Objective To investigate the different doses of dexmedetomidine on reducing the effects of restlessness after anesthesia.Methods Forty-eight patients who occurred restlessness after general anesthesia were collected and randomly divided into A,B,C group (16 cases in each group).Dexmedetomidine were given at dose of 0.3 μg/kg,0.5 μg/kg,1.0 μg/kg for treatment as A,B,C group.Blood pressure,heart rate,Riker sedation-restlessness (SAS) score and other changes of patients were recorded at different time points after treatment.Results SAS scores were significantly lower in B,C groups than that in A group (P ＜ 0.05) at immediately after administration and 5 min and 10 min after administration.Systolic pressure and heart rate were significantly lower in C group than in B,A group (P ＜ 0.05) at immediately after administration and 5 min after administration.Only the heart rate in B group at immediately after administration was lower than that in A group.Time in the recovery room in B group was (37.5 ± 6.4) min,significantly lower than A group and C group ((43.2 ± 8.9) min,(47.5 ± 9.8) min ; F =14.362 ; P ＜ 0.001).Conclusion Dexmedetomidine is a more ideal sedation drug and 0.5 μg/kg dexmedetomidine can reduce restlessness and cardiovascular reactions in patients with restlessness after general anesthesia,which is the best recommending therapeutic dose.

BACKGROUND: An ideal model of osteonecrosis of the femoral head is beneficial to the study on the cause of disease, pathogenesy and treatment. So far there has not been a coherent method to prepare this model. OBJECTIVE: To establish a rabbit model of osteonecrosis of femoral head induced by microwave heating, and to decide optimum microwave temperature and heating time.DESIGN: Randomized controlled animal trial.SETTING: Animal Experimental Center of Kunming Medical College.MATERIALS: The experiment was performed at the Animal Experimental Center of Kunming Medical College between September 2004 and November 2005. Forty-eight healthy adult New Zealand rabbits, either male or female, were provided by the Animal Experimental Center of Kunming Medical College. The animal procedure was accorded with the ethical standards. GW-92C multi-functional microwave therapy apparatus was the product of Grand World Medical Apparatus (Tianjin) Co., Ltd. METHODS: The microwave antenna was inserted into the rabbit femoral head. Ninety-six femoral heads in forty-eight rabbits were randomly divided into four groups (n =24) according to the microwave temperature and heating time: microwave heating at 50 ℃ for 10 minutes group; 55 ℃ for 10 minutes group; 50 ℃ for 20 minutes group and 60 ℃ for 10 minutes group. The models of osteonecrosis of femoral head were induced by microwave heating using multi-functional microwave therapy apparatus according to the temperature and heating time of grouping. MAIN OUTCOME MEASURES: In each group, two rabbits (four femoral heads) were killed immediately, one, two, four, eight and twelve weeks after operation, respectively. A series of examinations were carried out, including gross observation, X-ray to observe bone trabecular arrangement, cystis degeneration, head collapse or hip joint destruction, MRI to observe the necrotic area, and HE staining to observe the osteonecrosis and bone repair. RESULTS: Marrow tissues partially coagulated in the microwave heating at 50 ℃ for 10 minutes group at the end of the 1st week, and the osteonecrosis returned to normality at the end of the 8th week. In 55 ℃ for 10 minutes group, marrow tissues were completely coagulated at the end of the 1st week, and decreased signal on T1 weighted images and increased signal on T2 images were identified at the end of the 2nd week. In the 4th week, bone repair was found simultaneously when osteonecrosis occurred. At the end of the 12th week, the osteonecrosis continued and the repair stopped, and the femoral head collapse occurred. All femoral heads collapsed at the end of the 8th week in 50 ℃ for 20 minutes group and 60 ℃ for 10 minutes group. CONCLUSION: Microwave heating at 55 ℃ for 10 minutes is the optimal choice to develop a rabbit model of osteonecrosis of the femoral head.

