Objective To evaluate the effects of dexmedetomidine on the activity of nuclear factor kappa B (NF-κB) in neutrophil granulocytes during one-lung ventilation in the patients undergoing pulmonary lobectomy.Methods Thirty-eight ASA physical status Ⅰ or Ⅱ patients,aged 40-64 yr,weighing 50-75 kg,scheduled for elective pulmonary lobectomy,were randomized into 2 groups (n =19 each) using a random number table:control group (group C) and dexmedetomidine group (group D).In group D,dexmedetomidine 1.0 μg/kg was infused intravenously over 15 min before induction of anesthesia,followed by infusion at a rate of 0.5 μg· kg-1 · h-1 until 30 min before the end of operation.The equal volume of normal saline was given in group C.At 5 min after intubation,0,30 and 60 min of one-lung ventilation,0 and 30 min of two-lung ventilation,and 30 min after operation,blood samples were taken from the radial artery for blood gas analysis and for measurement of plasma concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).The oxygenation index and respiratory index were calculated.The nuclear protein of neutrophil granulocytes was extracted for measurement of NF-κB DNA-binding activity.Results Compared with group C,the respiratory index,plasma concentrations of TNF-α and IL-6 and NF-κB DNA-binding activity were significantly decreased,and no significant difference was found in the oxygenation index in group D.Conclusion Dexmedetomidine can inhibit the activation of NF-κB in neutrophil granulocytes and is helpful in reducing the systemic inflammatory responses during one-lung ventilation in the patients undergoing pulmonary lobectomy.

Objective To observe the effects and safety of oxycodone hydrochloride combined with parecoxib sodium in preventing postoperative hyperalgesia induced by remifentanil. Methods Eighty-eight ASA Ⅰ or Ⅱ patients undergoing elective laparoscopic myomectomy surgery were randomly divided into four groups (C,O,P,PO) with 22 cases in each group. Patients in group C,O,P,PO were given with 10 mL saline, 0.1 mg?kg-1 oxycodone hydrochloride, 40 mg parecoxib sodium, 0.1 mg?kg-1 oxycodone hydrochloride and 40 mg parecoxib sodium 30 min before the end of the surgery, respectively. The VAS scores were recorded at the end of surgery 30 min, 1 h, 2 h, 4 h, 8 h, and the cases of agitation, rigor, vomiting and increasing of analgesics were recorded. Results Compared with group C, the VAS scores in group O, P,PO were significantly lower(P<0.05). The VAS scores in group PO were lower than those in group O,P(P<0.05). The cases of agitation and rigor in group PO (0.0%, 5.0%) were less than those in group C (45.0%,23.0%) (P<0.05). The increased doses of analgesics in group PO(0) were less than those in groups C (12), group P (5), and group O (5)(P<0.05). Conclusion Oxycodone hydrochloride combined with parecoxib sodium can effectively prevent postoperative hyperalgesia induced by remifentanil, and reduce the incidence of postoperative agitation.

The AB 7300 Real-time PCR Systems in our hospital have been detected malfunction for three times in a short term. The detection indicated the major reason for the malfunction attributed to the fuse of the solder of the COVER at the same position with the serial number 4344490 D1. This article explicitly introduces how to detect and maintain this equipment. It serves as a good reference for colleagues. Meanwhile the author raises five issues for further exploration and discussion.
Equipment Failure Analysis ; Maintenance ; methods ; Polymerase Chain Reaction ; instrumentation ; methods

Objective:To compare the effects of dexmedetomidine combined with propofol on anesthesia and thromboelastography in patients undergoing radical gastrectomy.Methods:From September 2017 to December 2019, 120 patients undergoing radical gastrectomy in Chaoyang Central Hospital were prospectively selected and divided into control group and observation group according to random number table method, with 60 cases in each group.The two groups used the same drugs before induction and the same way of anesthesia induction. During the maintenance of anesthesia, remifentanil and propofol were injected intravenously in the control group, and dexmedetomidine was injected in the observation group on the basis of the control group. The indexes of thromboelastography, preoperative and postoperative cellular immune function, postoperative analgesic effect [Visual Analogue Scale (VAS)], Ramsay sedation score, and postoperative adverse reactions were compared between the two groups at different times.Results:The reaction time of coagulation factor (R) and fibrinogen (K) in the two groups decreased 3 hours after operation, and those in the observation group were lower than those in the control group (all P<0.05); The maximum thrombus amplitude (MA) of the two groups increased 3 hours after operation, and MA in the observation group was higher than that in the control group (all P<0.05). Compared with that before operation, the VAS scores and Ramsay sedation scores in the control group and the observation group at 24 h and 48 h after operation were significantly lower (all P<0.05), and the VAS scores and Ramsay sedation scores in the observation group at 24 h and 48 h after operation were significantly lower than those in the control group (all P<0.05). Compared with that before operation, the CD4 +, CD8 +, CD4 + /CD8 + in the control group and the observation group were improved at 6 h and 48 h after operation (all P<0.05), and the improvement in the observation group was significantly better than that in the control group at 6 h and 48 h after operation (all P<0.05). The incidence of adverse reactions in the control group was 6.67%(4/60), which was slightly higher than that in the observation group of 5.00%(3/60), but the difference was not statistically significant ( P>0.05). Conclusions:Compared with propofol and remifentanil alone, combined application of dexmedetomidine can help patients undergoing radical gastrectomy for gastric cancer to achieve better analgesic effect, improve the blood coagulation state of patients, and play a better regulatory role on cellular immune function, which is worthy of further promotion in clinic.

