Objective To investigate optimum dose of anesthesia in pediatric axillary brachial plexus branch block under ultrasound-guided. Methods Forty-eight children from May 2012 to May 2013 in hand surgery of our hospital,whose age was from 6 to 12 years,were randomly divided into four groups, each group has 12 cases. The doses of Ropivacaine were different in different groups. Group A was 0. 25 mL/kg,group B was 0. 2 mL/kg,group C was 0. 15 mL/kg,group D was 0. 10 mL/kg. And Ketamine was added to the treatment ac-cording to the incidence of anesthesia intraoperative. Evaluating the effect of anesthesia according to the situation of nerve block,observing an-esthesia duration time,dosage of anesthesia and rates of complications. Results The blocking effect of group A,B and C in each nerve area was correspond after 30 min,and anesthesia efficiency was higher than group D,but additional rate was lower than group D,the differences were statistically significant (P<0. 05). The block time in group D was shorter than the other groups,and the dose of Ketamine was most, and the block onset,perfect time were longer than the other groups (P<0. 05). But the differences between group A,B,C were not signifi-cant. Two cases in group D converted to general anesthesia. Four groups did not occur complication related narcotic drug. Conclusion In pediatric brachial plexus block used Ropivacaine under ultrasound-guided would get complete branch block,the exact effect of anesthesia, smaller dosage of local anesthesia. When the dosage of Ropivacaine was 0. 15 mL/kg could achieve a better anesthesia effect.

Objective To design an adjustable frame for four limbs disinfection, and applied it to clinic, to prevent skin damage of eatagmatic limb due to heighten the limb for the preoperative disin-fection.Methods 180 patients who need to heighten limb for diaplasis were divided into the observation group and the control group averagely according to the sequence of operation time.Patients in the observa-tion group were heighten limbs by using the adjustable frame, while the control group were heighten limbs onto the fluid frame by traditional methods.Skin lesions, the contamination of the limb and the time for disinfection were observed.Results Skin lesions of the observation group and the control group were 2% and 20%, re-spectively,the difference was statistically significant.There was no case in the observation group was contami-nated and 16 cases were contaminated in the control group, the difference was statistically significant.The aver-age time for disinfection in the observation group was (17.6 ± 2.4)minutes, in the control group,(21.3 ± 3.2) minutes, the difference was also statistically significant.Conclusions Using the adjustable frame for limbs disinfection can reduce the skin damage, shorten the disinfection time and improve work efficiency.

Objective To evaluate the effects of surgical treatment of acute deep vein thrombosis (DV T) of lower extremity. Methods Thirty-six patients with a cute DVT of lower extremity were treated by thrombectomy with thrombolytic,a nticoagulant and compression on the affected lower extremity during and after op eration. Results No death and serious complications happened i n this series. Thirty-one patients were followed-up for 2 to 20 months with a n average of 9 months. Symptoms disappeared totally in 23 patients , 8 patien ts had slight edema in the lower extremities. Conclusions Com bination of thrombectomy the thrombolytic and anticoagulant agent,and comp ression of the affected lower extremity is a safe and effective method in the t reatment of acute DVT of lower extremity.

Magnesium and its alloy are used for the most potential endovascular stent material due to their excellent mechanical capabilities, adjustable corrosive properties, the little side effects of the materials and their degradation products. The in vito degradation rate of the current magnesium and its alloy as endovascular stent is very quickly so that the artery is not supported long enough to prevent negative remodeling. This review detailed the approach to enhance the corrosion resistance, in vitro corrosion rate measurement of magnesium and its alloy, as well as the in vito corrosion research when as the endovascular stents.
Alloys ; chemistry ; Biocompatible Materials ; Corrosion ; Humans ; Magnesium ; chemistry ; Materials Testing ; Stents

Objective To study the management of vascular injury.Methods Retrospective analysis was made on the clinical data of 59 cases of vascular injury,including 55 cases of vascular injury in neck and(extremity) and 4 cases of portal vein and vena cava injury.Among them,21 cases had femoral artery injury with infection and 4 cases had vascular injury due to intervention therapy.All patients with vascular wound of extremity or neck had undergone hemostasis by compression and antishock treament before hospital admission.All cases of femoral artery injury with infection underwent hemostasis by arterial ligation and incision and(drainage) of abscess.Vascular anastomosis was performed in 11 cases,vascular grafting in 12 cases,and(vascular) repair in 14 cases.Results There were 2 deaths.5 cases had amputation(including a case of(femoral) embolism due to intervention trerapy).Postoperative intermittent claudication,decreased skin(temperature) and other signs of ischemia occurred in 21 cases of femoral artery injury with infection,but none developed limb gangrene. The other cases were discharged in good health.Conclusions In the treatment of vascular injury,wound hemostasis and antishock treatment should be done first to save the patient′s life and the management of the vascular injury depends on the situation,with the aim to try by all means to save the extremity.Vascular reconstruction is the main method for treatment of vassular injury.Vascular ligation can be done in cases of femoral artery injury with infection.

