Objective:To evaluate the effect of paravertebral nerve block (PVNB) combined with general anesthesia on intraoperative regional cerebral oxygen saturation (rScO 2) in elderly patients undergoing thoracoscopic lobectomy. Methods:Seventy American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 60-85 yr, with body mass index of 18-25 kg/m 2, were divided into 2 groups ( n=35 each) using a random number table method: general anesthesia group (group G) and PVNB combined with general anesthesia group (group PG). PVNB was performed at T 4 and T 6 with 0.5% ropivocaine 10 ml for each site under ultrasound guidance before induction of anesthesia in group PG.After induction of anesthesia, anesthesia was maintained with IV propofol and remifentanil, and a patient-controlled intravenous analgesia pump was connected at the end of operation.The maximum and minimum rScO 2 and cumulative time of rScO 2 below the baseline value were recorded.The rScO 2 was recorded before anesthesia (T 0), at 5 min before one-lung ventilation (T 1), at 5 min after one-lung ventilation (T 2) and at tracheal extubation (T 3). The length of postoperative hospital stay and complications within 30 days after operation were recorded. Results:Compared with group G, the minimum rScO 2 and rScO 2 at T 2 and T 3 were significantly increased, the incidence of postoperative cognitive dysfunction was reduced ( P<0.05), and no significant change was found in the other parameters mentioned above in group PG ( P>0.05). Conclusion:PVNB combined with general anesthesia can improve intraoperative rScO 2 and reduce the development of postoperative cognitive dysfunction in elderly patients undergoing thoracoscopic lobectomy.

Objective:To explore the consistency of peripheral whole blood and venous serum procalcitonin (PCT) levels, and the value of peripheral whole blood PCT in evaluating pediatric bacterial infection.Methods:This multicenter cross-sectional parallel control study was conducted in 11 children′s hospital. All the 1 898 patients older than 28 days admitted to these hospitals from March 2018 to February 2019 had their peripheral whole blood and venous serum PCT detected simultaneously with unified equipment, reagent and method. According to the venous serum PCT level, the patients were stratified to subgroups. Analysis of variance and chi-square test were used to compare the demographic characteristics among groups. And the correlation between the peripheral blood and venous serum PCT level was investigated by quantitative Pearson correlation analysis.The PCT resultes were also converted into ranked data to further test the consistency between the two sampling methods by Spearman′s rank correlation test. Furthermore, the ranked data were converted into binary data to evaluate the consistency and investigate the best cut-off of peripheral blood PCT level in predicting bacterial infection.Results:A total of 1 898 valid samples were included (1 098 males, 800 females),age 27.4(12.2,56.7) months. There was a good correlation between PCT values of peripheral whole blood and venous serum ( r=0.97 , P<0.01). The linear regression equation was PCT?venous serum=0.135+0.929×PCT peripheral whole blood. However, when stratified to 5 levels, PCT results showed diverse and unsatisfied consistency between the two sampling methods ( r=0.51-0.92, all P<0.01). But after PCT was converted to ordinal categorical variables, the stratified analysis showed that the coincidence rate of the measured values by the two sampling methods in each boundary area was 84.9%-97.1%. The dichotomous variables also showed a good consistency (coincidence rate 96.8%-99.3%, Youden index 0.82-0.89). According to the severity of disease, the serum PCT value was classified into 4 intervals（<0.5、0.5-<2.0、2.0-<10.0、≥10.0 μg/L）, and the peripheral blood PCT value also showed a good predictive value (AUC value was 0.991 2-0.997 9). The optimal cut points of peripheral whole blood PCT value 0.5、1.0、2.0、10.0 μg/L corresponding to venous serum PCT values were 0.395, 0.595, 1.175 and 3.545 μg/L, respectively. Conclusions:There is a good correlation between peripheral whole blood PCT value and the venous serum PCT value, which means that the peripheral whole blood PCT could facilitate the identification of infection and clinical severity. Besides, the sampling of peripheral whole blood is simple and easy to repeat.

