Objective To observe the clinical effect and safety of using Sufentanil in children's enteroscopy under general anesthesia. Methods 80 ASA Ⅰ ~ Ⅱ children, aged 5~10 years, weighed 18~35 kg, who scheduled for enteroscopy, were randomly divided into two groups: group Sufentanil (group S, n = 40) and group Fentanyl (group F, n = 40). Group S were given Sufentanil 0.2 μg/kg and Propofol 2.50 mg/kg in intravenous injection, group F were given Fentanyl 2.0 μg/kg and Propofol 2.50 mg/kg in intravenous injection. Proseal laryngeal mask airway (PLMA) was inserted when eyelash reflex disappeared and the submaxilla was loosen, and Propofol 6.00 ~8.00 mg/(kg?h) and 2% ~ 3% Sevoflurane inhalation for anesthesia maintenance. Parameters of HR, MAP, SpO2 and RR were recorded at different times: before induction (T0), insertion of PLMA (T1), enteroscopy to the ileocecal valve (T2) and end of operation (T3). Also, time of induction and recovery, pain on injection, perioperative body movement, intraoperative regurgitation, glossocoma, nausea and vomiting, throat pain and agitation were also recorded. Results Compared with T0, HR and MAP at T1 and T2 were significantly higher in group F (P < 0.05), but in group S, there was no significant differences (P > 0.05). RR in both groups were significantly lower at T1 compared with T0 (P < 0.05), and no significant differences between the two groups (P > 0.05). HR, MAP and RR were significantly lower in group S than that in group F at T1 and T2 times (P < 0.05). Pain on injection, body movement and agitation were significantly lower in group S than that in group F (P < 0.05). Induction and recovery time in group S were significantly shorter than that in group F (P < 0.05). Conclusions The anesthetic effect of Sufentanil for combined intravenous and inhalation anesthesia in children's enteroscopy is safe and satisfactory. It could provide more smoothly intraoperative hemodynamics and higher quality of awakening.

AIM To investigate whether the relaxation characteristics of phytoestrogens resveratrol and phloretin on contractile response of aortic strips are similar to that of estrogen and the mechanisms underground. METHODS Aortic strips from rabbits were suspended in organ baths containing Krebs solution, and then isometric tension was measured. RESULTS Resveratrol and phloretin inhibited the contractile responses to norepinephrine (NE), KCl and CaCl2, shifted their concentration-response curves rightward with pD2′ values of 2.89, 3.34, 3.37 for resveratrol and 3.23, 3.52, 3.77 for phloretin respectively. Also both of them concentration-dependently relaxed KCl-precontracted aortic strip. The relaxing response of resveratrol but not of phloretin in aortic strip was significantly reduced by removal of endothelium or incubation with Nω-L-nitro-arginine and methylthioninium chloride, however both their relaxant effects were not affected by indometacin and propranolol. In Ca2+-free Krebs solution containing 0.01 mmol·L-1 EGTA, resveratrol and phloretin inhibited NE-induced contraction which was caused by Ca2+ release from intracellular store, but did not affect the contraction which was induced by Ca2+ influx. CONCLUSION Resveratrol and phloretin can induce vasorelaxations which may relate to inhibition of Ca2+ influx through potential-dependent calcium channels and Ca2+ release from intracellular stores, and the relaxing response of resveratrol is endothelium-dependent in part, but of phloretin is not endothelium-dependent.

Objective To observe the effect of Nalmefene on postoperative recovery on neonates by laparoscopic pyloromyotomy. Methods Elective laparoscopic pyloromyotomy for 60 neonates under general anestheisa, aged 15 ~ 28 days, ASA Ⅱ~Ⅲ , were randomly divided into two groups: Nalmefene group (M group) and Naloxone group (L group), 30 cases in each. Nalmefene 0.25 μg/kg and Naloxone 1.00 μg/kg were respectively administrated in M group and L group when the procedures finished. Parameters SpO2, MAP, HR and RR were measured and analyzed statistically at different times: end of surgery before drugs were used (T0), 10 min after administration (T1), 30 mins after extubation (T2) and 2 h after extubation (T3). Meanwhile observing spontaneous breathing recovery time, extubation time, residence time at PACU and adverse events 24 s after surgery. Results There were no actual differences in the value of MAP, HR and SpO2 at T0, T1, T2 and T3 times in the two groups (P > 0.05). However, the values of RR was significant faster at T1, T2 and T3 times than that at T0 in both groups (P < 0.05), compared with L group, the value of RR at T1 was much faster in M group (P < 0.05). The times of extubation and residence at PACU have significant differences in M group than that in L group (P < 0.05). The adverse events in both groups have no differences. Conclusion Nalmefene can facilitate the recovery at laparoscopic pyloromyotomy on neonates. Compared with naloxone, it can reduce the extubation time, and promote the early rehabilitation.

