Objective To observe the effect of intravenous anesthesia (IVA) with propofol (P),ketamine (K) and fentanyl (F) in different ways in children. Methods 90 pediatric patients were divided into three groups ( n =30) randomly according to the drug used for IVA. Ⅰgroup used compounds of P, F and K; Ⅱgroup used compounds of P and F; Ⅲ group used compounds of P and K. All the drugs were injected intravenously with micro-pump. Total dosage of anaesthetics, awaken time after operation and variation of circulation and breath were observed and sedative and analgesic effect during operation were evaluated. Results Compared with Ⅱ or Ⅲ group, Ⅰgroup showed less dosage, shorter awaken time and smaller degree of change in circulation and breath with complete sedation and analgesia ( P

Objective To analyze the factors affecting quality of life (QOL) in patients with stroke. Methods Eight hundred and six stroke patients were recruited by using the stratification and random sampling method, and QOL questionnaire was applied. Results It was shown that QOL was worse comparatively in stroke patients with poorer education, divorce or lose of spouse, non-free medical service, unemployment, serious deficit of nervous function, while it was indicated by the results of multiple factor analysis that QOL was influenced mainly by such factors as education background, marriage and neurological function. Conclusion In order to improve QOL of patients, we should pay more attention to the health of elders, social security system, education and medical technology.

0.999 0, and RSDs were not more than 3.26%. The recovery rates were 94.12%-104.30% .The lowest detected concentration was 1.43 mg/L. There was no significant difference between the results of this method and Na2EDTA titration. Conclusion The method was rapid, accurate and highly sensitive.

Objective To clone VEGF gene and construct its eukaryotic expression vector for the evaluation of the possability of VEGF gene therapy in orthopedic disease. Methods Human vascular endothelial growth factor(hVEGF) cDNA was amplified by nested PCR method from the HL60 cells and cloned to expression vector pcDNA 3. The cDNA was identified by enzyme digestion and DNA sequencing. Rabbit osteoblasts were transfered with pCD-hVEGF165 plasmid by lipofectin mediated gene transfer method. The transient expression of VEGF were detected by Streptavidin-Biotin-enzyme Complex(SABC). Results The cloned cDNA was confirmed to be VEGF165 cDNA. It was observed that the expression of human VEGF gene was detected distinctly 72 h after transfering. Conclusion We successfully cloned hVEGF 165 gene and construced its eukaryotic expression vector, which provided the further foundation of VEGF gene therapy for ostenecrosis,bone defeat and fracture.

The paper describes the significance of clinical pathological congresses in clinical work. It argues that at present there is the tendency of laying stress on modern advanced diagnostic means at the expense of basic physical diagnostic means and traditional therapies, and traditional conduction of clinical pathological congresses for the purpose of summarizing medical experience and promoting medical advancement has even become a rarity, which is very harmful to the cultivation of qualified clinical doctors. The paper gives an account of how the authors' hospital encouraged performance of autopsies and persisted in holding clinical pathological congresses. Its experience is that clinical pathological congresses have many functions in clinical work, including solving knotty problems like multidisciplinary and multisystematic pathological changes by drawing upon all useful opinions; exchanging information, which is beneficial to doctors learning from one another and making common progress; cultivating personnel via tempering young doctors and updating senior doctors'knowledge; and strengthening the hospital's cohesive force.

Objective To investigate the correlation between levels of glycohemoglobin and cognitive function in elderly patients with type 2 diabetes. Methods Cognition function of 40 elderly patients with type 2 diabetes was assessed by Wechsler Memory Scale (WMS), Trail Marking Test and Wisconsin Card Sorting Test (WCST) and was compared with 40 healthy controls matched for age, gender, education level and profession. Meanwhile, the correlation between cognition function and levels of glycohemoglobin was analyzed by regression analysis.Results The scores of Wechsler Memory Scale in the patients were lower than that in normal controls (P＜0.01，P＜0.05). The patients needed much more time to complete the Trail Marking Test (P＜0.001). The scores of Wisconsin Card Sorting Test were significantly different between two groups (P＜0.01，P＜0.05). The regression analysis showed that there was an obvious correlation between serum level of glycohemoglobin and cognition functions in patients with type 2 diabetes(r=-0.38, -0.43, -0.48, -0.46, 0.41, P＜0.05). Conclusion Cognition function decreases and significantly correlates with the level of glycohemoglobin in the elderly patients with type 2 diabetes.

