Objective To compare the feasibility and efficacy between dexmedetomidine and midazolam in herniorrhaphy surgery for older patients. Methods Sixty American Society of Anesthesiology (ASA) gradeⅠ~Ⅱpatients, treated by herniorrhaphy surgery under local anesthesia,were randomly divided into dexmedetomidine group (n=30) and midazolam group (n=30) .Patients in dexmedetomidine group were given dexmedetomidine at a loading dose of 1μg/kg for 10 min,then they were injected continuously by 0.4μg/(kg·h),whereas midazolam group were given midazolam at a loading dose of 0.06 mg/kg, then 0.04 mg/(kg·h) injected continuously.The mean blood pressure (MAP) and heart rate (HR) were recorded before infusion (T0),incision of skin (T1),15min (T2) and 30 min (T3) after administration and when sutured skin (T4), adverse reaction were also assessed. Results The difference of sedation level was not significant between the two groups (P>0.05) .Compared with T0 , the decrease of HR was significantly more in dexmedetomidine group from T1 to T4 (P<0.05) . Compared with midazolam group , the decrease of HR was significantly more in dexmedetomidine group from T1 to T4 (P<0.05) . Compared with dexmedetomidine group, the rate of respiratory depression and restlessness were more in midazolam group, but bradycardia was lower (P<0.05) .Conclusions Dexmedetomidine is a comparable alternative to midazolam for sedation in herniorrhaphy surgery under local anesthesia. It is associated with better respiration and lower restlessness but with a high incidence of bradycardia.

BACKGROUND:The success of cell therapy will depend on the ability to monitor the fate of transplanted cells in vivo.Superparamagnetic iron oxide(SPIO)labeling is an ideal magnetic resonance contrast medium,and it offers the potential for non-invasive tracking of implanted cells.The chlormethylbenzamido-1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine (CM-Dil)labeling does not have cytotoxicity,so it cannot influence cell growth.OBJECTIVE:To investigate the effects of SPIO and CM-Dil labeling and tracking on bone marrow mesenchymal stem cells(BMSCs).METHODS:Porcine BMSCs were isolated and cultured by the whole bone marrow method.BMSCs were labeled with SPIO containing 50 mg/L Ferrum and CM-Dil.The labeled BMSCs were transplanted into porcine myocardial infarction model via intracoronary infusion.The frozen sections of the cardiac tissues were obtained after 4 weeks.RESULTS AND CONCLUSION:Efficiency of SPIO and CM-Dil labeling BMSCs was nearly 100%.The SPIO and CM-Dil labeled BMSCs could be found in the cardiac muscle tissues at 4 weeks after transplantation.SPIO and CM-Dil labeling BMSCs were efficiently tracked in vivo.

Objective To evaluate the effects of dyclonine gel on the success rate and complication of laryngeal mask airway(LMA)insertion. Methods Eighty ASAⅠ~Ⅱpatients undergoing ureteroscopic lithotripsy under general anesthesia received insertion of LMA coated with either dyclonine gel(group A,n=40)or paraffin oil(group B ,n = 40). Systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)were recorded before anesthesia (T0),after induction (T1),at LMA insertion (T2),and 3 min after LMA insertion (T3). Time and frequency of LMA insertion ,incidence of abnormal sensation of pharynx and sore throat after surgery in 2 groups were recorded. Results Compared with those at T0,the SBP,DBP and HR were lower at T1, T2 and T3 in 2 groups(P<0.05). The one-time success rate of group A and group B were 90%and 97.5%respec-tively(P>0.05).The incidence of abnormal sensation of pharynx and sore throat was significantly lower in group A (5%vs. 20%)(P<0.05). Conclusion Dyclonine gel cream-coated LMA can reduce the incidence of sore throat in patients undergoing ureteroscopic lithotripsy under general anesthesia.

Objective To observe the clinical effect of dexmedetomidine for preventing agitation during extubation period in the patients undergoing percutaneous nephrostolithotomy.Methods Sixty ASA Ⅰ-Ⅱ patients with elective percutaneous nephrostolithotomy under general anesthesia were selected and randomly assigned to the dexmedetomidine (DEM) and normal saline group (NS),30 cases in each group.The DEM group was given dexmedetomidine 0.5 μg/kg by intravenous pumping at 30 min before the end of the operation,while the NS group was given the equal volume of normal saline by intravenous pumping for 10 min.MAP and HR were recorded before anesthesia induction(T0),at the end of skin suturing(T1),at the moment of extubation(T2),at 5 min (T3) and 10 min(T4)after extubation.The eye opening time and extubation time,and incidence of agitation were observed in the two groups.Results MAP and HR at T2,T3 and T4 in the DEM group were lower than those in the NS group(P＜0.05).MAP and HR at T2,T3,T4 in the NS group were higher than those before anesthesia induction(P＜0.05).The total incidence rate of agitation during extubation period in the DEM group was also significantly lower that that in the NS group(P＜0.01).No statistically significant differences were found between the two groups in the recovery time and extubation time(P＞0.05).Conclusion Intravenous pumping of dexmedetomidine 0.5 μg/kg at 30 min before the end of percutaneous nephrostolithotomy can effectively reduce the occurrence of agitation during extubation period.

Objective To study the effects of different types of fluid resuscitation on mesenteric microcirculation and inflammatory factors in rabbits with hemorrhagic shock.Methods The model of hemorrhagic shock rabbits was established by reducing the basic mean arterial pressure by 40%through draining the blood from the common carotid artery.Animals were randomly divided into control group,saline group,lactate Ringer group,acetic acid Ringer group,hydroxyethyl starch group and succinyl gelatin group with 8 animals in each group.Mesenteric microcirculation was monitored with microcirculation monitor.Mean arterial pressure(MAP),heart rate(HR),microvascular perfusion ratio(PPV)and microvascular blood flow index(MFI)were recorded before bleeding(T0),at hemorrhagic shock(T1),at the beginning of fluid resuscitation(T2),at the completion of fluid resuscitation(T3),and at the end of the experiment(T4).The contents of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1)and lactic acid(Lac)were measured at T0,T2 and T4.Results Compared with hydroxyethyl starch group,there were statistically significant differences in T3 MAP(P<0.05),except for succinyl gelatin group,hydroxyethyl starch group had higher MAP at T4 than other groups,the difference was statistically significant(P<0.05).The differences in MAP between experimental control group and other groups were statistically significant at T4(P<0.05).PPV and MFI of hydroxyethyl starch group and succinyl gelatin group were higher than those of normal saline group,lactic acid Ringer group and acetic acid Ringer group at T4(P<0.05),and the lactic acid value of hydroxyethyl starch group at T4 was the lowest,compared with lactic acid Ringer group and normal saline group,the difference was statistically significant(P<0.05).There were statistical significances between all groups and experimental control group at T4(P<0.05).There were no significant differences in TNF-αand IL-1 in T0,T2 and T4 among all groups(P<0.05).Conclusion Hydroxyethyl starch solution and succinyl gelatin solution can improve the microcirculation of rabbits with hemorrhagic shock,but can not improve the level of inflammatory factors.