Dexmedetomidine,a medetomidine D-isomer,is an α2-adrenoceptor agonist with protent sedetation,analgesia and antianxiety effects.It can reduce sympathetic nerve reflex induced by operation and anesthesia,stabilize hemodynamic condition,and exert no inhibition of central respiratory system.Intravenous injection of dexmedetomidine is a commonly used route of administration,mainly for perioperative anesthesia and ICU sedation.Unfortunately,intravenous injection of dexmedetomide is invasive,thus it is not recommended for children.Compared with intravenous medication,non-intravenous use indicates slow but stable onset and wider range of safety,which has good anesthetic effect in perioperative patients or those outside the operating room,especially pediatric patients.Dexmedetomidine by nasal dripping is absorbed into the blood through nasal mucosa,which has immediate effect and high bioavailability.Colorless and tasteless dexmedetomidine provides less nasal mucosa irritation and has good tolerance.This article aims to update and review the safety and effectiveness of intranasal dexmedetomidine in pediatric general anaesthesia.

Objective To investigate whether intranasal dexmedetomidine prevents the emergency delirium after sevoflurane-based anesthesia (ASA) in children.Methods Ninety children (ASA I,2 to 7years) undergoing elective tonsillectomy with or without adenoidectomy,were randomly divided into group D1 (intranasal dexmedemidine 1.0 μg/kg),group D2 (intranasal dexmedemidine 0.5 μg/kg),and group NS (intranasal normal saline).Anesthesia was induced with sevoflurane (30 min after intranasal administration) and maintained with sevoflurane in 50/50％ O2/N2O.Heart rate (HR),blood pressure (BP),and hemoglobin oxygen saturation (SpO2) were monitored before intranasal administration to 2 hours after extubation.Time of operation and extubation were recorded.Pediatric anesthesia emergence delirium (PAED) scale,Modified Children's Hospital of Eastern Ontario Pain Scale (m-CHEOPS) Pain scale and the adverse effects were observed.Results The PAED scales of group D1 and Group D2 were significantly lower than group NS.No significant differences were found in hemodynamic and respiratory variables,pain scale,time of extubation and adverse effects among three groups.Conclusions Intranasal dexmedetomidine decreased the severity of emergence delirium after sevoflurane-based anesthesia in children without prolonging the time to extubate and affect hemodynamics and respiratory variables.

With the rapid development of general anesthesia technology and the occurrence of new types of inhalation and intravenous anesthetics,safety and comfort requirements of general anesthesia become increas-ingly higher. Therefore,emergence agitation and its adverse consequences gradually receive more and more atten-tion . Thus the etiology and prevention of emergence agitation is an important issue in pediatric anesthesia at pres-ent. In recent years, some achievement has been made in emergence agitation following general anesthesia in children. This article will summarize the related factors,possible mechanisms and prevention strategics of pediat-ric emergence agitation.

Objective To establish a method to detect viral integrity of human papillomavirus in women cervical HPV infection. Methods We amplified E6/E7 gene and E2 gene of HPV16,then inserted them into a plasmid containing single copy HBB gene. HPV16 infected cervical epithelium samples were screened out by genotyping with RDB of flow-through hybridization assay.Fluo-rescence quantitive PCR data of HBB,viral E2 gene and viral E6 gene of all samples were standardized by compared with respective parameters of the plasmid.The ratio IHPV and CHPV were calculated to find out E2 gene disruption and viral copies per cell in the cer-vical samples,respectively.Results The plasmid constructed for standardization was proved effective to make the FQ-PCR data of E2 gene,E6 gene and HBB gene comparable.Thirty-seven HPV16 positive cervical epithelium samples included 22 cases from women whose TCT were normal,and 15 cases from women who confirmed HIL/CIN 2-3 or above through colposcopic examina-tion plus biopsy.Fifteen samples were detected E2 gene disruption,including 10 HIL/CIN 2-3 or above samples and 5 TCT normal samples.E2 gene integrity in different groups were statistically significant different(P <0.05).The average viral copies per cell dis-played a significant decline along with E2 gene disruption(P <0.05).Conclusion The tandem single copy gene plasmid standard-ized methord for the detection of E2 gene disruption caused by viral integration in HPV16 infected cervical cells is feasible and effec-tive.

