Objective:To retrospectively analyze the anesthetic management characteristics of children undergoing resection of pheochromocytoma and paraganglioma (PPGL).Methods:The clinical data from patients undergoing resection of PPGL and confirmed histologically from January 1, 2010 to June 30, 2023 were retrospectively collected. The baseline characteristics, intraoperative conditions and postoperative complications were recorded.Results:The clinical data from 47 pediatric patients were analyzed. The overall incidence of hemodynamic instability events was 68% (32 cases). Lowering preoperative blood pressure to normal levels and the maximum diameter of tumor≥6 cm was helpful in reducing the incidence of the intraoperative hemodynamic instability events ( P<0.05). Postoperative hypotension developed in 7 cases, acute left heart failure in 1 case, arrhythmia in 1 case, adrenocortical insufficiency in 4 cases, and pulmonary infection in 13 cases. Conclusions:Thorough preoperative preparation, evidence-based anesthetic management, and meticulous postoperative vital sign monitoring can increase the perioperative safety for children undergoing resection of PPGL, thereby reducing the incidence of complications.

Objective:To evaluate the optimization effect of ultrasound-guided erector spinae plane block (ESPB)combined with general anesthesia on Nuss procedure in pediatric patients with pectus excavatum undergoing Nuss procedure.Methods:One hundred and eight pediatric patients of either sex, aged 7-18 yr, with body mass index within the normal range, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective Nuss procedure, were randomized into 3 groups ( n=36 each) using a random number table method: ultrasound-guided ESPB combined with general anesthesia group (group E), thoracic epidural anesthesia plus general analgesia group (group T), and general analgesia group (group G). Pediatric patients received ultrasound-guided bilateral ESPB (0.3% ropivacaine was injected, 0.5 ml/kg bilateral total volume [maximum 20 ml]) or thoracic epidural anesthesia (0.3% ropivacaine 0.5 ml/kg [maximum 20 ml/side]) after induction of anesthesia in group E and group T, respectively. All the three groups underwent general anesthesia, anesthesia was induced with propofol 2-3 mg/kg, sufentanil 0.3-0.5 μg/kg and cis-atracurium 0.1-0.2 mg/kg and maintained with propofol 6-10 mg·kg -1·h -1 and remifentanil 0.1-0.3 μg·kg -1·min -1. The patients were endotracheally intubated and mechanically ventilated after anesthesia induction. The parent-controlled intravenous analgesia (PCIA) was used for patients in all the three groups postoperatively. The consumption of intraoperative remifentanil and postoperative consumption of sufentanil for PCIA in each period after surgery were recorded. The time to the first rescue analgesia, consumption of ibuprofen and postoperative complications were also recorded. Results:Compared with group G, the intraoperative consumption of remifentanil and postoperative consumption of sufentanil for PCIA in each period were significantly decreased, the time to the first rescue analgesia was prolonged, and the consumption of ibuprofen was decreased in group E ( P<0.05). There was no significant difference among the three groups ( P>0.05). Conclusions:ESPB combined with general analgesia is helpful in reducing postoperative hyperalgesia in pediatric patients undergoing the Nuss procedure.

