As a non-pungency inhaled agent with less respiratory irritation,sevoflurane has been widely used in various surgeries for induction and maintenance of general anesthesia.However,the incidence of pediatric emergence delirium has been significantly increased with sevoflurane general anesthesia which severely disturbs the surgical effect and increases the requirement of medical staff in post anesthesia care unit.This article systematically reviews the research advance in emergence delirium in children with sevoflurane general anesthesia and introduces the reasonable intervention for the improvement of anesthesia quality.

Objective To investigate voicing changes of adult patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after H-uvulopalatopharyngoplasty (H-UPPP). Methods 56 adult OSAHS pa-tients and 40 healthy people were included in the study. Acoustic parameters and formant frequencies were measured for each patient before and after H- UPPP, and also for the control group. Results Acoustic parameters: each group demonstrated no differences in all the parameters except for normalized noised energy (NNE). NNE increased after H-UPPP. Formant frequency: F1, B1, F2, B2, F3 of OSAHS patients were significantly lower than normal control. There was no significant difference in the formant frequency before operation and one week after; however, F1 and F2 were lower than the normal control one week after surgery. One month after surgery, F1 and F2 were ob-viously higher than that obtained in one week. All the other parameters compared with normal controls showed no significant discrepancies. Conclusion Acoustic characteristics of adult OSAHS patients were different from healthy person. After H-UPPP, the vocal tracts of patients changed, thus causing improvement to the acoustic parameters and voicing qualities, especially at the formant frequency. After the surgery, the formant frequencies of the patients increased gradually to the range of healthy people.

Objective To explore the effectiveness and adverse effect of high frequency oscillation ventilation (HFOV) combined with Sildenafil (SIL) treatment on newborns with persistent pulmonary hypertension (PPHN).Methods A total of 89 cases of PPHN infants collected from Chengdu Women and Children's Central Hospital from Sep.2010 to Sep.2012 were randomly divided into HFOV group,constant mechanical ventilation (CMV) group,HFOV combined SIL group (HFOV + SIL group) and CMV combined with SIL group (CMV + SIL group).The arterial blood gas,pulmonary artery pressure (PAP) and adverse reactions were monitored before and 3 days after treatment.SNK multiple comparison method andx2 test were performed for data before and after treatment among groups for continuous variables and categorical variables,respectively.Results The levels of pa (O2) [(79.1 ± 13.7) mmHg (1 mmHg =0.133 kPa),(77.9 ±14.6) mmHg,(85.4 ±15.2) mmHg],Sa(O2) [(87.8 ±13.4)％,(88.4±15.6)％,(96.1±15.9)％],pa(CO2)[(42.5±11.3) mmHg,(40.2 ±10.5) mmHg,(35.6 ±8.7) mmHg] and PAP [(31.1 ± 8.1) mmHg,(30.4 ± 9.5) mmHg,(25.8 ± 7.3) mmHg] were all improved significantly in CMV + SIL group,HFOV group and HFOV + SIL group compared with those in CMV group[(69.9 ± 12.3) mmHg,(81.1 ± 14.9)％,(48.1 ±9.5) mmHg,(35.6 ±8.9) mmHg] (F =4.629 3,3.673 2,5.865 3,4.849 5,P ＜0.05),especially for HFOV + SIL group(P ＜ 0.05).No significant difference in such indicators was observed between CMV + SIL group and HFOV group (P ＞ 0.05).The effective rate in HFOV + SIL group (90％) was the highest among the 4 groups (x2 =7.938,P ＜ 0.05).During the treatment,all neonates have no adverse reaction.Conclusion The combined use of SIL and HFOV might be a more effective and safer method in the treatment of PPHN of neonate.

Objective:To establish the qualitative and quantitative methods for Corni Fructus in Guishao Dihuang pills. Methods:A TLC method was used to identify morroniside and loganin. An HPLC method was used to determine the content of morroniside and lo-ganin in Corni Fructus. Results:The TLC spots were clear with good separation and specificity. The linear range of morroniside was within 0. 010-2. 620 μg (r=0. 999 9) and the average recovery was 102. 75% (RSD=1. 40%, n=6). The linear range of loganin was within 0.009-2.170 μg (r =0.999 9), and the average recovery was 103.59% (RSD =1.10%, n =6). Conclusion: The method is accurate, simple and feasible with good repeatability, which can be used for the quality control of Corni Fructus in the prepa-ration.

