Objective To investigate the effect of desflurane on neuromuscular blockade of rocuronium Methods Thirty adult patients ,scheduled for selective surgery under general anesthesia, were randomly allocated to receiving intravenous propofol 4mg?mg -1 (group I,n=10),inhalation of 1MAC(6%) desflurane lasting 15 min (group Ⅱ,n=10) or 45 min(group Ⅲ,n=10) to maintain anesthesia,respectively Rocuronium 0 6 mg?kg -1 was given intravenously in group I following stable anesthesia , in group Ⅱ or group Ⅲ with the stable end tidal concentration of desflurane at 1MAC for 15 min or 45 min,respectively The onset time and degree of neuromuscular blockade were monitored with train of four(TOF) technique.Results The onset times of T 1 and TOF in group Ⅲ(1 3 and 0 8 min) were shorter than in group I(2 2 and 1 5 min)(P

ve To investigate the time course of potentiation of rocuronium produced by 1MAC of desflurane or isoflurane. Methods Twenty-four ASA I-II patients aged 18-60 years undergoing elective abdominal operation under general anesthesia were studied. Patients with neuromuscular, liver or kidney disease and those receiving any drug which may affect neuromuscular transmission were excluded. Premedication consisted of intramuscular phenobarbital 0.1 and atropine 0.5mg 30min before operation. Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1, fentanyl 6?g.kg-1 and etomidate 0.3mg?kg-1 .Tracheal intubation was facilitated with rocuronium 0.6mg?kg-1 iv. The degree of neuromuscular block was monitored by measuring muscle response to TOF using accelerography (Biometer) . For maintenance of anesthesia the patients were randomly assigned to receive either propofol + fentanyl (control group) or 1 MAC of desflurane + propofol + fentanyl (desflurane group) or 1 MAC of isoflurane + propofol + fentanyl(isoflurane group). Rocuronium was continuously infused during operation to maintain T1 at 5 % of the control and the infusion rate was recorded every 15 min. Results There were no significant differences among the three groups with respect to sex, age, body weight and duration of anesthesia. In Des and Iso groups the infusion rate of rocuronium was reduced in an exponential manner and maximal potentiation occurred at 90 min of isoflurane or desflurane inhalation. The maximal reduction in infusion rate was 42.7 % in Des group and 37.6% in Iso group. There was no significant difference between the two groups.Conclusions Desflurane and isoflurane can potentiate the muscle relaxation produced by rocuronium in a similar degree and the potentiation is time dependent.

Objective To investigate the change in neuromuscular blocking effect of rocuronium induced by liver dysfunction. Methods Forty patients undergoing elective liver and biliary tract operation under general anesthesia were divided into 2 groups : (A) control group included 20 patients with normal liver function and (B) liver dysfunction group included 20 patients with obstructive jaundice. The premedication consisted of phenobarbital 0.lg and atropine 0.5 mg. Anesthesia was induced with midazolam 0.1 mg?kg-1,fentanyl 6?g?kg-1 and etomidate 0.3 mg?kg-1.The neuromuscular function was monitored by TOF stimulation of the ulnar nerve using accelerograph (Biometer).Rocuronium 0.6 mg?kg-1 was administered iv via the vein in the upper arm.The patients were intubated when T1 was 95% depressed and mechanically ventilated.PETCO2 was maintained at 35-40 mm Hg.The onset time (from the end of injection to T1=0),clinical duration of action (from the end of injection to 25% recovery of T1) and recovery index (T1 from 25% to 95% ) were recorded.MAP, HR and SpO2 were recorded before and at 5 and 10 min after rocuronium injection.Results The demographic data including sex, age and weight were comparable between the two groups. The onset time was (63?19) s in group A and (70?21) s in group B.The difference was not statistically significant. The clinical duration of action was (41?16) min in group A and (67?29) min in group B (P0.05).Conclusion Liver dysfunction induced by obstructive jaundice prolongs the clinical duration of action,but does not significantly affect the onset time of and recovery from rocuronium.

Objective:To observe the protective effects of sodium ferulate (SF) on rabbit myocardial ischemia reperfusion injury. Method: Sixteen rabbits were divided randomly into three groups: group A undergoing all procedures except for ischemia-reperfusion and treatment, group B given the routine treatment after ischemia-reperfusion, and group C receiving the routine treatment combined with the intravenous infusion of SF 40mg?kg~(-1) after ischemiareperfusion. Result: Group C showed a significant reduction in myocardial MDA content and plasma ET level (P

Objective To establish a method for the determination of Radix et Rhizoma Rhei in Roufuyuliecuotie. Methods The sample was extracted with methyl and the chromatographic condition was as follows :C18 chromatographic column (250 mm?4.6 mm, 5 ?m), a mobile phase of acetonitrile-water- glacial acetic acid (60∶40∶l), the detection wavelength at 437 nm and the flow rate at 1.0 mL/min. Results A linearity of Radix et Rhizoma Rhei in Roufuyuliecuotie was obtained at range of 0.014～0.14 ?g, r =0.9996 (n =6). The average recovery was 98% and RSD=1.47% (n=6). Conclusion This method is easy, sensitive and accurate for the determination of Radix et Rhizoma Rhei in Roufuyuliecuotie.

Nonalcoholic fatty liver disease(NAFLD)is the most common cause for elevated liver enzymes in the developed nations.The treatment should be focused on the most important risk factors,obesity and insulin resistance.As a consequence of elucidating the pathogenesis of NAFLD,the number of potential therapeutic options increased,including weight reduction,antioxidants,insulinsensitizer,lipid lowering drugs and other liver protective drugs.The drug therapy for NAFLD was reviewed in this paper.

