Objective To compare the effect and safety of propofol with intranasal dexmedetomidine in analgesic enteroscopy for children.Methods Ninety children undergoing analgesic enteroscopy were ran-domly assigned to 3 groups.Intranasal dexmedetomidine followed by propofol was administered in the observ-ing group;sufentanil and followed by propofol was intravenously given to the control group A;propofol was given to the control group B.The scale of anesthetic effect,HR,RR,MAP and SpO2 30 min after intranasal administration were monitored.The intranasal sedation satisfaction rate,the dose of propofol,wake-up time, hospitalization,hemodynamics,adverse reaction and complication after anesthesia were recorded.Results Intranasal sedation satisfaction rate of the observing group was 83.3%(25 /30).The anesthetic effect in ob-serving group(excellent/good /bad:24 /6 /0)showed no significant difference from that in the control group A (excellent/good /bad:25 /5 /0),but better than that in the control group B(excellent/good /bad:12 /14 /4) (P <0.05).The amount of propofol in the observing group(96.2 ±5.3)mg showed no significant difference from that of group A(93.7 ±4.6)mg,but less than group B[(121.1 ±4.9)mg,P <0.05].The time of re-covery of infants in the control group A[(14.2 ±5.5)min]and the control group B[(13.7 ±3.9)min] were longer than that in observing group[(7.9 ±4.1)min,P <0.05].The hospitalization time of observing group[(14.3 ±5.4)min]was shorter than those of group A[(27.5 ±3.7)min,P <0.05]and group B [(26.3 ±6.6)min,P <0.05].The incidences of breath suppression,glossoptosis,nausea and dizziness were the lowest in the observing group,compared with the two others (all P <0.05).Conclusion In-tranasal dexmedetomidine combined with propofol,increasing children compliance,decreasing the adverse reaction,is satisfactory and safe for children anesthesia.

Objective Understand the variation of serum creatinine measurement in clinical laboratories of some hospitals in Beijing.Methods 8 samples of mixed frozen human serum added different creatinine concentration standard materials(the creatinine concentration were80-1 000 ?mol/L)and 8 samples of mixed frozen serum of patients(contained different creatinine concentration)were distributed to 13 clinical laboratories(31 series of detection systems)with the way of spot investigation.Every clinical laboratories measured the samples followed the standard operating procedure.Results As to the mixed frozen human serum added different creatinine standard materials,the CV of different detection systems results were 5.74%-9.68%;as to the mixed frozen patients' serum,the CV was 5.90%-11.69%. Compared with Beckman closed detection systems,the results of Dade systems(which used the kinetic alkaline pieric acid method)showed the bias were-5.99%-0.35%,and as to the other systems which measured by alkaline picric acid method,when creatinine concentrations were 200 ?mol/L,the results showed negative bias,and the greatest bias was-8.45%.The bias plots revealed negative for all of the detection systems with enzymatic method over the whole concentration range,and the greatest bias was -8.88%.Conclusions The creatinine determination results of Beckman and Dade closed detection systems were consistent.The results of detection systems which used enzymatic method were generally lower than Beckman detection systems.What's more,the creatinine measurement variations of clinical laboratories were very large,especially for the results of unclosed detection systems,so it was urgent need to solve the standardization of creatinine measurement.

ObjectiveTo evaluate the ability of high resolution magnetic resonance (MR) imaging at 3.0 tesla to depict the characterization of human carotid arterial vessel wall and detect atherosclerotic lesions ex vivo in comparison to histopathologic results. MethodsEighteen carotid arteries obtained from 9 elderly donors underwent fat-suppressed T1 - and T2-weighted MR imaging at 3.0 tesla MR system with a mouse coil. Corresponding histological sections were obtained for the comparison. Correlation between MR images and histopathologic slices was obtained by Pearson or Spearman correlation coefficient.Cohen K was computed to quantify the agreement between MRI and histopathologic findings.Results Lumen area,intima and media area measured on fat-suppressed T2-weighted images showed stronger correlation with the corresponding histopathologic slices [ MRI vs.histopathology:( 27. 53 ± 6. 77 ) mm2 vs.( 25.83 ±6. 69 ) mm2, r2 ＝ 0. 91,P2 ＝ 0. 024, ( 12.31 ± 3. 31 ) mm2 vs.( 12. 28 ± 3.71 ) mm2, r2 ＝ 0. 70, P2 ＝ 0. 020,Median 12. 29 mm2(Min 1.12 mm2, Max 33.18 mm2) vs.Median 11.62 mm2(Min 0.89 mm2, Max 32. 84 mm2 ), r2 ＝ 0. 74, P2 ＝ 0. 016, respectively]. The Cohen K score between the MR imaging and American Heart Association classifications was 0. 74, which corresponds to a good agreement. Conclusions 3.0 T high-resolution multi-sequence MRI can clearly show the structure of ex vivo carotid artery wall and allow quantitative assessment.Fat-suppressed T2Wimaging has a greater advantagein presenting atherosclerotic lesions.

