ABSTRACT
Objective To study the influence of intravenous injection of dezocine and fentanyl under general anesthesia on analepsia and analgesia after children appendectomy.Methods 86 children needed peritoneoscope appendectomy were enrolled in the study.All patients were randomized into two groups.The patients in group A were given intravenous injection of dezocine at half an hour before the end of the operation.The patients in group B were given intravenous injection of fentanyl before the end of the operation.The operation length,the postoperative catheter removal time and the heart rate,respiratory rate,mean arterial pressure,blood pressure saturability at the time of stopping using narcotic (T1),the time of catheter removal (T2),10min after catheter removal (T3) of the two groups were observed and recorded.At half an hour after catheter removal,Riker sedation-agitation scale and FLACC of two groups were estimated.Results The heart rate[(112.47±8.06)beats/min,(111.29±9.03)beats/min] and mean arterial pressure[(69.49±7.33)mmHg,(68.72±6.93)mmHg] of group A at T2,T3 were significantly lower than those of group B[heart rate: (126.98±7.24)beats/min,(131.54±8.62)beats/min and mean arterial pressure: (76.81±5.18)mmHg,(72.05±3.76)mmHg, heart rate tT2=3.294,tT3=5.018;mean arterial pressure tT2=4.029,tT3=2.287,all P<0.05].Besides,the FLACC score[(3.62±0.73)points] and Riker score[(2.93±0.75)points] of group A at half an hour after catheter removal were significantly lower than those of group B[(5.06±0.92)points,(3.96±1.17)points,tFLACC=6.390,tRiker=2.119,all P<0.05].Conclusion Intravenous injection of properdezocine at half an hour before the end of the operation has good postoperative analgesia effect for children appendectomy and children wake up in a more stable state,and the occurrence rate of postoperative analgesia and adverse reaction is low, so it has less influence on cardiovascular reaction and is applicable for clinical application.
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Objective@#To investigate the abnormalities of the blood system in landfill workers.@*Methods@#A cohort study was conducted for 224 landfill workers who were followed up for 6 consecutive years with abnormal routine blood test results and a low platelet count as the outcome events. The life-table method was used to analyze the incidence rates of these two outcome events, and the incidence rates were compared between first-and second-line workers.@*Results@#A total of 71 workers had abnormal routine blood test results, among whom 29 had abnormal leukocyte count, 14 had abnormal erythrocyte count, 40 had abnormal platelet count, 17 had abnormal hemoglobin, and 29 had a reduction in platelet count. For these landfill workers, the 6-year abnormal rate of routine blood test results was 43.2%, and the incidence rate of low platelet count within 6 years was 13.5%. The first-line workers had a significantly lower abnormal rate of routine blood test results than the second-line workers (P=0.020) , and the relative risk of abnormal routine blood test results in the first-and second-line workers was 0.592. There was no significant difference in the incidence rate of low platelet count between the two groups of workers (P≥0.05) .@*Conclusion@#The landfill has an adverse effect on the blood system of landfill workers, and the second-line workers have greater impairment than the first-line workers.
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Objective To evaluate the effects of measures on the schistosomiasis control after the earth quake in Lushan County so as to provide the experiences for post-disaster schistosomiasis control. Methods The measures taken in schistosomi-asis control after the earth quake were reviewed in Lushan County in 2013 and the epidemic situation of schistosomiasis was in-vestigated and the results were analyzed. Results The schistosomiasis control in floating population and the control of Oncome-lania hupensis snails were enhanced and no schistosome infections were found in both human and livestock. No infected snails and infested water were found. Conclusion The measures of schistosomiasis control after the disaster are effective in Lushan County and the goal to prevent major plague after the earth quake is achieved.
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This paper analyzes the recently epidemic status of schistosomiasis,the change of natural and social factors,and field survey and evaluation data of schistosomiasis in Ya’an City after Lushan Earthquake on April 20,2013,and proposes that it is necessary to strengthen the conventional schistosomiasis control measures,the control of exogenous infection sources,the con-trol of Oncomelania hupensis snails and health education for ensuring no major epidemics after the disaster. This paper also recom-mends the direction and suggestions for future schistosomiasis control in Ya’an City.
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Objective To evaluate the effect of epidural block on postoperative cognitive dysfunction in elderly patients undergoing laparoscopic radical operation for gastric cancer under general anesthesia.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 65-75 yr,with preoperative Mini-Mental State Examination (MMSE) score ＞ 23,scheduled for elective laparoscopic radical operation for gastric cancer under general anesthesia,were randomized into epidural block group (group E,n =30) and control group (group C,n =30) using a random number table.Epidural block was performed at T8,9 interspace before induction of anesthesia.Anesthesia was induced with iv injection of midazolam 0.03 mg/kg,propofol 1.0-1.5 mg/kg,fentanyl 3-4 μg/kg and rocuronium 0.9 mg/kg.The patients were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of remifentanil 0.15-0.25 μg· kg-1· min 1 and propofol target-controlled infusion (target plasma concentration 2.5-3.0μg/ml).In group E,10 ml of mixture of 0.25％ ropivacaine and 0.04 mg/ml butorphanol was injected via the epidural catheter at 30 min before skin incision.In the two groups,the mixture 10 ml mentioned above was administered via the epidural catheter at 10 min before the end of operation followed by patientcontrolled epidural analgesia.The development of postoperative cognitive dysfunction (MMSE score ＜ 21) was recorded within 72 h after operation.Blood samples were collected from the internal jugular vein to detect the concentration of serum protein S-100β.Results The concentration of serum protein S-100β was significantly lower at 6,12 and 24 h after operation,and the incidence of postoperative cognitive dysfunction within 72 h after operation was lower in group E than in group C (P ＜ 0.05).Conclusion Epidural block can decrease the development of postoperative cognitive dysfunction in elderly patients undergoing laparoscopic radical operation for gastric cancer under general anesthesia.