Objective To investigate the effect of dexmedetomidine on emergence agitation (EA) following sevoflurane anesthesia in children with cerebral palsy.Methods Fifty ASA physical status Ⅰ or Ⅱ children with cerebral palsy of both sexes,aged 2-12 yr,scheduled for elective muscle strength muscle tension adjustment method,were randomly allocated into 2 groups (n =25 each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with iv injection of sufentanil 0.3 μg/kg,cisatracurium 0.15 mg/kg,and propofol 1.5 mg/kg.The patients were tracheal intubated and mechanically ventilated.Dexmedetomidine 0.5 μg/kg was intravenously infused over 15 min after induction of anesthesia in group D and the equal volume of normal saline was given in group C.The operation was begun at the end of administration.Anesthesia was maintained with inhalation of 2％-4％ sevoflurane and the concentration was adjusted to achieve a target BIS value of 45-60.The heart rate,systolic blood pressure and diastolic blood pressure were recorded before infusion of dexmedetomidine (T1) and at skin incision (T2).The extubation time,emergence time and consumption of sevoflurane were also recorded.The end-tidal sevoflurane concentration was recorded at T1,T2,and the end of operation (T3).The adverse cardiovascular events and occurrence of EA were also recorded.The degree of EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.The peripheral venous blood samples were collected at T1,T2,T3 and extubation (T4) for determination of the blood glucose level and serum cortisol concentration.Compared with group C,the emergence time and extubation time were significantly shortened,and the consumption of sevoflurane,end-tidal sevoflurane concentrations at T2 and T3,PAED scores,incidence of agitation,and the blood glucose level and serum cortisol concentration at T4 were significantly decreased in group D (P ＜0.05 or 0.01).There was no significant difference in the incidence of bradycardia or heart rate,systolic blood pressure and diastolic blood pressure at each time point between the two groups (P ＞ 0.05).Conclusion Dexmedetomidine can decrease the development and degree of EA following sevoflurane anesthesia in children with cerebral palsy.

Objective:To establish a rat model of erectile dysfunction caused by the injury of the cavernous nerve. Methods:Rats topographical anatomy were done for identifing the cavernous nerve and major pelvic ganglion and pelvic nerve and hypogastric nerve .Polygraph intracavernous pressure of the models were detected continuously and evaluated. Results:Erectile process was controlled by erectile nerve. Major pelvic ganglion includes two inflows,they are called pelvic nerve and hypogastric nerve. The largest outflow is cavernous nerve. The injury of the cavernous nerve will lead to erectile dysfunction. Conclusion:Rat can be an ideal animal model for studying the erectile dysfunction caused by cavernous nerve injury. The neuvological mechanism of erectile dysfunction can be evaluated with determination of intracavernous pressure.

Objective The automated capillary zone electrophoresis (CE) is used for human serum protein analysis and compared with the results of agarose gel electrophoresis (AGE) for human serum protein analysis.Discuss its′ practical application in clinical.Methods With the Capillarys ?1-?2+reagent set, proteins in serum were separated at 7 kV for 4 min in 15.5 cm?25.0 ?m fused-silica capillaries (n=8) at 35.5℃ in a pH 10 buffer with online detection 200 nm.Results Capillary zone electrophoresis compared with agarose gel electrophoresis(AGE;Hydrasys-Hyry; Hydragel protein(e)15/30/54 reagent set;Sebia)in precision, relatives, linearity and potential interferences were analyzed.A samples without Para-protein (n=165) were performed relation test. The coefficient of relation between CE and AGE is 0.929 for albumin, 0.924 for for ?1-globulin, 0.841 for ?2-globulin, 0.789 for ?-globulin, 0.926 for ?-globulin. There was no significant difference (P

OBJECTIVE:To determine the content of glycyrrhetic acid in zhenkening capsules by RP-HPLC.METHODS:The separation was performed on Hypersil C 18,the mobile phase consisted of methanol-water-glacial acetic acid(87∶13∶2.5)with flow rate at 1.0ml/min and detection wavelength at 254nm,the column temperature was set at room temperature.RE-SULTS:The calibration cure of glycyrrhetic acide was linear in the concentration range of 10～120?g/ml(r=0.9999),the average recovery was 99.68%(RSD=0.49%).CONCLUSION:This method is simple,fast,accurate,and suitable for the determination of glycyrrhetic acid in zhenkening capsules.

