Dexmedetomidine (Dex) is a novel and highly selective o2-adrenoceptor agonist,it has anxiolytic,antisympathetic and certain analgesic effects,its sedative effect can lead to mimic natural sleep.Dex is widely applied in mechanical ventilation,invasive procedures and perianesthesia with other drugs by intravenous route.Recent basic and clinical researches show that Dex can be applied safely and effectively with local anesthetics in regional block,to improve anesthetic effect,promote stable hemodynamics and optimize postoperative analgesia.

Objective: To study Bacterial Endotoxins Test(BET) for Herbe Houttuyniae Injection.Methods: The interfering test for Herbe Houttuyniae Injection was carried out. Results: The test wasn't interfered when TAL(0.25EU/ml) was used and sample was diluted in a ratio of 1 to 4.Conclusions: The BET may replace the rabbit pyrogen test.

Objective:To observe the hemodynamic change and inhibitory effect on stress response of oxycodone during induction, maintenance and resuscitation period of general anesthesia in patients undergoing gastric cancer surgery.Methods:60 patients with general anesthesia undergoing elective gastric cancer from March 2018-March 2019 in No.904 Hospital were selected. According to the random number table method, they were randomly divided into two groups ( n=30): Oxycodone group (group O) and Fentanyl group (group F). The anesthesia was induced by intravenous oxycodone 0.3 mg/kg (group O) or fentanyl 3 μg/kg (group F), propofol 2 mg/kg and cisatracurium 0.25 mg/kg. Oxycodone (group O) or fentanyl (group F) with sevoflurane were used for maintenance of general anesthesia. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T 0), immediately intubation (T 1), 1 min (T 2) and 5 min (T 3) after intubation, immediately skin incision (T 4), surgery for 1 h (T 5), the end of operation (T 6) and 1 min (T 7) and 5 min (T 8) after extubation. The concentration of glucose (Glu), cortisol (Cor), epinephrine (E) and norepinephrine (NE) were detected in time T 0,T 2, T 4,T 5 and T 7. The time of extubation and the visual analogue scale (VAS) scores after extubation and 30 min after entering postanesthesia care unit (PACU) were recorded. The incidence of cough during induction, dysphoria during extubation and the adverse effects such as nausea, vomit and respiratory depression during PACU were also observed. Results:There were no significant difference between two groups in MAP and HR at the time point from T 0 to T 8 ( P>0.05); there were no significant difference about concentrations of Glu, Cor, E and NE at the time point of T 0,T 2,T 4,T 5 and T 7 ( P>0.05). Extubation time and VAS scores of 30 min after entering PACU in group O were significantly lower than those of group F ( P<0.05). Meanwhile, the incidences of cough during induction, dysphoria during extubation and respiratory depression in group O were significantly lower than in group F ( P<0.05). There was no significant difference in the incidence of nausea and vomiting ( P>0.05). Conclusions:Oxycodone can be safely and effectively used for induction and maintenance of general anesthesia in gastric cancer surgery, inhibit intraoperative stress response, and improve the quality of recovery period.