Objective: To study the effect of arsenic trioxide (As2O3) on human pancreatic cancer cell proliferation and apoptosis (mainly early stage) in vitro. Methods: SW1990 cells line were trea ted with As2O3 at different concentration. Cell proliferation was evaluated by MTT and apoptosis by Annexin-Ⅴ-fluostaining, electron-microscopy, flow cytometry and immunocytochemical staining of Bcl-2 and Bax. Results: As2O3 and cisplatin had the same cytotoxity on SW1990. The cytotoxic effe ct on tumor cell was produced by induction of apoptosis. Twelve hours after cult ure with 10 μg/ml As2O3, much more SW1990 cells went into apoptosis than t he control. The apoptosis rate reached 24% after 48 h with the similar concentra tion of As2O3. Immunohistochemical study revealed that the expression of Bcl -2 was decreased after treated with As2O3. Conclusion: As 2O3 can depress the proliferation of SW1990 in vitro, mainly through the i nduction of apoptosis, and it is a potential agent for pancreatic cancer chemoth erapy.

Objective: To study the effect of arsenic trioxide (As 2O 3) on human pancreatic cancer cell proliferation and apoptosis (mainly early stage) in vitro . Methods: SW1990 cells line were treated with As 2O 3 at different concentration. Cell proliferation was evaluated by MTT and apoptosis by Annexin Ⅴ fluostaining, electron microscopy, flow cytometry and immunocytochemical staining of Bcl 2 and Bax. Results: As 2O 3 and cisplatin had the same cytotoxity on SW1990. The cytotoxic effect on tumor cell was produced by induction of apoptosis. Twelve hours after culture with 10 ?g/ml As 2O 3, much more SW1990 cells went into apoptosis than the control. The apoptosis rate reached 24% after 48 h with the similar concentration of As 2O 3. Immunohistochemical study revealed that the expression of Bcl 2 was decreased after treated with As 2O 3. Conclusion: As 2O 3 can depress the proliferation of SW1990 in vitro , mainly through the induction of apoptosis, and it is a potential agent for pancreatic cancer chemotherapy.

Objective:To study the curative efficacy of decitabine combine with CAG regimen in the treatment of acute myeloid leukemia and its effects on the serum Interferon-γ (IFN-γ),alpha hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) levels.Methods:70 cases of patients with acute myeloid leukemia who were treated from February 2013 to October 2016 in our hospital were selected as research objects.According to the random number table,the patients were divided into the observation group (n=35) and the control group (n=35).Both groups of patients were treated conventional treatment.The control group was treated with CAG scheme,intravenous injection of aclarubicin,20 mg each time,granulocyte colony stimulating factor,300 μg each time,subcutaneous intravenous cytarabine,10～15 mg/m2 each time,while the observation group was treated with intravenous drip of decitabine on the basis of control group,15 mg/m2 each time.Then the therapeutic effect,serum interferon-γ (IFN-γ),alpha hydroxybutyrate dehydrogenase (HBDH),lactate dehydrogenase (LDH) levels before and after treatment,incidence of adverse reactions were compared between two groups.Results:After treatment,the total effective of observation group was significantly higher than that of the control group [91.42％(32/35)vs68.57％(24/35)] (P ＜0.05);the serum IFN-γ,HBDH,LDH levels were significantly higher than those of the control group [(3.21± 1.01)pg/ml vs.(5.13 ± 1.90)pg/mL,(103.62± 26.39)U/L vs.(118.80± 28.60)U/L,(101.36± 27.32)U/L vs.(123.08 ± 30.59)U/L] (P ＜0.05);the incidence rate of adverse reactions was significantly lower than that of the control group [20.00％(7/35) vs.42.85％(15/35)(P ＜0.05)].Conclusion:Decitabine combined with CAG regimen was more effective for acute myeloid leukemia than CAG regimen alone,which might be related to reduce the serum levels of IFN-γ, HBDH and LDH.

