Objective To study the effect of dexmedetomidine and midazolam on hemodynamics and sedation in patients with nasal intubation.Methods Forty patients whose ASA grade Ⅰ-Ⅱ and anticipated difficult airway were randomly divided into dexmedetomidine group(group D,20 cases)and midazolam group(group M,20 cases)according to the admission number.In group D,dexmedetomidine 1 μ g/kg were constant speed pumped in 10 minutes.In group M,midazolam 0.03 mg/kg were intravenous injected.Then nasal intubation were carried.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial blood pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO2),Ramsay sedation score,rate-pressure product(RPP),tip perfusion index(TPI)were recorded and compared before anesthesia (T0),fiberoptic bronchoscope pass by later nostril(T1),to spy on epiglottis(T2),intubation succeed(T3),after intubation 1 minute(T4)and after intubation 3 minutes(T5).Airway score and postoperative visit were evaluated.Results SBP,DBP,MAP,HR,RPP in group M were significantly higher at T1-T3 than those at T0 (P＜0.05),and were significantly higher than those in group D at the same time(P＜ 0.05).There was no significant difference in group D(P ＞ 0.05).Ramsay sedation score and TPI at T1-T3 in group M were significantly lower than those at To(P ＜0.05).Ramsay sedation score and TPI at T1-T5 in group D were significantly higher than those at T0(P ＜ 0.05),and were significantly higher than those in group M at the same time(P ＜ 0.05).The rate of airway score 1 score and intubation satisfaction in group D were significantly higher than those in group M[100％(20/20)vs.30％(6/20),90％(18/20)vs.50％(10/20)](P＜ 0.05).The rate of throat ache in group D was significantly lower than that in group M[5％(1/20)vs.35％(7/20)](P ＜0.05).Conclusions For difficult airway patients with nasal intubation during dexmedetomidine infusion,hemodynamics is stable and sedation is satisfied.

Aim To observe the neuroprotective effect of different doses of propofol on ischemic fetal rat brain.Methods Eighteen healthy pregnant SD rats were randomly allocated into the following six groups with three rats in each.Group S: sham operation group, Group IR: ischemia/reperfusion group, Group P1~P3: different doses of propofol groups, Group B: bicuculline group.In group S and group IR, 1 ml saline solution was administered via caudal vein.In group P1~P3, 10, 30, 50 mg·kg-1 of propofol was administered via caudal vein respectively.In group B, when 50 mg·kg-1 propfol was administered via caudal vein, 5 mg·kg-1 bicuculline was injected intraperitoneally at the same time.Bilateral uterine ovarian arteries were clamped for 11 mins to make intrauterine distress model of the fetal rats.The brains of fetal rats were removed after 3 days of reperfusion.Brain sections(5 μm thick) were mounted and stained with Hematoxylin and eosin(HE).The profile of the hippocampus CA1 was evaluated under a light microscope and neuronal Lesion-index(LI) was calculated.MDA content of fetal rat brain was detected by thiobarbituric acid reaction method to determine the lipid peroxidation degree of brain.Results LI was (7.2±0.9) and MDA was (3.86±0.20) μmol·g-1 in group S.LI was 71.9±2.8 and the content of MDA was (9.10±0.45) μmol·g-1 in group IR, which increased significantly compared with those in group S(P<0.01).LI was (40.8±2.6), (21.4±1.4), (20.1±1.3) and the content of MDA was (7.32±0.41), (5.65±0.27), (5.44±0.28) μmol·g-1 in propofol groups, which decreased significantly compared with those in group IR(P<0.05).LI and the content of MDA was (51.2±2.3), (7.54±0.31) μmol·g-1 in group B,respectively, reversing partly the neuroprotevtive effect of propofl.Conclusion Propofol could protect the neurons in hippocampus CA1 region of fetal rat against intrauterine distress by reducing the concentration of MDA in the brain.

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy combined with limited open repair of medial collateral ligament (MCL) for the treatment of multiple ligament injuries of knee joints.

METHODSFrom March 2006 and June 2012,the data of 14 patients (14 knees) with multiple injuries of ACL, PCL, and MCL were collected. There were 8 males and 6 females with an average age of (31.8 +/- 8.1) years old (ranged, 20 to 49 years old). All the patients were performed with X-ray and MRI examination, and the results showed that 10 patients had combined with injuries of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL); 4 patients had ALC,PCL and posterolateral corner (PLC) injuries. Four patients had medial meniscus injuries and 2 patients had lateral meniscus injuries. The MCL,PLC and meniscus injuries were treated with operation on the first stage, and functional exercises were performed 3 weeks after fixation. The reconstruction operation of ACL and (or) PCL was performed at the second stage under arthroscopy 3 to 6 months later when the movement range of knee joint recovered to the normal level with obvious relaxation.