Objective To observe the impact of Dezocine used before end of operation on postoperative recovery and safety effect on postoperative pain in children receiving laparoscopic appendectomy. Methods 60 ASAⅠ ~ Ⅱcases of aged 4~10 yr, underwent laparoscopic appendectomy, were randomly divided into 3 groups: Dezocine group (D group), Fentanyl group (F group) and control group (normal saline group), 20 cases in each group. Remifentanil combined with Propofol and Sevoflurane was given for conducting endotracheal intubation general anesthesia. At 30 min before the end of operation, D group was given Dezocine 0.10 mg/kg, while F group fentanyl 1.0 μg/kg, and the control group was given same volume of normal saline. 5 min before the end of the operation anesthetics disabled, then extubation until children open eyes on call and spontaneous breathing recovered satisfactorily. Observe and record MAP, HR, SPO2 and respiration rate (RR) at different times:drug withdrawal, extubation and 5 min after ex﹣tubation, while also record extubation time, Riker sedation-agitation scores and face, legs, activity, cry and consola﹣bility (FLACC) scores and adverse reactions in the recovery period (within 30 min after extubation). Results MAP and HR at extubation and 5 min after extubation in N group and F group were higher than that in D group (P<0.05);Compared with drug withdrawal time, HR and MAP at extubation and 5 min after extubation in group F and N were much higher (P< 0.05); MAP, HR, SPO2 and RR had no statistically significant difference in D group at each time point (P> 0.05). The Riker sedation-agitation scores and the FLACC scores at 30 min after extubation in D group were significantly lower than those in the F and N groups (P<0.05), adverse reaction such as respiratory inhi﹣bition, nausea, vomiting, lethargy, headache were not found in the 3 groups. Conclusion Intravenous Dezocine before the end of operation in children's laparoscopic operation can make awake quickly and smoothly, allow small hemo﹣dynamic changes, and can reduce postoperative pain and restlessness.

Objective To evaluate the efficacy of sniffing position in alleviating glossoptosis during the emergence from anesthesia in children. Methods Two hundred pediatric patients who developed glos?soptosis during the emergence from anesthesia, aged 2-8 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, were randomly divided into 4 groups ( n=50 each) using a random number table:head extension position group ( group A ) , head tilted position group ( group B ) , oropharyngeal airway group ( group C) and sniffing position group ( group D) . Alleviation of glossoptosis, and occurrence of la?ryngospasm, agitation, vomiting and oral hemorrhage were recorded. Alleviation rate was calculated. Re?sults Compared with group A, the alleviation rate was significantly increased in C and D groups, the alle?viation rate was decreased in group B, and the incidence of laryngospasm, agitation and oral hemorrhage was increased in group C ( P<0?05 ) . Conclusion Sniffing position can effectively alleviate glossoptosis during the emergence from anesthesia in children with good safety.

OBJECTIVETo study the status quo of oral professional and technical personnel of Guyuan city, Ningxia.

METHODSIn consultation with Administrative Department of Public Health, all oral health institutions by age, gender, education, professional, and department in four counties (Longde, Jingyuan, Pengyang and Xiji) and Yuanzhou district in Guyuan City were investigated. The distribution, basic information, professional branch, ratio with the amount of health system medical staff and population were analyzed.

RESULTSAll comprehensive hospital at the county level and above set up department of stomatology. Center for Disease Control and Prevention, health inspection bureau, maternity and child health care bureau and 78.46% town health center didn't set up department of stomatology. Oral professional and technical personnel of Guyuan city in number was 115 and mainly young doctors, men were more than women. On education, the tertiary education was mostly received. On professional title, number of middle and senior professional title was relatively small. On profession, multi-disciplinary was common. The ratio of oral professional to general medical staff were 1:30, to local population was 1:13 thousands.

CONCLUSIONThe education and professional title of oral professional and technical personnel should be improved. It is recommended that comprehensive hospitals above the county level should branch in Stomatology, Center for Disease Control and Prevention, health inspection bureau, maternity and child health care bureau and town health center should offer services of stomatology, at least provide one dental professional and technical personnel in each place.

