ObjectiveTo investigate the application of remifentanil and etomidate target controlled infusion anesthesia in operation for esophageal cancer and observe its effects on hemodynamics.Methods Sixty patients of esophageal cancer were divided into control group and observation group by random digits table with 30 cases each.The observation group was given remifentanil and etomidate for induction of the general anesthesia,while the control group was given remifentanil and propofol.The changes of mean arterial pressure(MAP),heart rate(HR),postoperative spontaneous breathing recovery time,waking time,extubation time were observed.ResultsMAP after induction was lower than that lying for 10 minutes after entering operating room in two groups (P ＜ 0.05),and observation group was lower than control group (P ＜ 0.05).MAP,HR after 5 minutes extubation were higher than those lying for 10 minutes after entering operating room(P ＜ 0.05 ),and observation group was higher than control group (P ＜ 0.05 ).The postoperative spontaneous breathing recovery time,waking time,extubation time in observation group [ (5.3 ± 1.5 ),(6.4 ± 2.1 ),(8.4 ± 2.5 ) min ] were shorter than those in control group [ ( 16.9 ± 8.7 ),(21.3 ± 7.7),(23.7 ± 5.8)min],and there were significant differences (P ＜0.05).ConclusionRemifentanil and etomidate target controlled infusion anesthesia in operation for esophageal cancer can maintain the stability of blood concentration and hemodynamics,shorten the recovery time,and improve the quality of anesthesia recovery and safety.

Objective To study the combination effectof curcumin and γray on the activity of human lung carcinoma NCI-H460 cells and explore the sensitization of curcumin to γray.Methods The NCI-H460 cells proliferation were detected by MTT,the cell cycle and apoptosis by flow cytometry.The expression of Bcl-2 and Bax were detected by Western Blot and the NF-κB gene expression by RT-PCR.In addition,the mice model of lung cancer was randomly divided into 4 groups:control group,curcumin group,γ ray group and combination group.After 28 days,the tumor volume was measured.Results The proliferation and cell cycle of NCI-H460 cells were inhibited and the apoptosis was increased in combination group.In addition,compared with curcumin group or γray group,the expression of Bcl-2 was inhibited,but the expression of Bax was increased and the mRNA expression of NF-KB was inhibited in combination group(all P＜0.05).Also in combination group the tumor volume was significantly inhibited compared with curcumin group or γ ray group(all P＜0.05).Conclusion Curcumin might induce the radiosensitivity of Human Lung Carcinoma NCI-H460 cells through the pathway.

Multidisciplinary team(MDT)diagnosis and treatment of colorectal cancer has been adopted by plenty of hospitals as a kind of effective comprehensive therapy.Compared with the traditional diagnosis and treatment methods,MDT diagnosis and treatment achieve standardization of diagnosis and treatment and technical promotion through specialization of the team to ensure better treatment and prognosis of patients.However,MDT diagnosis and treatment of colorectal cancer is not perfect,which can be limited by two aspects of hospitals and patients and can realize maximum utility with knowledge of its characteristics.This article will try to explore the distribution and usage of the resource in MDT diagnosis and treatment of colorectal cancer,the advantages over the traditional cure methods and the limits.

Osteoporosis is a common metabolic bone disease in the aging population society. The incidence is increasing during these years. Elderly people especially postmenopausal women are of greatest susceptibility. Fracture and other complications caused by osteoporosis may affect patients' life span and the quality of life. It also increased medical costs. The principles of managing osteoporosis are understanding the risk factors and susceptible population; appropriate evaluating bone mass and multidisciplinary approach. The present paper reviewed the update of epidemiology, pathophysiology, risk factors, evaluation methods and management of this disease.

