Objective To investigate the effects of caudal block with lidocaine plus drugs on postoperative analgesia in children. Methods Eighty children aged 1 to 4 years old received caudal block with 1% lidocaine 1 ml/kg and were randomly allocated to 4 groups with 20 cases each. The local anesthetic solution was added fentanyl 2 μg/kg in group Ⅱ , neostigmine 2 μg/kg in group Ⅲ, tramadol 2 mg/kg in group Ⅳ or nothing in group Ⅰ. Postoperative analgesia with fentanyl (nurse controlled analgesia, NCA) was given in all patients. Pain and sedation scores were evaluated at 1, 2, 4, 6 and 24 h after surgery. The duration of caudal analgesia, fentanyl requirements, sicle effects,and discharge time were recorded. Results Duration of caudal analgesia in group Ⅳ was (510. 7±64. 9)rain, which was longer than (174.5±39. 3) rain in roup Ⅰ , (291.7 ± 50. 8) min in group Ⅱ , or (242.0±62. 8) min in group Ⅲ. The incidence of postoperative nausea and vomiting was more [requent in group Ⅳ than that in the other groups(P<0. 05). Conclusion Combined 1 % lidocaine 1 ml/kg with tramadol 2 mg/kg for caudal block can provide better and longer postoperative analgesia, but with a higher incidence of postoperative nausea and vomiting.

Long-term or even permanent neuronal injury can follow administration of general anesthetics.It has been confirmed that some elderly patients may experience a decline in cognitive function after general anesthesia.However,the effects of general anesthetics on the central nervous system have not been determined yet.Here we summarize the effects of general anesthetics on the central nervous system in pediatric patients and immature animals.

Inflammatory bowel disease(IBD)is a chronic nonspecific intestinal inflammatory disease and its etiology is not yet clarified. MicroRNAs( miRNAs)is a class of endogenous noncoding RNA that exerts post-transcriptional regulation on gene expression. Studies found that miRNAs is involved in the regulation of intestinal mucosal barrier and mucosal immune system;abnormal expression of miRNAs is associated with the occurrence of IBD. This article reviewed the regulatory mechanism and clinical application of miRNAs in IBD.

In order to complete the seven-year microbiology teaching better,we used the theme discussion of PBL teaching in our teaching activities,i.e.by setting a certain scenario and giving some background information before the students'group discussion. The practice proved that the theme discussion of PBL teaching method in theoretical teaching and learning changed the traditional case-based discussion chiefly by teachers; as a result,the relative immobilization of the teaching mode became more flexible. These methods of teaching and learning not only stimulated the students'initiative and enthusiasm,but also helped them to think critically. Our assessment of PBL teaching and learning showed that the themes discussion of PBL in medical microbiology achieved better results.

Objective Hyalinizing trabecular tumor ( HTT) is often mistaken as thyroid papillary carcino-ma( TPC) ,which shares some morphological features with TPC .The aim of this study is to investigate HTT and TPC with immunohistochemical methods .Methods we detected the expression of the three Immunohistochemical index((CK19,HBME-1,MIB-1)in thirteen cases HTT and twenty cases TPC.Results In HTT samples, CK19:three of the thirteen were positive and focal positivity (1+);HBME-1:None of the thirteen samples was stained.MIB-1:ten in thirteen cases were stained in nucleus .In TPC samples,CK19:all of the twenty samples were intensely stained;HBME-1:nineteen of twenty samples were intensely stained;MIB-1:all of the twenty samples were stained in nucleus .The sensitivity and specific degrees of CK 19 and HBME-1 combination to diag-nosis HTT and TPC were 90.0%and 69.2%.Conclusion Our research could provide potent aid to differential diagnosis of HTT and TPC .The combination of CK19 and HBME-1 are adequate to identify HTT and TPC .

Objective: To better understand the effect of propofol on the spinal cord levels, and investigate whether there are different effects of propofol between nociceptive input and non-nociceptive input. Method: All Sprague-Dawley rats were spinally transected, the effect of propofol (2mg/kg, Ⅳ) on C response to the firing of electromyography, and the discharges of dorsal horn neurons were observed. Result: Propofol can produce a profound inhibition on C response,early discharges,late discharges and spontaneous discharges. Compared with early discharges, the extent of inhibition of late discharges increased but the lasting time was shorten. Conclusion: Propofol can suppress the transmission of nociceptive and non-nociceptive stimulus in spinal cord with stronger inhibition on nociceptive input,and the shorter lasting time. It is indicated that the loss of sense and pain results from the effect of propofol on the spinal cord.

Objective To investigate the effect of sevoflurane anesthesia on DNA methyltransferase (DNMT) mRNA expression in neonatal rat amygdala. Methods Forty-two 8-day-old SD rats were randomly divided into 2 groups ( n = 21 each): control group and experimental group. 5% sevoflurane was inhaled for 1 min, and then the inhaled concentration of sevoflurane was decreased to 3 % and maintained for 4 h. The rats were sacrificed at the end of sevoflurane inhalation and 24 h after the end of sevoflurane inhalation, and amygdala was removed for determination of DNMT, mRNA, DNMT3, mRNA and DNMT3b mRNA expression by RT-PCR. Blood samples were taken at the end of sevoflurane inhalation for blood gas analysis. Results Compared with control group, the DNMT, mRNA and DNMT3, mRNA expression was down-regulated (P ＜ 0.05). There were no significant differences in DNMT3b mRNA expression and parameters of blood gas analysis between the two groups (P ＞ 0.05). Conclusion Sevoflurane anesthesia can down-regulate DNMT, mRNA and DNMT,, mRNA expression in neonatal rat amygdala, which may result in functional deficits during the development of central nervous system.

