Objective To explore the effect of dexmedetomidine on the stress reaction and incidence of shivering in intravenous inhalation combined anesthesia scheme,and to improve the quality of anesthesia recovery accumulate experience.Methods 76 patients in Affiliated Union Hospital of Fujian Medical University from 2010 March to 2013 April were divided into study group and control group using random double blind method(n=38).Two groups of patients were underwent intravenous inhalation combined anesthesia,the research group in the process of anesthesia administered dexmedetomidine intravenous infusion,the control group was given normal saline intravenous infusion of the same dose,the same rate.The recovery period MAAS (muscle activity score),HR (heart rate),MAP (mean arterial pressure)and the incidence of shivering of two groups were observed and compared.Results The MAAS score on 5 min after extubation of study group was lower than that of control group (P<0.05);the MAP and HR values immediately in the drawing or after extubation 30 min in study group were lower than control group (P<0.05 ).The incidence of shivering and the chill time in study group was lower and shorter than control group (P<0.05).Conclusion Dexmedetomidine could effectively reduce the recovery period of stress level,and reduce the incidence of shivering in treatment of patients with intravenous inhalation combined anesthesia,It is conducive to patient of vital signs stable in recovery period.

Objective To investigate the causer of, and the way to deal with the measurement of protecting from vascular compromise in free flap transplantation. Methods To retrospectively study the clinical data collected from the 89th Hospital of PLA including 305 cases of vascular compromise in free flap transplantation held on June, 1983 to December, 2006. Accoding to the different tissue flaps and different sites to be repaired, 11 factors of vascular compromise of free flap transplantation were to be investigated including operation design, the recipe of free flap, the variation of vascellum, the skill of recipe, the operation opportunity, the match of vascellum, the debride of vascellum, the vascellum angiotasis, the vascular anastomosis, the management of vascular articulo and the infection. Results Among the 305 cases of free flap transplantation, arterial compromise existed in 270 cases, 10 cases developed arterial compromise during operation, 6 cases were due to the injury of nutrient vessel, the flap survived after the revascularization. 4 cases obtained part necrosis of 10 cases, and the rotation flap and skingrafting covered the raw surface. The rest 213 cases survived and 47 cased failed. Another 35 cases of vein compromise were obtained. Among them, 5 cases survived, part necrosis of 10 cases, and 20 cases failed. Conclusion Vascular compromise is the factor of necrosis in free flap transplantation. It is of cardinal importance to timely and correctly treat the vascular compromise in free flap transplantation whether happened intra-or postoperatively. This is the key to access high successful rate. Preventive measures are even more beneficial than proper management after its occurrence. The venous return disorder was the main factor of free flap transplantation failure.

Objective To explore the value of laparoscopic appendectomy (LA) in children. Methods A total of 52 children underwent laparoscopic appendectomy by using the 3-port technique from October 2002 to December 2004. Results The operations were performed smoothly in all the 52 cases. The operating time was 20~50 min (mean, 30 min). The patients were discharged from hospital at 2~4 postoperative days. Peri-port subcutaneous emphysema occurred in 2 cases. No other complications were found. Follow-up checkups for 3~29 months (mean, 14 months) in 49 cases found no intestinal obstruction or abdominal residual infection. Conclusions Laparoscopic appendectomy in children is safe, effective and minimally invasive.

The immunoregulatory effect of thalidomide on peripheral blood mononuclear cells in patients with thyroid-associated ophthalmopathy (TAO) was investigated.The resuhs showed that thalidomide (50 μg/ml)inhibited the proliferation of PBMC significantly.Thalidomide inhibitied tumor necrosis factor-α,IFN-γ,and interleukin-6 secretion,as well as mRNA expressions.