[Objective]To report the treatment and outcome of treatment of discoid lateral meniscal tear by arthroscopic surgery.[Method]During the period between Jan.1999 and Jun.2005,77 patients suffered from discoid lateral meniscal tear have been treated by arthroscopic surgery in Xijing Hospital. The standard arthroscopic portals (anteromedial and anterolateral)were used.Lateral menisci were totally removed in the 21 patients (29.2%) of total 77 cases,whereas lateral menisci of 13 patients (18.1%) were removed partially and meniscus-plasty was applied in 38 patients (52.8%).Thirty-nine (54.2%) of 77 patients were males,and 33 (45.8%) females.Their average age was 29.4?10.9 years (range 8~51 year).Five patients were lost in follow-up.The mean follow-up period of the rest 72 patients was 26.2 ?9.3 months (range 12~44 months).The patients were assessed pre-operationally and post-operationally by the Lysholm score.Moreover,the results of Lysholm score were analyzed by student-t test.[Result]All patients had progress in pain,swelling,range of motion and knee function. No complication,which included intraarticular infection,iatrogenic injury,fibroarthritis or loss of range of motion,was found.Lysholm score was 66.8?5.2 in average (range from 50 to 78) before operation,whereas it improved to 96.4?3.6 in average (range from 85 to 100) after operation.According to student-t analysis,very significant statistical difference was found between the pre-operative and post-operative results (t=34.7,P

Objective To solve the hemodialysis in patients at risk for bleeding. Methods A 1.6 mol/L trisodium citrate solution, a standard calcium-containing bicarbonate dialysate and a standard hollow fiber capillary dialyzer were used. Results 72 dialysis were performed successfully with this technique on 6 stable and 17 high bleeding risk patients. Systemic anticoagulation didn't occur as a result of any dialysis procedure, and in no instance bleeding was observed. No severe dialyzer clotting was observed. There was a significant decline in whole blood ionized calcium during citrate dialysis (0.981?0.11 vs 0.907 ?0.12 mmol/L, P

Advances in hepatic surgical technique,perioperative care and improvements in patient selection criteria have increased the number of patients who could undergo major or extended hepatectomy with curative intent.Posthepatectomy liver failure (PHLF) is one of the most serious complications after liver resection.Different risk factors are related to the occurrence of PHLF,among surgery-related factors,massive bleeding and remnant liver volume were related to higher frequency of PHLF.The presence of diabetes and liver disease such as cirrhosis,cholestasis,steatosis had been involved with the occurrence of PHLF.So far there is no good method for the treatment of PHLF,so prevention is very important.

Objective To evaluate the efficacy and safety of ultrasonography-guided percutaneous nephrolithotomy(PCNL).Methods Between May 2006 and June 2008,110 patients underwent PCNL by a single urological team at our hospital.The clinical data of the patients were retrospectively reviewed.Of the cases,supracostal access(the 11th intercostal space) was made in 62 patients(supracostal group),and subcostal access was obtained in 48 patients(subcostal group).Forty-five patients in the supracostal group(45/62) and 36 of the subcostal group(36/48) received CT three dimensional reconstruction.Results The stone free rate of the supracostal group was 72.6%(45/62),while that of the subcostal group was 60.4%(29/48;?2=1.818,P=0.178).The mean operation time of the supracostal group was(78.6?5.1) min,while that of the subcostal group was(102.4?7.1) min(t=-20.454,P=0.000).There was one patient in each group received blood transfusion.One patient in the supracostal group had pneumothorax and recovered uneventfully by conservative treatments.Conclusion Ultrasonography-guided PCNL via the supracostal approach is effective and safe with short operation time.

0.05). Of 98 cagE positive isolates, 14(14.3%) were cagA negative. Conclusion Most of the H. pylori isolates in Shanghai region may have intact cag PAI. cagE, could be taken as the marker for the presence of cag PAI. There is no correlation between the integrality of cag PAI and the clinical outcome of H. pylori of infection.

Objective To evaluate the learning curve in percutaneous nephrolithotomy under the guidance of B ultrasonography.Methods From January 2006 to July 2007,totally 60 cases of percutaneous nephrolithotomy were performed under the guidance of B ultrasonography by a single urologist.The patients were divided into 6 groups according to the date of the operation(10 cases in each).The time for setting the renal access and the stone-free rate were compared among the groups.Results The time for setting the renal access was(15.0?2.7),(14.0?2.1),(10.2?1.2),(5.8?0.7),(7.5?1.2),and(6.6?0.9)minutes respectively in group 1 to 6.ANOVA analysis showed significant difference among the groups(F=5.734,P=0.000).Significant difference was detected between groups 1 and 4(q = 5.655,P