Effect of Shenfu injection on acute lung injury in hemorrhagic shock rats / 临床麻醉学杂志

Objective To observe the effect of Shenfu injection on lung injury caused by hemor-rhagic shock(HS)in rats and explore the related potential mechanism.Methods Thirty-six SPF healthy male SD rats,aged 16-17 weeks,weighing 400-600 g,were randomly divided into three groups:sham op-eration group(group SH),HS group(group HS),and Shenfu injection group(group SF),12 rats in each group.In group SH,only the right femoral vein and femoral artery were separated after anesthesia,and ve-nous catheterization was not performed.HS model was established in groups SF and HS.In group HS,liquid resuscitation was performed through an intravenous catheter,and the resuscitation fluid consisted of the auto-blood lost and the compound sodium chloride injection equivalent to 1.5 times the blood loss and 10 ml/kg normal saline.In group SF,the resuscitation fluid consisted of the lost autoblood and the compound sodium chloride injection equivalent to 1.5 times the blood loss and Shenfu injection 10 ml/kg.The whole perfusion time was about 60 minutes.Six rats in the three groups were randomly anesthetized 24 and 48 hours after op-eration.The wet/dry weight ratio(W/D)of lung tissues was detected.The concentrations of interleukin-6(IL-6),IL-17,IL-10,and transforming growth factor-β(TGF-β)were detected by ELISA,the mRNA ex-pression of retinoic acid-related orphan nuclear receptor γt(RORγt),transcription factor forkhead box pro-tein 3(Foxp3),and hypoxia-inducible factor-1α(HIF-1α)in lung tissues were detected by PCR.The pro-tein contents of RORγt,Foxp3,HIF-1α,aquaporin 1(AQP1),and AQP5 in lung tissue were detected by Western blot.Pathological changesunder HE staining light microscope and lung injury scores were observed.Results Compared with 24 hours after operation,W/D,the concentrations of IL-6 and IL-17,mRNA ex-pression and protein content of RORγt and HIF-1α,and lung injury score were significantly decreased(P＜0.05),the concentrations of IL-10,and TGF-β,Foxp3 mRNA expression and protein content,and AQP1 protein content were significantly increased in group SF 48 hours after operation(P＜0.05).Compared with group SH,W/D,the concentrations of IL-6,IL-17,IL-10,and TGF-β,mRNA expression and protein content of RORγt,Foxp 3,and HIF-1α,and lung injury score were significantly increased(P＜0.05),AQP1 and AQP5 protein contents were significantly decreased in groups HS and SF 24 and 48 hours after operation(P＜0.05),and alveolar structure was damaged under light microscope and alveolar interstitium was filled with a large amount of edematous fluid,during which a large number of inflammatory cells infiltra-ted.Compared with group HS,W/D,the concentrations of IL-6 and IL-17,mRNA expression and protein content of RORγt and HIF-1α,and lung injury score were significantly decreased(P＜0.05),the concen-trations of IL-10 and TGF-β,Foxp3 mRNA expression and protein content,AQP1 and AQP5 protein con-tents were significantly increased in group SF 24 and 48 hours after surgery(P＜0.05),and the alveolar structure was improved under light microscope,and edema was reduced,and the number of inflammatory cells was reduced.Conclusion Shenfu injection can regulate the balance between pro-inflammatory factors IL-6 and IL-17,and anti-inflammatory factors IL-10 and TGF-β,increase the protein content of AQP1 and AQP5 in lung tissue,and decrease the W/D and injury score in lung tissue,thus alleviating lung injury in HS rats.The mechanism may be related to the regulation of HIF-1α-RORγt/Foxp3 balance.

Effect of fasting glucose levels on carotid intima-media thickness in premenopausal versus postmenopausal women