Objective To investigate the effect to the blood supply of the gastrocnemius if ligating the medial or lateral artery, and provide theory base for the sural artery flap repairing the soft tissue defects of legs injuries.Methods The anatomical study involved 16 fresh adult cadaver lower legs ligating the medial or lateral gastrocnemius vessel, the arteries of which were perfused with the Meglumine Diatrizoatis Mucilage,and then carried out the cross-sectional analysis of the CTA, the bifurcation, location length, diameter and perforator of the sural artery were recorded by dissection.To observe the anastomosis with gastrocnemius vessel in artery pipeline foundry made by 1 specimen.Results The consistent with the result of the angiography was the gastrocnemius can completely get enough blood supply from some anastomotic arteriole when ligating one side of the sural vessel.Under normal circumstances, the blood supply of gastrocnemius muscle mainly supplied by sural artery.In the case of the sural vessel was cut off, the blood supply of gastrocnemius come from the anastomotic arteriole between medial and lateral artery and the soleus.The anastomotic arteriole from soleus has larger diameter, but less quantity, and was invariably deteced in the lower third of the gastrocnemius muscle constantly.A lot of anastomotic arteriole were found between the muscle heads, and it was also invariably deteced in the lower third of the gastrocnemius muscle, communicating with the surai neurovascular axis, the average external diameter was less than 0.5 mm.Conclusion The blood supply of the gastrocnemius are enough when ligating the medial or lateral artery.

Objective To evaluate clinical application of the gastrocnemius blood vessles as recevier ones to anastomose with free flaps. Methods From June 2005 to July 2011,twenty adult lower limbs were infused with red glue to observe the origin,streching,branches and communication with other blood vessles of the gastrocnemius blood vessles and to measure their outer diameters and pedicle length. Operations were also simulated on these specimens to make the above chacracters of the vessles clear further.CT images of 16 fresh adult lower limbs were got to observe the effects of obstruction of one side of the gastrocnemius blood vessels to the blood supply of the gastrocnemius muscles. Fifty-two free flaps were transplanted to legs with large defects of skin and soft tissues where the gastrocnemius blood vessles were anastomosed with the flaps to supply artery blood and receive vein blood. Results The main blood vessles of the gastrocnemius muscles were medial and lateral gastrocnemius blood vessles. They both origined from the popliteal arteries and communicated with other blood vessles. The pedicles of the medial gastrocnemius blood vessles were 8.0 -13.8 cm in length which averaged 11.1 cm and their outer diameters were (1.8 ± 0.3) mm when they entered the muscles. The pedicles of the medial gastrocnemius blood vessles were 5.4 - 12.3 cm in length which averaged 8.8 cm.The outer diameters of the two accompanying veins were (1.8 ± 0.3)mm when they entered the muscles.When one gastrocnemius blood vessle were obstructed,the gastrocnemius muscles could got enough blood supply by co mmunicating branches between the obstructed vessle and other blood vessles.All the 52 free flaps survived. Through one to two-years follow-up, the defects cured with no infection and the knees' motions were normal. Conclusions With a long pedicle and wide diameter,the medial or lateral gastrocnemius blood vessle can be a reliable alternative used in free flap transplautation for repairing large defects of skin and soft tissues of seriously injured legs with no other choice of blood vessles, which causes unobvious effects to the blood supply of the legs and can simplify the free flap transplantation.

OBJECTIVETo investigate the application of microsurgical technique in the replantation of amputated ear.

METHODS7 cases of amputated ears were analyzed from June 2009 to April 2015 in our department. We used microsurgical technique to anastomose about five vessels and nerves. The blood supply of auricle was restored within three to six hours. All subjects underwent treatments including anti-freezing, anti-spasm and anti-infection treatment after the emergency surgery.

RESULTS7 amputated ears were all survived after replantation. The patients were followed up for one month to six months ( average for 28 months). The appearances of survived ears body were fully recovered without any significant atrophy or pigmentation. The sensory function of ears recovered to normal after 1 year.

CONCLUSIONSThe application of microsurgical technique in the replantation of amputated ear can expect the high success rate of ear replantation. However, skilled and high-quality anastomosis technique of small vascular are required.

