Purpose To investigate the influence of single slow intravenous infusion of dexmedetomidine (Dex) on femoral artery color Doppler hemodynamics during the induction of general anesthesia. Materials and Methods Forty patients of elective abdominal surgery under general anesthesia were elected and randomly divided into Dex group and the control group, with 20 cases in each group. Dex (0.2 μg/kg) 20 ml was injected with intravenous infusion in Dex group, and 20 ml saline was infused in control group, the infusion time was 10 min;then intravenous injection of Sufentanil, Propofol and Rocuronium were performed in turn for the induction of general anesthesia and endotracheal intubation. Femoral artery peak systolic velocity (Vs), early diastolic reverse peak velocity (Vd), systolic diameter (Ds), diastolic diameter (Dd), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) changes at each time point were observed and recorded. Results ① Compared with baseline, Vs increased and Vd decreased (P<0.05) 10 min after the infusion of Dex in Dex group;after induction, Vs and Vd in both of the two groups decreased, and the difference between the two groups was not statistically significant (P>0.05);Vs reduced significantly in both of the two groups at the intubation moment and 1, 3, 5 min after intubation, but the Dex group changed more smoothly (P<0.05), and Vd raised in both groups with the Dex group changing more smoothly (P>0.05);Ds and Dd of both groups did not change significantly at each time point (P>0.05). ② Compared with baseline, MAP and HR decreased (P<0.05) after the infusion of Dex in Dex group;after induction, MAP and HR of both groups decreased, and the difference between the two groups was not statistically significant (P>0.05); MAP and HR increased in both groups at intubation moment, but the Dex group changed more smoothly than the control group (P<0.05).③SBP, DBP and HR were negatively correlated with Vs (r=-0.507,-0.619,-0.750, P<0.05) in both groups; SBP, DBP and HR were positively correlated with Vd (r=0.821, 0.881, 0.883, P<0.05) in both groups;there was no significant correlation (r=0.419, P>0.05) between Vs and Vd. Conclusion Single slow intravenous infusion of Dex (0.2μg/kg) can accelerate the femoral artery Vs and slow down the Vd, resulting in more stable hemodynamics during the induction of general anesthesia.

Objective To investigate the changes in plasma concentrations of IL-6 and IL-10, pHi and the difference between tissue and arterial PCO2 [(P(t-a)CO2 ] during pulmonary surgery and the effects of thoracic epidural anesthesia on cytokine production and gut mucosal perfusion. Methods Twenty ASA class Ⅰ - Ⅱ patients undergoing elective pulmonary surgery, were randomly assigned to be operated upon under general anesthesia (group GA , n = 10) or under general anesthesia combined with thoracic epidural anesthesia (group GEA, n - 10) . Premedication in both groups consisted of pethidine 50mg and scopolamine 0.3 mg im 30 min prior to surgery and oral ranitidine 150 mg the night and 1 h before operation. Anesthesia was induced with fentanyl 2 ug?kg-1 , droperidol 1 mg, propofol 1.5-2.5 mg?kg-1 and succinylcholine 1-2 mg?kg-1 and maintained with inhalation of 1%-2.5% isoflurane and 50% N2O in oxygen and intermittent iv boluses of fentanyl and vecuronium. In GEA group epidural catheter was inserted through the needl placed at T7-8 or T8-9 and advanced cephalad for 2.5-3.0 cm. A loading dose of morphine 2 mg was given followed by epidural infusion of 0.4% ropivacaine at a rate of 6 ml?h-1 during maintenance of anesthesia and the concentration of isoflurance inhaled was reduced to 0.6%-1. 5% . Postoperative analgesia was provided by epidural infusion of 0.25% ropivacaine at 6-8 ml/2h until the morning of the 3rd postoperative day. Blood samples were taken before induction, at incision and 2 h, 4 h and 6 h after the incision and on the 1st and the morning of the 3rd postoperative day for determination of IL-6 ( by radioimmunoassay) and IL-10 (ELISA) . P(t-a)CO2 and pHi were assessed by tonometry before induction, at incision and 1 h, 2 h, 4 h and 6 h after the incision. Results (1) IL-6 and IL-10 increased significantly during operation as compared with the baseline value before induction in both groups and there was no significant difference between the two groups. (2) pHi decreased significantly during operation in both groups and there was no significant difference between the two groups. pHi was negatively correlated with IL-6. (3) P(t-a)CO2 increased significantly during operation in both groups and was negatively correlated with pHi. P(t-a)CO2 was significantly higher in GA group than that in GEA group at 4h after skin incision. Conclusion Pulmonary surgery elicits both pro- and and-inflammatory cytokine response which is not affected by thoracic epidural analgesia. Thoracic surgery leads to gut mucosal hypoperfusion of which P(t-a)CO2 is an indicator. Thoracic epidural anesthesia can improve gut mucosal perfusion. There may be some correlation between cytokine production and gut mucosal hypoperfusion.

