Objective To evaluate the effects of four different intravenous anesthetic agents on middle cerebral artery blood flow velocity(V MCA) measured with transcranial Doppler sonography (TCD) during induction of general anesthesia Methods Fourty patients were classified randomly into four groups (n=10 each) according to intravenous anesthetic agents used: propofol group (group P, propofol 2 0 mg/kg); etomidate group (group E, etomidate 0 3 mg/kg); midazolam group (group M, midazolam 0 15 mg/kg) and thiopental group (group T, thiopental 5 0 mg/kg) Anesthesia was induced with one of above drugs followed by endotracheal intubation and maintained with sevoflurane and nitrous oxide in oxygen The lungs were ventilated to maintain an end tidal PCO 2 of 35 40 mmHg The V MCA, arterial blood pressure (MAP), heart rate (HR) and end tidal PCO 2 were measured and recorded at following occasions: before induction, 1, 3, 5, 10 and 15min after induction Results There were no significant differences in preinduction data (patient age, body weight, sex, MAP, HR, and V MCA) among four groups Compared with the baselines, V MCA decreased by 34 4% in group P, by 34 2% in group E, and by 31 2% in group T(P0 05)1 min after the administration; immediately after the endotracheal intubation, V MCA increased markedly in group M (P0 05) Conclusions The cerebral artery blood flow velocity can be affected differently by various induction agents

Objective To compare the effects of propofol-alfentanil and sevoflurane-N2O anesthesia on cerebral vascular reactivity to the changes in carbon dioxide (CO2). Methods Forty ASA class I - II patients undergoing abdominal operations, were randomly divided into two groups. In group I (n = 20), anesthesia was maintained with infusion of propofol at 0.1mg.kg-1 .min-1, plus alfentanil at 1ug.kg-1. min-1. In group II (n = 20), anesthesia was maintained with 1 % sevoflurane and N2 O-O2 (N2 O: O2 = 3: 2). Mean arterial blood pressure (MAP), heart rate (HR), body temperature (T), end-tidal CO2 tension (PETCO2 ), sevoflurane concentrations, pulse O2 saturation (SpO2 ) and the parameters of the middle cerebral artery blood flow, including mean blood flow velocity (Vm), diastolic blood flow (Vd), pulse index (PI) and resistance index (RI), were measured at following occasions: after intubation and when PETCO2 reached 40, 45, 50, 45, 40, 35, 30 and 40mmHg, which was achieved through adjusting mechanical ventilation. The CO2 reactivity index (CRI) was calculated as delta Vm/delta PETCO2 ratio. Results CRI and Vm were lower in propofol--alfentanil group than sevoflurane-N2O group (P

Objective To identify the risk factors for the development of intraoperative hypothermia in the patients undergoing thoracic surgery.Methods One hundred twenty patients of both sexes,aged 23-83 yr,weighing 43-92 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective thoracic surgery,who had an expected surgical duration of more than 2 h,with the core body temperature of 36.0-37.5 ℃,were included.After admission to the operating room,the core body temperature was measured.Intraoperative nasopharyngeal temperature of lower than 36 ℃ was defined as hypothermia.The patients were randomly divided into hypothermia group or non-hypothermia group according to whether or not intraoperative hypothermia occurred.Factors including the patient characteristics,the total amount of fluid infused (including the volume of blood transfused),duration and way of anesthesia and duration and type of surgery were recorded.The risk factors associated with intraoperative hypothermia were identified by logistic regression analysis.Results A total of 94 patients developed hypothermia during surgery,and the incidence of hypothermia was 78.3％.The lowest body temperature was 33.6 ℃.There was significant difference between the two groups in age,duration of surgery,the total amount of fluid infused,and the body temperature when patients were admitted to the operating room.Logistic regression analysis revealed that the total amount of fluid infused＞2 000 ml (OR =3.499) and low body temperature when patients were admitted to the operating room (OR =0.074) were independent risk factors for intraoperative hypothermia in the patients undergoing thoracic surgery.Conclusion The total amount of intravenous fluid infused＞2 000 ml and low body temperature when patients were admitted to the operating room are independent risk factors in the patients undergoing thoracic surgery.

Objective To explore the morbidity,the diagnosis and the method of therapy of accidental prostatic carcinoma. Methods From Jan of 1984 to May of 2004, 19 cases of prostatic accidental carcinoma were confirmed on pathological examination after prostatectomy for BPH. Bilateral orchiectomy and Estrogen treatment were performed in 6 cases and Bilateral orchiectomy in 7 cases alone but no treatment in 6 cases. Results 5 of the patients wereA1 stage and 14 A2 stage. 12 of them were followed up for 3 to 120 months. 14 of them survived and one untreated died of metastasis to pubis and vertebra after one year. Conclusions Most patients of prostatic accidental carcinoma are A1 and have a better prognosis. Bilateral orchiectomy and Estrogen treatment might improve the patients’s survival rate.

