0.05). The onset time of 0.2mg/kg and 0.4mg/kg cisatracurium was significantly shorter than that of 0.1mg/kg cisatracurium and 0.5mg/kg atracurium (P

Objective To evaluate the accuracy of a new generation bioimpedance cardiac output monitor as compared with thermodilution and end expiratory CO 2 techniques Methods Sixteen patients (14 males, 2 females) aged (58?12) years undergoing elective coronary artery bypass (CAB) surgery were studied Cardiac output was measured after CAB surgery in ICU using a new generation bioimpedance cardiac output monitor(Rheo Bioimpedance Hemodynamic monitor) and conventional thermodilution technique in 16 patients and end expiratory CO 2 technique in 10 patients Cardiac output was also measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers consisting of equal numbers of male and female The volunteers of each sex were further divided into 5 equal groups of 20 each: (1)20 29 years, (2)30 39 years, (3)40 49 years, (4)50 59 years and (5)60 70 years Results Cardiac outputs measured by bioimpedance and thermodilution techniques were well correlated (r=0 83) and there was also a good correlation between cardiac outputs measured by bioimpedance and end expiratory CO 2 techniques(r=0 88) Cardiac out measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers showed that there was a significant difference in cardiac output between 60 70 years age group and the other age groups in both male and female Conclusions Cardiac output and other hemodynamic parameters measured with the new generation bioimpedance hemodynamic monitor are accurate and can be used for preoperative cardiovascular function evaluation and postoperative monitoring of dynamic changes in circulatory function

Objective: To compare cumulative dose technique with single dose technique for determining dose-re sponse relationship of rocuronium during balanced anesthesia. Method: Thirty-four ASA grade Ⅰ-Ⅱ patients, aged 23- 65 years, undergoing elective surgery,were randomly allocated to single dose group(n=24) or cumulative dose group (n=10). Single dose group was further divided into 4 subgroups receiving 150,200,250 or 300?g/kg of rocuronium re spectively. In cumulative dose group, the initial dose of 150 or 200 ?g/kg rocuronium was followed by a second dose de termined individually to produce about 90% neuromuscular block. The ulnar nerve was stimulated at the wrist to mea sure the accelography of thumb adduction. The relationship between probit-transformed depression of first twitch height of TOF and the logarithm dose of rocuronium was analysed using linear regression. Result: ED_50 and ED_95 of rocuronium were 193.6?69.1 and 367.2?72. 7?g/kg respectively in single dose group, and 213.0?55.1 and 418.5? 61.7?g/kg respectively in cumulative dose group. No statistically significant differences were found in the slope,inter cept,ED_50 and ED_95 values between two groups. Conclusion: The two-dose cumulative technique can be used as effec tively as traditional single dose technique in determining the dose-response relationship of rocuronium.

Objective To investigate bile leakage prevention in laparoscopic common bile duct (CBD) choledochoscopic exploration through micro-incision approach at the cystic duct-CBD junction.Methods From August 2007 to February 2015,a total of 147 cases undergoing laparoscopic CBD choledochoscopic exploration through micro-incision approach at the cystic duct-CBD junction were included in this study.From August 2007 to November 2012,57 patients were treated with laparoseopic CBD exploration (control group).From November 2012 to February 2015,90 patients were with optimized suture method of CBD (study group).The outcomes of patients in two groups were compared,including procedure time (PT),postoperative hospitalization time (PHT),and postoperative complications.Results In control group,the bile leakage rate was 5.3％,compared to 1.1％ in study group.There were significant differences in postoperative hospitalization time(t =1.98,P =0.0007) and hile leakage rate (x2 =139.5,P =0.04)between the two groups.Conclusions The prophylaxis measurements during operation are important to prevent bile leakage in laparoscopic CBD choledochoscopic exploration through micro-incision approach,including strict indications for micro-incision operation,proper expertise for laparoscopic cholecystectomy and laparoscopic suturing,choledochoscopic exploration,and suturing the whole layer of CBD wall,and carefully checking the suturing spot in case of bile leakage.T-tube placement is recommended while bile leakage is suspected.

Objective Serological characteristic analysis for patients with autoimmune hemolytic anemia(AIHA)who has cold and warm auto‐antibody when undergoing blood type and cross‐matching .Methods Choosed 3 donors of red blood cells of group O to absorb autoantibodies of the patient′s serum(by using the methods of cold absorption) and used 2‐mercaptoethanol(2‐Me) to de‐stroyed the IgM antibody .Results The patient of AIHA blood type was B+ .There was cold and warm auto‐antibody in the pa‐tient′s serum ,and the result of cross‐matching is incompatible .Conclusion The patient′s serum contains cold and warm auto‐anti‐body which interferes blood type and cross‐matching .In emergency ,considering the patients condition ,blood transfusion combined with the drug treatment could achieve good effects .

