Efficacy of bronchial blocker outside endotracheal tube for one-lung ventilation in pediatric patients / 中华麻醉学杂志

Objective To evaluate the efficacy of bronchial blocker outside the endotracheal tube for one-lung ventilation (OLV) in pediatric patients. Methods Thirty-eight American Society of Anesthe-siologists physical status ⅠorⅡ patients of both sexes, aged 4-8 yr, weighing 14. 0-28. 6 kg, scheduled for elective thoracic surgery under general anesthesia, were enrolled in this study. The size of tracheal tube was selected according to the endotracheal diameter at the level of clavicle and sternum on chest X-ray. Af-ter anesthesia induction, the distal end of the bronchial blocker was bent toward the target bronchus with a videolaryngoscope and then inserted until resistance was felt, and the preselected tracheal tube was inserted with a videolaryngoscope at a depth of (age∕2+12) cm. The position of the bronchial blocker was adjusted using a bronchofiberscope so that the upper edge of the blue cuff was 0. 5-1. 0 cm below the carina. The heart rate, mean arterial pressure, SpO2and airway pressure were recorded, arterial blood gas analysis was performed, and PaCO2and PaO2were recorded immediately before OLV (T1), at 30 min after OLV (T2) and at the end of OLV (T3). The intubation time, success rate of intubation at first attempt, displacement of bronchial blocker and occurrence of postoperative laryngeal pain and hoarseness were recorded. The pul-monary collapse was evaluated according to the standard described by Campos.Results Compared with the baseline at T1, PaO2was significantly decreased and airway pressure was increased at T2,3(P＜0. 05), and no significant change was found in heart rate, mean arterial pressure, PaCO2or SpO2at T2,3( P＞0. 05). The average intubation time was (185±38) s. The success rate of intubation at first attempt, rate of bronchial blocker displacement, excellent and good rates of pulmonary collapse and incidence of laryngeal pain and hoarseness were 95%, 16%, 100% and 11%, respectively. Conclusion Bronchial blocker outside the endotracheal tube can be effectively used for OLV in pediatric patients.

Efficacy of WeChat platform combined with problem-based learning teaching method when applied to the standardized training for residents in a department of anesthesiology / 中华麻醉学杂志

Objective To evaluate the efficacy of WeChat platform conbined with problem-based learning (PBL) teaching method when applied to the standardized training for residents in a department of anesthesiology.Methods Ninety-six residents who were undergoing the standardized training in the Department of Anesthesiology of our hospital were divided into 3 groups (n =32 each) using a random number table:lecture-based learning teaching method group,PBL teaching method group and WeChat platform plus PBL teaching method group.The examination scores after the end of teaching,satisfaction with teaching and scores of interest in anesthesiology were recorded.Results The total scores of examination,scores of comprehension memory problems,clinical application problems and comprehensive analysis problems,rate of satisfactory teaching and scores of interest in anesthesiology were significantly higher in WeChat platform plus PBL teaching method group than in the other two groups (P＜0.05).Conclusion WeChat platform combined with PBL teaching method can improve the teaching quality of the standardized training for residents in a department of anesthesiology and win praise from residents,and it is worth promoting the application.

Comparison of different puncture positions for combined spinal-epidural anesthesia in cesarean section / 临床麻醉学杂志

Objective To compare the effect of different puncture positions in the combined spinal epidural anesthesia (CSEA)in cesarean section.Methods Ninety uterogestation women under-going elective Caesarean section were randomly divided into two groups,45 in each group.L3-4 inter-vertebral space was selected as puncture point.Group R kept right lateral position for two minutes af-ter puncture and turned 30°left tilt supine position until ready for surgery.Group L was turned to su-pine position after left lateral punctured and then turned to 30 left tilt supine position until ready for surgery.1% ropivacaine 1.5 ml+ 10% glucose 0.5 ml was used for spinal anesthesia.The sensory block level and adverse reaction within 1 5 min after the spinal anesthesia were observed,and the neo-natal Apgar score and the pH value of umbilical artery blood were recorded.Results The final block level of the group R was significantly lower than group L,and the time achieving final block height was significantly shorter than that in group L(P <0.05 ).The ephedrine dosage of group R 0 (0-6) mg was significantly lower than that of group L6 (0-12)mg (P <0.05).The PH value of umbilical artery blood in group R was significantly higher than that in group L (P <0.05).There was no sig-nificant difference in neonatal Apgar score.Conclusion In Cesarean section,keeping right lateral puncture position for two minutes after infusion and then turning 30° left tilt supine position can a-chieve better effects than 30°left tilt supine position immediately after puncturing.

Application of endobronchial blocker in thoracoscopic-laparoscopic resection for patients with esophageal cancer / 中华全科医师杂志

Sixty patients with esophageal carcinoma undergoing thoracoscopic-laparoscopic resection were randomly divided into two groups with 30 cases in each group:endobronchial blocker was used during operation in group E and double-lumen tube( DLT) was used in group D.The results showed that compare to group D,intubation time was shorter and the incidence of postoperative hoarseness and sore throat was lower in group E [(27.4 ±8.6) vs.(37.2 ±10.3)s, 1 and 9 cases,5 and 14 cases, all P0.05].The study indicates that application of endobronchial blocker can reduce the incidence of postoperative hoarseness and sore throat and shorten the intubation time;especially, it is easy to operate and there is no need to replace the tube after surgery.

