Objective To observe the outcomes of satellite ganglion block(SGB)via posterior edge of stcmoclcidomastoid approach.Methods SGB was performed in 2 400 patients,who wererandomly divided into two groups with l 200 cases each.The puncture of SGB in group SPA was via posterior edge of sternocleidomastoid approach and that in group TPA via traditional paratracheal approac}L The same local anesthetics was used in two groups.The success rate(Horner'S syndrome appearance)and complications were compared.Results The success rate was higher in group SPA than that in group TPA(97% VS.92%)(P<0.05).Repeated puncture was needed in 16 cases ingroup SPA,which were less than 98 cases in group TPA(P<0.05).Laryngeal nerve block wasoccurred in 24 cases in group SPA.which were less than 37 cases in group TPA(P<0.05).Conclusion Compared to the traditional paratracheal approach,SGB via posterior edge ofsternocleidomastoid approach has the advantages of clear positioning,easy puncture,higher success rate and less complications.

Purpose To investigate the clinical and pathological features of inflammatory fibroid polyps ( IFPs) and to discuss its diag-nosis, differential diagnosis and treatment. Methods Clinicopathological data of 14 cases of IFPs were collected and analyzed retro-spectively. Results Most of the 14 cases were found to have submucosal polyps of the digestive tract protruding growing into the cavi-ty. Perivascular onion skinning which formed by spindle fibrocytes around vascular proliferation and eosinophilic inflammatory infiltrates were present as the characteristic feature of lesions. ABC results demonstrated that the lesions showed fibroblastic, myofibroblastic and dendritic cell signs. Conclusions IFPs are rare, benign tumors that can arise throughout the digestive tract, with unique histological changes in pathology. Surgical excision or endoscopic removal is the main treatment.

Objective To evaluate the efficacy of the nasopharyngeal airway for airway management during anesthesia recovery in obese patients. Methods Eighty ASA Ⅰ-Ⅲ patients, aged 48-72 yr, body mass index > 30 kg/m~2 , were randomly divided into 2 groups (n=40 each) : nasopharyngeal airway group (group Ⅰ) and oropharyngeal airway group (group Ⅱ). The extubation was performed after recovery of breathing (RR ≥ 10 bpm, V_T≥5 ml/kg). The nasopharyngeal airway was inserted though the nasal cavity immediately after extnhation in group Ⅰ, and the oropharyngeal airway was inserted though the oral cavity after extubation in group Ⅱ. Oxygen (3 L/min) was then inhaled by mask until recovery of consciousness in both groups, and if SpO_2 < 90%, the rescue medication was given. The changes in RR, SpO_2 , HR, SP and DP were observed at 1 min (T_1), 5 min (T_2), 10 min (T_3) and 20 min (T_4) after insertion of the airway and complications were recorded in 20 min after insertion of the airway. Results The RR, SpO_2, HR, SP and DP were all maintained in the normal range after insertion of the airway in both groups. The RR,HR, SP and DP at T_(3,4) and incidence of resdessness, nausea and vomiting, and laryngospasm were significantly lower in group Ⅰ than in group Ⅱ (P<0.05), while there was no significant difference in SpO_2 at each time point between group Ⅰ and group Ⅱ(P>0.05). Conclusion The efficacy of the nasopharyngeal airway is similar to that of the oropharyngeal airway for the relief of the upper respiratory tract obstruction during anesthesia recovery in obese patients, but the stress response induced is lower and complications are fewer.

OBJECTIVE To investigate the trend of distribution and drug resistance of clinical isolates of Enterobacter cloacae during the last three years in our hospital. METHODS Strains collected from daily specimens were identified and drug resistantce with SENSITITRE bacteria analysis system. RESULTS The most strains were isolated from samples of sputum,urine,nad other excretion. The drug resistance rates to imipenem and cefepime were less than 32%. Cefoxitin,ampicillin and cefazolin were ineffective to contralE. cloacae. The drug resistance rates to penicillins,cephalosporins,chloramphenicol and aminoglycoside antibiotics increased more than 20% in last three years. CONCLUSIONS E. cloacae is multiple-resistant to antibiotics and displays higher levels of antibiotic resistance. It is suggested that antibiotics be used reasonably under the guidance of antibiotic susceptibility testing.

