Objective To investigate the effects of dexmedetomidine on anesthesia and postoperative analgesia in children under-going adenoidectomy and tonsillectomy.Methods 58 children aged 2-12 years old,ASA rated as Ⅰ or Ⅱ level,scheduled to re-ceive selective adenotonsillectomy were divided into three groups at random,group C(n=22),group D1 (n=18)and group D2 (n=18).The anesthesia induction and the anesthesia maintaining scheme were same in 3 groups.Dexmedetomidine 0.75μg/kg was intr-aoperatively given in the group D1 and D2 ,while the same volume of normal saline was given in the group C as control at the same time.After operation,postoperative analgesia recipe in the group C and D1 was sulfentanyl 2μg/kg,tramadol 5 mg/kg dexametha-sone 0.5 mg and ondansetron 2 mg,which in the group D2 was same except reducing sulfentanyl to 1μg/kg.All were diluted to 100mL by normal saline and given by the same type of disposable infusion pump at a rate of 2 mL/h.The blood pressure and heart rate were observed and recorded before anesthesia induction(T0 ),instantly after endotrachel intubation(T1 ),at 5,10,15,20 min af-ter endotrachel intubation(T2-T5 )and the operation end(T6 );the autonomous respiration recovery time,extubation time,remo-ving monitoring time after operation and drug withdrawal were recorded;the heart rate,respiration rate,SpO2 ,and sedation and an-algesia scores were observed and recorded per 1 h within postoperative 6 h.Results The intraoperative hemodynamics was stable. The postoperative autonomous respiration recovery time,extubation time and removing monitoring time had no statistical differ-ences among 3 groups(P>0.05);during the postoperative observation period,the heart rate,respiration rate,sedation and analgesia scores had no statistical difference among 3 groups(P>0.05).Conclusion Intraoperative dexmedetomidine has no adverse influ-ence on the hemodynamics without affecting the recovery quality after anesthesia and possesses the postoperative analgesic effect.

The procedure of every life can be thought as a series of variation of the en-tropy. But,how to understand the variation of life entropy precisely during anesthesia is still a problem. Here we posed a simple 2 dimensional coordinate conceptual diagram,intent to deepen the apprehension of this vague problem. Furthermore,it contributes to our cognition of the princi-ple of clinical anesthesia,so as to help us take control of the anesthesia process full-scale,elevate anesthesia quality and containment anesthesia risk.

Objective To evaluate the effects of polymorphism of angiotensin Ⅱtype Ⅰ receptor (AT1R) gene A1166C on arterial blood pressure during cardiopulmonary bypass (CPB).Methods Eighty-two patients (46 male, 36 female) aged 17-55 yr undergoing surgical correction of congenital heart disease or valve replacement under moderate hypothermic CPB were studied. Blood sample was taken from each patient and gene type was identified by polymerase chain reaction and restriction fragment length polymorphism (PCR-RLFP) method. The patients were divided into mutation group and normai group according to whether there was an A→C replacement in 1166 position of the AT1R gene code. MAP was continuously recorded at 1 min intervals during CPB. The plasma level of angiotensin Ⅱ was measured before and 40 min after CPB was started. The relationship between the AT1R polymorphism and the fluctuation in MAP was analyzed. Results There were 7 heterozygote patients with AC gene type (mutation group) and 75 homozygote patients with AA gene type ( normal group) . The average MAP in mutation group ( n = 7) was 64 ?5 mm Hg, significantly higher than that in normal group [ (58 ? 8) mm Hg] . The amount of phentolamine given was significantly larger in mutation group. The plasma level of angiotensin Ⅱ was significantly increased during CPB as compared with the baseline level before CPB. There was no significant difference in plasma angiotensin Ⅱ level between the two groups either before or during CPB. Conclusion AT1R A1166C polymorphism results in significant increase in MAP during CPB and may be partly responsible for hyperperfusion.