ABSTRACT Objective: To investigate the relationship between fasting blood glucose (FBG) and carotid intima-media thickness (IMT) in premenopausal and postmenopausal women. Subjects and methods: The study enrolled 2,959 women seen at the Maanshan People's Hospital of Anhui Province from December 2013 to December 2018. Carotid IMT was measured using Doppler ultrasound. Linear regression and R smoothing curves were used to analyze the relationship between blood glucose level and carotid IMT in the premenopausal and postmenopausal groups. Results: Postmenopausal compared with premenopausal women had higher mean IMT (mIMT; 0.81 ± 0.23 mm versus 0.70 ± 0.14 mm, respectively, p < 0.001) and maximum IMT (maxIMT; 0.86 ± 0.35 mm versus 0.74 ± 0.16 mm, respectively, p < 0.001) values. On linear regression analysis, mIMT values increased with increasing FBG values when FBG level was ≤ 7 mmol/L, but no significance was found between FBG and maxIMT. After stratification by menopausal status, mIMT and maxIMT increased with increasing FBG when FBG was ≤ 7 mmol/L in the premenopausal group. In the postmenopausal group, mIMT and maxIMT increased with increasing FBG. After adjustment for covariate factors, the relationship between FBG and mIMT remained the same as before the adjustment, but when FBG was ≤ 11 mmol/L, the maxIMT increased with increasing FBG. In the stratification analysis, maxIMT increased with increasing FBG when FBG was ≤ 7 mmol/L in the premenopausal group, while both mIMT and maxIMT increased with increasing FBG when FBG was > 10 mmol/L in the postmenopausal group. Conclusion: Levels of FBG contributed more to increased IMT in postmenopausal than premenopausal women. The influence of FBG was greater on maxIMT than mIMT. Additionally, FBG was helpful in assessing focal thickening of the carotid intima.

Meta-analysis of the effect of acupuncture combined with antiemetics on prevention and treatment of nausea and vomiting after general anesthesia / 临床麻醉学杂志

Objective To evaluate the effect of acupuncture(manual acupuncture,electroacu-puncture)on prevention and treatment of nausea and vomiting after general anesthesia.Methods By searching CNKI,VIP,China Biomedical Literature Database,Wanfang Medical,Embase,PubMed,Co-chrane Clinical Trial Registry,randomized controlled trial(RCT)on acupuncture combined with antiemetics for the prevention and treatment of nausea and vomiting after general anesthesia were performed.The retrieval period was from the establishment of the database to September 2022.RevMan 5.3 was used for statistical analysis.Results Fifteen studies involving 1 493 patients were included.There were 741 patients in the antiemetic group and 752 patients in the acupuncture combined antiemetic group.The incidence of postoperative nausea in the acupuncture combined with antiemetics group was significantly lower than that in the simple antiemetics group(OR=0.43,95％CI 0.34-0.54,P＜0.001).The incidence of postopera-tive vomiting in the acupuncture combined with antiemetics group was significantly lower than that in the simple antiemetics group(OR=0.55,95％CI 0.45-0.66,P＜0.001).Conclusion The incidence of postoperative nausea and vomiting was lower in patients treated with acupuncture(manual acupuncture,electroacupuncture)combined with antiemetics than with antiemetics alone.

Determination of methylmercury in urine by direct mercury analyzer / 中华劳动卫生职业病杂志

Objective: To develop asolvent extraction-direct mercury analyzer method for determination of methylmercury in urine. Methods: After the urinehydrolyzesd by hydrobromic acid, methylmercury was extracted by tolueneand reverse-extracted from L-cysteine solution, it was then detectedbydirect mercuryanalyzer. Results: The linear range was 0.2-50.0 μg/L, and the related coefficient was 0.9999. The relative standard deviations (RSD) within the group were 5.04%-6.64%, and the RSD between the group were 5.65%-8.11 %. The average recovery efficiencies were 85.4%-95.5%. The detection limitation was 0.0482 μg/L and the quantification concentrations was 0.1607 μg/L. Conclusion: The method, which has low detection limit, high sensitivity, easy to operate, is stability for the determination of methylmercury in urine.

Analysis of the efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula / 中华实用儿科临床杂志

Objective:To investigate the clinical efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula.Methods:Clinical data of 69 female infants with congenital anal atresia combined rectal vestibular fistula admitted to Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from July 2012 to July 2022 were retrospectively analyzed.They were divided into 2 groups according to the surgical methods: 34 cases of anal dimple anorectoplasty(group A) and 35 cases of anterior sagittal anorectoplasty(group B). The operation time, length of stay, short-term complications, long-term complications and bowel function (determined by the Rintala score at 6 months postoperatively) of the two groups were compared.The difference in the incidence of postoperative complications between groups was compared by Chi- square test, and the remaining differences between groups were compared by the paired t-test. Results:The operative time [(80.18±9.29) min vs.(103.85±8.26) min] and postoperative hospital stay[(6.10±1.52) d vs.(7.63±2.40) d] in group A were significantly shorter than those of group B ( t=11.40, 2.62; all P<0.05). The Rintala total score at 6 months postoperatively in group A was significantly higher than that of group B[(19.36±0.93) points vs.(18.76±0.44) points]( t=3.20, P<0.05). There were no significant differences in the incidences of short-term [(4/34, 11.8%) vs.(7/35, 20.0%)] and long-term complications [(2/34, 5.9%) vs.(4/35, 11.4%)]between group A and group B ( χ2=0.75, 0.75; all P>0.05). Conclusions:Anal dimple anorectoplasty for female infants with congenital anal atresia combined rectal vestibular fistula is safe and effective.

