Objective To explore the degree of cooperation and the effect of hemodynamics in preschool children who received preoperative use of dexmedetomidine.Methods One hundred preschool children who scheduled for lower abdominal operation were randomly divided into two groups,each 50patients.The treatment group was given bolus infusion dexmedetomidine 0.5 μ g/kg (20 ml),the control group was given bolus infusion 0.9％ sodium chloride 20 ml.They were completed in 20 min.The cooperation was assessed by induction compliance checklist (ICC) score,and the level of mean arterial pressure (MAP),heart rate(HR),pulse oxygen saturation(SpO2),end-tidal pressure of carbon dioxide(PnCO2) at monitoring ward before bolus infusion (T1),end of bolus infusion (T2),before induction (T3),after induction (T4),incised skin (T5) and end of operation (T6) were compared.Results The scores ofICC in treatment group was significantly lower than that in control group [(2.73 ± 0.12) scores vs.(6.17 ± 0.91) scores] (P ＜ 0.05).In treatment group,48 patients ICC score was 0,2 patients ICC score ＞5 scores,and in control group,there was 48,2 patients,there was significant difference(P ＜ 0.05).The level of MAP,HR at T1,T2,T4between two groups had no significant difference (P ＞ 0.05).The level of MAP,HR at T3,T5,T6 in treatment group were significantly lower than those in control group(P ＜ 0.05).In control group,the level of MAP,HR at T3,T5,T6 were significantly higher than those at T1 (P ＜ 0.05).In treatment group,the level of MAP,HR at T2-T6 had no significant difference compared with T1 (P ＞ 0.05).The level of SpO2,PnCO2 between two groups and interclass had no significant difference (P ＞0.05).Conclusion Bolus infusion dexmedetomidine before operation can improve the induction of anesthesia and operation smoothly,and improve the patients early rehabilitation.

Objective To investigate the association between global registry of acute coronary events (GRACE) score,N-terminal pro brain natriuretic peptide (NT-proBNP) and heart function in patients with acute coronary syndromes(ACS).Methods One hundred and seventy-four ACS patients and 60 healthy persons were enrolled our study.Of ACS patients,96 cases were with unstable angina pectoris(UP) and 78 cases with acute myocardial infarction (AMI).The level of NT-proBNP,left ventricular ejection fraction (LVEF) and GRACE score were measured.Results The NT-pro BPN of patients with UP or AMI were 87.00(38.25,245.75) ng/L and 686.00 (169.00,1 852.75) ng/L,and GRACE score were (87.51 ± 17.69) and (134.74 ± 23.56),which were higher than that in the control group (31.50 (13.00,54.75) ng/L,(81.10 ± 15.75)).LVEF in patients with AMI (57.72 ± 9.04) ％,lower than that of the control group ((64.45 ± 6.31) ％),and there were statistically significant difference among the three groups (Z =44.111,P ＜ 0.001 ; F =172.366,18.176,P ＜0.01).There was positive correlation between serum NT-pro BNP levels and GRACE score(r =0.451,P ＜ 0.001),and negative correlation was seen between serum NT-pro BNP and LVEF (r =-0.294,P ＜ 0.001)Conclusion NT-pro BNP level increases and LVEP decreases in patients with ACS and they are related to GRACE score as well as associated with the degree of risk in patients with ACS.

Objective To investigate the effect of target -oriented fluid therapy on the tissue perfusion of patients with hemorrhagic shock during ectopic pregnancy .Methods From December 2015 to June 2017 ,80 patients with ectopic pregnancy hemorrhagic shock in Laiyang Central Hospital of Yantai were enrolled in this study .They were divided into two groups according to the random number method ,with 40 cases in each group .The control group was given routine fluid supplementation .The observation group was given target -oriented fluid therapy .The average arterial pressure,central venous pressure and urine output in two groups were compared .The vasoactive drug use and use time were analyzed in the two groups .Results The mean arterial pressure in the observation group was (115.6 ±10.3)mmHg,which was higher than that in the control group [(86.9 ±5.6)mmHg](t=15.482,P<0.05).The central venous pressure in the observation group was (7.1 ±0.5)cmH2O,which was higher than that in the control group [(5.9 ±0.2)cmH2O](t =14.093,P<0.05).The urine output in the observation group was (256.8 ±15.9)mL,which was more than (53.1 ±5.0)mL in the control group(t=77.294,P<0.05).The use rate of vasoactive drug in the observation group was 7.5％,which was lower than 37.5％in the control group(t=8.674, P<0.05).The duration of vasoactive drug use in the observation group was (35.0 ±0.1)min,which was shorter than (49.6 ±1.8)min in the control group(t=13.707,P<0.05).Conclusion Target-oriented fluid therapy for ectopic pregnancy hemorrhagic patients is more effective for fluid resuscitation and less usage of vasoactive drugs .

