[The correlation between burst suppression on electroencephalogram during laparoscopic surgery and emergence delirium in elderly patients].

Objective: To investigate the relationship between intraoperative electroencephalogram burst suppression (BS) and emergence delirium (ED) in elderly patients undergoing elective laparoscopic surgery under total intravenous anesthesia (TIVA). Methods: From October 2017 to September 2019, a total of 358 elderly patients who underwent elective laparoscopic surgery under TIVA at Xiangya Hospital, Central South University, were included. Patients were divided into two groups based on the confusion assessment method for the intensive care unit (CAM-ICU) assessment conducted before leaving the post-anesthesia care unit (PACU): the ED group [n=63, 46 males, 17 females, average age of (70.8±0.6) years] and the non-ED group [n=295, 220 males, 75 females, average age of (69.7±0.2) years]. Preoperative general information, intraoperative conditions, and intraoperative electroencephalogram BS status were collected. A multivariate logistic regression model was employed to identify risk factors associated with ED. Results: In the ED group, the duration of surgery, intraoperative blood loss, the burst suppression ratio (BSR)>10% lasting for more than 1 minute were (224.4±9.6) min, (240.8±33.9) ml, 36.5% (23/63), respectively, which were higher than those of the non-ED group [(204.7±3.6) min, (150.5±9.2) ml, 21.7% (64/295), all P<0.05]. Multivariate logistic regression analysis revealed that a longer duration of education was a protective factor for ED (OR=0.904, 95%CI: 0.833-0.982,P=0.016), whereas increased intraoperative blood loss (OR=1.002, 95%CI: 1.000-1.003, P=0.013) and BSR>10% lasting for more than 1 minute (OR=2.131, 95%CI: 1.004-4.524,P=0.049) were identified as risk factors for ED. Conclusion: In elderly patients undergoing laparoscopic surgery under TIVA, intraoperative electroencephalogram BS may be a risk factor for ED.

MiR-582-5p inhibits the growth and invasion of osteosarcoma cell by targeting NOVA1.

OBJECTIVE: To investigate the role of microRNA-582-5p (miR-582-5p) on osteosarcoma (OS) cell behaviors and provide potential therapeutic targets for OS. MATERIALS AND METHODS: Expression levels of miR-582-5p in OS cell lines and normal cell lines were measured by quantitative real-time PCR. Cell proliferation, migration and invasion capacities were assessed by cell counting kit-8 assay, wound-healing assay, and transwell invasion assay, respectively. Downstream target of miR-582-5p was confirmed by Luciferase activity reporter assay and Western blotting assay. RESULTS: MiR-582-5p expression was downregulated in OS cell lines compared with normal cell lines. Overexpression of miR-582-5p inhibits OS cell proliferation, migration, and invasion capacities. Neuro-oncological ventral antigen 1 (NOVA1) was chosen as target gene of miR-582-5p by bioinformatics analysis and Luciferase reporter assay. Moreover, overexpression of NOVA1 could impair tumor suppression role of miR-582-5p on OS cell behaviors. CONCLUSIONS: MiR-582-5p exerts tumor-suppressive role on OS cell behaviors via targeting NOVA1 in vitro, which will help us to understand the mechanisms underlying OS progression.

[Relationship between liver controlled attenuation parameters and body fat mass and its distribution].

Objective: To explore the relationship between liver controlled attenuation parameters (CAP) and body fat mass and its distribution. Methods: From May to December 2018, 978 adult patients visited at the fatty liver center of the Third People's Hospital of Changzhou were treated. The patient's liver controlled attenuation parameters were measured by transient elastography and the body fat mass and its distribution were measured by bioelectrical impedance technology. Pearson's correlation coefficient was adopted to describe the correlation between liver CAP value and body mass index (BMI), body fat mass index (BFMI), trunk fat mass index (TFMI), limbs fat mass index (LFMI) and visceral fat area (VFA). Receiver operating characteristic curve (ROC) and area under the curve (AUC) were used to evaluate BMI, BFMI, TFMI, LFMI and VFA to differentiate the cut-off points and efficacy of CAP for diagnosing grading of fatty liver changes in S0-1 and S2-3. Results: In 653 cases of male, S0 ~ S3 accounted for 4.90%, 3.37%, 22.36% and 69.37%, respectively, and in 325 cases of females, S0 ~ S3 accounted for 7.38%, 6.46%, 13.23% and 72.92%, respectively. Female patients had more visceral, trunk and limbs fat than male (P < 0.01). Body mass, body fat mass, body fat percentage, BMI, BFMI, TFMI, LFMI, and VFA were increased in male and female patients with increasing liver fat grade (P < 0.01). CAP values ​​of male and female patients were positively correlated with BMI, BFMI, TFMI, LFMI and VFA. Percentage of body fat mass increased with increasing liver fat grade (male: F = 13.42, P < 0.001; female: F = 3.22, P = 0.023); while limb fat mass percentage did not increase with liver fat grade (Male: F = 1.13, P = 0.34; female: F = 1.05, P = 0.37). Hepatic steatosis grading (S0 ~ 1 or S2 ~ 3) diagnosed with CAP were distinguished through BMI, BFMI, TFMI, LFMI and VFA. AUC was 0.80 ~ 0.82 in males (P < 0.01), and 0.75 ~ 0.78 in females (P < 0.01). Conclusion: The liver CAP value is positively correlated with the body's limbs, trunk and visceral fat, and has a strong correlation with trunk and visceral fat. BMI, BFMI, TFMI, LFMI and VFA up to some extent can identify the CAP diagnosis of grading of fatty liver changes in S0-1 and S2-3.

