Objective To investigate the sedative effects of different doses of dexmedetomidine with mid-azolam in spinal anesthesia. Methods 130 cases of spinal anesthesia were randomly divided into 2 groups,group D1 and group D2,with 65 cases in each group. Patients in 2 groups were given midazolam and dexmedetomidine with different doses. The heart rates ,blood pressure ,SpO2 ,Narcotrend value and Ramsay sedation scores were recorded at mutiple time points. The working time ,maintaining time of sedative effect ,and adverse reactions were compared between 2 groups. Results MAP,HR and NT decreased significantly in 2 groups(P < 0.05,respec-tively). The keeping time was relatively longer in group D1 compared with group D2(P<0.05). The working time was faster in group D2 compared with group D1. The rate of bradycardia in group D2 was relatively higher than that in group D1. Conclusion Good sedative effect can be obtained by drug in 2 groups. Group D1,with midazolam 0.05 mg/kg+dexmedetomidine 0.3μg/kg,may have a certain advantage in anaesthesia in the spinal canal.

Objective To investigate the risk factors to acute lung injury based on multiple trauma to provide a theoretical basis for early intervention .Methods The emergency surgical patients with multiple trauma in our hospital from March 2006 to March 2011 were selected .The patients meeting the diagnostic criteria for acute lung injury were taken as the study group and the others as the control group .All patients were enrolled for evaluating the injury severity score (ISS) ,acute physiology and chronic health Ⅱ(APACHE Ⅱ) score and recording smoking ,alcohol abuse ,diabetes mellitus ,number of organ damage ,gastrointestinal bleeding , pulmonary contusion ,diffuse intravascular coagulation (DIC ) ,vomiting ,traumatic shock ,time to correct shock ,blood transfusion . The polymorphism of rs3788853 ,rs13306087 ,rs12709426 of angiotensin-converting enzyme(ACE) gene were analyzed .Results In the study group and the control group ,there were statistical differences in 6 influencing factors of the ISS ,APACHE Ⅱ score ,blood transfusion ,DIC ,traumatic shock ,time to correct shock>6 h(P<0 .05);the gene and genotype frequencies of ACE between the two groups had no statistical difference (P>0 .05);the 6 kinds of influencing factors were risk to acute lung injury based on multi-ple trauma by Logistic regression analysis .Conclusion The ISS ,APACHE Ⅱ score ,blood transfusion ,DIC ,traumatic shock ,long time to correct shock are the risk factors to acute lung injury based on multiple trauma .

Objective To investigate the best time of mini-traumatic operation to treat hypertensive intracerebral haemorrhage in internal capsule. Methods Sixty-four patients were divided into treatment group and control group according to operative time. Patients who were treated with mini-traumatic operation within 6 hours were as treatment group, those treated with mini-traumatic operation beyond 6 hours were as control group. Results Twelve of 40 patients in treatment group were cured, 16 became better, 5 had no effect, 7 were dead, and the effective rate was 70.00%. Five of 24 patients in control group were cured, 6 became better, 5 had no effect, 8 were dead, and the effective rate was 45.83%. Conclusion The effect of mini-traumatic operation to treat hypertensive intracerebral haemorrhage in internal capsule within 6 hours is clearly better than that beyond 6 hours.

Objective To investigate the sedative effects and the adverse reactions in the elderly patients received different speed of dexmedetomidine (Dex) intravenous infusion. Methods Eighty elderly cases were randomly divided into four groups. Group D0 was the control group, while the group D1, D2 and D3 were the trial groups. The heart rates, blood pressure, SpO2, Ramsay sedation score and Narcotrend value were recorded. Results The sedation onset time of the D2, D3 group was faster than those in the D0 and D1 groups (P <0.05, respectively), and the duration of sedation in groups D2 and D3 were significantly longer than that in the D0 and D1 groups (P < 0.05). Among the four groups, no significant differences in the incidence of hypotension or bradycardia needed vasopressors or atropine to treat and oxygen saturation were shown (P > 0.05). Conclusion Intravenous infusion of Dex by doses of 0.75 ~ 1.0 μg/(kg·h) during hip surgery in the elderly patients under spinal anesthesia could lead to a safe and effective sedation.

Selective salpingography and transvaginal catheter dilatation using a self- made coaxial catheter set were performed in 45 women with infertility and fallopian tube ob- struction.The successful catheterization rate was 95.5% for fallopian tubes and the recanal- ization rate proximal allogian tubes was 80%,Normal intrauterine pregnancy was achieved in total 15 women(33.3%)with in two years follow-up 50% and 17.4% pregnant rates were obtained in secondary infertility and primary infertility,respectively.The authors be- lieve that transvaginal catheter dilization is a useful method for female infertility with fallopi- an tube obstruction,especially for the secondary infertility and proximal fallopian tube ob- struction.The self-made coaxial catheter set holds the advantages of effectiveness,safety, and inexpensiveness.

Objective To evaluate the effects of age factors on sedation induced by dexmedetomidine.Methods One hundred and thirty-nine patients,aged 18-103 yr,with body mass index ≤ 30 kg/m2,scheduled for elective surgeries on lower abdomen or lower extremities,were divided into4 groups according to the age:group Ⅰ (18 yr≤age≤44 yr,n=40);group Ⅱ (45 yr≤age≤59 yr,n=38);group Ⅲ (60 yr≤age≤89 yr,n=39);group Ⅳ (≥90 yr,n=22).A catheter was placed in the subarachnoid space at L3,4 interspace,and ropivacaine 10-20 mg was injected via the catheter.At 20 min after ropivacaine injection,dexmedetomidine 1 μg/kg was infused via a pump over 10 min.The onset time and duration of sedation were recorded,and the occurrence of adverse effects such as hypoxemia,bradycardia and hypotension was observed.Results There was no significant difference in the onset time of sedation and incidence of bradycardia among the 4 groups (P＞0.05).Compared with group Ⅰ,the duration of sedation was significantly prolonged in Ⅱ-Ⅳ groups (P＜0.05).Compared with Ⅱ and Ⅲ groups,the duration of sedation was significantly prolonged in group Ⅳ (P ＜ 0.05).The incidence of hypoxemia and hypotension was significantly higher in group Ⅳ than in Ⅰ-Ⅲ groups (P＜0.05).Conclusion Dexmedetomidine-induced sedation is influenced by age factors,the duration of sedation induced by dexmedetomidine is prolonged,and the occurrence of adverse effects is increased,especially if the patients ≥ 90 yr of age.

