Objective To observe the effect of propofol target-controlled infusion on stress response during nasoscopic procedures.Methods Totally 40 patients with ASA gradesⅠ-Ⅱ scheduled for the nasoscopic operation ware randomly divided into two groups:Group A(propofol continuously injection,2.5 mg?kg-1,n=20)and Group B(propofol target-controlled infusion,4 ?g?ml-1,n=20).The operations were all performed under general anesthesia.Venous blood samples were taken to measure cortisol and blood glucose at three time points:before operation,at 30 min after the operation started,and 60 min after the endotracheal catheter was withdrawn.Meanwhile,HR and MAP of the patients were recorded.Results At both 30 min after the operation started and and 60 min after the endotracheal catheter was withdrawn,Group A showed significantly higher MAP and serum levels of glucose and cortisol than Group B.At 30 min after the operation started:HR:(73?8)/min vs(65?13)/min,t=2.344,P=0.024;MAP:(74?7)mm Hg vs(68?7)mm Hg,t=2.711,P=0.010;blood glucose:(6.28?0.11)mmol/ml vs(5.31?0.15)mmol/ml,t=23.321,P=0.000;cortisol:(125.3?11.5)ng/ml vs(89.6?9.9)ng/ml,t=10.521,P=0.000.At 60 min after the endotracheal catheter was withdrawn:MAP:(79?6)mm Hg vs(73?8)mm Hg,t=2.683,P=0.011;blood glucose:(6.18?0.09)mmol/ml vs(5.62?0.16)mmol/ml,t=10.082,P=0.000;cortisol:(169.1?16.3)ng/ml vs(149.5?15.3)ng/ml,t=3.921,P=0.000.Conclusion Propofol target-controlled infusion can inhibit the stress response caused by nasoscopic operation.

Animals ; Animals, Newborn ; Cell Survival ; drug effects ; Cells, Cultured ; Cerebral Cortex ; cytology ; drug effects ; Dose-Response Relationship, Drug ; Neurites ; drug effects ; Neurons ; cytology ; drug effects ; Organometallic Compounds ; toxicity ; Rats ; Rats, Wistar

Objective To investigate the factors affecting the protective effects of morphine preconditioning on murine hippocampal neurons against anoxia/reoxygenation (A/R) injury and the underlying mechanisms.Methods Hippocampal slices (400 μm thick) were prepared using hippocampi isolated from decapitated mice. A/R injury was simulated in vitro using artificial cerebral spinal fluid (ACSF) deprived of O_2 and glucose for 20 min followed by reoxygenation and glucose supply for 2 h. The experiment was performed in 4 parts: I .The slices were incubated with 5 different concentrations of morphine (0.1, 0.3, 0.5, 1.0, 3.0, 10.0 /μmol/L) for 30 min at 30 min before A/R; Ⅱ. The slices were incubated with morphine 3.0 /μmol/L for 5 different periods of time (5, 15, 30, 45, 60 min) at 30 min before A/R; Ⅲ. The slices were incubated with morphine 3.0 μmol/L for 30 min followed by A/R at 6 different intervals (0, 5, 15,30,60, 120 min); Ⅳ. The slices were incubated with (a) chelerythrine (a non-selective PKC antagonist) 10 /μmol/L or (b) εVl-2 (a selective nPKCe isoform antagonist) 2 μmol/L or (c) AIP 2 μmol/L (a selective CaMK Ⅱ antagonist) or (d) MK-801 10 μmol/L (a non-competitive NMDA receptor blocker) for 30 min and then for another 30 min together with morphine 3.0 μmol/L before A/R at 30 min interval. The survival rates of the hippocampal neurons were assessed by TTC staining. Results Neuronal survival rates were significantly higher in morphine preconditioning groups which preconditioned with morphine (0.5-10.0 μmol/L) for 15-60 min at an interval of 0-60 min before A/R than in A/R group. Increase in neuronal survival rate induced by morphine preconditioning was partially blocked by chelerythrine or εV1-2 or AIP or MK-801. Conclusion Preconditioning with appropriate concentrations of morphine (0.5-10.0 μmol/L) for appropriate period of time (15-60 min) at appropriate interval (within 60 min) before A/R can protect hippocampal neurons against A/R injury through activation of nPKCε, NMDA receptor and CaMKⅡ.

Objective To investigate the influence of preterm premature rupture of membranes (PPROM) on neurological development of preterm infants.Methods The preterm infants were classified into 2 groups( PPROM group and control group).The neonatal behavioral neurological assessment (NBNA) and CDCC of infants in two groups were measured and compared after retrieved:gestational age 40 weeks,3 months and 6 months.Results Psycho-moter developmental index(PDI) of PPROM group after retrieved gestational age 3,6 months was significantly lower than that of control group(Pa

