Objective To evaluate the effects of different analgesics combined with propofol of intravenous anesthesia on postoperative analgesia and emotion in patients of artificial abortion. Methods One hundred and twenty-two patients who had underwent painless artificial abortion were selected. The patients were divided into 4 groups by random digits table method: simple propofol group (C group, 29 cases), fentanyl combined with propofol group (F group, 30 cases), oxycodone combined with propofol group (Q group, 30 cases) and sufentanil combined with propofol group (S group, 33 cases). The induced dose of propofol was 2.5 mg/kg. When patients had limb movement during operation, a single addition of propofol 0.5 mg/kg was added until the body movement disappeared. The changes of mean arterial pressure (MAP), heart rate and respiratory rate before and after operation were compared among the 4 groups. The emotional status was assessed with affective scale before operation and 1 h after operation. The visual analog scale (VAS) was used to evaluate the degree of abdominal pain at 10, 30 and 60 min after palinesthesia. The propofol dose, operation time, recovery time and adverse reaction were recorded. Results No obvious adverse reactions were found during the operation. There was no statistical difference in operation time among 4 groups (P>0.05). The propofol dose, recovery time, body movement and the VAS score at 10, 30, 60 min after palinesthesia in F group, Q group and S group were significantly lower than those in C group, and there were statistical differences (P<0.05);but there were no statistical difference among F group, Q group and S group (P>0.05). The MAP, heart rate and respiratory rate at beginning of the surgery and during the surgery were significantly lower than that before anesthesia in the 4 groups, and there were statistical differences (P<0.05); but there were no statistical differences in MAP, heart rate and respiratory rate among 4 groups (P>0.05). The positive affective score after operation in C group, F group, Q group and S group was significantly higher than that before operation: (24.6 ± 5.6) scores vs. (21.7 ± 6.2) scores, (24.6 ± 3.1) scores vs. (20.6 ± 4.6) scores, (28.3 ± 6.3) scores vs. (20.8 ± 5.3) scores and (25.2 ± 5.4) scores vs. (19.9 ± 4.8) scores, and the negative affective score after operation in C group, F group, Q group and S group was significantly lower than that before operation: (17.0 ± 5.3) scores vs. (29.7 ± 7.4) scores, (17.2 ± 3.0) scores vs. (30.8 ± 5.0) scores, (16.1 ± 5.1) scores vs. (30.4 ± 4.9) scores and (17.9 ± 4.0) scores vs. (32.1 ± 5.5) scores, and there were statistical differences (P<0.05). The positive affective score after operation in Q group was significantly higher than that in C group, F group and S group, and there was statistical difference (P<0.05). There was no statistical difference in negative affective score after operation among 4 groups (P>0.05). Conclusions The fentanyl, sufentanil and oxycodone combined with propofol of intravenous anesthesia in patients underwent artificial abortion can reduce propofol dose, shorten recovery time, improve positive affective score, decrease negative affective score and strengthen the analgesic effect, and doesn't increase the adverse reaction. The respiratory and circulatory inhibition effects of different analgesics combined with propofol of intravenous anesthesia were similar, but oxycodone can increase positive affective score.