Objective To explore the diagnostic value of "Standard" EEG,which include common induced test with sleeping induce(1.5 to 2.0 h) and choice sphenoidal electrode description in epilepsy.Methods 236 epileptic patients were inspected with routine,standard EEG early and late, and then they were diagnosed primarily and once more.Results The epileptic discharges positive rate(81.36%) of standard EEG was higher than routine EEG (29.66%),(P

Objective To understand the plasma protein differential expression before and after cardiopulmonary bypass (CPB)through conducting the comparative proteomics study on rats in order to find the plasma markers with potential value in the early diagnosis of CPB resulted complications.Methods 10 adult male SD rats were divided into the experiment group and the con-trol group randomly (n=5),and took food and water freely before operation.The rat models of CPB were constructed in the experi-ment group.But no any CPB operation was administered in the control group in addition to anesthesia induction,arterial and venous puncture procedure.1 mL of blood sample was extracted for separating plasma before CPB and at the end of CPB in the two groups. The total plasma protein was purified.Then the 2-dimensional electrophoresis and the scanning imaging by ImageScanner were per-formed.The protein spots verified to be differential expression were performed the cutting,enzymolysis and peptide fragment ex-traction.Finally the mass spectrometer was adopted to conduct the analysis and identification.Results The number of visualized spots was increased significantly after CPB.17 protein spots with up-regulated expression were identified as differential expression caused by CPB.5 proteins were verified by mass spectrometer analysis and database research.They were gelsolin,haptoglobin,apo-lipoprotein A-1,immunoglobulin gamma-2b and Ba1-647 respectively.Conclusion CPB can cause the differential expression of plas-ma proteins in rat model.According to the function analysis,gelsolin,haptoglobin and apolipoprotein A-1 have the potentiality of be-ing the plasma markers for studying CPB complications.

With the approaches of lifecycle, structurizing and prototype applied, the dynamic management subsystem for medical equipment is developed, and thus the management level and economic benefit can be improved.

Objective:To explore the clinical efficacy of alanyl glutamine (Ala-Gln) combined with octreotide in the treatment of severe acute pancreatitis (SAP) and its effects on the serum interleukin-6 (IL-6),C reactive protein (CRP) levels and related biochemical parameters.Methods:100 cases of patients with SAP in our hospital from January 2013 to December 2016 were selected and randomly divided into two groups.The control group was treated by octreotide,while the observation group was treated by Ala-Gln combined with octreotide.The clinical effect,changes of serum IL-6,CRP,amylase (AMY),lactate dehydrogenase (LDH),prealbumin (PA) and albumin (ALB) levels before and after therapy were compared between two groups.Results:On the 10th day after treatment,the overall effective rate of observation group was 88.0％ which was significantly higher than that of the control group (64.0％,P＜0.05).The serum IL-6,CRP,AMY and LDH levels of both groups on the 10th day after treatment were significantly lower than those before treatment (P＜0.01).Compared with the control group,the improvement of serum IL-6,CRP,AMY,LDH levels of observation group were more significant(P＜0.01).Compared with those before treatment,the serum PA and ALB levels of both groups were significantly increased on the 10th day after treatment(P＜0.05),and the improvement of serum PA and ALB levels of observation group on the 10th day after treatment were significantly better than those of the control group(P＜0.01).Conclusion:Alanyl glutamine combined with octreotide could effectively eliminate or alleviate the symptoms and signs of patients with severe acute pancreatitis,control the inflammatory reaction,improve the level of metabolism,improve the prognosis.