Objective To compare the efficacy of intra?articular dexmedetomidine or morphine mixed with ropivacaine for postoperative analgesia after arthroscopic knee surgery?Methods Sixty ASA physical status I or II patients scheduled for elective arthroscopic knee surgery were randomly assigned into 3 equal groups using a random number table?The group R received 0?25% ropivacaine, and the group RD received 1 μg/kg dexmedetomidine and 0?25% ropivacaine,and the group RM received 2 mg morphine and 0?25% ropivacaine intraarticularly in a total volume of 20 ml?Visual analogue scales( VAS) scores when the patients actively flexed the operated knee to 90° were recorded at 2, 4, 8, 12, 18 and 24 h after surgery?The analgesic duration and consumption of fentanyl at 24 h after surgery were recorded?The complications such as bradycardia,hypotension, nausea,vomit,cutaneous pruritus and uroschesis were followed up?Results At 8 and 12 h after surgery,VAS scores were significantly lower in group RD ( ( 3?23 ± 0?45 ) points, ( 3?18 ± 0?47 ) points ) and RM ( ( 3?20 ±0?46) points,(3?13±0?45) points) than in group R((4?01±0?74) points,(3?93±0?71) points),and at 18 and 24 h after surgery,they were significantly higher in group R((3?85±0?62) points,(3?72±0?57) points) and RD((3?83±0?57) points,(3?71±0?55) points) than in group RM((3?07±0?43) points,(3?02±0?41) points),and there was significant difference(F between groups=124?65,P=0?021,F inner grouP=11?65,P=0?004,F across groups=67?65,P=0?024)?The analgesic duration was significantly different in three groups (F=45?78,P<0?001),and in group RD((668?3±133?4) min) and RM((1 412?8±275?67) min) was significantly longer than in group R(402?3±81?5) min,P<0?05),and the group RM was longer than the group RD( P<0?05)?The consumption of fentanyl at 24 h after surgery was significantly different in three groups ( F=34?47,P<0?001),and it was significantly lower in group RD((32?6±7?3) μg) and RM((12?8±3?7) μg) than in group R((151?3±28?5) μg,P<0?05),and the group RM was lower than the group RD(P<0?05)?No significant side effects were found?Conclusion Intra?articular dexmedetomidine or morphine all can improve the efficacy of ropivacaine for postoperative analgesia after arthroscopic knee surgery,while morphine is superior to dexmedetomidine.

BACKGROUND: Previous research has indicated that graphite carbon nanoparticles have a strong adsorbability. While, when the concentration is effectively controlled, graphite carbon nanoparticles also have well compatibility and sensitizing effect. OBJECTIVE: To observe the morphology of graphite carbon nanoparticles, and to investigate the effects of graphite carbon nanoparticles on cell proliferation and ultramicrostructure.METHODS: Graphite carbon nanoparticles (0.5 g) were put in 100 mL triple distilled water to obtain graphite carbon nanoparticle mother liquid after oscillation and microfiltration. HepG2 cells, L02 cells, HI7702 cells, and 3T3 cells in the logarithmic phase were adjusted to the concentration of 5×10~7/L and inoculated in 6-well culture plate with 0.5 mL per well. Thereafter, the cells were cultured with RPMI-1640 culture media (1.5 mL) containing fetal bovine serum, penicillin, and streptomycin. The original culture solution was removed after 24 hours. The 1-5 wells were considered as the experimental group, and 25, 10, 7.5, 5, 0.25 mg/Lgraphite carbon nanoparticles (2.0 mL) were respectively added into each well; while, the sixth well was considered as the blank control group without graphite carbon nanoparticles. The cells in the blank control group were cultured for 24 hours. Particle diameter was measured using atomic force microscopy; morphology was observed using electron microscope; effect of different concentrations of graphite carbon nanoparticles on cell number was detected using hemacytometry under optic microscope; the effect of 7.5 mg/L graphite carbon nanoparticles on ultramicrostructure was observed under transmission electron microscope. RESULTS AND CONCLUSION: Graphite carbon nanoparticles were around and 20 nm diameter. Compared with the blank control group, cell numbers except HepG2 cells were increased, especially the effect of 7.5 mg/L graphite carbon nanoparticles was greatest (P < 0.05). Transmission electron microscope indicated that graphite carbon nanoparticles were distributed into cells, including cytoplasm, nucleus, and mitochondrion; while, subcellular structure damage and cell apoptosis and necrosis were absent. Graphite carbon nanoparticles have no side effects on in vitro cultured cells and can promote cell proliferation, showing a dose-dependence correlation, especially the concentration of 7.5 mg/L.

