Objective To explore the relationship between the level of synaptic monoamine transmitters and epilepsy and its severity.Methods The models of seizure were made with intraperiloneal injection. The concentrations of serotonin (5-HT), dopamine (DA), and norepinephrine (NE) in palium(Pal), hippocampus (Hip) and corpus and striatum (Str) were determined with flurospectrophotometry. Results The severity of epilepsy was negatively correlated with the level of 5-HT in all three regions (P<0.05) with that of NE in Hip (P<0.01). The level of 5-HT of three seizure groups dropped significantly, the level of DA dropped significantly only in Str (P<0.01), and the level of NE dropped significantly only in Hip (P<0.01). Conclusion Monoamine transmitters in different regions closely affect the severity and sensitivity of epilepsy depends on the level of special transmitters in different brain regions.

0 05), but HR was significantly higher (P

Objective To observe the changes of haemodynamics and cerebral state index during double-lumen endobronchial intubation with glidescope ranger video laryngoscope (GSVL) and macintosh direct laryngoscope (MDLS). Methods Forty-eight ASA Ⅰ or Ⅱ patients aged 35 ～ 67 yrs were enrolled in this study, who were scheduled for elective pulmonary cancer or cancer of esophagus radical correction tients were random divided into 2 groups( n =24 each), GSVL group and MDLS group. After anesthesia was induced, all patients were given a score of Cormack grading under MDLS and GSVL, and then endobronchial intubation was performed. Noninvasive BP and HR were recorded before and after induction of anesthesia, during endobronchial intubation and after endobronchial intubation was completed for 1,2, 3, 4,5 min. The CSI was continuously monitored and recorded before and after induction of anesthesia, and after endobronchial intubation for 1 ～ 2 min and 3 ～ 5 min. Results Compared with MDLS group, the rate of Cormack grade 1 was significant higher in GSVL group (91% vs 58% ) ( P ＜0. 01 ). BP of two groups at T1 and T5 ～ T7 were significantly decreased compared to T0 values ( P ＜0. 01 ). Endobronchial intubation (T2 ～T4) caused significant increase in BP and HR compared to post-induction values(T1 ) ( P ＜0. 01).The highest values of HR after intubation exceeded even their baseline values before induction of anesthesia.The haemodynamic responses to endobronchial intubation in GSVL group at T2 ～ T4 were significantly different from those in MDLS group( P ＜0. 05). CSI of two groups at T1 was significantly decreased compared to To values( P ＜0. 01 ), CSI of two groups at T2 induced significant increase compared to T1 values, and the increase of CSI in MDLS group was stronger than that in GSVL group( P ＜0.01). Condusion The haemodynamic responses produced by orotracheal intubation using GSVL had more obvious advantages than MDLS, but GSVL seemed to provide a clear view of glottis and a little change CSI effect.

ObjectiveTo discuss the diagnosis and treatment of rupture of spleen in a base-level hospital with limited conditions. MethodsThe clinical data, diagnosis of bleeding by ultrasound, and results of (nonoperative) and operative treatment of 317 patients with rupture of spleen in Vila Central Hospital of the (Republic) of Vanuatu were retrospectively analyzed. ResultsUltrasound diagnosed 30 patients with (subcapsular) hemorrhage and 287 patients with true rupture of spleen. Based on ultrasound results, (conservative) treatment was used for 29 patients and 288 patients underwent operation. Conclusions(Ultrasonography) had a high positive diagnostic rate for rupture of spleen, and the diagnosis of bleeding volume was consistent with the findings at operation. The findings on ultrasonography can be considered in selection of cases with appropriate indications for splenectomy. Ultrasonography is an effective method for use in the (treatment) of rupture of spleen.

