Objective To study the effect of sevoflurane or propofol/remifentanil general anesthesia undergoing gynecological surgery.Methods A total of 80 patients scheduled for selected gynecological surgery were divided into sevoflurane group or propofol/remifentanil group by random digits table method and 40 cases in each group.The induction of anesthesia was conducted with midazolam,propofol,sulfentanil,and rocuronium.After tracheal intubation,anesthesia was maintained with sevoflurane in sevoflurane group,and with propofol/remifentanyl target-controlled infusion in propofol/remifentanil group.Bispectral index was monitored in each group,and which was maintained 40-60.Blood pressure and heart rate was observed.At the end of operation,all anesthetics were discontinued,and the time of consciousness recovery,tracheal extubation,orientation was recorded.The incidence of agitation,nausea and vomiting within 24 h after surgery and the use of rescue drugs such as epinephrine,atropine or urapidil was recorded.Results No statistically significant difference was observed with respect to the time of consciousness recovery,tracheal extubation,orientation between two groups (P ＞ 0.05).The use of atropine and epinephrine in sevoflurane group was lower than that in propofol/remifentanil group [7.5％(3/40) vs.22.5％(9/40),20.0％(8/40) vs.32.5％(13/40)],and there was significant difference(P ＜ 0.05),and the use of urapidil in sevoflurane group was higher than that in pmpofol/remifentanil group [22.5％ (9/40) vs.2.5％ (1/40)],and there was significant difference (P ＜ 0.01).There was no statistically significant differences with respect to the incidence of agitation,nausea and vomiting within 24 h after surgery between two groups (P ＞0.05).Conclusion Propofol/remifcntanil and sevoflurane both provide satisfactory anesthesia for gynecological surgery.

Maxillary first molar with twin-root canal in palatal side is rare. This article described two cases of maxillary first molar with twin-root canal. A properly designed and prepared access of the cavity is helpful for the diagnosis and negotiation of the root canal morphology.
Dental Pulp Cavity ; Humans ; Maxilla ; Molar ; Root Canal Therapy

OBJECTIVE:TO summarize the newest clinical application of permanent cardiac pacemaker, and introduce the relationship between the therapy efficacy and mechanism.DATA SOURCES: Related papers were searched in Pubmed from January 2000 to December 2006 with the terms of "pacemaker,application",and the language of paper was limited to English,at the same time,related papers were searched in WangFang Database with the same terms and the language of paper was limited to Chinese.STUDY SELECTION:The papers relevant to the newest large-scale clinical trial about the cardiac pacemaker were primarily collected.Exclusion criteria:repetitive studies.DATA EXTRACTION:A total of 203 pieces of papers related to the newest clinical application of cardiac pacemaker were collected,among which,30 pieces accorded with the inclusion criteria.DATA SYNTHESIS:The pacemaker can simulate the normal myocardium cell's function pacing and conducting the rhythm. Consequently it can substitute the abnormal myocardium cell to ensure the sequence and completeness of the cardiac pacing and conducting system,the natural electrophysiological activity,and the efficiency of the cardiac ejection and blood supply.The clinical application is not only for single bradycardia, but also for cardiac electric failure, cardiac electric turbulence,and some heart diseases without cardiac electric abnormity.With pacemaker miniaturization,digital signal processing, improved diagnostics and endocardial electrograms, modern pacemakers are able to offer a sophisticated therapeutic and diagnostic platform for the patients with refractory symptoms.CONCLUSION:The pacemaker can simulate the normal myocardium cell's function pacing and conducting the rhythm.It therapy for congenital heart disease.

Liver transplantation is a valid treatment option for select patients with Hepatocellular Carcinoma HCC and end-stage liver disease. However, in approximately 20% of patients, recurrent HCC is the rate-limiting factor for longterm survival. Despite identification of clinical parameters that may stratify patients at high risk and exhaustive preoperative staging, cancer recurrence is likely the result of microscopic extrahepatic disease. With a desperate donor organ shortage, locoregional ablation techniques and resection are being employed in patients on the waiting list to serve as a bridge to OLT. Further more, some have advocated aggressive surgical resection of isolated metastasis in both the liver and extrahepatic viscera. Whether these creative strategies confer a survival advantage is unknown, requiring longterm follow-up to determine their efficacy.

Objective To investigate the feature of pathogen distribution and antibiotic resistance of venti-lator associated pneumonia from Jan.to Dec,2007 in our ICU in order to provide a reference data guiding the appro-priate use of clinical antibiotics.Methods The 148 VAP cases of pathogen and drug sensitive tests were retrospec-tively analyzed.Results The incidence rate of VAP was 70.81%.Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,Acinetobacter sp were the top pathogen of Gram negative bacillus.Staphylococcus aureus (MBSA)was the major pathogen of Gram positive coccus.The resistance rates of Klebsiella pneumonia and Pseudomonas aeruginosa were very high.The effect rates of frequently used antibiotics were not satisfactory.The fungus infection rate was 6.76% among all the cases.Conclusion MRSA,Klebsiella pneumoniae and Pseudomonas aerugmosa are the major pathogens of VAP in our ICU with a high drug resistance rate.Gram negative bacillus is the major Pathogen of VAP with a faidy high drug resistance rate.