Objective To study long-term outcome and prognostic factors of nasopharyngeal carcinoma treated by intensity modulated radiotherapy.Methods A total of 299 patients with nondisseminated nasopharyngeal carcinoma who received initial radiotherapy were analyzed retrospectively.The primary lesion and the upper neck received 70 Gy (5 fraction per week in all 30 fraction) by intensitymodulated radiotherapy (IMRT).The lower neck and the supraclavicular fossa was given 54 Gy (5 fraction per week in all 30 fraction) by a single anterior tangent field with spinal cord block.A median dose of 9.2 Gy (4-20.Gy) was given to the residual primary lesion by IMRT or X-knife.The Kaplan-Meier method was used for calculating the overall survival (OS),disease progression-free survival (DPFS),distant metastasisfree survival (DMFS),Log-rank test was used for evaluating the differences between groups.Multivariate prognostic factor was analyzcd by Cox method.Results The follow-up rate was 99.7％.119 patients were followed-up more than with 5 years.The 5-year OS for stage Ⅰ + Ⅱ,stage Ⅲ and stage Ⅳ were 97.1％,82.7％ and 52.2％(x2=46.19,P=0.000),the 5 years DPFS were 100％,77.6％ and 57.7％ (x2=23.29,P =0.000),DMFS were 100％,82.3％,63.7％ (x2 =16.57,P =0.000) respectively.The 5 year OS,DPFS and DMFS of male and female were 70.7％ vs 94.1％ (x2=16.82,P=0.000),71.5％ vs 87.3％ (x2 =4.74,P =0.029) and 77.2％ vs 89.7％ (x2 =4.38,P =0.036) respectively.For patients who were younger than 45-years,the male had a significantly unfavorable 5-year OS (66.8％ vs.91.2％,x2=7.07,P=0.008),DPFS (59.9％ vs.91.2％,x2=7.72,P=0.005) and DMFS (66.4％ vs.94.0％,x2 =8.46,P =0.004) ;For patients who were old than 45-years,only OS was significantly different between male and female (72.2％ vs.96.0％,x2 =10.19,P =0.001).Multivariate analysis showed the independent prognosticfactors for OS,DPFS,DMFS,were gender (x2 =14.27,5.72,17.64,P =0.000,0.017,0.000),TNM stage (x2 =5.33,15.70,10.57,P =0.021,0.000,0.001) and lymph nodes capsular invasion (x2 =4.30,11.08,21.24,P =0.038,0.001,0.000).Intracranial invasion and supraclavicular lymph node metastasis were independent prognostic factors for OS (x2 =13.32,5.38,P =O.000,0.020).Conclusions The TNM stage,lymph nodes capsular invasion and gender are independent prognostic factors for nasopharyngeal carcinoma treated by intensity-modulated radiotherapy.The patients of younger than 45years own a worse outcome.

Objective To investigate the late toxicities after intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma and analyze the risk factors for treatment complications.Methods A total of 299 patients with nasopharyngeal carcinoma were given initial IMRT.The nasopharyngeal lesion and cervical lymph nodes were given a prescribed dose of 70 Gy ; the dose was 60 Gy to subclinical region ; the prophylactic dose was 54 Gy to the lower neck and supraclavicular region;these doses were given in 30 fractions over 6 weeks.The clinical records of 176 patients followed up were analyzed.The hazard factors were analyzed with Logistic method.Results The median follow-up was 52 months,and the follow-up rate was 99.7％.The most common radiotherapy-induced toxicities were xerostomia and hearing loss,with incidence rates of 54.5％ and 61.4％.The incidences rate of grade 0-1 adverse reaction of skin,subcutaneous tissue,or nasopharyngeal mucosa was 91.5 ％,93.2％,or 97.2％ ;the incidence rate of grade 1-2 trismus was 3.4％.Severe complications included cranial nerve injury (5 patients) and epistaxis (2 patients,one dying due to profuse epistaxis).The hazard factors for xerostomia and hearing loss were chemotherapy (x2 =7.38,P =0.007 ; x2 =7.96,P =0.005) and median doses to the parotid gland and inner ear (x2 =4.09,P =0.043 ; x2 =7.96,P =0.005).Conclusions Most patients develop only mild toxicity of the skin,subcutaneous tissue,or nasopharyngeal mucosa after IMRT.The incidence rates of xerostomia and hearing loss remain high owing to radiotherapy dosage and chemotherapy.

Objective To describe the status of adherence to antiretroviral therapy (ART) in low endemic area,and to explore the factors affecting ART adherence so as to provide evidence for behavior management program.Methods A cross-sectional study was conducted in 53 patients receiving free ART in Chuanying and Yongji of Jilin Province.Structured face-to-face interview was carried out to determine sociodemographic characteristics,medical treatment information,medication adherence behaviors,health belief and self-efficacy,doctor-patient relationships and health service information.Results Among 53 patients,3 reported drug discontinuance.Of the other 50 patients,41 (82.0％) obeyed the request of the doctors (to be defined as adherence).All the participants had high levels of perceived benefits of adherence,perceived severity of non-adherence and self-efficacy.94.3％ of them reported using medication reminders,88.7％ reported receiving directly observed therapy (DOT),and 73.6％ reported falling into the habit of drug administration.Conclusions HIV/AIDS patients show relatively good adherence to medical treatment.Local comprehensive education and supportive programs may contribute to patients' good adherence to ART.

Objective To compare the time-course of relaxant effect of rocuronium between patients with ocular and generalized myasthenia gravis (MG).Methods Twenty-seven ASA physical status I or Ⅱ patients with MG of both sexes,aged 12-64 yr,with body mass index of 17-26 kg/m2,scheduled for elective extended thymectomy,were divided into 2 groups according to Osserman stage:ocular group (group O,n =10) and generalized group (group G,n =17).Anesthesia was induced with iv injection of fentanyl 2 μg/kg,midazolam 0.05 mg/kg,and propofol 1.5 mg/kg.All patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propofol 4-8 mg· kg-1 · h-1 and remifentanil 0.2 μg· kg-1 · min-1.Twitch tension was monitored in the adductor pollicis muscle by train-of-four stimulation of the ulnar nerve (intensity 60 mA,interval 12 s,frequency 2 Hz,wave length 0.2 ms).Rocuronium 0.6 mg/kg was injected intravenously after calibration.Mean arterial pressure (MAP),HR,heart rate variability (HRV) and low frequency and high frequency (LF/HF) ratio was recorded.The onset time of muscle relaxation,time for T1 to recover to 25％,time for T1 to recover to 50％ and recovery index were recorded.Results Compared with the baseline value,there were no significant changes in MAP,HR,HRV,LF/HF ratio at all time points in the two groups (P ＞ 0.05).Compared with group O,there was no significant change in the onset time of muscle relaxation,and the time for T1 to recover to 25％,time for T1 to recover to 50％ and recovery index were significantly prolonged in group G (P ＜ 0.05).Conclusion The duration of rocuronium-induced neuromuscular block is significantly longer in patients with generalized MG than those with ocular MG,while the onset time is comparable between the two groups.