Amputation, Traumatic ; surgery ; Anastomosis, Surgical ; methods ; Ear Deformities, Acquired ; surgery ; Ear, External ; blood supply ; innervation ; Graft Survival ; Humans ; Microsurgery ; methods ; Replantation ; methods

Objective To investigate the effects of zoledronic acid on the expression of HIF-1α and VEGF in osteosarcoma LM8 cell line under hypoxic condition. Methods The hypoxic culture model was established. After LM8 cells were treated with zoledronic acid, semi-quantitative PCR was used to assess the expression of HIF-1α and VEGF mRNA. The expression of HIF-lct and VEGF protein was de-tected by immunohistochemical staining and ELISA respectively. Results Compared with cells in normoxic conditions, cells in the hypoxic environment and cells treated with zoledronic acid in the hypoxic condition did not show a significant change in the mRNA level of HIF-1α(P >0. 05). However, the protein expression of HIF-1α was markedly decreased in the cells treated with zoledronic acid in the hypoxic envi-ronment. In contrast, both mRNA and protein expression levels of VEGF were down-regulated in the zoledronic acid treatment hypoxic group (P <0.05). Conclusion Under hypoxic conditions in vitro, zoledronic acid inhibited the expression of HIF-1α protein, which decreased VEGF mRNA level and protein expression in osteosarcorna LM8 cell line.

Objective:To explore the pharmacodynamic differences of india madder root before and after charcoal in antiinflammatory,ease pain,promoting blood circulation for removing blood stasis and hemostasis function.Methods: The india madder root and india madder root charcoal decoction pieces were processed by the same one operation,then the water decoction of them were given to the mouse by intragastric administration in different dosages.The method of auricle tumefaction was adopted to compare the antiinflammatory function,body wrings was adopted to compare the ease pain function,to compare the hemostasis function of india madder root before and after charcoal by snipping off the mouse’s tail and capillary method.Blood stasis model was made by injecting Dexamethasone Sodium Phosphate,then to compare the promoting blood circulation for removing blood stasis function of india madder root before and after charcoal of india madder root before and after charcoal.Results: India madder root decoction pieces is more effective than india madder root charcoal decoction pieces in antiinflammatory,ease pain,promoting blood circulation for removing blood stasis,but less effective in hemostasis.Conclusion: The function of antiinflammatory,ease pain,promoting blood circulation for removing blood stasis of india madder root were less effective after charcoal,but the fuction of hemostasis was more effective.

Objective To study the effects of erythropoietin (rhEPO) in high glucose induced proliferation and apopto?sis of human kidney proximal tubular epithelial (HK-2) cells, and the possible mechanism thereof. Methods HK-2 cells cultured in vitro were divided into several groups randomly:blank control group, high glucose group, mannitol group, rhEPO control group, different concentrations of rhEPO treatment groups (5, 10, 20 U/mL) and Rho kinase group. The reverse tran?scription polymerase chain reaction (RT-PCR) was used to evaluate the mRNA levels of RhoA and ROCK after 24 hours. Tetrazolium salt method (MTT) was used to determine the cell proliferation. Cell apoptosis was detected by flow cytometry. Results Compared with blank control group the expression levels of RhoA and ROCK1 mRNA were significantly in?creased in high glucose group (P < 0.05). RhoA, ROCK1 mRNA expressions significantly decreased in rhEPO group than those of high glucose group (P<0.05). There was a positive correlation between the expression levels of RhoA mRNA and ROCK1 mRNA in high glucose group and rhEPO group. MTT method showed that rhEPO significantly promoted the prolifer?ation of HK-2 cells (P<0.05). Flow cytometry analysis showed that high glucose induced apoptosis in HK-2 cells, which was significantly inhibited in rhEPO group and Rho kinase group as compared to that of high glucose group in a concentra?tion dependent manner (P<0.05). Conclusion rhEPO can promote HK-2 cell proliferation and inhibit apoptosis, which may be related to RhoA/ROCK signaling pathway.