Objective To analyse the expression of alpha-fetoprotein variant-L3(AFP-L3)and glypican-3(GPC-3)in primary he-patic carcinoma(PHC)with different concentration of alpha-fetoprotein (AFP),so as to provide references for the diagnosis of PHC.Methods 240 cases of outpatients,inpatients and individuals on physical examination were selected as subjects and serum levels of AFP-L3 and GPC-3 were detected.All of the subjects were divided into negative group(0≤AFP<20 ng/mL),low concen-tration group(20≤AFP<400 ng/mL)and high concentration group(AFP≥400 ng/mL)according to the serum levels of AFP.Ser-um levels of AFP-L3 and GPC-3 were compared among the three groups.And the sensitivity,specificity and accuracy of single de-tection of AFP-L3 or GPC-3 and those of combined detection of AFP-L3 and GPC-3 were compared as well.Results The serum levels of AFP-L3 and GPC-3 in the low concentration group and high concentration group were both higher than those in the nega-tive group,and those in the high concentration group were also higher than those in the low concentration group,had statistically significant differences(P < 0.05 ).The sensitivity,specificity and accuracy of combined detection of AFP-L3 and GPC-3 were 84.4%,95.9% and 93.8% respectively,which were higher than those of single detection of AFP-L3 or GPC-3.Conclusion Com-bined detection of AFP-L3 and GPC-3 could improve the sensitivity,specificity and accuracy for diagnosis of PHC,which has clinical significance for the diagnosis of PHC.

Objective:To investigate cancer mortality in Zhejiang cancer registration areas from 2010 to 2014. Methods:Cancer regis-tration data were collected from 14 cancer registries of Zhejiang province. The number of cases, crude rates, proportions, age stan-dardized rates, cumulative rates, cut rates, age-specific rates, top 10 mortality ranks, and annual percentage change (APC) of cancer mortality were calculated. Results:A total of 108,514 cancer deaths in Zhejiang cancer registration areas from 2010 to 2014, including 70,578 males and 37,936 females, were recorded. The crude mortality rate was 186.06/105. The standardized mortality rates in Chi-nese (ASMRC) and world populations were 103.02/105 and 101.73/105, respectively. The cumulative mortality rate (0-74 years old) was 11.46%. The ratio of ASMRC in male and female was 1.95, and that in urban and rural areas was 0.93. Age-specific cancer mortality in-creased significantly after 40 years old and peaked at the 85+age group. The crude cancer mortality increased from 2010 (182.85/105) to 2014 (191.00/105) by 4.46%. After age standardization, the mortality rate standardized by Chinese population was reduced from 107.85/105 to 100.60/105. The APC of ASMRC was-1.96%(P=0.017). The top three mortality cancers were lung cancer, liver cancer and gastric cancer. The top 10 cancers accounted for 89.51%of all cancer deaths. The mortality rates in different age groups were inconsis-tent. Leukemia was the main cancer type among 0~14-year-old population. Liver cancer was the most common cancer type in 15~44-year-old population. Lung cancer was the main cancer in population above 45 years old. The ASMRCs of liver cancer, gastric cancer and esophageal cancer decreased, whereas those of pancreatic cancer, prostate cancer and ovarian cancer increased. Conclusion:Can-cer mortality in Zhejiang cancer registration areas increased, which revealed that the number of cancer deaths will continue to in-crease. However, the ASMRC decreased, which indicated that cancer prevention in Zhejiang province had achieved certain effects. Fur-ther measurements, such as health education, cancer screening, and early detection and treatment, should be improved to reduce the danger of cancer.

Objective To investigate the related prognostic factors of stage Ⅳ gastric cancer.Methods The clinical data of 248 patients with stage Ⅳ gastric cancer and intact follow up data in the Tumor Prevention and Treatment Center of Sun Yat-Sen University from 2000 to 2010 were retrospectively summarized.The twelve clinicopathological parameters served as the observation indicators,including age,sex,body mass reduction,H b,CEA,CA19-9,Borrmann type,tumor location,tumor size,pathological pattern,operative mode,metastatic sites and therapeutic model.The survival curve was drawn by using the Kaplan-Meier method.The median survival time was calculated.The univariate analysis was conducted with Log-rank test.The prognosis multivariate analysis was conducted by the Cox's proportional hazards regression analysis.Results MST in the patients of whole group was 254 d.The univariate analysis showed that sex,Borrmann type and therapeutic mode were the related factors afecting gastric cancer prognosis,while the Cox regression model revealed that above 3 indicators were also independent factors affecting the prognosis of the patients with stage Ⅳ gastric cancer in this group(P＜0.05).Conclusion The treatment mode is an important independent factor affecting the survival of stage Ⅳ gastric cancer,the translational medicine model of palliative chemotherapy combined with palliative operation conduces to improve the prognosis in the patients with stage Ⅳ gastric cancer.

Objective By comparing the medical complaints and disputes between the two tertiary general hospitals in Beijing and Lhasa, this paper proposed on how to build a harmonious doctor-patient relationship.Methods A study of annual reports of these two hospitals analyzed descriptively patient complaint rate, rate of medical disputes registered for court jurisdiction, makeup of medical disputes, and their solutions.Results In 2016, the patient complaint rate, and rate of medical disputes registered for court jurisdiction were 3.5/10 000 and 12.4/10 000 respectively, much higher than 0.8/10 000 and 1.1/10 000 of the Lhasa counterpart hospital.A significant gap was also found in the makeup of medical disputes, their solutions, and role of hospital leadership between the two hospitals.Conclusions Beijing is recommended to appoint hospital leader on duty, to assist in handling medical complaints and disputes, and ease doctor-patient contradictions.Lhasa is recommended to improve the medical dispute handling mechanism, improve medical service competency and management.