Objective To investigate the effects of esmolol and remifentanil on minimum alveolar concentration (MAC) of isoflurane in patients undergoing upper abdominal surgery. Methods One hundred ASAⅠorⅡpatients aged 18-60 yr undergoing upper abdominal surgery under general anesthesia were randomly divided into 5 groups (n=20 each):group A isoflurane alone; group B isoflurane + large dose esmolol; group C isoflurane + remifentanil; group D isoflurane + remifentanil + small dose esmolol and group E isoflurane + remifentanil + large dose esmolol. In group B and E esmolol was infused at 250 μg·kg-1·min-1 after a loading dose of 1 mg/kg (large dose esmolol). In group D esmolol was infused at 50 μg'kg-1·min-1 after a loading dose of 0.5 mg/kg (small dose esmolol). In group C, D and E remifentanil was infused at 0.05 μg·kg-1·min-1 after a loading dose of 0.25 μg/kg. As soon as the patients lost consciousness, tracheal intubation was facilitated with succinyl choline 1.5 mg/kg. The patients were mechanically ventilated (VT=8 ml/kg, RR 12 bpm, FiO2= 100% ). PET CO2 was maintained at 32-38 mm Hg and naso-pharyngeal temperature above 35.5℃. End-tidal isoflurane concentration was continuously monitored. If the patient moved his/her hand, foot, head or body within 60 seconds after skin incision was made the end-tidal isoflurane concentration was increased by 10% in the next patient; if the patient did not respond to skin incision the end-tidal concentration of isoflurane was decreased by 10% in the next patient. The initial end-tidal isoflurane concentration was 1.24% in group A and B, 0.78% in group C, D and E. Results The MAC of isoflurane was 1.24% ± O.14%, 1.22%±0.09%, 0.77%± 0.05%, 0.75% ±0.06%, 0.60%±0.05% in group A, B, C, D, E respectively. Remifentanil significantly reduced MAC of isoflurane in group C, D and E as compared with group A. The MAC of isoflurane was significantly lower in group E than in group C. Conclusion Remifentanil infusion at 0.05 μg·kg-1·min-1 combined with large dose esmolol can reduce MAC of isdlurane by 52% in patients undergoing upper abdominal surgery.

Objective To determine the median effective dose of remifentanil for maintaining the tolerance to ProSeal laryngeal mask airway in awake and spontaneously breathing patients.Methods Sixty ASA Ⅰ orⅡpatients aged 20-55 years old were recruited.Sixty patients was randomized into six groups with 10 case each Remifentanil was infused in a dose of 0.061,0.048,0.039,0.03,0.025 or 0.02μg·kg~(-1) 5 minutes after inserting PLMA.Single dose of remifentanil 0.25/μg/kg was given before continuous intravenous infusion.Respiratory response subscore of comfort scale(CSRR)and Ramsay sedation scale(RSS)were recorded after 25 minutes.ED50 was calculated.Results The ED50 of remifentanil for ProSeal laryngeal mask airway tolerance was 0.027μg·kg~(-1)(95%CI:0.023-0.030μg·kg~(-1)·min~(-1)in awake and spontaneously breathing patients.Conclusion The patients tolerate stimulus of laryngeal mask with a low dose continuous intravenous infusion of remifentanil in awake.and can maintain the hemodynamics stable.

Objective To study the incidence and risk factors of retinopathy of prematurity (ROP) in a single tertiary center during different times(Phase 1:2009 to 2011;Phase 2:2012 to 2014). Methods From 2009 to 2014, fundus examinations were performed on premature infants admitted to NICU of our hospital. The incidence and risk factors of ROP were compared between the two phases. Results During Phase 1,68 (11. 1% ) cases were diagnosed with ROP among 614 premature infants. During Phase 2, 121 (15. 2% ) cases were diagnosed with ROP among 794 premature infants. The incidences of ROP between the two phases were significantly different (P <0. 05). During Phase 1 and 2, 10 (14. 7% ) infants and 12 (9. 9% ) infants were diagnosed with Grade 3 and above or threshold ROP, respectively. The incidence of Grade 3 and above or threshold ROP between the two phases were also significantly different (P < 0. 05). Logistic analysis demonstrated that gestational age(GA), birth weight (BW), duration of oxygen therapy and mechanical ventilation(MV) were independent risk factors during hase 1, whereas GA, MV and blood transfusion were independent risk factors during Phase 2. Pulmonary surfactant (PS) was protective factor of ROP in both two groups. GA in Phase 2 was significant lower than Phase 1 (P <0. 05), while duration of oxygen therapy, incidence of MV, PS and blood transfusion were higher in Phase 2 ( P < 0. 05) . Conclusions The incidence of ROP has increased. Reducing the incidence of preterm delivery, duration of oxygen therapy, incidence of MV and blood transfusion has important role in preventing ROP. Reducing the use of MV and the oxygen concentrations, appropriate PS therapy and focusing on early ophthalmic screening are important preventing severe ROP.

