Objective To investigate the effect of dezocine combined with sufentanil on postop-erative analgesia and side effects in the upper-abdominal surgery and hip replacement surgery,and ex-plore the potential mechanisms.Methods One hundred patients scheduled for selective upper-abdomi-nal operation and hip replacement surgery were randomly divided into group dezocine (group D), dezocine 0.3 mg/kg combined with sufentanil 1 μg/kg group(group DS1),dezocine 0.3 mg/kg com-bined with sufentanil 1.5 μg/kg group(group DS2)and dezocine 0.3 mg/kg combined with sufentanil 2 μg/kg group(group DS3).Analgesia was maintained by remifentanil 6-8 μg·kg-1·h-1 under total intravenous anesthesia.Patients were administered 5 μg sufentanil during sewing the skin.Visual Analogue Score (VAS)of both silence and 90°turn over situation,Ramsay score,and adverse effects at 1 h (T1 ),4 h (T2 ),8 h (T3 ),12 h (T4 ),24 h (T5 ),36 h (T6 ),48 h (T7 )after the operation were recorded respectively.Results The total amount of sufentanil and dezocine of group DS1 group showed a significant higher than the other three groups (P <0.05).The VAS in silence of group DS1 were higher than group DS3 at T1-T3 (P <0.05).There was no significant difference in VAS under 90°turn over situation.The side effect of group DS3 were higher than the other three groups (P <0.05).Conclusion Dezocine combined with sufentanil for postoperative patient-controlled intravenous analgesia(PCIA)is effective and safe in patients undergoing upper-abdominal surgery and hip replace-ment surgery,and while dezocine 0.3 mg/kg combined with sufentanil 1.5 μg/kg,it has the best effect of postoperative analgesia and least side effects.

Objective To explore the bronchoscopic features of endobronchial tuberculosis induced by lymphatic fistula and the efficacy of interventional treatment. Methods The data on 31 patients with endobronchial tuberculosis induced by lymphatic fistula who had received bronchoscopic diagnosis and treatment in our hospital during the period of January 2010 to June 2013 were reviewed. The bronchoscopic features , along with the frequency of interventional therapies and duration of the therapies , were retrospectively analyzed; and the efficacy of the therapies and the related complications were assessed. Rusults The endoscopic appearance showed: granuloma (19.4%), necrosis (51.6%), granuloma with necrosis (25.8%), and fistulous opening (3.2%). Dark gray matter or carbon deposition inside the lesions was the characteristics of endobronchial tuberculosis induced by lymphatic fistula. There were 76 orificium fistulae in 31 patients , mostly in the right side. The median frequency of treatment was five in patients with single orificium fistulae and the median treatment duration was 65 days; whereas the median frequency of treatment was nine in patients with multiple fistulae and the median treatment duration was 108 days. There were significant differences between the two groups (P < 0.05 for both comparisons). The effectiveness rate of treatment was 98.7%. The therapy-related complication was of a small amount of bleeding, with a rate of 2.1%. Conlusions Endobronchial tuberculosis induced by lymphatic fistula shows certain characteristics under bronchoscopic examination. Bronchoscopic clamping combined with infusions with antituberculosis agents is a safe, simple, effective therapeutic method.

Objective To evaluate the effects of hydrogen-rich saline on the expression of miR-210 and miR-21 in hippocampus during global cerebral ischemia-reperfusion (I/R) in rats.Methods Seventy-two healthy male Sprague-Dawley rats,aged 9-10 weeks,weighing 250-300 g,were randomly divided into 3 groups (n =24 each):sham operation group (group S),group I/R,and hydrogen-rich saline group (group H).Global cerebral I/R was produced by 4-vessel occlusion method.In group H,0.6 mmol/L hydrogen-rich saline 5 ml/kg was injected intraperitoneally at 0 and 6 h of reperfusion,while the equal volume of normal saline was injected instead of hydrogen-rich saline in the other two groups.Rats were sacrificed at 24 and 72 h of reperfusion,and then the bilateral hippocampi were removed for detection of the expression of miR-210 and miR-21 using RT-PCR.The global brain tissues were also obtained and stained with HE for examination of the changes in pyramidal cells in the CA1 region of hippocampus.Results Compared with group S,the expression of miR-210 and miR-21 was significantly up-regulated,and the number of pyramidal cells was decreased in group I/R (P ＜ 0.05).Compared with group I/R,the expression of miR-210 and miR-21 was significantly down-regulated,and the number of pyramidal cells was increased in group H (P ＜ 0.05).The pathological changes were significantly ameliorated in group H.Conciusion The mechanism by which hydrogen-rich saline attenuates global cerebral I/R injury is related to downregulation of the expression of miR-210 and miR-21 in rat hippocampus.

ObjectiveTo explore the effects of different doses of PcTx1,a specific blocker of acid-sensing ion channel 1a,on global cerebral ischemia/repedfusion (I/R) injury in rats,MethodsSixty adult male Sprague Dawley rats (weighing 250-300 g) were randomly divided into 6 grups ( n =10 each):sham operation group (group S),I/R group,different doses of PcTx1 ( 10 ng/ml,group P1 ; 25 ng/ml,group P2 ; 50 ng/ml,group P3 ;and 500 ng/ml,group P4 ) groups.Global cerebral ischemia was induced by the modified procedure of Pulsinelli 4-vessel occlusion.In groups P1,P2,P3 and P4,different doses of PcTx1 ( 10,25,50 and 500 ng/ml),6 μl each,were respectively injected into the lateral cerebral ventricle at the initiation of reperfusion,while equal volume of double distilled water was injected instead in group I/R.Six rats in each group were sacrificed at 24 h of reperfusion,and the brains were immediately removed,Thereafter,the contents of malondialdehyde (MDA),reduced glutathione (GSH) and ritric oxide (NO),the activities of constitutive NO synthase (eNOS) snd inducible NO synthase (iNOS) were detected in hippocampus.Four rats in each group were sacrificed at 72 h of reperfusion,and hematoxylin and eosin staining was used to observe the pathomorphological changes of the hippocampal neurons.ResultsCompared with group S,the other groups showed decreases in the contents of GSH,while increases in the contents of MDA and NO and the activities of cNOS and iNOS ( P ＜ 0.05 or 0.01 ).The contents of GSH increased,while the contents of MDA and NO and the activities of cNOS and iNOS decreased in groups P2,P3 and P4 compared with group I/R ( P ＜ 0.05 or 0.01).Compared with group P1,the contents of GSH increased,the contents of MDA and the activities of cNOS decreased in groups P2,P3 and P4,and the contents of NO and the activities of iNOS decreased in groups P3 and P4 ( P ＜ 0.05 or 0.01 ).Compared with group P2,the activities of iNOS decreased in groups P3 and P4(P ＜ 0.05 or 0.01).The damage to neurons in hippocampal CAI was severe in groups I/R and P1,but it was attenuated in groups P3 and P4.ConclusionPcTx1 25,50 and 500 ng/ml (6 μl)injected into lateral cerebral ventricle can attenuate global cerebral I/R injury in rats,and the dose 50 ng/ml (6 μl) is more suitable.