Objective To explore the effect on ultrasound localization method with radial artery cannulation in infants.Methods Sixty infants (1 month-1year old)undergoing elective surgical proce-dures required artery pressure,were randomly divided into two groups:ultrasound localization group (group B):the infants were used of portable B ultrasound probe in the wrist with two dimensional ul-trasound image to determine the body position of the radial artery;control group (group C):tradi-tional palpation determine the radial artery puncture position.One puncture success rate,total punc-ture success rate,the period of puncture time and incidence of complications were recorded;MAP, the radial artery diameter,the vertical distance from the ultrasound probe to the skin and the length from the puncture spot to the radial artery were also measured.Results The success rate of first puncture in group B was higher than that of group C (P <0.05),the times of puncture and procedure time were significantly less than those of group C (P <0.05),the incidence of hematoma was lower than that in group C (P <0.05).Conclusion The application of ultrasound-guided method for radial artery cannulation is safe and reliable with accurate localization,highly successful rate of puncture at first time,lower complication and shorter time for placement.

This study was aimed to analyze the plasma metabolicomics pathway in rats with heart blood stasis syn-drome. KEGG database was used in the signal pathway analysis. HMDB was used in the analysis of molecular metabolite annotation, enzyme or transporter associated and its related properties. The metPA network software was used in the visualization of metabolite path. The results showed that 9 metabolites involved in 15 metabolic pathways. Among them, the P-value of metabolic pathway of pantothenate and CoA biosynthesis, propanoate metabolism, biosynthesis of unsaturated fatty acids was less than 0.05. It was concluded that the metabolic pathways of pan-tothenate and CoA biosynthesis, propanoate metabolism, biosynthesis of unsaturated fatty acids were involved with the pathological process of rats with heart blood stasis syndrome.

This study was aimed to analyze the bioinformatics of proteomics of rat bone marrow mesenchymal stem cells (MSCs) intervened by active principle region of Yang-Xin Tong-Mai Formula (apr-YTF). The latest versions of bioinformatics tools including DAVID (http://david.abcc.ncifcrf.gov/) and GO (http://www.geneontology.org/) were combined to assign a precise function to rat bone marrow MSCs intervened by apr-YTF. KEGG and VISANT were assigned with a precise function to rat bone marrow MSCs intervened by apr-YTF. The results showed that a total of 102 biological processes were mainly involved, with 35 cellular components and 6 molecular functions. These proteins interacted in 3 signal transduction pathways. It was concluded that the following proteins and signal transduction pathways played an important role in the process of apr-YTF inducing BMSCs differentiation into cardiomyocytes. Presenilin-1 and Presenilin-2 were in the Notch signaling pathway. And syntaxin-4 protein was in soluble N-ethylmaleimide sensitive fusion protein attachment protein (SNARE). The apr-YTF played a role on MSCs from multiple sites, with multiple links through different biological processes. The bioinformatics of proteomics can predict action mechanism of traditional Chinese medicine (TCM) from the holism concept. The validation in combination with molecularbiology was a good way for TCM modernization.

Objective:To evaluate the efficacy of ultrasound-guided bilateral erector spinae plane (ESP) block for pediatric patients undergoing Nuss procedure with general anesthesia.Methods:Thirty-two American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 4-15 yr, undergoing Nuss procedure with general anesthesia, were divided into ESP block plus general anesthesia group (group EG, n=16) and general anesthesia group (group G, n=16) using a random number table method.Bilateral ESP blocks were performed after anesthesia induction in group EG.Intravenous analgesia was performed postoperatively in both groups.Face Legs Activity Cry Consolability (FLACC) scores both at rest and during coughing were recorded on admission to postanesthesia care unit (PACU) and at 1, 6, 12, 24 and 48 h after operation.When FLACC score at rest >4, ibuprofen 5.0-7.5 mg/kg was taken orally according to the requirements of pediatric patients and their parents.The intraoperative amount of propofol and remifentanil used and postoperative requirement for fentanyl and ibuprofen were recorded.The development of postoperative hypoxia (SpO 2 <90%), nausea and vomiting, and urinary retention was recorded.The development of puncture site infection, hematoma and subcutaneous emphysema was recorded.The tracheal extubation time, duration in PACU and length of postoperative hospital stay were also recorded. Results:Compared with group G, FLACC scores at rest within 12 h after operation and during coughing within 6 h after operation were significantly decreased, the intraoperative consumption of remifentanil was reduced, the postoperative requirement for fentanyl and ibuprofen was decreased, the incidence of hypoxemia was decreased, the tracheal extubation time and duration in PACU were shortened ( P<0.05), and no significant change was found in the consumption of propofol, incidence of nausea and vomiting, or length of postoperative hospital stay in group EG ( P>0.05). Conclusion:Ultrasound-guided bilateral ESP block can reduce the consumption of opioids in the perioperative period and enhance the analgesic efficacy with a higher safety, which is helpful in promoting short-term outcomes for pediatric patients undergoing Nuss procedure with general anesthesia.

Objective:To retrospectively analyze the anesthetic management characteristics of children undergoing resection of pheochromocytoma and paraganglioma (PPGL).Methods:The clinical data from patients undergoing resection of PPGL and confirmed histologically from January 1, 2010 to June 30, 2023 were retrospectively collected. The baseline characteristics, intraoperative conditions and postoperative complications were recorded.Results:The clinical data from 47 pediatric patients were analyzed. The overall incidence of hemodynamic instability events was 68% (32 cases). Lowering preoperative blood pressure to normal levels and the maximum diameter of tumor≥6 cm was helpful in reducing the incidence of the intraoperative hemodynamic instability events ( P<0.05). Postoperative hypotension developed in 7 cases, acute left heart failure in 1 case, arrhythmia in 1 case, adrenocortical insufficiency in 4 cases, and pulmonary infection in 13 cases. Conclusions:Thorough preoperative preparation, evidence-based anesthetic management, and meticulous postoperative vital sign monitoring can increase the perioperative safety for children undergoing resection of PPGL, thereby reducing the incidence of complications.