Mechanism of Shenfu injection in regulating stress response based on network pharmacology and molecular docking / 中华麻醉学杂志

Objective:To investigate the potential mechanism of Shenfu injection in regulating stress response via the neuro-endocrine-immune system by network pharmacology and molecular docking. Methods:The main active ingredients and related targets of Shenfu injection were screened using the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform.PharmMapper, Swiss Target Prediction platform and Uniprot database were used to predict the target and unify the gene names.GeneCards, OMIM, TTD, CTD, Drugbank, Disgenet and Pharmgkb databases were searched to screen the related targets regulated by stress responses.Venny 2.1 tool was used to obtain the potential effect targets of the intersection between Shenfu injection and stress response regulation, and the STRING database was imported to construct the interaction PPI network and screen the key targets.Potential effect targets were uploaded to Metascape database online analysis for study on the mechanism through GO and KEGG enrichment analysis.Autoduck and Pymol were used for molecular docking and visualization.Results:Forty-three main active ingredients and 257 related targets for Shenfu injection were obtained by component screening and target prediction.A total of 4 811 targets related to stress response regulation were retrieved from the database, 188 potential effect targets were obtained by intersection with Shenfu injection component-related targets, and 14 key targets were obtained by PPI network screening.Eighteen samples were screened by GO enrichment analysis, which mainly involved the circulatory system and humoral regulation, responses to external stimuli and trauma, MAPK cascade reaction, postsynaptic membrane, receptor complex and ion channel complex and neurotransmitter receptor activity, etc.KEGG enrichment analysis showed 20 highly correlated pathways, mainly covering neuroactive ligand-receptor interaction, calcium signaling pathway, adrenergic signaling, steroid hormone biosynthesis, IL-17, TNF, MAPK, cGMP-PKG, PI3K-Akt, NF-κB, Toll-like receptor signaling pathway and cell apoptosis, etc.The results of molecular docking indicated that the main active components had good binding force with the key target.Conclusions:The components of Shenfu injection such as kaempferol, β-sitosterol, Demethyldelavaine, Stigmasterol, ginsenoside, Carnosifloside, hypaconitine may act on targets such as AKT1, TNF, IL1B, PTGS2, HSP90AA1, MAPK1, NFKBIA, NR3C1 and ADRB2 and regulate the stress response through the mechanisms such as regulation of the functional state of the neuro-endocrino-immune system, inhibition of inflammatory responses, anti-oxidative stress and reduction of cell apoptosis.

The effect of endoscopic retrograde appendicitis therapy in the treatment for children's acute uncomplicated appendicitis / 中华普通外科杂志

Objective:To evaluate endoscopic retrograde appendicitis therapy in treatment of children with acute uncomplicated appendicitis.Methods:Sixty children patients were admitted at the Affiliated Hospital of Zhengzhou University from Oct 2019 to Jun 2021 and were divided into ERAT group ( n=30) and LA group ( n=30). Results:All operations were successfully performed . ERAT children started oral feeding earlier [(6.8±2.0) h vs. (12.3±2.0) h, t=-10.636, P<0.001], postoperative hospital stay was shorter [(3.2±1.3) d vs. (5.0±1.3) d, t=-5.360, P<0.001]. After 14 months follow up, the recurrence rate in the ERAT group was 6%. The complication rate of LA was 10%. Conclusion:ERAT is a safe and effective therapy in treating children with acute uncomplicated appendicitis with low,acceptable recurrence rate.

