Objective To observe the effects of dexmedetomidine hydrochloride on the cisatracurium-induced neuromuscular blockade in geriatric, young and middle-aged patients. Methods Forty elderly patients and forty young and middle-aged patients undergoing elective abdominal surgery under general anesthesia were randomly divided into 4 groups ( n=20 each):elderly dexmedetomidine hydrochloride group (group DE),elderly control group (group CE),young and middle-aged dexmedetomidine group (group DY) and young and middle-aged control group (group CY).In groups DE and DY,a loading dose of 0.5 μg?kg-1 dexmedetomidine was intravenously infused over 10 min before induction of anesthesia,respectively,followed by infusion at a rate of 0.4μg?kg-1?h-1 until the end of surgery.Equal volume of 0.9% sodium chloride was given in groups CE and CY.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium 0.15 mg?kg-1.Four groups were maintained with infusion of propofol and remifentanil. Neuromuscular blockade was maintained with continuous cisatracurium infusion in the four groups and was monitored with TOF-Watch SX acceleromyography at the adductor pollicis.The onset time,TOF no reaction period,duration of action,the amount of cisatracurium consumption,and the spontaneous recovery index ( T1 25% to 75%) were recorded. Results The four groups were comparable in the demographic data.Intubation conditions,the onset time and recovery index were not significantly different among the four groups. The duration of blockade action in groups DE and DY was ( 61. 1 ± 8.9) min and (53.6±9.3) min,which was significantly longer than that in group CE [(49.9±5.8) min] and group CY [(44.8± 6.4) min] (P<0.01).The duration of blockade action was significantly longer in groups DE and CE than in groups DY and CY (P<0.05).The amount of cisatracurium consumption in groups CE and CY was significantly higher than that in groups DE and DY (P<0.05). Conclusion The neuromuscular blockade is longer and the requirement of cisatracurium is less in elderly patients than in young and middle-aged patients.Continuous infusion of dexmedetomidine hydrochloride can't accelerate the onset time of cisatracurium.But duration of action is prolonged and the amount of cisatracurium consumption is lower in patients with infusion of dexmedetomidine hydrochloride.

Objective To compare the effects of Ephedrine and combined with small dose cisatracurium treatments on the onset time of cisatracurium and hemodynamics in elderly patients.Methods Sixty cases of elderly patients undergoing elective surgery under general anesthesia were randomly divided into 4 groups:E group (ephedrine pretreatment),P group (cisatracurium primin),PE group (cisatracurium priming and ephedrine pretreatment) and C group(control),and each group of 15 cases.Cisatracurium 0.15 mg/kg were given in P group and PE group,and then ephedrine 70 μg/kg were given in PE group and E group.Anesthesia was induced with target controlled infusion of propofol (target plasma concentration 3-5 pg/ml),fentanyl 3-4 pg/kg.Cisatracurium 0.015 mg/kg were given in E group and C group,and P group and PE group dose intravenous cannula remaining.Tracheal intubation was performed when the twitch height depressed to 0.Results The Onset time of PE,C,E and P group were (164±28) s,(306±61) s,(187±31) s and (193±40) s and there were significant differences(F=33.990,P＜0.01).The onset time of PE group was shorter than that in C,E,P group,and the difference was significant (P＜0.05).Systolic pressure (SBP) and mean arterial pressure (MAP) levels in four groups after induction were lower than those before induction (F =35.783,30.015,P =0.000).SBP,diastolic blood pressure (DBP),MAP in PE group and E group were significant higher than those in C group(P＜0.05).After inductions,heart rate(HR) in PE group was significant different form that in C group(P ＜0.05),and HR of C group was significantly decrease than before inductions(P＜0.05).After inductions,the cases with DBP were 11 patients(73.3％) in C group,10 patients(66.7％) in P group:,5 patients(33.3％) in E group,and 4 patients (26.7％) in PE group,the different were significant (x2 =9.867,P ＜ 0.05).After intubation,cases with increase blood press were 3 patients (20.0％) in C group,5 patients(33.3％) in E group,and 4 patients(26.7％) in E group and PE group(P＞0.05).Conclusion Ephedrine of 70 μg/kg can relief the circulatory depression and accelerate the onset time of cisatracurium in the elderly patients.Combined with cisatracurium priming can further shorten the onset time and be for elders.

Objective:To evaluate the effect of age factor on the potency of cisatracurium-induced neuromuscular block in the obese patients.Methods:American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ obese patients, with a body mass index of 30-35 kg/m 2 and waist circumference (female ≥ 80 cm, male ≥ 90 cm), 40 elderly patients (age 65-75 yr) and 40 young and middle-aged patients (age 18-64 yr), scheduled for elective surgery with general anesthesia, were included in this study. Based on the random number table method, the patients were assigned into dosage groups of 40, 50, 60 and 70 μg/kg, served as OF1-4 groups and YF1-4 groups, with 10 patients in each group. The consumption of cisatracurium was calculated based on fat-free mass using a single-dose method. The neuromuscular block of cisatracurium was monitored by recording the response of the adductor pollicis muscle to TOF stimulation, the maximum suppression degree of T 1 and onset time were recorded using the Mindray BeneVision N17 monitor, and the dose-response relationship regression equation was developed to calculate the median effective dose. Results:There was no significant difference in the onset time among groups ( P>0.05). The median effective dose in elderly obese patients and young and middle-aged obese patients were 50.01 and 48.71 μg/kg, respectively, and there was no significant difference between the two groups ( P>0.05). Conclusions:There is no significant difference in the potency of cisatracurium-induced neuromuscular block between elderly obese patients and young and middle-aged obese patients, suggesting that age factor has no significant effect on it.

The electroencephalogram (EEG) signal is a general reflection of the neurophysiological activity of the brain, which has the advantages of being safe, efficient, real-time and dynamic. With the development and advancement of machine learning research, automatic diagnosis of Alzheimer's diseases based on deep learning is becoming a research hotspot. Started from feedforward neural networks, this paper compared and analysed the structural properties of neural network models such as recurrent neural networks, convolutional neural networks and deep belief networks and their performance in the diagnosis of Alzheimer's disease. It also discussed the possible challenges and research trends of this research in the future, expecting to provide a valuable reference for the clinical application of neural networks in the EEG diagnosis of Alzheimer's disease.
Humans ; Alzheimer Disease/diagnosis* ; Neural Networks, Computer ; Machine Learning ; Brain ; Electroencephalography