Objective To investigate the effect of desflurane anesthesia on the autonomic nervous system in patients at high risk for coronary artery disease.Methods Thirty patients at high risk for coronary artery disease scheduled for elective abdominal operation were selected. Heart rate variability (HRV) was assessed at preoperation, inhalation of 05,10,15 and 20 MAC of desflurane with Holter electrocardiography Results Low-frequency component increased markedly inhaling low concentration of desflurane. With the increase of the concentration of desflurane, both the high-frequency and low-frequency components decreased significantly (P0 05).Conclusions Desflurane balanced anesthesia dose not increase the activity of sympathetic nervous system.

Objective:To explore the propagable experience and methods of controlling the rate of cesarean sec-tion through the summary of the innovative measures in four counties. Methods:The cases of natural birth and cesare-an section from 2009 to 2013 in four counties were analyzed respectively. The interventions of controlling cesarean section rate have been summarized. Results:The average cesarean section rate of four counties in five years is on the decline, since 2009 the rate were 60. 2%,62. 3%,59. 3%,51. 4%,48. 1%. Conclusions: The interventions really worked, but did not do the best. Improving the social attention on these innovative measures, strengthening surveil-lance mechanism, regulating the medical behaviors of delivery hospitals, enhancing the midwifery training and promo-ting the interventions under the coordination of local government can further reduce the rate of cesarean section.

Long-term tachycardia may cause tachycardiomyopathy(TCM),clinical manifestation is similar to the dilated cardiomyopathy.But,after treatment,cardiac function can be partially or completely recovered.By the explanation of definition,etiology,pathogenesis,diagnosis and treatment progress of TCM,the aim of the thesis is to enrich the knowledge of clinician about the diagnosis and treatment of TCM.

Toxoplasma gondii is a globally distributed Apicomplexan Protozoa which can infect all warm-blooded animals and cause serious diseases in immunocompromised host.More attention has been paid to wide distribution and opportunistic pathogenesis of T.gondii.This paper is summarized the history,the lastest hotspots in Toxoplasma and future challenges in toxoplasmosis control.

Objective To study the difference of Han male children and adolescent bone age of wrist-hand in Beijing and Guangzhou.Methods Bone age (BA) of left hand-wrist was assessed using X-ray by two radiologists based on CHN atlas method in 993 healthy children and adolescents (age range:1.0-19.0 years).The radiologists were blinded to the chronological age (CA) of those children.The interobserver variations were analyzed for evaluating the reliability of CHN Atlas method.The difference between CA and BA were separately assessed,and were analyzed by t test.Results Close correlation was found between BA and CA (r =0.969,0.957,P ＜ 0.01) in both two regions.The bone age was advanced at 1.0-3.9,and 7.0-15.9 years in Beijing boys,and at 1.0-2.9,6.0-7.9 years in Guangzhou bpys.There was significant difference at 1.0-1.9,9.0-14.9 years between Beijing and Guangzhou.Conclusions The bone age of Han male children adolescent in Beijing and Guangzhou area has the characteristic of acceleration.There is significance difference at some years between Beijing and Guangzhou,and the results can provide potential value for the further study of BA and clinical medicine.

