Application of dexmedetomidine in cerebral aneurysm embolization in patients with hypertension / 实用医学杂志

Objective To observe the effect of dexmedetomidine in cerebral aneurysm embolization in pa-tients with hypertension. Methods Sixty patients with hypertension undergoing emergency cerebral aneurysm em-bolization were randomly divided into two groups:research group(dexmedetomidine given group) and control group. SBP,DBP,HR,plasma norepinephrine(NE):baseline value(T0),before intubation(T1),after intubation (T2),after extubation(T3). Extubation time and anesthetic-related complications were also recorded. Results The hemodynamic parameters and plasma norepinephrine concentration in the research group were more stable than those in the control group at different time point during perioperative period. There was no difference between two groups about extubation time. The incidence of anesthetic-related complications in research group was lower than control group(P < 0.05). Conclusions Dexmedetomidine can reduce the stress response of intubation ,extuba-tion and perioperative hemodynamic fluctuations in cerebral aneurysm embolization in patients with hypertension. It can also reduce the consumption of prorofol and the incidences of adverse effects.

The influence of taurine on superoxide dismutase and malondialdehyde in liver tissue of rat models of liver fibrosis / 中国组织工程研究

BACKGROUND:Studies have reported that taurine has a certain therapeutic effect on the disease of various systems, such as nervous system, cardiovascular system, immune system and digestive system. The liver is the main place, also the important target organ, of taurine metabolism. Therefore, the relationship between taurine and hepatopathy has become a hot topic in recent years. OBJECTIVE:To investigate the influence of taurine on superoxide dismutase and malondialdehyde expression in the liver tissue of rat models of liver fibrosis induced by carbon tetrachloride. METHODS:Thirty male C57B/L rats of SPF grade were randomly and evenly divided into blank control, model and taurine groups. Rats in the blank control group were intraperitonealy injected with 100% peanut oil of 1 mL/kg, twice a week, in total 10 weeks. Rats in the model group were intraperitonealy injected with peanut oil of 1 mL/kg containing 20% carbon tetrachloride, twice a week, in total 10 weeks. Rats in the taurine group were intraperitonealy injected with peanut oil of 1mL/kg containing 20% carbon tetrachloride, twice a week, in total 10 weeks, and were intragastricaly administered taurine of 500 mg/kg per day starting from the 3rd week til the 10th week. RESULTS AND CONCLUSION:Compared with the blank control group, the serum levels of hyaluronic acid, laminin, typeⅢ procolagen, typeⅣ colagen, alanine aminotransferase, aspartate aminotransferase were significantly increased (P < 0.05), the level of superoxide dismutase in the liver tissue was lowered (P < 0.05), the level of malondialdehyde in liver tissue was significantly increased (P < 0.05), and liver index was increased (P < 0.05) in the model group. Pathological examination showed that there were necrosis of liver cels, fat vacuoles, fibrous tissue hyperplasia and inflammatory cel infiltration in the rats of the model group. Compared with the model group, the serum levels of hyaluronic acid, laminin, typeⅢ procolagen, typeⅣ colagen, alanine aminotransferase, aspartate aminotransferase were significantly lowered (P < 0.05), the level of superoxide dismutase in the liver tissue was significantly increased (P < 0.05), the level of malondialdehyde in the liver tissue was significantly lowered (P < 0.05), and liver index was significantly decreased (P < 0.05) in the taurine group. Pathological examination showed that there were no inflammatory cel infiltration, fat vacuoles, and fibrous tissue deposition in the liver tissue. The results indicate that taurine can decrease the contents of superoxide dismutase and malondialdehyde, and relieve the degree of liver fibrosis induced by carbon tetrachloridevia exerting its antioxidative effects.

Longitudinal study on infantile nocturnal sleep-wake pattern developmental trajectory with Actiwatch / 中华儿科杂志