Clinical analysis of 176 cases of fungal keratitis in Jingzhou / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the infection characteristics and clinical treatment outcome of patients with fungal keratitis(FK)in Jingzhou area, so as to provide basis for clinical diagnosis and treatment of FK. METHODS: The data of 176 patients with FK diagnosed by etiology in Jingzhou Central Hospital from January 2015 to July 2020 were collected, and the epidemiological characteristics, identification results of fungal strains, drug sensitivity and clinical treatment outcome of the patients were analyzed. RESULTS:Among the 176 patients with FK, 118 were male and 58 were female, and the ratio of male to female is 2.03:1. The age of onset was the largest number of patients in 50-59 years old and 60-69 years old. The peak seasons of onset were April to June and October to December. Risk factors include trauma and possible history of trauma, ocular surface diseases, post ophthalmic surgery, wearing corneal contact lenses and long-term local drug use. The main pathogens were Fusarium(39.8%), aspergillus(30.7%), alternaria(15.9%)and candida(5.1%). The results of drug sensitivity showed that voriconazole and amphotericin B were sensitive, while the drug resistance rate of fluconazole was very high. There were 125 eyes improved or cured after conservative treatment, 12 eyes were injected into corneal stroma, 15 eyes were covered with conjunctival flap or amniotic membrane transplantation, and 21 eyes were treated with corneal transplantation. Enucleation of ocular contents was performed in 8 eyes, including 5 eyes with severe endophthalmitis after conjunctival flap covering. CONCLUSION:The incidence of FK in Jingzhou area is mostly middle-aged and elderly men, mostly caused by corneal trauma in the process of agricultural labor. The main pathogens were fusarium and aspergillus. It is very important to select reasonable antifungal drugs and treatment methods according to the drug sensitivity results.

Prevalence survey of implementation status of appropriate technique of Traditional Chinese Medicine in perioperative period in China / 中华麻醉学杂志

Objective:To investigate the implementation status of appropriate technique of Traditional Chinese Medicine (TCM) in the perioperative period in China using questionnaires.Methods:From May to June 2022, the questionnaire designed by ourselves was sent to anesthesiologists participating in the survey through the WeChat platform nationwide, and the system automatically recorded the survey.Results:A total of 6 230 anesthesiologists participated in the questionnaire survey, there were 6 160 valid questionnaires, with an effective rate of 98.88%.The anesthesiologists participating in the questionnaire survey were distributed in 16 provincial administrative regions in China, of which the rate from tertiary hospitals was 32.59%, the rate from secondary hospitals was 67.41%, and the application rate of TCM appropriate techniques in the perioperative period was 9.8%.The application rate of TCM appropriate techniques in the perioperative period was higher in tertiary hospitals than in secondary hospitals (9.51% vs. 6.31%, P<0.05), and the application rate was significantly higher in TCM hospitals than in integrated Chinese and Western Medicine hospitals and Western medicine general hospitals (26.15% vs.7.26% vs. 2.49%, P<0.05). Among the provinces participating in the survey, Guangdong Province had the highest application rate of TCM appropriate techniques in the perioperative period (13.60%). In the anesthesiologists carried out TCM appropriate techniques in the perioperative period, the highest application rate of TCM appropriate techniques in non-drug therapy was 59.0%, and the highest application rate in abdominal surgery was 47.4%, and most anesthesiologists (68.1%) selected TCM appropriate techniques according to the type of surgery in patients.Anesthesiologists who applied TCM appropriate techniques in the perioperative period believed that TCM appropriate technique cloud reduce the development of nausea and vomiting in the perioperative period (66.8%), alleviate perioperative pain (54.8%), promote the recovery of perioperative gastrointestinal function (49.8%), and reduce the development of perioperative neurocognitive disorders (47.0%). The main reasons for the lack of TCM appropriate techniques in the perioperative period were the lack of standardized technical training and relevant guidelines (87.11%), the lack of relevant charging items (58.30%), the technical level of operators (46.20%), the lack of support by surgeons (43.40%), and the non-cooperation of patients (27.10%). Conclusions:At present, the application rate of TCM appropriate techniques in the perioperative period is generally low, and the application rate varies greatly among different provinces and hospitals of different levels.Publicity should be expanded through multiple channels, various forms of technical training should be carried out, the implementation plan and guidelines of TCM appropriate technologies should be continuously optimized, and the promotion and application of TCM appropriate techniques in the perioperative period should be strengthened.

Neuroinflammation Mediates Faster Brachial Plexus Regeneration in Subjects with Cerebral Injury / 神经科学通报·英文版

Our previous investigation suggested that faster seventh cervical nerve (C7) regeneration occurs in patients with cerebral injury undergoing contralateral C7 transfer. This finding needed further verification, and the mechanism remained largely unknown. Here, Tinel’s test revealed faster C7 regeneration in patients with cerebral injury, which was further confirmed in mice by electrophysiological recordings and histological analysis. Furthermore, we identified an altered systemic inflammatory response that led to the transformation of macrophage polarization as a mechanism underlying the increased nerve regeneration in patients with cerebral injury. In mice, we showed that, as a contributing factor, serum amyloid protein A1 (SAA1) promoted C7 regeneration and interfered with macrophage polarization in vivo. Our results indicate that altered inflammation promotes the regenerative capacity of the C7 nerve by altering macrophage behavior. SAA1 may be a therapeutic target to improve the recovery of injured peripheral nerves.

