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:Study the effect about cone beam CT(CBCT) image guidance sytem to improve the positioning accuracy and reducing the set-up uncertainty in precise radiotherapy. Methods:Use CBCT system to scan head and neck tumors patients (30 cases) and chest tumor patients (40 cases), including head and neck tumor patients were scaned 90 times, chest tumor patients were scaned 113 times. Setup deviation statistics about anterior and posterior, head and feet, left and right direction. Results:The patients with head and neck cancer, the maximum error of anterior-posterior is 6mm, Three directions errors which greater than 3mm all less than 10%. Patients with chest tumor position error are in the head and foot direction, greater than 5 mm up to 21.51%. Before and after the direction of the error did not exceed 5mm. The left and right direction greater than 5 mm up to 4.53%. Conclusion:It greatly enhances the precision of radiotherapy, improved the curative effect of radiotherapy by using CBCT online image guidance system for the patient position correction. Compared with EPID, patients scaned with CBCT absorb smaller cumulative dose, the image resolution is higher, image matching is more accurate. But compared with the ordinary helical CT,the resolution and scanning range also need to improve.

Through analyzing the teaching effect,collected disagreements and suggestions by questionnaire,combining our teaching rules,we proposed efficient innovative methods and suggestions in probation of obstertrics-gynecology.

Objective To comparing the safety and effectiveness of patient-controlled sedation and analgesia with topical anesthesia during strabismus surgery. Methods Sixty-eight patients were selected and randomly divided into two groups (n=34): patient-controlled sedation and analgesia (P group) and control group(C group). SBP, HR, Ramsay's score, cooperation score, satisfactory score, visual pain score(VAS) and side-effects such as agitation and low SpO2 during the surgery were measured. Results There were no significant changes of SBP, HR in P group from 10 minutes after the starting of operation to the end,while SBP, HR in C group were higher in all the procedure than those of the base value. Ramsay's score, cooperation score, satisfactory score of the patients in P group were higher than those in C group. VAS score, agitation and groan incidence were higher in C group than those of in P group. Conclusions Patient-controlled sedation analgesia with a combination of sufentanil and propofol is a safe and effective method for strabismus surgery.

Objective To study the preparation technique for Jiegeng Zaogan capsules (capsules of total saponins from the roots of Platycodon grandiflorum A.DC).Methods The optimal preparation technique for Jiegeng Zaogan capsules was investigated by L9(34) orthogonal test with the Platycodin D content as the observation index.Results The optimized extraction procedure was as follows:extracting for 3 hours each time and 3 times in total,adding 10-fold water,alcohol sedimentation concentration at 65 %,and alcohol sedimentation solution staying for 48 hours.Conclusion The preparation process of Jigeng Zaogan capsules is reliable with stable quality,which offers a feasible method for the industrialization production of the capsules.

10.3969/j.issn.1008-9691.2013.03.004

Studying classic cases is one of the applicable methods for student's self-learning,especially at clinical rotation period.Seven-year program pediatric students (2004 grade) from pediatric medical collage,Capital Medical University of China shared classic cases from New England Journal of Medicine (NEJM),reported clinical cases they took part in and summarized their writing of case report.Through these measures,students felt the significance of studying classic cases and noticed that case study played an important role in training of clinical reasoning,multidisciplinary approach,as well as self-learning ability for medical students.

Objective To investigate the clinical therapeutic effect of Xuebijing injection for treatment of patients with diabetic nephropathy(DN)and its mechanism. Methods 60 DN patients were randomly divided into Xuebijing group and control group(each,30 cases). The patients in both groups received western conventional treatment,and the patients in Xuebijing group received additionally Xuebijing injection intra-venous injection once a day for 14 days. The fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),urinary albumin excretion rate(AER),blood urea nitrogen(BUN),serum creatinine(SCr),hematocrit(HCT),fibrinogen(Fg),whole blood viscosity,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and interleukin -6(IL-6),tumor necrosis factor-α(TNF-α)and urine β2-microglobulin(β2-MG)levels before and after treatment were detected,and the curative effect was also observed in both groups. Results In the control group blood FBG,BUN,SCr,TC,IL-6 and TNF-αafter treatment were significantly decreased and HDL-C significantly increased compared with those before treatment(all P<0.05). Compared with those before treatment,in Xuebijing group after Xuebijing therapy,blood FBG,β2-MG,AER,BUN, SCr,TC,TG,HCT,blood viscosity,IL-6 and TNF-αwere significantly decreased,and HDL-C was obviously increased,but there were no significant differences in HbA1c,LDL-C and Fg before and after treatment. The above indexes were changed significantly in Xuebijing group compared with those in control group〔FBG(μg/L):6.98±1.14 vs. 9.73±1.62,β2-MG(μg/L):32.1±10.9 vs. 57.2±15.1,AER(μg/min):86.0±28.1 vs. 152.0±51.6,BUN (mmol/L):12.4±8.1 vs. 19.5±8.9,SCr(μmol/L):301.2±151.9 vs. 371.3±168.6,HCT:0.283±0.075 vs. 0.351±0.059,TC(mmol/L):3.4±1.8 vs. 4.1±1.5,TG(mmol/L):3.4±1.5 vs. 3.6±1.7,HDL-C(mmol/L):1.90±0.75 vs. 1.50±0.25, IL-6 (ng/L):8.96±2.07 vs. 12.75±2.47, TNF-α(pmol/L):17.85±4.75 vs. 20.87±4.90,P<0.05 or P<0.01〕. The total efficiency in Xuebijing group was significantly higher than that in control group(83.3%vs. 36.7%,P<0.01). Conclusion Xuebijing injection has significant protective effects on patients with DN,and the mechanism might be associated with increasing tissue perfusion and inhibiting excessive inflammatory cytokines release.

Gene Deletion ; Genes, p16 ; Humans ; In Situ Hybridization, Fluorescence ; Mesothelioma ; diagnosis ; genetics ; Neoplasms ; diagnosis ; genetics ; Pleural Neoplasms ; diagnosis ; genetics

Objective To evaluate the cardioprotective effect of trimetazidine in elderly patients with myocardial ischemia and chronic heart failure of coronary artery disease. Methods Eighty nine patients with angiographically proven coronary artery disease were randomized to therapy group (n=45) and controlled group (n=44). The patients in therapy group were given both the routine treatment and trimetazidine 20 mg, 3 times daily, for 6 months. The patients in controlled group were given only the routine treatment. Results After the therapy, the episode of angina pectoris every week was fewer and weekly consumption of nitroglycerin tablets was less in patients of therapy group than those in controlled group: (3.0?1.7 )episodes/w vs (3.9?2.1 )episodes/w,P0.05). Work load were increased 〔(10.2? 2.2) vs( 9.3 ?1.7)METs, P