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Objective To evaluate the effect of hypothermia on the endotracheal tube cuff pressure during cardiopulmonary bypass in the pediatric patients with congenital heart disease. Methods Forty pedi-atric patients of both sexes, of American Society of Anesthesiologists physical status Ⅱ-Ⅳ, aged 1 months-14 yr, weighing 3-58 kg, scheduled for elective surgery for congenital heart disease using cardiop-ulmonary bypass, were included in this study. All the pediatric patients were intubated with a cuffed endo-tracheal tube. After anesthesia induction and endotracheal intubation, the air was injected into the cuff to make the cuff pressure reach 20 cm H2 O ( baseline) . The endotracheal tube cuff pressure was recorded when the esophageal temperature was reduced to 34, 32, 30, 28 and below 28℃ and returned to 28, 30, 32, 34 and 36 ℃. Results The cuff pressure was significantly decreased when the esophageal temperature was reduced to 30 and 28 ℃ and below 28 ℃ and returned to 28, 30, 32 and 34 ℃ as compared with the baseline ( P<0. 05) . Conclusion Hypothermia can reduce the endotracheal tube cuff pressure during car-diopulmonary bypass, and it is recommended to routinely monitor the cuff pressure in the pediatric patients with congenital heart disease.
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Objective To evaluate the effect of positive end-expiratory pressure (PEEP) on lung atelectasis using lung ultrasound ( LUS) in the pediatric patients without high risk factors. Methods One hundred American Society of Anesthesiologists physical statusⅠor Ⅱ patients of both sexes, aged 1-6 yr, with body mass index in the normal range, scheduled for elective non-abdominal surgery, were divided into no PEEP group (group C, n=50) and PEEP group (group P, n=50) using a random number table meth-od. The animals were mechanically ventilated in volume-controlled mode after intravenously injecting propo-fol, with PEEP 5 cmH2 O, tidal volume 8 ml/kg, inspiratory/expiratory ratio 1 : 2, respiratory rate 20-25 breaths/min in group P. In group C, the animals received no PEEP, and the other treatments were similar to those previously described in group P . Lung ultrasound was carried out after anesthesia induction and at the end of surgery. The severity and development of lung atelectasis were recorded. Results Compared with group C, the severity of lung atelectasis was significantly reduced after anesthesia induction and at the end of surgery, and the incidence of lung atelectasis was decreased in group P ( P＜0. 05) . Conclusion Early application of PEEP 5 cmH2 O can reduce the occurrence of atelectasis for the pediatric patients with-out high risk factors for atelectasis.
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Objective To evaluate the effect of injecting alkalinized lidocaine into the tracheal tube cuff on the responses to extubation in pediatric patients.Methods One hundred and twenty-six pediatric patients,aged 3-13 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective abdominal surgery under general anesthesia requiring oral tracheal intubation,were divided into 3 groups (n =42 each) using a random number table:control group (group C),normal saline group (group NS) and alkalinized lidocaine group (group L).Air was injected into the tracheal tube cuff in group C.Normal saline was injected into the tracheal tube cuff in group NS.Alkalinized lidocaine was injected into the tracheal tube cuff in group L.Cuff pressure was monitored and maintained below 20 cmH2O.The differences in mean arterial pressure (ΔMAP) and heart rate (ΔHR) immediately after stopping inhalation of anesthetics and immediately after extubation were calculated.The response to extubation was defined as Δ MAP or / HR＞20％ of the baseline value and/or development of moderate and severe bucking and agitation.The development of coughing,hoarseness and sore throat during the period in postanesthesia care unit and the period from being discharged from postanesthesia care unit until 8 h after extubation were recorded.Results Compared with group C and group NS,the incidence of response to extubation and sore throat was significantly decreased (P＜0.05),and no significant change was found in the incidence of coughing or hoarseness in group L (P＞0.05).The volume of the alkalized lidocaine solution in the cuff was (4.2±2.3) ml[(60±33) mg] in group L.No cuffdamage was found in three groups.Conclusion Injecting alkalinized lidocaine into the tracheal tube cuff can safely and effectively inhibit responses to extubation and is helpful in improving outcomes in pediatric patients.
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Objective To investigate the clinical efficacy of electrothermal acupuncture in treating ankylosing spondylitis.Method Sixty patients were randomly allocated to treatment and controlgroups, 30 cases each.The treatment group received electrothermal acupuncture and the control group took methotrexate plus sulfasalazine.The extent of chestexpansion, the severity of sacroiliac joint tenderness, the number of tender joints and morning stiffness time were examined,Schober's testscores at different time points were recorded and interleukin-1 (IL-1) and interleukin-6 (IL-6) contents were measured before and after 4 and 8 weeks of treatment.Result In the treatment group, there were statistically significant differences in the extent of chestexpansion, the severity of sacroiliacjoint tenderness, the number of tender joints, morning stiffness time andSchober's testscores after 4 and 8 weeks of treatment compared with before treatment (P0.05). ConclusionElectrothermal acupuncture has a marked therapeutic effect onankylosing spondylitisand is of high safety.The mechanism of electrothermal acupuncture treatment forankylosing spondylitismay be related to its regulating IL-1 and IL-6 levels in the body.
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microRNAs is a class of non-coding RNA, which is the transcriptional regulator of gene expression at the post transcriptional level.These endogenous non-coding RNA are expressed abnormally in tumor cells, in the tumor cell growth, reproduction, apoptosis and metastasis and other processes play an important regulatory role.Recently, microRNAs was widely regarded as biological diagnostic and prognostic markers of tumor in clinic, has been widely viewed.This article will introduce the important role of miRNA in tumor gene expression, as well as the use of miRNA as a tumor targeted therapy clinical application before the need to solve the problem .