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.

As the change of concept of health,the aim of medicine is not only to prolong life and improve the function of organs,but also to help patients to integrate to social life.Previous studies always pay much attention to clinical outcomes ineluding mortality,morbidity,long-term or short-term survival,but patients with liver cancer usually have long disease history and with background diseases such as liver cirrhosis.Traditional liver transplantation and liver resection ale both effective modalities for liver cancer,but liver resection has disadvantages of hish recurrence rate and repeated hepatic artery interventional therapy,and liver transplantation is high-cost.So the health economics and life quality of patients should not be ignored when comparing liver transplantation and liver resection.

AIM: To compare the therapeutic effects, adverse reactions and the costs between recombinant human growth hormone(rhGH) and human serum albumin(HSA) in treatment of liver cirrhosis patients with hypoproteinemia METHODS: Using pharmacoeconomic cost-effectiveness analysis , rhGH was compared with HSA in treatment of 66 liver cirrhosis patients with hypoproteinemia(divided into two groups). RESULTS:After 4 weeks treatment, the effective rates of rhGH and HSA we- re 69.70% and 84.85%, the cost-effectiveness ratios were 27.36, 38.89, respectively. After 8 weeks treatment, the effective rates of rhGH and HSA were 78.79% and 54. 57% ,the cost-effectiveness ratios were 2420, 60.47, respectively. CONCLUSI- ON: rhGH can effectively treat liver cirrhosis with hypoproteinemia and can obviously increase serum albumin level. From a Long-term point of view, its cost effectiveness ratio is superior to that of HSA.

0 05),the cost-effectiveness ratios were 762 49 and 111 85 respectively(P

This paper demonstrated the importance of Homocysteine detection. It was proved that Hyperhomocysteinemia has the evident relationship to the Cardiovascular and cerebrovascular diseases and homocysteine is a new independent factor of danger and prediction, and more attentions should be given on homocysteine in clinic. As regard to the situation that Homocysteine detection has not been popularly used in China, the authors give some advice in homocysteine detection, such as: population choosing, normal range defining, quality insurance and so on.

ve To evaluate the effects of desflurane and sevoflurane on postoperative cognitive function in the elderly to see if there is any difference. Methods Seventy ASA Ⅰ-Ⅱ patients agedl≥65yr undergoing total knee or hip replacement were randomly assigned to one of the two anesthetic groups of thirty-five patients each:desflurane group and sevoflurane group. All patients were premedicated with midazolam 1 mg iv. Anesthesia was induced with fentanyl 1.0-1.5?g?kg-1, propofol 1.0-2.0 mg?kg-1 and succinylcholine 1 mg?kg-1 and maintained with either 2%-4% desflurane or 1.0%-1.5% sevoflurane combined with N2 O in O2 (1:1) and intermittent iv boluses of vecuronium. MAP, HR, ECG, SpO2, PETCO2 and end-tidal concentration of desflurane or sevoflurane were monitored continuously during operation. After tracheal intubation the patients were mechanically ventilated and PETCO2 was maintained at 30-40 mm Hg. The Mini-Mental State (MMS) test was used to assess cognitive function before and at 1, 3, 6 and 24h after surgery. Results Compared with the baseline values the MMS scores decreased significantly at 1h after operation in both groups. However the MMS scores returned to preoperative baseline levels within 6h after surgery in both groups. There were no significant differences in MMS scores between the two groups before and after operation. At 1h after operation 51% of the patients in desflurane and 57% in sevoflurane group experienced cognitive impairment. But at 3h after surgery the percentage of the patients with cognitive dysfunction decreased to 11% in desflurane group and 9% in sevoflurane group. Conclusions In the elderly the postoperative cognitive dysfunction is temporary lasting only a few hours and the effects of desflurane and sevoflurane are similar.

Objective To study the expression of the fibronectin (FN) and ? 1 integrin (? 1) in epiretinal membranes(ERM) of eyes with proliferative vitreoretinopathy(PVR). Methods Twenty epiretinal membranes were obtained from eyes undergone vitrectomy for retinal detachment complicated with PVR and observed by immunohistochemical methods. Results Overexpression of FN and ? 1 were observed in 18 and 16 membranes respectively. Conclusion The synergism of FN and ? 1 in their action mignt be one of the important roles in the development of PVR.

ObjectiveTo explore the surgical techniques, efficacy and the management of complicated ocular trauma with anterior-posterior segment complications such as cyclodialysis. Methods Fifty-five patients (55 eyes) with complicated ocular trauma were enrolled in this study. Among them, there were 35 cases with eyeball contusion and 20 cases of eyeball rupture. Preoperative visual acuity was from no light perception to 0. 15, intraocular pressure (IOP) ranged from one to 10 mm Hg (1 mm Hg=0. 133 kPa).Cyclodialysis, vitreous hemorrhage or retinal detachment were revealed by B-ultrasound and ultrasound biomicroscopy (UBM). Cyclodialysis clefts ranged from one to 12 clock-hours. All patients underwent 3-port pars plana vitrectomy with gas/silicone oil tamponade and ciliary body reattachment by cryotherapy (cyclodialysis clefts ≤ three clock-hours) or suture fixation ( cyclodialysis clefts ＞ three clock-hours).Healing after surgical trauma, visual acuity, intraocular pressure, intraocular hemorrhage, ciliary body and retinal reattachment were followed up. Results In one month after surgery, UBM showed 54 patients out of 55 patients had good ciliary body reattachment. Gonioscopy revealed cyclodialysis still existed in one patient, and this was cured by a second surgical suture fixation. In three months after surgery, ocular trauma healed in all 55 patients, the visual acuity ranged from no light perception to 0. 15, with a best corrected visual acuity of 0.8. The ciliary body and retina had good reattachment. IOP of 52 patients was normal; IOP of three patients was still lower than 10 mm Hg. Three patients had secondary glaucoma which was treated by glaucoma surgery. Conclusions Complicated ocular trauma with cyclodialysis can be treated with vitrectomy and cryotherapy or transscleral sutures. The procedure is safe and effective.

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 evaluate the clinical application of ultrasonic integrated backscatter(IBS) parameters and assess the lesion of myocardium in patients with different left ventricular geometric patterns.Methods Four groups were analyzed according to left ventricular mass index and relative wall thickness in 146 essential hypertensive patients,including group 1(n=64),group 2(n=18),group 3(n=20),group 4(n=44).Myocardial IBS,normalized IBS (IBS%),cyclic variation of IBS(CVIB) and transmural gradient of IBS(TGIB) of interventricular septum(IVS) and post wall(PW) were measured in 4 groups and 32 normal control subjects.Results Among the four groups,IBS% of IVS and PW were the highest in group 3 ( 53.6%? 9.8%, 52.8%? 8.3%,respectively) and next higher in group 2 ( 49.8%? 7.2%, 49.6%? 9.0%,respectively) and group 4 ( 49.0%? 7.7%, 48.9%? 8.2%,respectively),and was low in group 1 ( 42.3%? 8.4%, 41.8%? 9.1%,respectively) (P