Objective:To identify the risk factors for the first weaning failure following mandibular distraction osteogenesis in pediatric patients with Pierre Robin sequence (PRS).Methods:Clinical data of pediatric patients with PRS who underwent mandibular distraction osteogenesis from January 2018 to February 2023 were collected, including sex, age, premature birth, birth weight, surgical weight, cleft palate, syndrome type PRS, laryngeal/tracheobronchial malacia, simple congenital heart disease, complex congenital heart disease, preoperative mechanical ventilation, preoperative pulmonary infection, blood albumin concentration, difficulty in tracheal intubation under a visual laryngoscope, surgical duration, postoperative ventilator-associated pneumonia, duration of mechanical ventilation at first weaning, and traction length at first weaning. Children in whom the first postoperative machine withdrawal failed were included in observation group and matched to control cases(control group) in a 1∶4 ratio. The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify the risk factors for postoperative weaning failure. Results:There were significant differences in birth weight, cleft palate, duration of mechanical ventilation and traction length at first weaning, rate of combined cleft palate, preoperative pulmonary infection rate, rate of preoperative mechanical ventilation, and rate of postoperative ventilator-associated pneumonia between the two groups ( P<0.05). Binary logistic stepwise regression analysis showed that the preoperative mechanical ventilation ( OR=18.154, 95% CI 3.971-82.990, P<0.001) and postoperative ventilator-associated pneumonia ( OR=36.942, 95% CI 1.307-1043.985, P=0.034) were independent risk factors for first weaning failure after mandibular distraction osteogenesis, while birth weight gain ( OR=0.225, 95% CI 0.076-0.668, P=0.007) was a protective factor for first weaning failure ( P<0.05). Conclusions:Preoperative mechanical ventilation and postoperative ventilator-associated pneumonia are independent risk factors and birth weight gain is a protective factor for first weaning failure following mandibular distraction osteogenesis in pediatric patients with PRS.

AIM:To observe the effect of Pingwei capsule on the precancerous lesions of gastric cancer(PLGC)cell model induced by N-methyl-N'-nitro-N-nitrosoguanidine(MNNG),and to preliminarily explore its mecha-nism.METHODS:Blank serum and Pingwei capsule-containing serum were prepared for later use.A PLGC cell model was established by MNNG-induced human gastric mucosal epithelial cell line GES-1.To evaluate the model,cell morpho-logical changes were observed under inverted microscope,and the expression of proliferating cell-related antigen Ki67 was detected by immunofluorescence staining.CCK-8 assay was used to screen the optimal intervention concentration and time of serum containing drugs.Reactive oxygen species(ROS)content in cells was detected using a fluorescent probe DCFH-DA.Malondialdehyde(MDA)content was detected by ELISA,and the activity of superoxide dismutase(SOD)and gluta-thione peroxidase(GSH-Px)was detected using biochemical reagents.A novel fluorescent probe JC-10 was used to detect mitochondrial membrane potential.The mRNA expression levels of Ki67 and melanoma differentiation-associated gene-7(MDA-7)were detected by real-time fluorescence quantitative PCR.The protein expression levels of Ki67,interleukin-6(IL-6)and MDA-7 were detected by Western blot.RESULTS:Compared with normal group,the ROS and MDA levels in model group and blank serum group were significantly increased(P<0.01),while the activity of SOD and GSH-Px was significantly decreased(P<0.01).The mitochondrial membrane potential was significantly decreased(P<0.01).The protein expression levels of Ki67 and IL-6 were significantly increased(P<0.01),while the protein expression level of MDA-7 was significantly decreased(P<0.01).There were no significant differences of the above indicators between model group and blank serum group(P>0.05).Compared with blank serum group,the Pingwei capsule-containing serum group showed significantly decreased ROS and MDA levels(P<0.01),significantly increased activity of SOD and GSH-Px(P<0.05),significantly increased mitochondrial membrane potential(P<0.01),significantly decreased protein expres-sion levels of Ki67 and IL-6(P<0.01),and significantly increased protein and mRNA expression levels of MDA-7(P<0.01).CONCLUSION:Pingwei capsule can significantly alleviate MNNG-induced oxidative damage and inflammatory response,and regulate the expression of oncogenes and tumor suppressor genes,thereby playing a role in prevention and treatment of PLGC.

Objective To evaluate the efficacy of nasotracheal intubation for airway management in neonates with Pierre Robin sequence undergoing surgery with general anesthesia. Methods Sixty full-term neonates of both sexes with Pierre Robin Sequence, aged 2-28 days, weighing 2. 4-3. 8 kg, scheduled for elective mandibular distraction osteogenesis, were divided into 2 groups ( n=30 each) using a random num-ber table method: nasotracheal intubation group (group N) and orotracheal intubation group (group O). Combined intravenous-inhalational anesthesia was used during surgery. The success rate of intubation, intu-bation time, heart rate, mean arterial pressure and SpO2 during intubation, and occurrence of complica-tions during intubation were recorded, and the time of extubation and occurrence of complications after extu-bation were also recorded. Results Compared with group O, the intubation time was significantly short-ened, the first-time intubation success rate was increased, the heart rate and mean arterial pressure were decreased at 2 min after intubation, the lowest SpO2 was increased during intubation, and the incidence of pharyngeal soft tissue injury during intubation and hoarseness after extubation was decreased in group N ( P<0. 05) . Conclusion Nasotracheal intubation can be used for airway management in neonates with Pierre Robin sequence undergoing surgery under general anesthesia, and the efficacy is superior to that of orotra-cheal intubation.