Objective To investigate the protective effect and potential mechanisms of hypertonic sodium chloride hydroxyethyl starch solution (HSH) against the cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH).Methods Twenty-four male Sprague-Dawley (SD) rats were randomly assigned to four groups according to the random number table,with 6 rats in each group.The SAH-CVS model was reproduced by injection of the blood twice through the cisterna magna.Rats in both model and HSH treatment groups received 8 mL/kg normal saline (NS) or HSH treatment everyday via caudal vein.Rats in sham group were injected with 1.5 mL/kg NS into cisterna magna followed by 8 mL/kg NS treatment.Rats in normal group received no treatment.Rats were sacrificed to harvest basilar artery after 7 days.The thickness of vessel wall and lumen area were measured using hematoxylin-eosin (HE) staining.The rate of apoptosis of vascular smooth muscle cell (VSMC) was assessed using flow cytometry.Caspase-3 activity was measured by a fluorometric assay.The expressions of Bax and Bcl-2 were determined by Western Blot.Intracellular reactive oxygen species (ROS) was detected by H2DCFDA.Results Compared with normal group,increased thickness of vessel wall (μm:27.72 ± 1.94 vs.18.30 ± 1.10,P＜0.05),decreased lumen area (μm2:26 115 ± 1 991 vs.55 080 ± 2 091,P＜0.05),and elevation of rate of apoptosis of VSMCs [(35.05 ± 5.54) ％ vs.(5.93 ± 1.53) ％,P＜ 0.05] were found in model group.Compared with model group,decreased thickness of vessel wall (μm:22.55 ± 1.50 vs.27.72 ± 1.94,P＜0.05),increase of lumen area (μm2:48 115 ±2 460 vs.26 115 ± 1 991,P＜0.05),and depressed rate of apoptosis of VSMCs [(16.54 ± 5.94) ％ vs.(35.05 ± 5.54) ％,P＜ 0.05] were found in HSH treatment group.Caspase-3 activity,intracellular ROS level,Bax and Bcl-2 expressions in model group were (188.40 ± 19.35)％,(163.50 ± 17.02)％,(208.71 ± 26.04)％ and (44.52 ± 9.61) ％ of those of normal group,and the differences of these parameters between model and normal groups were statistically significant (all P＜0.05).Caspase-3 activity,intracellular ROS level,Bax and Bcl-2 expressions in HSH treatment group were (135.05 ± 19.52)％,(119.44 ± 11.50)％,(139.20 ± 18.04)％ and (85.35 ± 13.12)％ of those of normal group,respectively,and the differences of these parameters between HSH treatment and model groups were statistically significant (all P＜0.05).The differences of all measurements between sham and normal groups were not statistically significant.Conclusion The current results demonstrate that HSH attenuates the SAH-induced CVS,alleviates thickness of vessel wall,and increases lumen area via inhibition of VSMCs apoptosis.

OBJECTIVE To establish the fingerprints of Ardisia crenata， Sophora tonkinensis and their couplet medicines， and to determine the contents of five components in them. METHODS Using water as solvent， single lyophilized powder of A. crenata and S. tonkinensis and combined lyophilized powder of their couplet medicines were prepared by combining lyophilization technology. The fingerprints of three lyophilized powder samples were established by using high-performance liquid chromatography （HPLC）， and the contents of 5 kinds of components such as gallic acid were determined simultaneously. RESULTS There were 5， 10 and 14 common peaks in the fingerprints for single lyophilized powder of A. crenata and S. tonkinensis and combined lyophilized powder of their couplet medicines； the similarities of them with the control fingerprints were all greater than 0.90. For combined lyophilized powder of couplet medicines， peak 3 Δ 基金项目 国家重点研发计划项目（No.2018YFC1708100）；贵 州省科技计划项目（No.黔科合基础-ZK〔2022〕一般483，No.黔科合成 was identified as gallic acid， peak 4 as matrine， peak 6 as 果〔2021〕一般137）；贵州省教育厅高等学校科学研究项目（青年项目） oxymatrine， peak 8 as bergenin， and peak 14 as trifolirhizin. In single lyophilized powder of A. crenata， the average contents of gallic acid and bergenin were 0.499 3 and 4.962 6 mg/g， respectively. In single lyophilized powder of S.tonkinensis， the average contents of matrine， oxymatrine and trifolirhizin were 3.046 0， 2.336 6 and 0.278 6 mg/g， respectively. In combined lyophilized powder of couplet medicines， the average contents of gallic acid， matrine， oxymatrine， bergenin and trifolirhizin were 0.560 6， 2.548 7， 1.382 2， 5.960 7 and 0.279 1 mg/g， respectively. The transfer rates were 8.87%-513.19%. CONCLUSIONS The established fingerprint and content determination methods are stable and feasible， and can be used for the quality control of A. crenata and S. tonkinensis and their couplet medicines. The average contents of matrine and oxymatrine in combined lyophilized powder of A. crenata-S. tonkinensis couplet medicines are decreased.