Objective To investigate the analgesic efficacy and safety of decozine combined with sufentanil on patients after laparoscopic radical gastrectomy.Methods Sixty patients undergoing laparoscopic radical gastrectomy,American Society of Anesthesiologists (ASA) Ⅰ ～ Ⅱ,were selected,and were randomly divided into two groups.All of the patients were treated with intravenous-inhalation combined anesthesia,and was given patient controlled intraveous analgesia (PCIA) when the patient was awoken.PCIA was administered with subsequent bolus of 0.5 ml with lockout time 15 minutes and background infusion of 2 ml/h.A ratio (3 μg/kg) of sufentanil and 0.5 mg palonosetron were mixed in PCIA pump in sufentanil group (S group);and 1.5 μg/kg sufentanil,0.3 mg/kg dezocine,and 0.5 mg palonosetron in PCIA were mixed in dezocine combined with sufentainl group (DS group),they were diluted to 100 ml with saline.The visual analogue scale (VAS),Bruggrmann comfort scale (BCS),Ramsay and incidence of adverse reactions of two groups were observed in 2 h (T1),6 h (T2),12 h (T3),24 h (T4),48 h(T5) after operation.Results There was no significant difference of VAS and BCS between two groups at each time point after operation (P ＞ 0.05);The Ramsay score of S group was significantly higher than that of DS group at T1,T2,and T3 (P ＜ 0.05).The Ramsay scores of two groups at T4,T5 were lower than those of T1,T2,and T3.The incidence of nausea,vomiting of DS group was significantly lower than that of S group (P ＜0.05).Conclusions Dezocine combined with sufentainl used in PCIA on postoperative gastric cancer patients can obtain satisfactory analgesic effects,but has fewer side effects than single sufentainl.

To explore the accuracy of simple selection method of Fengshi (GB 31). Through the study of the ancient and modern data,the analysis and integration of the acupuncture books,the comparison of the locations of Fengshi (GB 31) by doctors from all dynasties and the integration of modern anatomia, the modern simple selection method of Fengshi (GB 31) is definite, which is the same as the traditional way. It is believed that the simple selec tion method is in accord with the human-oriented thought of TCM. Treatment by acupoints should be based on the emerging nature and the individual difference of patients. Also, it is proposed that Fengshi (GB 31) should be located through the integration between the simple method and body surface anatomical mark.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians

A typical investigation on third-tier general hospitals, third-tier specialty hospitals, second-tier district or county central hospitals, urban community hospitals, and rural township health centers in Shanghai was conducted so as to examine the responsiveness of outpatients and inpatients to the health system. Most of the patients surveyed said that they could get prompt attention and that they had convenient access to medical information from the community or the mass media. More than half of the inpatients and outpatients thought that they had autonomy with regard to treatment and a greater number of patients made their own choices of doctors and nurses. Most of the patients were willing to talk freely with their doctors about their confidential medical history and could get rational explanations about their conditions from the doctors. The results indicate that reform of the health system in Shanghai has attached importance to the responsiveness of patients and that good effects have been achieved.

Objective To investigate if mitochondrial KATP channels are involved in the cardioprotective effects of astragalus membranaceus in immature rabbit hearts. Methods Twenty-four New Zealand white rabbits of both sexes aged 14-21 days weighing 300-350 g were anesthetized and heparinized. The hearts were rapidly removed after thoracotomy and mounted on a Langendorff apparatus via ascending aorta and perfused with oxygenated (95% O2-5% CO2) Krebs-Hensleit buffer (KHB) solution at 60 cm H2O (perfusion pressure) and 38 ℃ . A fluid-filled latex balloon was inserted into left ventricle via left atrium for measurement of left ventricular developed pressure ( LVDP) , Global myocardial ischemia was induced by suspension of perfusion for 30 min followed by 45 min reperfusion. The animals were randomly divided into 3 groups with 8 animals in each group : group A control;group B astragalus and group C astragalus +- 5-HD (a selective inhibitor of the mitochondrial KATP channel). In group B the hearts were perfused with astragalus 40 g? L-1 for 15 min before ischemia. In group C the hearts were perfused with 5-HD 100?mol?L-1 for 5 min followed by 10 min astragalus perfusion before ischemia. In control group the hearts were perfused with only KHB before ischemia. Coronary flow (CF), HR, LVDP and ? dp/dtmax, were measured at 5, 10, 15, 30 and 45 min of reperfusion and recorded. Coronary effluent was collected at 10 min of reperfusion for determination of CK-MB, LDH and CK levels . At the end of 45 min reperfusion the isolated heart was removed for determination of myocardial ATP and iNOS levels and electron microscopic examination.Results In astragalus group (B) LVDP ? dp/dtmax and CF recovered significantly better and myocardial ATP content was significantly higher as compared with group A and C (P