Objective To study effects of hepatic microcirculation and hepatic function using low dose HSS40 preoperation on the partial hepatectomy patients.Methods Sixty-five partial hepatectomy patients were randomly divided into study group (32 cases with HSS40,4 mL/kg,in 30 min) and control group (33 cases with RL,4 mL/kg,in 30 min).Patients of two groups were monitored in liver microcirculation,hepatic function parameters at different times before and after the infusion.Results Compared with the study group,the control group were more infusion (2400 ± 1650) mL and blood transfusion (550 ± 190) mL,the differences were statistically significant (P ＜0.05).Control group of nitric oxide (NO) T3 time(17.84 ± 6.26) μmol/L in the preexpansion compared with preoperative T0 time(38.06 ± 9.34) μmol/L and the study groupT3 time (36.37 ± 9.15) μmol/L was significantly decreased (P ＜ 0.05),and endothelin (ET) (T3 time 185.16 ± 41.34 pg/mL) was significantly higher (P ＜ 0.05),and the study group(T3 time 99.75 ± 30.31 pg/mL) than the control group variation amplitude,time later,the difference was statistically significant (P ＜ 0.05) ; Control group ALT,AST,DBLI,TBLI rise after preexpansion (P ＜ 0.05),and significantly higher than the study group (P ＜ 0.01),and the study group than the control group variation amplitude,time later,differences were statistically significant (P ＜ 0.05) ; while no significant changes in the concentration ALB two groups,the difference was not statistically significant difference (P ＞ 0.05).Conclusion Using low dose HSS40 preoperation on the partial hepatectomy patients can improve cardiovascular stability,protective effect on ischemia-reperfusion injury of liver,can increase the tissue perfusion,and improve the hepatic microcirculation,better able to maintain the stability of the liver function.

Objective To observe the effects of endobronchial decimeter wave therapy on ventilation func-tion of patients with the constrictive endobronehial tuberculosis (EBTB). Methods Forty-four EBTB patients weredivided into an experiment group and a control group. All the patients of the two groups were treated with generalchemotherapy, the patients of experiment group accepted endobronehial decimeter wave therapy at the same time. Thepurulent secretion or caseous necrosis of the diseased region was drawn-off from the bronchi lumina by bronchoseope,then the antenna of the decimeter wave irradiator was inserted into the diseased region through the biopsy pore to per-form the radiation. The vital capacity, forced expiratory volume in the 1st second and maximal voluntary ventilationwere tested before and 60 days after the operation. Results Endobronehial decimeter wave therapy significantly re-duced the constriction of bronchi, improved the lung ventilation function, and relieved the anhelation symptom of pa-tients in the experiment group to a significantly larger extent than those in the controls group (P< 0. 01 ). Moreover,the therapeutic effects of endobronchial decimeter wave therapy were more significant for the endomembrane tuberculo-sis with pulmonary closure due to ulcerous necrosis or granulation hyperplasy ( P < 0. 05 ) , but ineffective for the atro-phy due to fibrous constriction. Conclusion Endobronchial decimeter wave therapy could reduce the incidence oflung closure in endomembrane tuberculosis and improve lung function.

Purpose To investigate the diagnostic value of the arrhythmogenic right ventricular dysplasia (ARVD) using multi-slice spiral CT (MSCT). Materials and Methods Thirty-four patients who were suspected as ARVD received right ventricular radiography, including 16 ARVD patients and 15 non-ARVD patients regarded as control group. The structural and shaped change of heart on reconstructed images of long axis, short axis and four cavity surface and analyze were observed, and MSCT features of right ventricular radiography characteristics were analyzed for ARVD patients. Results Sixteen cases of ARVD were correctly diagnosed by MSCT, and 14 cases had fatty infiltration including 11 cases of apex of heart, 8 cases of inferior wall, 5 cases of anterior wall, 5 cases of anterior wall of funnel area, 3 cases of diagram, 4 cases of papillary muscle, 6 cases of muscular trabecula and moderator band and 1 case of whole right ventricular free wall. Five cases showed scallop sign, 16 cases excessive trabecular change, 11 cases thinned changes, and 16 cases enlarged changes of right ventricular wall. Conclusion MSCT features of right ventricular for ARVD have relative diagnostic characteristics, and the scallop sign and excessive trabecular change of right ventricular wall are its specific imaging characteristics.

