Objective To investigate the effects of mannitol on the activity of erythrncyte aldose reduclase (AR),plasma nitric oxide(NO)and malondialdehyde(MDA)concentrations in patients undergoing hepatolobectomy.Methods Forty ASA Ⅰ or Ⅱ patients(aged 24-63 yr and weighing 50-68 kg),receiving combined general and epidural anesthesia and undergoing selective hepatolobectomy,were randomly assigned into a mannitol group (group M)and a normal saline group(group C).During hepatic portal occlusion,normal saline 1.5 ml/kg and 20％ mannitol 1.5 ml/kg were intravenously infused in groups C and M respectively for 30 min.Venous blood samples were collected to measure the erythrocyte AR activity and plasma NO and MDA concentrations at the following time points:before anesthesia induction(T0),at the end of hepatic portal occlusion(T1),at the end of operation(T2),one day after operation(T3)and three days after operation(T4),respectively.Results Compared with group C at T1,2,the erythrocyte AR and plasma MDA concentration decreased while plasma NO concentration increased in group M(P ＜ 0.05).Conclusion Mannitol can reduce hepatic ischemia and reperfusion injury in patients undergoing hepatolobectomy,which may be related to the mechanism of mannitol removing oxygenderived free radicals and inhibiting lipid peroxidation.

Objective To investigate the impact of thoracic epidural anesthesia on stress hyper-glycemia in patients undergoing major abdominal operations.Methods Forty patients were divided in-to two groups:general anesthesia (group I)and thoracic epidural and general anesthesia (group E). The venous samples were collected for the measurements of blood glucose (Glu),nitric oxide (NO), malonadialdehyde (MDA),glutathione (GSH)and the activities of aldose reductase (AR),glucose-6-phasphate dehydrogenase (G-6PD), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD),catalase(CAT)in red blood cells at 30 min before induction (T0 ),90 min after incision (T1 ),60 min after surgery (T2 )and on the 1st,2nd postoperative day (T3 and T4 ).Results The lev-el of Glu was increased from T1 to T3 in two groups compared with T0 .The activities of AR,G-6PD and CAT in RBC and plasma MDA were increased markedly at T3 while plasma levels of GSH and NO were decreased significantly in group I (P<0.05).Above parameters,except Glu,changed slightly and did not reach significance in group E.Compared to group I,the level of Glu and the activities of AR,G-6PD,CAT in group E were decreased and NO level was increased significantly at T3 (P <0.05).SOD and GSH-Px activity changed slightly within and between two groups.Conclusion Tho-racic epidural anesthesia can effectively attenuate stress hyperglycemia in patients undergoing major abdominal surgery.

Objective To investigate the measurement , feasibility and clinic effect of hyperthermic intraperitoneal chemotherapy (HIPEC) guided by B ultrasound in the treatment of malignant ascites from peritoneal carcinomatosis. Methods From July 2011 to June 2013, B ultrasound-guided approach was used to perform HIPEC on 36 patients affected by malignant ascites secondary to peritoneal carcinomatosis. Every patient underwent HIPEC for three times , by way of continuous circulatory perfusion into peritoneal cavity with saline at 400 ~ 600 mL/min and intraperitoneal perfusion with 5-FU mitomycin-C and cisplatin for 90 minutes with an inflow temperature of (43 ± 0.2)℃. These patients were followed up for a long term. Results Intraoperative course was uneventful in all cases. Complete clinical regression of ascites and related symptoms was achieved in all the 26 patients, partial regression achieved in 8 patients, and no curative effect achieved in 2 cases. The acquired total clinic effectiveness was 94.44%. No postoperative deaths and complication related to the procedure occurred in this study. The KPS grades of patients rose (P < 0.001), the level of tumor markers decreased, including CA199 (P < 0.001), CEA (P < 0.001), CA125 (P = 0.003). Conclusion HIPEC guided by B ultrasound appears to be a safe, feasible and effective procedure for the treatment of debilitating malignant ascites from unresectable peritoneal carcinomatosis , which would have a clinic good perspective in future.

Objective To investigate the efficacy of precise ultrasound-guided stellate ganglion block(UG-SGB)combined with ozonated autohemotherapy in the treatment of sudden hearing loss.Methods Fifty-seven patients with sudden hearing loss,27 males and 30 females,aged 19-82 years,BMI 20-29 kg/m2,ASA physical status Ⅰ or Ⅱ,were randomly divided into drugs combined with UG-SGB and ozonated autohemotherapy treatment group(group U,n=29)and drugs group(group D,n=28)accord-ing to the random number table.All patients were given drug therapy.In addition to the treatment above,pa-tients in group U also received precise ultrasound-guided stellate ganglion block once on affected side com-bined with ozonated autohemotherapy once daily for 10 consecutive days.Patients in group D received drug therapy only.The average hearing threshold of the two groups was compared before treatment(T0),at dis-charge(T1),1 month(T2),3 months(T3),and 6 months after discharge(T4).The hearing improve-ment of the two groups was also compared at T1-T4 on the basis of T0.Moreover,tinnitus rate of the two groups was recorded T0-T4.In addition,adverse reactions such as toxicosis of local anaesthetics,pneumo-thorax were recorded.Results Compared with T0,the average hearing threshold was reduced significantly in both groups at T1-T4(P＜0.05),the incidence of tinnitus was reduced significantly at T1-T4 in both groups(P＜0.05).Compared with T,,the average hearing threshold was reduced significantly in group U at T2-T4(P＜0.05).The average hearing threshold of group U was lower than that in group D at T1-T4(P＜0.05).The hearing improvement in group U was better than that in group D at T2-T4(P＜0.05).The proportion of complete hearing recovery in group U was increased significantly than that in group D at T2-T4(P＜0.05)The proportion of effective hearing improvement in group U was decreased than that in group D at T3-T4(P＜0.05).No obvious adverse reaction was recorded,such as toxicosis of local anaesthetics,pneumothorax.Conclusion Precise ultrasound-guided stellate ganglion block combined with ozonated auto-hemotherapy based on drug treatment significantly improves the average hearing threshold of patients with sudden hearing loss in acute stage and improve their hearing.