The therapeutic method of defensive,qi,nutrient and blood phases in Treatise on Epidemic Febrile Diseases is the signif icant achievement of YE Tian-shi in the process of studying febrile disease.Among the total,the syndrome of defensive phase should be treated on basis of syndrome differentiation,if only using diaphoresis without syndrome differentiation will result in damaged yin and replenished pathogen and deteriorated syndrome.It has important theoretical and clinical meaning to know law and characteristics of febrile disease in lung-wei phase by understanding'applying diaphoresis to treat syndrome of defensive phase'.

Under socialism market economy, the construction of medical moral engineening directed by theory of system engineering should be based on political education, conveyed by competition .combined with administration and led by the reasearch of theory.

Objective To discuss the matching method of irregular device for radiological equipment. Method Related experiences were summed up. Result A set of interventional protective device matching DSA was developed through tripartite corporation. Conclusion The matching method is beneficial to equipment management.

Objective To study the effect of magnetic field on serum activity of superoxide dismutase (SOD), content of malon-dialdehyde (MDA)and content of nitric oxide (NO)in patients undergoing operation for pituitary Tumor. Methods Sixteen ASA Ⅰor Ⅱ patients undergoing pituitary tumor surgery under general anesthesia were randomly divided into 2 groups (n=8 each): magnetic field group (M) and control group (C). Patients in magnetic field group were exposed in 150 mT magnetic field during the operation period.Blood samples were taken from radial artery for determination of serum SOD,MAD and NO before induction of anesthesia(T_0, baseline),after induction(T_1),70 min after induction(exposed in magnetic field for 60 min) (T_2)and 130 min after induction (exposed in magnetic field for 120 min) (T_3). Results There was no significant difference between the two groups in age, sex (M/F ratio),body weight,body height,duration of operation and duration of anaesthesia.The serum activity of SOD and content of NO were significantly higher at T_3 in group M than that in group C,and the serum content of MDA was lower at T_3 in group M than that in group C. Conclusions The magnetic field not only increases serum SOD activity and the content of NO in patient undergoing operation for pituitary tumor,but also reduces the content of MDA in them.

Objective To investigate carpal instability after distal radial fractures have been treated with cast immobilization or operation and its effect on clinical functions.Methods 124 patients with distal radial fracture were treated with cast immobilization,external fixation or plate internal fixation.They were followed up.Their carpal instability was evaluated according to X-ray manifestations before and after treatment;their clinical carpal functions were assessed according to Gartland and Werley scoring system.Results The follow-ups revealed five types of carpal instability:palmar or dorsal shift of the carpus,VISI(volar intercalated segment instability),DISI(dorsal intercalated segment instability)and scapholunate dissociation.The incidence of carpal instability was 58.1%before treatment,21.8%after treatment and 22.6%at the follow-ups.Functional results were excellent and good in 80.6 %of the total patients,in 84.5%of those in the stability group,and in 75.0%of those in the instability group.Conclusions Distal radial fractures usually lead to carpal instability.Operations can correct radius-carpal instability effectively,but it is difficult to correct scapholunate dissociation.The function of carpal joint is evident ly poorer in patients with carpal instability than in those with carpal stability,for it is mainly affected by the integrality of radius-carpal joint.

Objective To compare the effects among 1A29, CsA and their combined use on rejection after liver transplantation and hepatocellular apoptosis in rats. Methods The stable rat model of liver transplantation was established. Rats of the same strain were employed as the control group. The effects of 1A29, CsA and their combined use on rejection after liver transplantation were determined in both groups. Meanwhile, the hepatocellular apoptosis was recorded and evaluated. Results No rejection was found between the rats of the same strain (SDSD), while different levels of rejection was seen between the rats of different strains (WistarSD). Biochemical test showed a significant increase in levels of enzyme spectrum and bile in the blood. An apparent pathological change due to rejection was also observed. CsA of optimal dose (10mg/kg) effectively suppressed the rejection while 1A29 of optimal dose did not. When used alone, CsA of sub-optimal dose had no effect on rejection. On the contrary, the combined use of CsA of sub-optimal dose and 1A29 of optimal dose could significantly inhibit the rejection. There was a marked increase of the hepatocellular apoptosis in the liver graft rejected by the recipient. However, the level of hepatocellular apoptosis showed no remarkable change in the liver graft without rejection due to use of immunosuppressors. Conclusions Hepatocellular apoptosis is closely related to rejection of the liver graft. The apoptosis is not significantly correlated to application of 1A29. The use of 1A29 can result in significant decrease in dose of CsA. Using 1A29 alone can not effectively inhibit the rejection after liver transplantation.

Objective To investigate the effects of enalapril on tachycardia induced acute atrial electrical remodeling in human.Methods 27 patients with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation were randomly divided into control group (16 patients) and enalapril group (11 patients). After autonomic blockade, atrial effective refractory period (AERP) in multiple sites, AERP rate adapting feature, AERP dispersion (AERPd) and inducibility of atrial fibrillation were measured before and after rapid atrial pacing with maximal atrial capture rate(349?37bpm)in both groups. Results ①In control group, AERP shortened significantly after rapid atrial pacing, but it did not change dramatically in enalapril group; ② Before and after rapid atrial pacing, curve estimation showed that the slope values were 0 062 and 0 018 in control group. In enalapril group the slope values were 0 059 and 0 053 respectively; ③After rapid atrial pacing, the inducibility and duration of atrial fibrillation increased significantly in control group, which did not change dramatically in enalapril group. Conclusion Enalapril can prevent acute atrial electrical remodeling and reduce the inducibility of atrial fibrillation after rapid atrial pacing.