Chemical and Drug Induced Liver Injury ; Dimethylformamide ; Humans ; Occupational Exposure

Objective To investigate the perioperative management,coagulation factor regulation in total knee arthroplasty (TKA) for hemophilia arthritis and evaluate its short-term clinical efficacy.Methods A retrospective study was performed in hemophilia arthritis patients who had undergone TKA from March,2009 to March,2014.Patients with type A hemophilia received Lyophilized Human Factor Ⅷ,and type B hemophilia patients received Prothrombin Complex.Perioperative accurate dosage of coagulation factor was determined by preliminary test.AORI T1,T2 bone defects were filled with PMMA,and severe contained AORI T3 defects were fixed with impaction allograft and screws,and for non-contained AORI T3 bone defects,structural allografts and stem extension may be considered.Knee function was evaluated by HSS score,and imaging change was evaluated by anteroposterior and lateral radiographs of knee at latest follow-up.Results Eight patients (10 knees) were included with a mean age of 38.3±5.0 years,in which 6 were type A,and the other 2 were type B.Preoperative APTT was 63.9±4.0 s,and coagulation factor activity was 2.6％±0.9％.All the patients had flexion deformity with extension of-12.0°±5.9° and flexion of-88.0°± 11.4°.Three patients (3 knees) had valgus deformity with-3.0°±5.4°,and 2 patients (4 knees) had varus deformity with-4.5°±6.0°.All the 8 patients were followed for a mean of 14.3 months.The range of motion was improved with 0°-98.5°±6.7° at latest follow-up,and the postoperative HSS score was 88.3±4.6 compared with 42.3±10.9 preoperatively.Bone-grafting was survival,and no loosening of prosthesis or screws were detected from X-ray at latest follow-up.Conclusion The early results of TKA in Hemophilia arthritis patients are satisfactory.Preoperative preliminary test was helpful to determine the accurate dosage of coagulation factor.A stable high level of coagulation factor was vital to control bone-cement bleeding and make prosthesis stable.Tibial bone defects involving ＜ 1/3 area and ＜ 1 cm in depth could be filled with PMMA,and impaction allograft and screws could be used to fix severe contained bone defects.For segmental bone defects,except of structural allograft,stem extension was recommended to reduce stress and increase stability.

Objective To explore the clinical characteristics of huge pancreatic pseudocysts and to evaluate the effect of different surgical treatments. Method We retrospectively analyzed the clinical data of 27 patients with huge pancreatic pseudocyst managed from Feb 1991 to Feb 2008. Result Among a total of 129 patients with pancreatic pseudocyst treated during this period of time,27 (20.9% ) patients were diagnosed as with huge pancreatic pseudocyst (diameter > 10cm). As to the etiology, 51.9% of the psudoeyst was caused by acute pancreatitis, 33.3% by pancreatic trauma and previous surgery, 11.1% by chronic pancreatitis. Pseudoeysts in the majority of cases(21/27)had a history less than 6 weeks. Upper GI obstruction complicated 30% cases (8/27). Imaging showed that all huge pancreatic pseudocysts were single. ERCP showed communication with the main pancreatic duct in 9 out of 11 cases. Nine cases underwent catheter drainage, 10 cases underwent cystogastrostomy,2 cases underwent endoscopic drainage of pancreatic pseudocyst via ERCP, 17 cases underwent Roux-en-Y cystojejunostomy including 11 cases in which other previous procedures failed. All 27 cases were finally cured. Conclusions Huge pancreatic pseudocyst might have unique clinical characteristics. Anatomical changes of main pancreatic duct were found in most cases under ERCP. The proper time and indication for surgical intervention might be different from minor pancreatic pseudocyst.