<p><b>OBJECTIVE</b>To understand the infantile nocturnal sleep-wake pattern developmental trajectory with Actiwatch, which would benefit the clinical assessment of infantile sleep.</p><p><b>METHOD</b>This study was a longitudinal study conducted between 7 Oct, 2009-30 Oct, 2011 in 10 hospitals of 9 cities of China ( Beijing, Xi'an, Qingdao, Wuhan, Changsha, Chongqing, Huzhou, Xiamen and Liuzhou). Actiwatch was used to track the sleep-wake pattern development trajectory of healthy infants in the first year of life in the home setting. Participating infants were followed up at 10th day and 28th day during the first month, and then monthly from the second to the sixth month after birth, and then at ninth and twelve months of age respectively. Meanwhile, infantile sleep was observed continuously for about 60 hours at each visit. According to the characteristics of repeated measurement data of this study, two-level random effect model was adopted to analyze the trend of infantile nocturnal sleep-wake parameters changing with age, and the gender difference.</p><p><b>RESULT</b>A total of 473 healthy infants were included in this study, among whom 246 (52.0%) were boys, and 227 (48.0%) were girls; 355 (75.1%) infants completed the whole year follow-up survey. With infants' age increasing, the latency of infants' nighttime sleep onset decreased from 66.8 minutes on 10th day to 15.5-18.7 minutes at 6-12 months of age. The number of night wakes also decreased with age, while uninterrupted sleep periods lengthened with age. On the 10th day, there were 3.0 times of nightwaking on average, and the longest continuous sleeping interval lasted for 227.6 minutes on average. At 12-month of age, infants could sleep continuously for 350.9 minutes at most on average, while the number of nightwaking decreased to 1.6 times per night on average. Generally, nighttime sleep efficiency increased from 66.3% on the 10th day to 86.3% at 12-month of age. The differences of sleep-wake patterns between boys and girls presented as boys' nocturnal longest uninterrupted sleep period was 19 minutes shorter(266.6 vs. 285.6 min), and the average nighttime sleep efficiency was 2.2% lower (74.2% vs. 76.4%) compared with girls respectively. And the differences of sleep efficiency between boys and girls reduced gradually along with the growth.</p><p><b>CONCLUSION</b>During the first 6 months after birth, infantile sleep-wake pattern undergo obvious change. The capability of sleep-onset and uninterrupted sleep improved with age, and the sleep efficiency increased.</p>

The update of pediatric interventional pulmonology in China / 中华实用儿科临床杂志

With the rapid development of science and technology,respiratory endoscopy has entered the era of interventional pulmonology.Pediatric endoscopy in our country lags behind in the adult department.In recent years,pe diatric colleagues in China according to the characteristics of the pediatric pioneering the application of thermal ablation (electric coagulation,argon plasma coagulation,laser cutter);cryotherapy;balloon dilatation;tracheal stent were used in pediatrics.Application of new interventional techniques plays a revolutionary progress both in diagnosis and treatment on pediatric respiratory system infection,allergy,interstitial lung disease or in airway tumor,tuberculosis,trauma,airway stenosis caused by external pressure and congenital dysplasia.Pediatric endoscopy from the national level of management and standardization,and training will make our pediatric respiratory endoscopy more rapid and stable development.

Diagnostic value of transbronchial lung biopsy in pediatric interstitial lung diseases / 中华实用儿科临床杂志

Objective To evaluate the diagnostic value of transbronchial lung biopsy (TBLB) in pediatric interstitial lung diseases.Methods Retrospective data evaluation the efficacy and application of 10 undiagnosed pediatric interstitial lung diseases patients by No-X-ray guided TBLB between December 2013 and December 2014 were investigated.Results Specimens from all cases were successfully obtained,6 patients were confirmed by pathological diagnoses,and4 patients were confirmed by pathology and clinical manifestations.Among 10 patients,3 of them had allergic alveolitis,2 cases had bronchiolitis obliterans organizing pneumonia (BOOP),1 had pulmonary vasculitis,2 cases had nonspecific interstitial pneumonia,and the other 2 had bronchiolitis obliterans.The complications include 2 pneumothorax,1 case was cured with thoracic cavity closed drainage,and the other case case did not receive special treatment and alleviated himself.No bleeding and other complications occurred.Conclusion The results suggest that TBLB is a safe and effective minimally invasive modality for the diagnosis of pediatric diffuse lung disease.

Preliminary discussion about hypermastigote bronchopulmonary infection of children / 中华实用儿科临床杂志

The children with pulmonary hypermastigote infection,has not been reported at home and abroad.In recent years,we have carried out the children's electronic bronchoscopy,bronchoalveolar lavage fluid routine smear examination,found a lively movement round or oval body-hypermastigote.Metronidazole treatment is effective in controlling the disease.After discovery,understanding,rediscovery,reunderstanding,now have a preliminary understanding of the disease,first reported as follows.

Airway stents in children / 中华实用儿科临床杂志

Airway obstruction in children is a rare,in recent years,with the development of CT technology and the development of fiber bronchoscopy,the number of cases of children with tracheal stenosis has increased year by year,but difficult clinical problem,with no clear agreement on optimal therapeutic approach.Stenting of the airway has been used successfully in adults,and is an attractive alternative in children.Fundamental differences of pediatric compared to adult use include the benign nature of most stenoses,the narrow and soft airways of children,the required long-term tolerance and adaptation to growth.So it is controversial in the indications.

