The postoperative recurrence rate of gastrointestinal cancer is high. The therapeutic effect of traditional chemotherapy is not satisfactory, such as chemotherapy through vein and intestine perfusion and so on, and the side effects are obvious. In recent years, researchers in and abroad have begun to study the effect of intraperitoneal chemotherapy. Whether early postoperative intraperitoneal chemotherapy affect the healing of anastomotic stoma is still controversial. Intraperitoneal chemotherapy combined with medicine can achieve a better therapeutic effect. This article reviewed current issues of intraperitoneal chemotherapy, espe-cially its validity and safety.

Objective To study the effect of dexmedetomidine complex with remifentanil in elderly patients with laparoscopic colon cancer resection.Methods 80 cases of elderly patients with laparoscopic colon cancer resec-tion were selected and divided into the study group and the control group with 40 patients in each group according to the random number table method.Two groups were induced conventionally,and intraoperative anesthesia maintained by remifentanil and sevoflurane.The study group were pumped dexmedetomidine 0.8μg/kg 10min before induction, then the doses reduced to 0.2 μg·kg -1 ·h -1 for continuous pumping until to the end of surgery,while the control group was pumped the same dose 0.9% sodium chloride injection,then the heart rate(HR)and mean arterial pres-sure(MAP)of the two groups were compared when entered into surgery room(T0 ),administered 5min(T1 ),after intubation(T2 ),surgical incision(T3 )and after extubation(T4 ),and the compose score,recovery time,and agitation score of two groups were compared.Results HR and MAP of the study group at T1 ,T2 ,T3 and T4 were (62.2 ± 1.1)times/min,(67.3 ±3.2)times/min,(69.2 ±2.3)times/min,(70.2 ±2.5)beats/min and(68.3 ±0.5)mmHg,(70.1 ±0.9)mmHg,(71.5 ±0.9)mmHg,(68.2 ±1.9)mmHg significantly lower than which of the control group (t =9.289,10.293,8.928,9.039,9.278,10.789,9.322,8.399,all P <0.05),and HR and MAP of the control group at T1 ,T2 ,T3 and T4 were significantly higher than T0,the differences were statistically significant(t =8.928, 9.892,8.387,8.927,9,783,9,073,9.039,7.938,all P <0.05);Compose score(4.2 ±1.3)points of the study group was significantly higher than (1.2 ±0.2)points of the control group,but the agitation score of the study group was(1.2 ±0.7)points,which was significantly lower than (2.9 ±1.5)points of the control group,the differences were statistically significant(t =9.38,8.379,all P <0.05).Conclusion Dexmedetomidine complex with remifen-tanil has a anesthetic good effect in elderly patients with laparoscopic colon cancer resection,and which can maintain the more stable hemodynamics.

Objective To observe the clinical effect of propofol combined with sufentanil in laparoscopic ovarian cyst resection.Methods 80 cases who underwent laparoscopic ovarian cyst resection were chosen,they were divided into the observation group and control group with 40 patients in each group according to the random number table method.The observation group was anaesthetized with propofol combined with sufentanil,while the control group was anaesthetized with propofol combined with fentanyl,the recovery status,operation time,intraoperative bleeding volume,recovery time of gastrointestinal function and postoperative complications in the two groups were compared. Results The recovered spontaneous breathing time,recovery time,extubation time of the observation group were (8.4 ±2.3)min,(10.51 ±3.3)min,(12.7 ±2.3)min,which of the control group were (10.11 ±2.2)min, (12.3 ±2.6)min,(15.3 ±3.5)min,there was statistically significant difference between the two groups (t =3.378, 2.710,3.926,all P <0.05);The operation time,operation amount of bleeding,gastrointestinal function recovery time of the observation group were (44.7 ±5.4)min,(19.5 ±3.5)mL,(18.3 ±2.4)h,which of the control group were (67.5 ±7.8)min,(42.7 ±2.8)mL,(42.4 ±3.2)h,there were significant differences between the two groups(t =15.200,32.736,38.105,all P <0.05).Postoperative analgesia,postoperative awareness,emergence delirium inci-dence rates of the observation group were 25%,0%,7.5%,which were significantly lower than 57.5%,12.5%, 37.5% of the control group,the differences were statistically significant(χ2 =8.717,5.333,10.323,all P <0.05). Conclusion The propofol combined with sufentanil in laparoscopic ovarian cyst resection has more significant effect, which can shorten the operation time,promote the postoperative recovery,reduce complications,worthy to be widely used in clinical practice.