Objective To summarize the experience in the diagnosis and treatment of hepatic trauma. Methods The clinical data of 260 patients with hepatic trauma admitted from January 1988 to December 2007 were retrospectively reviewed with regard to degree of trauma, treatment methods, therapeutical effects, complications and SO on. Results One hundred and fifty-three eases were treated by operative management,1 07 cases by nonoperative management.236 cases were cured,24 cases died,and the case fatality rate was 10.2%.There were no death among 139 patients with hepatic trauma grades Ⅰ～Ⅱ,22 death among 119 grades Ⅲ～Ⅴ patients, all death of 2 in grade VI, which demonstrated the correlation between death and hepatic trauma grade was statistically significant. Complications appeared in 82 eases, mainly including Secondary hemorrhage, abdominal infection and so on. Conclusions Nonoperative management is suitable for hepatic trauma with stable hemodynamics. Operative management is rapidly selected when the hemodynamics aren't stable. The cooperation of many specialities can enlarge the application of nonoperative management and decrease complications.

Objective To study the immunoregulatory effects of emodin on macrophages during Brucella infection and to provide theoretical and experimental basis for developing new drugs to treat brucello-sis. Methods Bone marrow cells were isolated from BALB/c mice and cultured with MG-CSF to induce differentiation. Flow cytometry was used to detect the differentiation of bone marrow cells into macrophages (MΦ) by using FITC-labeled mouse anti-F4/80 antibody and PE-labeled anti-CD11b antibody. MTT meth-od was used to detect the influences of various concentrations of emodin on the survival rate of MΦ. Doxy-cycline was used as the control to compare half maximal inhibitory concentrations (IC50) of the two drugs. MΦ were cultured with Brucella at a ratio of 100 : 1 for 4 h. MΦ and Brucella were further cultured for 1, 6,12,24 and 48 h after adding emodin. Effects of emodin on the survival of MΦ were analyzed by colony counting method. ELISA was performed to detect the levels of TNF-α, IL-6 and IFN-γ in culture superna-tants. Results On day 8 of culturing,91.28% of bone marrow cells differentiated into macrophages. The IC50of emodin(608.4 μg/ml) was significantly higher than that of doxycycline(225.5 μg/ml). The logC-FU values of emodin stimulation groups (6,12,24 and 48 h) were significantly lower than those of blank control groups. Among all emodin stimulation groups, the 24 h group had the lowest logCFU value, which was also lower than that of the doxycycline treatment group. The levels of TNF-α,IL-6 and IFN-γ in 6,12 and 24 h emodin stimulations group increased significantly as compared with those of the corresponding con-trol groups. The levels of TNF-α, IL-6 and IFN-γ peaked at 24 h of culturing Brucella-infected MΦ with emodin. No significant difference in IFN-γ level was found between the 12 and 24 h emodin stimulation groups [(74.233 ±4.416) pg/ml vs (78.328 ±8.932) pg/ml]. Conclusion Emodin may enhance the ability of macrophages to kill Brucella through promoting the expression of TNF-α,IL-6 and IFN-γ.

Background/Aims: Existing hepatocellular carcinoma (HCC) prediction models are derived mainly from pretreatment or early on-treatment parameters. We reassessed the dynamic changes in the performance of 17 HCC models in patients with chronic hepatitis B (CHB) during long-term antiviral therapy (AVT). Methods: Among 987 CHB patients administered long-term entecavir therapy, 660 patients had 8 years of follow-up data. Model scores were calculated using on-treatment values at 2.5, 3, 3.5, 4, 4.5, and 5 years of AVT to predict threeyear HCC occurrence. Model performance was assessed with the area under the receiver operating curve (AUROC). The original model cutoffs to distinguish different levels of HCC risk were evaluated by the log-rank test. Results: The AUROCs of the 17 HCC models varied from 0.51 to 0.78 when using on-treatment scores from years 2.5 to 5. Models with a cirrhosis variable showed numerically higher AUROCs (pooled at 0.65–0.73 for treated, untreated, or mixed treatment models) than models without (treated or mixed models: 0.61–0.68; untreated models: 0.51–0.59). Stratification into low, intermediate, and high-risk levels using the original cutoff values could no longer reflect the true HCC incidence using scores after 3.5 years of AVT for models without cirrhosis and after 4 years of AVT for models with cirrhosis. Conclusions The performance of existing HCC prediction models, especially models without the cirrhosis variable, decreased in CHB patients on long-term AVT. The optimization of existing models or the development of novel models for better HCC prediction during long-term AVT is warranted.

Objective: To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Methods: Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations. Results: Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Conclusion Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.