Objective To provide evidence for the long-term development of biobank in China,we retrieved literature on biobank for analyzing the development status and trend of Biobank in the world and China.Methods Using the topic of "Biobank" to search articles from 2008 to 2017 in the core collection of Web of ScienceTM,we conducted statistical analysis covering the annual published quantity,the corresponding national/regional distribution,h-index,and the authors of these articles.Results A total number of 2012 articles on Biobank published from 2008 to 2017 were retrieved from the core collection of Web of ScienceTM,in which the annual published quantity on Biobank in the world and China was basically similar,and was on the upward trend;among them,the top three countries/regions with the published quantity were United States,England and China;the top three countries/regions with the h-index were United States,England and the Netherlands,and China ranked fifth;the cooperation degree and co-authorship rate of the authors in China were higher than that in the world.Conclusions The annual growth trend of published quantity on Biobank in China is basically consistent with that in the world.Chinese Biobank plays an important role in the world,and the Chinese researchers on biobank attach more importance to cooperation.However,the scientific research achievements with significant academic influence need to be further improved.Therefore,in order to build a standardized and high-quality biobank,Chinese biobank still needs innovation and exploration continuously.

Objective:To identify the risk factors for decrease in regional cerebral oxygen saturation (rScO 2) during one-lung ventilation (OLV) in the patients undergoing thoracic surgery. Methods:A total of 175 patients of both sexes, aged ≥55 yr, with expected operation time≥2 h, scheduled for elective thoracic surgery with OLV, were selected in the Fourth Hospital of Hebei Medical University from August 2017 to September 2018.The rScO 2 was continuously monitored from the beginning of anesthesia induction until removal of tracheal intubation.General anesthesia, general anesthesia combined with epidural block or general anesthesia combined with local nerve block were used.The baseline characteristics, previous medical history and history of anesthesia surgery, type of surgery, method of anesthesia, duration of anesthesia, duration of OLV, duration of surgery, and intraoperative adverse events (hypoxemia, hypotension, bradycardia, etc.) were recorded.According to whether a decrease in rScO 2 occurred during OLV (absolute value of rScO 2 was less than 65% or a decrease of more than 20% of the baseline value), the patients were divided into 2 groups: low rScO 2 group and normal rScO 2 group.Multivariate logistic regression analysis was used to identify the risk factors for decrease in rScO 2 during OLV. Results:One hundred and seven patients developed decrease in rScO 2 during OLV, with an incidence of 61.1%.The results of logistic regression analysis showed that hypoxemia was an independent risk factor for decrease in rScO 2, and general anesthesia combined with epidural block was a protective factor for decrease in rScO 2 during OLV. Conclusion:Hypoxemia is an independent risk factor for decrease in rScO 2 during OLV, while general anesthesia combined with epidural block is a protective factor for decrease in rScO 2 in the patients undergoing thoracic surgery.

Objective To provide evidence for the long-term development of biobank in China,we retrieved literature on biobank for analyzing the development status and trend of biobank in the world and China.Methods Using the topic of "Biobank" to search articles from 2008 to 2017 in the core collection of Web of ScienceTM,we conducted statistical analysis covering the annual published quantity,the corresponding national/regional distribution,h-index,and the authors of these articles.Results A total number of 2012 articles on biobank published from 2008 to 2017 were retrieved from the core collection of Web of ScienceTM,in which the annual published quantity on biobank in the world and China was basically similar,and was on the upward trend;among them,the top three countries/regions with the published quantity were United States,England and China;the top three countries/regions with the h-index were United States,England and the Netherlands,and China ranked fifth;the cooperation degree and co-authorship rate of the authors in China were higher than that in the world.Conclusions The annual growth trend of published quantity on biobank in China is basically consistent with that in the world.Chinese biobank plays an important role in the world,and the Chinese researchers on biobank attach more importance to cooperation.However,the scientific research achievements with significant academic influence need to be further improved.Therefore,in order to build a standardized and high-quality biobank,Chinese biobank still needs innovation and exploration continuously.

