Objective To observe the effect of propofol of dento-anaesth dosage on prevention of emergence ngitatian(EA). Methods Forty ASA Ⅰ-Ⅱ patients, aged 32-56 years old and undergoing elective laparoscopic cholecystectomy, were randomly divided into two groups, propofol group (group P, 20 cases) and control group (group C, 20 cases). Anesthesia was induced intravenously with 0.1 mg/kg midaxolam, 1.0 mg/kg propofol, 2 μg/kg fentanyl and 0.15 mg/kg vecuronium. Anesthesia was maintained by intravenous and inhalation combined anesthesia. Vecuronium was discontinued about 15 min before the end of sur gery. After entered the postoperative care unit, patients in group P received propofol (0.5 mg/kg) and those in group C were administrated with normal saline (0.05 ml/kg). Time to recovery of spontaneously breathing, duration of opening eyes on verbal command, extubation time were recorded. Incidence of EA in both groups was calculated. Results Time to recovery of spontaneously breathing, duration of opening eyes on verbal com-mand and extubatian time in group P [(15.6±4.5), (18.2±6.5), (22.6±5.5) min, respectively] were sig-nificantly longer than those in group C[(13.2±5.4), (15.7±6.2), (18.4±6.8) min, respectively ]. In-cidence of EA in group P(5% ) was significantly less than that in group C(30%). Conclusion The propofol of dento-anaesth dosage can obviously decrease the incidence of EA in patients undergoing elective laporo-scopic cholecystectomy.

Objective To analyze the clinical effect of treating adjacent multi-vertebral tuberculosis by anterior radical debridement, titanium mesh bone fusion and internal fixation. Methods Twenty-four patients with adjacent multi-vertebral tuberculosis were treated by anterior radical debridement, titanium mesh bone fusion and internal fixation from April 2002 to May 2004. There were different types of tuberculosis symptoms in all the cases, including local pain and preoperative kyphosis deformity, and paraplegia in 6 cases. The preoperative kyphosis angle was 27.5??3.5?. After intensive anti-tuberculosis medication for 2 to 4 weeks before operation, 24 patients were reconstructed with Ti-Mesh filled with autograft rib and anterior internal fixation. After operation, the anti-tuberculosis medication was continued for one year. Results All the patients were followed up for 1.5 to 2.5 years postoperatively, with the average of 1.9 years. Their focus was eliminated completely, all the wounds healed in the first stage. The postoperative kyphosis angle was 5??2.5?. The average subsidence of Ti-Mesh was (3.5?0.5) mm at 8th weeks postoperation and the loss angle of kyphosis correction was 4.1??1.0? at lastest follow-up. Ti-Mesh began to fuse 3 to 6 months after operation. No looseness and dislocation were found during follow-up period. 6 patients with paraplegia recovered completely after 6 months, and kyphosis was rectified. ESR of these patients reduced a month after operation and reached to normal level after 6 months. Conclusion Anterior radical debridement, titanium mesh bone fusion and internal fixation show good results in treatment of adjacent multi-vertebral tuberculosis. The large bone deficit in the spine after debridement can be successfully reconstructed and kyphosis can be rectified. As the result of a better stability of the spine, secondary paraplegia can be avoided, and there is no need for iliac bone harvest, so without any relative complications.

Objective To investigate the relationship between noninvasive brachial artery blood pressure (B) and radial artery blood pressure (R) of the right arm.Methods Two hundred and ninetyfive patients with 149 males and age of (47 ± 16) years were studied.The height of patients was 163 ± 8 cm,and weight of patients was (61.2 ± 7.8) kg.The patients with peripheral vascular disease,wounds of arm skin or subcutaneous tissue infection were all excluded.Their B (with adult cuffs) and R (with infant cuffs) of the right arm were measured and analyzed after the patients under general anesthesia and stable hemodynamics.The relationships between B and R were analyzed by linear regression,the differences between B and R of each interval were compared using one-way ANOVA and then followed by SNK procedure.Results Right brachial artery blood pressure was significantly lower than radial artery blood pressure.The differences between the two varied from 13 to 18 mmHg in systolic BP (SBP),diastolic BP (DBP) and mean blood pressure (MAP).And linear regression was most applicable to describe their correlation [r=0.841 (SBP),0.808 (DBP),0.833 (MAP),all P＜0.01].Conclusions Radial artery blood pressure measured with infant cuffs can well reflect the variation of brachial artery blood pressure.