Objective To study the clinical features and therapeutic effects of pituitary adenomas in elderly patients. Methods The clinical materials including main clinical manifestations, diagnostic methods and outcome of treatments of 49 elderly patients with the pituitary adenomas from 1987 to1998 were analyzed retrospectively. Results It was showed from the data that the average duration of illness was 4 4 years; and 46(93 8%) cases were with visual deterioration, 20 (40 8%) with headache, and 16(32 7%) with endocrine abnormality. The diameter of tumors was more than 3 cm in 25 (51 0%), and the non functioning adenomas were found in 27 (55 1%). Operation was undergone through trans sphenoidal (61 2%), subfrontal (32 7%) and extensive subfrontal extradural approaches(6 1%), respectively. Among the 49 cases, tumor was totally or subtotally removed in 38 cases (77 6%), large partially or partially removed in 11 cases (22 4%). The results of operation through the trans sphenoidal approach were superior to other routes All patients were long term followed up for an average of 50 5 months. Visual disturbances were improved in 27 of 46(58 7%). A total of 43 patients could live by themselves Tumor disappearance was observed in 30 cases and recurrence in five cases. Five cases showed no changes in tumor size. 28 cases underwent radiotherapy after surgery and the occurrence rate of hypopituitarism after radiotherapy turned to be 50%. Total tumor control rate was calculated as 93%. Conclusions Macroadenomas and non functional pituitary adenomas happened most frequently in elderly patients and the main clinical symptoms was visual deterioration. Trans sphenoidal route for microsurgery was believed to be the first choice of operation. Tumor recurrence can be controlled or delayed by postoperative radiotherapy, but severe complication of the visual injury and pituitary dysfunction should be paid much attention.

Objective To study the feasibility and reliability of median nerve somatosensory evoked potential monitoring in neurosurgery around the brain stem. Methods in selected 43 patients SEP N20, waveforms were recorded after stimulation of left and right median nerves respectively. Anesthesia was maintained with intravenous anesthetics throughout the operation. As soon as N20 waveform changed significantly, the surgeon was informed and the operative procedure was modified whenever possible. Results SEP waveforms were almost stable during maintaining with total intravenous anesthesia (TIVA). Within 43 cases, SEP waveform of & patients significantly changed. In these cases, SEP of 5 patients returned to normal gradually and no further neurologic dysfunction happened postoperatively. The other 3 cases did not recover, and postoperative neurologic complications happened. There was no false-negative or false-positive result. The correlation between intraoperative SEP changes and postoperative neurologic alterations was significant statistically. Conclusions SEP recording is a reliable technique for intraoperative monitoring during neurosurgery around the brain stem. TIVA is helpful for SEP monitoring.

ve In order to improve the reliability of somatosensory evoked potentials (SSEP) monitoring during anesthesia, we compared the effects of three commonly used volatile anesthetics on SSEP to choose suitable volatile anesthetic and determine the appropriate end-expiratory concentrations which have least effects on SSEP monitoring. Methods Sixty ASA I - II patients undergoing elective intracranial surgery were randomly divided into three groups: group A received enflurane; group B isoflurane and group C desflurane. The demographic data including age, body weight, height and sex were not significantly different between the three groups. In addition to SSEP, ECG, BP, SpO2, PET CO2 and end-tidal concentration of inhalation anesthetic were monitored. The SSEP electrodes were placed on N13 on the neck and N20 on the scalp. Before experiment the patient was asked to lie quietly for 10 min, then the patient started breathing 100% O2 and fresh-gas-flow (FGF) was set at 5 L/min. Median nerve on one side was stimulated and SSEP waves from cortex and cervical spinal cord were recorded as baseline tracing before anesthesia. The concentration of inhalation anesthetic was gradually increased from 0 to 0.3, 0.5, 0.75, 1.0 and 1.5 MAC. Each concentration was maintained for 15 min and SSEP waves were recorded. During experiment if the patient developed respiratory depression, oral airway was inserted and assisted ventilation was performed to maintain PETCO2 at 35-45minHg. If the patient developed hypotension, fluid was infused at an increased rate and vasopressor was given if necessary to maintain normal BP (baseline ? 20 % ) . Results The three volatile anesthetics did not change N13 latency and amplitude. Increasing concentrations of enflurane, isoflurane and desflurane were associated with graded reduction in N20 amplitude and increase in N20 latency and N13-N20 interpeak latency. Conclusions The results suggest (1) cortical SSEPs are moresensitive to the volatile anesthetics than subcortical SSEPs, (2) end-tidal concentration of enflurane less than 0.75 MAC is compatible with effective SSEP monitoring, whereas the end-tidal concentration of isoflurane or desflurane compatible with effective SSEP monitoring was less than 1.0 MAC. Enflurane has greater effect on SSEP than isoflurane and desflurane.