Objective To investigate surgical techniques of minimally invasive management for multiple calculi in the kidney and ureter. Methods Combined use of ureteroscopic lithotripsy(URSL) and minimally invasive percutaneous nephrolithotomy(MPCNL) was carried out in 21 patients with multiple calculi in homolateral kidney and ureter between January and October 2005 in this hospital.Results Percutaneous nephrostomy was required before the stone removal in 2 patients with pyonephrosis.Of the remaining 19 patients,all the ureteral calculi were completely removed on one session.And the renal calculi were removed by single session in 13 patients,by secondary percutaneous nephrolithotomy in 3 patients,and by tertiary nephrolithotomy in 2 patients.The combination treatment failed in 1 patient because of stricture of uretero-vesical orifice and a conversion to open surgery was needed.Conclusions Combination use of ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy is effective for the treatment of multiple calculi in homolateral kidney and ureter,offering advantages of minimal invasion,rapid recovery,and few complications.

Objective To probe the application value of radionuclide bone imaging in pre-treatment selection of therapeutic plan and regular post-treatment follow-up of patients with primary pulmonary cancer.Methods 810 patients with primary pulmonary cancer had radionuclide bone imaging respectively before the treatment. The follow-up radionuclide bone imaging was performed in 492 cases that were treated by surgery in 2 years after the operation. For 318 cases that were treated by non-surgery way,only 142 cases that had no skeletal metastases had follow-up radionuclide bone imaging in 2 years after the treatment. Results 179 cases (22.1%) had skeletal metastases in 810 cases. Multiple skeletal lesions were found in 157 cases and single skeletal lesion found in 22 cases. The majority sites of skeletal metastases were ribs, vertebrae column and pelvis. 57 cases that were treated by surgery had new skeletal lesions in 2 years after the operation. For non-surgery patients,79 cases had new skeletal lesions in 2 years after the treatment. Conclusion Radionuclide bone imaging is useful in the selection of therapeutic plan and staging of primary pulmonary cancer before the treatment.Regular bone imaging after the operation is helpful to detect early bone metastasis and choose the therapeutic plan, and should be regarded as a foremost method to detect the skeletal lesion. Radionuclide bone imaging after the non-surgery treatment maybe help us to conclude the prognosis of the patients.

AIM: To compare the effects, adverse reactions and emotion change of venlafaxine vs furazolidone for harmful alcoholics.　METHODS: Sixty-eight patients with harmful alcoholics were divided into two groups. Thirty-four patients (M34; age 37 a± s 6 a) were treated with venlafaxine, 25-50 mg, po, tid, for 8 wk. The other thirty-four patients (M34;age 38 a±6 a) with furzolidone, 0.1-0.2 g, po, tid, for 8 wk, with drinking alcohol at regular intervals during treating with furazolidone.　RESULTS: The total effective rate was 79% in venlafaxine group at 3 mo. There were no obvious adverse reactions, the anxiety disorder and depressive disorder during treating with venlafaxine. And the total effective rate was 65% in furazolidone group (P<0.05). There were obvious adverse reactions such as hypotension, myocardial ischemia, anxiety disorder and depressive disorder after treating with furazolidone.　CONCLUSION: Adverse reaction of venlafaxine on harmful alcoholics is smaller than furazolidone and the effect of venlafaxine on alcoholics is better than furazolidone.

