Objective To discuss the anesthesia experience for the elderly patients undergoing total. Methods All 50 cases received the epidural anesthesia, during the operation, MAP,HR and SPO2 were monitored. The blood glucose was monitored for each 45 minutes for the diabetes patients. Results All patients satisfied with the effect of epidural anesthesia, blood pressure dropped to varying degrees, the appropriate colloidal solution was used to expand capacity, prepared baek-ephedrine and alropine. These measures help maintain a stable blood pressure, iinprove the blood indexes, save blood transfllsion, reduce the ineidenee of lung infection, also provide a good postoperative epidnral analgesia. reduce Ihe occurrence of postoperative complications. Conclusion Continuous epidural anesthesia in ehterly patients with total hip replacement might help reduce postoperative complications and improve the quality of rehabililtation.

Objective To compare the therapeutic effect of endoscopic variceal ligation (EVL) and β-blockers plus isosorbide mononitrate (ISMN) in prevention of esophageal varieeal re-bleeding. Methods The randomized clinical trials (RCTs) on EVL and β-blockers plus ISMN for the prevention of esophageal varieeal re-bleeding were searched, and only the results from those with Jadad score higher than 3 were eval-uated with RevMan 4. 2 software for odds ratio (OR) with 95% confidence intervals (95%C1). Analysis of sensitivity was performed on the quality of the data and publication bias was investigated with funnel plots. Results Four trials matched the criteria were recruited including 504 cases with a follow-up from 8 to 25 months. There was no significant difference in rates of re-bleeding (OR =0. 93, 95% CI =0. 41 ～ 2. 11 ; P = 0. 87), re-bleeding due to esophageal varices (OR = 0. 68, 95% CI = 0. 19 ～ 2. 37 ; P = 0. 54), therapy-re-lated adverse effects (OR = 1.12, 95% CI =0. 75 ～ 1.67, P = 0. 57), severe adverse events (OR = 0. 89, 95% CI =0. 47 ～ 1.67, P = 0. 71), bleeding-related mortality (OR = 2. 11, 95% CI = 0. 88 ～ 5.08, P = 0. 10), or overall mortality (OR = 1.46, 95% CI = 0. 95 ～ 2. 24, P = 0. 09) between EVL and β-blockers plus ISMN groups. However, a trend towards lower bleeding-related mortality and overall mortality favored drug therapy. There was no heterogeneity found in the outcomes apart from re-bleeding (P = 0. 003) or re-bleeding from esophageal varices (P <0. 0001). The result of sensitivity analysis remained statistically sta-ble. Symmetric funnel plots showed there was no evidence of publication bias. Conclusion EVL and β-blockers plus ISMN show an equivalent efficacy and safety for the prevention of esophageal variceal re-bleed-ing. There is a trend towards lower bleeding-related mortality and overall mortality in drug therapy. But EVL is free from drug-related side effects, and its adverse events are similar to those of drug therapy. Thus, either of the two approaches can be used as the first choice for prophylaxis of re-bleeding of esophageal varices.

The neonatal period is important for the dramatic increment as well as function improvement of islet β-cell.β-cell mass augmentation is primarily regulated by neogenesis,replication,and apoptosis.The mechanisms involve cell cycle related proteins and mitosis-promoting signaling pathways.This remodeling period has far-reaching effects on the body in adapting to the metabolic needs and regulating glucose homeostasis later in life.

The β-cyclodextrin cross-linked polymer(β-CDCP) was used as adsorbent to pre-concentrate/separate the trace p-nitrophenol and then the determination was carried by UV-Vis spectrophotometry. Under alkaline condition,the adsorption/elution behavior of p-nitrophenol was studied. In 0. 02 mol/L NaOH solution and at room temperature for 30 min,the resin could separate and pre-concentrate the p-nitrophenol effectively. Methanol solution(1:1,V/V) was used as eluent and the β-CDCP could be used repeatedly. The linear range and detection limit was 0.5 -90.0 mg/L and 3. 10 μg/L,respectively. The proposed method has been used to determine the p-nitrophenol in synthesized sample with satisfactory results.

AIM　To observe the protective effects of TGP on local cerebral ischemia. METHODS　The local cerebral ischemia in rat was made by middle cerebral artery occlusion(MCAO). The infraction weight was determined by NBT stain. SOD, MDA and apoptosis were determined with different method respectively. RESULTS　TGP 20 mg*kg-1 ip markedly improved the abnormal nervous symptoms, increased the SOD activity and reduced contentes of MDA in MCAO rat. TGP 20 mg*kg-1 ip significantly decreased the numbers of apoptotic cells in ischemic cortex. CONCLUSION　TGP has protective effects against cerebral infarction, and its mechanism may be related to anti-apoptosis and free radical.