Objective To evaluate the intraoperative advantage and postoperative outcomes of threedimensional laparoscopic common bile duct (CBD) choledochoscopic exploration by micro-incision made at the cystic duct-CBD junction (LCBDEM) for gall stones and choledocholithiasis.Methods From January 2014 to December 2015,31 patients were operated under 3D LCBDEM (study group) and 37 patients under 2D LCBDEM (control group).The outcomes of patients in two groups were compared,including total procedure time (TPT),modified procedure time(MPT),suturing time(ST) and the wrong grasping per 100grasps(WG)of the LCBDEM.8 surgeons experienced in 3D LCBDEM were asked to fill in a subjective questionnaire.Results In control group,the TPT,MPT,ST and WG were (148 ± 47) min,(108 ± 42)min,(20 ±3)min and (19 ±4)per 100 grasps,respectively.In study group,the TPT,MPT,ST and WG were (148 ± 46) min,(9 1 ± 25) min,(1 8 ± 3) min and (8 ± 2) per 100 grasps,respectively.There were significant differences in MPT (t =-2.026,P ＜ 0.05),ST (t =-2.239,P ＜ 0.05) and WG (Z=-7.062,P ＜ 0.001).In subjective questionnaire survey,3D laparoscopy has advantages over 2D laparoscopy in visual and operation experience.But 3D laparoscopy made eyes more easily tired and dizzy.31 aparoscopy was inferior to 2D laparoscopy in spinning the camera around to get optimal field of vision.Conclusions 3D LCBDEM shortens procedure time and suturing time,increases operating accuracy and safety by providing high definition stereovision.

BACKGROUND: The residual root of anterior teeth are usually repaired by means of post and cores plus porcelain fused metal crown in clinic, and the retention force is mainly provided by the post because of the deletion of crown, so the retention force provided by the post is directly correlated with the long-term effect of repair.OBJECTIVE: To analyze the changes of retention of cast metal post and core restorations with different convergence angles, and investigate the influence of convergence angles on retention.DESIGN: A repeated observational measurement.SETTING: Department of Prosthodontics, West China School of Stomatology, Sichuan University.MATERIALS: The experiments were carried out in the building of high polymer material of Sichuan University in May 2005. Fifty-four simulated tooth roots were manufactured by the numerical control machine tools.They were divided into six groups according to the convergence angles of post being 0°, 3.93°, 5.71°, 7.48°, 11.31° and 14.71°, with nine specimens in each group.METHODS: ① Manufacture of the standard specimens: The tooth roots with the convergence angles of 0°,3.93°, 5.71°, 7.48°, 11.31° and 14.71° were prepared with the digital control precision machine. ② Manufacture of the cast post and cores: The post and core wax patterns of the specimens were made in the condition similar to the clinical practice. The post and cores were cast and tried in, necessary grinding was made to ensure the adoption of the posts and the specimens. Then the posts were luted to the specimens with ZPC after the posts and the simulated root canals having een cleaned by alcohol. The posts and the specimens were pressed until the ZPC solidified. ③ Retention Force test: After having been dipped in physiological saline for 24 hours, the bonded castings and specimens were subjected to a tensile testing at the drawing speed of 10 mm per minute.The retention force of post was the load recorded when the post was pulled out from the specimen. ④ Planar bonding strength test: We cut a PMMA stick into the same little cylinders and made angular milling on the flank of the cylinders. The angle between the milled bevel and the central axis of the cylinder was controlled to 0°, 1.9°, 3°, 6°, 9°, 12° and 15°. Afterwards we cut the brass into pieces. Eight wafers were cast with the same diameter of 8 mm and thickness of 1 mm. With the same procedure of bonding the posts to specimens, the brass pieces were bonded to the cylinder bevels and the wafers were adhered to the upside of some unmachinized cylinders.Immerged in physiological saline for 24 hours, their bonding force were tested at the speed of 10 mm per minute, and the load was recorded when the pieces and wafers were separated from the cylinders. ⑤ Calculation of the frictional and interlocking forces: As the post can be regarded as a frustum, the bonding surface area can be calculated with the formula calculating the flank area of frustum, and the area of the occlusal bonding surface is the sum of the annulus part of the root surface and the circular part of the post tip. Some regressions were made to the retention force, frictional strength, bonding strength per unit area, retention force per unit area and frictional force per unit area to convergence angles.MAIN OUTCOME MEASURES: ① Bonding strength of different convergence angles; ② Influence of different convergence angles on the area and bonding strength of the post; ③ Retention force and frictional force of posts with different convergence angles; ④ The results of the one-way analysis of variance (ANOVA) of bonding strength, retention force and frictional force per unit area.RESULTS: ① The bonding strength of different convergence angles: It was 0.309 0 N/mm2 for the occlusal plane, 0.128 3 N/mm2 for the axial plane with a convergence angle of 0°, 0.108 7 N/mm2 for the 1.9°axial plane, 0.107 2 N/mm2 for the 3°axial plane, 0.084 9 N/mm2 for the 6°axial plane, 0.056 7 N/mm2 for the 9°axial plane, 0.046 3 N/mm2 for the 12°axial plane, 0.027 4 N/mm2 for the 15°axial plane. ② Bonding strength and bonding area of posts with different convergence angles: The post with a 0°convergence angle had a total post area of 108.047 mm2 and bonding strength of 19.041 N; The most tapered post with 14.71°had a total post area of 90.245 mm2 and bonding strength of 5.131 N. ③ The retention force of cast post and the bonding strength of ZPC declined with the increasing of convergence angles of the post. For the parallel post (convergence angle=0°), the retention force was 321.60 N, the frictional force was 302.559 N, retention force per unit area was 2.976 N/mm2,frictional strength was 3.885 N/mm2; for the most tapered post (convergence angle=14.71°), the retention force was 9.93 N, frictional force was 54.799 N, retention force per unit area was 0.664 N/mm2, frictional force was 0.681 N/mm2. ④ A one-way ANOVA showed that there were significant differences in the bonding strength, retention force and frictional force per unit area among the groups (P ＜ 0.05).CONCLUSION: The retention force, frictional force and the bonding strength of ZPC decrease with the increasing of convergence angles of posts, so the convergence angles of posts should be reduced as much as possible to obtain greater retention.