Objective To estimate the arterial-to-end-tidal carbon dioxide tension difference (Pa-ET CO 2 )in children with cyanotic or acyanotic congenital heart diseases;evaluate whether hyper-ventilation can reduce the tension difference or not;analyze the effect of sevofleurane on Pa-ET CO 2 . Methods One hundred and twenty patients (male 60 cases,female 60 cases,aged 1 month-6 years, ASA class Ⅱ or Ⅲ)undergoing selective cardiac surgery were randomly divided into 6 groups (n =20 each)based on right-to-left or left-to-right intracardic shunts:group A1,cyanotic with sevoflurane of 0.5 MAC;group A2,cyanotic with sevoflurane of 1.0 MAC;group B1,acyanotic with sevoflurane of 0.5 MAC;group B2,acyanotic with sevoflurane of 1.0 MAC;group C1,cyanotic with no inter-vention factors;group C2,acyanotic with no intervention factors.All the children received general an-aesthesia after placing an intravenous and arterial catheter.The value of PET CO 2 ,SpO 2 ,PaCO 2 , SaO 2 ,Hct and temperature(nasopharyngeal temperature and rectal temperature)were obtained before operation,after hyperventilation(the control groups without hyperventilation)and five minutes before surture sternum.Results The values of Pa-ET CO 2 were more than the normal one in six groups before operation.The value of Pa-ET CO 2 in group B1 was less than that in group A1,that in group B2 was less than that in group A2 and that in group C2 was less than that in group C1 before operation (P <0.01).Compared with the time point before operation,the values of Pa-ET CO 2 in groups A1,A2,B1 and B2 decreased significantly after hyperventilation (P < 0.05 or P < 0.01 ).Moreover, this reduction was more significant in groups B1 and B2.Compared with the time point before operation, the values of Pa-ET CO 2 in groups B1,B2,C2 increased significantly (P <0.01)and that in groups A1, A2,C1 decreased significantly (P <0.05)at 5 minutes before surture sternum.There was no statisti-cal difference at three different time points between group A1 and A2,B1 and B2.Conclusion The value of Pa-ET CO 2 in cyanotic children increased more significantly than that in acyanotic children.Hy-perventilation can reduce the value of Pa-ET CO 2 especially in acynanotic children with pulmonary con-gestion.The concentration (from 0.5 MAC to 1.0 MAC)of sevoflurane had little effect on the value of Pa-ET CO 2 .

BACKGROUND:In recent years, a lot of studies have reported the feasibility and efficacy of transplanting seed celsvia tissue-engineered cardiac patches into specific infarcted myocardial area, helping regeneration of damaged heart tissue and improving heart functions.
OBJECTIVE:To review the methods and strategies of fabricating tissue-engineered cardiac patches and to analyze the structure and functional characteristics of cardiac patches prepared by different methods.
METHODS: The first author retrieved relevant articles about the fabrication methods of tissue engineered cardiac patches by searching PubMed and Web of science data bases. The key words were “cardiac infarction, cel death”.
RESULTS AND CONCLUSION:The fabrication methods and strategies of tissue-engineered cardiac patches are as folows: (1) obtaining multi-layer cel sheets by overlapping monolayer cel sheets; (2) combing gelatin with cels to construct multi-layer cel sheets; (3) seeding cels on scaffolds; (4) homogeneous arrangement of cels. Recent studies about tissue-engineered cardiac patches have demonstrated that the biological activities of seed cels, such as retention, survival and paracrine effects, greatly influence the effect of cardiac patches on the repair and regeneration of infarcted myocardial tissues. Temperature-sensitive method is the most mature and wide-spread used constructing technique; besides, other strategies also successfuly improve the biological activities of seed cels to different extents, and they also increase the mechanical strength and thickness of cel sheets in order to have better operability. Tissue-engineered cardiac patches are usualy prepared by different combined strategies on purpose to obtain better biological and mechanical properties.

Objective To evaluate the effects of epidural capsaicin on pain threshold and nerve tissue structure in adult rats. Methods Twenty-four adult male Wistar rats weighing 250-300 g were used in this study. A catheter was inserted into epidural space at L5,6 according to the method of Philippe. 0.4 ml of capsaicin 0.1% (group A), 0.25% (group B) or 0.5% (group C) or 10% Tween 80 (control group) was injected via the epidural catheter. Pain threshold was measured by thermal stimulation of the tail before (baseline) and on the 3rd, 7th and 14th day after epidural capsaicin. The animals were then killed. The lumbar segment (L4-6) of the spinal cord and spinal nerve roots were removed immediately for light and electron microscopic examination. Results Pain threshold was significantly higher in group A, B and C than in control group (P