Objective To observe the clinical effect and safety of using Sufentanil in children's enteroscopy under general anesthesia. Methods 80 ASA Ⅰ ~ Ⅱ children, aged 5~10 years, weighed 18~35 kg, who scheduled for enteroscopy, were randomly divided into two groups: group Sufentanil (group S, n = 40) and group Fentanyl (group F, n = 40). Group S were given Sufentanil 0.2 μg/kg and Propofol 2.50 mg/kg in intravenous injection, group F were given Fentanyl 2.0 μg/kg and Propofol 2.50 mg/kg in intravenous injection. Proseal laryngeal mask airway (PLMA) was inserted when eyelash reflex disappeared and the submaxilla was loosen, and Propofol 6.00 ~8.00 mg/(kg?h) and 2% ~ 3% Sevoflurane inhalation for anesthesia maintenance. Parameters of HR, MAP, SpO2 and RR were recorded at different times: before induction (T0), insertion of PLMA (T1), enteroscopy to the ileocecal valve (T2) and end of operation (T3). Also, time of induction and recovery, pain on injection, perioperative body movement, intraoperative regurgitation, glossocoma, nausea and vomiting, throat pain and agitation were also recorded. Results Compared with T0, HR and MAP at T1 and T2 were significantly higher in group F (P < 0.05), but in group S, there was no significant differences (P > 0.05). RR in both groups were significantly lower at T1 compared with T0 (P < 0.05), and no significant differences between the two groups (P > 0.05). HR, MAP and RR were significantly lower in group S than that in group F at T1 and T2 times (P < 0.05). Pain on injection, body movement and agitation were significantly lower in group S than that in group F (P < 0.05). Induction and recovery time in group S were significantly shorter than that in group F (P < 0.05). Conclusions The anesthetic effect of Sufentanil for combined intravenous and inhalation anesthesia in children's enteroscopy is safe and satisfactory. It could provide more smoothly intraoperative hemodynamics and higher quality of awakening.

Objective To examine if high-dose glucocorticoid has any cerebral protective effects aftercardiopulmonary resuscitation. Methods Twenty-one healthy mongrel dogs of both sexes weighing 10 .5-15 kg weresubjected to cerebral ischemia using Pittsburgh standard ventricular fibrillation-cardiac arrest (VF-CA) model. Theanimals were anesthetized with intraperitoneal pentobarbital sodium 30 mg?kg~(-1) and mechanically ventilated thertracheal intubation (V_T 15 ml?kg~(-1), RR 18-20 bpm). Right femoral vein was cannulated for fluid administration(lactated Ringer's solution 0. 15 ml?kg~(-1)?min~(-1)) and right femoral artery was cannulated for BP monitoring. ECGwas continuously monitored. The animals were randomly divided into 3 groups: group A received only routineresuscitation treatment (control, n = 5); group B received dexamethasone 5 mg?kg~(-1) (n = 8) and group Cmethylprednisolone 30 mg?kg~(-1) (n = 8) after successful cardiopulmonary resuscitation. 8 hours after resuscitationthe animals were anesthetized and three pieces of brain tissue were obtained from right parietal lobe for light andelectron microscopic examination and determination of dopamine (DA) and 5-hydroxy-tryptamine (5-HT) contentsusing high-performance liquid chromatography- electrochemical technique (HPLC- ECD ). Results The DA and 5 -HT contents in parietal lobe of cortex were significantly decreased in group B and C as compared with group A (P

Objective To observe the effect of Nalmefene on postoperative recovery on neonates by laparoscopic pyloromyotomy. Methods Elective laparoscopic pyloromyotomy for 60 neonates under general anestheisa, aged 15 ~ 28 days, ASA Ⅱ~Ⅲ , were randomly divided into two groups: Nalmefene group (M group) and Naloxone group (L group), 30 cases in each. Nalmefene 0.25 μg/kg and Naloxone 1.00 μg/kg were respectively administrated in M group and L group when the procedures finished. Parameters SpO2, MAP, HR and RR were measured and analyzed statistically at different times: end of surgery before drugs were used (T0), 10 min after administration (T1), 30 mins after extubation (T2) and 2 h after extubation (T3). Meanwhile observing spontaneous breathing recovery time, extubation time, residence time at PACU and adverse events 24 s after surgery. Results There were no actual differences in the value of MAP, HR and SpO2 at T0, T1, T2 and T3 times in the two groups (P > 0.05). However, the values of RR was significant faster at T1, T2 and T3 times than that at T0 in both groups (P < 0.05), compared with L group, the value of RR at T1 was much faster in M group (P < 0.05). The times of extubation and residence at PACU have significant differences in M group than that in L group (P < 0.05). The adverse events in both groups have no differences. Conclusion Nalmefene can facilitate the recovery at laparoscopic pyloromyotomy on neonates. Compared with naloxone, it can reduce the extubation time, and promote the early rehabilitation.