Objective To examine plasma inflammatory cytokines and assess stress response in different general anesthesia schemes in cesarean operation. Methods Sixty caesarean operation puerperas were randomly divided into two groups, including the group of sevoflurane (Group S) and the group of propofolum (Group P) in 30 cases of each group. At different time point, we recorded the mean arterial pressure and heart rate, text the blood concentration of inflammatory cytokines; The Apgar scores and arteria umbilicalis pH value after baby delivery were recorded. Results The blood pressure and heart rate of the P group after anesthesia induction of baby in delivery were lower than that before the anesthesia induction(P < 0.05). And there were also significant differences when compared with the S group (P < 0.05). The blood concentration of IL-6 and TNF-α of the P group afte operation were higher than that before the anesthesia induction(P < 0.05). There were also significant differences when compared with the S group(P < 0.05). The blood concentration of sTNFRⅡof the P group after operation and 24 hours after the surgery were higher than that before the anesthesia induction (P < 0.05). And there were also significant differences when compared with the S group (P < 0.05). Conclusion Administering Sevoflurane compound with Remifentanil to general anesthesia in Caesarean operation is safty and steady to inhibit stress reaction and prevent explicit memory from the operation.

Objective To investigate the clinical significance of velocity vector imaging(VVI)in evaluating the left ventricular(LV)segmental longitudinal systolic function in patients with coronary artery disease(CAD).Methods In 25 patients with myocardial ischemia,28 patients with myocardial infarction,26 patients with coronary lumen stenosis＜50%,according to coronary arteriography and electrocardiogram,the myocardial segments of LV were divided into 4 groups:ischemic segments group,infarcted segments group,non-ischemic segments group and normal segments group.Twenty-eight healthy subjects were selected as control group.Dynamic imaging of all subjects were collected,the systolic peak strain(Smax)and strain rate(SRmax),the time to peak strain(PTs)and the time to peak strain rate(PTsr)were measured respectively.Results Smax and SRmax of the ischemic segments and infracted segments were significantly lower than those of the control group respectively,PTs and PTsr of the ischemic segments and infracted segments were significantly longer than those of the control group respectively.Smax and SRmax of infarcted segments were significantly lower than those of the ischemic segments,there were no differences of PTs and PTsr between ischemic segments and infracted segments.Smax and SRmax cutoff of -14.08%,-0.83 s-1 for detecting ischemic segments and cutoff of -6.65%,-0.38 s-1 for detecting infracted segments,respectively,gave an optimal sensitivity and specificity.Conclusions VVI is a kind of novel noninvasive-tool to quantitatively assess LV regional systolic function in CAD patients.It is competent to differentiate between the ischemic segments and infarcted segments.

Objective To evaluation the efficacy of dexmedetomidine mixed with dezocine and levobupivacaine for patient-controlled epidural analgesia (PCEA) after cesarean section.Methods A total of 300 patients, aged 23-35 yr, with body mass index of 24-28 kg/m2 , of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective cesarean section under epidural anesthesia, were randomly divided into 3 groups (n =100 each) according to the random number table: morphine and levobupivacaine group (ML group), dezocine and levobupivacaine group (DL group), and dexmedetomidine, dezocine and levobupivacaine group (DDL group).In group ML, the loading dose included morphine 2 mg + levobupivacaine 10 mg + 5 ml normal saline, and PCEA solution contained morphine 5 mg + levobupivacaine 150 mg + normal saline 100 ml.In group DL, the loading dose included dezocine 3 mg+ levobupivacaine 10 mg+ normal saline 5 ml, and PCEA solution contained dezocine 15 mg + levobupivacaine 150 mg + normal saline 100 ml.In group DDL, the loading dose included dezocine 2 mg+ levobupivacaine 10 mg + dexmedetomidine 0.5 μg/kg + normal saline 5 ml, and PCEA solution contained dezocine 7.5 mg+ levobupivacaine 150 mg + dexmedetomidine 1.5 μ g/kg + normal saline 100 ml.At 10 min before the end of operation, the loading dose was given via the epidural catheter, and the PCEA pump was connected and set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.Analgesia was maintained until 42 h after operation.Visual analog scale score was main-tained ≤ 3, and (or) visual analog scale for fatigue score ≤ 2.When PCEA failed, morphine 2 mg was injected epidurally as rescue analgesic.At 4, 8, 24 and 42 h after operation, the modified Bromage score and Ramsay sedation score were recorded, and patients' satisfaction with analgesia was evaluated.The occurrence of epidural analgesia-related adverse reactions was recorded.Results The consumption of PCEA solution and requirement for rescue analgesics were significantly lower in group ML than in group DL.Compared with group ML, Ramsay sedation score was significantly decreased at 4 and 8 h after operation, the degree of patients' satisfaction with analgesia was increased, and the incidence of nausea, vomiting, dizziness and pruritus was decreased in DL and DDL groups, and the incidence of urinary retention was decreased in group DDL.The degree of patients' satisfaction with analgesia was significantly higher, and the incidence of dizziness and urinary retention was lower in DDL group than in group DL.No patients developed epidural analgesia-relatcd hypotension, bradycardia, or respiratory depression in the three groups.Conclusion The efficacy of dexmedetomidine mixed with dezocine and levobupivacaine is good when used for PCEA after cesarean section, and the adverse reactions are fewer.