Argon plasma coagulation combined CO2 freezing through the flexible bronchoscope for treatment of airway granulation proliferation in children / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the safety and the efficacy of bronchoscopic argon plasma coagulation (APC) combined with CO2 freezing for the treatment of airway granulation hyperplasia after pediatric airway stenting.</p><p><b>METHOD</b>From April 2010 to December 2012, APC combined CO2 cryotherapy was performed for granulation tissue hyperplasia in 8 children after airway stenting, their clinical data, complications and postoperative outcomes and follow-up data were analyzed.</p><p><b>RESULT</b>Five of the 8 cases were male and 3 female, when stenting their age was 2 to 17 months, the average age was (8.63 ± 5.50) months. Granulation tissue hyperplasia appears in the range of bracket covering, common to both ends of the stent. The time from stentinging to find hyperplasia of granulation tissue was 20 days to 19 months. As a result, in 30%-100% of children airway narrowing was found. We applied APC treatment when the bronchoscopy found hyperplasia lesions, then we used CO2 cryotherapy, i.e., freezing was persisted for 1 min twice and more, then the probe was moved until the APC burning area was entirely frozen, dyspnea in children were significantly improved and two cases of atelectasis patients' lung were completely re-expanded. Eight patients had varying degrees of postoperative low to moderate fever, three cases had a small amount of active bleeding after APC treatment, hemostasis was achieved after topical application of endoscopic injection of epinephrine or reptilase bleeding and freezing, no complications occurred with CO2 cryotherapy. According to the efficacy criteria in this article, the result was significantly effective in 6 cases, effective in 1 case, and partially effective in 1 case.</p><p><b>CONCLUSION</b>APC combined with CO2 cryotherapy may be one of the optional methods that rapidly eliminates granulation tissue and remove the airway obstruction, so it can be used in treatment of pediatric airway' benign lesions.</p>

Status and prospect of Chinese pediatric interventional pulmonology / 中国小儿急救医学

Pediatric bronchoscopy has been understanded by Chinese pediatricians,physicians,earnose-throat doctors and surgeons.It is quite safe and reliable.It is the effective means for the diagnosis and treatment of pediatric diseases.Neodymium doped yttrium aluminum garnet laser,high-frequency electric coagulation (high-frequency electric knife),argon plasma coagulation,microwave coagulation,cryotherapy,balloon bronchoplasty,tracheal,bronchial stent,and pollution prevention sampling brush have been used in Chinese pediatric clinic,and achieved a important breakthrough.They have really improved the level of diagnosis and treatment of pediatric diseases.We need to explore more new field and techniques of pediatric interventional pulmonology,and we should have sufficient preparation.

Application of flexible fiberoptic bronchoscopy for the critical patients with severe respiratory diseases in PICU / 中国小儿急救医学

Objective To explore the role of flexible fiberoptic bronchoscope(FFB) in the critical patients with severe respiratory diseases of PICU.Methods One hundred and eighty-nine cases of severe respiratory diseases had undergone FFB from Jul 2010 to Jan 2011.One hundred and fifty-seven (83.06％) cases were less than 3 years.FFB examinations were made through nose (226 times) and endotracheal intubation (25 times).Bronchoscopic lavage for bacterial culture was performed by injecting normal saline solution (NSS) via a syringe into the working channel of FFB.Results Of all 189 cases,bacteria were isolated from 80 cases (42.3％) for bacterial culture of bronchoscopic lavage fluid,which included G-bacilli in 51 cases,G + cocci in 21 cases,and fungi in 8 cases.Six cases with tracheobronchial foreign bodies and 31 cases with respiratory tract anatomical abnormalities were found through FFB.Forty cases of severe pneumonia complicated with respiratory failure underwent bronchoscopic lavage,which were effective in 35 cases,and ineffective in 5 cases.In 20 cases of severe pneumonia atelectasis,pulmonary reexpansion were found in 16 cases by bronchoscopic lavage,atomization inhalation,and systemic administration,4 cases improved.Tracheobronchial foreign bodies were removed in all 6 cases by FFB.During FFB,bradycardia was found in 1 cases.There was no FFBrelated death.Conclusion FFB is safe for severe patients with respiratory diseases in PICU.FFB play important role in diagnosis and treatment for children in PICU,including feasible intervention under bronchoscopy.