Objective To survey the bacterial species and drug resistance of bacteria isolated from blood, urine and other samples in 12 military hospitals located at different areas in China. Methods A total of 1099 non-repetitive bacterial isolates were collected from 12 military hospitals and sent to the General Hospital of PLA for re-identification and drug susceptibility test. The minimal inhibitory concentrations (MICs) of antimicrobial agents were determined by agar dilution method. The results were evaluated according to the standards of CLSI (2007) and analyzed by WHONET 5.4 software. ESBLs, AmpC ?-lactamases were detected using the confirmatory test and APB discs method, respectively. Results Gram positive cocci and gram negative bacilli constituted 39.7% and 60.3% of 1099 clinical isolates respectively. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 62%, and methicillin-resistant coagulase negative Staphylococcus (MRSCN) accounted for 92%. ESBLs-producing and AmpC-producing strains of Escherichia coli accounted for 51.1% and 11.3%, respectively, and of Klebsiella pneumoniae accounted for 45.1% and 16.2%, respectively. As to caftazidime, amikacin, cefotaxime, cefoxitin and levofloxacin, the resistance rate in Escherichia coli (E. coli) and Klebsiella pneumoniae isolated from blood was lower than that isolated from urine. However, as to meropenem, ceftazidime, polymyxin and minocyclin, the resistance rate in Pseudomonas aeruginosa and Acinetobacter spp isolated from blood was higher than that isolated from urine. Conclusion MRSA, MRSCN, and producers of ESBLs and AmpC ?-lactamases are common in military hospitals. Resistance pattern of bacteria from blood differs from that of bacteria from urine. It is necessary for military hospitals to take the bacterial distribution and resistance levels to antimicrobial agents under surveillance in order to guide the proper use of antibiotics for military doctors, and the results may serve as guidelines in the use of antimicrobial agents in war time.

[Objective]To observe the effect of Shenkang Infusion on latent nephritis of syndrome of deficient spleen and kidney.[Method]Select the said patients,randomly divide them into treatment group 34 and control group 35 cases,both take Ciwujia Injection and Breviscapine(IVD),the treatment group takes Shenkang Infusion.Observe their TCM sign integral,24h urinary protein quantity,protein and red cells change in routine urine test.[Result]In treatment group,the total effective rate was 83.33%,urinary protein 86.67%;and 53.33% and 60% for control group respectively;the treatment one was better than control one.Both TCM sign integrals were decreased markedly,the treatment group was more obvious.[Conclusion]Shenkang Infusion can much alleviate clinical demonstrations and reduce 24 urinary protein quantity of latent glomerulus nephritis of the disease.

Neutrophils play important role in anti - tumor response of tumor-bearing host as a kind of important effector cells. In order to identify the anti-tumor mechanisms of G-CSF gene therapy, we investigated the number and functions of the peripheral neutrophils in the C-26 colon adenocarcinoma-bearing mice receiving G - CSF gene therapy and high - dose chemotherapy. After G - CSF gene therapy, the number of neutrophils in peripheral blood was increased markedly in C-26 mice receiving high - dose 5 - Fu as compared with control groups including in vivo administration of rhG - CSF. The more potent cytotoxicity to C - 26 cells could be detected. The phagocytic activity, the secretion of IL-1, TNF, NO of the neutrophils were significantly enhanced. These data showed that G - CSF gene therapy can increase the number of neutrophils, activate the functions more effectively than in vivo administration of rhG - CSF.