Objective To explore effect of propofol or sevoflurane combined with dexmedetomidine on postoperative cognitive function , erythrocyte sedimentation rate and oxidative stress in patients with bone tumour .Methods 52 cases with bone tumor and requiring a surgery were selected and divided into sevoflurane group and propofol group randomly.The sevoflurane group were anesthetized with sevoflurane and dexmedetomidine.Propofol group were anesthetized with propofol and dexmedetomidine.The cognitive function score, recovery time, sedimentation value and oxidative stress level were compared after operation.ResuIts Compared with propofol group at the same time, the cognitive function score of patients in sevoflurane group at postoperative 6, 12, 24 h were higher (P<0.05) and restored to preoperative levels at postoperative 24 h (P<0.05) .The recovery time of spontaneous breathing, eyes open, remove endotracheal intubation and directional force in sevoflurane group were shorter than that in propofol group (P<0.05).Compared with propofol group at the same time, the erythrocyte sedimentation rate in sevoflurane group at postoperative 5, 10d were lower (P<0.05) and restored to preoperative levels at postoperative 10 d (P<0.05).Compared with propofol group postoperation, the superoxide dismutase (SOD) and methane dicarboxylic aldehyde (MDA) levels in sevoflurane group were lower, total antioxidant capacity (T-AOC) level was higher (P<0.05).ConcIusion Sevoflurane has a smaller effect on postoperative cognitive function than propofol in patients with bone tumor, combined with dexmedetomidine, which has an important significance to clinical surgery.

Objective To evaluate the accuracy and value of ventricular function in conotruncal defects(CTD)by three-dimensional echocardiography(3DE).Methods Fifty-two children with CTD and forty-three children with normal hearts were examined by 3DE.The measurements of left ventricular volume and wall mass were outlined and calculated.The measurements of left ventricular volume and wall mass of 3DE in preoperative CTD were compared with those of 2D biplane Simpson-method in preoperative CTD,3DE in control group and 2D biplane Simpson-method in control group.The results of 3DE and 2DE preoperative measurements were also compared with their postoperative clinical cardiac conditions.Results From the findings of analysis of variance and Student-Newman-Keuls(SNK)test,there was no significant difference between 3DE and 2DE measurements of left ventricular function in normal children,but there was significant difference between 3DE and 2DE measurements of left ventricular function in children with CTD.2DE measurements of left ventricular volume and wall mass in the CTD group were significant underestimated and less correlated with their postoperative clinical cardiac conditions(r=0.20,P=0.2086)than 3DE measurements(r=0.39,P=0.0090).Furthermore,left ventricular function in the CTD group was poorer than that in the control group.Stroke volume and effective function were reduced due to increasing end-systolic volume.while left ventricular wall mass was increased due to the possible compensation of its ventricular muscle.With the lower end-diastolic volume,stroke volume and effective function,patients were more likely to have the occurrence of postoperative low cardiac output.Conclusions By making a precise quantitative assessment,3DE is very useful in providing more information for preoperative diagnosis in CTD and predicting such postoperative prognoses as the occurrence of postoperative low cardiac output.

Objective To investigate the effect of doxapram on inhibition of medullary respiratory center excitability by sevoflurane in rats.Methods Neonatal Sprague-Dawley rats of both sexes,aged 1-4 days,were used in this study.Isolated medulla oblongata-spinal cord specimens were made according to the method described by Suzue and perfused with the artificial cerebrospinal fluid saturated with 95％O2-5％CO2.The specimens were randomly divided into 3 groups ( n =9 each):control group (group C),sevoflurane group (group S) and sevoflurane + doxapram group (group S + D).Respiratory rhythmical discharge activity of the hypoglossal nerve rootlets was recorded using suction electrode.After 10 min of equilibration,the specimens were perfused with the artificial cerebrospinal fluid,5％ sevoflurane and the mixture of 5％ sevoflurane and 5 μmol/L doxapram for 10 min in groups C,S,and S + D respectively.The respiratory cycle,inspiratory time and integral amplitude of inspiratory discharge were recorded.Results Compared with group C,the respiratory cycle was significantly prolonged,the inspiratory time was significantly shortened,and the integral amplitude of inspiratory discharge was significantly decreased in group S (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group S + D (P ＞ 0.05).Compared with group S,the respiratory cycle was significantly shortened,the inspiratory time was significantly prolonged,the integral amplitude of inspiratory discharge was significantly increased in group S + D ( P ＜ 0.05).Conclusion Doxapram antagonizes sevoflurane-induced inhibition of excitability of medullary respiratory center in rats.