Objective:To evaluate the efficacy of ultrasound-guided bilateral erector spinae plane (ESP) block for pediatric patients undergoing Nuss procedure with general anesthesia.Methods:Thirty-two American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 4-15 yr, undergoing Nuss procedure with general anesthesia, were divided into ESP block plus general anesthesia group (group EG, n=16) and general anesthesia group (group G, n=16) using a random number table method.Bilateral ESP blocks were performed after anesthesia induction in group EG.Intravenous analgesia was performed postoperatively in both groups.Face Legs Activity Cry Consolability (FLACC) scores both at rest and during coughing were recorded on admission to postanesthesia care unit (PACU) and at 1, 6, 12, 24 and 48 h after operation.When FLACC score at rest >4, ibuprofen 5.0-7.5 mg/kg was taken orally according to the requirements of pediatric patients and their parents.The intraoperative amount of propofol and remifentanil used and postoperative requirement for fentanyl and ibuprofen were recorded.The development of postoperative hypoxia (SpO 2 <90%), nausea and vomiting, and urinary retention was recorded.The development of puncture site infection, hematoma and subcutaneous emphysema was recorded.The tracheal extubation time, duration in PACU and length of postoperative hospital stay were also recorded. Results:Compared with group G, FLACC scores at rest within 12 h after operation and during coughing within 6 h after operation were significantly decreased, the intraoperative consumption of remifentanil was reduced, the postoperative requirement for fentanyl and ibuprofen was decreased, the incidence of hypoxemia was decreased, the tracheal extubation time and duration in PACU were shortened ( P<0.05), and no significant change was found in the consumption of propofol, incidence of nausea and vomiting, or length of postoperative hospital stay in group EG ( P>0.05). Conclusion:Ultrasound-guided bilateral ESP block can reduce the consumption of opioids in the perioperative period and enhance the analgesic efficacy with a higher safety, which is helpful in promoting short-term outcomes for pediatric patients undergoing Nuss procedure with general anesthesia.

Objective To construct a scoring system of combination of procalcitonin and C-reactive protein for diagnosis of invasive bacterial diarrhea in children. Methods The clinical data of hospitalized children with acute diarrhea were retrospectively analyzed. All of the children were divided into two groups, invasive bacterial diarrhea group and nonbacterial diarrhea group. The scoring system of combination of two markers for diagnosis of invasive bacterial diarrhea in children was constructed by means of two categories logistic regression analysis using procalcitonin and C- reactive protein as parameters. In addition,receiver operating characteristic curve(ROC)was used to evaluate the diagnostic accuracy.Results One hundred ten cases of invasive bacterial diarrhea and 108 cases of nonbacterial diarrhea were included. The levels of serum procalcitonin and C-reactive protein in invasive bacterial diarrhea group were significantly higher than those in nonbacterial diarrhea group, and there were statistical difference(P all<0.05).The area under the ROC curve(AUC)of invasive bacterial diarrhea was 0.894 when the established scoring system was used, which was higher than the AUCs when either serum procalcitonin or in C- reactive protein was used (P<0.05). The best diagnostic boundary value for combination of serum procalcitonin and C- reactive protein scoring was 0.52 with a sensitivity at 80.9% and specificity at 88.9%. Conclusions The scoring system of combination of procalcitonin and C- reactive protein has good accuracy in diagnosis of invasive bacterial diarrhea in children, and can assist the early diagnosis of the disease.

Objective To investigate the inhibitory effects of RNA interference targeting GFI?1 on growth and proliferation of atypical chronic myelogenous leukemia ( aCML) NT1 cells. Methods NT1 cells were transfected with PBS and liposome complex ( vehicle group) , scrambled siRNA and liposome complex ( negative control, NC group ) , and GFI?1 siRNA and liposome complex ( GFI?1 siRNA group ) , respectively. Real?time quantitative RT?PCR ( qRT?PCR) and Western blot were performed to examine the expression levels of GFI?1 mRNA and protein, respectively. The proliferation abilities of NT1 cells of the three groups were evaluated by MTT assay. The cell cycle in cells of the three groups was analyzed by flow cytometry. Moreover, nude mouse xenograft model was used to detect the tumor formation ability in the three group cells. Results Quantitative real?time PCR data showed that the expression level of GFI?1 mRNA in GFI?1 siRNA group was significantly lower than those of NC group and vehicle group [(0.367±0.017) vs. (0.918±0.006) and (1.010±0.005), respectively, (P<0.05)]. Western blot results showed that the GFI?1 protein expression level in the GFI?1 siRNA group was also significantly reduced, compared with those of the NC group and vehicle group ( P<0.05 for both) . From MTT assay data, the absorbance value of NT1 cells in the GFI?1 siRNA group (0.667±0.059) was significantly lower than those of the NC group (1.096±0.049) and vehicle group (1.193±0.064, P=0.023). Flow cytometry data showed that sub?G1 and G0/G1 phase proportions of the GFI?1 siRNA group were significantly higher than those of the NC and vehicle groups [ sub?G1: (8.2±2.5)% vs. (1.9±1.3)% and (2.0±3.6)%, respectively, (P<0.05);G0/G1:(66.7±3.8)% vs. (53.3±4.5)% and (48.6±3.2)%, respectively, (P<0.05)]. Furthermore, the tumor weight in the GFI?1 siRNA group [(0.37±0.02) g] was significantly lower than those in the NC group [(0.83±0.06) g] and vehicle group [(0.92±0.04) g] (P<0.05). Conclusions RNA interference targeting GFI?1 inhibits the growth and proliferation of NT1 cells, which may provide a new therapeutic target for atypical chronic myelogenous leukemia.

