Objective To invetigate the effect and safety of sufentanil mixed levobupivacaine on postoperative analgesia in pediatric caudal block anesthesia.Method Sixty pediatric patients (2 ～ 6 years old) who were undergoing elective abdominal surgery,such as repair hernia of high ligation,were randomly divided into three groups with 20 cases each.after intravenous induction,0.25％ levobupivacaine was injected in sacrum tube in group Ⅰ,0.5 μg/ml sufentanil mixed 0.25％ levobupivacaine and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine were injected in sacrum tube in group Ⅱ and group Ⅲ respectively.The analgesia effect,the analgesia time,recover time and adverse reaction were observed and recorded 2,4,8,12,16,24 hours after the surgery.Results The analgesia effect in group Ⅱ、Ⅲ were significantly better than the group Ⅰ when 4、8、12 hours after the operation(P ＜0.05),and the analgesia effect in groupⅢ were significantly better than the group Ⅱ when 8 hours after the operation (P ＜ 0.05).There were no significant differences in three groups when 2、16、24 hours after the operation(P ＞0.05),the analgesia time in group Ⅱ、Ⅲ were significantly longer than the group Ⅰ (P ＜ 0.05),and the analgesia time in group Ⅲ were significantly longer than the group Ⅱ (P ＜ 0.05).There were no differences in the recovery time of three groups (P ＞ 0.05).There were no adverse reactions in three groups.Conclusions 0.5 μg/ml and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine may be used on postoperative analgesia in pediatric caudal block anesthesia safely and analgesia effect and time were more better and longer than 0.25％ levobupivacaine singly.The analgesia effect in group with 1.0μg/ml sufentanil mixed 0.25％ levobupivacaine was the best in three groups with the fewest side effects.

Objective To determine the roles of thymic stromal lymphopoietin receptor (TSLPR) and its antibody in airway inflammatory response in asthmatic mice, and to promote maturation and activation of dendritic cells (DCs) in mouse airway. Methods BALB/c mice were randomly divided into group A, B and C. The mice in group B and C were intraperitoneally injected with OVA for allergization while the mice in group A were intraperitoneally injected with PBS as the normal control. The mice in group B and C were treated by inhalation of non-specific IgG and TSLPR IgG respectively, before provocation of asthma using OVA. The bronchoalveolar lavage fluid (BALF) of the mice in different groups were collected for cell differential counts and quantitative detection of IL-4, IL-5, IFN-γand IL-10 levels by ELISA. Moreover, the pulmonary tissue specimens of the mice were collected for pathological examination, and the numbers and phenotypes of DCs from the local lymph nodes and pulmonary tissue were determined by flow cytometry. Results The levels of all the tested cytokines in the BALF from mice in group B and C were remarkably higher compared to those from mice in group A (P<0.01). However, both the IL-4 and IL-5 levels in the BALF from group C mice that pre-blocked with TSLPR IgG were lower than those from group B (P<0.05, P<0.01), whereas both the IFN-γ and IL-10 levels in the BALF from group C mice were higher than those from group B (P<0.05, P<0.01). Furthermore, the numbers of total cells, eosinophils and lymphocytes in the BALF from group C mice were also lower than those from group B (P<0.01). A large number of inflammatory cell infiltration around the bronchus, beaker cell proliferation and mucous secretion reinforcement could be found in the samples from group B mice, while slight inflammatory cell infiltration and beaker cell proliferation in the samples from group C mice. The numbers of DCs in mediastinal lymph node and the levels of I-Ad, CD40, CD80 and CD86 expression of pulmonary DCs from group B mice were higher than those from group C mice (P<0.05). Conclusion TSLP/TSLPR have an effect on promoting asthma, which is closely relative to its regulation of DCs activation. And the interference of TSLPR antibody can decrease the effect of TSLP/TSLPR which indicating a potential of the antibody as a novel anti-asthma drug.

