0.05),but the total of propofol was different(P

Objective:To study the clinical benefit of propofol anesthesia with target-controlled influsion technic modulated by cerebral state index in the elderly patients with tumor. Methods:A total of 126 ASA Ⅰ or Ⅱ aged65 yrs or older patients underwent gastrectomy and rectal surgery were randomly divided into tow groups(n=63 each):group by target-controlled influsion technic modulated(groupⅠ)and group by target-controlled influsion(groupⅡ). CSI of groupⅠwas 50. Propofol of two groups was administered by TCI at a target blood concertration of 2?g/ml during induction of anesthesia and maintenance of anesthesia,sufentanil of two groups was administered by TCI at a target blood concertration of 1.5?g/ml during induction of anesthesia and of 0.3ng/ml during maintenance of anesthesia. MAP,HR,HRV and CSI of the foundation(T1),intubation(T2),five minutes after intubation(T3),chip(T4),the tumor excision(T5) and the end of surgery(T6) were recorded. And the total of propofol was recorded. Results:MAP at T3,T4 and T5 of groupⅡdecreased obviously compared to that of groupⅠ(P

The present study was performed to investigate the relationship between the countercurrent of portal vein and intrahepatic cancerometastasis in patients with hepatic carcinoma under color Doppler flow imaging.To display the situation of portal carcinomatous thrombosis and intrahepatic cancerometastasis, two dimensional ultrasound was carried out in patients with hepatitis hepatocarcinoma and non hepatitis hepatocarcinoma. Also, color Doppler flow imaging was employed to examine the incidence of the pylic countercurrent and the portal vein hepatic artery fistula in four groups: hepatitis hepatocarcinoma group, non-hepatitis hepatocarcinoma group, hepatocirrhosis group and control group. The results showed that the incidences of portal carcinomatous thrombosis,intrahepatic cancerometastasis and the incidences of the countercurrent in portal vein were higher in hepatitis hepatocarcinoma group than those in non hepatitis hepatocarcinoma group ( P

OBJECTIVE:To find out a cost-efficient antibiotic prophylaxis of p ul monary and esophageal surgery by way of pharmacoeconomic analysis METHODS:To c ompare the efficacy and cost between short-term and long-term of prophylactic uses of ceftriaxone in pulmonary and esophageal surgery by randomized controlled study and cost-effectiveness analysis RESULTS:Single-dose ceftriaxone regim en and four-dose ceftriaxone regimen were equally effective in preventing posto perative infections in pulmonary and esophageal surgery,the average cost per pa tients for single-dose ceftriaxone regimen(1 257 84?769 67)yuans was signi ficantly lower than that for four-dose ceftriaxone regimen(1 786 69?652 83 ) yuans,P

Objective To study causes of deterioration of sudden mydriasis in craniocerebral trauma patients with normal intracranial pressure and verify the efficiency of specific treatments.Methods A retrospective analysis was performed on causes of four cases of accidental mydriasis in normal intracranial pressure among 473 cases of craniocerebral trauma treated from June 2008 to March 2012.Changes of patients' condition and monitoring indices were observed after specific treatments.Results Abnormal mydriasis with synchronously normal intracranial pressure was largely due to sufficient decompression after a certain period of intracranial hypertension and persistence of brain perfusion pressure to more than 110 mm Hg or due to high cerebral perfusion pressure caused by redundant drainage of cerebrospinal fluid or low intracranial pressure (＜ 10 mm Hg),together with factors like low plasma osmotic pressure and carbon dioxide accumulation.The study showed that the intracranial pressure was maintained normal,that the brain swelling took a turn for better,that medical condition were stabilized and that pupil returned to normal in the four cases after treatment with specific protocol.GOS was four points in three cases and five points in one during follow-up at six months postoperatively.Conclusion Incidence of mydriasis with normal intracranial pressure in craniocerebral trauma patients can be efficiently declined through reduction of peripheral blood pressure,perfusion pressure controlling,hypertonic remedy maintenance and brain edema relief.

To explore the value of acoustic radiation force impulse (ARFI) technique in the differential diagnosis of benign and malignant hepatic neoplasms.Retrospective analysis of touch tissue quantification (VTQ) and general ultrasonic examination of interesting region were performed for hepatocellular carcinoma (HCC),hepatic hemangioma,focal nodular hyperplasia (FNH) and controls.Significant differences existed between HCC and hepatic hemangioma,hepatic FNH and controls (all P ＜0.01).No significant difference existed between primary and metastatic HCC (P ＞ 0.05).There was no significant difference between hepatic hemangioma,FNH and controls (all P ＞ 0.05).With a cut-off VTQ value of 1.95 m/s,the sensitivity and accuracy rate in the differentiation of benign and malignant hepatic neoplasms was 90％ and 83％ respectively.The sensitivity and accuracy rate in general ultrasound examination of hepatic neoplasms was 88％ and 70％ respectively.Significant differences existed in accuracy rate between two methods (P ＜ 0.01).It was confirmed that ARFI could reflect the stiffness of liver neoplasm noninvasively.Compared with general ultrasonography,ARFI is better at differentiating benign and malignant hepatic neoplasms.

