Objective To compare the influence between target controlled infusion propofol vein anesthesia and midazolam vein anesthesia toward serum amylase and triglyceride in children with cleft lip and palate.To make a definitude that the feasibility of target controlled infusion propofol used in children′s anesthesia.Methods Sixty children with cleft lip and palate aged from 4 months to 3 years,weighting 6.5-15.9 kg,American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ,were randomly allocated to group P and group M(n=30,each).Group P received target controlled infusion propofol.Anesthesia was induced with target controlled infusion propofol at the target effect-site concentration 3.0 mg/L,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and target controlled infusion propofol at the effect-site concentration 3.0 mg/L.Group M received intermittent boluses of midazolam 0.1 mg/kg.Anesthesia was induced with midazolam 0.2 mg/kg,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and intermittent boluses of midazolam 0.1 mg/kg every hour.The venous blood samples were taken before anesthesia induction(T1),4 hours(T2) and 24 hours(T3) after surgery to measure the serum concentration of serum amylase and triglycride.Results The duration of anesthesia induction,extubation and emergence were shorter in group P compared with group M(Pa0.05).Conclusions The serum concentration of triglyceride may increase because of the stress of anesthasion and operation,and can be higher during target controlled infusion propofol,but does not exceed the normal value.The serum amylase concentration does not increase during target controlled infusion propofol in children.

Adult ; Female ; Heart Neoplasms ; Humans ; Pericardium ; Pheochromocytoma

Objective To investigate the clinical values of extracapsular invasion at sentinel lymph nodes in patients with breast cancer.Methods From Jan,2010 to Jan,2013,80 patients underwent axillary lymph node dissection due to sentinel lymph nodes invasion were enrolled in this prospective study.Patients were signed to extracapsular at sentinel lymph nodes positive group (n =45)and control group (n =35)according to the intra -operative pathology.The primary outcome was rate of positive non -sentinel lymph nodes and the second outcomes were 3 -year recurrence -free survival,mortality and health -related quality of life.Results Compared with the control group,the patients in extracapsular at sentinel lymph nodes positive group got a significantly higher rate of positive non -sentinel lymph nodes (91.11% vs.28.57%,χ2 =33.321,P <0.001 );a significantly lower rate of 3 -year recurrence -free survival(57.78% vs.88.57%,χ2 =9.114,P =0.003);a significantly higher rate of mortality (17.78% vs.2.86%,χ2 =4.390,P =0.036);and a significantly lower level of health -related quality of life[(78.43 ±12.43)vs.(87.54 ±11.89),t =11.324,P =0.000].Conclusion Extracapsular invasion at sentinel lymph nodes was a reliable predictor for non -sentinel lymph nodes invasion and long -term clinical outcomes.

Objective To investigate the association between the lumbar vertebral fracture damage degree with the fracture classification,injury score,kyphosis deformity and nerve function injury.Methods According to the damage degree of posterior lig ament complex(PLC),the patients were divided into the PLC intact group and PLC injury group.Its relationship with PLC injury was researched by evaluating the fracture classification,injury score and nerve function injury situation in the two groups.Results The LCS score and TLICS score in the PLC injury group were (7.1±0.8) points and (8.2±0.6) points,which were higher than (5.7±0.5) points and (4.6±0.7) points in the PLC intact group.The Denis score in the PLC injury group was more serious.The Cobb angle in the PLC injury group was 29°,and which in the PLC intact group was 19°.The proportion of nerve function insufficiency in the PLC injury group was 89％,while which in the PLC intact group was only 60 ％.Conclusion The thoracolumbar vertebral fracture is closely related with PLC.PLC damage degree is positively correlated with the fracture classification,injury score,kyphosis deformity and nerve function injury degree.