Objective To evaluate the role of contrast-enhanced ultrasound (CEUS) for preoperative detection of colorectal liver metastases.Methods 42 consecutive patients with colorectal liver metastases confirmed by histopathology after surgery were recruited in the study.They all had undergone preoperative CEUS examination with contrast agent SonoVue.The number,location and size of the hepatic lesions found by CEUS were correlated with postoperatively histopathologic results on a lesion-by-lesion basis.Results 96 liver metastases in 42 patients with colorectal cancer had been resected and confirmed by histophathology.The size of the metastatic lesions ranged from 0.3～8.5 cm [average (2.6 ± 1.8)cm].From one to eight metastatic lesions were detected in one patient.21 (21.9％) metastatic lesions were equal to or less than 1.0 cm.86 of 96 metastatic lesions were correctly depicted by CEUS,with a sensitivity of 89.6％.And the sensitivity for metastatic lesions equal to or less than 1.0 cm was 71.4％ (15 of 21 tumors) by CEUS.35 metastatic lesions were found between the portal venous phase and late phase by CEUS and 19 (54.3％) metastatic lesions among them could not be detected at conventional ultrasound.The curative resection was performed in 37 (88.1％) of 42 patients.With 3 - 39 months follow-up,the intrahepatic recurrence rate within two years was 32.4％ (12 of 37 patients) and the one-year survival rate was 90.0％.Conclusions CEUS is highly sensitive for detecting liver metastases resulted from colorectal cancer,especially for small metastatic lesions.CEUS is helpful to choose reasonable therapeutic strategies and can be regarded as one of the most importantly and noninvasively preoperative imaging modalities.

Objective To summarize the experience of intraoperative rapid parathyroid hormone (PTH) detection by immunochromatography in thyroid surgery.Methods Patients undergoing thyroid surgery in Shanghai Tenth People's Hospital from Nov.2016 to Jul.2017 were collected and the clinical data including level of blood calcium,serum phosphorus and PTH,and pathological findings were analyzed.Results In this study,im munochromatographic assay was used in 45 cases (experimental group) and nano carbon method was used in 47 cases (control group).In benign cases,levels of blood calcium and PTH in experimental group were higher than those in the control group ((2.07±0.09) vs (2.04±0.06) and (3.41±1.82) vs (3.34±1.84),P＞0.05).In malignant cases,blood calcium level in experimental group was higher than that in the control group ((2.02±0.13) vs (1.99±0.38),P＞0.05) and PTH level was significantly higher than that in the control group ((2.22±1.27) vs (1.44±1.44),P＜0.05).Serum phosphorus level in experimental group group was much lower than that in the control group ((1.02±0.17) vs (1.14±0.23),P＜0.05).Conclusions Using intraoperative rapid PTH detection by immunochromatography can identify parathyroid and avoid accidental injury of parathyroid gland,which can reduce the postoperative incidence of hypocalcemia.

Objective:Acute retinal necrosis syndrome(ARNS) is a rare disease with high blinding rate.The surgery of vitrectomy,endolaser photocoagulation and silicone oil injection is considered an effective treatment of ARNS.The study investigated the effect of vitrectomy,endolaser photocoagulation and silicone oil injection treating ARNS.Methods:A consecutive 16 eyes of 16 patients with ARNS were treated with vitrectomy,endolaser photocoagulation and silicone oil injection.The 5 eyes without retinal detachment were photocoagulated from the posterior border of necrosis to the ora serrata.The 11 eyes with retinal detachment were treated with subtotal retinal photocoagulation,air/fluid exchange and silicone oil injection.The follow-up time were 6 months at least,16 months in average.Results:The final best-correcting visual acuity was counting fingers in 3 eyes(18.8%),0.02-0.3 in 7 eyes(43.8%),0.4-0.6 in 5 eyes(31.3%),0.7 in 1 eye(6.3%).The silicone oil was uneventfully removed in 14 patients(87.5%) from 3 to 12 months.No one had a recurrent retinal detachment.Conclusion:There is a favorable effect in ARNS with the treatment of vitrectomy,endolaser photocoagulation and silicone oil injection.

Real-time free breathing cardiac cine imaging is a reproducible method with shorter acquisition time and without breath-hold for cardiac magnetic resonance imaging. However, the detection of end-diastole and end-systole frames of real-time free breathing cardiac cine imaging for left ventricle function analysis is commonly completed by visual identification, which is time-consuming and laborious. In order to save processing time, we propose a method for semi-automatic identification of end-diastole and end-systole frames. The method fits respiratory motion signal and acquires the expiration phase, end-diastole and end-systole frames by cross correlation coefficient. The procedure successfully worked on ten healthy volunteers and validated by the analysis of left ventricle function compared to the standard breath-hold steady-state free precession cardiac cine imaging without any significant statistical differences. The results demonstrated that the present method could correctly detect end-diastole and end-systole frames. In the future, this technique may be used for rapid left ventricle function analysis in clinic.
Exhalation ; Heart Ventricles ; pathology ; Humans ; Magnetic Resonance Imaging ; Respiration ; Ventricular Function, Left

Objective To develop a recognition method of liver steatosis degree on type-B ultrasonic images based on multi-fractal spectrum texture analysis method and pattern recognition. Methods Features of singularity strength width and multi-spectrum area were extracted from the curve of multi-fractal spectrum of each liver ultrasonic images. These two features and the feature of mean intensity ratio comprised a three-dimensional feature vector, which would be classified by BP neural network. Results The classification accuracy was 96.00% for normal liver, 80.00% for mild fatty liver, 88.00% for moderate fatty liver and 92.00% for severe fatty liver. Conclusion Feature vector combined with BP neural network can identify the steatosis degree of liver on the ultrasonic images and can be used as an assistant diagnostic method.

