Objective To compare the effects of different doses of dexmedetomidine on postoperative analgesia and sedation.Methods From January 2014 to November 2015,60 cases who needed postoperative analgesia and sedation in our hospital were selected.According to the dosage of dexmedetomidine,they were divided into control group and observation group,30 cases in each group.Two groups of patients were given analgesia pump for analgesia, with 0.5μg·kg-1·h-1,1.0μg·kg-1·h-1 two doses of dexmedetomidine,and analgesia 48 h.At different time points,the VAS pain score,Ramsay sedation score of the two groups were compared,the calm satisfaction in both two groups was recorded,the average incidence of delirium and delirium score in the process of the treatment and the occurrence of adverse reactions were observed.Results With the extension of time of postoperative analgesia,VAS scores in each group decreased,VAS scores in the observation group after 4h,8h,12h were (3.01 ±0.53)points, (1.95 ±0.58)points,(1.52 ±0.35)points,which were lower than those of the control group[(3.92 ±0.32)points, (2.86 ±0.67)points,(2.25 ±0.78)points],the differences were statistically significant (t=3.42,4.11,2.43,all P<0.05).After 24h,48 h,VAS score between the two groups had no significant difference(P>0.05).Postoperative 4h Ramsay score between the two groups had no significant difference (P >0.05 ).With increased postoperative analgesia time,Ramsay scores in two groups decreased,postoperative 8h,12h,Ramsay scores in the observation group [(2.95 ±0.83)points,(2.22 ±0.55)points]were lower than the control group[(3.76 ±0.78)points,(2.98 ± 0.89)points,t=3.45,2.38,all P<0.05].Postoperative 24h,48 h,the Ramsay scores between the two groups had no significant difference(P>0.05).The sedation satisfaction of the observation group (96.67%)was higher than the control group (86.67%),the incidence rate of delirium and delirium average score [3.33%,(15.11 ± 2.03)points]were lower than the control group[13.33%,(19.23 ±2.21 )points],the differences were significant between the two groups (t =4.32,4.32,3.27,all P<0.05 ).After treatment,the adverse reactions were mainly bradycardia,nausea,vomiting,drowsiness,respiratory depression,urinary retention.The overall incidence rate of adverse reactions between the two groups had no significant difference (P >0.05 ).Conclusion The effect of 1 .0μg·kg-1 · h-1 concentration dexmedetomidine within 24h of postoperative analgesia sedative is best,it can reduce the incidence of postoperative delirium,and without obvious drug side effects.

Objective To observe the efficacy of CTLA-4Ig gene local transfection on the survival of renal allografts. Methods The kidneys of BN rats were transfected with CTLA-4Ig gene-recombined adenovirus. The transfected kidneys were transplanted to Lewis rats (transfection group). BN→Lewis kidney transplantation with non-transplanted kidneys served as controls. The allograft survival time and the allograft function between the two groups were compared. Results The allograft survival time of transfection group was longer than that of controls significantly (32? 8.0?days vs 8.5 ? 1.4?days , P

AIM: To compare the effects of different surgeries in the treatment of angle closure glaucoma with cataract and the improvement of quality of life.METHODS: The clinical data of 60 cases (60 eyes) with angle closure glaucoma and cataract who were admitted to the hospital between January 2014 and October 2016 were collected.According to the surgical method, they were divided into the control group (simple trabeculectomy, n=28) and the observation group (trabeculectomy combined with phacoemulsification and intraocular lens implantation, n=32).The changes of visual acuity and intraocular pressure before and after surgery were compared between the two groups.The incidence of postoperative complications was statistically analyzed, and the quality of life was compared between the two groups.RESULTS: Before surgery, there was no significant difference in visual acuity, intraocular pressure and anterior chamber depth between the two groups (P>0.05).At 4wk after surgery, the visual acuity of two groups increased and intraocular pressure decreased.The anterior chamber depth of observation group increased while that of the control group decreased (P<0.05).At 4wk after surgery, the visual acuity and anterior chamber depth of observation group were higher than that of the control group but intraocular pressure was lower than that of control group (P<0.05).The success rate of surgery and the opening rate of chamber angle after surgery in the observation group were higher than those in the control group (P>0.05).The incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05).Before surgery, there was no statistically significant difference in quality of life score between the two groups (P>0.05).At 4wk and 3mo after surgery, the scores of the two groups increased (P<0.05), and the quality of life scores of observation group were higher than those of the control group at different time (P< 0.05).CONCLUSION: The success rate of trabeculectomy combined with phacoemulsification and intraocular lens implantation is high in the treatment of angle closure glaucoma with cataract.The regimen can improve the visual function, reduce the incidence of postoperative complications, and improve the quality of life of patients.