Objective To investigate the effectiveness and safety of endovascular coiling and microsurgical clipping for ruptured intracranial aneurysms. Methods Patients w ith ruptured intracranial aneurysm treated w ith endovascular coiling or microsurgical clipping w ere enrol ed retrospectively. The demography, baseline clinical data, outcome, and complications in patients received endovascular coiling and microsurgical clipping w ere compared. Results A total of 85 patients w ith ruptured intracranial aneurysm were enroled, including 40 were treated with microsurgical clipping (surgical clipping group) and 45 were treated w ith endovascular coiling (endovascular coiling group). There w ere no significant differences in the proportions of the patients in male (37.5%vs.40.0%; χ2 =0.056, P=0.813), hypertension (30.0%vs. 33.3%; χ2 =0.109, P=0.742 ), smoking ( 50.0%vs.48.9%; χ2 =0.010, P=0.918 ), drinking (45.0%vs.46.7%; χ2 =0.024, P=0.878), aneurysm site (anterior communicating artery: 50.0%vs. 48.9%;posterior communicating artery:35.0%vs.33.3%; middle cerebral artery:10.0 %vs.11.1%;vertebral artery: 5.0%vs.6.7%; al P>0.05), aneurysm maximum diameter < 10 mm (80.0%vs. 77.8%;χ2 =0.063, P=0.802), Hunt-Hess grade 1-2 (55.0%vs.57.8%; χ2 =0.066, P=0.797), Fisher grade 1-2 ( 60.0%vs.57.8%; χ2 =0.043, P=0.835 ), and time from onset to treatment < 72 h (62.5%vs.64.4%; χ2 =0.035, P=0.853) in the surgical clipping group and endovascular coiling group. There w ere no significant differences in the complete occlusion rate of aneurysms ( 97.5%vs.91.1%;P=0.364) and the good outcome rate (65.0%vs.68.9%; χ2 =0.145, P=0.703) betw een the surgical clipping group and the endovascular coiling group. No patients died in the surgical clipping group and 1 patient died in the endovascular coiling group, and there w as no significant difference ( P=1.000). One patient (2.5%) had cerebral infarction in the surgical clipping group and no patients had cerebral infarction in the endovascular coiling group, and there w as no significant difference ( P=0.471). Conclusions The efficacy and safety of microsurgical clipping are the same as those of endovascular coiling for ruptured intracranial aneurysms.

Objective To evaluate the effect of preoperative intramuscular injection of of dextromethorphan in three dosages on fentanyl consumption in postoperative PCA in order to optimize its pre-emptive analgesia dose. Methods 80 ASA Ⅰ-Ⅱ patients underwent spine operations under general anesthesia were randomly divided into four groups, who respectively received intramuscular dextromethorphan 10mg (DM10 group), 20mg (DM20 group), 40mg (DM40 group), or normal saline (CON group) respectively. The PCA fentanyl consumption as well as VAS pain scores were observed 4h, 24h, and 48h after the operation. Results Although there was no significant differences in pain VAS score between the four groups, the fentanyl consumption was significantly lower in groups DM20 and DM40 compared with group CON and DM10. However, there was no significant difference between group DM20 and group DM40. Conclusion Preoperative IM dextromethorphan shows a dose-dependant fentanyl spare effect on postoperative PCA, and a dose of 20mg seems to be optimal for preoperative use.

ObjectiveTo evaluate magnifying endoscopy combined with flexible spectral imaging color enhancement(FICE)for diagnosis of early gastric cancer.MethodsThe suspicious small depressive lesions(SDL) was further studied with magnifying endoscopy or magnifying endoscopy combined with FICE from April 2009 to March 2011 in our hospital.The endoscopic diagnostic criteria of early gastric cancer was made according to the structure of the pit,the microvascular and the demarcation line.ResultsIn 74 SDL,17 were pathologically diagnosed as cancer,and 56 were noncancer.The sensitivity,specificity and accuracy of magnifying endoscopy were 41.18％,94.74％and 82.43％,respectively,which were 86.67％,96.49％ and 91.89％,respectively for magnifying endoscopy combined with FICE.The diagnostic sensitivity of magnifying endoscopy combined with FICE was significantly higher than that of magnifying endoscopy (P ＜0.05 ).ConclusionMagnifying endoscopy combined with FICE can reveal the structure of the pit,microvascular and demarcation line more clearly.The endoscopic diagnostic criteria is a more comprehensive description of the mucosal micro-morphological features of early gastric cancer.

Objective:To prepare and identify the monoclonal antibody against hPPAR?2.Methods:cDNA of hPPAR?2 was obtained from pMD18-T/hPPAR?2.hPPAR?2 was expressed in prokaryocyte and purified successfully.The anti-hPPAR?2 monoclonal antibodies (mAbs) 1B4,3H2,3H10,10D6 and 10D8 were produced by immunization with purified hPPAR?2.The specificity of the antibodies was identified by ELISA,Western blot assay and immunocytochemistry.Results:Five novel murine monoclonal antibodies only against hPPAR?2 were harvested,and they were all specific to hPPAR?2.Conclusion:The antibodies obtained provide more useful tools for following research and settling the basis for screening new drugs and mechanism.