Objective To evaluate the efficacy of multimodal-antiemetic therapy on postoperative dizziness,headache,nausea and vomiting (PONV) in patients undergoing thyroidectomy.Methods One hundred patients (39 males and 61 females,ASA physical status Ⅰ or Ⅱ) scheduled for thyroidectomy were randomly divided into two groups according to random number table: control group (group C) and multimodal-antiemetic therapy group (group M).Two groups received total intravenous anesthesia (TIVA) with propofol and remifentanil.Prophylactic dexamethasone 10 mg were given after anesthesia induction and palonosetron hydrochloride 0.25 mg was used 30 min before the end of surgery in both groups.Mannitol 2 ml/kg in group M and the same amount of normal saline in group C were given 30 min before the end of surgery.The incidence of dizziness,headache and PONV were observed for 24 h in two groups.Results The incidence of headache was 5 cases (10%)and PONV was 5 cases (10%) in group M,which were respectively significantly lower than that of group C of 15 cases (30%) and 12 cases (24%) in 24 h after surgery (P<0.05).The additional antiemetic therapy for 24 h after surgery in group M of 2 cases (4%) was significantly lower than that of group C of 9 cases (18%) (P<0.05).Conclusion The multimodal-antiemetic therapy: prophylactic dexamethasone,palonosetron hydrochloride and mannitol were used 30 min before the end of surgery could significantly reduce the incidence of dizziness,headache and PONV after thyroidectomy.

Objective To evaluate the efficacy of volume therapy guided by stroke volume variabil-ity ( SVV) in the patients undergoing surgery for severe traumatic brain injury. Methods Thirty patients of both sexes with severe traumatic brain injury, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅲ, who were admitted to the hospital within 24 h after injury, with Glasgow Coma Scale ( GCS) score≤8, were divided into control group ( C group, n=15) and SVV group ( n=15) using a ran-dom number table method. In group C, conventional fluid administration was performed to maintain mean arterial pressure at 65-110 mmHg, central venous pressure at 5-12 cmH2 O and urine volume>1 ml·kg-1 ·h-1 . Fluid was given according to SVV, maintaining SVV≤13％ and mean arterial pressure at 65-110 mmHg in group SVV. Immediately after skin incision ( T0 ) , immediately after opening cerebral dura mater ( T1 ) , at 1 h after opening cerebral dura mater ( T2 ) , immediately after suturing cerebral dura mater ( T3 ) and at the end of operation ( T4 ) , blood samples were collected from the radial artery and inter-nal jugular venous bulb for blood gas analysis, the jugular venous oxygen partial pressure, jugular venous bulb oxygen saturation, blood lactate, arterial oxygen partial pressure, arterial oxygen saturation and Hbwere recorded, and the cerebral artery and arteriovenous blood O2 content difference and cerebral O2 extrac-tion rate were calculated. Blood samples were collected from the internal jugular venous bulb at T0-2 , T4 and 24 h after operation ( T5 ) for determination of S100β protein concentrations by enzyme-linked immunosor-bent assay. The intraoperative volume of fluid intake and output and consumption of vasoactive drugs were recorded. GCS scores were recorded immediately after admission to the operating room, and at 1, 3, 7 and 14 days after operation. The development of postoperative length of hospitalization and complications ( pul-monary infection and brain edema) was recorded. Glasgow Outcome Scale Score was used to assess the early postoperative quality of life. Results Compared with group C, the urine volume was significantly in-creased, the consumption of vasoactive drugs was reduced, jugular venous bulb oxygen saturation was in-creased at T2,3 , the cerebral O2 extraction rate was decreased at T2-4 , the serum S100β protein concentra-tion was decreased at T2 , and the GCS score was increased at day 3 after operation ( P<0. 05) , and no sig-nificant change was found in blood lactate, postoperative Glasgow Outcome Scale score or length of hospital-ization at each time point in group SVV ( P>0. 05) . Conclusion SVV-guided volume therapy can improve cerebral oxygen metabolism, ensure adequate tissue perfusion and reduce craniocerebral injury in the pa-tients undergoing surgery for severe traumatic brain injury.

Objective:To observe the dynamic changes in specific IgG antibodies induced by recombinant hepatitis E vaccine using different immunization strategies in BALB/c mice.Methods:BALB/c, C57BL/6, NIH and KM mice were immunized intraperitoneally with serially diluted hepatitis E vaccine to select a mouse strain appropriately responding to hepatitis E vaccine. Then the selected BALB/c mice were randomly divided into three experimental groups, one-dose immunization group (0 week), two-dose immunization group (0 and 4 weeks) and three-dose immunization group (0, 4 and 12 weeks), and three adjuvant control groups with the same immunization strategy as the corresponding experimental group. Blood samples were collected from the intraocular canthus at different time points and serum antibody levels were detected quantitatively.Results:The BALB/c and NIH mice had proper responses to hepatitis E vaccine administrated at different doses than the C57BL/6 and KM mice, and the antibody positive conversion rates also showed a certain dose-effect relationship. Thus, the BALB/c mice were used as the animal model. The level of specific IgG antibodies in BALB/c mice immunized with one dose of vaccine reached a peak of 44.35 U/ml around the 10th week after the immunization, and then maintained at (5.52-13.28) U/ml after a decrease. The antibody level in the two-dose immunization group increased rapidly after the second immunization and peaked at the 8th week. From the 10th week, it gradually decreased and maintained at (16.50-32.54) U/ml. The trend of antibody changes in the three-dose immunization group was similar to that of the two-dose immunization group during the first 12 weeks, but a significant increase was induced after the third immunization and the level maintained at (62.65-72.61) U/ml for a long time, which was about nine times higher than that of the one-dose immunization group and three times of the two-dose immunization group.Conclusions:This study showed that BALB/c mice were suitable models to study the dynamic changes in specific IgG antibodies elicited by hepatitis E vaccine using different immunization strategies, which provided reference for future research on its in vivo efficacy.