Sedation and analgesia with fentanyl and etomidate for intrathecal injection in childhood leukemia patients.

In this study, we tried to find a safe as well as fast effective treatment for sedation and analgesia for intrathecal injection in childhood leukemia patients, relieving treatment difficulties and pain, increasing the success rate of single intrathecal injection.The patients were divided into the experimental group (fentanyl combined with etomidate) and the control group (lidocaine only) randomly. The experimental group was given fentanyl 1 to 2 µg/kg intravenously first, then etomidate 0.1 to 0.3 mg/kg intravenously after the pipe washed. The patients younger than 1.5 years or who did not achieve satisfied sedative and analgesic situation received an additional time of etomidate (0.1-0.3 mg/kg). The patients were given oxygen at the rate of 4-5 L/min during the whole operation, and the finger pulse oximeter was used simultaneously to detect the changes in heart rate (HR) and blood oxygen saturation (SpO2). The doctors who performed the procedures assessed the quality of sedation and analgesia.In the experimental group, the patients' HR increased slightly after given fentanyl combined with etomidate. The patients' SpO2 was stable. Most patients achieved a good sedative and analgesic state within 1 to 2 minutes, and no case of respiration depression or cardiac arrhythmias occurred during the whole operation. The wake-up time was 55.42 ±â€Š20.62 min. In the control group, the patients were not very cooperative during the intrathecal injection, which made the procedures very difficult.During intrathecal injection, pain obviously reduced and the success rate of single lumbar puncture increased. It is safe and effective to apply fentanyl combined with etomidate for sedation and analgesia.

[Clinical observation on electroacupuncture for arousing consciousness of comatose patients with severe trauma brain injury].

OBJECTIVE: To observe the arousal effect of electroacupuncture (EA) stimulation of Baihui (GV 20), Shuigou (GV 26), etc. on severe craniocerebral injury patients. METHODS: A total of 90 cases of severe craniocerebral injury were randomly allocated to routine medication, naloxone and EA groups, with 30 cases in each group. For patients of the routine medication group, mild hypothermia therapy, medicines for dehydration, hormonal therapy, vascular dilation, cerebral nutrition supporting, anti-inflammation, etc. were given. For patients of the naloxone group, intravenous drip of naloxone 0.4 mg/kg in the first 3 days, 0.2 mg/kg for 7 days and 0. 1 mg/kg afterwards. For patients of the EA group, EA (1 Hz/50 Hz) was given for 30 min once daily. All the treatments were conducted once a day for 14 days. The Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) were used for assessing the therapeutic effect. RESULTS: In comparison with pre-treatment in each one of the routine medication, naloxone and EA groups, GCS scores were all obviously increased in the 3 groups following the treatment, and one month's follow-up (P<0. 05). The GCS scores of both naloxone and EA groups were significantly higher than those of the routine medication group (P<0.05). No significant difference was found between the naloxone group and EA group in GCS scores (P>0. 05). According to the GOS, one month's follow-up showed that of the three 30 cases in the routine medication, naloxone and EA groups, 6, 12 and 14 were improved, 8, 10 and 10 moderate handicap, 8, 3 and 2 severe handicap, 5, 3 and 2 vegetative state, and 3, 2 and 2 dead, with the arousal rates being 46. 66% , 73. 33% and 80. 00%, respectively. The therapeutic effects of both naloxone and EA groups were significantly superior to those of the routine medication group (P<0.05). CONCLUSION: EA intervention at early stage can promote the recovery of neurological function, accelerate the consciousness from coma and improve the outcomes of patients with severe traumatic brain injury.

4-Tosyl-1-oxa-4-aza-spiro-[4.5]deca-6,9-dien-8-one.

In the mol-ecule of the title compound, C(15)H(15)NO(4)S, the two six-membered rings are almost parallel to each other [dihedral angle = 1.87 (9)°] and perpendicular to the mean plane through the five-membered ring [dihedral angles of 89.98 (10) and 89.04 (10)°]. The crystal structure is stabilized by inter-molecular C-H⋯O hydrogen-bonding inter-actions.

[Synthesis and spectral analysis of three kinds of epoxy pregnene derivatives].

Three kinds of derivatives, 16alpha, 17alpha-epoxy-6-methylene-pregn-4-ene-3,20-dione(EMPD I), 16alpha, 17alpha-epoxy-6-methyl-pregn-4,6-diene-3,20-dione (EMPD II) and 16alpha, 17alpha-epoxy-6-methyl-pregn-4-ene-3, 20-dione(EMPD III) were synthesized and their FTIR, UV and 1H NMR spectra were described. EMPD II is a novel compound. In the UV spectra, the maximum absorptions peaks of EMPD I, EMPD II and EMPD III are at 259, 287 and 239 nm respectively. Their IR spectra are also obviously different. For EMPD I, there are two absorption peaks, which are respectively at 3084 cm(-1) originated from ==CH2 and 3 030 cm(-1) from C==CH--. For EMPD II and III, there is only one absorption peak at 3054 cm(-1). From 1710-1660 cm(-1), only one absorption peak appears for EMPD III, but two appear for EMPD I and EMPD II. In 1H NMR spectrum, the peaks at 4.92 (s, 1H), 5.06 (s, 1H) and 5.88 (s, 1H) were observed for EMPD I; the peaks at 1.83 (s, 3H), 5.87 (s, 1H) and 5.85 (s, 1H) for EMPD II; while the peaks at 1.06-1.07 (d, 3H), 5.78 ppm (s, 1H, 1 ppm=l nicrog x mL(-1)), for EMPD III.

[Detection of transgenic crop with gene chip].

Some selected available sequences of reporter genes,resistant genes, promoters and terminators are amplified by PCR for the probes of transgenic crop detection gene chip. These probes are arrayed at definite density and printed on the surface of amino-slides by bioRobot MicroGrid II. Results showed that gene chip worked quickly and correctly, when transgenic rice, pawpaw,maize and soybean were applied.