Objective To evaluate retrospectively the role of 18 F-fluorodeoxyglucose (FDG) PET/CT associated with MRI in the localization of epileptogenic foci. Methods Sixty-seven patients with medically resistant epilepsy were included from 2003 to 2008. All underwent 18F-FDG PET/CT and MRI for presurgical evaluation as well as post-surgical evaluation 12 to 65 months after operation. Based on postoperative seizure occurrence, patients were divided into two groups. One group was free of seizures ( Engel classification Ⅰ, Group 1) and the other was with postoperative seizure occurrence of any type ( Engel classification Ⅱ-Ⅳ, Group 2). X2-test or Fisher's exact test was used for the statistical analysis. Results About 71.6% (48/67) patients were defined as group 1, and 19 patients were group 2 ( 11 were Engel Ⅱ , 5 were Engel Ⅲ, and 3 were Engel Ⅳ ). In Group 1, no statistically significant difference was found between concordant (45/63) and discordant findings (3/4) with regard to 18F-FDG PET/CT and MRI images (Fisher's exact test, P ＞0.05). For 41 patients that showed focal abnormality both on MRI and 18F-FDG PET/CT, 80.5% (33/41) were found in group 1. For 20 patients that showed focal lesions on MRI while with multi-focal or generalized abnormal metabolism on 18F-FDG PET/CT, 11 (55.0%) were in group 1 and9 (45.0%) were group 2. There was no significant difference (33/41 vs 11/20, X2 =4.34, P ＜0.05 ). Conclusion 18F-FDG PET/CT associated with MRI may offer more helpful information for pre-surgical evaluation and prediction of prognosis of epileptic patients.

One hundred and fifty ASA Ⅰ-Ⅱ infants scheduled to undergo surgery on unilateral inguinal region,were randomly assigned to 3 groups with 50 in each group.In groups Ⅰ and Ⅱ puncture was performed at traversus abdominis plane under ultrasound-guidance,0.4 or 0.5/kg of 0.25％ ropivacaine was injected respectively.In group Ⅲ the triangle of Petit was positioned through palpating and then 0.5 ml/kg of 0.25％ ropivacaine was injected.HR,RR,SpO2,PETCO2,expired sevoflurane concentration and BIS value at the time of entering the operation room (T1),incision of skin (T2),pulling hernia sac (T3),ending the surgery (T4),waking (T5),the number of pressing the analgesia pump after operation were recorded.The results showed that HR at T2 and T3 of groups Ⅰ and Ⅱ was lower than group Ⅲ (P ＜ 0.05).The were significant differences in case numbers of insufficient intraoperative analgesia among 3 groups(x2 =10.500,P =0.005).The CHEOPS scores and the number of pressing analgesia pump after operation in groups Ⅰ and Ⅱ were lower than those in group Ⅲ (x2 =7.230,P =0.027).Results indicate that ultrasound-guided transversus abdominis plane block is safer and more effective than conventional method for operations of inguinal region in infants; it may reduce dose of local anesthetics and postoperative use of analgesics.

Objective To explore brain plasticity of upper extremities motor function recovery after stroke with diffusion tensor imaging (DTI). Methods 25 stroke patients with internal capsule lesions and affected corticospinal tract (CST), 4-8 weeks after onset, were divided randomly into rehabilitation group (n=13) and control group (n=12). Both groups received routine medication and the rehabilitation group also received rehabilitation. All the patients were scanned with DTI and assessed with upper extremity Fugl-Myer Assessment (UE-FMA) before and 3 months after treatment. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The bilateral corticospinal tracts were reconstructed with diffusion tensor tractography. Results The scores of UE-FMA increased in both groups after treatment (P<0.05), and increased more in the rehabilitation group than in the control group (P<0.05). There was significant difference in FA, rFA and FAasy in the corona radiate section of CST after treatment in the rehabilitation group (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant differences in FA, rFA and FAasy in the control group. The ipsilesional CST fibers were more compact after treatment in the rehabilitation group. Conclusion Rehabilitation can improve the upper extremities function recovery after stroke, which may associated with the repairment of CST in the corona radiate section.

At present, most clinical thrombolytic drugs are plasminogen activators, which are highly dependent on the plasminogen level of the patient. Therefore, the efficacy of those drugs is restricted. Unlike the conventional thrombolytic plasminogen activator drugs, fibrinolytic drugs have direct fibrinolytic activity. Thus, fibrinolytic drugs can directly dissolve the thrombus, and its thromlysis efficacy is not restricted by the patients' plasminogen. This is a new type of thrombolytic drug with higher thrombolytic efficiency and safety, and has become one of the research hotspots at present. Although more and more agents that can be used as fibrinolytic drugs have been discovered, only a few of them can successfully be applied in clinical practice. The mainly underlying reason is the risk of bleeding. In this paper, based on the latest research progress of fibrinolytic drugs, the bleeding mechanisms and coping strategies of fibrinolytic drugs were systematically reviewed, five types of bleeding mechanisms of fibrinolytic drugs were summarized, and three types of coping strategies were proposed. We hope our work can provide theoretical basis for the development of safer and more efficient fibrinolytic drugs.