Objective To investigate the feasibility and safety of OLV anesthesia about infant lung resection of CCAM by video-assisted thoracicscopy. Methods Endo-tracheal intubation was performed after 43 CCAM infants had undergone rapid intravenous induction. One side of lungs was ventilated by injecting 4 ~ 6 mmHg CO2 for the construction of artificial pneumothorax, and the side lung was compressed forming OLV. SpO2, ECG, MAP, PETCO2, T, PaO2, PaCO2, bleeding volume and urine volume were monitored. The numerical value of SpO2, PaO2, HR, MAP, PETCO2, and PaCO2 were recorded at scheduled intervals. Results Compared with 5min after induction,the PaO2,HR and MAP of the infants significantly reduced; the PETCO2 and PaCO2 significantly increased at OLV at 10 min and 60 min. Compared with OLV at 10 min, the PaO2, PETCO2 significantly increased at OLV 60 min. Conclusion Appropriate respiratory management and drug usage are feasible and safe for infant surgery of CCAM by video-assisted thoracicscopy.

Objective To determine the socioeconomic factors and main causes of treatment failure among bacillary-positive pulmonary tuberculosis patients in Shanghai.Methods A 1:1 matched case-control study was performed.Ninety two cases who were treated longer than 18 months,and 85 controls who completed treatment during 2003-2004 in Shanghai were selected.Cases and controls were matched by sex,age,and previous treatment.Results Adjusted by sex,age,and previous treatment,the associated factors of treatment failure among bacillary-positive pulmonary tuberculosis patients were drug resistance (?2=14.764,P

ObjectiveTo evaluate the efficacy and safety of flurbiprofen axeyil injection combined with sufentanil for postoperative patient undergoing ovarian cancer radical operation.Methods60 postoperative patients undergoing radical ovarian cancer surgery were randomly divided into three groups with 20 cases in each group, including Sufentanil 150 μg (group S) ,Flurbiprofen Axeyil injection 200 mg (group F) ,Flurbiprofen Axeyil injection 100 mg plus Sufentanil 100 μg (group FS).The drugs in each group were added with Azasetron 10 mg and diluted to 100 ml, then infused by a pump in a rate of 2 ml/h.The visual analogue scale (VAS) and Ramesays scores were used to evaluate the analgesic effect at 0.5,2,4,8,12,24 and 48 h after surgery.The incidence of side effects was recorded.ResultsAll the patients showed good pain relief with PCIA.The VAS of group F(3.3 +0.8) at 2 h after operation was slightly higher than that of group S (2.6 + 1.0) and SF (2.8 + 1.1) (P ＜ 0.05), which became similar 4 h later (P ＞0.05).In groups F (2.4 +0.8,2.3 +0.6) and FS(2.9 +0.8,2.6 ±0.4), the average Ramsay score was slightly lower than that in group S(3.8 +0.9,3.6 +0.5) (P ＜0.05).But the differences were not significant within 8 h after operation (P ＞ 0.05).The accidence rates of nausea, vomiting, itching, somnolence of group S(20％ ,15％ ,20％) were significantly higher than those in group F (5％ ,0,5％)and FS(5％,5％ ,5％) (P ＜0.05).No respiratory depression or abnormal bleeding occurred in three groups during the period of postoperative 48 hour.The amount of hydrothorax had no difference between 3 groups (P ＜0.05).ConclusionsIntravenous postoperative analgesia with Flurbiprofen Axeyil injection combined with Sufentanil had a better analgesic effect than Sufentanil or Flurbiprofen Axeyil used alone, and it could significantly reduce the dose requirement of Sufentanil as well as its associated side effects.