Objective To investigate the inhibitory effects of RNA interference targeting GFI?1 on growth and proliferation of atypical chronic myelogenous leukemia ( aCML) NT1 cells. Methods NT1 cells were transfected with PBS and liposome complex ( vehicle group) , scrambled siRNA and liposome complex ( negative control, NC group ) , and GFI?1 siRNA and liposome complex ( GFI?1 siRNA group ) , respectively. Real?time quantitative RT?PCR ( qRT?PCR) and Western blot were performed to examine the expression levels of GFI?1 mRNA and protein, respectively. The proliferation abilities of NT1 cells of the three groups were evaluated by MTT assay. The cell cycle in cells of the three groups was analyzed by flow cytometry. Moreover, nude mouse xenograft model was used to detect the tumor formation ability in the three group cells. Results Quantitative real?time PCR data showed that the expression level of GFI?1 mRNA in GFI?1 siRNA group was significantly lower than those of NC group and vehicle group [(0.367±0.017) vs. (0.918±0.006) and (1.010±0.005), respectively, (P<0.05)]. Western blot results showed that the GFI?1 protein expression level in the GFI?1 siRNA group was also significantly reduced, compared with those of the NC group and vehicle group ( P<0.05 for both) . From MTT assay data, the absorbance value of NT1 cells in the GFI?1 siRNA group (0.667±0.059) was significantly lower than those of the NC group (1.096±0.049) and vehicle group (1.193±0.064, P=0.023). Flow cytometry data showed that sub?G1 and G0/G1 phase proportions of the GFI?1 siRNA group were significantly higher than those of the NC and vehicle groups [ sub?G1: (8.2±2.5)% vs. (1.9±1.3)% and (2.0±3.6)%, respectively, (P<0.05);G0/G1:(66.7±3.8)% vs. (53.3±4.5)% and (48.6±3.2)%, respectively, (P<0.05)]. Furthermore, the tumor weight in the GFI?1 siRNA group [(0.37±0.02) g] was significantly lower than those in the NC group [(0.83±0.06) g] and vehicle group [(0.92±0.04) g] (P<0.05). Conclusions RNA interference targeting GFI?1 inhibits the growth and proliferation of NT1 cells, which may provide a new therapeutic target for atypical chronic myelogenous leukemia.

Objective To evaluate the efficacy of Ambu AuraOnce laryngeal mask airway (LMA) in Chinese patients undergoing general anesthesia.Methods Fifty-six female patients, aged 20-64 yr, weighing 45-75 kg, of American Society of Anesthesiology physical status Ⅰ or Ⅱ (Mallampati Ⅰ-Ⅲ), scheduled for elective breast surgery under general anesthesia, were equally and randomly divided into either Ambu AuraOnce LMA group (group A) or LMA Supreme group (group S) using a random number table.After induction of anesthesia, Ambu AuraOnce LMA was inserted in group A, and LMA Supreme was placed in group S.After successful placement of LMA, correct position was confirmed by fiberoptic laryngoscopy.Intermittent positive pressure ventilation was performed during surgery to maintain pulse oxygen saturation ＞ 95％ and partial pressure of end-tidal CO2 at 30-45 mmHg.The success rate, insertion time, extubation time, airway sealing pressure, peak airway pressure and occurrence of air leakage of LMA were recorded.After removal of the LMA, the blood stains on the LMA were checked, and the occurrence of hypoxemia, regurgitation, nausea, vomiting and bucking was recorded.The occurrence of sore throat, hoarseness and dysphagia was also recorded within 24 h after surgery.Results There were no significant differences in terms of insertion time, overall success rate, success rate at first attempt, removal of LMA time, airway sealing pressure, and incidence of air leakage of LMA, hypoxemia, blood stains on the LMA, sore throat, hoarseness and dysphagia between the two groups.The rate for correct position of LMA confirmed by fiberoptic laryngoscopy was significantly higher in group A than in group S.Conclusion Ambu AuraOnce LMA can safely and effectively be applied for airway management in Chinese patients undergoing general anesthesia.