Objective To evaluate the efficacy of sniffing position in alleviating glossoptosis during the emergence from anesthesia in children. Methods Two hundred pediatric patients who developed glos?soptosis during the emergence from anesthesia, aged 2-8 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, were randomly divided into 4 groups ( n=50 each) using a random number table:head extension position group ( group A ) , head tilted position group ( group B ) , oropharyngeal airway group ( group C) and sniffing position group ( group D) . Alleviation of glossoptosis, and occurrence of la?ryngospasm, agitation, vomiting and oral hemorrhage were recorded. Alleviation rate was calculated. Re?sults Compared with group A, the alleviation rate was significantly increased in C and D groups, the alle?viation rate was decreased in group B, and the incidence of laryngospasm, agitation and oral hemorrhage was increased in group C ( P<0?05 ) . Conclusion Sniffing position can effectively alleviate glossoptosis during the emergence from anesthesia in children with good safety.

Objective To investigate the scintigraphic features of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) and to explore the clinical significance of 99Tcm-EHIDA hepatobiliary scintigraphy.Methods Hepatobiliary scintigraphy with 99Tcm-EHIDA was performed in 28 genetic confirmed NICCD cases (16 males,12 females,1-8 months).Normal dynamics (i.e.,time-activity curve) of the tracer in heart,liver and kidneys was defined as normal hepatic uptake function.Decreased liver uptake of the tracer and/or prolonged heart and kidneys radioactivity retention was defined as impaired hepatic uptake function.Normal or delayed biliary excretion was defined as radioactivity appearing in the bowel within 60 min or after 60 min.Occluded biliary excretion was defined as absent bowel radioactivity within 24 h.The characteristics of hepatobiliary scintigraphy and their relationship with levels of serum total bilirubin (TB),direct bilirubin(DB),ALT,total bile acid (TBA) were retrospectively analyzed.Statistical analysis was performed using Kruskal-Wallis rank sum test.Results Of 28 NICCD patients,20 showed normal uptake while 8 had impaired hepatic uptake.Ten of twenty patients with normal uptake function showed normal biliary excretion and the others showed delayed biliary excretion.Four of eight cases who presented impaired hepatic uptake function were with delayed biliary and the rest displayed biliary excretion occlusion.Compared with the patients with normal hepatic uptake function,patients with impaired hepatic uptake had significantly higher levels of TB and DB (TB:183.6(128.7-280.9) mmol/L vs 105.5(80.0-141.7) mmol/L,Z=-2.25;DB:135.6 (95.7-212.6) mmol/L vs 73.1(53.9-97.9) mmol/L,Z=-2.73; both P＜0.05).Compared with the cases with normal biliary excretion function,patients with delayed biliary excretion had significantly higher levels of TB,DB and TBA (TB:137.5 (122.0-170.9) mmol/L vs 81.7(65.7-93.5) mmol/L,Z=-3.92;DB:96.5 (81.1-108.0) mrrol/L vs 54.1(45.3-72.6) mmol/L,Z=-3.74; TBA:245.6(183.9-299.2) mmol/L vs 136.0(73.5-163.2) mmol/L,Z=-2.57; all P＜0.05).The levels of TB (262.0(152.1-542.8) mmol/L) and DB (192.7(118.1-407.2) mmol/L; both Z=-2.82; both P＜0.05) were the highest in patients with occluded biliary excretion.Compared with the patients with delayed excretion,the occluded excretion subgroup had significantly higher levels of ALT (71.5 (48.5-144.8) U/L vs 20.0(16.5-27.7) U/L,Z=-2.66,P＜0.05).Conclusion 99Tcm-EHIDA hepatobiliary scintigraphy may evaluate hepatic uptake and excretion function of the NICCD infants.When the hepatic uptake is remarkably decreased,the occluded biliary excretion can be shown.

