Objective To examine the differences in the level of sedation and adverse effects produced by equivalent analgesic doses of remifentanil,sufentanil and fentanyl.Methods Eighty ASA Ⅰ female patients aged 18-39 yr with BMI of 18-25 kg/m2 scheduled for laparoscopic surgery under general anesthesia were randomly divided into 4 groups ( n =20 each):group control (group C) ; group remifentanil ( group R) ; group sufentanil (group S) and group fentanyl (group F).Remifentanil 2 μg/kg,sufentanil 0.2 μg/kg and fentanyl 2 μg/kg in normal saline 10 ml were infused iv over 2 min in groups R,S and F respectively.Depth of sedation was assessed and scored using OAA/S scale (5 =alert,1 =no response to prodding) and wavele index (WLI),before (baseline) and at 2,4,6,8 and 10 min after drug administration.Besides RR,pulse oxygen saturation,BP,HR were also monitored.The incidences of apnea,muscle rigidity,nausea and vomiting,pruritus,vertigo,bradycardia,profuse sweating and skin rash were measured and calculated.Results The 4 groups were comparable with respect to age,BMI and height.The lowest values of OAA/S scores,WLI and RR were significantly lower in groups R,S and F than in group C.Sufentanil produced the deepest sedation among the 3 opioids.Remifentanil produced strongest respiratory depression and nausea and vomiting.Conclusion The equivalent analgesic dose of sufentanil produces deeper sedation than that of remifentanil and fentanyl while remifentanil has the greatest impact on RR.

Purpose To observe the changes of choroidal circulation and the retinal lesions caused by ocular contusion with indocyanine green angiography (ICGA). Methods ICGA examination was performed on 30 cases (30 eyes) of various traumatic condition in conjunction with fundus fluorescein angiography (FFA). Results FFA of 19 cases (63.3%) showed the hypofluorence in quadrant or whole disc in accordance with the area of delayed filling of choroid. Twenty six cases (86.2%) showed defected choroidel perfusion in ICGA,among them 16 cases showed localized delayed perfusion, in which the shortest perfusion time was 1 min 50 s and the longest time was 5 min.43 s,and 10 patients showed localized perfusion defect,and reversed filling time of retinochoroid vessels in 6 patients. Five cases (16.6%) had delayed filling time in both choroidal and central retinal vessels. Damage of retinal pigment epithelium was found in the areas of choroidal abnormal perfusion. Conclusion ICGA combined with simultaneously FFA, is valuable in evaluating blunt injury of the ocular fundus and beneficial to its diagnosis and treatment.

0.05). Conclusion Tirofiban is safe and can reduce ischemic cardiac events and myocardial injury in treating ACS.

Hematopoietic Stem Cell Mobilization ; methods ; Humans ; Peripheral Blood Stem Cell Transplantation ; methods

Objective To observe the dynamic changes of interferon gamma(IFN-?) and transforming growth factor bata1(TGF-?_1) in animal model of hyperoxia-induced lung injury,and to explore the mechanism of fibrosis.Methods Thirty-two juvenile Wistar rats were randomly divided into room-air group and hyperoxia group,the hyperoxia group were further divided into 3 subgroups of hyperoxia-exposure for 3,7 and 14 days.The mRNA levels of IFN-? and TGF-?_1 in the lung were measured by reverse-transcription polymerase chain reaction(RT-PCR).The expressions of IFN-? and TGF-?_1 protein were measured by immunohistochemical(stai)-ning.Results The level of IFN-? mRNA of groups under hyperxia-exposure for 3,7 and 14 days were higher than that of control group.The expression of IFN-? mRNA notably elevated and was up to its peak(P

Hemoglobinuria, Paroxysmal ; therapy ; Humans

Adult ; Chordoma ; Humans ; Male ; Nasal Septum ; pathology ; Nose Neoplasms

AIM:To evaluate the repeatability of axial length (AL) and anterior chamber depth (ACD) obtained by A scan ultrasonography, and to compare AL and ACD obtained by A scan with those obtained by IOL Master.METHODS:Two hundred and fifty-seven cataract eyes of 170 patients were included.IOL Master and A scan were performed for each eye.Five measurements of IOL Master and 3 measurements of A scan were obtained.All the tested eyes were divided into 5 groups according to AL obtained by A scan:Group A (2129mm, 21 eyes).Cronbach's Alpha coefficient and intraclass correlation coefficient (ICC) were applied to evaluate the repeatability of AL and ACD obtained by A scan.Paired t test and Pearson correlation coefficient were used to analyze the differences and correlations of AL and ACD obtained by the 2 devices, respectively.Bland-Altman plots were presented to analyze the agreements of AL and ACD obtained by the 2 devices.RESULTS:All the Cronbach's Alpha and ICCs of AL and ACD values were more than 0.98.The differences of AL values between A scan and IOL Master were-0.11±0.08mm in Group A,-0.15±0.10mm in Group B,-0.19±0.15 mm in Group C,-0.29±0.16mm in Group D and-0.45±0.29mm in Group E, respectively (all P<0.01).The differences of ACD values between A scan and IOL Master were-0.10±0.16mm in Group A,-0.06±0.13mm in Group B,-0.06±0.13mm in Group C,-0.19±0.10mm in Group D,-0.18±0.21mm in Group E, respectively (all P<0.01).In all groups, the AL and ACD values obtained by A scan and IOL Master presented good correlations (all r>0.89, all P<0.01).CONCLUSION:The AL and ACD values in cataract eyes obtained by A scan were repeatable.The AL and ACD values obtained by A scan were smaller than those obtained by IOL Master.With the increase of AL values, the differences of AL values between A scan and IOL Master increased.