Objective To summarize the perioperative clinical effect of extracorporeal membrane oxygenation (ECMO) technique in bilateral lung transplantation of patients with idiopathic pulmonary arterial hypertension.Methods Of 18 recipients with idiopathic pulmonary arterial hypertension receiving double lung transplantation,there were 11 cases of 11 grade Ⅲ (WHO cardiac function ratings) and 7 cases of grade Ⅳ.All patients were given ECMO technique after anesthetic induction,and the speed and volume of ECMO were adjusted according to oxygenation and cardiac function.At the end of the operation,the ECMO flow rate was decreased to 1 L·min-1 ·m-2.If the hemodynamics was stable and the oxygenation index was above 300,the ECMO could be removed.All data were Collected at 7 time points (preoperation,30 min after two lung ventilation,15 min after ECMO,the establishment of one lung ventilation,30 min after pulmonary artery occlusion,30 min after pulmonary artery open and at the end of the operation).The prognosis of the recipients was observed postoperatively.Results All patients successfully completed operation under the support of ECMO technique.As compared with preoperation,PaO2 and PaCO2 were significantly increased at 30 min after two lung ventilation (P＜0.05).As compared with 30 min after two lung ventilation,PaO2 was significantly elevated (P＜0.05),PaCO2 and PAP were reduced at 15 min after ECMO (P＜0.05).As compared with 15 min after ECMO,PAP was significantly increased at 30 min after pulmonary artery occlusion (P＜0.05).As compared with 30 min after pulmonary artery occlusion,PAP was significantly reduced at 30 min after pulmonary artery open (P ＜ 0.05).ECMO of 3 patients was removed after operation at once and of 15 patients were not removed until 3.3 ± 2.5 days in ICU.Tencases suffered from left cardiac insufficiency to varying degrees after removing ECMO (including 3cases whose ECMO was removed at once after operation),3 of them received ECMO bypass again and 7 of them were relieved after administration of cardiotonic,diuretics and vasodilators.Two cases sufferred from wound fat liquefaction and infection and 2 cases had moderate femoral artery thrombosis after postoperative ECMO.One case had renal failure 5 days after operation and thereafter died of multiple organ failure 2 weeks later after treatment with the continuous ECMO pipelines of hemofiltration,then 17 cases were cured.The pulmonary arterial pressure of all recipients was (30.79 ± 6.18) mmHg 2 months after operation and the cardiac function rating was significantly increased (P ＜0.01).Conclusion The application of ECMO technique in the lung transplantation patients with idiopathic pulmonary hypertension can reduce the pulmonary arterial pressure,improve the safety of operation and has obvious auxiliary effect on the perioperative cardiac function.

AIM:To study the induction of apoptosis by c-myc antisense oligonucleotide in osteosarcoma cell(MG-63).METHODS:The designed c-myc antisense oligonucleotide fragment was transfected into human osteosarcoma MG-63 cells.The cell growth and apoptosis were measured by the methods of MTT,FCM,HE staining and transmission electron microscopy.RESULTS:The results showed that the proliferation of human osteosarcoma MG-63 cells was inhibited and apoptotic rate was 37.92% when treated with c-myc antisense oligonucleotide at the does of 10.0 ?mol/L for 48 h.c-myc antisense oligonucleotide(10.0 ?mol/L) also inhibited the expression of c-myc protein.CONCLUSION:c-myc antisense oligonucleotide is able to induce apoptosis in human osteosarcoma MG-63 cells.

Objective To determine the diagnostic value of cardiovascular magnetic resonance (CMR) in children with myocarditis. Methods A total of 27 children with myocarditis were examined with cardiac MRI, including 16 new?onset cases and 11 chronic cases, as well as 14 cases with non?myocarditis. Sequences included SSFP in axial, two chamber, four chamber and short axis, T2?weighted triple inversion recovery, T1?weighted spin echo before and after gadolinium injection, and inversion recovery?gradient echo after gadolinium injection(late gadolinium enhancement, LGE) in axial and short axis. Qualitative and quantitative image analysis was performed to obtain focal T2 signal intensity and early enhancement signal intensity(SI) ratio of myocardium to skeletal muscleon EGE and LGE.The sensitivity, specificity and accuracy were calculated. Mann?Whitney and χ2 test were used for statistical comparison. Results The median value of EF was 60.20%(44.40%,70.20%), median value of T2W SI ratio was 2.50(2.04, 3.79),and there were 13 cases with LGE positive findings in myocarditis group. The median value of EF was 73.60%(65.40%,75.85%), the median value of T2WI SI ratio was 1.85(1.77, 2.15), and one case presented LGE positive sign in non?myocarditis group. There were significant statistical differences between the two groups (Z=-2.94,-2.52 ,χ2=5.19 ,P<0.05). The sensitivities for T2WI, EGE, LGE were 81.5%(22/27), 14.8%(4/27) and 48.1%(13/27) respectively. The specificities for T2WI, EGE, LGE were 57.1%(8/14), 100.0%(14/14)and 92.9%(13/14) respectively. The diagnostic accuracies for T2WI, EGE, LGE were 73.2%(30/41), 43.9%(18/41) and 63.4%(26/41) respectively. The best diagnostic performance was obtained when“any?two”of the three sequences were positive in the same patient, yielding a 51.9%(14/27)sensitivity, 92.9%(13/14) specificity, and 65.9%(27/41) diagnostic accuracy.Conclusions The combined CMR approach using T2?weighted imaging, early and late gadolinium enhancement, provides a high diagnostic accuracy and is a useful tool in the diagnosis and assessment of children with myocarditis.

