Objective To investigate the effect of dexmedetomidine on emergence agitation (EA) following sevoflurane anesthesia in children with cerebral palsy.Methods Fifty ASA physical status Ⅰ or Ⅱ children with cerebral palsy of both sexes,aged 2-12 yr,scheduled for elective muscle strength muscle tension adjustment method,were randomly allocated into 2 groups (n =25 each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with iv injection of sufentanil 0.3 μg/kg,cisatracurium 0.15 mg/kg,and propofol 1.5 mg/kg.The patients were tracheal intubated and mechanically ventilated.Dexmedetomidine 0.5 μg/kg was intravenously infused over 15 min after induction of anesthesia in group D and the equal volume of normal saline was given in group C.The operation was begun at the end of administration.Anesthesia was maintained with inhalation of 2％-4％ sevoflurane and the concentration was adjusted to achieve a target BIS value of 45-60.The heart rate,systolic blood pressure and diastolic blood pressure were recorded before infusion of dexmedetomidine (T1) and at skin incision (T2).The extubation time,emergence time and consumption of sevoflurane were also recorded.The end-tidal sevoflurane concentration was recorded at T1,T2,and the end of operation (T3).The adverse cardiovascular events and occurrence of EA were also recorded.The degree of EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.The peripheral venous blood samples were collected at T1,T2,T3 and extubation (T4) for determination of the blood glucose level and serum cortisol concentration.Compared with group C,the emergence time and extubation time were significantly shortened,and the consumption of sevoflurane,end-tidal sevoflurane concentrations at T2 and T3,PAED scores,incidence of agitation,and the blood glucose level and serum cortisol concentration at T4 were significantly decreased in group D (P ＜0.05 or 0.01).There was no significant difference in the incidence of bradycardia or heart rate,systolic blood pressure and diastolic blood pressure at each time point between the two groups (P ＞ 0.05).Conclusion Dexmedetomidine can decrease the development and degree of EA following sevoflurane anesthesia in children with cerebral palsy.

Randomized controlled trial (RCT) is considered as the gold standard for the efficacy assessment of medicines. With the increasing number of Chinese patent drugs for treatment of type 2 diabetes, the methodology of post-marketing RCTs evaluating the efficacy and specific effect has become more important.

【Objective】 To explore the significance of electrocard iogram monitoring during the effective application of radiofrequency energy to s low atrioventricular (AV) nodal pathway ablation. 【Methods】 Slow AV nodal pathway ablation was performed in 58 patients with slownfast AV nodal ree-trant tachyca rdi a (AVNRT). The changes of electrocardiogram were monitored during the effective application of low radiofrequency RF energy (15～25 W). A faster rate of junctio nal ectopy (>150 min-1), ventriculoatrial (VA) block in association with j unctional ectopy, and l ong P-R interval during sinus beat were considered as harbingers of atrioventri cular (AV) block. RF energy deliveries were discontinued as soon as the harbinge rs of AV block occurred. Otherwise, RF energy continued until junctional ectopie s were decreased or vanished. If junctionnal ectopies were not decreased, RF ene rgy continued lasted for 90～120 s. 【Results】 Slow AV nodal pathway ablation w as successful in all patients who had junctional ectopy during the effective del ivery of RF energy. The effective ablation time was (128±26) s. 54 patients exp erienced one time successful ablation, and 4 patients experienced two times abla tion. Unsustained AV block occurred in 6 patinets after RF energy deliveries whi ch were immediately terminated because of VA block in association with junctiona l ectopy in 4 patinets and long P-R interval during sinus beats in 2 patients. No patients developed permanent AV block. Recurrent AVNRT requiring second ablat ion occurred in 2 of 58 successfully ablated slow pathway during (18±16) months of follow-up. 【Conclusion】 RF energy deliveries could be instructed b y intracardiac electrocardiogram monitoring during AVNRT ablation, which could e nhance the successful rate of slow pathway ablation, reduce recurrence and avoide permanent AV block.

