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.

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.

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 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.

Purpose　To investigate relationship between androgen receptor and apoptotic index and to further understand the tumor biology of prostate cancer. Methods　Fifty-six patients with histologically proven prostate cancer and 20 cases with benign prostatic hyperplasia(BPH) were collected. Androgen receptor(AR) were stained by 2H12 monoclonal antibody using immunohistochemical method. The apoptotic index (AI) was determined by the terminal deoxynucleotidyl transterase-mediated dUTP biotin nick end labeling (TUNEL) technique on serial sections of formalin fixed, paraffin embedded tissues. Results　AR was not found significantly difference (P>0.05) between prostate cancer and BPH. The association of AR with AI according to Gleason score were not observed in prostate cancer. AI were significantly higher in prostate cancer compared to BPH (P<0.05).AI were also significantly higher in AR-positive prostate cancer than in AR-negative prostate cancer（P<0.05）. Conclusion　AR expression can induce prostate cancer cells to become apoptosis, and may be a useful predictor in functional classification and endocrine response of prostate cancer.

Objective To determine the dose-response relationship of 0.2％ ropivacaine for ultrasoundguided stellate ganglion block (SGB).Methods Seventy-five ASA physical status [or Ⅱ patients with migraine,aged 23-55 yr,with body mass index of 22-28 kg/m2,scheduled for elective ultrasound-guided SGB,were randomly divided into R1-5 groups (n =15 each) using a random number table.In R1,R2,R3,R4 and R5 groups,the patients underwent ultrasound-guided SGB with 0.2％ ropivacaine 1,2,3,4 and 5 ml,respectively.A successful SGB block was confirmed by the onset of ptosis (Horner syndrome) on the injected side.Probit analysis was used to calculate the effective dose of 0.2 ％ ropivacaine in 50 ％ and 95 ％ of the patients (ED50 and ED95) and 95％ confidence interval (95％ CI).Results The ED50 of 0.2％ ropivacaine for ultrasound-guided SGB was 2.2 ml (95％CI 1.9-2.5 ml) and ED95 was 3.2 ml (95％CI 2.8-4.1 ml).Conclusion The ED50 and ED95 of 0.2％ ropivacaine for ultrasound-guided SGB are 2.2 and 3.2 ml,respectively.

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.

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.

Totally, 125 elderly inpatients with aspiration pneumonia (AP) were enrolled from departments of respiratory medicine and neurology at Zhongnan Hospital, Wuhan during June 2005 to October 2009 for analysis. Results showed that listlessness was manifested in 70 cases (56%), primary neurological illness in 80 cases (64%), 57 of them (46%) complicated with respiratory failure and 26 died with case-fatality of 21%. Main pathogen for them was Gram-negative bacillus, accounting for 57% of the total. Two kinds or more of antibiotics had ever been administered in 98 cases (78%), with an average length of antibiotics use for 28 days, ranging from one day to 128 days. Nasal feeding was instituted for those with choking over their feeding and coughing, and their inspired feeding was aspirated from the trachea or bronchi and lavished with bronchoscopy, with 38 cases by tracheal intubation, 26 by tracheotomy and 42 with artificial ventilation. Their average duration of hospital stay spanned 28 days with an average cost of 25 000 RMB yuan per capita, significantly higher than that for those with common pneumonia. In conclusion, clinical features of these elderly patients with AP were not so typical, most of them manifest severe, with lots of medical cost and bad prognosis.