Objective To observe the pharmacodynamic characteristics of different doses of cis-atracurium used in laparoscopic surgery on children.Methods 80 cases of selective laparoscopic surgery on children were randomly divided into 2 groups, 2 ED95 (Ⅰ group) or 3 ED95 (Ⅱ group) of cis-atracurium were intravenously given respectively.Record two group's muscle block time-effect and intubation conditions to observe the onset time of block, TOF-free response period, duration of anesthesia, muscle relaxation index and time in vivo recovery.Results Tracheal intubation in group Ⅱ with muscle relaxant block and intubation conditions better than groupⅠ;onset time of muscle relaxation in group Ⅱshorter than that in groupⅠ;TOF non-response period, maintain time of block and the time of function in vivo of two groups were different significantly;muscle recovery index were not significantly different Conclusion 3ED95 inducing dose of cis-atracurium effect on children with fast and excellent intubation conditions, and no response to TOF period and maintain time of block and the time of function in vivo longer than 2ED95 dose cis-atracurium;two groups had no significant difference in recovery index.

Objective To summarize the clinical and laboratory features of chronic manganese poisoning. Methods A retrospective analysis was conducted on the clinical data of 4 cases with chronic manganese poisoning, including gener?al information, medical history, clinical manifestations, laboratory examination such as electrophysiological and imaging. Results Patients with chronic manganese poisoning mainly presented with mild mental disorder and autonomic nerve dis?order during early stage and then gradually developed extrapyramidal symptoms and signs. The laboratory examination of chronic manganese poisoning lacked of specificity. EMG showed neurogenic damage in 3 cases and normality in 1 case. EEG showed slightly increased full guide slow wave in 1 case and normality in 3 cases. cranial MRI revealed the damag?es in bilateral symmetry of the basal ganglia nuclei in 4 cases of Chronic manganese poisoning. There was no significant correlation between the changes of urinary manganese level before or after treatment and the clinical manifestations. Conclusions Although there is lack of specific clinical manifestations of chronic manganese poisoning, the possibility of this disease should be considered when patients with mild mental disorders or autonomic nerve disorder with or without extrapyramidal symptoms. The main treatment of chronic manganese poisoning includes excretion of manganese, symp?tomatic and supportive treatment. Patients usually have the sequelae of tremor, muscle tension, and other symptoms.