Objective:To investigate the correlation between plasma homocysteine (Hcy) concentration and transient ischemic attack (TIA) and traditional vascular risk factors.Methods:The plasma Hcy concentrations of 112 patients with TIA and 62 controls were measured by fluorescenee polarization immunoassay.Hcy concentrations and related risk factors were analyzed.Results:The risk of TIA was increased significantly in plasma Hcy concentration 10.0 to 14.9 μmol/L group(OR=2.450,95% CI 1.091 to 5.502) and≥15.0 μmol/L group(OR=5.169,95% CI 2.096 to 12.746) compared with plasma Hcy concentration＜10.0 μmol/L group.Using TIA as the dependent wariable,various vascular risk factors (including plasma Hcy concentration) as the independent variable,logistic regression was analyzed.The result showed that the risk of TIA was increased significantly in plasma Hcy concentration＞10.0 μmol/L group compared with plasma Hcy concentration＜10.0 μmol/L group(OR=3.150,95% CI 1.380 to 7.192).Conclusions:Plasma Hcy concentration is an independent risk factor for TIA.

Objective To assess the application value of high time-resolved MR angiography (TR-MRA) in postoperative follow-up study of children with congenital heart diseases. Methods Seventy-three patients (median age 6 years, range 1-20 years) with congenital heart diseases who underwent TR-MRA scan after operation were retrospectively analyzed. Twenty-nine cases also were performed conventional contrast-enhanced MRA and forty-four cases were performed phase-contrast MRA. A 3D T1-weighted fast gradient-echo sequence was used for time-resolved three-dimensional MRA (10-20 dynamic data sets, less than three seconds per dynamic data set). The flow dynamics and morphology of pulmonary circulations, lung perfusion and collaterals flow direction were noted. All imaging quality was evaluated by using 5 scales. Left and right pulmonary artery flow volumes were measured and left and right pulmonary artery ratio was noted. SPSS22.0 was used in statistic analysis. The statistical analysis of comparing imaging quality was performed by using paired t-test. The intermodality agreement between TR-MRA and phase contrast in assessing left and right pulmonary perfusion was tested by Kappa coefficient. Results In 73 cases, imaging scores were over 3 and imaging quality was good enough for diagnosis. In 29 cases, there was no statistic difference between TR-MRA and conventional CE-MRA in demonstrating great vessels (P>0.05) except that CE-MRA scores(3.77 ± 0.39)was higher than TR-MRA scores(3.44 ± 0.55)of
inferior vena cava (IVC). There was statistic difference(t=3.68,P=0.01)between two sequences. TR-MRA could qualitatively demonstrate the pulmonary perfusion comparing to the results of PC. In PC sequence, there were 8 cases with symmetric and 36 cases with asymmetric left and right pulmonary perfusion. In TR-MRA sequence, there were 6 cases with symmetric and 38 cases with asymmetric left and right pulmonary perfusion. There was an excellent agreement between PC and TR-MRA (Kappa=0.83,P=0.01). Conclusions TR-MRA not only supplies with high spatial resolution imaging which demonstrates postoperative great arteries anatomy and also with high temporal resolution imaging which can demonstrate the preferential or balanced pulmonary blood flow and collaterals flow direction. TR-MRA is a very important sequence in follow-up study of congenital heart disease.

Objective: To understand physical development of children aged 7 to 12 in the oroqen autonomous banner experimental primary school in the oroqen settlement area from 2013 to 2018, and to provide scientific basis for their physical fitness and health. Methods: According to the standards of "National Student Physical Health Standards (2014 Revised Edition)" and the standards of "Overweight and Obesity Screening for School age Children and Adolescents" issued by the National Health and Family Planning Commission in 2018, the Oroqen Autonomous Banner Experimental Primary School was 7-12 years old. The average value and growth rate of children s height, weight and BMI in the past 6 years. Results: From 2013 to 2018, the height and weight of boys and girls aged 7 to 12 showed an increasing trend, with height growth values of boys were 1.8,1.7,1.9,2.6,5.7,5.9 cm,girls were 2.8,4.5,1.9,1.8,3.6,2.9 cm.And the weight groups values of boys were 2.2,2.5,5.1,6.3,6.4,7.2 kg,girls were 2.4,3.6,3.1,1.3,4.6,3.0 kg. The growth rate of girls aged 7 to 8 was higher than that of boys, and the growth rate of boys aged 9 to 12 was higher than that of girls. With the increase of age, the average BMI of boys and girls aged 7 to 12 showed an upward trend, and the BMI of boys of the same age was always higher than that of girls. Among them, the average BMI of boys aged 7 to 12 in 2018 exceeded the critical value of overweight BMI. Conclusion The physical shape of children aged 7-12 years increases with age, but the development tends to be overweight and obese, which is related to the natural environment of life, lifestyle, and reduction in physical activity.