0.05).But for the patients with wide-base vocal cord polyps,the effective rate of self-retaining laryngoscope group was higher than that of electronic laryngoscope(P

OBJECTIVE:To prepare Xiaocuo emulsion and to study its stability.METHODS:The formula and techniques were optimized with metronidazuo,cimetidine,chloramphenicol and salicylic acid as the chief ingredients,and with the uniformity of emulsion as the indicator.The stability test was performed using storage test and accelerated centrifugal test.RESULTS:The optimized formula was the following,5ml azone,4ml tween-80,1g metronidazole,2g cimetidine,2g chloramphenicol,1g salicylic acid and 100ml deionized water.CONCLUSION:The preparation is reasonable in formula,simple in preparative techniques,stable in quality and feasible in production.

Objective To observe the feasibility of combining dezocine with fentanyl in the application of single integral high in‐tensity focused ultrasound(HIFU)ablation of uterine fibroids .Methods One hundred and sixty patients with uterine fibroids trea‐ted by HIFU under conscious sedation were randomly divided into 2 groups(n=80):group A with treatment combined fentanyl and midazolam and group B treated with combined dezocine ,fentanyl and midazolam .Analgesic effect was evaluated with visual analog scale (VAS) .Variation of patients′vital signs (blood pressure ,heart rate ,electrocardiogram ,oxygen saturation) ,pain scores ,com‐fort scores ,sedation scores ,analgesic consumption and side effects were recorded before treatment (T0 ) ,during drug delivery (T1 ) , at the beginning of the treatment(T2 ) ,30 minutes after drug delivery (T3 ) ,at the end of the treatment(T4 ) ,2 hours after treatment (T5 ) ,4 hours after treatment (T6 ) ,8 hours after treatment (T7 )and 24 hours after treatment(T8 ) .Results Both groups showed reliable analgesic effects and vital signs of each time point were stable .VAS scores and Ramsay scores of group A were higher than those of group B ,but there was no statistical difference (P>0 .05) .Three patients in group A showed dysuria and relieved after symptomatic treatment .No respiratory depression occurred in both groups .But compared to group A ,the incidence of the analgesic side effects of group B was significantly lower and patients satisfaction was significantly higher(P<0 .05) .Conclusion The analge‐sic effects of dezocine combined with fentanyl are reliable in HIFU ablation of uterine fibroids with fewer side effects ,and could be worthy to be promoted in clinical use .

Objective To understand the undergraduate nursing students’ awareness of the basic situation of occupational exposure in Kunming Medical University, and to understand their knowing status of occupational exposure knowledge. Methods We used self- designed questionnaire to investigate 449 undergraduate nursing students in Kunming Medical University to obtain the status of occupational exposure and protection knowledge level of students.Results (1) 449 students were investigated, and 258 of them had been in clinical practice, and occupational exposure occurred in 48.8% of them. (2) Occupational exposure factors included grade, washing hands and wearing gloves;The results showed that:Grade was a risk factor and wearing glove and washing hands were protective factors. (3) There was relevance between accepting the occupational protection education and the occupational exposure. Conclusions A useful measure to reduce the occurrence of occupational exposure is Pre-service training for undergraduates nursing students. Operation should be in strict accordance with operating specifications. Schools and departments should implement occupational protection system, so as to strengthen the related knowledge vocational education,enhance self-protection awarenes,and reduce or minimize the occurrence of occupational exposure.

Objective To observe the effects of low frequency electrical stimulation (LFES) on the proliferation of endogenous brain neural stem cells (NSCs) and on the expression of basic fibroblast growth factor (bFGF)and epidermal growth factor (EGF) in rats with acute cerebral infarction; to explore the therapeutic mechanism of LFES in improving neural function. Methods Fifty-four rats were randomly divided into a LFES group, a placebo stimulation group and a sham-operated group. Each group was further divided into 3rd day, 7th day and 14th day subgroups, with 6 rats in each subgroup. An acute cerebral infarction model was induced in the rats of the LFES and placebo stimulation groups by middle cerebral artery occlusion (MCAO). Three days after the operation, rats in the LFES group began LFES treatment (frequency 30 Hz, pulse width 250 μs, current intensity 3 mA, 10 min/d) ,while the placebo stimulation group was treated identically but without electricity. The rats in the sham-operated group had no special treatment. The expression of nestin positive cells in the subgranular zone of the hippocampus and the subventricular zone was detected by immunohistochemical staining. The expression of bFGF, EGF proteins and mRNA in the ischemic hemisphere was detected by Western blotting and RT-PCR analysis. A screen test was applied to evaluate motor function. Results Nestin-positive cells in the subgranular and subventricular zones of rats in the LFES group increased significantly more than in the placebo stimulation group at the 7th and 14th day. The expression of bFGF, EGF proteins and mRNA in the ischemic hemisphere was up-regulated compared to the placebo stimulation group at the 7th and 14th day. At the 14th day a difference in motor function was observed in rats in the LFES group compared with the placebo stimulation group. Conclusion LFES can promote the proliferation of endogenous brain NSCs and the expression of bFGF and EGF in rats with acute cerebral infarction. It can also improve motor function and enhance neural plasticity in the brain.