Objective To evaluate the efficacy of a type of endotracheal tube of extended with terminal swelling and resistance bending pressure for airway management during mechanical ventilation in children in prone position.Methods Sixty pediatric patients with cerebral palsy of both sexes,aged 3-7 yr,weighing 11-23 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective selective functional posterior rhizotomy,were randomly allocated into 2 groups (n =30 each) using a random number table:endotracheal tube of extended with terminal swelling and resistance bending pressure group (group E) and reinforced tracheal tube group (group C).After induction of anesthesia,the type of endotracheal tube of extended with terminal swelling and resistance bending pressure was inserted in group E,and the reinforced endotracheal tube was inserted in group C.The tidal volume,minute ventilation,dynamic lung compliance,arterial oxygen saturation and end-tidal pressure of carbon dioxide in pressurecontrolled ventilation mode were recorded in the two groups.Tube shedding caused by using of the extended tube was recorded during operation.Blood samples were collected from the femoral artery for blood gas analysis.Results Compared with group C,the tidal volume and minute ventilation were significantly increased (P＜0.05),and no significant change was found in dynamic lung compliance,arterial oxygen saturation and end-tidal pressure of carbon dioxide in group E (P＞0.05).Compared with the value before anesthesia,no significant change was found in pH value,arterial oxygen partial pressure and partial pressure of arterial carbon dioxide at the end of operation in the two groups (P＞0.05).In group C,the extended tube wasused in 3 patients,and among the 3 cases,one patient developed tube shedding which was treated immediately.Conclusion The type of endotracheal tube of extended with terminal swelling and resistance bending pressure provides better efficacy than the reinforced endotracheal tube when used for airway management during mechanical ventilation in children in prone position.

AIM: To study the reactions of human platelet to active complement and the effects of anti-CD59 on human platelet activation induced by complement. METHODS: By applying CVF to activate complement, the platelet aggregation and release reactions induced by activated complement with or without appling anti-CD59 with different doses to block the complement modulative protein CD59 in healthy individuals, were observed. RESULTS: CVF induced platelet release and significant and lasting metamorphosis in healthy individuals, but platelet aggregation was not observed. CVF-induced platelet metamorphosis showed positive linear correlation to lg concentration of CVF (r=0 970. P

Objective To study the levels of soluble thrombomodulin (sTM)in patients with acute coronary syndrome (ACS) and evaluate its clinical significance. Method Measured the sTM levels with enzyme linked immunosorbent assay, and described the characteristics of coronary arteriography, risk factors of coronary heart disease, and adverse events in a case-control study of 48 ACS patients (ACS group)and 10 normal people (control group). Results The level of sTM in ACS group was (3.67±1.71) μg/L, and (2.34±0.43)μg/L in control group (P<0.05). The level of sTM in the patients of risk factors or impaired vessels number more than 2 increased significantly than those in the patients of risk factors or impaired vessols number inferior or equal to 2, (4.93±2.76) μg/Lvs (3.13±0.81) μg/L, P<0.05, (4.60± 2.83) μg/L vs (2.91±0.23) μg/L, P < 0.05 respectively. The incidence of cardiac events in the patients of sTM more than 3.2 μg/L (70.0%)was higher significantly than that in the patients of sTM inferior or equal to 3.2 μg/L(35.7%), P< 0.05. Conclusions The levels of sTM are valuable markers to evaluate the impaired degree and scope of endothelial cells in ACS. They are also associated with the number of risk factors, and useful in predicting the extent and prognosis of the disease.

Objective To evaluate the effect of cerebral palsy factor on the sensitivity of postopera?tive pain in the pediatric patients. Methods Twenty?five pediatric patients with cerebral palsy of both se?xes, of American Society of Anesthesiologists physical statusⅠorⅡ, aged 3-7 yr, weighing 11-25 kg, scheduled for elective lower abdominal or lower extremity surgery, served as cerebral palsy group ( group P). Another 25 pediatric patients without cerebral palsy of both sexes, of American Society of Anesthesiol?ogists physical status Ⅰ orⅡ, aged 3-7 yr, weighing 11-25 kg, served as control group ( group C) . At 2 h after surgery, pain was evaluated by using CRIES ( crying, requires O2 saturation, increased vital sign, expression and sleeplessness) . Peripheral venous blood samples were collected before surgery, and at 2 and 24 h after surgery, and the concentrations of plasmaβ?endorphin were measured by radio?immunity method, and the concentration of plasma catecholamine ( adrenaline) was determined by high performance liquid chromatography. Results Compared with the value before surgery, the plasma concentrations of β?endorphin were significantly decreased, and the concentrations of plasma catecholamine were increased after surgery in the two groups (P < 0?01). Compared with group C, the CRIES score was significantly in?creased after surgery, the concentration of plasmaβ?endorphin was decreased before and after surgery, and the concentration of plasma catecholamine was increased after surgery in group P ( P< 0?05 or 0?01) . Con?clusion The sensitivity of postoperative pain is increased in the pediatric patients with cerebral palsy.