Objective To investigate the potential of a novel preservation solution,raffinose-low potassium dextran lung preservation solution with blood (BR-LPDS) in the preservation of the isolated lungs in rats,when compared to low-potassium dextran solution (LPDS).Methods Fifty donor lungs of Sprague-Dawley rats were randomly flushed with either R-LPDS (R-LPDS group,n =25) or RLPDS modified by the addition of blood (BR-LPDS group,n =25).After reperfusion,the double lungs were kept half inflate and then the pulmonary artery and bronchus were clamped.Then the grafts were flushed with and submerged in cold preservation solution at 4 C for 24 h.And they were excised for measurement of wet-to-dry ratio,as well as histologic examination to evaluate pulmonary edema,inflammation and cleaved caspase-3 expression at 0,2,4,5,6,8,10,12,14,16,24 h.Results As compared with the R-LPDS group,the mean wet-to-dry ratio of lungs in the BR-LPDS group was significantly reduced from 4 to 10 h after reperfusion.Upon histologic examination,less inflammatory cell aggregates and lower caspase-3 activity were seen in the lungs of the BR-LPDS group from 10 to 12 h and 10 to 14 h after reperfusion,respectively.Conclusion The addition of blood to the R-LPDS solution was shown to be more effective in reducing swelling,inflammation and caspase-3 expression of donor lungs than the R-LPDS solution.Further investigation is needed to evaluate lung preservation in BR-LPD solution as a viable option for transplant.

Objective To study the effects of different concentrations of sevoflurane on monophasic action potentials (MAPs)of three-layer myocardium of ischemia reperfusion in isolated rat hearts.Methods Thirty-two healthy SD male rats,weighing 280-320 g,were randomly divided into four groups after successful preparation of langendorff isolated heart perfusion model and 1 5 min perfusion and balance of K-H fluid.In the ischemia-reperfusion group(group IR),K-H fluid perfusion was stopped and balanced for 15 min and cardiac arrest was induced for 60 min with the injection of Thomas solution (4℃,20 ml/kg)while the heart was protected by the low temperature Thomas so-lution (4℃)around it.Reperfusion of Thomas solution (4℃,10 ml/kg)was performed for 30 min and the heart was resuscitated by the perfusion of K-H fluid for 60 min.In the 0.5 MAC sevoflurane group (group Sev0.5 ),K-H fluid contained 0.5 MAC sevoflurane and other procedures were the same as in group IR.1.0 MAC sevoflurane group (group Sev1.0 ),K-H fluid contained 1.0 MAC sevoflurane and other procedures were the same as in group IR.2.0 MAC sevoflurane group (group Sev2.0),K-H fluid contained 2.0 MAC sevoflurane and other procedures were same as in group IR. HR,MAPs including time course (MAPD50,MAPD90)and MAP amplitude of endocardium,mid-layer myodardium and epicardium was recorded at the time of continuous balance perfusion for 1 5 min (T0),continuous perfusion for 15 min (T1),reperfusion for 15 min (T2)and 30 min (T3). Results Compared with T0and T1,HR was slower at T2and T3(P<0.05);Compared with group IR at T2and T3,HR in group Sev0.5 and group Sev1.0 was higher,that in group Sev2.0 was slower P<0.05);At T2,arrhythmia was observed in 6 rats in group IR,while arrhythmia was observed in 1 rats in group Sev0.5 ,and arrhythmia was observed in 2 rats in group Sev1.0 and arrhythmia was observed in 1 rats in group Sev2.0;Compared with group IR at T3,MAPD50in group Sev0.5 was shorter in three sites(P<0.05);Compared with group IR at T3,MAPD90in other three groups was shorter.Conclusion Different concentrations of sevoflurane can shorten MAPD90of MAPs,and the effects don＇t depend on the concertrations of sevoflurane when it changes from 0.5 MAC to 2.0 MAC;which may be the mechanism of decreased arrhythmias risk caused by sevoflurane.