Azabicyclo Compounds ; blood ; Chromatography, Gas ; Humans ; Piperazines ; blood ; Serum ; chemistry

Objective To discuss the safety of using etomidate combined with remifentanil by target controlled infusion ( TCI) for painless bronchofibroscopy. Methods Sixty patients were divided into two groups: painless bronchoscopy group (treatment group, 24 patients) and the routine bronchoscopy group (control group, 36 patients). Treatment group received TCI of remifentanil and intravenous injection of etomidate fat emulsion. Control group was subjected to surface anesthesia with 2%lidocaine. SpO2 , blood pressure, heart rate and breath changes during examination and complete awakening were continuously monitored. Bronchofiberscopy time, body movement during examination, bucking and satisfaction degree after examination were also recorded. Results Treatment group patients felt senseless and painless during bronchoscopy, without memory of bronchoscopy and pain. Patients in control group had discomfort, body movement and acute bucking, and most of them had painful memory. There were significant differences between the two groups (P<0. 01). In treatment group, after examination, blood pressure, respiratory frequency, heart rate and SpO2 were significantly decreased (P<0. 01). During examination, the blood pressure, respiratory frequency and heart rate were increased, and SpO2 decreased in control group compared to the baseline (P<0. 01). There was no significant difference in SpO2 between treatment group and control group during examination (P>0. 05). Conclusion TCI etomidate combined with remifentanil during bronchoscopy achieved satisfying anesthetic effect.

Objective To investigate dexamethasone on airway inflammation and CD4+ CD25 + regulatory T cells (CD4+ CD25 +Tr) of asthmatic rats,and elucidate the possible mechanism of dexamethasone in treatment of asthma.Methods 30 Wistar rats were randomly divided into control group,asthma group and dexamethasone-treated group.Bronchoalveolar lavage fluid (BALF) was collected,and cytology study was conducted.The lung tissue was obtained and pathologic analysis was done through HE stain.Flow eytometry was used to detect the CD4+ CD25 +Tr ratio in PBMCs.Results Total cells number,the percentage of lymphocytes,neutrophils and eosinophils (Eos)in BALF of dexamethasone-treated group were lower than that of asthma group (P＜0.05,P＜0.01).Compared with the asthma group,less infiltration of inflammatory cells in lung tissues was observed in the dexamethasone-treated group.CD4+ CD25 + Tr of asthma group was lower than that of control and dexamethasone-treated group (P＜0.05).Conclusion Dexamethasone could suppress airway inflammation of asthmatic rats,which probably be due to increasing the number of CD4+ CD25 + Tr.

Objective To investigate the immunological mechanism of inhibitory effect of Danshen injection combined with dexamethasone(DXM) on asthmatic airway inflammation.Methods 50 Wistar rats were randomly divided into normal control(NC),asthma,Danshen,DXM and Danshen+DXM group.Cytology study of Bronchoalveolar lavage fluid(BALF) was conducted.Pathology of lung tissue was done through HE.Flow eytometry was used to detect CD4+CD25+ regulatory T Cells(CD4+CD25+ Treg) ratio in peripheral blood mononuclear cells(PBMCs).IL-4 and IL-5 levels in BALF were detected by ELISA.Results Total cells number,percentage of lymphocytes,neutrophils and eosinophils(Eos) in BALF of the three treated groups were lower than that in asthma group(P<0.05,P<0.01),particularly in Danshen+DXM group,which showed significant difference as compared with the other two treated groups(P<0.05).There was severe inflammation in lung tissue of asthma group,moderate inflammation in Danshen group and DXM group,and no inflammation of Danshen+DXM group.CD4+CD25+ Treg/CD4+ T ratio in the three treated groups were higher than that in asthma group,and the levels of IL-4 and IL-5 were lower than those in asthma group(P<0.05).In Dansben+DXM group,it showed significant difference on the change of CD4+CD25+ Treg,IL-4 and IL-5 as compared with other treated groups(P<0.05).Conclision Danshen injection combined with DXM could suppress airway inflammation in asthmatic rats,which may be through increasing the expression of CD4+CD25+ Treg,decreasing the levels of IL-4 and IL-5 and resuming the balance of Th1/Th2.