Objective To investigate the effect of dexmedetomidine on restlessness in recovery stage in patients with limbs fracture undergoing combined intravenous inhalation anesthesia and operation.Methods Eighty patients with limbs fracture undergoing combined intravenous inhalation anesthesia and operation in our hospital were randomly divided into the control group and the dexmedetomidine group,40 cases in each group.Before operation, patients in the dexmedetomidine group were given dexmedetomidine 0.5 μg/kg intravenously in 15 min;patients in the control group were given the same volume of 0.9% saline solution.The recovery time, extubation time, the incidence of restlessness, agitation score and sedation score were compared between the two groups.Results The recovery time and extubation time had no significant difference between the two groups.The incidence of restlessness and agitation score in the dexmedetomidine group were significantly lower than those in the control group(P<0.05),while the sedation score in the dexmedetomidine group was significantly higher than that in the control group(P<0.05).Conclusion Dexmedetomidine can reduce the incidence of restlessness and the degree of restlessness in patients limbs fracture undergoing combined intravenous inhalation anesthesia and operation.

Objective To investigate the molecular basis of ABO gene in a patient with serologic ABO blood group discrepancy.Methods Serologic blood group identification,Coombs' test and antibody screening were detected with DG Gel Confirm cards,Neutral cards,Coombs cards by WADiana/8XT Compact Analyzer (from Diagnostic Grifols,S.A).The enhancer,promoter,exon 1 ～ 7 and their adjacent intron region of ABO gene were amplified by using polymerase chain reaction (PCR) method.Results The patient's red blood cells was determined as weak B phenotype showing two groups in gel and mixed field in tube with monoclonal anti-B,and A phenotype with monoclonal anti-A.DNA sequencing showed nine variants in ABO gene.One heterozygous variation in exon 6 (297A＞G) and eight heterozygous variations in exon 7 (467C＞T,526C ＞G,657C＞T,703G＞A,796C＞A,803G＞C,829G＞T 930G＞A) were identified and 829G＞T was the novel variant.Compared with Blood Group Antigen Gene Mutation Database,genotype of the patient was weak expression of A102/B101.Conclusion The novel variation of B allele is the main reason of Bweak phonetype in A102/B101 genotype.Serological and molecular biological detection help to understand the characteristics of blood group phenotype and genotype,provide the guidance for clinical transfusion strategies.