patients manifest clinical heterogeneity.Muscle biopsies show features of centralized nuclei pronounced increase , type Ⅰfibers predominance , etc.These can provide evidences for the diagnosis of the disease.