Objective To investigate the effect of acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction on hemiplegia,hemorheology and neurotrophic factors in pa-tients with cerebral infarction differentiated as type of Qi deficiency and blood stasis.Methods A to-tal of 84 hospitalized patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis from March 2018 to June 2023 were selected as research objects,and they were randomly divid-ed into observation group and control group,with 42 cases in each group.The control group was con-ducted with acupuncture and routine treatment,while the observation group was conducted with modi-fied Buyang Huanwu Decoction on the basis of the control group.Clinical efficacy after 2 weeks of treatment as well as the scores of main symptoms,neurological function,limb function,hemorheologi-cal indicators and levels of neurotrophic factors before and after treatment were compared between two groups.Results After 2 weeks of treatment,the total effective rate of the observation group was sig-nificantly higher than that of the control group(P＜0.05);after treatment,the scores of symptoms such as hemiplegia,deviated mouth and awkward speech in both groups decreased significantly when compared to those before treatment,and these scores in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the score of the National Institutes of Health Stroke Scale(NIHSS)in both groups decreased significantly when compared to that before treat-ment,and the score in the observation group was significantly lower than that in the control group(P＜0.05);the score of the Motor Function Assessment Scale(Fugl-Meyer)after treatment in both groups was significantly higher than that before treatment,and the observation group was significant-ly higher than that in the control group(P＜0.05).After treatment,the plasma viscosity,red blood cell aggregation index,whole blood high shear viscosity and whole blood low shear viscosity in both groups decreased significantly when compared to those before treatment,and these indexes in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the levels of serum brain derived neurotrophic factor(BDNF),nerve growth factor(NGF)and glial cell line-derived neurotrophic factor(GDNF)in both groups increased significant-ly when compared to those before treatment,and the levels of these indexes in the observation group were significantly higher than those in the control group(P＜0.05).Conclusion Acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction can enhance the therapeutic effect for patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis,im-prove clinical symptoms,repair nerve damage,and promote the recovery of limb function.

Objective To investigate the effect of acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction on hemiplegia,hemorheology and neurotrophic factors in pa-tients with cerebral infarction differentiated as type of Qi deficiency and blood stasis.Methods A to-tal of 84 hospitalized patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis from March 2018 to June 2023 were selected as research objects,and they were randomly divid-ed into observation group and control group,with 42 cases in each group.The control group was con-ducted with acupuncture and routine treatment,while the observation group was conducted with modi-fied Buyang Huanwu Decoction on the basis of the control group.Clinical efficacy after 2 weeks of treatment as well as the scores of main symptoms,neurological function,limb function,hemorheologi-cal indicators and levels of neurotrophic factors before and after treatment were compared between two groups.Results After 2 weeks of treatment,the total effective rate of the observation group was sig-nificantly higher than that of the control group(P＜0.05);after treatment,the scores of symptoms such as hemiplegia,deviated mouth and awkward speech in both groups decreased significantly when compared to those before treatment,and these scores in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the score of the National Institutes of Health Stroke Scale(NIHSS)in both groups decreased significantly when compared to that before treat-ment,and the score in the observation group was significantly lower than that in the control group(P＜0.05);the score of the Motor Function Assessment Scale(Fugl-Meyer)after treatment in both groups was significantly higher than that before treatment,and the observation group was significant-ly higher than that in the control group(P＜0.05).After treatment,the plasma viscosity,red blood cell aggregation index,whole blood high shear viscosity and whole blood low shear viscosity in both groups decreased significantly when compared to those before treatment,and these indexes in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the levels of serum brain derived neurotrophic factor(BDNF),nerve growth factor(NGF)and glial cell line-derived neurotrophic factor(GDNF)in both groups increased significant-ly when compared to those before treatment,and the levels of these indexes in the observation group were significantly higher than those in the control group(P＜0.05).Conclusion Acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction can enhance the therapeutic effect for patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis,im-prove clinical symptoms,repair nerve damage,and promote the recovery of limb function.