Objective: To explore the effects of peritoneal dialysis on acute renal insufifciency and on relevant blood indicators in children with congenital heart disease (CHD) after the operation.
Methods: A total of 48 CHD patients received direct open heart surgery by cardiopulmonary bypass and suffered from post-operative acute renal insufifciency in our hospital from 2011-12 to 2014-12 were retrospectively analyzed. The patients were divided into 2 groups: Peritoneal dialysis group and Routine medication group,n=24 in each group. The differences of renal function indexes, the blood levels of electrolyte and inlfammatory factors were compared between 2 groups.
Results: Compared with Routine medication group, the patients in Peritoneal dialysis group presented decreased serum critinine, BUN and urine β2-micro globulin, 24-hour protein level,P<0.05; decreased blood K+ level and increased blood levels of Ca2+, HCO-3P<0.05; decreased plasma levels of hs-CRP, TNF-α, IL-6,P<0.05. The cure rate and mortality in Peritoneal dialysis group were better than those in Control group,P<0.05. No long term complication related to peritoneal dialysis was found.
Conclusion: Peritoneal dialysis may improve the renal function in CHD patients with post-operative acute renal insufifciency and optimize the blood levels of electrolyte and inlfammatory factors.

Objective To evaluate the influence of precise liver resection techniques on intestinal permeability in the diseases needing liver resection.Methods Eighty-seven patients needing liver resection were randomized to receive the precise liver resection (n =58,PLR group) or the conventional liver resection (n =29,CLR group).D-lactate and and endotoxin in abdominal fluid were detected in all the patients.The abdominal fluid bacteria cultures were performed.Results The postoperative hospitalization time,the needed time of blood routine,temperature,and oppetite resuming were significantly shorter in PLR group than those in CLR group (t ≥7.36,P ＜ 0.01) ; The postoperative abdominal effusion was significantly less in PLR group than that of CLR group(t ≥ 14.17,P ＜0.01).The abdominal fluid concentrations of D-lactate and endotoxin in operation or at 1d after operation were significantly higher than those at 5d after operation in both groups(t ≥10.41,P ＜0.01).Those parameters decreased significantly at 2d after operation,returned to the normal level at 3d after operation in PLR group,and those parameters were significantly lower in PLR group than those in CLR group at the same time phase after postoperative 2 or 3 days (t ≥9.23,P ＜0.01) ; Those parameters began to drop at 3d after operation,returned to the normal level at 5d after operation in CLR group.The positive rate of abdominal fluid bacteria cultures was significantly lower in PLR group than that in CLR group(13/29) (x2 =23.51,P ＜ 0.01).Conclusions The precise liver resection techniques had an important influence on intestinal permeability in the diseases needing liver resection.

ObjectiveTo retrospectively analyze the experience in the treatment of cardiac rupture caused by blunt chest trauma and to explore the approaches and methods to improve patient survival.Methods From 2004 to 2010,16 cases of closed chest trauma caused by cardiac rupture,who were treated in our hospital,were treated by heart repair using median sternotomy incision approach.Results Except for 1 patient occurred cardiac arrest before the establishment of CPB,who was failed for cardiopulmonary resuscitation after surgical repair,the remaining 15 patients were all successfully treated.Conclusion The diagnosis of cardiac rupture should be made as soon as possible once it occurs.Timely and decisive rescue and emergency surgery should be given.Heart repair can greatly improve the patient's survival.

ObjectiveTo investigate the changes in stroke volume variation (SVV) monitored by FloTrac/Vigileo system during mechanical ventilation in patients undergoing pulmonary lobectomy.MethodsForty-four ASA Ⅰ or Ⅱ patients aged 44-64 yr weighing 47-86 kg undergoing elective pulmonary lobectomy performed under general anesthesia were studied.Blood volume was maintained by fluid (crystalloid∶ colloid 1∶1) infusion at a rate of 6-8 ml·kg-1 ·h-1.Cardiac output index (CI),stroke volume index (SVI) and SVV were measured based on arterial pressure wave form analysis by FloTrac/Vigileo System (Edwards Co.,USA) and recorded at following time points:at 5 min of two-lung ventilation (TLV) in supine position,2 min TLV in lateral position,during one-lung ventilation (OLV) before thoracotomy,at 5 and 30 min of OLV after thoracotomy,1 and 15 min OLV + PEEP of 5cm H2 O,before and immediately and 1 min after reflation of the remaining lobes.The normal value for SVV is less than 13％.ResultsThe hemodynamic parameters were stable during lobectomy.CI and SVI were within normal range.SVV was less than 13％ at all time points except that at immediately after reflation of the remaining lobes.ConclusionSVV obtained with FloTrac/Vigileo system can be used to guide fluid therapy during OLV in mechanically ventilated patients undergoing pulmonary lobectomy.