Objective:To identify proteins associated with nasopharyngeal carcinoma (NPC) metastasis,and provide scientific basis for the prevention and cure of NPC.Methods:A two-dimensional gel electrophoresis and mass spectrometry were performed to screen for differential proteins between highly metastatic 5-8F and non-metastatic 6-10B NPC cell lines.Western blot was used to confirm the differential proteins.We used siRNA to inhibit the expression of differential protein nm23-H1 to determine the association of nm23-H1 with NPC in vitro invasive ability.Immunohistochemistry and statistics were used to evaluate the correlation of nm23-H1 expression with clinicopathological features and clinical outcomes in paraffin-embedded archival tissues including 93 cases of primary NPC and 20 cases of cervical lymphonode metastatic NPC (LMNPC).Results:A total of 15 differential proteins in the 2 cell lines were identified by a proteomic approach,and 3 differential proteins were selectively confirmed.Downregulation of nm23-H1 by siRNA significantly increased the in vitro invasive ability of 6-10B.Significant nm23-H1 downregulation was observed in LMNPC compared with primary NPC.nm23-H1 downregulation in primary NPC was positively correlated with lymphonode and distant metastasis,advanced clinical stage and recurrence.Survival curves showed that patients with nm23-H1 downregulation in primary NPC had a poor prognosis.Multivariate analysis confirmed that nm23-H1 expression level in primary NPC was an independent prognostic indicator.Conclusion:nm23-H1 behaves as a metastasis suppressor in NPC,and nm23-H1 downregulation is a biomarker for poor NPC prognosis.

Objective To observe the influence of nocturnal prolonged hemodialysis (INHD) on patients＇ nutrition status. Methods Thirty-two maintenance hemodialysis patients received INHD (3 times per week and 7.5 hours each session) and thirty-five maintenance hemodialysis patients received conventional hemodialysis (3 times per week and 4 hours each session) as control were observed for 6 months.The nutrition status of these patients on various aspects which concluded physical measurements,laboratory tests,and dietary record at baseline(0month) and exit (6 months) were recorded. Results (1)There were no differences in age,sex,body weight,and primary diseases between two groups.(2)The body weight,triceps skinfold thickness (TSF),and hand grip strength increased at exit point,but no statistical difference compared with the control group.Mid-upper arm circumference (MAC) increased signicantly from (27.1±4.2) to (30.5±6.1) cm (P＜0.05).Compared with the control group (26.9±3.4) cm,there was a significant difference (P＜0.05).(3)Serum phosphate decreased significantly from (0.5±0.5) to (0.1±0.6) μ mol/L (P=0.001) in INHD group.(4)The nutrition status were improved in INHD group evaluated by subjective global assessment (SGA)(P=0.03).(5) Dietary intake was recorded by a 3-day food record.Dietary intake of energy,protein,lipid,calcium,potassium,and phosphate increased in INHD group.None of the differences achieved statistical significance between two groups. Conclusion As compared with conventional hemodialysis,INHD can increase the dietary intake,decrease serum phosphate level,and improve patients nutrition status.

Preparation of a poly (gamma-glutamic acid)-cisplatin conjugate was introduced and its in vitro antitumor effect was investigated. Poly (gamma-glutamic acids) was obtained by using fermentation methods. The hydrolyzed small molecular weight of poly (gamma-glutamic acids) was prepared by acid hydrolysis. The interaction between poly (gamma-glutamic acids) -cisplatin conjugate (PGA-CDDP) and DNA was investigated by PCR model. MTT assay was used to investigate the in vitro anticancer activity of the conjugate. Apoptosis assay of the conjugate was investigated by FCM assay and the in vivo toxicity was also proceeded. The results showed that the poly (gamma-glutamic acids) -cisplatin conjugate was obtained successfully and its yield is 10% - 12%. It has obvious antitumor effects on human liver tumor BEL7404 cells, human lung tumor H446 cells and human colon tumor RKO cells. At the same time, it also has apoptosis effects on the three kinds of tumor cell lines. The in vivo toxicity of PGA-CDDP was examined in normal mice and the results showed that the in vivo toxicity of this conjugate was significantly lower than that of free CDDP. In conclusion, the poly (gamma-glutamic acids) -cisplatin conjuate could be used as a potential clinic antitumor drug. The poly (gamma-glutamic acids) obtained by fermentation can be used as a valuable drug carrier system.
Animals ; Antineoplastic Agents ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Cell Survival ; drug effects ; Cisplatin ; administration & dosage ; pharmacology ; Drug Carriers ; Female ; Fermentation ; Hydrogen-Ion Concentration ; Male ; Mice ; Polyglutamic Acid ; administration & dosage ; pharmacology

OBJECTIVETo determine the effect of neostigmine on antagonizing atracurium-induced neuromuscular blockage with sulfate magnesium pretreatment.