Objective To explore the adverse effects of recurrence of acute ischemic stroke at discharge.Methods Continuously including 3 440 acute ischemic stroke patients from June 1,2009 to May 31, 2012 in Department of Neurology of the People's Hospital of Xinganmeng of Inner Mongoha Autonomous Region were esearch objects.Poor outcome was defined as the occurrence of disability or death at discharge.Disability was defined as the Modified Rankin ' s Scale (MRs), when MRs was 3 or more.Binary logistic regression was used to analysis the risk factors ,calculated the odds ratios(OR) and 95％ confidence interval (95％CI).Results A total of 359 (10.44％) patients occurred poor outcomes, of whom 136 (37.88％) patients occurred the recurrence of ischemic stroke.Multiple logistic regression analysis showed that age (OR=1.24,95％CI 1.09-1.41), body temperature (OR =1.92,95 ％ CI 1.43-2.57), hypertension (OR =1.73,95 ％ CI 1.33-2.24), high blood sugar (OR=1.67,95％CI 1.26-2.20) ,glycerin trilaurate(OR=0.41,95％CI0.27-0.62) ,smoking (OR =1.37,95％CI 1.01-1.85) and recmrrence(OR=1.49,95％CI 1.15-1.95) were independent risk factors of poor outcome at discharge.The recurrence of acute ischemic stroke can increase the risk of the occurrence of poor outcome at discharge up to 49％.Conclusion Recurrence is an independent risk factor for the poor outcome of acute ischemic stroke, we should focus on secondary prevention of stroke patients at the clinical work and health education to reduce the recurrence of ischemic stroke.

Objective To establish a scientific and practical principle , grading standard and reasonable statistical method for evaluating the protective effect of health food to gastric mucosal injury , based on general pathology and histopathological diagnosis .Methods A methodological study was conducted on rat model of acute gastric mucosa injury induced by alcoholic through comprehensive analysis and comparing shortcomings of the current standard evaluation method, and methods of semi-quantitative analysis and corresponding information statistic processing were based on characteristics of the lesion and principles of pathology .Results Gross pathological evaluation of gastric mucosa lesion was based on the area occupied and proportion in the whole gastric mucosa .Histopathological diagnosis was based on the mucous layer depth of lesion as main determination point and other lesions as reference factors .Grades of lesion were divided into no abnormality (0), mild lesions (1 point), moderate lesions (2 points), and severe lesions (3 points). Ridit statistical method was used for pathological analysis of semi-quantitative results .Conclusion A scientific and feasible evaluation method for the protective effect of health food to gastric mucosal injury was provided from the aspects of gross pathology , histopathological evaluation method , data processing method and result determination .

Objective To evaluate the effect of cerebral palsy factor on the sensitivity of postopera?tive pain in the pediatric patients. Methods Twenty?five pediatric patients with cerebral palsy of both se?xes, of American Society of Anesthesiologists physical statusⅠorⅡ, aged 3-7 yr, weighing 11-25 kg, scheduled for elective lower abdominal or lower extremity surgery, served as cerebral palsy group ( group P). Another 25 pediatric patients without cerebral palsy of both sexes, of American Society of Anesthesiol?ogists physical status Ⅰ orⅡ, aged 3-7 yr, weighing 11-25 kg, served as control group ( group C) . At 2 h after surgery, pain was evaluated by using CRIES ( crying, requires O2 saturation, increased vital sign, expression and sleeplessness) . Peripheral venous blood samples were collected before surgery, and at 2 and 24 h after surgery, and the concentrations of plasmaβ?endorphin were measured by radio?immunity method, and the concentration of plasma catecholamine ( adrenaline) was determined by high performance liquid chromatography. Results Compared with the value before surgery, the plasma concentrations of β?endorphin were significantly decreased, and the concentrations of plasma catecholamine were increased after surgery in the two groups (P < 0?01). Compared with group C, the CRIES score was significantly in?creased after surgery, the concentration of plasmaβ?endorphin was decreased before and after surgery, and the concentration of plasma catecholamine was increased after surgery in group P ( P< 0?05 or 0?01) . Con?clusion The sensitivity of postoperative pain is increased in the pediatric patients with cerebral palsy.