BACKGROUND:The existed femoral head necrosis(FHN)model can not reflex the clinical necrosis of femoral head correctly.Microwave heating provides a new approach for model preparation.but the concrete standard remains uncertain.OBJECTIVE:To study the optimal temperature and time jn preparing a FHN model induced by microwave heating.METHODS:Totally 48 rabbits were randomly divided into 4 groups on the basis of the microwave temperature(50,55,60℃)and heating time(10,20 minutes).The microwave antenne was inserted into the rabbit femoral head.The rabbits were sacrificed immediately and at 1,2,4,8 and 1 2 weeks after operation.A series of examinations were performed including gross observation,X-ray.histology and MRI to observe the femoral head necrosis and repair status.RESULTS AND CONCLUSION:Marrow partially solidified in the group(50℃,10 minutes)at 1 week,and the osteonecrosis returned to normaI at 8 weeks after operation.1n the group(55℃,10 minutes),marrow was completely coagulated at 1 week and low signal on T1 weighted images and increased signal on T2 images were identified at 2 weeks.Osteonecrosis and repair occurred at the same time at 4 weeks.At 12 weeks,the osteonecrosis continued and the repair stopped,and the femorel heads started to collapse.All femoral heads collapsed at 8 weeks in group(50℃,20 minutes)and group(60℃,10 minutes).Accordingly.microwave heating is a good method in developing FHN model.55℃ and 10 minutes are the optimal temperature and time for the development of FHN model of rabbits induced by microwave heating.

Objective To observe the efficacy of a kind of complex composed of biphasic ceramic biologic bone (BCBB), bone morphogenetic protein (BMP) and basic fibroblast growth factor (bFGF) on the repair of necrotic areas of the femoral head. Methods The femoral head necrosis model of 64 femoral heads in 32 rabbits induced with microwave heating were randomly divided into four groups, which implanted with nothing (group A), BCBB/BMP (group B), BCBB/BMP/bFGF (group C) and with cancellous bone autograft (group D). The specimens were harvested separately at the end of 2, 4, 8 and 12 weeks after operation. 4 femoral heads were taken off at each interval in every group. A series of examinations were carried out including of naked eyes and gross anatomic observation, X-ray, histology, and blood vessel immunohistochemical staining. Results In group A, 1 femoral head collapsed by the end of 12 weeks, and there was only a little osteoid tissue formed. At the same time, a lot of new bone formed in group B and group C, and the boundary between the bone grafting area and the post bone still existed, but the boundary was unclear in group D, with the density consistent to the post bone. Under X-ray, the defect could be found and one femoral head collapsed in group A by the end of 12 weeks. The density of bone grafting area was high and the boundary to the post bone was unclear in group B and in group C. The density of bone grafting area was the same as the post bone and the boundary between them was unclear in group D. There was only a little osteoid tissue formed in group A by the end of 4 weeks. At the same time, there was a little new bone formed in group B, and BCBB was partly degraded. There was a lot of new bone formed in group C and group D, and BCBB was partly degraded in group C, but cancellous bone autograft was almost absorbed in group D. The new bone area by the end of 4, 8 and 12 weeks from more to less were: group C and group D (P>0.05), group B, and group A (P<0.05). At the end of 2, 4 and 8 weeks, the blood vessel area of group C was more than that of group A, group B, and group D (P<0.05). Conclusion The BCBB/BMP/bFGF complex can induced osteoinduction and revascularization, to repair rabbit femoral head necrosis as effective as cancellous bone autograft.