Objective To study the distribution of the regions of ultrasound-guided erector spinae plane block (ESPB) at the level of T5 transverse process.Methods Thirty male patients,aged 18-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracotomy,were enrolled in this study.ESPB was conducted with 0.5％ ropivacaine hydrochloride 0.4 ml/kg at the level of T5 transverse process under ultrasound guidance before induction of general anesthesia.Blocks in each thorax and back region (the left side of the body was divided into 18 different regions based on the anatomical "landmarks" on the body surface,No.1-18) were assessed by cold stimulation.Effective block in each region was recorded at 10,15,20,25,30,40 and 50 min after administration.The adverse reactions such as pneumothorax,puncture hematoma and local anesthetic intoxication were recorded.Results The blocking range was basically fixed at 30 min after a single ESPB injection at the level of T5 transverse process,and the regions covered from the sternal angle to the level of the rib arch.The regions of effective block were No.1-3 and 5-7 in ≥95％ patients,and the regions of effective block were No.1-15 and 17 in patients ≥90％ and ＜ 95％.No patients developed adverse reactions such as pneumothorax,puncture hematoma or local anesthetic intoxication.Conclusion The regions of effective ultrasound-guided ESPB at the level of T5 transverse process are mainly distributed in T2-T8 thoracodorsal skin areas.

Objective:To investigate the effects of dexmedetomidine on perioperative cardiac adverse events in elderly patients with coronary heart disease.Methods:Sixty elderly patients,who were diagnosed as coronary heart disease and underwent gastric cancer operation,were randomly divided into 2 groups (n=30):the dexmedetomidine group (Dex group) and the control group.In the Dex group,dexmedetomidine was administered intravenously at 0.5 μtg/(kg.h) after a bolus infusion at 0.5 μg/kg for 10 min before anesthesia induction.In the control group,equal volume of normal saline was infused instead of dexmedetomidine.The 2 groups received the same anesthesia treatment.The venous bloods were collected at the preoperative 0 h and postoperative 24 h.The concentrations of cardiac troponin (cTnⅠ),N-terminal pro-brain natriuretic peptide (NT-proBNP) and hypersensitive C-reactive protein (hs-CRP) were determined.The ECG was monitored at the above time and the postoperative incidence of cardiac adverse events was recorded.Results:The levels of cTnⅠ,NT-proBNP and hs-CRP in serum were elevated in the 2 groups after the operation.Compared with the control group,the levels of cTnⅠ,NT-proBNP and hs-CRP were significantly decreased in the Dex group (P＜0.05).Compared with the control group,the incidence ofbradycardia were significantly increased,while the myocardial ischemia and tachycardia were significantly decreased in the Dex group during the operation (P＜0.05);the incidence of silent myocardial ischemia and arrhythmia was significantly reduced at 3 days after operation in the Dex group (P＜0.05).Conclusion:Dexmedetomidine could decrease the incidence of cardiac adverse events in elderly patients with coronary heart disease.

Objective To explore the effect of health education improvement on promotion of timely vaccination among migrant children in community and to provide references for community health service center.Methods A total of 155 migrant children's parents were recruited from July 2015 to February 2016,and improved health education intervention was carried out on the basis of routine health education to promote parents' health belief on timely vaccination.The compliance of parents' participation in health education activities,the health belief of parents themselves on timely vaccination at different stages of intervention and parents' satisfaction,and the rate of timely vaccination of migrant children before and after intervention were evaluated.Results Regarding the compliance of health education activities for parents in 12 weeks,the first 3 weeks was 85％ ～ 91％,the last 4 weeks were 95％ and above.Six months after intervention,the score of parents' health belief on timely vaccination was higher than that after 3 months of intervention and before intervention,and the difference was statistically significant (P＜0.05).The timely vaccination rates in the study group for migrant children was higher than that in the historical groups (P＜0.05).After intervention,the satisfaction rate for parents was 95.484％.Conclusion Health education improvement could effectively promote parents' health belief on timely vaccination,satisfaction rate and rate of timely vaccination among migrant children.

