Objective To compare the influence between target controlled infusion propofol vein anesthesia and midazolam vein anesthesia toward serum amylase and triglyceride in children with cleft lip and palate.To make a definitude that the feasibility of target controlled infusion propofol used in children′s anesthesia.Methods Sixty children with cleft lip and palate aged from 4 months to 3 years,weighting 6.5-15.9 kg,American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ,were randomly allocated to group P and group M(n=30,each).Group P received target controlled infusion propofol.Anesthesia was induced with target controlled infusion propofol at the target effect-site concentration 3.0 mg/L,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and target controlled infusion propofol at the effect-site concentration 3.0 mg/L.Group M received intermittent boluses of midazolam 0.1 mg/kg.Anesthesia was induced with midazolam 0.2 mg/kg,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and intermittent boluses of midazolam 0.1 mg/kg every hour.The venous blood samples were taken before anesthesia induction(T1),4 hours(T2) and 24 hours(T3) after surgery to measure the serum concentration of serum amylase and triglycride.Results The duration of anesthesia induction,extubation and emergence were shorter in group P compared with group M(Pa0.05).Conclusions The serum concentration of triglyceride may increase because of the stress of anesthasion and operation,and can be higher during target controlled infusion propofol,but does not exceed the normal value.The serum amylase concentration does not increase during target controlled infusion propofol in children.

Adult ; Female ; Heart Neoplasms ; Humans ; Pericardium ; Pheochromocytoma

Objective To investigate the clinical values of extracapsular invasion at sentinel lymph nodes in patients with breast cancer.Methods From Jan,2010 to Jan,2013,80 patients underwent axillary lymph node dissection due to sentinel lymph nodes invasion were enrolled in this prospective study.Patients were signed to extracapsular at sentinel lymph nodes positive group (n =45)and control group (n =35)according to the intra -operative pathology.The primary outcome was rate of positive non -sentinel lymph nodes and the second outcomes were 3 -year recurrence -free survival,mortality and health -related quality of life.Results Compared with the control group,the patients in extracapsular at sentinel lymph nodes positive group got a significantly higher rate of positive non -sentinel lymph nodes (91.11% vs.28.57%,χ2 =33.321,P <0.001 );a significantly lower rate of 3 -year recurrence -free survival(57.78% vs.88.57%,χ2 =9.114,P =0.003);a significantly higher rate of mortality (17.78% vs.2.86%,χ2 =4.390,P =0.036);and a significantly lower level of health -related quality of life[(78.43 ±12.43)vs.(87.54 ±11.89),t =11.324,P =0.000].Conclusion Extracapsular invasion at sentinel lymph nodes was a reliable predictor for non -sentinel lymph nodes invasion and long -term clinical outcomes.

Objective To investigate the association between the lumbar vertebral fracture damage degree with the fracture classification,injury score,kyphosis deformity and nerve function injury.Methods According to the damage degree of posterior lig ament complex(PLC),the patients were divided into the PLC intact group and PLC injury group.Its relationship with PLC injury was researched by evaluating the fracture classification,injury score and nerve function injury situation in the two groups.Results The LCS score and TLICS score in the PLC injury group were (7.1±0.8) points and (8.2±0.6) points,which were higher than (5.7±0.5) points and (4.6±0.7) points in the PLC intact group.The Denis score in the PLC injury group was more serious.The Cobb angle in the PLC injury group was 29°,and which in the PLC intact group was 19°.The proportion of nerve function insufficiency in the PLC injury group was 89％,while which in the PLC intact group was only 60 ％.Conclusion The thoracolumbar vertebral fracture is closely related with PLC.PLC damage degree is positively correlated with the fracture classification,injury score,kyphosis deformity and nerve function injury degree.

Azabicyclo Compounds ; blood ; Chromatography, Gas ; Humans ; Piperazines ; blood ; Serum ; chemistry

Objective To discuss the safety of using etomidate combined with remifentanil by target controlled infusion ( TCI) for painless bronchofibroscopy. Methods Sixty patients were divided into two groups: painless bronchoscopy group (treatment group, 24 patients) and the routine bronchoscopy group (control group, 36 patients). Treatment group received TCI of remifentanil and intravenous injection of etomidate fat emulsion. Control group was subjected to surface anesthesia with 2%lidocaine. SpO2 , blood pressure, heart rate and breath changes during examination and complete awakening were continuously monitored. Bronchofiberscopy time, body movement during examination, bucking and satisfaction degree after examination were also recorded. Results Treatment group patients felt senseless and painless during bronchoscopy, without memory of bronchoscopy and pain. Patients in control group had discomfort, body movement and acute bucking, and most of them had painful memory. There were significant differences between the two groups (P<0. 01). In treatment group, after examination, blood pressure, respiratory frequency, heart rate and SpO2 were significantly decreased (P<0. 01). During examination, the blood pressure, respiratory frequency and heart rate were increased, and SpO2 decreased in control group compared to the baseline (P<0. 01). There was no significant difference in SpO2 between treatment group and control group during examination (P>0. 05). Conclusion TCI etomidate combined with remifentanil during bronchoscopy achieved satisfying anesthetic effect.