Objective To explore the application of bilevel non-invasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease(COPD) with respiratory failure.Methods 126 COPD patients with type Ⅱ respiratory failure were selected and divided into control group and research group,63 cases in each group.The control group received regular treatment,and the research group received bilevel non-invasive mechanical ventilation on the basis of regular treatment.,The results of blood gas analysis,respiratory frequency(RR),heart rate(HR) and expiratory flow(PEF) were observed and compared between the two groups.Results The indicators of pH,PaCO2,PaO2 in the research group after treatment were (7.41±0.08),(51.26±12.13)mmHg,(77.28±15.34)mmHg,which in the control group were (7.26±0.07),(67.21±13.05)mmHg,(69.26±14.31)mmHg,compared with before treatment,pH and PaO2 of the two groups were increased,PaCO2 was decreased after treatment,and the three indicators of the research group were changed significantly better than those of the control group,the differences were statistically significant(t=11.2,7.11,3.03,all P<0.01).After treatment,HR and PR of the two groups were decreased,PEF was increased.The three indicators of the research group were also changed significantly better than those of the control group,the differences were statistically significant(t=3.13,8.58,5.45,all P<0.01).Conclusion Bilevel non-invasive mechanical ventilation in the treatment of COPD with respiratory failure has remarkable clinical effects,can significantly improve the patients' blood gas analysis index,HR,RR and PEF,and it is worthy of clinical application.

Newborn due to low birth weight caused by preterm or fetal growth restriction will have an adverse effect on kidney development. In adulthood,the long-term adverse effects of low birth weight are associ-ated with a variety of kidney disease. Current studies suggest that low birth weight may participate in a variety of kidney disease development and progression by affecting the nephron number,the function of the vascular struc-ture and the endocrine level. This paper mainly reviews the relationship between low birth weight and kidney dis-ease.

Objective To investigate the relationship between auxotypes,antibiotic resistance and plasmid of Neisseria gonorrhoeae. Methods 83 isolates of Neisseria gonorrhoeae from Chongqing during the period from January 1994 to November 1995 were examined.Results Eight auxotypes were detected in 83 strains. The prevalent auxotypes were proline requiring strains (51.8%) and nonrequiring (18.1%). The agar dilution method was performed to detect the susceptibility of 83 isolates to pencillin,tetracycline and spectinomycin, the results indicated that 15.6% of strains was penicillin resistant,70% was tetracycline resistant, 1.2% was spectinomycin resistant. Plasmid profile of 44 isolates,which was tested by rapid alkaline extraction method, showed that 70% of the strains carried 24.5 Md conjugative plasmid, 80% carried 2.6Md cryptic plasmid, 66% carried both 24.5Md and 2.6Md plasmids, and no plasmid was found in 16% of the strains. In Pro - strains both penicillin resistant strains and 24.5Md plasmid carrying strains were more common than other auxotypes (P

Objective To report a pedigree of generalized atrophic benign epidermolysis bullosa (GABEB),a special type of junctional epidermolysis bullosa(JEB). This is the first case report in China. Methods The clinical, histologic, electron microscopic, and immunofluorescence changes of the disease were evaluated. Results Besides the symptom of inherited epidermolysis bullosa, the patient had special clinical manifestations such as atrophic alopecia and dental dysplasia. The disease was inherited in an autosomal recessive mode in this pedigree. Electron－ microscopy found the fissure in lamina lucida, accompaning with dysplasia and sparse hemidesmosome. Immunofluorescence study did not show BPAg2 in the basement membrane zone, indicating that mutation in the gene encoding BPAg2 leading to the disease in this family. Conclusions The case is diagnosed as GABEB, a special type of JEB. Although GABEB has its characteristic, clinical manifestations, electron microscopy and immunofluorescence study are important for confirmative diagnosis and classification, and will guide the study of mutation detection.

Objective To evaluate the possible association between depression and cellular immunologic status in patients with condyloma acuminatum (CA). Method Depression was assessed with the Self-rating Depression Scale (SDS) and the activity of natural killer (NK) cells, the interleukin-2 (IL-2) produced by peripheral blood mononuclear cells (PBMC) were measured in 60 patients with CA. Results The SDS scores in patients with CA were significantly higher than those in the controls (P 3 months) were significantly higher than those in patients with short duration (≤3 months) (P