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 observe the value of lumbar spine bone marrow MR T1 mapping radiomics for predicting clinical risk of acute lymphoblastic leukemia(ALL)in children.Methods Lumbar bone marrow T1 mappings were prospectively acquired from 77 newly diagnosed ALL children.The volume of interest(VOI)of L3 vertebral body was segmented using 3D Slicer software and 2 060 radiomics features were extracted,and the best features were screened.The children were divided into training and testing sets at the ratio of 8:2.Logistic regression(LR),support vector machine(SVM)and random forest(RF)were used to established radiomics models based on the best features,respectively,which were trained in training set and verified in testing set.The clinical risk was evaluated according to newly diagnosed risk and the response to chemotherapy after MR examination.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each model for predicting clinical risk of ALL in children.Results There were 52 cases in low-medium risk group and 25 in high risk group.The training set consisted of 44 cases of low-medium risk and 17 of high risk,while the testing set consisted of 8 cases of low-medium risk and 8 of high risk.Twelve best features were selected to establish radiomics models.The sensitivity and accuracy of RF model in training set were both 100％,but its sensitivity(50.00％)and accuracy(75.00％)in testing set were both low,which indicating overfitting.The AUC(0.95)of LR model was slightly higher than that of SVM model(0.92)in testing set,but no significantly difference was found(P＞0.05),and the accuracy of these two models was consistent.Conclusion Both lumbar bone marrow T1 mapping LR and SVM radiomics models could be used to predict clinical risk of ALL in children,and LR model had better predictive efficacy.