[Objective] To investigate the effect of sevoflurane and isoflurane anesthesia on the renal function of patients with severe fracture after surgery.[Methods] Sixty-two patients with severe fracture who needed surgery were enrolled and all received general anesthesia.All the patients were divided by random digits table method into two groups with 31 cases each:sevoflurane group(anesthesia maintenance with 1.5％-3.0％ sevoflurane)and isoflurane group(anesthesia maintenance with 1.5％-3.0％ isoflurane).The patients in two groups received 0.1-0.2 μg/(kg·min)remifentanll continuous intravenous infusion and atracuurium intermittent intravenous injection for anesthesia maintenance.Serum creatinine(SCr)and blood urea nitrogen(BUN)in two groups after surgery were compared,as well as the number of hemodialysis.[Results]SCr and BUN at 1,3,7 d after surgery in two groups were significantly lower than those before surgery[seveflurane group:(517 ± 187),(163 ± 110),(103 ± 99)μ mol/L vs.(853 ± 220)μmol/L,(17.1 ± 7.8),(9.5 ± 4.1),(9.7 ± 3.8)mmol/L vs.(21.8 ± 9.3)mmol/L;isoflurane group:(539 ± 188),(136 ± 108),(101 ± 95)μ mol/L vs.(881 ± 220)μmol/L,(17.5 ± 7.4),(9.5 ± 3.5),(9.8 ± 3.3)mmol/Lvs.(20.0 ± 8.9)mmol/L](P ＜ 0.05).SCr and BUN between two groups at every time point after surgery had no statistical significance(P ＞ 0.05).There was 1 case(3.2％)in sevoflurane group needed hemodialysis within 7 d after surgery,as well as in isoflurane group,and there was no statistical significance between two groups(P＞0.05).[Conclusions] For patients with severe fracture who need general anesthesia and surgery,sevoflurane and isoflurane both have no significant adverse reaction to renal function.Therefore,it is acceptable for the patients to use sevoflurane for anesthesia and it is worthy of clinical popularization and application.

OBJECTIVE: To explore the clinical and genetic characteristics of a child with MEGDEL syndrome. METHODS: Clinical data of the child was reviewed. Peripheral blood samples of the child and his parents were collected. Mitochondrial genome and the whole exome of the child were analyzed by next-generation sequencing. Candidate variants and its origin were verified by Sanger sequencing and fluorescence quantitative PCR. RESULTS: The patient, a 2-year-and-6-month-old male, has featured hypoglycemia, mental and motor retardation with regression. Cranial MRI showed bilateral putamen damage suggestive of Leigh syndrome. Testing of urine organic acid indicated that the level of 3-methylpentenoic acid was slightly increased. Whole exome sequencing revealed that the child has harbored heterozygous deletion of exons 6 to 17 and c.307A>T nonsense variant of the SERAC1 gene, which were respectively inherited from his parents who were asymptomatic. Treatment with Levocarnitine, vitamin B1, vitamin B2, coenzyme Q10, baclofen and glucuronolactone resulted in improvement of sleep and mental state. CONCLUSION A case of MEGDEL syndrome without deafness was diagnosed. Discovery of the nonsense mutation and large fragment deletion have enriched the spectrum of SERAC1 gene variants.
Child, Preschool ; Hearing Loss, Sensorineural/genetics* ; Humans ; Leigh Disease ; Male ; Metabolism, Inborn Errors/genetics* ; Molecular Biology ; Mutation

OBJECTIVE: To study the effect of nanohydroxyapatite (nHA) for promoting surface mineralization of demineralized dentin discs and adsorption of lead ions in simulated sewage water. METHODS: Sixty dentin disks were prepared from freshly extracted teeth with intact crown (including 30 premolars and 30 molars) and treated with 10% citric acid for 2 min to simulate dentinal tubules with dentin hypersensitivity. The etched dentin discs were brushed with distilled water, 0.2 g HA or 0.2 g nHA for 2 min twice a day for 7 consecutive days, after which scanning electron microscopy (SEM) was performed and calcium and phosphorus contents in the dentin discs were detected using EDS. Lead ion adsorption capacities of HA and nHA were tested by mixing 1 mL serial concentrations of HA and nHA suspensions with 50 mL lead ion solutions (1.0 mg/L). After 24 h, the residual lead ion concentration in the supernatant was measured using ICP to calculate lead ion adsorption rate and adsorption capacity of the materials. RESULTS: SEM showed a smooth surface and empty dentin tubules in the acid- etched dentin dics. The dentin dics treated with HA were covered with masses of particles that loosely attached to the surface, and the diameter of the dentin tubules was reduced. In nHA group, the dentin discs showed a fine and homogeneous surface clogging with a tight attachment, and the dentin tubule diameter was obviously reduced. Daily brushing with HA and nHA, especially the latter, significantly increased calcium and phosphorus contents on the surface of the dentin dics ( < 0.000). In lead ion adsorption experiment, the lead ion adsorption rate of HA decreased as its concentration increased with the highest adsorption rate of 83.01%; the adsorption rate of nHA increased with its concentration until the adsorption equilibrium was reached, and its highest adsorption rate was 98.79%. A good liner relationship was found between the adsorption ability and concentration of HA. CONCLUSIONS Compared with HA, nHA has a better capacity for surface mineralization of acid-etched dentin discs and also a better ability of lead ion adsorption.