Objective To evaluate the effects of peritoneal jet ventilation on peritoneal oxygenation in pigs.Methods Twenty-four pigs of both sexes (12-16 weeks,35-45 kg) were randomly divided into 3 groups (n=8 each): sham operation group (group S) ; peritoneal regular frequency jet ventilation group (16 bpm)(group N) and peritoneal high-frequency jet ventilation group (150 bpm) (group H).Oral tracheal intubation was performed.The animals were mechanically ventilated (VT 8-12 ml/kg,RR 12-16 bpm,I:E 1.0:1.5,FiO2 100％) via airway.Endotracheal tubes were inserted into abdomen through the incisions in the left lower (for peritoneal jet ventilation) and right upper quadrant (for outlet of air).Arterial blood PaO2 and PaCO2 were measured before (baseline) and at 30,60,90,120,150,180,210 and 240 s of peritoneal jet ventilation.Peritoneal jet ventilation was started after the lungs being mechanically ventilated for 35 min.Peritoneal jet ventilation was terminated when SpO2 dropped to SpO2 ＜ 90 ％.The duration of safe apnea (DSA,from the moment of begging of peritoneal jet ventilation to the time when PaO2 ＜ 60 mm Hg).Results PaO2 was significandy higher and DSA longer in group H than in groups S and N.But there was no significant difference in PaCO2 among the 3 groups.Conclusion Peritoneal high-frequency jet ventilation can significantly enhance the efficiency of peritoneal oxygenation and prolong DSA,while peritoneal regular frequency jet ventilation has no effect on peritoneal oxygenation.

Objective To explore multi-causes and therapy of massive hemothorax after thoracic operation.Methods Sixty-six patients suffered from massive hemothorax after thoracic operation.All of them were executed conservative treatments for postoperative hemothorax.The noneffeetive cases were executed re-exploration.The relationship of area of residual cavity,fluctuation of intrapleural pressure and volume of hemothorax were analyzed between lobectomy in 30 eases and wedge,segmental or no excision of lung in 24 cases in 24 h postoperation.Results Thirty-two of 66 cases being executed conservative treatments were suteessful,2 cases were dead,while 32 cases were executed re-exploration,and 29 of them were cured.but 1 case of them dead,and 2 cases suffered from bronchial fistula,who were cured by thoracoplasty.The operations of wedge,segmental or no excision of lung in 24 cases were compared with lobectomy in 30 cases.It Was proved that the former had the smaller area of residual cavity,the lower intrapleural pressure.and the less volume of hemothorax(P＜0.05).Conclusions The multiplicity analysis of massive hemothorax after thoracic operation are flucmafion of intrapleural pressure after operation,intracavitary suction with negative pressure,rise of pressure in microcirculation at wound,abnormality of blood coagulation function and so on.It can reduce complications that proper therapy is timely performed,and even avoid of re-exploration.

Objective To investigate the effects of angle and length of lightwand in three-dimensional reconstruction images of the upper airway based on computed tomography.Methods A total of 245 patients,aged 18-86 years,were scanned by helical computed tomography in the head and neck.Reconstructed images,obtained by Aw4.4 Workstation,were printed out by the ratio of 1 ∶ 1.The tracheal tube was used to investigate the anatomic structure of the upper airway.The length L and angle α of the tracheal tube were recorded.And two distances (D1,D2) and one angle (β) were recorded:D1,the distance between the upper central incisor and root of epiglottis;D2,the distance between the root of epiglottis and midpoint of glottis;angle β,the angle of line D1 and D2.Results The oα value in male patients was significant higher than that in female patients:(70.02 ± 15.49)° vs.(55.84 ± 14.70)°.The β value in male patients was significant higher than that in female patients:(129.74 ± 14.82)° vs.(120.40 ± 14.19)°.The L value in male patients was significant higher than that in female patients:(12.80 ± 0.85) cm vs.(11.50 ± 0.65) cm.The D1 and D2value in male patients were significant higher than those in female patients:(7.53 ± 0.66) cm vs.(6.76 ± 0.53) cm,(3.13 ± 0.52) cm vs.(2.45 ± 0.32) cm.There were significant differences (P ＜ 0.05).The 245 patients were classified to 2 groups by using the function of hierarchical cluster analysis in the statistical software.The α value in group 2 was significant higher than that in group 1:(75.45 ± 9.53)° vs.(48.17 ± 9.29)°.The 3 value in group 2 was significant higher than that in group 1:(136.27 ± 9.86)° vs.(112.31 ± 8.64)°.The age in group 2 was significant higher than that in group 1:(53.92 ± 19.64) years vs.(36.93 ± 17.21) years.Correlation analysis showed that in 245 patients,angle α was positively correlated to angle β and age (P ＜ 0.05),and angle β was positively correlated to age (P ＜ 0.05).Conclusions The bent length and angle on lightwand can be affected by both the patients' gender and ages.