Objective To study the effect of auricular-plaster and meridian-pressing instrument on the prevention of gallstones recurrence after stone removeol.Methods 120 cases which were after endoscopic minimally cholecystolithotomy were selected and randomly divided into the control group and treatment group.All cases were observed for 3 years.Results This research altogether fell off 6 cases,including 2 cases in the control group and 4 cases in the treatment group.The treatment group's gallbladder wall (2.13 ± 0.36)mm was more thinner than the control group's(3.21 ± 0.40)mm,the treatment contract function was more strenghen than the control group,and the gallstone recurrence after stone removeol of the treatment was more smaller.Conclusion Aricular-plaster and meridian-pressing instrument can reduce inflammation of the gallbladder wall,enhance the gallbladder contraction function,and prevent the recurrence of gallstone.

OBJECTIVEThis study aimed to improve students' ability in practical and theoretical courses of oral health education and to promote students' learning interest and initiative.

METHODSFourth-year students of the oral medical profession from 2006 to 2008 at Weifang Medical University were chosen as research objects for oral health education to explore the experimental teaching reform. The students were divided into test and control groups, with the test group using the "speak out" way of teaching and the control group using the traditional teaching method. Results of after-class evaluation of the test group, as well as final examination and practice examination of the two groups, were analyzed and compared.

RESULTSAfter-class evaluation results of the test group showed that the "speak out" teaching method was recognized by the students and improved students' ability to understand oral health education. The final examination and practice examination results showed that the score of the test group was higher than that of the control group (P < 0.01).

CONCLUSION"Speak out" teaching methods can improve students' ability for oral health education, in accordance with the trend of teaching reform.

Visiting doctors' training is a main part of medical education in general hospital,but it has not gained full attention.Based on the features of visiting doctors and the department,a new teaching method-tutorial system was applied to enhance the responsibility of tutors and the sense of belongings of visiting doctors.Individual teaching method was used to enhance the overall quality of visiting doctors and to guarantee the safety of anesthesia treatment for patients.The tutorial system clarified and enhanced the relationship between tutors and visiting doctors and it would be a new teaching mode for the visiting doctors' education in the department of anesthesiology.

Objective To evaluate the topical anesthetic effects of compound lidocaine cream ( CLC) coated endo-tracheal tube on the prevention of cough/agitation during extubation in thyroidectomy under general anesthesia . Methods 42 patients scheduled for thyroidectomy in Peking Union Medical College Hospital were continuously en -rolled in this prospective double-blinded randomized controlled trial .Patients were randomized into two groups . Group L were intubated with endotracheal tube coated with CLC , while the control group , group C with liquid par-affin .The end point of study was spontaneous or induced cough /agitation during extubation .Hemodynamic parame-ters and the consumption of opioids were recorded .Patients were followed for major complications during their stay in hospital .Results Spontaneous cough/agitation rate was lower in group L than group C ( 15% vs 65%, P<0.01 );so was induced cough/agitation (35%vs 90%, P<0.001 );the value of SBP ×HR was lower in group L at 1 min after extubation ( P<0.05 ) .Conclusions The topical anesthetic effects of CLC coated endotracheal tube could prevent cough and agitation during extubation in thyroidectomy under general anesthesia .

Objective To investigate the effects of tumor necrosis factor-α ( TNF-α ) on the resensitization of human lung cancer cell lines A549/DDP to cisplatin (DDP) and to explore the relationship between the expression of TNF-αand resistance-related protein (LRP) in lung tissue.Methods The cytotoxic effects of combinational treatment by TNF-α and cisplatin on A549/DDP were measured by MTT assay.The expression of LRP was assessed by immunocytochemistry methods.Results The IC50 of A549/DDP to cisplatin were decreased from 7.12 ng/L to 5.02 ng/L,4.41 ng/L respectively by 250 U/ml and 1000 U/ml TNF-α treatment ( P ＜ 0.01 ),with the sensitivity of A549/DDP to cisplatin increased by 1.42 and 1.62 fold respectively.LRP was overexpressed in A549/DDP cell.250 U/ml or 1000 U/ml TNF-α plus cisplatin treatment down-regulated the expression of LRP with the positive rates of ( 60.14 ± 6.54 ) ％ and ( 57.23 ± 5.98 ) ％respectively,which were significantly lower than that of cisplatin alone treatment ( 75.97 ± 5.32 ) ％ and control group (79.63 ± 4.78 ) ％ ( both P ＜ 0.01 ).Conclusion Tumor necrosis factor-α can reverse the resistance of A549/DDP to cisplatin,which may be partially attributed to down-regulating LRP expression.

This study was aimed to investigate the theoretical basis of Jian-Shen Li-Shui (JSLS) formula. Knowledge
of acute phase of cerebral hemorrhage in ancient Chinese medicine literature, modern pathophysiology theories, experimental researches and clinical results were studied, in order to discuss theoretical basis of JSLS formula. The results showed that JSLS formula embodied basic theories of traditional Chinese medicine (TCM) and experiences of physicians from different generations. It also reflected modern pharmacology research results. It was supported by animal experiments and clinical research results. It was concluded that JSLS formula was in accordance with essence of TCM syndrome differentiation. There were enough evidences for the formation of the formula. It was worthy of further study.