Objective To observe the effect of oxycodone for postoperative patient-controlled intravenous analgesia of laparoscopic total hysterectomy with or without background infusion.Methods Seventy five patients, aged 40-65 years, BMI 18-24 kg/m2, ASA physical statusⅠ orⅡ, scheduled for elective laparoscopic total hysterectomy surgery under general anesthesia were randomly assigned into 3 equal groups (n = 25 each) using a random number table:morphine group (group M), oxycodone with background infusion group (group O1) and oxycodone without background infusion group (group O2).The anesthesia was induced by intravenous fentanyl 4μg/kg, propofol 2-2.5 mg/kg and cisatracurium 0.2 mg/kg.Group M was given morphine 50 mg+ondanstron 8 mg in100 ml normal saline, groups O1 and O2 were given oxycodone 50 mg+ ondanstron 8 mg in 100 ml normal saline.The PCIA pump of group M and group O1 were set up with a 0.5 ml bolus dose, a 5 min lockout interval and background infusion at a rate of 2 ml/h.Group O2 was set up with a 4 ml bolus dose, a 5 min lockout interval and without background infusion.The NRS scores of three groups at 4, 8, 12, 24 and 48 hafter operation were recorded.The total morphine or oxycodone consumption, and the number of rescue analgesia within 48 hafter surgery were recorded.The adverse events within 48 hafter surgery were also observed.Results Compared with group M, the NRS scores at rest were significantly decreased at 4, 8, and 12 hafter operation (P<0.05), and the NRS scores at movement were significantly decreased at 4 and 8 hafter operation (P<0.05), and the number of rescue analgesia within 48 hafter surgery was significantly decreased in groups O1 and O2 (P<0.05).The total analgesic consumption and the incidence of adverse event within 48 hafter surgery in group O2 were significantly lower than those in groups M and O1 (P<0.05).Conclusion Compared with morphine, oxycodone for patient-controlled intravenous analgesia can obtain more satisfactory effects after laparoscopic total hysterectomy surgery.Meanwhile, the total consumption of oxycodone and the incidence of nausea and vomiting are significantly decreased.

Objective:To evaluate the effectiveness of esketamine during perioperative anesthesia for acute and chronic pain after cesarean section.Methods:One hundred and fifty patients scheduled for elective cesarean section under spinal anesthesia were randomly assigned into 2 equal groups ( n=75) using a random number table: esketamine group (group E) and control group (group C). Subarachnoid block was administered with 9-11 mg of hyperbaric bupivacaine with 0.33% glucose concentration. After the delivery of the fetus, 0.15 mg/kg (1 mg/ml) esketamine was pumped intravenously for 30 min in the group E, while the same dosage of normal saline was administered in the group C. Furthermore, patients received an intravenous patient controlled intravenous analgesia (PCIA) pump after surgery (100 μg sufentanil + 1.25 mg/kg esketamine + 8 mg ondansetron for the group E, 100 μg sufentanil + 8 mg ondansetron for the group C). Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded in the initial time of esketamine administration, and 5, 15 min, and 30 min after administration. The pain Numerical Rating Scale (NRS) score at rest and during coughing were recorded at 2, 6, 12, 24 h and 48 h after surgery. The first analgesic time and cumulative sufentanil consumption were recorded at 0-12 h, 12-24 h, 24-48 h, 0-24 h and 0-48 h after surgery. Moreover, we recorded the incidence of chronic pain at 3 and 6 months after surgery. Results:There were no significant differences in HR, SBP and DBP between the two groups immediately after administration of esketamine and 5, 15 min and 30 min after administration (all P>0.05). At rest or during coughing, the pain NRS score were significantly lower at 2, 6 h, and 12 h postoperatively in group E compared to group C (all P<0.05). The time to first analgesia in group E was significantly longer than the group C [(176.8±18.3)min vs (148.5±16.9)min, P<0.05]. The cumulative sufentanil consumption was significantly lower in group E during 0-12 h, 12-24 h, 0-24 h and 0-48 h postoperatively than in group C (all P<0.05), but there was no statistical significance between the two groups at 24-48 h ( P>0.05). There were no significant difference between the two groups in the incidence of chronic pain at 3 months and 6 months after surgery ( all P>0.05). The incidence of chronic pain in group E was lower than that in group C at 3 months [13.4%(9/67) vs 18.8%(13/69), P=0.392] and 6 months [10.7%(6/56) vs 16.1%(10/62), P=0.391], but the difference was not statistically significant. Conclusions:Perioperative administration of esketamine provided superior short-term analgesia after cesarean section and did not increase the psychotomimetic adverse event rate. However, the development of chronic pain was not restrained.

