AIM To observe the predictive value of gastric intramucosal pH (pHi) for critical patients.METHODS The gastric intramucosal pH (pHi) of 32 ICU patients was measured with a self-madegastrointestinal tonometer, and the APACHE l score was determined simultaneously.RESULTS pHi of the nonsurvivors was significantly lower than that of the survivors (P<0.05). The pHiwas remarkably higher in the nonsepsis group than in the sepsis group (P<0.01). Only in multiple organfailure groups, pHi was found statistically lower (P<0.05).CONCLUSION pHi may be the most simple, reliable, sensitive and accurate parameter to indicate theadequacy of tissue oxygenation, and it may be widely used in ICU monitoring in near future.

Objective.To assess patients' knowledge,attitudes,and concerns regarding anesthetic management.Method.A survey of 55 items was developed and administered preoperatively to 500 patients including 190 men and 310 women in our hospital.Patients were interviewed on their knowledge of the role of anesthesiologists,their preferences regarding anesthetic management,and also their concern about potential anesthetic complications.Results.Patients' perceptions of anesthesiologists' training and role have reached a certain level.Most significant preoperative concerns regarding the anesthesiologists focused on experience,qualifications,and presence or absence during the anesthesia.Patients' concerns also included the possibility of not being waken up following anesthesia,experiencing postoperative pain,and becoming paralyzed.The variations of concerns depended partially on patients' sex,type of anesthesia,and proposed surgical procedure,partially on their education and living environments.Conclusion.It is suggested that anesthesiologists address significant patient concerns during the preoperative visit to enhance their effectiveness in patient care.Efforts to educate the public on the anesthesiologists' role in preoperative care would improve patients' confidence.

Objective: To evaluate the role of MHC Ⅱ expression in posttrauma immune disturbances and infections.Methods: In experimental study, peritoneal macrophages were harvested from traumatized mice and treated with GM-CSF, Ia molecules were determined by flow cytometry. In 24 trauma patients, monocyte HLA-DR expression was measured by APAAP technique.Results: Marked inhibition of MHC Ⅱ molecule expression was found in both traumatized mice and patients. In traumatic patients with infection, the inhibition was more severe. Treatment with GM-CSF in mice partially restored the Ia expression.Conclusions: Inhibition of MHC Ⅱ molecules plays an important role in postrauma immune disturbances.There is a close relationship between HLA-DR inhibition and clinical infections.