Objective To evalutate the effects of different doses of sufentanil combined with low target plasma concentration of propofol for induction of anesthesia on hemodynamics in patients undergoing coronary artery bypass grafting using Swan-Ganz catheter.Methods Fifty ASA physical status Ⅱ-Ⅲ patients (NYHA Ⅱ or Ⅲ) patients,aged 45-64 yr,with body mass index ≤ 30 kg/m2 and left ventricular ejection fraction (LVEF) ≥ 50 ％,scheduled for elective coronary artery bypass grafting,were randomly assigned into 2 groups (n =25 each) using a random number table:sufentanil 0.5μg/kg group (group S1) and sufentanil 1.0 μg/kg group (group S2).Central venous catheter and Swan-Ganz catheter were all placed via the right jugular vein before induction of anesthesia.Anesthesia was induced with iv injection of sufentanil 0.5 μg/kg (group S1) or 1.0 μg/kg (group S1),and 60 s later propofol was given by target-controlled infusion (target plasma concentraion 2 μg/ml).Rocuronium 0.8 mg/kg was administered when consciousness was lost.The patients were endotracheally intubated and mechanically ventilated.Before induction (T1),immediately after loss of consciousness (T2),immediately before intubation (T3),and immediately after intubation (T4),HR,mean artery pressure monitoring (MAP),central venous pressure (CVP),pulmonary arterial wedge pressure (PAWP),cardiac index (CI),stroke volume index (SVI),systolic vascular resistance and mixed venous oxygen saturation (Sv-O2) were recorded.The development of adverse cardiovascular events was recorded during induction of anesthesia.Results Compared with the baseline value at T1,the MAP and systolic vascular resistance were significantly decreased at T3 in group S2 (P ＜ 0.05),and no significant changes were found in the parameters of hemodynamics at T2-4 in group S1 (P ＞ 0.05).Compared with group S1,the MAP was significantly decreased at T3 and the incidence of hypotension was increased in group S2 (P ＜ 0.05).Conclusion For the patients undergoing coronary artery bypass grafting,the optimum dose of sufentanil for induction of anesthesia is 0.5 μg/kg when combined with low target plasma concentration of propofol.

Objective To compare the consistency of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in detecting c-erbB-2 status in breast cancer tissues. Methods A total of 50 breast cancer paraffin embedded samples were selected, of which there were 10 cases of c-erbB-2 protein expression (+), 20 cases of (++) and 20 cases of (+++). FISH was used to assess the amplification of c-erbB-2 gene, and SPSS 13.0 software was employed to analyze the difference and consistency between the two methods. Results IHC and FISH methods had a good consistency when detecting c-erbB-2 (+) and (+++) expressions in breast cancer tissues, with the coincidence rate of 89.2%. However, when IHC was used to test c-erbB-2 (++), the result of FISH was quite different, with the coincidence rate of only 35.3%. Conclusion IHC is a preliminary method to detect c-erbB-2 status in breast cancer. IHC and FISH methods have a good consistency in detecting c-erbB-2 (+) and (+++) status in breast cancer tissues. As detection of c-erbB-2 (++) with IHC has a different result from FISH, such patients should receive FISH confirmation for herceptin therapy.

OBJECTIVE: To investigate the clinical characteristics of nasopharyngeal teratomas (NPT), improve the diagnosis and treatment of the disease. METHOD: We reported a 14 years old girl with NPT, and reviewed the literatures. RESULT: NPT was transorally expected under nasal endoscope, no recurrence was found over a 5 year follow-up. CONCLUSION NPT is rare,the diagnosis of the disease relies on clinical manifestations, imaging and pathological examination. Transoral endoscopic surgery is an effective method of treatment.
Adolescent ; Female ; Humans ; Nasopharyngeal Neoplasms ; Teratoma

Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.