Objective To observe the effects of perioperative oral pregabalin combined with postop-erative administration of esketamine on acute and chronic pain after thoracoscopy.Methods A total of 129 patients undergoing elective thoracoscopic lobectomy under general anesthesia from September 2020 to August 2021,68 males and 61 females,aged 18-80 years,BMI 15-30 kg/m2,ASA physical status Ⅰ-Ⅲ,were divided into three groups using random number table:esketamine combined with pregabalin group(group PE),pregabalin group(group P),and control group(group C),43 patients in each group.Groups PE and P received 150 mg of oral pregabalin 1 hour before surgery and 150 mg of oral pregabalin continu-ously for 7 days after surgery,twice per day.Group C did not take pregabalin during the perioperative peri-od.The analgesics of patient-controlled intravenous analgesia(PCIA)were sufentanil 100 μg+esketamine 1.25 mg/kg+tropisetron 4 mg with saline added to 100 ml in group PE,and sufentanil 100 μg+tropise-tron 4 mg with saline added to 100 ml in groups P and C.The NRS pain scores at rest and during coughing were recorded 3,6,12,24,and 48 hours after surgeiy.The effective press number of PCIA and the total press number of PCIA were recorded.The dosage of remifentanil,the cumulative sufentanil consumption were recorded during 0-12,12-24,24-48,and 0-48 hours after surgery.The adverse effects such as nau-sea,vomiting,dizziness,pruritus,hallucinations,and nightmares 48 hours after surgery were recorded.The incidences of chronic pain 3 and 6 months after surgery were recorded.Results Compared with group C,the NRS pain scores 3,6,12,24,and 48 hours after surgery,the cumulative sufentanil consumption during 0-12,12-24,24-48,and 0-48 hours after surgery,the effective press number of PCIA,the total press number of PCIA in groups PE and P were significantly decreased(P＜0.05),the incidences of chro-nic pain 3 and 6 months after surgery in group PE were significantly decreased(P＜0.05).Compared with group P,the incidences of chronic pain 3 and 6 months after surgery in group PE were significantly de-creased(P＜0.05).There were no significant differences between the three groups in the dosage of remifentanil,and adverse effects such as nausea,vomiting,dizziness,pruritus,hallucinations,and night-mares 48 hours after surgery.Conclusion Perioperative oral pregabalin combined with postoperative ad-ministration of esketamine can significantly decrease the incidence of chronic pain after thoracoscopy,reduce acute postoperative pain,and spare postoperative opioid usage.

Objective: To investigate the clinical efficacy and adverse effects of stereotactic body radiotherapy (SBRT) in the treatment of T₂N₀M₀ non-small cell lung cancer (NSCLC) patients. Methods: By retrospectively analyzing the clinical data of 30 inoperable patients with stage T₂N₀M₀ NSCLC treated by SBRT, the overall survival, progression-free survival, cancer-specific survival and adverse effects were determined. Results: The median follow-up was 18.4 months. The 1-, 2-, and 3-year overall survival rates were 92.2%, 92.2% and 80.6%, respectively. The corresponding cause-specific survivals were 95.7%, 95.7% and 83.7%. The progression-free survivals were 70.2%, 54.1% and 40.6%. The local control rates were 100%, 94.4%, and 94.4%. The regional controls were 84.2%, 72.1%, and 54.1%; and distant controls were 84.6%, 72.4% and 64.3%, respectively. Twenty patients (66.7%) developed symptoms of grade 1 radiation-related toxicities: dyspnea, chest pain, fatigue, cough, esophagitis, or pneumonia. Among these, 5 patients suffered grade ≥2 radiation pneumonitis, and one patient experienced grade 4 radiation pneumonitis. Conclusions SBRT was efficient and safe for patients with inoperable T₂N₀M₀ NSCLC, imposing tolerable toxicities.