Objective To determine the optimal dose of oxycodone for patient-controlled intravenous analgesia (PCIA) after gastrointestinal surgery when combined with dexmedetomidine in elderly patients.Methods Sixty patients of both sexes,aged 65-80 yr,weighing 50-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,undergoing elective open gastrointestinal surgery,were divided into 3 different doses of oxycodone groups (group O1,group O2 and group O3,n=20 each) using a random number table.At 15 min before the end of surgery,oxycodone 0.1 mg/kg was intravenously injected,and PCIA pump was connected simultaneously.In O1,O2 and O3 groups,the PCIA solution contained dexmedetomidine 2.0 μg/kg and oxycodone 0.3,0.5 and 0.7 mg/kg in 100 ml of 0.9％ normal saline,respectively.The PCIA pump was set up to deliver a 0.5 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.Oxycodone 0.05 mg/kg was intravenously injected as a rescue analgesic after surgery,postoperative pain was assessed using a verbal rating scale,and the verbal rating scale score was maintained ≤4.The number of successfully delivered doses and requirement for rescue analgesics were recorded within 48 h after surgery,and the rate of rescue analgesia was calculated.The occurrence of adverse reactions such as nausea,vomiting,dizziness,respiratory depression,somnolence,bradycardia,hypotension and over-sedation was recorded.Patients' satisfaction with analgesia at postoperative 72 h and the length of postoperative hospital stay were also recorded.Results Compared with group O1,the rate of rescue analgesia after surgery and the number of successfully delivered doses were significantly decreased,and the degree of patients' satisfaction with analgesia was increased in O2 and O3 groups,and the incidence of nausea and somnolence was significantly increased in group O3 (P＜0.05).Compared with group O2,no significant change was found in the rate of rescue analgesia after surgery or the number of successfully delivered doses (P＞0.05),and the incidence of nausea and somnolence was increased in group O3 (P＜0.05).Conclusion When combined with dexmedetomidine 2.0 μg/kg,the optimal dose of oxycodone for PCIA is 0.5 mg/kg after gastrointestinal surgery in elderly patients.

Objective To evaluate the role of mitochondrial ATP-sensitive potassium(mito-KATP) channels in dexmedetomidine-induced attenuation of myocardial ischemia-reperfusion(I∕R)injury in rats. Methods Forty pathogen-free healthy male Sprague-Dawley rats, aged 8-12 weeks, weighing 200-350 g, were divided into 5 groups(n=8 each)using a random number table: sham operation group(group S), I∕R group, dexmedetomidine group(group DEX), a specific mito-KATPchannel blocker 5-hydroxyde-canoate(5-HD)group(group 5-HD)and dexmedetomidine plus 5-HD group(group DEX+5-HD). Myo-cardial I∕R was produced by occlusion of the anterior descending branch of the left coronary artery for 30 min followed by 120 min reperfusion in pentobarbital sodium-anesthetized rats. Dexmedetomidine 5 μg∕kg was intraperitoneally injected at 15 min prior to reperfusion in group DEX.5-HD 40 mg∕kg was intraperitoneally injected at 30 min prior to reperfusion in group 5-HD. In group DEX+5-HD, 5-HD 40 mg∕kg and dexme-detomidine 5 μg∕kg were intraperitoneally injected at 30 and 15 min prior to reperfusion, respectively. The parameters of cardiac function such as left ventricular systolic pressure(LVSP), left ventricular end-dias-tolic pressure(LVEDP)and the maximum rate of increase or decrease in left ventricular pressure(±dp∕dtmax)were recorded before ischemia(T0)and at 60 and 120 min of reperfusion(T1,2). Blood samples were collected from the carotid artery at the end of reperfusion for determination of the concentrations of cre-atine kinase-MB(CK-MB)and cardiac troponin I(cTnI)in serum. The animals were then sacrificed, and hearts were removed for determination of the myocardial infarct size in the left ventricular myocardial tissues. Results Compared with group S, the LVSP and ±dp∕dtmaxwere significantly decreased, and the LVEDP was increased at T1-2, and the concentrations of CK-MB and cTnI in serum and myocardial infarct size were increased in the other groups(P<0.05). Compared with group I∕R, the LVSP and ±dp∕dtmaxwere signifi-cantly increased, and the LVEDP was decreased at T1-2, and the concentrations of CK-MB and cTnI in ser-um and myocardial infarct size were decreased in group DEX, and the LVSP and ±dp∕dtmaxwere significant-ly increased at T1-2, the concentrations of CK-MB and cTnI in serum and myocardial infarct size were de-creased(P<0.05), and no significant change was found in LVEDP in group DEX+5-HD, and no signifi-cont change was found in the parameters mentioned above in group 5-HD(P>0.05). Compared with group DEX, the LVSP and ±dp∕dtmaxwere significantly decreased, and the LVEDP was increased at T1-2, and the concentrations of CK-MB and cTnI in serum and myocardial infarct size were increased in DEX+5-HD group(P<0.05). Conclusion The mechanism by which dexmedetomidine attenuates myocardial I∕R inju-ry is partially related to promotion of mito-KATPchannel opening in rats.