Clinical studies of rocuronium rapid sequence induction in patient undergoing laparoscopic cholecystectomy / 中国基层医药

Objective To observe the safety and efficacy of rocuronium rapid sequence induction in patient undergoing laparoscopic cholecystectomy(LC).Methods 100 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups(n =50):control group(group C)and rocuronium rapid sequence induction group (group R).Conventional induction of anesthesia was used in group C,rocuronium rapid sequence induction was used in group R and assisted ventilation was not implemented in the induction process.Oxygen saturation(SpO2 ),partial pressure of oxygen(PaO2 ),carbon dioxide partial pressure(PaO2 ),pH were recored at the condition of breathing air (T0 ),breathing pure oxygen 5 minutes(T1 ),after intubation(T2 )and mechanical ventilation five minutes(T3 ).The grade of the exposure in operation field,the operative time,indwelling of gastric suction tube,the time of no ventilation in group R were recorded,too.Results Compared to T1 time point,PaO2 and pH in group R decreased,but PaCO2 was significantly higher at T2 time point(P 0.05),but SpO2 and PaO2 were higher than preoperative at every time point(P <0.05).The incidence of Indwelling gastric suction tube is higher in group C than in group R,the grade of exposure in the operation field were better in group R than in group C(P <0.05).Conclusion Application of rocuronium rapid sequence induction technique in laparoscopic cholecystectomy can improve the operative conditions and field,it can be safely used in clinical anesthesia.

Comparison of three intubation methods in patients with restricted cervical movement / 中华全科医师杂志

The clinical data of 96 intubated inpatients with restricted cervical movement from June 2012 to June 2014 were retrospectively reviewed.They were divided into fiberoptic bronchoscope, Shikani optical stylet and McCoy laryngoscope groups (n =32 each).Identical anesthesia induction was applied.Compared with McCoy laryngoscope group, the total success rate and one-time success rate of tracheal intubation was higher in Shikani optical stylet group, tracheal intubation time was shorter and postoperative complications were fewer (P ＜ 0.05).Compared with group F, endotracheal intubation time was shorter (P ＜0.05).However, heart rate, mean arterial pressure (MAP), oxygen saturation (SpO2), total success rate of tracheal intubation, one-time success rate of tracheal intubation and complication rate showed no significant inter-group differences at all timepoints (P ＞ 0.05).Shikani optical stylet intubation has a less impact on hemodynamics and intubation time is short so that it is ideal for surgical patients with restricted cervical spine.

Detection and clinical significance of interleukin-8 in the children with nephrotic syndrome / 中国基层医药

Objective To study the level of serum interleukin-8 and its clinical significance in the children with nephrotic syndrome. Methods The level of serum interleukin-8 in the children with nephrotic syndrome(n=45 ) and normal controls group(n=35) were detected by enzyme linked immunosorbent assay. Results The level of serum interleukin-8 in children with nephrotic syndrome at acute stage were significantly higher than those in nephrotie syndrome at catabasis stage and normal controls group(P＜0.05). The level of serum albumin in children with nephrotic syndrome at acute stage and catabasis stage were significantly lower than that in normal controls group(P＜0.05), the level of serum albumin in children with nephrotic syndrome at acute stage were significantly lower than that in catabasis stage(P＜0.05). There was a negative correlation between the level of interleukin 8 and the level of serum albumin in children with nephrotic syndrome at acute stage(r=-0. 607, P＜0.05 ). Conclusion The invasion of nephrotic syndrome maybe were related to interleukin-8.

Detection and significance of cellular immune function in the children with nephrotic syndrome / 中国基层医药

Objective To study the evolution and significance of cellular immune function in the children with nephrotic syndrome. Methods The level of peripheral blood T lymphocyte, netural killer in the children with nephrotic syndrome( n = 45) and normal controls group ( n = 30 ) were detected by flow cytometry. Results The percentage of CD3+ cells, CD4+ cells, CD(+16 + 56)+ cells and the ratio of CD4+/CD8+ were significantly lower at nephrotic syndrome active stage than thee in nephrotic syndrome catabasis stage and normal controls group( P < 0.05 ), the percentage of CD3+ cells were significantly lower at nephrotic syndrome catabasis stage than that in normal control group( P < 0.05 ). Conclusion The invasion of nephrotic syndrome was related to cellular immune function.

Cloning and expression of the cDNA of a murine soluble Fas / 华中科技大学学报（医学）（英德文版）

In order to regulate the apoptosis induced by Fas-FasL system, a soluble isoform of mouse Fas was cloned from thymocytes of immature mice with the primers designed according to the full-length Fas cDNA sequence in the GeneBank. It was directionally inserted into the intermedium vector pUC19. DNA sequencing proved that it was consistent with the expected sequence. Then it was subcloned into the eukaryotic expression vector pCA13, which was used to construct the recombinant vector pCA13-FasC. By lipofectamine (LF2000)-mediated transfection, pCA13-FasC was transfected into the 293 cells. RT-PCR and Western blot indicated that the murine soluble Fas C protein was expressed in the 293 cells. Apoptosis inducing test showed that the expression of this murine Fas C could block the Fas-induced apoptosis, which confirmed the biological activity of the recombinant Fas C.