Objective To evaluate the prognostic value of plasma D dimer level in cancer thrombosis and vascular invasion assessment and to analyze the correlation between plasma D dimer level and the Pittsburgh modified TNM staging in patients with hepatocellular carcinoma for orthotopic liver transplantation. Methods The plasma D dimer level was quantitated using Golden method in 120 patients with hepatocellular carcinoma for orthotopic liver transplantation. Cancer thrombosis in trunk vein and microvascular invasion was diagnosed by pathology. The relationship between plasma D dimer level in different Child pugh’s classification patients and vascular invasion as well as the Pittsburgh modified TNM staging was analyzed with ? 2 test, factorial analysis of variance and q test by microsoft SPSS 9.0.Results In Child Pugh’s A, B and C patients, the difference of plasma D dimer level between patients with trunk vein cancer thrombosis and patients without vascular invasion was significant ( P 0.05). The differences of plasma D dimer level between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅲ tumor, and between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅳ tumor were significant ( P 0.05). Conclusion Plasma D dimer level, which increasing as upgrade of the Pittsburgh TNM staging, is useful in the vascular invasion and cancer thrombosis assessment in patients with hepatocellular carcinoma for liver transplantation, and the correlation was more significant as progression of vascular invasion and upgrade of Child pugh’s classification.

OBJECTIVE: To investigate the characteristics and influence factors of sensitization hy allergens in patients with allergic rhinitis in the junction of Guangdong and Guangxi provinces. METHOD: One thousand one hundred and twenty-four patients who were diagnosed with allergic rhinitis hy clinical history and symptoms underwent a skin prick test. The percent of allergens with positive skin response and Multiple Allergens Positive Scores were recorded, and their influence factors, included age, gender and test period were evaluated. RESULT: The percent of top three inhalant allergens with positive skin tests were as follow: dermatophagoides pteronyssinus (77.0%) ,dermatophagoides farina (77.1%), blattella germanica (42.3%); the percent of top three ingested allergens with loositive skintests were as follow: crab ( 39.5%), shrimp (31.1%), ribbonfish (10.8%). The average Multiple Allergens Positive Score was (3.6 +/- 2.7). The percent of allergens with positive skin response and Multiple Allergens Positive Score of different allergens changed as age, gender and text period changed, and the changing trend of them was accordant. The percent inhalant allergens with positive skin tests in dermatophagoides pteronyssinus, dermatophagoides farinae and cat fur in different gender showed a significant difference. CONCLUSION Acarine allergens were the most common allergens in patients with allergic rhinitis in the junction of Guangdong and Guangxi provinces. The percent of allergens with positive skin response and the severity of multiple allergy were influenced by age, gender and text period. The severity of multiple allergy can be measured by Multiple Allergens Positive Score.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Allergens ; analysis ; immunology ; Child ; Child, Preschool ; China ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; diagnosis ; immunology ; Skin Tests ; Young Adult

Microcalcifications are among the most common imaging findings of breast cancer. This article reviews the recent liter-ature regarding the foci of microcalcifications in breast cancer. In particular, we summarize the composition, formation mechanism, and biopsy method of the microcalcifications;the relationship between the foci and clinicopathologic indicators;and the influence of neoad-juvant chemotherapy on the foci.

OBJECTIVE:To investigate the characteristics and regularity of adverse drug reaction (ADR) in a third grade class A hospital,and to provide reference for rational drug use in clinic. METHODS:A total of 813 cases of ADR reported to Na-tional ADR Monitoring by the hospital during 2013-2015 were summarized and analyzed retrospectively in terms of age,gender,route of administration,drug type,organs or systems involved in ADR,clinical manifestation and outcome. RESULTS:Among 813 cases of ADR,there were 391 male (48.09%) and 422 female (51.91%). Patients aged more than 60 were with high inci-dence of ADR,involving 347 cases(42.68%). Among routes of administration,most ADR cases were caused by intravenous ad-ministration,involving 747 cases (91.88%). Among all drug types,the number of ADR cases caused by anti-infective drugs was the most,involving 382 cases(46.99%);cephalosporins took up the highest proportion,being 38.22%(146 cases). Organs or sys-tems involved in ADR were mainly skin and its appendants,involving 434 cases (53.38%). CONCLUSIONS:ADR monitoring should be strengthened for elderly patients receiving anti-infective drugs intravenously so as to reduce the occurrence of ADR and guarantee medication safety.

OBJECTIVE To ensure safe operation of medical equipment through raising procurement staffs′ awareness of safety and quality control in the process of purchasing medical equipment and exerting fine control of safety and quality throughout procurement. METHODS To sum up regulations,rules and ways on the safety and quality control at all links in the process of purchasing.RESULTS The acceptance rate of quality inspection of introduced medical equipment was 100% and the operating rate of equipment for the annual working hours was 95%.In 2002,our work together with other departments work in our hospital passed the proof of ISO9000. CONCLUSIONS They can not keep hidden safety perils of medical equipment outside the gate of the purchasing and can not ensure the safe operation of medical equipment and its vital role in every medical activity,unless purchasing staffs observe all purchasing regulations and rules and exert fine control of safety and quality of the purchasing.