METHODSForty patients who undertook elective gynecologic laparoscopic examinations and treatments under general anesthesia were randomized into four groups (group A, B, C, and D, group A paired with group C, and group B paired with group D). Before induction of general anesthesia, patients in group A and group C received MgSO4 30 mg/kg in saline intravenously within 5 min, while patients in group B and group D received the same volume of saline. Anesthesia was induced with fentanyl and propofol; subsequently tracheal intubation was performed with 0.5 mg/kg atracurium after stabilization of the electromyography recording, and neostigmine (0.02 mg/kg) and atropine (0.01 mg/kg) were infused in group C and group D when neuromuscular recovery (T1/T(C)) reached 10%. T1/T(C) changes after neostigmine infusion as well as haemodynamic changes and other responses during induction and neostigmine and atropine infusion were recorded.

RESULTSThe neuromuscular recovery speed had no significant difference between group A and group B after the neuromuscular recovery reached 10%, but it was lower in group C than in group D (P < 0.05). Significant difference existed between group AC and group BD (P < 0.05). No haemodynamic changes and other responses were found during induction and neostigmine and atropine infusion.

CONCLUSIONNeostigmine-induced neuromuscular recovery can be attenuated in patients pretreated with magnesium sulfate.

Adolescent ; Adult ; Anesthesia, General ; Atracurium ; antagonists & inhibitors ; Cholinesterase Inhibitors ; pharmacology ; Female ; Humans ; Laparoscopy ; Magnesium Sulfate ; pharmacology ; Middle Aged ; Neostigmine ; pharmacology ; Neuromuscular Blockade ; Neuromuscular Nondepolarizing Agents ; antagonists & inhibitors

BACKGROUNDOur previous study confirmed that oligodendrogliomas had higher frequency of chromosome 1p/19q deletion. In order to improve the diagnostic criteria and to predict the prognosis of oligodendroglioma patients, the status of chromosome 1p/19q deletion, the methylation of O(6)-methylguanine-DNA methyltransferase (MGMT), and the expression of p53 protein were evaluated and investigated in relation to patients' outcomes.

METHODSMethylation of MGMT in 73 cases was analyzed by nested methylation-specific PCR (MSP). The levels of MGMT and p53 protein were tested with immunohistochemistry. Pearson's chi-square test and Fisher's exact test were used. Multivariate and Kaplan-Meier analysis were performed to determine patients' outcomes.

RESULTSBoth oligodendrogliomas and astrocytic gliomas exhibited frequent methylation of MGMT. However, the results of MSP did not completely correspond to that of the immunohistochemical staining for MGMT. The expression of p53 protein was more frequently observed in patients without a 1p or 19q deletion in anaplastic oligodendrogliomas (P = 0.032, 0.025). In low-grade oligodendrogliomas, methylation of MGMT was more frequent in patients with 1p/19q deletion than in patients with 1p/19q intact (P = 0.038). Patients with oligodendrogliomas with 1p/19q loss of heterozygosity and p53-negative showed a longer progression-free survival.

CONCLUSIONDetection of chromosome 1p/19q status combined with p53 protein immunohistochemistry might be beneficial to improve the pathological diagnosis and to determine the prognosis of patients with oligodendrogliomas.

Adolescent ; Adult ; Aged ; Astrocytoma ; genetics ; Brain Neoplasms ; diagnosis ; genetics ; mortality ; Child ; Chromosome Deletion ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 19 ; DNA Methylation ; DNA Modification Methylases ; genetics ; DNA Repair Enzymes ; genetics ; Disease-Free Survival ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Loss of Heterozygosity ; Male ; Middle Aged ; Oligodendroglioma ; diagnosis ; genetics ; mortality ; Prognosis ; Tumor Suppressor Protein p53 ; analysis ; Tumor Suppressor Proteins ; genetics

OBJECTIVETo investigate partial anomalous pulmonary venous connection (PAPVC) with echocardiography.

METHODSThe right ventricular volume overload was detected by routine echocardiography in 37 child patients, who underwent further echocardiography to find the abnormal locations of pulmonary vein opening at superior, inferior vena cava and right atrium. The ultrasound results were compared with surgical findings.

RESULTSIn 30 patients the ultrasound diagnosis was consistent with surgery results, 7 were misdiagnosed by ultrasound with a detective rate of 81.1 %. All 37 PAPVC patients presented varying degrees of right heart enlargement; PAPVC combined with atrial septal defect (ASD) was found in 34 cases.

CONCLUSIONThe possibility of PAPVC should be considered when unexplained right heart volume overload was detected by echocardiography. Superior, inferior vena cava and right atrium should be inspected when the pulmonary veins were not seen in echocardiography.

Child ; Child, Preschool ; Echocardiography ; Female ; Heart Atria ; abnormalities ; diagnostic imaging ; Heart Septal Defects, Atrial ; diagnostic imaging ; Humans ; Infant ; Male ; Pulmonary Veins ; abnormalities ; diagnostic imaging