Objective To observe the impact of Dezocine used before end of operation on postoperative recovery and safety effect on postoperative pain in children receiving laparoscopic appendectomy. Methods 60 ASAⅠ ~ Ⅱcases of aged 4~10 yr, underwent laparoscopic appendectomy, were randomly divided into 3 groups: Dezocine group (D group), Fentanyl group (F group) and control group (normal saline group), 20 cases in each group. Remifentanil combined with Propofol and Sevoflurane was given for conducting endotracheal intubation general anesthesia. At 30 min before the end of operation, D group was given Dezocine 0.10 mg/kg, while F group fentanyl 1.0 μg/kg, and the control group was given same volume of normal saline. 5 min before the end of the operation anesthetics disabled, then extubation until children open eyes on call and spontaneous breathing recovered satisfactorily. Observe and record MAP, HR, SPO2 and respiration rate (RR) at different times:drug withdrawal, extubation and 5 min after ex﹣tubation, while also record extubation time, Riker sedation-agitation scores and face, legs, activity, cry and consola﹣bility (FLACC) scores and adverse reactions in the recovery period (within 30 min after extubation). Results MAP and HR at extubation and 5 min after extubation in N group and F group were higher than that in D group (P<0.05);Compared with drug withdrawal time, HR and MAP at extubation and 5 min after extubation in group F and N were much higher (P< 0.05); MAP, HR, SPO2 and RR had no statistically significant difference in D group at each time point (P> 0.05). The Riker sedation-agitation scores and the FLACC scores at 30 min after extubation in D group were significantly lower than those in the F and N groups (P<0.05), adverse reaction such as respiratory inhi﹣bition, nausea, vomiting, lethargy, headache were not found in the 3 groups. Conclusion Intravenous Dezocine before the end of operation in children's laparoscopic operation can make awake quickly and smoothly, allow small hemo﹣dynamic changes, and can reduce postoperative pain and restlessness.

Objective To assess the sensitivity of indices of hip development in children with spastic diple-gia resulting from cerebral palsy. Methods X-ray images of the hips of 57 children with cerebral palsy ( the cere-bral palsy group) were checked, and the acetabular index ( AI), femur head migration percentage ( MP), center-edge angle and neck-shaft angle (NSA) were compared with those of normal children ( the control group, n = 30).Results The differences in MP and NSA between the two groups were significant. The prevalence of hip subluxation was 20.45% among the children with spastic diplegia who could not walk independently, and the prevalence was sig-nificantly greater in children 3 to 5 years old than among those under 3. Conclusion The MP can be used as a sen-sitive index to evaluate hip development. Age is a relevant factor affecting the hip development of children with cere-bral palsy.

Objective To assess the characteristics of magnetic resonance imaging (MRI) for spinal cavernous angiomas.Methods The examinations of plain scan and contrast enhanced scan of magnetic resonance (MR) were performed in three patients with spinal cavernous angiomas.Results The focus of two cases was located in thorax segment of the spinal cord and one in lower cervical segment.All focuses were single and the shape of spinal cord was normal or slightly thick. MRI characteristic of spinal cavernous angiomas was just like popcorn or mulberry with a jumbled gobbet signal. Low and short T2 signal appeared around the focus. In all cases, there were no obvious contrast enhanced signal in 2 cases and one case with moderate contrast enhanced signal. The diameter of hemorrhage was smaller than that of the spinal cord.Conclusion MRI has higher sensitivity and specificity in the diagnosis of spinal cavernous angioma.

Objective To evaluate the efficacy of nasotracheal intubation for airway management in neonates with Pierre Robin sequence undergoing surgery with general anesthesia. Methods Sixty full-term neonates of both sexes with Pierre Robin Sequence, aged 2-28 days, weighing 2. 4-3. 8 kg, scheduled for elective mandibular distraction osteogenesis, were divided into 2 groups ( n=30 each) using a random num-ber table method: nasotracheal intubation group (group N) and orotracheal intubation group (group O). Combined intravenous-inhalational anesthesia was used during surgery. The success rate of intubation, intu-bation time, heart rate, mean arterial pressure and SpO2 during intubation, and occurrence of complica-tions during intubation were recorded, and the time of extubation and occurrence of complications after extu-bation were also recorded. Results Compared with group O, the intubation time was significantly short-ened, the first-time intubation success rate was increased, the heart rate and mean arterial pressure were decreased at 2 min after intubation, the lowest SpO2 was increased during intubation, and the incidence of pharyngeal soft tissue injury during intubation and hoarseness after extubation was decreased in group N ( P<0. 05) . Conclusion Nasotracheal intubation can be used for airway management in neonates with Pierre Robin sequence undergoing surgery under general anesthesia, and the efficacy is superior to that of orotra-cheal intubation.