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 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 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 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 investigate the change characteristics of serum ferritin(SF)and parathormone (PTH)levels in differ-ent stages of chronic kidney disease(CKD)and their correlation with serum beta 2-microglobulin(β2-MG).Methods The levels of serum PTH,SF andβ2-MG in different stages of CKD were detected and the detection results were compared with those in the con-trol group.The correlation between serum SF and PTH withβ2-MG in each stage of CKD was analyzed.Results The level of ser-um PTH,SF andβ2-MG in the compensation group had no statistical difference compared with the control group (P >0.05),while which had statistical differences among the decompensation group,renal failure group and uremia group (P <0.05)The correlation analysis showed that serum PTH was positively correlated with serumβ2-MG in 145 cases(r=0.92,P <0.05),and the serum SF level was also positively correlated with serumβ2-MG level(r=0.92,P <0.05).Conclusion Detecting serum PTH,SF andβ2-MG levels possesses the important clinical significance for understanding CKD condition and prognosis.

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 Using Nutrition Risk Screening (NRS 2002),to assess the nutritional risk of inpatients with digestive diseases and evaluate its clinical significance.Methods The information of 274 patients med the inclusion criteria were collected in our department from August to October 2011.Nutrition status was assessed according to NRS 2002 by trained nurses.Results The prevalence of nutritional risk was 22.99 ％ (63/274).The rate of nutritional risk of the elderly inpatients (≥ 65y) with digestive diseases was significant higher the younger ones (＜ 65y)(32.95％ vs 18.28％,P ＜ 0.05).74.6％ inpatients with nutritional risk and 52.13％ with no risks were given enteral or parenteral nutritional support during the hospitalized period.Conclusion There was higher nutritional risk rate in inpatients with digestive diseases,especially the elderly ones.For deferent patients,the nutritional support should be on the basis of patient' s nutritional state.

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.