Objective To investigate the effects of different anesthesia depths on stress states and inflammatory mediators in patients undergoing video-assisted thoracoscopic lobectomy.Methods A total of 89 lung cancer patients who underwent video-assisted thoracoscopic lobectomy were selected as study subjects.Based on intraoperative bispectral index(BIS)range,the patients were divided into deep anesthesia group(BIS of 40 to＜50,n=45)and shallow anesthesia group(BIS of 50 to＜60,n=44).Vital signs(mean arterial pressure,heart rate and blood oxygen saturation),anesthesia re-covery time,extubation time,dosage of vasoactive drugs,postoperative pain intensity[Visual Ana-logue Scale(VAS)],postoperative analgesic dosage,perioperative stress state[prostaglandin E2(PGE2),nerve growth factor(NGF)and substance P(SP)],levels of inflammatory mediators[neuron-specific enolase(NSE),tumor necrosis factor-α(TNF-α)and S100β protein]at different time points(before anesthesia induction,immediately after intubation,before lesion resection and at the end of surgery)and the incidence of anesthesia-related adverse reactions were compared between the two groups.Results Before lesion resection and at the end of surgery,the mean arterial pressure and heart rate in the deep anesthesia group were significantly lower than those in the shallow anesthe-sia group(P＜0.05).The anesthesia recovery time and extubation time in the deep anesthesia group were significantly longer than those in the shallow anesthesia group(P＜0.05).At the end of surgery and on postoperative day one,the levels of PGE2,NGF and SP in the deep anesthesia group were significantly lower than those in the shallow anesthesia group,while the levels f NSE,TNF-α and S100β protein were significantly higher than those in the shallow anesthesia group(P＜0.05).There were no significant differences in the dosage of vasoactive drugs,VAS scores,sufentanil dos-age and the incidence of anesthesia-related adverse reactions between thetwo groups(P＞0.05).Conclusion During one-lung ventilation in patients undergoing video-assisted thoracoscopic surgery lobectomy,deep anesthesia can effectively control surgical stress and maintain stability of intraopera-tive hemodynamics,but it is associated with delayed postoperative awakening and more pronounced inflammatory response.Shallow anesthesia results in faster postoperative awakening and lower levels of inflammatory mediators,but it is associated with more significant intraoperative stress response and unstable hemodynamics.

Objective To observe the therapeutic effect of stellate ganglion block for the treatment of facial paralysis. Methods 128 patients were randomly divided into two groups. Control group was treated by routine therapy , treatment group was treated by routine therapy plus stellate ganglion block. The effects of the two groups were evaluated by facial paralysis scale. Effective rate and cure rate as well as the course of therapy after treatment were also observed and compared. Results The cure rate of treatment group was 65% , effective rate was 98%. The cure rate of control group was 35% .effective rate was 82%. The cure rate and effective rate of treatment group were significantly higher than that of control group (P < 0. 05 ). The mean effective time and cure time of treatment group were shorter than the control group (P < 0.05). Conclusion Stellate ganglion block plus routine therapy produced better therapeutic effect and shortened the therapeutic course of facial paralysis.

Objective To observe the analgesic effects and safety of morphine combined low-dose ketamine with patient control subcutaneous analgesia(PCSA) for patieats with moderate to severe late cancer pain. Methods 60 patients with moderate to severe late phase cancer pain were randomly average divided into two groups (group Ⅰ and group Ⅱ). 30 patients of group Ⅰ were treated with morphine PCSA and 30 patients of group Ⅱ were treated lowdose ketamine plus morphine PCSA,respectively. The VAS(Visual Analogue Scale) of pain scores were evaluated after treatment 1 h、24 h、48 h. Effects and the rate of side effects were also comparred. Results There was no significant difference in VAS pains scores in each period. Morphine dosage in group Ⅰ (56.43 mmg) was significantly more than that in group Ⅱ (31.23mg) (x~2 =6. 18,P ＜0.05). Group Ⅱ :The incidence of nausea or vomiting was 4cases (13.3%) ,constipation was 2cases(6. 7%) ,drowsiness was 2cases(6. 7%) ,skin titillation was 0(0.0) ;but Group Ⅰ of it was 21 (70.0%), 18 (60.0%) ,9 (30.0%), 8 (26. 7%), The incidence of group Ⅱ was lower than group Ⅰ .Conclusion Small dosage ketamine combined with morphine patient control subcutaneous analgesia (PCSA) approach appears to provide a safe and effective method for advanced cancer patients with moderate to severe pain.