Background In recent years,some researches had been conducted on the pathologic changes of the secondary injury of perihematoma in animal experiments,but only a few studies had been done on the dynamic pathologic and ultrastructural changes of the perihematoma in ICH patients. The unique contribution of our study is to investigate the dynamic pathologic and ultrastructural changes of the perihematoma in ICH patients and provide significant insights into how the pathophysiology and ultrastructures changed after ICH.Methods The written informed consents were obtained from the ICH patients or their relatives. 30 patients (the supertentorial hemotoma volume＞30 mi and the cerebellar hemotoma volume ＞10 mi) were divided into 8 groups according to the time passed after ICH:＜6 h (6 patients), 6 ～ 12 h (7 patients), 12 ～24 h (5 patients), 24～48 h (3 patients), 48 ～72 h (3 patients), 3 ～4 days group (3 patients), 5 days group (2 patients) and 8 days group ( 1 patient) and subjected to craniotomy for hemotoma evacuation. During the operation for the hemotoma's evacuation, a small amount of tissues that must be removed, which located at 1 cm near the hematoma, were taken as experimental groups; And the same tissues of 7 patients (＜12 h), which were far from the hemotoma on the operational way, were taken as control group. The pathologic and ultrastructral changes were observed.Results The tissues of the control group were almost normal while the damages of the tissues from the experimental groups were slight in ＜6 h groups, more severe after 6h and got to the maximum between 24 ～48 h , recovered gradually after 72 h, became similar to the 6 ～ 12 h group on 5 th day, got better on 8 th day and resembled the 6 h group.Conclusions The injury of the perihematoma occurred in early stage, reached the peak level between 24 and 48 hours after ICH; which was consistent to the clinical nervous functional deficits in the ICH patients.

Objective To explore the value of conventional and functional MRI image parameter in preoperative grade of pancreatic neuroendocrine tumours (pNET).Methods Data of 35 cases of pNET were retrospectively analyzed,including tumor size,intensity of T1WI's and T2WI's signal,enhancement feature,and apparent diffusion coefficients (ADC)value.All kinds of tumors were classified into G1 to G3 according to WHO's classification in 2010.Results There were 40 pNETs (mean size(4.2±2.9)cm) among the 35 patients (20 male,and 15 female).By WHO's tumor grading,the number of patients from G1 to G3 was 18(45％),12(30％),and 10(25 ％),respectively.A higher grade was associated with larger tumor size (P＜0.05).Intensity of T1WI and T2WI signal has no significance for predicting tumor grade.Enhancement feature had statistical significance on tumor's grade (P＜0.05).ADC value decreased with the increase of tumor's grade,(2.23±0.80) × 10-3,(1.80±0.73) × 10-3,(0.92±0.24) ×10-3 mm2/s respectively for tumors from grade G1 to G3.Conclusion Enhancement features of MRI image and ADC value are conducive to preoperative grading of pNET.

In the process of radical resection of abdominal malignant tumors, large blood vessels are often invaded, which not only increases the difficulty of operation, but also directly affects the curative effect and prognosis. As the concept of expanded radical surgery combined with vascular resection and reconstruction and related techniques have been gradually recognized, surgeons have begun to use autologous, allogeneic or artificial vessels to repair the defective blood vessels during surgery, so as to achieve the effect of radical surgery. However, due to the short comings of these materials, scholars have been looking for better alternatives. In view of the fact that the mesothelial cells of the peritoneum and the endothelial cells of the blood vessels have many similarities in embryology, histology and physiology, and peritoneum is also easier to obtain than autologous, allogeneic or artificial vessels. To make the autologous peritoneum into a patch for repairing the defective blood vessels is feasible in theoretical and technical. In this paper, we review the current research progress of autologous peritoneal patch to repair blood vessels of defect.

In the process of tumor growth, with the proliferation and expansion of cancer cells, the reconstruction of extracellular matrix (ECM) of cancer tissues, the restriction of surrounding tissues and the flow of cancer tissue interstitial fluid, the special stress environment is formed in the tumor tissues. Significant differences are found in the mechanical environment and mechanical characteristics of different regions of tumor tissues, that is, mechanical heterogeneity. The reseach shows that the mechanical properties of tumor tissue invasion frontier areas are more significant and complex. In particular, the epithelial-mesenchymal transition (EMT) of tumor cells also prefers to concentrate on this area. The mechanical stress generated by the invasion front can induce EMT of tumor cells through TWIST1, TGF-β, WNT and other force signal transduction pathways, and promote tumor cell invasion. From the perspective of tumor biomechanics, this review focuses on the relationship between mechanical heterogeneity of tumor cells and EMT, so as to provide the theoretical basis for mechanoenvironment-targeted therapy of tumors.

【Objective】 To study the effects of platelets donation frequency on iron, copper, zinc content and superoxide dismutase(SOD) activity in plasma of blood donors. 【Methods】 128 apheresis platelet donors from August 25, 2020 to August 25, 2021 in our center were divided into 4 groups according to the frequency of platelet donation: first-time donors(n=30) were enrolled as group 1, and donors with 2 to 7 donations(n=23), 8 to 14 donations(n=29), 15 to 24 donations(n=46) within the previous period were group 2, group 3 and group 4. All these donors were males, with the average age of 42 ± 8.3, and had not donated whole blood in the past two years. Inductively coupled plasma mass spectrometry(ICP-MS) was used to detect the content of copper, iron and zinc in plasma of different groups of platelet donors. The SOD activity was detected by WST colorimetric kit. All data were statistically analyzed by SPSS 19.0 software. 【Results】 Significant differences in the content of iron and copper, but no in zinc, were noticed in donors of different groups(P<0.05). Multiple comparison showed that first-time blood donors presented significantly higher iron content but significantly lower copper content than those of donors with 15 to 24 blood donations per year(P<0.05), and no significant difference was found in iron and copper content among other groups(P>0.05). There was no significant difference in zinc content between every two groups(P>0.05). The SOD inhibition rate of blood donors in different groups was not significantly different. 【Conclusion】 The content of plasma iron, copper, and zinc and the SOD activity were not significantly affected if platelet donations were less than 15 times within a year. For those donated platelets more than 15 times within a year, the content of iron was found to decrease and copper to increase. It is suggested that platelet donations more than 15 times is correlated with the content of iron and copper in plasma of blood donors. Therefore, the proportion of iron-rich food should be appropriately increased in the daily diet for high-frequency(≥15 times per year) apheresis platelet donors after blood donation.