Objective To evaluate the characteristics of quantitative monitoring of brain function during the perioperative period in elderly patients and its relationship with postoperative cognitive dysfunction (POCD).Methods Seventy ASA physical status Ⅰ or Ⅱ patients,aged ≥ 60 yr,scheduled for elective lumbar spine decompression and fusion surgery under general anesthesia,having an expected postoperative length of hospital stay ≥ 7 days,were enrolled in the study.The cognitive function was assessed by using Mini-Mental State Examination before operation and the results were normal.Fifty healthy elderly volunteers were chosen and served as control group.Cognitive function was assessed at l day before operation (D0) and 3 (D3) and 7 days after operation (D7).Z score was used to identify POCD.All the patients were then divided into POCD group or control group (group C) according to the results of diagnosis.Quantitative monitoring of brain function was carried out using a traction system,and the wavelet index (WLI),i_22 and i_20 were recorded.Results A total of 67 patients completed the study and were enrolled in the analysis,there were 9 cases in group C,and 58 cases in group POCD.The WLI was significantly decreased at D7,and no significant change was found in WLI at D3 as compared with the value at D0.The WLI was significantly lower at D7 than at D3.There was no significant difference in i_22 and i_20 between the three time points.Compared with group C,i_22 was significantly decreased at D0,and no significant change was found in i_22 at the other time points and in WLI at each time point in POCD group.Conclusion During quantitative monitoring of brain function during the perioperative period in the elderly patients,WLI is significantly decreased on 7th day postoperatively,and no significant change is found in i_20 and i_22,however,the pre-operative low i_22 value can predict the development of POCD.

Objective To evaluate the intraoperative opioid?sparing effect of different duration transcutaneous electrical acupoint stimulation ( TEAS ) in video?assisted thoracoscopic lobectomy. Methods Seventy?five patients, aged 18-64 yr, weighing 40-96 kg, of ASA physical status Ⅰ or Ⅱ, scheduled for elective video?assisted thoracoscopic lobectomy under general anesthesia, were randomly divided into 3 groups (n=25 each) using a random number table: control group (group C), 30 min of stimulation before induction of anesthesia group ( group B) , and stimulation throughout surgery ( group T) . In group B, the patients received TEAS ( frequency 2∕100 Hz ) on acupoints Xinshu ( BL15 ) , Feishu (BL13), Neiguan (PC6), Hegu (LI4) on the operated side starting from 30 min before induction of anesthesia until the beginning of induction, and the intensity was the maximum current that could be tolerated. The intensity for Neiguan ( PC6) and Hegu ( LI4) was 6-12 mA, and for Xinshu ( BL15) and Feishu ( BL13 ) was 9-18 mA. In group T, the patients received TEAS on the four acupoints mentioned above starting from 30 min before induction of anesthesia until the end of surgery. The patients had the electrodes applied, but received no stimulation in group C. After anesthesia was induced with propofol?sufentanil?cisatracurium, double lumen endotracheal tube was inserted. Propofol was given by target?controlled infusion to maintain BIS value within the range of 40-60. Cisatracurium was infused continuously to facilitate muscle relaxation. The infusion rate of remifentanil was adjusted to maintain analgesia nociception index value within the range of 50-70. The intraoperative consumption of remifentanil ( the intraoperative consumption of sufentanil was converted to the consumption of remifentanil producing the equivalent effect by 1∶ 10) was recorded. Results Compared with group C, the intraoperative consumption of remifentanil was significantly decreased in B and T groups. The intraoperative consumption of remifentanil was significantly lower in group T than in group B. Conclusion TEAS on Xinshu ( BL15 ) , Feishu (BL13), Neiguan ( PC6) and Hegu acupoints throughout surgery and for 30 min before induction of anesthesia significantly reduces intraoperative opioid consumption in the patients undergoing video?assisted thoracoscopic lobectomy, while TEAS throughout surgery provides better effect.