Objective:To investigate the relationship between gene polymorphisms of disease-relevant multiple cytokines including TNF-α,IL-6,IL-10,TGF-β1,IFN-γand acute graft versus host disease(aGVHD) in allogeneic hematopoietic stem cell trans-plantation ( allo-HSCT ) . Methods:32 cases of recipients received allo-HSCT and 36 cases of normal groups in January 2014 to December 2015 were selected as objects of study. We detected genotypes on specific SNP of target genes by polymerase chain reation ( PCR) combined with gene sequencing and observed the occurrence of aGVHD in postoperative recipients. The influence of cytokine gene polymorphisms on prognosis of allo-HSCT patients was analyzed,and the potential relationship between specific SNP mutation of the disease-relevant cytokine genes and severity of aGVHD was discussed. Results:Distribution of cytokines gene polymorphism including TNF-α-308(G/A),IL-6-174(G/C),IL-10-1082(A/G),TGF-β1+915(G/C),IFN-γ(T/A) had no significant differences with incidence of severe aGVHD(P>0. 05). However,the occurrence of severe aGVHD in allo-HSCT recipients with C/T genotype was significantly higher than C/C and T/T in SNP of TGF-β1+869(P<0. 01). Conclusion:Gene polymorphism of TGF-β1+869(C/T) in allo-HSCT patients was closely related to the occurrence of severe aGVHD. The research show allo-HSCT patients with C/T genotype occurred severe aGVHD more frequently, which is an important potential risk factor to induce the incidence of severe aGVHD. Therefore,detecting gene polymorphism of TGF-β1+869 ( C/T ) in allo-HSCT recipients and developing the appropriate therapeutic regimen may be helpful to reduce the incidence of aGVHD.

OBJECTIVE:To investigate the significance of tacrolimus blood concentration monitoring to the therapy of mem-branous nephropathy. METHODS:41 patients with membranous nephropathy received tacrolimus,and the blood concentration of ta-crolimus reached to steady state. The trough concentration of tacrolimus was determined by EMIT. The patients were followed up, and clinical therapeutic efficacies were recorded. The relationship of blood concentration of tacrolimus with clinical efficacy was evaluated by SPSS 16.0 software. RESULTS:The blood concentration of tacrolimus was(7.47±2.74)ng/ml in complete remission (CR)group,(5.72±1.19)ng/ml in partial response(PR)group,and(3.30±1.08)ng/ml in no response(NR)group,with total remission rate of 75.61%. The blood concentration of CR group was the highest,followed by PR group and NR group,there was statistical significance among 3 groups(P<0.05). CONCLUSIONS:The clinical efficacy of tacrolimus in the treatment of nephrot-ic syndrome is correlate to the blood concentration intimately. Trough concentration monitoring of tacrolimus has important signifi-cance to the treatment of membranous nephropathy.

Objective To investigate the effect of dexmedetomidine on acute kidney injury in endotoxemic rats.Methods Thirty adult male Sprague-Dawley rats,aged 4-6 months,weighing 180-220 g,were randomly divided into 3 groups (n =10 each) using a random number table:control group (group C),lipopolysaccharide group (group L),and dexmedetomidine (group D).Lipopolysaccharide (LPS) 5 mg/kg was injected slowly into the femoral vein to establish the model of endotoxemic in rats anesthetized with chloral hydrate.In group D,after LPS injection,a loading dose of dexmedetomidine 7 μg/kg was injected intravenously,and 15 min later dexmedetomidine was infused for 6 h at 5 μg · kg-1 · h-1,while the equal volume of normal saline was given in L and C groups.At 6 h after the end of LPS administration,blood samples were collected from the femoral vein for determination of serum creatinine (Cr),blood urea nitrogen (BUN),tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) concentrations.At 24 h after the end of LPS administration,the animals were sacrificed and kidneys were removed for microscopic examination and for determination of the expression of tight junction proteins ZO-1 and occludin in renal tissues by Western blot.Results Compared with group C,the serum Cr,BUN,TNF-α and IL-6 concentrations were significantly increased,and the expression of ZO-1 and occluding was down-regulated in L and D groups.Compared with group L,the serum Cr,BUN,TNF-α and IL-6 concentrations were significantly decreased,the expression of ZO-1 and occluding was up-regulated,and the pathological changes of kidneys were mitigated in D group.Conclusion Dexmedetomidine can alleviate acute kidney injury in endotoxemic rats.