Objective To study the nlanifestation and the clinical significance of the cerebral angiography of the isehemic cerebrovascular diseases.Methods Digital sublraction angiography(DSA)was taken in 312 patients with cerebral infarction and transient ischemic attack(TLA).The distribution of the lesion in the extra/intracranial arteries was compared.Results Cerebral angiography showed that the stenosis and occlusion was dominant in the intracranial arteries at the cerebral infarction in the internal carotid artery system and vertebrobasilar artery system[59.57%(56/94)and 61.90%(26/42)].TIA of internal carotid artery system was mainly because of stenosis of intracranial arteries (68.75%,22/32).TIA of vertebrobasilar artery system was mainly because of stenosis of extracranial arteries(61.70%,29/47).Conclusions The diseases of the intracranial arteries are the main causes of cerebral infarction(including internal carotid artery system and vertebrobasilar artery system) and TIA of internal carotid artery system. The diseases of the extracranial arteries are main causes of TIA of vertebrobasilar artery system.

ObjectiveTo investigate the antitumor effect of cyclooxygenase-2 (COX-2) antisense RNA combined with celecoxib on hepatoma CBRH7919 cells. MethodsThe effect of celecoxib on in vitro proliferative activity, cell cycle, and apoptosis of hepatoma cell lines CBRH7919, CBRH7919-E, and CBRH7919-A (transfected with COX-2 antisense gene segment) were observed. MTT assay, cell cycle analysis, and RT-PCR were used to evaluate the change in in vitro proliferation of hepatoma cell lines. A multivariate analysis of variance was used for comparison of continuous data between groups, and the SNK-q test was used for further comparison between two groups. ResultsAfter the treatment with celecoxib, CBRH7919-A cells had a significant reduction in growth rate compared with CBRH7919 and CBRH7919-E cells (F=38.303, P＜0.01), in a time- and dose-dependent manner (F=162.638 and 22.666, both P＜0.01). Celecoxib significantly increased the proportion of cells in G0/G1 phase and had a marked inhibitory effect on cells in S phase in a dose-dependent manner (F=32.515, P＜0.01), while there was no significant change in the proportion of cells in G2/M phase. Compared with CBRH7919 and CBRH7919-E cells, CBRH7919-A cells were more sensitive to celecoxib (F=1219.506, P＜0.01). After the treatment with celecoxib at different concentrations (40 and 80 μmol/L), all three groups had a significant increase in cell apoptosis (all P＜001), and there was no significant difference in apoptosis between the three groups (P＞0.05). ConclusionCOX-2 antisense RNA combined with celecoxib can inhibit the in vitro growth and proliferation and cell cycle of hepatoma CBRH7919 cells, promote apoptosis, and thus exert a potential therapeutic effect on hepatoma cells.

Objective:To understand the current status of medication adherence in patients with pulmonary arterial hypertension (PAH) , and to explore the influencing factors of their medication adherence.Methods:From April 8 to December 10, 2019, convenience sampling was used to conduct a cross-sectional survey of 226 patients with PAH hospitalized in a Class Ⅲ Grade A hospital in Beijing. Medication adherence of PAH patients was evaluated with the Morisky Medication Adherence Scale, and patients were investigated with the General Information Questionnaire, Pulmonary Arterial Hypertension Knowledge Questionnaire, Social Support Rating Scale, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) . Factors that may affect the medication adherence of PAH patients were included, so as to conduct univariate analysis and multiple stepwise regression analysis.Results:The medication adherence score of patients with PAH was (5.26±0.11) . Disease cognition, residence, education level and depression level of PAH patients were the influencing factors of their medication adherence ( P<0.05) . Conclusions:Patients with PAH have poor medication adherence. In the future clinical work, we should pay attention to improving patients' awareness of diseases, strengthen the evaluation of patients' depression, so as to achieve early detection and early intervention, and at the same time strengthen psychological care and health education, and improve patient compliance with medication.

