Objective To compare the effect of epidural anesthesia combined with general anesthesia and general anesthesia in upper abdominal and thoracic tumor surgery anesthesia. Methods A total of 80 cases of ASAⅠ-IIelective surgery with the abdomen and chest patients were selected from July 2013 to December 2014 in our hospital, and divided into two groups, each of 40 cases, group A was treated with epidural block joint general anesthesia, group B was treated with general anesthesia. The amount of the anesthesia drug, anesthesia recovery and hemodynamic changes at different times of two groups were compared. Results Propofol, fentanyl and cis-atracurium dosage of group A were significantly reduced than group B, spontaneous breathing surgery recovery time, extubation time and fully awake time were significantly shorter, the occurrence of emergence agitation pain was significantly lower, the differences were statistically significant(P<0.05). HR in group B on T2 was significantly faster than group A, HR, SBP, DBP on T3 and T4 were significantly higher than that in group A, the differences were statistically significant (P<0.05). Conclusion Compare with general anesthesia, anesthesia of intraoperative hemodynamic stability, can suppress the stress response to surgery, recovery after extubation time is shorter than the general anesthesia group, perioperative application is more security and stability.

OBJECTIVE: To explore the genetic basis, clinical phenotype and pathogenesis for a child with mosaicism ring chromosome 4. METHODS: Clinical data of the child was collected. Peripheral blood chromosomal karyotype G banding analysis, chromosomal microarray analysis (CMA), fluorescence in situ hybridization (FISH) were carried out for the child, in addition with a review of the literature. RESULTS: The child was born full-term with low birth weight, facial dysmorphism, patent ductus arteriosus and ventricular septal defect. His karyotype was determined as mos46,XY,r(4)(p16.3q35.2)[259]/45,XY,-4[25]/47,XY,r(4)(p16.3q35.2), +r(4)(p16.3q35.2)[8]/46,XY,der(4)del(4)(p16.3)inv(4)(p16.3q31.1)[6]/46,XY,dic?r(4;4)(p16.3q35.2;p16.3q35.2)[4]/48,XY,r(4)(p16.3q35.2),+r(4)(p16.3q35.2)×2[3]/46,XY,r(4)(p1?q2?)[2]; CMA result was arr[GRCH37]4p16.3(68 345-2 981 614)×1; FISH result was 45,XY,-4[12]/45,XY,-4×2,+mar1.ish r1(4)(WHS-,D4Z1+)[1]/ 46,XY,-4,+mar1.ishr1(4)(WHS-,D4Z1+)[73]/46,XY,-4,+mar2.ishr2(4)(WHS-,D4Z1++)[1]/47,XY,-4,+mar1×2.ishr1(4) (WHS-, D4Z1+)×2[4]/46,XY,del(4)(p16.3).ish del(4)(p16.3)(WHS-,D4Z1+)[9]. CONCLUSION In this case, the ring chromosome 4 as a de novo variant has produced a number of cell lines during embryonic development and given rise to mosaicism. The clinical phenotype of ring chromosome 4 is variable. The instability of the ring chromosome itself, presence of mosaicism, chromosome breakpoint and range of deletion and/or duplication may all affect the ultimate phenotype.
Humans ; Pregnancy ; Female ; Ring Chromosomes ; In Situ Hybridization, Fluorescence ; Karyotyping ; Karyotype ; Mosaicism