Objective To investigate the influence of Bupivacaine injection speed on blood pressure of patients undergoing cesarean section.Methods 90 patients(ASAⅠ-Ⅱ)who underwent cesarean section were selected with combined spinal-epidural anesthesia were divided randomly into three groups(20 for each).0.5% bupivacaine 1.4ml(7mg),the speed of injection in group A,group B and group C is 10 seconds,20 seconds,30 seconds.Systolic blood pressure(SBP),Diastolic blood pressure(DBP)and Heart rate(HR)were recorded before anesthesia and 5min,10min,15min and 30min after anesthesia.Cases need to be added epidural drug were all recorded.Results The age,body length and body weight in the three groups has no significant difference,location of injection and posture were same.The best effect of anesthesia was founded in group B,blood pressure(BP)and HR was stable.The effect of anesthesia was better but BP and HR were obviously descent in group A.The block level of anesthesia was unsatisfactory and need to add epidural drug in group C.Conclusion The injection speed of 0.5% bupivacaine 1.4ml in combined spinal-epidural anesthesia is suitable of 20 seconds when patients underwent cesarean section.

Objective To evaluate arterial reconstruction of traumatic iliac-femoral artery pseudoaneurysm in parenteral drug abusers.Methods Data of 21 consecutive patients who presented with iliac-femoral artery pseudoaneurysm with the diameter ranging from 3.0 cm～7.5 cm secondary to parenteral drug abuse from 2004 to 2007 were analyzed.Fifteen patients were male and the median age was 3 1.3 years.the aneurysm involved the common femoral artery and distal external iliac artery.Autologous greater saphenous vein was used as a graft for arterial reconstruction after iliac-femoral artery pseudoaneurysm excision through a single curved inguinal incision.Results The surgical procedure was successful in all 21 eases without intraoperative mortality and severe complications.All the 21 patients were free of postoperative claudication symptoms except 1 case with preoperative popliteal artery stenosis.Wound infection and tissue fistula developed in one ease.Ingunal incisional hematoma and cutaneous abnormal sensation developed in one each eases.Conclusions The use of autologous greater saphenous venous grafts for aaefial reconstruction after false aneurysm excision in drug abusers is safe and effective.The harvest of the greater saphenous vein is precondition of this precedure.These preliminary results indicate that the implementation of this technique offers advantages compared with the artery ligation alone without revascularization,that is frequently associated with later intermittent claudication.

Objective To evaluate the role of α2A adrenergic receptor (α2AAR) in dexmedetomidine-induced inhibition of TLR4/NF-κB signaling pathway activation during hypoxia-reoxygenation (H/R)caused injury to alveolar type Ⅱ epithelial cells.Methods Type Ⅱ] alveolar epithelial cells of rats RLE6TN cells cultured in vitro were divided into 4 groups (n =6 each) using a random number table method:control group (group C),H/R injury group (group H/R),dexmedetomidine group (group D) and α2A AR small interfering RNA (siRNA) plus dexmedetomidine group (group α2AAR-siRNA+D).H/R was produced by exposing cells to 1％ O2-5％ CO2-94％ N2 for 24 h followed by 4-h reoxygenation.Cells were incubated for 1 h with dexmedetomidine at the final concentration of 1 nmol/L,and then H/R model was established in group D.In group α2AAR-siRNA+D,cells were transfected with 50 nmol/L α2AAR-siRNA,48 h later dexmedetomidine at the final concentration of 1 nmol/L was added,cells were incubated for 1 h,and then H/R model was established.The cell viability was measured using CCK-8 method,cell apoptosis rate was determined by flow cytometry,and the expression of TLR4 and NF-κB was detected by immunofluorescence.Results Compared with group C,the cell viability was significantly decreased,the apoptosis rate was increased,and the expression of TLR4 and NF-κB was up-regulated in group H/R (P＜0.05),and no significant change was found in the parameters mentioned above in group D (P＞0.05).Compared with group H/R,the cell viability was significantly increased,the apoptosis rate was decreased,and the expression of TLR4 and NF-κB was down-regulated in group D (P＜0.05),and no significant change was found in the parameters mentioned above in group α2AAR-siRNA+D (P＞0.05).Compared with group D,the cell viability was significantly decreased,the apoptosis rate was increased,and the expression of TLR4 and NF-κB was up-regulated in group α2AAR-siRNA+D (P＜0.05).Conclusion The mechanism by which dexmedetomidine inhibits TLR4/NF-κB signaling pathway activation may be related to activating α2AAR during H/R-caused injury to alveolar type Ⅱ epithelial cells.

OBJECTIVE: To explore the feasibility of using network system to carry out desktop health emergency response exercise for sudden poisoning incidents,and to understand the emergency response capability on sudden poisoning incident in Guangdong Province. METHODS: A chemical poisoning incident caused by drinking polluted water was simulated. Eight questions were designed in 4 sections including the emergency report,response,disposal and strain capacity to the emergency. A total of 10 teams from prefecture-level city in Guangdong Province answered through the desktop network exercise system designed by National Institute of Occupational Health and Poison Control. Meanwhile,the experts judged score using this system. RESULTS: Ten teams were familiar and adapted to the network system in a relatively short period of time. The scores of emergency report,response,disposal and strain capacity on emergency were(14. 9 ± 2. 3),(6. 0 ±2. 2),(20. 7 ± 4. 1) and(13. 2 ± 3. 5),respectively. The score rates of above 4 sections were(74. 5 ± 11. 5) %,(50. 4 ±18. 7) %,(43. 5 ± 8. 5) % and(66. 2 ± 17. 5) %,respectively. The score rate of emergency report was higher than that of response and disposal( P < 0. 05). The score rate of strain was higher than that of disposal( P < 0. 05). The total score of desktop exercises of the 10 teams was(55. 0 ± 8. 0),which was low on the whole. CONCLUSION: The network system can be used for desktop exercise for sudden poisoning incidents. There is a weak link in the health emergency response capacity of sudden poisoning incidents in Guangdong Province and the capability of emergency response and disposal should be strengthened.