BACKGROUND: The involvement of genetic factors in migraine has been under close investigation, and geneiic epidemiological study and segregation analysis have confirmed genetic disposition as an important risk factor for migraine.OBJECTIVE: To analyze the connection between mutations in CACNA1A gene and familial hemiplegic migraine (FHM) in southern Chinese Han patients by examining the three most frequently mutated sites in CACN1A gene.DESIGN: Sampled survey.SETTING: First Affiliated Hospital of Zhongshan University and Baoan Xixiang People's Hospital of Shenzhen City.PARTICIPANTS: All the participants were selected from patients in the above two hospitals and their relatives, including 10 patients with FHM, 12 relatives of the patients in 2 pedigrees, 53 migraine patients with aura without family history, and 10 healthy control subjects.METHODS: The exons 13, 16 and 17 of CACNL1A4 gene were amplified by PCR. Single-strand conformation polymorphism technique was employed to detect the most frequent mutations in the 3 exons (T666M, R583Q and D715E) in these subjects.MAIN OUTCOME MEASURES: ① Results of PCR amplification of the 3 exons of CACNL1A4 gene; ② Results of SSCP for mutation analysis of the 3 exons.RESULTS: Participants completed the study. The target fragment length of exons 13, 16 and 17 were 247 bp, 268 bp and 204 bp, respectively.None of mutations of T666M, R583Q and D715E were detected in the subjects, including FHM patients and their relatives, migraine patients without family history and the healthy control subjects.CONCLUSION: None of the 3 most frequent mutations (T666M, R583Q and D715E) can be detected in southern Chinese FHM pedigrees or migraine patients without family history.

In this paper,we present analysis,servi-ce and study for zero grating in H-300.Transmission electron microscope made in Japan.It is well known that this kind of electron microscope have been used in most university and institute over twenty years, so all most of the electron microscope have problem in its dependability.In order to analyze and service the electron microscope,we make much efforts in the material chosen and the service technics,the experimental results show that our methods are available for servicing those electron microscope. Moreover,we discuss the failure of the electron microscope and the jointing crafts,these results are useful for those who works in this field.

Objective To evaluate the role of chemokine receptor CXCR4 in spinal dorsal horn in the development of morphine tolerance in rats with bone cancer pain (BCP).Methods Forty female Sprague-Dawley rats,weighing 180-220 g,were equally randomized into 5 groups using a random number table:sham operation group (group S),BCP group (group B),BCP + AMD3100 (specific CXCR4 antagonist) group (group BA),BCP + morphine group (group BM),BCP + morphine + AMD3100 group (group BMA).BCP was induced by injecting Walker 256 mammary gland cancer cell suspension (4 × 105 cells/ml) 5 μl into the bone marrow of the right tibia of rats anesthetized with chloral hydrate.On 6 days after injection of mammary gland cancer cells,AMD3100 2 mg/kg was intraperitoneally injected twice a day for 9 days in BA group,and morphine 10 mg/kg was subcutaneously injected twice a day for 9 days in BM group.AMD3100 was intraperitoneally injected and morphine was subcutaneously injected as previously described at the corresponding time point in BMA group.Before injection of mammary gland cancer cells (T0) and on 4,6,8,10,12 and 14 days after injection of mammary gland cancer cells (T1-6),paw withdrawal threshold to von Frey hair mechanical stimulation (PWMT) was measured.The rats were then sacrificed and L3-5 segments of the spinal cord were removed for determination of c-fos expression in spinal dorsal horn using immunofluorescence.Results Compared with S group,PMWT was significantly decreased at T2-6 in B and BA groups and at T4-6 in BM group,and c-fos expression was up-regulated at T6 in BM group (P ＜0.01).PMWT was significantly higher at T3-5 in BM group and at T3-6 in BMA group than in group B (P ＜ 0.01).Compared with BM group,PMWT was significantly increased at T5,6 and c-fos expression was down-regulated at T6 in BMA group (P ＜ 0.01).Conclusion Chemokine receptor CXCR4 in spinal dorsal horn is involved in the development of morphine tolerance in rats with BCP and the mechanism may be related to activation of c-fos.