ObjectiveTo investigate the changes of renin-angiotensin-aldosterone system (RAAS) and glomerular filtration rate (GFR) in epidurally-anesthetized patients undergoing gynecological laparoscopy with 15° head-down position and low insufflation pressure. MethodsTwenty gynecological patients(ASA grade I- Ⅱ )were studied during CO2 insufflation with an intra-abdominal pressure of 1012mmHg and 15° head-down position. Arterial blood samples were obtained for the measurements of serum concentrations of plasma renin activity(PRA), angiotensin Ⅱ (All), aldosterone(ALD) and β2-microglobulin(β2-MG)by radioimmunoassay at the following five time points: before insufflation, at 10min, 30min and 60 min after insufflation respectively and after desufflation. Arterial blood gas analysis was made in 10 of the cases simultaneously. ResultsCompared with preinsufflation, there was no significant decrease in the plasma levels of PRA, All ,ALD and β2-MG during CO2 pneumoperitoneum except for PRA at 10 min after insufflation(P ＜0.05). As the time of insufflation went on, the measurements above showed a tendency of slightly increase. The PaCO2 during peritoneal CO2 insufflation was increeseing ( P ＞ 0.05) and reached its maximum at 30 min after insufflation. The pH values of 30～60 min after insufflation were significantly decreased as compared with that of before insufflation. ConclusionThe epidural anesthesia may inhibit the response of RAAS to (CO2 insufflation pressure of 10-12mmHg and has no effect on GFR during gynecological laParoscopy.

Objective To assess the anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing video-assisted thoracoscopic surgery(VATS).Methods Forty ASA Ⅰ-Ⅱpatients. undergoing VATS were randomly divided into remifentanil-propofol group(group P,n=20)and remifentanil-desflurance group (group D,n=20).MAP and HR were monitered during the entire procedures. Conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score were recorded and compared between two groups. Results During the operation, MAP was decreased significantly in group D (P＜0.05).There was no significant difference in conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score between two groups. Conclusions The anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing VATS were both with quick recovery, but the fronter has more stable hemodynamics.

Objective To detect the epidemiologic features of pediatric patients with fall from height injury in an effort to provide a reference for prevention and scientific treatment.Methods Data of pediatric patients with fall from height injury treated from January 2011 to December 2012 were collected in the form of questionnaires.Epidemiologic features and relationship of associated factors were measured.Results Pediatric fall injury occurred very often in warmer season,namely on April and May,and in a day,it was more likely to happen when parents slacked at noon and night.Stairs and balconies were the most common sites of falls and head was most vulnerable to the injury.Falling height was the primary factor to the severity of injury.Conclusion To strengthen the protection reform in key areas,the supervision in peak time for falls and the care to children of the migrant workers can reduce fall injury in a certain extent.

OBJECTIVETo investigate the expression pattern of resistin (RSTN) in skeletal muscle tissue and its influence on glycometabolism in rats with traumatic brain injury (TBI).

METHODSSeventy-eight SD rats were randomly divided into traumatic group (n=36), RSTN group (n=36) and sham operation group (n=6). Fluid percussion TBI model was developed in traumatic and RSTN groups and the latter received additional 1 mg RSTN antibody treatment for each rat. At respectively 12 h, 24 h, 72 h, 1 w, 2 w, and 4 w after operation, venous blood was collected and the right hind leg skeletal muscle tissue was sampled. We used real-time PCR to determine mRNA expression of RSTN in skeletal muscles, western blot to determine RSTN protein expression and ELISA to assess serum insulin as well as fasting blood glucose (FBG) levels. Calculation of the quantitative insulin sensitivity check index (Q value) was also conducted. The above mentioned indicators and their correction were statistically analyzed.

RESULTSCompared with sham operation group, the RSTN expression in the skeletal muscle as well as serum insulin and FBG levels revealed significant elevation (P<0.05), and reduced Q value (P<0.05) in traumatic group. Single factor linear correlation analysis showed a significant negative correlation between RSTN expression and Q values (P<0.001) in traumatic group.

CONCLUSIONThe expression of RSTN has been greatly increased in the muscular tissue of TBI rats and it was closely related to the index of glycometabolism. RSTN may play an important role in the process of insulin resistance after TBI.

Animals ; Brain Injuries ; metabolism ; Glucose ; metabolism ; Insulin Resistance ; Male ; Muscle, Skeletal ; chemistry ; metabolism ; Rats, Sprague-Dawley ; Resistin ; analysis