Studies show the waste anesthetic gas is harmful to the person working in operating room.At present,there are some problems in traditional scavengers and the gas absorber.This paper introduces a novel scavenger forwaste anesthetic gas which makes use of atmospheric pressure and negative pressure in operating room.This setting can scavenge the exhaust gas absolutely without affection the normal work of anaesthesia apparatus.

Objective To evaluate the scavenging efficacy of a novel scavenger in removing isoflurane.Methods Forty five patients undergoing abdominal surgery were enrolled and randomly divided into three groups.The Datex-ohmeda S/5 anesthetic machine was applied to provide general anesthesia with isoflurane in group A,Datex-ohmed Aestiva/5 in group B,and Drager RA2S in Group C.After 60 minutes,the gas samples were taken at the waste gas outlet,airtake and airout of stripe tubes of anesthetic machines by Philips intellivue MP60 Anesthesia monitor to identify the concentrations of isoflurane and PCO2 both before and after the application of the scavenger.Results The novel scavenger could completely eliminate waste anesthetic gases including isoflurane and CO2.Conclusion The eliminating rate is 100% and the air quality in operating room is improved apparently.

BACKGROUND:Prostacyclin (PGI2) and its analogs have been reported to prevent pressure overload-induced cardiac hypertrophy, and to reduce cardiac ischemia/reperfusion injury. However, clinical application of PGI2 is chalenging due to its short half-life (< 2 minutes). Thus, we have generated PGI2 expressing rat endothelial progenitor cel strains (PGI2-EPCs) that constitutively secrete prostacyclin.
OBJECTIVE:To investigate the protective effectof PGI2-EPCs against oxidative stress-induced cardiomyocyte injury.
METHODS:Cultured H9c2 celsin vitrowere assigned into four groups: H9c2 cels treated by H2O2for 4 hours. H9c2 cels were pretreated by conditioned medium (colected form EPCs and PGI2-EPCs or colected form EPCs and PGI2-EPCs mixed with native EPCs) before the addition of H2O2. PBS instead of conditioned mediums served as negative control. The paracrine effect of PGI2-EPCs onin vitro angiogenesis of native EPCs was evaluated. MTT and Hoechst 33342 assays were used to examine the protective effect of conditioned medium on H2O2-induced rat embryonic cardiomyocyte apoptosis and cel viability. Finaly, the effect of conditioned medium on the electric activities of adult cardiomyocyteswas measuredby whole-cel patch clamp techniques.
RESULTS AND CONCLUSION:When native EPCs mixed with conditioned medium of PGI2-EPCs, the total length of tubes was significantly longer compared with those mixed with CM of EPC. Rat embryonic cardiomyocytes pretreated with conditioned medium of PGI2-EPCs significantly reduced H2O2-induced apoptosis and preserved cel viability compared with pretreatment with EPC-conditioned medium and without pretreatment (P< 0.01). Pretreatment of rat adult cardiomyocyteswith conditioned medium of PGI2-EPCs abolished H2O2-induced early afterdepolarization and shortened H2O2-induced action potential duration prolongation (P< 0.01) towards baseline.Our findings indicate thatPGI2-EPCs protect against oxidative stress-induced cardiomyocyte injury through paracrine action.ThisStudy providesthe groundwork for an innovative cel therapy approach to treat ischemic heart disease.