Objective To investigate the association between PARK16 gene polymorphism and Parkinson's disease(PD)susceptibility in Chinese Han population.and to analyze its single-nucleotide polymorphism(SNP)genotypes,frequencies and odds ratios(OR)of different genotypes.Methods The association between two SNP loci in PARK16 gene(Rs947211,Rs823128)and PD susceptibility was investigated by TaqMan quantitative polymerase chain reaction(PCR)in 226 PD patients and 362 healthy controls.Allele and genotype frequencies were calculated by the Chi-square test,and the clinical data were also analyzed.Results Three genotypes of Rs947211(GG,AG and AA)account for 34.1%(77/226),46.0%(104/226),19.9%(45/226)in the PD group,and 23.8%(86/362),53.0%(192/362),23.2%(84/362)in the control group,respectively.There was significant difference between two groups (P<0.05).Setting the GG genotype as the reference,OR values of AG and AA genotype were 0.57(95%CI0.38-0.85,P=0.006)and 0.55(95%CI 0.34-0.85,P=0.015),while the OR value for exposure to the A allele(AA+AG)was 0.56(95%CI0.38-0.82,P=0.003).Genotypes of Iate-onset PD were also significantly different from the controls(OR valne of AG=0.46,95%CI 0.27-0.78,P=0.004:OR value of AA=0.35.95%CI 0.18-0.68,P=0.002).And there was no diffefence in clinical features among the 3 genotypes. The frequency of Rs823128, another locus, in PD group was not significantly different from the control group( AA genotype as the reference, OR value of AG was 1. 12, 95% CI 0. 75-1.68, P = 0.568; OR value of GG was 0.99, 95% CI 0.35-2.76, P = 0.994). Conclusion Polymorphism of PARK 16 locus Rs947211 is associated with PD patients in Chinese Han population.

Objective: To explore the diagnostic value of serum glutamyltransferase (GGT) and osteopontin (OPN) for asymptomatic secondary common bile duct stones. Methods: A total of 150 gallbladder stones patients were divided into asymptomatic secondary common bile duct stones patients (common bile duct stones group) 34 cases and gallbladder stone group 116 cases. The difference of serum liver function indexes and OPN concentration between 2 groups were compared. Meanwhile, the diagnostic value of serum GGT combined with OPN was assessed by receiver operating characteristic curve. Results: There were no statistical difference in alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and direct bilirubin (DBil) between 2 groups (P>0.05). The GGT, alkaline phosphatase (ALP) and OPN in common bile duct stones were significantly higher than those in gallbladder stone group: (141.57 ± 47.11) U/L vs. (77.26 ± 21.76) U/L, (150.10 ± 17.55) U/L vs. (137.65 ± 24.36) U/L and (16.21 ± 3.26) mg/L vs. (11.50 ± 3.99) mg/L, there were statistical differences (P<0.05). Logistic multivariate analysis showed that GGT, ALP and OPN were the independent risk factors of asymptomatic secondary common bile duct stones (P<0.05). The areas under curve of GGT and OPN in diagnosis of asymptomatic secondary common bile duct stones were significantly higher than ALP (P<0.05). Conclusions Serum GGT and OPN can be served as early predictors for the gallbladder stone combine with asymptomatic secondary common bile duct stones.

Objective To assess the efficacy of using four kinds of proteins / peptides to distinguish the tuberculosis patients from healthy people. Methods A, B, C and D were used to represent four proteins /peptides with 1 060, 1 944, 2 081 and 3 954 of mass to charge ratio (m / z) in serum, respectively. Levels A, B, C and D in serum of 57 patients with tuberculosis and 30 healthy people were determined by using the surface-enhanced laser desorption-ionization time of flight mass spectrometry (SELDI-TOF-MS). Then the differences of levels of f A, B, C and D were anlyzed between tuberculosis patients and healthy people. The efficacy of distinguishing tuberculosis patient from healthy people were evaluated by using diagnostic test evaluation method. Results (1) The levels of A, B, C and D were 1 ± 11, 1 597 ± 3 102, 460 ± 765 and 1 208 ± 1 003 in tuberculosis patients, while they were 123 ± 201, 47 ± 98, 36 ± 93 and 397 ± 355 in healthy people. (2) The area under the receiver operator characteristic (ROC) curve was 0.644, 0.848, 0.735 and 0.810 respectively. The serum levels of A, B, C and D could be used to distinguish tuberculosis patient from healthy people and the cut-off values of A, B, C and D were ≤166, ≥318, ≥48 and ≥728, respectively. Conclusions B, C and D have better performances to distinguish tuberculosis patients from healthy people , which may be regarded as new promising candidate markers for diagnosis of tuberculosis.