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 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 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.

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 .

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.

Objective To evaluate the effects of different sequences of intravenous administration on fentanyl-induced cough during induction of general anesthesia.Methods One hundred patients of both sexes,aged 18-70 yr,weighing 42-88 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were equally randomized to 2 groups using a random number table:fentanyl-propofol group (group FP) and propofol-fentanyl group (group PF).In FP group,fentanyl 3 μg/kg was injected intravenously over 3 s,and then propofol 1.5 mg/kg was injected intravenously.In PF group,propofol 1.5 mg/kg was injected intravenously,and then fentanyl 3μg/kg was injected intravenously over 3 s.The development,intensity and onset time of cough were recorded within 1 min after fentanyl injection.Results Compared with FP group,the incidence of cough was significantly decreased,and no significant change was found in the intensity and onset time of cough in PF group.Conclusion Administration in the propofol-fentanyl sequence can reduce the development of fentanyl-induced cough as compared with that in the fentanyl-propofol sequence during induction of general anesthesia.

34 medical college students and 26 patients with primary hypertension were served as the subjects on low sodium salt diet for 4 weeks. Before and after the experiment, serum and urinary sodium and potassium, as well as blood presure, pulse rate, and body weight were measured. During the testing period, calorie and protein were supplied sufficiently and the salt content in their common diet taken was restricted strictly. The results showed that the serum sodium decreased, potassium increased at the end of the experiment, but the changes were all within the physiological permissible limits. On the contrary, urinary sodium increased, potassium decreased and the Na/K dropped markedly, body weight increased slightly in healthy subjects and decreased by 1.0-3.0kg in patients with hypertension. The blood pressure, both systolic and diastolic, was decreased but no change in the pulse rate was observed.It was obvious that in the subjects on common salt diet, the body sodium was high and potassium low, otherwise on low sodium salt diet, such situation might be improved, and the high blood pressure could also be ameliorated in the type Ⅰ and Ⅱ of hypertension.

Objective To evaluate the efficacy and safety of tulobuterol patch in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) in the elderly. Methods Totally 165 elderly patients with moderate to severe AECOPD were divided into trial group and control group randomly.83 patients of trial group were treated with tulobuterol patch,2 mg once a day,and fluticasone inhalation 250 μg twice a day; 82 patients of control group were treated with inhalation of salmeterol/fluticasone 250 μg/50 μg twice a day.Basic therapy was the same in two groups. Results After 10-14 days' treatment,forced expiratory volume in one second(FEV1),peak expiratory flow (PEF),6-min walking distance and symptom scores were ( 1.30 ± 0.31 ) L,(245.3 ± 56.1 ) L/min,(263.0±53.2)m,(33.2±12.1)scores in trial group,and (1.21±0.23)L,(213.9±58.4) L/min,(230.0±45.6)m,(37.8± 14.5) scores in control group,respectively.The lung function,6 minute walk distancc and symptom score were improved (t=2.120,3.521,4.279,2.212,all P＜0.05).The frequencies of rescue medication,waking-up suffocating at night and the days of hospital stay were deceased significantly in trial group as compared with control group[(2.5 ± 0.6) time/d,( 1.8 ± 0.5)time/week,(12.9±1.6)dvs.(2.90.8) time/d,(2.2±0.7) time/week,(14.1±1.8) d,t=3.610,4.219,4.524,all P＜0.05].The incidence of adverse reactions was not significant difference between two groups[8 cases(9.6％)vs.7 cases(8.5％),P＞0.05] and the adverse reactions were mild.Conclusions Tulobuterol patch is a newly formulated,effective and safe medication for the treatment of acute exacerbation of AECOPD.