Gunshot-caused Facial Injury Combined with Lower Cervical Spine Injury: A Case Report.

A 32-year old male patient was wounded by a pistol. As shown in computed tomography (CT) scanning images, there was comminuted fracture of the left mandible and the bullet was found in the left side behind the sixth cervical vertebra. After the patient was hospitalized, the debridement was done in the emergency room and the operation of open reduction and internal fixation for comminuted fracture of left mandible was performed successfully. Eighteen days later, the patient was taken to surgery for anterior cervical decompression and fusion with autogenous iliac bone grafting for the sixth cervical vertebra. Postoperative follow-up of the patient over two years indicated that the left biceps muscle strength was recovered to level 4. Gunshot wound to the face associated with injury of the low cervical spine has the possibility of survival. It is safe to treat facial wounds early in the patient's treatment course, even if the bullet remains in the cervical vertebral body and there is neurological function damage.

Effect of cigarette tax increase on cigarette consumption in Taiwan.

OBJECTIVES: This study evaluates the effect of a 5 New Taiwan Dollar (NTD 5) Health and Welfare Tax increase on the consumption of domestic and imported cigarettes and cigars. METHODS: Using statistics published annually from 1971 through 2000, we set up a model based on the Central Bureau of Statistics (CBS) demand model to estimate price and expenditure elasticity coefficients of cigarettes and cigars. RESULTS: Our results showed that the price elasticity coefficients for domestic and imported cigarettes were -0.644 and -0.822. The consumption of imported cigarettes was reduced by 7.51 packs per capita, and the consumption of domestic cigarettes was reduced by 15.21 packs per capita. Total per capita consumption of cigarettes was reduced by 22.72 packs (18%). CONCLUSIONS: From the public health and financial perspectives, the increase in this excise tax on tobacco to the Taiwan government will have significant effect in reducing cigarette consumption; it will also generate additional tax revenues.

[Clinical application of the medial multiplex flap pedicled with the posterior tibial vessel].

OBJECTIVE: To investigate the clinical results of the medial multiplex flap pedicled with the posterior tibial vessel. METHODS: Twelve cases with soft tissue defects and bone defects of limbs were treated with the medial multiplex flap pedicled with the posterior tibial vessel from September 1992 to May 1999. Among them, bone and soft tissue defects following opened fracture in 7 cases, chronic ulcer following chronic osteomyelitis in 2 cases, melanoepithelioma in 2 cases, bone and soft tissue defects following osteoma resection in 1 case. The bone defect area was from 2.5 cm x 5.0 cm to 4.5 cm x 11.0 cm. Free graft was performed in 5 cases, bridged transposition in 3 cases and reversal transposition in 4 cases, among them, periosteal myocutaneous flap with autogenous or allogeneic bone grafting in 8 cases, myocutaneous flap in 4 cases. The area of the flaps from 6 cm x 8 cm to 12 cm x 25 cm. RESULTS: All flaps were healed by first intention, but in the distal fragments of bigger flaps were partially necrosed in 2 cases. In 10 cases bone healing were obtained after 16 weeks of operation according to the X-ray photos. All cases were followed up from 6 to 18 months. All cases achieved satisfactory result but 1 case died because of lung metastasis of osteoma. CONCLUSION: The multiplex graft pedicled with the posterior tibial vessel is an ideal graft for repairing the large soft tissue defects and bone defects, because it has such advantages as adequate blood supply, big vascular diameter, long pedicle and big dermatomic area.

[Clinical study of 76 cases of counterattack induced by acute organic phosphorus pesticides intoxication].

76 cases of counterattack induced by acute organic phosphorus pesticides intoxication were analysed. The activity of cholinesterase did not show a significant difference before the counterattack as compared to that after the counterattack (P > 0.05). The average dosage of atropine for pre-atropinization was 58.6 +/- 2.7 mg/h and it was 203.9 +/- 17.7 mg/h between the post-counterattack and the second atropinization (P < 0.01). Compared the mortality in reaching and non-reaching the second atropinization was 22.8% VS 100% (P < 0.01). The survival rate was 37.5% in collaborating blood transfusion cases and 20.6% in noncollaborating ones (P > 0.05). We also studied on the treatment, mechanism, precursory symptoms, causes of death, degrees of intoxication and pesticide types etc.

[Determination of ethyl paraben in shengmaiyin oral liquid using gas chromatography].

This paper describes a gas chromatographic method for the determination of preservative--ethyl paraben in shengmaiyin Oral Liquid. The method is simple, rapid and accurate. The recovery is good (99.5%), and the coefficient of variation is 0.288%.