Objective To observe the possible mechanism and inhibitory effects of curcumin on pulmonary fibrosis induced bleomycin in rats at the fibrosing stage. Methods 80 male Sprague-Dawley rats were random divided into 4 groups (20 rats in each group). Rats in the fibrosis model group, the prednisone group and the curcumin group were induced by instilled bleomycin through tracheal, rats in the control group with same volume normal saline. Since the 15th day after bleomycin administration, the curcumin group and prednisone group were given curcumin (300 mg/kg) or prednisone (5mg/kg) per day by intragastric administration, respectively. The normal control group and the model group were given 1% sodium carboxymethyl cellulose ( 10ml/kg). Six rats of each group were random sacrificed on the 21st, 28th, 42nd and 56th days after bleomycin administration. The histological changes of the pulmonary were evaluated by H. E and Masson dyeing. The expressions of transforming growth factor-β1 (TGF-β1), platelet-derived growth factor (PDGF) and hydroxyproline in the tissue of pulmonary were assessed by immunohistochemistry and digestion method. Results Pulmonary fibrosis and hydroxyproline level in the curcumin group were obviously reduced as compared with the model group on the 42nd and 56th day[42 d:1. 28 ±0. 61 vs 2. 28 ±0. 39,P <0. 01 ;(1.73 ±0. 22)mg/g vs (2.50 ±0. 37) mg/g, P <0.01;56 d:1.00 ±0.59 vs 1.73 ±0.36, P< 0. 05; ( 1.57 ± 0. 36) mg/g vs (2. 20 ± 0. 42) mg/g, P < 0. 01 ], and it was also lower than that in prednisone group on the 42nd day( P < 0. 05 ). The expression of TGF-β1 and PDGF in the curcumin group were obviously lower than that in the model group on the 28th, 42nd and 56th day[28 d:TGF-β1 :3642. 05 ±839. 31 vs 5067. 35 ±738. 39, P <0. 05 ;PDGF:2957. 55 ±739. 16 vs 4457. 75 ±568. 39, P <0. 05;42 d: TGF-β1: 2689. 73 ± 529.22 vs 4089. 50 ± 619. 37, P < 0. 01; PDGF: 2834. 46 ± 567. 16 vs 3239. 52 ±628. 26, P <0. 01 ;56 d:TGF-β1: 1968.57 ±408. 36 vs 2968.20 ±498.42, P <0. 01 ;PDGF: 1083.36 ±381.35 vs 2019. 40 ±412. 36, P <0. 01 ], which was lower than that in prednisone group on the 42nd and 56th day (42 d,TGF-β1 :3529. 07 ±981.35,PDGF:2618. 34 ±813. 34;56 d,TGF-β1 :2530. 83 ±439. 37,PDGF: 1738. 35 ±536. 62, Pall <0. 05 ) , and it had no obvious difference compared with control group on the 56th day ( P > 0. 05 ). Conclusion Curcumin could alleviate bleomycin-induced pulmonary fibrosis in rats at the fibrosing stage by inhibiting the expressions of TGF-β1 and PDGF.

AIM:To perform a new method for orbital implant and contracted socket through one time and its results. ·METHODS:Totally 114 patients 114 eyes, from January 2008 to June 2014, with contracted socket participated in this study. We incised the bulbar conjunctiva horizontally and excised scar tissue, then implanted the hydroxyapatite in the four extraocular muscles and tightly sutured the Tenon ' capsule. After that, we put the superior and inferior conjunctival petals backwards and sutured them to the Tenon ' s capsule. All the patients were divided into four groups according to the vertical diameter length of the conjunctival defect area:GroupⅠ:≤5mm; Group Ⅱ: 6-10mm; Group Ⅲ: 11-15mm; and Group Ⅳ: ≥16mm. These patients were followed up for 6mo to 3y to observe the conjunctival sac shaping and growth of conjunctiva. ·RESULTS:There were 64 cases in GroupⅠ, 31 cases in Group Ⅱ, 16 cases in Group Ⅲ and 3 cases in Group Ⅳ. All patients ' conjunctival defect was covered by new conjunctiva and scar tissue 4 to 6wk after surgeries. Ten cases had contracted socket; 2 cases had orbital implant exposure, requiring reoperation. Of the 114 cases, 8 had contracted socket and could use a smaller conformer, 106 could use a normal size conformer. ·CONCLUSION: When the conjunctival defect was ≤15mm, this new method can address the orbital implant and contracted socket at the same time. While it was ≥16mm, flap transplantation is necessary.