Granulocyte colony - stimulating factor (G - CSF) is a hematopoietic growth factor that is responsible for the differentiation and proliferation of hematopoietic progenitor cells to mature granulocyte, and can increase the number of peripheral neutrophils. It has been demonstrated that it could inhibit the metastasis of the murine tumors in spontaneous and experimental metastasis models by in vivo administration of recombinant human G - CSF. In order to examine the antitumor effect of G - CSF gene therapy on mice receiving high - dose chemotherapy, C - 26 colon adenocarcinoma - bearing mice which were prepared by S. c. injection of 1?105C-26 cells were i. p. injected with rhG-CSF (2?g/day?14day) or implanted with 1?107 collagen encapsulated NIH3T3-G-CSF cells which secrete high level of G - CSF after gene transfection. In our experiment, rhG-CSF could inhibit the tumor growth and extend the survival time of early stage C-26 bearing mice. However, G - CSF gene therapy could inhibit the tumor growth and prolong the survival both in early or middle stage C-26 mice. The results showed that both rhG - CSF and G - CSF gene therapy have exact antitumor effect and G - CSF gene therapy show more effective than rhG - CSF in vivo. Then we investigated the therapeutic effects of G - CSF gene therapy on C-26-bearing mice receiving high - dose chemotherapy (5-Fu 150mg/mice i. p.) . More effective results could be observed in C-26 - bearing mice receiving high dose chemotherapy after G - CSF gene therapy. The results also suggested that G-CSF gene therapy can inhibit the tumor growth more effectively both in C-26-bearing mice or C-26-bearing mice receiving high - dose chemotherapy.

Objective To investigate the effect of isoflurane on lung ischemia reperfusion injury in rabbit in vivo Methods Thirty two healthy New Zealand white rabbits of either sex weighing 2 0 2 5kg were randomly divided into four groups of eight each:sham operation (group A): chest was opened and left main bronchus and pulmonary artery and vein were isolated but not clamped The lungs were ventilated for 120min; ischemia reperfusion (group B): left hilum was isolated and clamped for 60min, after declamping the lungs were ventilated for another 60min Isoflurane+ischemia reperfusion(group C): the lungs were first ventilated with 1MAC isoflurane for 15min then the left hilum was clamped for 60min, after declamping the lungs were ventilated with 1MAC isoflurane for another 60min Isoflurane(group D): left hilum isolated but not clamped The lungs were ventilated with 1MAC isoflurane for another 60min Animals were then killed by blood letting, left lung was excised for microscopic examination and measurement of wet/dry weight(W/D) ratio and MDA content Results The W/D ratio and MDA content of left lung were significantly higher in group B and group C than those in group A and group D, while W/D ratio and MAD content in group B were significantly higher than those in group C Microscopic examination showed that there were severe leukocyte infiltration and edema formation in alveolar spaces and alveolar structure was destroyed in group B and group C, but the changes were less severe in group C Conclusions Inhalation of 1MAC isoflurane before ischemia and during reperfusion protects the lungs against ischemia reperfusion injury in rabbit in vivo

Objective To investigate the effects of different doses of propofol on erythrocyte lipid peroxidation in patients undergoing open heart surgery Methods Twenty seven adult patients with rheumatic heart disease undergoing elective value replacement were divided randomly into three groups of nine patients each: control group (group C), low dose propofol group (group LP) and high dose propofol group (group HP) The patients were premedicated with intramuscular morphine 0 08mg/kg and scopolamine 0 06mg/kg Anesthesia was induced with propofol 2 0 mg?kg -1 (group LP and HP) or midazolam 0 2mg?kg -1 (group C), fentanyl 5 0 ?g?kg -1 and vecuronium 0 1mg?kg -1 After tracheal intubation the patients were mechanically ventilated Anesthesia was maintained with propofol 5mg?kg -1 ?h -1 (group LP) or 10mg?kg -1 ?h -1 (group HP) or Isoflurane inhalation (group C) in addition to fentanyl (total dose 40 60?g?kg -1 ) and vecuronium Blood samples were taken from internal jugular vein before operation (T 1), 60min after initiation of CPB(T 2), 15min (T 3) and 60min (T 4) after aorta declamping and 24h after termination of CPB (T 5) for determination of plasma and erythrocyte LPO (P LPO and E LPO) and erythrocyte SOD (E SOD) The shape of erythrocyte was also viewed under electron microscope Results The levels of P LPO and E LPO increased significantly after initiation of CPB and the level of E SOD was higher than baseline level at T 2, then decreased from T 3 to T 5 in the three groups (P

Objective To investigate the effect of milrinone on the gastric intramucosal pH (pHi), endotoxemia and systemic inflammatory response during cardiopulmonary bypass (CPB) Methods Twenty adult patients undergoing valve replacement were randomly divided into two equal groups of ten patients each: control group (C) and milrinone group (M) In group M milrinone 30?g?kg -1 was given as an intravenous bolus after induction of anesthesia followed by 0 5?g?kg -1 ?min -1 infusion, while in group C normal saline (NS) was given instead of milrinone Patients with ejection fraction (EF)