Objective: To evaluated the efficacy of dexmedetomidine (DEX) as a local anesthetic adjuvant for brachial plexus block (BPB). Methods: The PubMed, Embase and Cochrane Library was searched on a computer to find randomized controlled trial (RCTs) of the effect of ropivacaine combined with DEX in brachial plexus block. The time limit for searching was from the establishment of the library to December 30, 2017. At the same time retrospective references were included in the literature. Two reviewers independently screened literatureaccording to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies. Then Meta analysis was performed using RevMan 5.3. Results: A total of 13 RCTs involving 804 patients were included. Meta analysis showed that compared with that in the control group, sensory onset time (MD=-2.06, 95% CI - 3.96-- 0.15, P<0.01), and motoronset time (MD=-2.07, 95% CI- 4.30 - 0.15, P<0.01) were shorter and sensory block duration (MD=166.26, 95%CI 85.57 - 246.96, P<0.01), and motor block duration (MD=137.55, 95%CI 44.73-230.37, P<0.01) were longer in group of dexmedetomindine combined with ropivacaine.Duration of analgesia (MD=224.66, 95%CI 123.82-325.50, P<0.01) was longer in experimental group. Conclusions DEX combined with ropivacaine in brachial plexus block shortens the onset time and prolongs the duration of bolckade and duration of postoperative analgesia.

Objective:To preliminarily study the effect of Louqin Zhisou decoctions with the mechanism of clearing heat and resol-ving phlegm on the blood level of neutrophil elastase ( NE) in the rat model of acute exacerbation of chronic obstructive pulmonary dis-ease ( AECOPD) . Methods:The rat model of AECOPD was established by passive cigarette smoking, intratracheal instillation of li-popolysacchricle ( LPY) and intranasal instillation of staphylococcus aureus. Totally 60 AECOPD rats were randomly divided into 3 groups, the model control group (n=20), ambrohexel group (n=20), and Louqin Zhisou decoctions group (n=20). NE was detec-ted by ELISA. Results:Compared with that before the treatment, NE in ambrohexel group and Louqin Zhisou decoctions group was de-creased significantly(P<0. 01). Conclusion:Clearing heat and resolving phlegm method probably can decrease NE by reducing air-way mucus hypersecretion and obstruction in AECOPD rats.