Objective To investigate the risk factors of pulmonary fungal infection in intensive care unit(ICU),and discuss the strategy of prevention and treatment.Methods Forty children with pulmonary fungal infection in ICU of Wuhan Children's Hospital from Jan.2003 to Jan.2007 were analyzed retrospectively,including primarily diseases,application of antibiotics,adrenal cortical hormone and virulence operation,therapy and turnover.Results All children were accepted the therapies of broad spectrum antibiotics and glucocorticoids for long time before definite diagnosis of pulmonary fungal infection.Seventy-five percent children were received invasive operations or therapies.Their average time of stayed in hospital was 37.8 d.The clinical symptoms and imaging examinations were untypical.Blastomyces albicans was the main pathogen.After the antifungal agents and supportive treatment used in time,35 cases(87.5%) were cured and 5 cases(12.5%) died.Conclusions The major risk factors of children pulmonary fungal infection are long-time use of broad spectrum antibiotics and glucocorticoids.The pulmonary fungal infection can decrease by rational use of broad spectrum antibiotics and glucocorticoids,decreasing the unnecessary invasive operations,strengthening the supportive therapies of micro-ecosystem,and applying the antifungal agents in time.

0.05).But after the treatment,there were significant increases in pa(O2),SaO2 and PCIS(Pa0.05).Conclusions Early application of hyperoxia liquid could decrease multiple organ anoxia and the damage of lipid peroxidation.It has obviously protective effects on multiple organ damage during ischemic reperfusion in infants with muggy syndrome.

Objective To evaluate the treament of central retinal artery occlusion by thrombolysis infusion via super selective ophthalmic artery catheterization.Design Retrospective,observational case series.Participants 21 eyes of 21 patients with CRAO. Methods 21 patients with CRAO were diagnosed by stereoscopic color fundus photography and flouorescein fundus angiography, and were treated by urokinase infusion via super select ophthalmic artery catheterization seldinger technique.Main Outcome Measures Visual acuity and the postoperative complications.Results In the 21 patients,10 had showed the occlusion of ophthalmic arterial trunk by super selective internal carotid artery angiography,the others can be found the appearance of ophthalmic arterial trunk and all patients had undergone thrombolysis therapy successfully.Imaging times of central retinal artery before and after thrombolysis infusion treatment are 38.18?10.86 seconds,12.65?3.30 seconds(t=-11.89,P=0.000).Mean foflow-up time is 3.23?1.26 months.After the treatment,the visual acuity was more than 0.25 in 4 patients,improved to different extent in 9 and remained unchanged in 8. Conclusions Super selective arterial catheterization with thrombolysis for CRAO can improve the visual acuity of the patients,a speedy execution of all internal,neurological,and ophthalmology diagnostic measures;and a prompt therapy are necessary.

Bronchitis ; diagnosis ; Diagnostic Errors ; Humans ; Infant ; Male

Objective To evaluate the accuracy of endoscopic ultrasonography (EUS) in preoperative TNM staging of gastric cancer.Methods EUS and abdominal helical computed tomography (HCT) were performed one week before the surgery in 126 gastric cancer patients who would receive surgery to determine the depth of tumor invasion (T),lymph node metastasis (N) and distant metastasis (M) stage and which were also compared with pathologic TNM stage after surgery to evaluate the accuracy of EUS in TNM staging.Pairing x2 test was performed for data analysis.Results Compared with pathologic TNM stage after surgery,the accuracy of EUS in T1,T2,T3 and T4 staging of gastric cancer were 84.6％,14/18,82.0 ％ and 85.7％ respectively.The accuracy of EUSin N0,N1,N2 and N3 staging of gastric cancer were 74.2％,75.0％,57.9％ and 5/17 respectively.The accuracy of HCT in N0,N1,N2 and N3 staging of gastric cancer were 80.6％,75.0％,73.7％ and 12/17 respectively.The accuracy of EUS was similar to HCT in N0 and N1 stage.For N2 and N3 stage,HCT was obviously better than EUS (x2 =4.89,P=0.027; x2 =13.88,P＜0.01).The accuracy of EUS and HCT in M1 stage of gastric cancer were 36.4％ and 95.5％respectively,HCT was better than EUS in M1 determination (x2 =7.90,P=0.001).Conclusions The clinical application value of EUS in the preoperative gastric cancer T staging was high,however the accuracy in determining lymph node metastasis N2 and N3 staging and distant metastasis M staging should be improved.In order to acquire more accurate preoperative TNM stage to guide the treatment selection,the combination with HCT examination is necessary.

ObjectiveTo evaluate the effect of facial fat tissue grafting and remodeling with SMAS suspension in facial rejuvenation.MethodsThe treatment process of 12 patients with facial fat tissue grafting and SMAS-suspended rhytidectomy were reviewed retrospectively,the surgical operative procedure and treatment results of facial liposuction and autologous fat grafting with SMAS-suspended rhytidectomy were analyzed and evaluated.Results12 patients underwent facial liposuction,SMAS-suspended rhytidectomy and autologous free fat tissue grafting and remodeling.All the followed-up cases obtained good results without complications.ConclusionsCombined surgery of facial fat tissue remodel with SMAS-suspended rhytidectomy not only corrects the soft tissue laxity,but also modifies the faical volume loss.It solves the aging problems in different angles through soft tissue lift and volume restoration.It is a relatively ideal surgical method of facialplasty for those aged patients.