RESULTSAll incisions healed by primary intention. All the patients were followed up with a mean duration of 48.9 months (ranged, 24 to 80 months). The Lysholm score was improved from preoperative 19.6 +/- 0.9 to the latest follow-up 87.1 +/- 2.8 (t=12.3, P<0.01). The International Knee Documentation Committee (IKDC) rating: 9 cases nearly recovered to normal, 5 cases were abnormal.

CONCLUSIONFor multiple ligament injuries in the knee, staged repair and reconstruction can effectively restore knee joint stability and function.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective To compare the efficacy of different target concentrations of sufentanil target-controlled infusion used to supplement topical anesthesia for fiber-optic bronchoscopy (FOB)-assisted awake nasotracheal intubation in patients with obstructive sleep apnea syndrome (OSAS).Methods Forty-five ASA physical status Ⅱ or Ⅲ patients with OSAS,aged 28-60 yr,with body mass index of 30-40 kg/m2,scheduled for elective surgery,were randomly assigned into 3 groups (n =15 each):control group (group C) and sufentanil with the target plasma concentration of 0.4 ng/ml (group S1) and 0.6 ng/ml groups (group S2).Naso-pharyngeal and laryngeal mucous membrane was sprayed with 2％ lidocaine mixed with 1％ ephedrine for topical anesthesia in both groups.In addition 1％ tetracaine 3 ml was injected into trachea through cricothyroid membrane.FOB-assisted awake nasotracheal intubation was performed after the target concentration was achieved.The degree of airway obstruction was scored during intubation.The highest values of MAP and HR,rate-pressure product ＞ 12 000,decreased respiratory rate and hyoxemia were recorded during the period between induction of anesthesia and 3 min after intubation was completed.The changes in MAP and HR as percent of baseline values were calculated.Before topical anesthesia (T0),when target concentrations were reached (T1),and at 1 and 3 min after intubation (T2,3),blood samples were taken to determine the plasma concentrations of epinephrine (E),norepinephrine (NE) and cortisol.Results Compared with group C,the airway obstruction score was significantly decreased in group S1,the incidence of changes in MAP and HR ＞ 30％ of baseline values and rate-pressure product ＞ 12 000 was decreased,the plasma concentrations of E,NE and cortisol were decreased in S1 and S2 groups,and the incidence of the respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with group S1,the airway obstruction score were significantly decreased,and the incidence of respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with the baseline value at T0,the plasma concentrations of E,NE and cortisol were significantly increased at T2,3 in group C,while decreased at T1 in S1 and S2 groups (P ＜ 0.05).Conclusion Compared with pure topical anesthesia,sufentanil with the target plasma concentration of 0.4 ng/ml does not induce respiratory depression,maintains hemodynamics stable,attenuates the stress responses and provides better intubation conditions when used to supplement topical anesthesia for FOB-assisted awake nasotracheal intubation in patients with OSAS.

Objective To investigate the effect of different doses of sufentanil combined with dexmedetomidine ( DEX) on hemodynamic and Narcotrend index ( NI) during pediatric anesthesia induction. Methods A total of 45 children with lower abdominal surgery were randomly divided into three groups evenly: sufentanil 0. 1 μg·kg-1+ DEX (S1 group),sufentanil 0. 2 μg·kg-1+DEX (S2 group),and sufentanil 0. 3μg·kg-1+DEX (S3 group). Patients in each group began with intubation at the peak point of administration. Blood pressure,heart rate,perfusion index (PI) and NI were detected at the baseline (t0), delivering DEX 0.5 μg·kg-1·h-1 and sufentanil intravenously for 5 min (t1),delivering sufentanil for 3 min (t2),time of intubation ( t3 ) ,1 min ( t4 ) ,and 5 min ( t5 ) after intubation. The application rate of atropine and propofol was recorded. Patient recovery time and adverse reactions were observed. Results Compared with basicline value at t0 time point, hemodynamic parameters and NI were decreased at t1 and t2 ,while PI was increased in both groups. At t3 ,t4 ,and t5 ,all of the indicators in S1 group were significantly different from those at t0 ,and also significantly different from those in S2 and S3 group. Six patients were treated with propofol in S1 group and four presented with agitation after operation,more than S2 and S3 groups. Three patients were treatment with atropine in S3 group. Conclusion Sufentanil (0. 2 μg·kg-1 ) combined with dexmedetomidine can be used to induce intubation for pediatric anesthesia with stable hemodynamic profile and low incidence of adverse effects.

