Objective To determine the median effective plasma concentration of remifentanil (EC50) inhibiting cardiovascular response to tracheal intubation and skin incision when combined with propofol in patients of Uighur nationality.Methods Thirty ASA Ⅰ or Ⅱ Uighurs aged 20-60 yr with body mass index of 18-30 kg/m2 undergoing elective laparoscopic cholecystectomy were enrolled in this study.Anesthesia was induced and maintained with propofol infusion.BIS value was maintained at 40-50.TCI of remifentanil was then started.The initial target plasma concentration (Cp) was 6.0 ng/ml.EC50 of remifentanil was determined by modified Dixon' s upand-down sequential experiment.Each time Cp increased/decreased by 0.5 ng/ml.Tracheal intubation was facili.tated with cisatracurium 0.2 mg/kg at 2 min after a new Cp was set when target effect-site concentration (Ce) was balanced with Cp.Positive cardiovascular response was defined as increase in SBP by 15％ and/or HR ＞ 90 bpm lasting＞15 s.The EC50 (95％ confidence interval) of remifentanil blunting responses to tracheal intubation and skin incision was calculated.Results EC50 (95 ％ confidence interval) of remifentanil inhibiting cardiovascular response to tracheal intubation and skin incision when combined with propofol was 3.4 (2.3-4.5) ng/ml and 3.8 (2.8-4.9) ng/ml respectively.Conclusion When depth of anesthesia was maintained at BIS value 40-50 with propofol infusion,the EC50 of remifentanil inhibiting cardiovascular response to tracheal intubation and skin incision is 3.4 and 3.8 ng/ml respectively.

Objective To determine the median effective concentration (EC50) of remifentanil inhibiting responses to tracheal extubation in patients of Uygur nationality.Methods The patients of Uygur nationality,aged 18-60 yr,of ASA physical status Ⅰ or [Ⅱ,scheduled for elective surgery,were enrolled in this study.After the end of surgery,remifentanil was given by target-controlled infusion until tracheal extubation.The initial target plasma concentration (Cp) of remifentanil was 2.0 ng/ml.The response was defined as positive when MAP and/or HR increased by ＞ 15％ of the level at the end of operation and the duration ＞ 15 s during extubation.Each time the target Cp increased/decreased if the cardiovascular response was positive or negative.The ratio between the two successive concentrations was 1.1.The EC50 and 95 ％ confidence interval of remifentanil blunting responses to extubation was calculated by Probit method.Results Twenty-eight patients completed the study.The EC50 and 95 ％ confidence interval of remifentanil required for inhibiting the responses to extubation was 1.75 ng/ml and 1.45-2.01 ng/ml.Conclusion The EC50 of remifentanil inhibiting the responses to tracheal extubation is 1.75 ng/ ml in patients of Uygur nationality.

Objective To determine the median effective target effect-site concentration (EC50) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with propofol in patients of Uygur nationality.Methods Thirty-one ASA Ⅰ or Ⅱ Uighurs of both sexes,aged 21-59 yr,with body mass index 18-28 kg/m2,undergoing elective surgery,were enrolled in this study.Anesthesia was induced and maintained with propofol and sufentanil target-controlled infusion and iv injection of cisatracurium 0.2 mg/kg.The target effect-site concentration (Ce) of propofol was set at 3.0 μg/ml.Tracheal intubation was performed after the target Ce and plasma concentrations were balanced.The target Ce was set at 0.8 ng/ml in the first patient.Each time Ce increased/decreased by 10％ in the next patient depending on whether or not the cardiovascular response to tracheal intubation occurred.The positive cardiovascular response was defined as increase in systolic blood pressure by 15％ and/or HR＞ 90 bpm lasting for ＞ 15 s.The EC50(95％ confidence interval) of sufentanil blunting cardiovascular responses to trancheal intubation was calculated by Probit analysis.Results EC50 (95 ％ confidence interval) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with 3.0 μg/ml propofol was 0.46 (0.43-0.49) ng/ml.Conclusion EC50 of sufentanil inhibiting cardiovascular response to tracheal intubation is 0.46 ng/ml in patients of Uygur nationality when combined with propofol.

Objective To evaluate the feasibility and safety of endovascular intervention for the treatment of filter-related long segment obstruction of IVC and iliac vein.Methods From January 2014 to October 2016,a total of 8 patients with filter-related chronic long segment obstruction of IVC and iliac vein were treated with percutaneous transcatheter angioplasty (PTA) and stent implantation.The clinical data and imaging materials were collected.The endovascular interventional treatment methods were discussed,and the technical success rate,procedure-related complications and follow-up results were analyzed.Results Successful recanalization of the obstructed IVC-iliac vein segment was achieved in all 8 patients.In 7 patients,angiography performed immediately after PTA and stent implantation showed that the blood flow in the stent was smooth and the collateral vessels were decreased.In one patient,acute in-stent thrombosis occurred after PTA and stent implantation,then catheter-directed thrombolysis had to be adopted,and angiography performed 2 days later indicated that in-stent thrombosis was completely dissolved and the blood flow resumed smoothly.The patients were followed up for 2-13 months,with a mean of (4.7±3.9) months.Reexamination with both CT and venography of lower limb showed that the stent was kept in good position to the last visit in all 8 patients.Slight intimal hyperplasia was observed in 3 patients,but the blood flow was unobstructed.Conclusion Long term implantation of filter may cause filter-related chronic long segment obstruction of IVC and iliac vein.PTA with stent implantation is a safe and feasible method to effectively open the occluded vessels.