Objective To study the factors such as artificial abortion frequency, pregnancy time and so on on development of adeno-myosis (AM). Methods A retrospective analysis was carried in 462 patients who were from the department of gynaecology and obstetrics in Affiliated Hospital of Nantong University and Beijing Aviation Center Hospital from January 2004 to December 2008. The patients were divided into two groups: AM and no - AM. The two groups were compared for abortion frequency, pregnancy time, age, menarche age and so on. Results There were no significant differences between the two groups in age, menarche age, age of the first artificial abor-tion, bearing frequency, IUD with pregnancy and so on(P > 0.05). The proportion of patients with repeated artificial abortion or history of curettage of uterus in AM group was higher than that in the no - AM group. The patients with pregnaney time more than 8 weeks who re-ceived artificial abortion had higher rate of development of AM. Conclusion Repeated artificial abortion, pregnancy time and history of curettage of uterus were the risk factors of development of adenomyosis.

thoracic. No immunoreactive product was seen in the ventral horn. The possible functions of CGRP in substantia gelatinosa of the spinal dorsal horn were discussed.

Objective To investigate the effect of astragalus polysaccharide,a component of an aqueous extract of Astragalus Membranaceus roots,on differentiation and maturation of dendritic cells in vitro. Methods 30 BALB/c mice were randomly divided into three groups,normal control group,100,200 mg/kg APS intraperitoneal injection groups. After one week,weight the mouse spleen,account the splenetic index. Collect the mouse bone marrow cell,induced and cultured with rmGM-CSF and rmIL-4. With inverted microscope to investigate the morphous of DC cell. The phenotypes of DC were detected by flow cytometry and the expression of the GM-CSF protein in serum was tested by ELISA. Results Astragalus polysaccharide injection had obvious effects on the spleen weight of mice. The degree of CD11c and MHC-Ⅱ expression in 100 mg/kg and 200 mg/kg groups on flow cytometry were advanced significantly compared with that in normal control group,but the degree of CD80 and CD86 was not increased. And the expression of the GM-CSF protein in serum in 100 mg/kg group and 200 mg/kg group were both not increased significantly compared with nomal control group. Conclusion The intraperitoneal injection of astragalus polysaccharide could stimulate the proliferation of the pre DC in bone marrow. The angtigen presentation of DC might be enhanced,but this effects was not positive correlation with concentration of GM-CSF.

Objective To understand the risk factors of allergic rhinitis in adults. Methods Using 1:1 paired matching case-control study design, 100 pairs of adults allergic rhinitis patients and the relevant controls from the E.N.T. department of Renmin Hospital of Peking University were recruited. Cases and controls were interviewed face to face using a designed health questionnaire in which the general social demographic characters, disease history, smoking history, occupation, indoor environmental situation and family genetic history were included. The questionnaires were analyzed by signal and multiple regression model of SPSS software. Results Allergic rhinitis was associated with the pollen allergic history (OR=2.04,95%CI: 1.31-3.20), occupational exposure to dust was a risk factor of allergic rhinitis (OR=1.46, 95%CI:0.83-2.57), the mother allergic rhinitis history could increase the risk of their off-springs suffering from allergic rhinitis(OR=2.05, 95%CI:1.03-4.07) and keeping ventilation could significantly decrease the risk suffering from allergic rhinitis(OR=0.70, 95%CI:0.34-1.18). Conclusion The occupational dust exposure, pollen allergy and mother allergic rhinitis history are related to allergic rhinitis in adults. Keeping ventilation may be a protective factor of allergic rhinitis in adults.

0.05).The proportion of patients with repeated artificial abortion or history of curettage of uterus in AM group was higher than that in the no-AM group.The patients with pregnancy time more than 8 weeks who received artificial abortion had higher rate of development of AM.Conclusion Repeated artificial abortion,pregnancy time and history of curettage of uterus were the risk factors of development of adenomyosis.

Objective To investigate the timing for delivery in twin pregnancies to improve the perinatal outcome. Methods A multicentered and retrospective study was conducted on 655 women with twin pregnancies in 6 hospitals of Shanghai from Jan 1993 to Oct 2003. The average birthweight(BW) for both twins in different gestation, the incidence of small for gestational age (SGA) and severe neonatal asphyxia were analyzed. Results For the smaller babies in all twins, the 50 percentile of the birth weight was far behind the singletons throughout the pregnancy. But for the larger babies, it was similar to the singletons if delivered before 33 weeks, lighter than the singletons if after 33 weeks and remarkable difference was shown beyond 39 weeks. The largest BW of the larger babies was 3073 g presented at 39 weeks, while 2670 g for the smaller babies at 40 weeks after which the average BW was decreased. It reached 2555 g and 2303 g at 41 weeks for the larger and smaller babies, respectively (P