0.05); the levels of LL, LI, RRS in CBA group and CBA+IBT group were significantly lower than those in control group(P

AlM: To investigate the association between the degree of anterioruveitis and related factors including inflammatory markers as well as sacroiliac joint imaging in patients with ankylosing spondylitis ( AS) .
METHODS: Anterior changes evaluated by slit lamp, erythrocyte sedimentation rate ( ESR ) , C - reactive protein ( CRP ) and magnetic resonance imaging of 55 cases with AS associateduveitis were retrospectively analyzed. A modified endotoxin-induced uveitis ( ElU ) clinical standard was used for uveitis grading. SPARCC sacroiliac scoring was used to evaluate bone edema of sacroiliac joint. The correlation between the degree of uveitis and sacroiliitis was assessed.
RESULTS: ln the 55 patients with AS, ElU grading scored 2-10, and SPARCC index scored 0-22. Further analysis showed that the severity of uveitis was significantly correlated with ESR (r=0. 869, P<0. 001) and CRP (r=0. 485, P<0. 001). The degree of anterior uveitis in AS patients was not correlated with inflammation of sacroiliac joint (r=0. 237, P=0. 081).
CONCLUSlON: Local autoimmunity of uveitis and sacroiliac joint inflammation with subsequent bone formation in AS might be mutually independent processes.

Objective:To investigate the effect of electroacupuncture (EA) at Ganshu (BL 18) and Shenshu (BL 23) on vascular endothelial growth factor (VEGF) and platelet endothelial cell adhesion molecule-1 (PECAM-1)/CD31 around the cerebral infarction focus in middle cerebral artery occlusion (MCAO) rats and the possible mechanism, thus to provide a new strategy for the treatment of cerebral ischemic stroke by acupuncture. Methods:A total of 180 healthy male Sprague-Dawley (SD) rats were randomly divided into a sham operation group, a model group, an acupoint group and a non-acupoint group, 45 rats in each group. MCAO model was established using the modified line-embolus method in all rats except for those in the sham operation group; rats in the acupoint group were treated with EA at Ganshu (BL 18) and Shenshu (BL 23); rats in the non-acupoint group were treated with EA at the control points; rats in other 2 groups were only subjected to bundling without treatment. Ten rats in each group were randomly selected on the 3rd day, the 14th day and the 21st day after acupuncture stimulation to test the neurological function impairment. The expression levels of CD31 and VEGF were also detected. Results:Compared with the model group and non-acupoint group, the neurological function score of the acupoint group was decreased at each time point, and the differences were statistically significant (P<0.05,P<0.01). The expressions of VEGF and CD31 in each group were the lowest on the 3rd day, reached the peak on the 14th day and still remained at high level on the 21st day. And the differences among groups were statistically significant both on the 14th day and the 21st day (P<0.05,P<0.01). Compared with the model group and the non-acupoint group, the expressions of VEGF and CD31 in the acupoint group were increased, and the differences were statistically significant (allP<0.05). Conclusion: EA at Ganshu (BL 18) and Shenshu (BL 23) can significantly improve the neurological function score of MCAO model rats, and shows protective effect on cerebral ischemia. The protective mechanism may be related to the up-regulation of CD31 and VEGF expression around the cerebral infarction focus in the MCAO model rats and induction of angiogenesis.

Blood Donors ; DNA Virus Infections ; epidemiology ; virology ; Hepatitis Viruses ; classification ; isolation & purification ; pathogenicity ; Hepatitis, Viral, Human ; epidemiology ; virology ; Humans ; Transfusion Reaction

OBJECTIVETo investigate the relationship between cardiac Cerebrovascular disease and serum uric acid(SUA) in the coastal inhabitant, and try to provide base for prevention of the local metabolic disease and cardiac Cerebrovascular disease.

METHODWe got 3111 local people who had participated in the annual physical examination in the perch hospital for the research on the level of SUA and the relative risk factor. According to SUA level we divided the cases into two groups. One is hyperuricemia group and the other is control group.

RESULTS(1)The average SUA level was (380.2-/+62.58) micromol/L in the males, while (290.82-/+60.32) micromlo/L in the female. The sick rate of hyperuricaemia rate, was 21.8% for male, and the 17.6% of female. This disease affected more men than women. It has significant difference (P<0.01); (2)The SUA level of the showed a positive correlation with the indexes of the total cholesterol, the triglyceride, the blood pressure and the body weight index. The SUA level in overweight/obesity people was obviously higher than that of the normal weight people.

CONCLUSIONS(1)The sick rate of hyperuricaemia is high in Zhongshan coastal area, which due to many related factors. As far as, few people know it, so we should adopt the synthesis measure to prevent and control it to reduce the sick rate; (2)the rise of The SUA level possibly becomes one of the independent dangerous and predictive factor for the heart cerebral von disease.

Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Case-Control Studies ; Cerebrovascular Disorders ; blood ; epidemiology ; pathology ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Sex Distribution ; Uric Acid ; blood ; Young Adult