Objective To investigate the hemodynamics and structural effect of rat endothelial progenitor cells (EPC) transplant on pulmonary artery hypertension (PAH) induced by monocrotaline(MCT) in rats.Methods EPCs were identified and marked.Twenty-one days after injection of EPCs,the pulmonary hemodynamic parame- ters,average pulmonary artery pressure (mPAP),right heart index were determined.The vascular endothelial cells and pulmonary vascular structural changes were verified by fluoresccuse microscope.Results Compared with the model,EPCs treatment(n=10) decreased mPAP significantly (mPAP,EPCs:25.9?0.7 mmHg vs model group:29.3?2.2 mmHg,P

Objective To report the clinical outcomes of open reduction and internal fixation for capitellum fractures in adolescents.Methods From January 2010 to January 2015,14 adolescents with capitellum fracture were admitted to our department.They were 12 males and 2 females,aged from 12 to 16 years (13.7 years).By the Dubberley classification,we had 2 cases of type ⅠA,8 cases of type ⅡA,3 cases of type Ⅲ A and one of type Ⅲ B.We summarized their clinical characteristics and injury mechanisms.At the last follow-up,the therapeutic efficacy was assessed by the Mayo elbow function scores,and the ranges of motion of the elbow and forearm on the affected side were recorded.Results The 14 patients obtained an average follow-up of 12 months (from 6 to 18 months).All the cases achieved fracture union within 3 months,but malunion appeared in one.At the last follow-up,the ranges of flexion and extension of the affected elbow averaged 120.6° (from 110° to 135°),and the ranges of lateral rotation of the affected forearm averaged 160.3° (from 150° to 175°).According to the Mayo scores at the last follow-up,the elbow function was rated as excellent in 12 and as good in one.Mild traumatic arthritis occurred in 3 cases.Conclusions Capitellum fractures in adolescents are often Dubberley type A ones without a complicated fracture of the posterior condyle.Usually,the capitellum is impacted by the radial head in the process of elbow extension with valgus stress.After definite diagnosis,open anatomical reduction and reasonable and reliable internal fixation can result in good clinical results.

Objective To explore the significance and important measure of integrative treatment of multiple trauma patients with severe craniocerebral injury in emergency center. Methods One hundred and forty-eight multiple trauma patients with severe craniocerebral injury in emergency center from November 2002 to February 2006 were analysed retrospectively. Result In total 148 cases, 72 were cured and 26 dead, 7 were in status of plant man, 17 experienced severe deformity, and 26 did mild deformity. Conclusion Multiple trauma patients with severe craniocerebral injury usually experience a serious situation and rapid development. Therefore emergency doctors are required for organizing salvage of such patients, at the same time treatment and diagnosis are implemented. Firstly the most important key to successful salvage is appropriate disposal of fatal injury and early elimination of shock. Proper surgical choice, especially at the first time, inspection and protection of visceral functions, and attention to nutritional support are other vital methods to gain more successful salvage. ICU is also emphasized for its essentiality.

Objective:To investigate the onset mechanism of cervical vertigo from the proprioceptive sensation and provide clinical basis for its treatment.Methods:Among the 121 cases that conformed to the diagnostic criteria of cervical vertigo,70 cases who presented with negative neck-rotation test and cervical vertigo without obvious vascular factors by transcranial Doppler(TCD)were assigned to the observation group,while 51 cases who presented with positive neck-rotation test and cervical vertigo due to spasm of vertebral basal artery or insufficient blood supply by TCD were assigned to the control group.The cases in the two groups were treated once every day,5 days make up one treatment course and the resuIts were statistically analyrzed after one treatment course.Results:The skull triaxial spatial offset of the cases in the two groups were significantly reduced after the treatment (P<＜0.01).However, there was no statistically significant difference between the skull triaxial spatial offset between the two groups (p＞0.05).It is not conclusive that the therapeutic effect in the two groups was significantly different after one treatment course.Conclusion:Tuina manipulation therapy can improve the skull spatial ofrset repositioning ability of the Patients.

Aim The protective effect of total salvianolic acids (Sal) on cerebral hypoxia inmice was studied. Methods Acute cerebral hypoxia was induced by sodium nitrite scand decapitation.The effect of Sal on acute cerebral hypoxia in mice and neuronalhypoxia injury induced by sodium dithionite in primary cultures were ob-served. Results Sal in the doses of 10, 20 mg?kg-1 iv protected mice against theacute cerebral hypoxia and inhibited the production of lipid peroxidation in brain tis-sue of mice caused by cerebral hypoxia. Sal in the doses of 1~10 ?g? L-1 reduced therate of cell death and the content of MDA and lowered LDH content in extra-cellularbathing media in oxygen deprived cortical cultures.Conclusions Sal protects miceagainst cerebral hypoxia by suppressing the generation of lipid peroxide.

Objective:To discuss the effect of amlodipine combined with atorvastatin in the treatment of elderly patients with acute cerebral infarction hypertension. Methods:Totally 86 cases with acute cerebral infarction hypertension were randomly divided into the treatment group (43 cases) and the control group (43 cases). The control group received amlodipine 5mg, po, qd, and the treatment group was given atorvastatin 20mg additionally, po, qd. After the one-month treatment, the efficacy of the two groups was studied and compared, and the changes in neural function defect scale, blood pressure, blood lipids and CRP were also investigated. Results:Af-ter the treatment, the total effective rate and the total effective rate of antihypertensive effect in the treatment group were both signifi-cantly higher than those in the control group (P<0. 05). The neurological deficit scores of the two groups were significantly higher than those before the treatment (P<0. 05), and those of the observation group was significantly higher than those of the control group (P<0. 05). The blood pressure of the two groups was both decreased after the treatment(P<0. 05), and the decrease in the treat-ment group was more significant (P<0. 05). TC, TG, LDL-C and CRP levels of the two groups had significant decrease after the treatment (P>0. 05), and those in the treatment group was significant lower than those in the control group (P<0. 05). Conclu-sion:Amlodipine combined atorvastatin in the treatment of elderly patients with acute cerebral infarction hypertension shows significant effect with low incidence of adverse drug reaction, which is worthy of wider application.