Objective To explore the diagnostic value of color doppler flow imaging (CDFI) on subclinical varicocele(SVC) and the weakening effect of SVC on male fertility.Methods Thirty patients with SVC were exam-ined by CDFI, the diameter and regurgitation duration of spermatic vein were recorded.All semen specimens were rou-tinely analyzed according to the WHO criteria for sperm morphology.Thirty healthy sperm donors were served as con-trols.Results CDFI displayed a widened diameter( 1.94±0.28 mm vs 1.36 ±0.15 mm, P < 0.05 ) and prolonged regurgitation duration[(1.33 ±0.22)s vs(0.43 ±0.16)]s,P<0.05)of spermatic vein in patients with SVC.Sperm density[(20.2±0.1)106/ml vs(86.3±0.6)]106/ml,motihty[(50.7±0.9)% vs(78.5±3.6)]% and vitality [(41.5 ±0.3)% vs (58.7 ±0.6)]% were significantly decreased in patients with SVC compared with those in con-trols (all P< 0.05) ,while the rate of teratospermia remarkably increased in SVC group[(10.5±0.2)vs(4.8±1.7 )]%(P< 0.05 ).Conclusion CDFI was clinically valuable for diagnosis of SVC for its revealing morphological and hemodynamic changes of varicocele.When combined with semen quality analysis,which evaluates the weakening effect of SVC on male fertility, CDFI was suitable to provide the appropriate clinical approaches for SVC therapy.

Objective To investigate the clinical efficacy of the urethra URSL combined with micro-puncture and drainage treatment for pediatric calculus of lower urinary tract. Methods From January 2003 to January 2013, 66 cases with pediatric urinary tract calculi in our hospital were randomly equally divided into experimental group and control group. The experimental group was treated with transurethral bladder micro URSL combined puncture and drainage treatment, and the control group was given a simple transurethral URSL method of treatment. The operative time, postoperative urine turned clear time,pulling stone clearance after catheter time,postoperative hospital stay and the incidence of postoperative urethral stricture were observed and recorded. In addition, these data were compared between the two groups. Results The operations of two groups have successfully completed. The mean operative time, postoperative urine turned clear time, pull out the catheter stone clearance after time and postoperative hospital stay of control group was 30.2±2.45 minutes,2.5±0.5 days,2.1±0.8 days and 4.0±0. 5 days, respectively. Patients were followed up 1 year after operation, and 1 case of urethral stricture occurred. However, the mean operative time, postoperative urine turned clear time, pull out the catheter stone clearance after time and postoperative hospital stay of the test group was 20.36±2.35 minutes,1.5±0.7 days,1.1±0.25 days and 3.1±0.3 days,respectively,with no urethral stricture case occurred. There were significant differences between the two groups ( <0.05) . Conclusion Transurethral bladder URSL micro puncture and drainage combined with transurethral ureteroscopy lithotripsy treatment for children with lower urinary tract calculi has better efficacy and safety. It could shorter operative time, postoperative urine turned clear time, the gravel discharge time and average hospitalization time, reduce the incidence of postoperative secondary urethral stricture.

Objective To observe the effect and safety of the treatment of urethral stricture with guide wires leading a balloon dilatation catheter.Methods The clinical date of 25 cases of male patients suffering traumatic posterior urethral stricture were analyzed retrospectively,was treated with a balloon dilation catheter led by guide wires.Results All our patients were cured successfully with a guide-wire-leading balloon dilatation catheter expanding only once and there were no complications such as urethral perforation,rectal injury etc.Although 2 cases had not been ohviously improved risht after dilatation,but improved furtherly six months later.The follow-up was six to twelve months.23 cases were cured.2 osses were improved.The recovery rate was 92%.The effective rate was 100%.Conclusion It was safe and effective to treat urethral stricture with balloon dilation catheter led by guide wires.