Objective To investigate the effects of different doses of dexmedetomidine on perioperative inflammatory responses in patients undergoing one-lung ventilation (OLV).Methods Thirty-six ASA T or Ⅱ patients (aged 43-72 years and weighing 50-78 kg) scheduled for esophagectomy were randomly divided into three groups (n =12 each):control group (group C),low dose dexmedetomidine group (group D1) and high dose dexmedetomidine group (group D2).Dexmedetomidine 1 μg/kg was infused intravenously 10 minutes before anesthesia induction,then infused at a rate of 0.2 μg· kg-1 · h-1 (group D1) or 0.5 μg· kg-1· h-1 (group D2) until 30 minutes before the end of operation.Group C received the equal volume of normal saline.Blood samples were collected before anesthesia induction (T0),immediately before OLV (T1),30 minutes after OLV (T2),90 minutes after OLV (T3),30 minutes after lung inflation (T4) and 2 hours after operation (T5) for monitoring serumlevels of tumor necrosis factor-alpha (TNF-α) and interleukin-8 (IL-8).Results Compared with T0,serum levels of TNF-α and IL-8 significantly increased at T3 and T5 in all the three groups (P ＜ 0.05).Compared with group C,serum levels of TNF-α and IL-8 significantly decreased at T3 and T5 in group D2 (P ＜ 0.05).There was no significant difference in the indexes mentioned above between group C and group D1 (P ＞ 0.05).Conclusion Dexmedetomidine 1 μg/kg given before anesthesia induction and then infused at the rate of 0.5 μg· kg-1 ·h-1 during operation can reduce inflammatory responses in patients undergoing OLV.

Objective To observe influence of continuous lumbar cistern drainage on levels of amyloid β-peptide (Aβ) subtype (Aβ1-42) in cerebrospinal fluid and plasma in patients with diffuse axonal injury (DAI) and investigate its clinical significance.Methods Eighty-one DAI patients were enrolled and randomized into treatment group (42 cases) and control group (39 cases).Patients in control group received simple conventional therapy,while the patients in treatment group received not only conventional therapy but 14 days of continuous lumbar cistern drainage.Levels of Aβ1-42 in cerebrospinal fluid and plasma were detected by ELISA assay before therapy and at 1,5,9,and 14 days after therapy.Prognosis was assessed using GOS at 6 months after therapy.Results Levels of Aβ1-42 in cerebrospinal fluid and plasma showed a decrease in the first place and a gradual decrease afterwards in both groups,but a bigger and earlier drop of Aβ1-42 levels was observed in treatment group.Two groups showed significant difference of Aβ1-42 levels at day 14 (P ＜ 0.05).At 6 months after therapy,GOS score between treatment and control groups was (4.1 ± O.5) and (3.4 ± 0.3) points respectively (P ＜0.05).Conclusion Continuous lumbar cistern drainage improves the prognosis of DAI and this may relates to the decrease of Aβ1-42 levels in cerebrospinal fluid and plasma.

Objective To reveal the character of tricuspid valve in hypoplastic right ventricular heart syndrome (HPRVHS) using 3-dimensional echocardiography(3DE). Methods Twenty eight patients with HPRVHS were included in the study, and they were divided into two groups according the degree of tricuspid regurgitation. Eighteen normal children were included as the control. Volume of right ventricle(VRV), area of tricuspid annulus(TVA),proportion of the leaflets and the distance from tips of leaflets to the nearest papillary muscle were measured with 3DE. These data was standardized by body surface area. Results The volume of right ventricle in HPRVHS was significantly less than that in normal group. The area of tricuspid annulus was significantly correlated with volume of right ventricle(r = 0. 90, P < 0. 0001). In the tricuspid regurgitation group, the proportion of area of anterior leaflet to area of tricuspid annulus was significantly higher than non-regurgitation group and normal group(P <0. 0001). Respectively,the proportion of the area of posterior leaflet to the area of tricuspid annulus in regurgitation group was significantly less than normal and non-regurgitation group. The distance from tips of leaflets was significantly shorter in HPRVHS than in normal group. Furthermore, the distance from the tip of septal leaflet to the nearest papillary muscle was shorter in regurgitation group than non-regurgitation group ( P = 0. 0023). Conclusions 3DE could be applied for evaluating the pathologic change of tricuspid valve in congenital heart disease. In HPRVHS, hypoplastic of posterior leaflet and shortness of the cords of septal leaflet could be the cause of tricuspid regurgitation.

Objective To investigate the effects of original antigenic sin caused by previous expo-sure to influenza A virus subtype H1N1 on the immune response to inactivated H5N1 vaccine. Methods In this study, the BALB/c mice were first infected with A/PR8 (H1N1) virus or immunized with inactivated vaccine to induce immune responses against the A/PR8 virus. Then they were injected once with inactivated H5N1 vaccine at dosages of 0. 01μg, 0. 1μg and 1μg, respectively. The levels of IgG and neutralizing an-tibodies in serum samples were detected after immunization. Four weeks after immunization, the mice were challenged with a lethal dose of H5N1 virus. Some indicators including the survival rate, body weight loss and residue virus titer in lung were recorded for further evaluation. Results The pre-existing anti-A/PR8 antibodies in mice didn′t alleviate the immune responses to inactivated H5N1 vaccine. Conclusion This study indicates that the original antigenic sin associated with the previous exposure to A/PR8 virus has no significant effect on the immune efficacy of H5N1 vaccine.