It has been reported that celastrus orbiculatus has anti-cancer activities. The mechanism mainly lies in its functions of inhibiting tumor cell proliferation, inducing tumor cell apoptosis, repressing tumor angiogenesis, and reversing tumor multidrug resistance, etc. To study the material basis of its anti-cancer pharmacodynamics and the mechanism of tumor inhibition has significant meanings and a wide application perspective.

In order to observe the nutrition state in the severe multiple trauma patients undergoing adjuvant recombinant human growth hormone (rhGH) nutritional support therapy, 45 patients with severe multiple traumas (ISS>25) were randomly divided into 3 groups. All the 3 groups had been supplied with nitrogen and caloricity according to the need of patients for 16 days. The rhGH therapy started 48 h after surgery and lasted for 14 days in two rhGH-treated groups in which rhGH was 0.2 and 0.4 U/(kg . d) respectively, and the resting group served as control one. The levels of nitrogen balance, prealbumin and safety variables (blood sugar, Na+, TT3 and TT4) were observed and compared among the three groups. The levels of nitrogen balance on the postoperative day (POD) 3 and 5 in the rhGH-treated groups were -1.28+/-3.19, 5.45+/-2.00 and -0.18+/-2.55, 6.11+/-1.60, respectively, which were significantly higher than those in the control group (-5.17+/-1.68 and -1.08+/-3.31, P<0.01). The values of prealbumin on the POD 3 and 5 in the rhGH-treated groups were 180.19+/-27.15, 194.44+/-50.82 and 194.94+/-29.65, 194.11+/-16.17, respectively, which were significantly higher than those in the control group (117.42+/-19.10 and 135.63+/-28.31, P<0.01). There was no significant difference between the rhGH 0.2 U/(kg . d) group and rhGH 0.4 U/(kg . d) group in both of the levels of nitrogen balance and prealbumin. It is concluded that the nutritional support therapy with adjuvant rhGH which starts 48 h after surgery improves the nutrition state of the patients with severe multiple trauma. It is safe for severe multiple trauma patients who accept rhGH at the dose of 0.2 and 0.4 U/(kg . d).

ObjectiveTo study the risk factors for children with incomplete Kawasaki disease(IKD) to decrease the development of coronary artery lesions (CAL).MethodsAll children diagnosed as IKD from Jan.2005 to Apr.2011 in our department were reviewed retrospectively for their clinical data,laboratory values and treatment measures.ResultsEight of the children (8/36,22.2％ ) were positive for CAL.The count of white blood cell( WBC),count of platelet(PLT),hematocrit and C reactive protein(CRP) level were ( 18.36 ± 4.63) × 109/L,(450.30 ± 155.40) × 109/L,( 25.63 ± 3.53 ),( 18.30 ± 3.80) mg/L and ( 13.48 ±3.27) × 109/L,(350.60 ± 56.80) × 109/L,( 33.78 ± 2.24 ),(9.70 ± 2.50) mg/L in the CAL group and non-CAL group respectively.And there were significant differences on the four indexes between CAL group and non-CAL group ( t =2.58,2.65,2.73,2.48,respectively,P ＜ 0.05 ).Pyretolysis time of children first undergoing globulin treatment was (2.5 ± 1.5 ) d and ( 1.5 ± 1.0 ) d in children under 1-year old and those above l-year old respectively,and the difference was significant ( t =2.35,P ＜ 0.05).ConclusionCAL should be cautiously prevented in IKD infants under l-year old with a fever lasting for over 5 days,decreased hematocrit and elevated WBC count,PLT count,Hct and CRP.Infant IKD patients are not so sensitive to intravenous gamma globulin and tend to occur CAL.They should be given an early diagnosis and timely treatment.