OBJECTIVE: To establish a fast and efficient HPLC method for the chiral separation of ondansetron hydrochloride and determination of the enantiomic impurity of (-)ondansetron(R)hydrochloride.

Objective To investigate the effects of diclofenac sodium suppositories on emergence agitation after sevoflurane maintenance in children undergoing adenotonsilleetomy. Methods Forty-five patients selected for adenotonsillectomy were randomly divided into three groups (n=15). Patients in group 1 were given diclofenac sodium suppositories 12.5 mg right after intubation, those in group 2 were given diclofenac sodium suppositories 12.5 mg immediately after operation, while those in control group were not treated with diclofenac sodium suppositories before or after operation. The extubation time and time spent in post-anesthctic ICU (PACU) were recorded, the modified Aldrete score and pain score were assessed after entrance into PACU, and pediatric anesthesia emergence delirium (PAED) scale was administered 10, 20 and 30 rain after entrance into PACU. Results There was no significant difference in extubation time and time spent in PACU among three groups(P>0.05). Ten minutes after entrance into PACU, the PAED score of group 1 was significantly lower than those of group 2 and control group(P<0.05), while there was no significant difference between the latter two groups(P>0.05). Twenty and thirty minutes after entrance into PACU, the PAED scores of group 1 and group 2 were significantly lower than that of control group(P<0.05). There was no significant difference in the modified Aldrete score right after entrance into PACU among three groups. The pain scores of group 1 and group 2 were signifiantly lower than that of control group(P< 0.05). Conclusion Diclofenac sodium suppositories can decrease the incidence and severity of emergence agitation after sevoflurane maintenance in children undergoing adenotonsillectomy.

OBJECTIVETo study the effects and underlying mechanisms of Zhuyun Recipe (ZR) on the endometrial receptivity in ovarian stimulation (OS) and blastocyst implantation dysfunction (BID) mice.

METHODSTotally 200 normal female Kunming mice were randomly divided into 6 groups, i. e., the control group (Group A), the OS group (Group B), the OS + ZR group (Group C), the BID group (Group D), the BID + ZR group (Group E), and the ZR group (Group F). The pregnant mare's serum gonadotrophin (PMSG) and human chorionic gonadotrophin (HCG) were intraperitoneally injected to mice in Group B. Mifepristone was subcutaneously injected to mice in Group D at 9:00 am on the 4th gestation day. Corresponding medications were given to mice in Group C, E, and F at 1.5 mL/100 g by gastrogavage at 8:00 am from the first to the 4th gestation day. Eight uterus samples were collected at 9:00 pm on the 4th gestation day and fixed. The expression levels of leukemia inhibitory factor (LIF) and integrin beta3 were detected using immunohistochemical assay. The pregnant mice were sacrificed at 9:30 pm on the 8th gestation day, and their uterus were taken out. The number of blastocysts was counted.

RESULTSCompared with Group A, the pregnant rate was 6.67% (1/15 cases) in Group B and 18.75% (3/16 cases) in Group D, the mean OD value of LIF was 0. 18 +/- 0.02 in Group B and 0.23 +/- 0.02 in Group D, and the mean OD value of integrin beta3 was 0.20 +/- 0.05 in Group B and 0.19 +/- 0. 02 in Group D, showing statistical difference (P < 0.01). The pregnant rate was 54.55% (12/22 cases) in Group C and 65. 22% (15/23 cases) in Group E, the mean OD value of LIF was 0.37 +/- 0. 09 in Group C and 0.39 +/- 0.02 in Group E, and the mean OD value of integrin beta3 was 0.34 +/- 0.04 in Group C and 0.38 +/- 0.08 in Group E, showing statistical difference when compared with those of Group B and Group D respectively (P < 0.05).

CONCLUSIONSOS and BID had negative effects on the endometrial receptivity and hindered the blastocyst implantation. ZR could improve the uterine receptivity and elevate the pregnant rate by up-regulating the expressions of endometrial LIF and integrin beta3.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Embryo Implantation ; drug effects ; Endometrium ; drug effects ; physiology ; Female ; Integrin beta3 ; metabolism ; Leukemia Inhibitory Factor ; metabolism ; Mice ; Mice, Inbred Strains ; Ovulation Induction ; Pregnancy