Sixty gynecological patients undergoing laparoscopic surgery during October 2010 to June 2011were randomly divided into 2 groups:laryngeal mask airway proseal ( PLMA group,n =30 ) and laryngeal mask airway classic (CLMA group,n =30).Laryngeal mask was inserted after induction.The heart rate (HR),mean arterial pressure (MAP),airway sealing pressure,the average time of placement,the pulmonary satisfaction and complications were recorded.There was no significant difference in heart rate and MAP between the two groups(P＞0.05).The airway sealing pressure [ (26 ±6) cm H2O ( 1cm H2O =0.098 kPa) vs.(16±5) cm H2O],the average time of placement [(36±5) vs.(24±6) s)] and the excellent lung ventilation(90％ vs.73％ ) in the PLMA group were more significantly increased than those in the CLMA group(P ＜0.05).PLMA can assure good airway sealing and is more suitable for gynecological patients undergoing laparoscopic surgery.

ObjectiveTo evaluate the feasibility of using dexmedetomidine (Dex) as supplement to stellate ganglion block (SGB) in the treatment of trigcminal post-herpetic neuralgia in elderly patients.MethodsForty-five ASA Ⅱ patients with trigeminal post-herpetic neuralgia aged 65-85 yr weighing 45-85 kg undergoing stellate ganglion block were randomly divided into 3 groups ( n =15 each): group SGB; group Dex 0.4 and 0.6 μg/kg +SGB (groups DS1 and DS2).SGB was performed on the affected side with 0.5％ ropivacaine 8-10 ml.Dex 0.4 and 0.6 μg/kg in normal saline were infused iv over 15 min before SGB in groups DS1 and DS2 respectively.The onset time and duration of block were recorded.Bradycardia,hypotension and respiratory depression were also recorded.The intensity of pain was assessed with VAS scores (0=no pain,10 =worst pain) before and at 1,2,4,8 weeks after SGB.VAS score ≤3 was defined as satisfactory analgesia.The rate of satisfactory analgesia was calculated.ResultsThere was no significant difference in the incidence of bradycardia,hypotension and respiratory depression among the 3 groups.The duration of block was significantly longer and the rate of satisfactory analgesia at 2,4,8 weeks after SGB was significantly higher in groups DS1 and DS2 than in group SGB.There was no significant difference in the onset time,duration of block and the rate of satisfactory analgesia between groups DS1 and DS2.ConclusionSGB with Dex has better therapeutic effect than SGB in elderly patients with trigeminal post-herpetic neuralgia.

With the progress of visualization technology, more and more visual tools were applied to anesthesia. It has accurate positioning, mild trauma, a high success rate and less complications for endotracheal intubation, which increase the safety and efficiency of airway management. Disposcope endoscope is an endotracheal intubation tool with a visual stylet, which has many advantages, such as visual, lens barrel can be bent and wireless transmission. This paper summarizes the current progress in the application of Disposcope endoscopy in tracheal intubation.

Objective To evaluate the myocardial protective effect of dexmedetomidine in the pediatric patients undergoing total correction of tetralogy of Fallot.Methods Forty ASA physical status Ⅱ] or Ⅲ pediatric patients of both sexes,aged 9 months-5 yr,weighing 7-21 kg,scheduled for elective total correction of tetralogy of Fallot under cardiopulmonary bypass,were randomly divided into 2 groups (n =20 each):control group (C group) and dexmedetomidine group (D group).Anesthesia was induced with iv injection of midazolam,sufentanil,etomidate and rocuronium.The patients were endotracheally intubated and mechanically ventilated.After intubation,dexmedetomidine was infused intravenously at 0.6 μg· kg-1 · h-1 until the end of operation in group D,while the equal volume normal saline was given instead of dexmedetomidine in group C.Venous blood samples were obtained before operation,at the end of operation and at 24 h after operation for determination of plasma TNF-α and IL-6 concentrations.The occurence of anoxic spells was recorded.Results The concentrations of plasma TNF-α and IL-6 were significantly lower at the end of operation and 24 h after operation in group D than in group C(P ＜0.05).The incidence of anoxic spells was 0 in group D,however it was 20％ in group C.Conclusion For the pediatric patients undergoing total correction of tetralogy of Fallot under cardiopulmonary bypass,dexmedetomidine infused at 0.6 μg· kg-1 · h-1 during operation can exert myocardial protective effect with clinical significance.

Objective To compare HC video-laryngoscope with Macintosh laryngoscope for tracheal intubation.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index 19-27 kg/m2,Mallampati grade Ⅰ-Ⅱ,undergoing elective surgery,were randomly divided into 2 groups (n =30 each):HC video-laryngoscope group (group H) and Macintosh laryngoscope (group M).After induction of anesthesia,the patients underwent orotracheal intubation assisted by HC video-laryngoscope in group H,and by Macintosh laryngoscope in group M.The glottic exposure time,intubation time,Cormack-Lehane grade,the number of pressing the cricoid and intubation-related complications were recorded.Results The rate of satisfactory glottic exposure was significantly higher and the number of pressing the cricoid was smaller in group H than in group M (P ＜ 0.05).There was no significant difference in the glottic exposure time,intubation time and incidence of intubation-related complications between the two groups (P ＞ 0.05).Conclusion The efficacy of tracheal intubation guided by HC video-laryngoscope is better than that guided by Macintosh laryngoscope.

Objective: To investigate the effects of apoptotic bodies (ABs) derived from dental pulp stem cells (DPSCs) on macrophage polarization and inflammation response in vivo. Methods : Human DPSCs were extracted, cultured and identified. Staurosporine was used to apoptosis induction and differential methods were performed for ABs identification. The in vitro cultured macrophages were divided into 3 groups: solvent control, lipopolysaccharide (LPS), and the LPS+ABs. The macrophages were stimulated with LPS to induce inflammation followed by ABs treatment. In the untreated group, macrophages were added with an equal amount of solvent. The specific uptake of ABs by macrophages, the expression level of CD206 and the levels of inflammatory cytokines were analyzed. The mouse models of cutaneous wounds and dextran sulfate sodium (DSS)-induced colitis were established, and the mice were randomly divided into 3 groups: the PBS-treated group, the DPSCs-treated group, and the ABs-treated group. The mice were injected with the same volume of PBS, DPSCs and ABs, respectively. The body weight, histological pathology, the expression levels of CD206 and cytokines, and the extent of tissue regeneration were measured. Results : DPSCs and ABs derived from DPSCs were successfully isolated and characterized. ABs could be taken up by macrophage. While lipopolysaccharide(LPS) induced production of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), ABs significantly reduced the levels of these pro-inflammatory cytokines and increased the expression of transforming growth factor-β (TGF-β) and CD206 (P < 0.01). In the cutaneous inflammatory wound model, the wound closure rate in mice intravenously injected with ABs was significantly accelerated (P < 0.05). The administration of ABs markedly reduced the pro-inflammatory factors levels and increased the CD206+ cell number. In the colitis model, treatment with ABs markedly reduced the loss in bodyweight (P < 0.05), recovered the colon length (P < 0.01), and significantly increased the CD206+ cell number. Conclusion DPSCs-derived ABs could enhance macrophage M2 polarization and attenuate inflammation. Therefore, ABs could be used as a promising cell replacement for inflammatory regulation and tissue regeneration.