Objective To investigate the effect of evidence-based nursing on oral ulcer of leukemia patients undergoing chemotherapy. Methods A total of 60 leukemia patients in our hospital from January 2014 to October 2014 were enrolled as observation group, and given evidence-based nursing intervention including health education, pH adjustment of mouth, mouthwash by ice water, and oral ulcer nursing according to the degree. Clinical data of 60 leukemia patients from April to December 2013 before the implementation of evidence-based nursing( control group) was retrospectively analyzed and the incidence rate and recovery of oral ulcer were compared. Results The incidence rate of oral ulcer in observation group (21. 67%, 13/60) was lower than that in the control group (60. 00%,36/60) (χ2 =5. 964,P<0. 05); the healing time of oral ulcer in the observation group (4.23 ±2.14)d was shorter than that in the control group (7.15 ±2.44)d (t =4. 614,P<0. 05). Conclusions Taking evidence-based nursing in leukemia patients can promote the quality of nursing care, reduce the incidence of oral ulcer, and improve the rehabilitation effect.

Objective To construct Cchl1a3 gene R528H knock-in mouse model related to hypokalemic periodic paralysis.Methods ES cells were transfected with Cchl1a3-Konckin targeting vector linearized by Not I digestion , selected in the medium containing both G 418 and ganciclovoir .Resistant clones were screened by PCR and further confirmed by DNA sequencing for correct homologous recombinants .Chimera mice were obtained by routing microinjection of homologous recombined ES cells into blastocysts .Heterozygous mice were obtained by mating .Through heterozygous mice with FLP mice mating , removal of neo gene heterozygous mice were established and identified with the PCR and DNA sequencing . After mating, homozygous offspring were constructed and observed .Results ES cells were successfully transfected withtargeting vector .It was confirmed that 9 resistant clones happened right homologous recombination by PCR and DNA sequencing .7 chimera mice were obtained by microinjection .After breeding the chimeric mice , heterozygous mice were mated FLP mice to obtain 9 heterozygous mice removal of neo gene, the finally obtained 15 homozygous mice with Flp-deleted neo gene.In the developmental stage of sexual maturity , the spirit of the mice, restaurants and activities in good condition, but the gradual emergence of hair removal at 4 months of age, skin ulceration and even death .Conclusions We successfully constructed Cchl1a3 gene R528H mutation homozygous mice.And it laid a foundation for the study of human CACNA1S gene function and to clarify the molecular mechanism of hypokalemic periodic paralysis .

Objective:To observe the clinical efficacy of acupuncture combining with temperature sensitive point moxibustion therapy on laryngeal cough with yin-deficiency of lung-kidney. Methods:Divided 80 patients into test group and control group. Each included 40 people. The test group adopted the therapy by acupuncture kaiyin 1,Tianrong point,combining with temperature sensitive point (this point ofen appears in Yongquan Point Branch) moxibustion therapy,and the control group took the Western medicine conventional treatment. Then calculated the total effective rates of the two groups and analyzed statistically. Results:At the end of treatment,the total effective rate of test group was 95%,and the control group's was 85%,the difference between total effective rate was signifi cant difference (P