Objective To observe value of echocardiographic evaluation on infants with pulmonary atresia and intact ventricular septum(PA/IVS)for surgical decision and post operation right ventricle(RV)development.Methods Forty-six PA/IVS infants who underwent pulmonary valve(PV)annuloplasty(group A,n=25),PV annuloplasty and RV outflow tract reconstruction with/without additional systemic-to-pulmonary artery shunt(group B,n=15),and systemic-to-pulmonary artery shunt and atrial septal enlargement(group C,n=6)were retrospectively enrolled.Status of RV developments were compared among groups before operation as well as 1 and 6 months after operation.Results The presentation age in group B was younger than,while in group C was older than that in group A(both P＜0.05).Before operation,tricuspid valve(TV)annulus diameter,TV annulus Z-score and TV/mitral valve(MV)annulus ratio in groups B and C were both smaller than those in group A(all P＜0.05),whereas RV/left ventricle(LV)longitudinal diameter ratio in group B was larger and PV annulus Z-score in group C was smaller than those in group A(both P＜0.05).Meanwhile,preoperative PV annulus Z-score and RV/LV longitudinal diameter ratio in group B were both larger than those in group C(both P＜0.05).One month after operations,TV annulus diameter,TV annulus Z-score and TV/MV annulus ratio in group B and C,as well as PV annulus diameter,PV annulus Z-score and RV/LV longitudinal diameter ratio in group C were all smaller than those in group A(all P＜0.05),while PV annulus diameter,PV annulus Z-score and RV/LV longitudinal diameter ratio in group C were all smaller than those in group B(all P＜0.05).Six months after operations,no significant difference of TV annulus diameter,PV annulus diameter,PV annulus Z-score,TV/MV annulus ratio nor RV/LV longitudinal diameter ratio was found between group A and B(all P＞0.05),but the above indexes in group C were all lower than those in group A and B(all P＜0.05).Besides,no significant difference of TV annulus Z-score was found between group A and B(P＞0.05),which were lower in group C than in group A(P＜0.05).Conclusion Echocardiographic evaluation on PA/IVS infants was helpful to establishment of forward blood flow from RV to pulmonary arteries in time,hence promoting RV development.

Objective:To summarize the effect of one and a half ventricle repair in the treatment of Ebstein’s Anomaly.Methods:The data of 149 patients diagnosed with Ebstein’s Anomaly and received with surgical treatment in Pediatric Cardiac Surgery Department of Beijing Anzhen Hospital affiliated to Capital Medical University from January 2010 to December 2018 were continuously collected, and the survival rate, reoperation rate and tricuspid regurgitation were followed up in the medium-long term.Results:There were 68 males and 81 females, with a median age of 5.58 years. Patients were divided into Biventricular repair group and one and a half ventricle repair group. The operative age was significantly younger in the one and a half ventricle repair group (4.15 years vs. 6.71 years, P=0.019). There were also significant differences in patiens’ body length[(107.70±31.28)cm vs. (123.20±35.22)cm, P=0.014]and body weight[(19.69±12.22)kg vs. (29.65±20.41)kg, P=0.001], between the two groups, which may be related to the severity of the disease and the need for early surgical intervention. However, there was no significant difference between the two groups in preoperative cyanosis, hemoglobin level, cardiac function, arrhythmia, and common cardiac malformations such as atrial septal defect. Notably, the proportion of preoperatively complicated pulmonary stenosis (10.81% vs. 1.79%, P=0.016) and right ventricular dysplasia (16.22% vs. 3.57%, P=0.008) was significantly higher in the one and a half ventricle repair group. In intraoperative and postoperative indicators, as one and a half ventricle repair under the collateral circulation, extracorporeal circulation time was slightly longer [(125.51±37.35)min vs. (100.44±25.24)min, P<0.001], and other indicators such as aortic cross-clamp time, endotracheal intubation time, length of hospital stay, and mid-term follow-up results, including mid-term mortality, reoperation rate, cardiac function and valvular regurgitation, there was no significant difference between the two groups. However, the proportion of hospital mortality in half ventricular therapy group was slightly higher, which may be related to the poor right heart function and postoperative recovery difficulties. Conclusion:Good follow-up results have been achieved in the treatment of two surgical therapy. Patients with right ventricular dysplasia and pulmonary artery stenosis should be paid more attention to. Pulmonary artery pressure and pulmonary vascular development should be evaluated before surgery to make preparations for one and a half ventricle repair.