This study was aimed to investigate the effect of Bu-Shen Y i-Sui Sheng-Xue (BSYSSX) method on pro-liferation and differentiation mechanisms of hematopoietic progenitor cells. The rat models were established by 60Co-γrays and cyclophosphamide. Compound Chinese medicine was gavaged to rats of the normal control group, model group, stanozolol group, Yi-Sui Sheng-Xue (YSSX) group, Wen-Shen Sheng-Xue(WSSX) group and Zi-Shen Sheng-Xue (ZSSX) group. Then, serum of rat was prepared. Rat bone marrow cells were incubated with AA rats serum ac-counted for 20% and the number of hematopoietic progenitor cells colony-forming units (CFU) were counted. The level of GATA-1 and PU.1 mRNA in colony cells were detected with RT-PCR. The results showed that compared with the normal control group, the number of bone marrow cells, CFU-E, BFU-E, CFU-GM, as well as the expres-sion of GATA-1 and PU.1 mRNA in the model group decreased significantly (P< 0.01). Compared with the model group, the number of bone marrow cells, CFU-E, BFU-E, CFU-GM of each treatment group were significantly in-creased (P< 0.01). CFU-E and BFU-E of the ZSSX group were better than the YSSX group (P < 0.01). CFU-GM of the ZSSX group was better than the YSSX group and the WSSX group. The expression of GATA-1 and PU.1 mR-NA in each treatment group were significantly higher than the model group (P< 0.01). The expression of GATA-1 mRNA in the ZSSX group was better than the YSSZ group and WSSX group (P< 0.05). The expression of PU.1 mR-NA in the ZSSX group was higher than the YSSX group and WSSX group. It was concluded that BSYSSX method may increase the expression of GATA-1 and PU.1 mRNA in order to promote the proliferation and differentiation of bone marrow hematopoietic progenitor cells. The ZSSX method was better than the YSSX method and WSSX method.

Objective To evaluate the accuracy of nostril width method in intubation model choose in children with cerebral pal‐sy FSPR surgery .Methods Three hundred and fifty six cases of cerebral palsy FSPR surgery were selected ,the endotracheal intu‐bation were selected by nose width method and modified weight method ,and then we made a comparison between the two methods . Kappa consistency test and rank correlation analysis were both used to analyze the consistency .Results With Kappa=0 .81 ,rank correlation coefficient 0 .905 ,we could know that there was high degree of consistency between the two methods (P<0 .01) ,of which 298 cases (83 .7% ) children selected the same model intubation strengthen model in different method ,58 cases (16 .3% ) pe‐diatric intubation choice of two methods differ by one model .Conclusion Nostril width method was simple and reliable to select in‐tubation in pediatric surgery to strengthen FSPR model .

This paper was aimed to observe the effect of Yisui Shengxue (YSSX) granules on CD4+ CD25 + regulatory T cells (Treg cells) and its treatment mechanism in aplastic anemia (AA) rats.Male SD rats were selected and randomly divided into different groups according to their weight.In the model group,subcutaneous injection of benzene (1 mL· kg-1)was given every other day for 7 consecutive weeks.Ten days before the rats were sacrificed,intraperitoneal injection of CTX (25 mL · kg-1) was given for 3 consecutive days.On the 4th week,model rats were divided into the model group,stanozolol group,and the YSSX granules group.Intragastric administration of corresponding drug was given.Same volume of normal saline was given to the normal group and the model group.At the end of the experiment,WBC,RBC,HGB and PLT in peripheral blood were detected.Blood smear and bone marrow smear were prepared.The Foxp3 protein expression of Treg cells in spleen tissues was detected by immunohistochemistry (IHC).RT-PCR was used to detect the Foxp3 mRNA expression in bone marrow tissues.The results showed that compared with the normal group,WBC,RBC,HGB and PLT in the model group were significantly reduced (P ＜ 0.01).The blood smear showed poor permeability of blood cells,reduced WBCs,and increased degenerated cells.The bone marrow smear indicated significantly increased fat drops,significantly reduced hematopoietic cells,and increased nonhematopoietic cells.After the treatment of YSSX granules,WBC,RBC,HGB and PLT were significantly increased (P ＜ 0.01).Both the blood smear and bone marrow smear showed cell permeability improvement,cell form returns to normal,fat drops significantly reduced,significantly increased hematopoietic cells,significantly increased Foxp3 protein expression in spleen tissues and Foxp3 mRNA expression in bone marrow tissues (P ＜ 0.01).It was concluded that YSSX granules can upregulate both gene and protein expression of Foxp3,regulate AA immune function in order to improve the AA immune environment,promote the recovery of bone marrow hematopoietic function,which played an important role in AA treatment.