Objective To observe the changes of TNF‐α,interleukin IL‐6 ,IL‐10 and gas analysis though one lung ventilationone with two different pattern to study the effects lung injury and values of oxygenation on patients undergoing esophageal surgery . Methods 60 patients with esophageal cancer were randomly divided into two groups of A and B with 30 cases each .A term :contin‐ual one lungventilation and 4 cm H2 O peep until the end operate ,B term :intermittent one lung ventilation each 45 min with two lung ventilation 5 min .Blood gas analysis were determined immediately before one lung ventilation ,30 min following OLV ,60 min following OLV ,90 min following OLV ,120 min following OLV ,the end of the OLV ,after operate 24 h observe the MAP ,HR ,P , R ,SpO2 .PETCO2 and airway peak were recorded during operate .Results (1)SpO2 in group A was decreased at T3 and reached lest level at T5 ,which was higher than that in group B at T3 ,T5(P<0 .05) .(2)the levels of IL‐6 ,TNF‐α and IL‐10 in the two groups began to rise at T3(P<0 .01) ,reached peak level at T6 ,and decreased gradually at T7 ,which were still higher than those at T1(P<0 .05) .(3) The levels of TNF‐αand IL‐6 were lower in group A than those in g roup B at T3-T6(P<0 .05) ,T1 ,T2 ,T7 (P>0 .05) .The levels of IL‐10 was higher in group A than those in group B at T3-T7(P<0 .05) .Conclusion Compared with A term ,B term without VT has more lung injury although it increases values of oxygenation .

Objective To compare the different doses of dexmedetomidine combined with remifen-tanil and propofol for anesthesia in the burn patients with non-intubation. Methods Sixty burn patients of both sexes, aged 18-64 yr, with body mass index of 19-24 kg∕m2 , of American Society of Anesthesiologists physical statusⅠorⅡ, scheduled for elective skin grafting with burn covering less than 10％ of the total body surface, tangential excision, or dressing change with burn covering 10％-50％ of the total body surface, were selected and divided into A, B and C groups using a random number table method, with 20 patients in each group. In A, B and C groups, dexmedetomidine 1. 0 μg∕kg was intravenously infused for 10 min at a constant rate, followed by an infusion of 0. 6, 0. 8 and 1. 0 μg·kg-1 ·h-1 , respectively, until 10 min be-fore the end of surgery. Remifentanil and propofol were given by target-controlled infusion via the dual chan-nel, the target plasma concentration of propofol was adjusted to maintain the index of consciousness at 40-60, and administration was stopped at the end of surgery in three groups. The development of respiratory depres-sion, body movement and hypotension was observed during operation. The consumption of remifentanil and propofol, emergence time and Ramsay sedation score at 1 h after operation were recorded. Results Com-pared with group A, the incidence of respiratory depression and consumption of propofol were significantly de-creased, and the rate of satisfaction with sedation was increased in B and C groups (P<0. 05), and the inci-dence of hypotension was significantly increased in group C ( P<0. 05) . The incidence of hypotension was sig-nificantly higher in group C than in group B ( P<0. 05) . There were no significant differences in the consump-tion of remifentanil or emergence time among three groups ( P>0. 05) , and no body movement was found in three groups. Conclusion Intravenously infused dexmedetomidine 0. 8 μg·kg-1 ·h-1 combined with remifentanil and propofol provides better efficacy when used for the burn patients with non-intubation.

Objective To investigate the relationship between serum histone deacetylase 4(HDAC4)and myeloid differentiation protein 88(MYD88)levels and hemorrhagic transformation after intravenous throm-bolysis with recombinant tissue plasminogen activator(rt-PA)in patients with acute cerebral infarction(ACI).Methods A total of 169 patients with ACI who were treated with rt-PA intravenous thrombolysis in this hospital from May 2020 to May 2022 were selected as the research objects,and they were divided into transformation group(46 cases)and non-transformation group(123 cases)according to whether hemorrhagic transformation occurred after rt-PA intravenous thrombolysis.In addition,156 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to detect the serum levels of HDAC4 and MYD88 in each group,and the gen-eral data of transformation group and non-transformation group were compared.Pearson correlation was used to analyze the correlation between serum HDAC4 and MYD88 levels in ACI patients.Multivariate Logistic re-gression analysis was used to analyze the related factors of hemorrhagic transformation in ACI patients after intravenous thrombolysis with rt-PA.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of HDAC4,MYD88 levels and their combination for hemorrhagic transformation in ACI patients after rt-PA intravenous thrombolysis.Results The serum level of HDAC4 in ACI group was signifi-cantly lower than that in control group,and the serum level of MYD88 in ACI group was significantly higher than that in control group(P＜0.05).There were no significant differences in gender,age,body mass index,fasting blood glucose,hyperlipidemia,and coronary heart disease between the non-transformation group and the transformation group(P＞0.05),while there were significant differences in atrial fibrillation,National In-stitute of Health Stroke Scale(NIHSS)score,and the time from onset to thrombolysis between the two groups(P＜0.05).The level of serum HDAC4 in transformation group was lower than that in non-transfor-mation group,and the level of serum MYD88 in transformation group was higher than that in non-transforma-tion group,and the difference was statistically significant(P＜0.05).Pearson correlation analysis showed that serum HDAC4 level was negatively correlated with MYD88 in ACI patients(r=-0.401,P＜0.001).Multi-variate Logistic regression analysis showed that atrial fibrillation,time from onset to thrombolysis,NIHSS score and MYD88 level were the risk factors for hemorrhagic transformation in ACI patients after rt-PA intra-venous thrombolysis,HDAC4 level was a protective factor for hemorrhagic transformation in ACI patients af-ter intravenous thrombolysis with rt-PA(P＜0.05).The area under the curve(AUC)of combined HDAC4 and MYD88 was 0.876,and the sensitivity and specificity were 65.22％and 98.37％,respectively,which was better than that of HDAC4 and MYD88 alone(Zcombined-HDAC4=2.298,P=0.022;Zcombined-MYD88=2.5 4 5,P=0.011).Conclusion The serum levels of HDAC4 and MYD88 in ACI patients are closely related to hemor-rhagic transformation after intravenous thrombolysis with rt-PA.