Neuroinflammation Mediates Faster Brachial Plexus Regeneration in Subjects with Cerebral Injury / 神经科学通报·英文版

Our previous investigation suggested that faster seventh cervical nerve (C7) regeneration occurs in patients with cerebral injury undergoing contralateral C7 transfer. This finding needed further verification, and the mechanism remained largely unknown. Here, Tinel's test revealed faster C7 regeneration in patients with cerebral injury, which was further confirmed in mice by electrophysiological recordings and histological analysis. Furthermore, we identified an altered systemic inflammatory response that led to the transformation of macrophage polarization as a mechanism underlying the increased nerve regeneration in patients with cerebral injury. In mice, we showed that, as a contributing factor, serum amyloid protein A1 (SAA1) promoted C7 regeneration and interfered with macrophage polarization in vivo. Our results indicate that altered inflammation promotes the regenerative capacity of the C7 nerve by altering macrophage behavior. SAA1 may be a therapeutic target to improve the recovery of injured peripheral nerves.

Impaired Parahippocampal Gyrus-Orbitofrontal Cortex Circuit Associated with Visuospatial Memory Deficit as a Potential Biomarker and Interventional Approach for Alzheimer Disease / 神经科学通报·英文版

The parahippocampal gyrus-orbitofrontal cortex (PHG-OFC) circuit in humans is homologous to the postrhinal cortex (POR)-ventral lateral orbitofrontal cortex (vlOFC) circuit in rodents. Both are associated with visuospatial malfunctions in Alzheimer's disease (AD). However, the underlying mechanisms remain to be elucidated. In this study, we explored the relationship between an impaired POR-vlOFC circuit and visuospatial memory deficits through retrograde tracing and in vivo local field potential recordings in 5XFAD mice, and investigated alterations of the PHG-OFC circuit by multi-domain magnetic resonance imaging (MRI) in patients on the AD spectrum. We demonstrated that an impaired glutamatergic POR-vlOFC circuit resulted in deficient visuospatial memory in 5XFAD mice. Moreover, MRI measurements of the PHG-OFC circuit had an accuracy of 77.33% for the classification of amnestic mild cognitive impairment converters versus non-converters. Thus, the PHG-OFC circuit explains the neuroanatomical basis of visuospatial memory deficits in AD, thereby providing a potential predictor for AD progression and a promising interventional approach for AD.

Faster R-CNN-based artificial intelligence image-aided diagnosis platform in identifying EMVI of rectal cancer: A multicenter clinical study / 中国实用外科杂志

OBJECTIVE: To explore the clinical application value of artificial intelligence image aided diagnosis platformbased on Faster R-CNN in identifying EMVI of rectal cancer.METHODS: In the multicenter retrospective study,500 patients with rectal cancer who underwent high-resolution MRI examination between July 2016 and February 2019 wereselected from seven hospitals in China. They were divided into 174 positive and 326 negative patients. Patients wererandomized to a training group(400 patients,including 133 positive and 267 negative) and a validation group(100 patients,including 41 positive and 59 negative) using a random number method. Using the Faster R-CNN to learn and train 20 430 high-resolution MRI images of thetraining group,an artificial intelligence image-aided diagnosis platform was established. The5107 high-resolution MRI images of thevalidation group were clinically validated.Receiver operating characteristic(ROC) curveand area under the curve(AUC) were used tocompare the diagnostic results of the artificialintelligence image-aided diagnosis platform andthe senior image expert.RESULTS: The accuracy,sensitivity,specificity,positive predictive valueand negative predictive value of EMVI forartificial intelligence image-aided diagnosis platform were 93.4%, 97.3%, 89.5%, 0.90 and 0.97,respectively. The area under the receiver operating characteristiccurve(AUC) was 0.98. The time required to automatically recognize a single image was 0.2 seconds,which had clearadvantages compared to radiologists(estimated to be about 10 seconds).CONCLUSION: The artificial intelligence image-assisted diagnosis platform based on Faster R-CNN has high efficiency and feasibility for identifying rectal cancerEMVI,and can assist imaging diagnosis.

Autologous limbus conjunctival flap transplantation for pterygium accompaniedwith conjunctival cyst / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the efficacy of surgical excision combined with autologous limbus conjunctival flap transplantation in the treatment of pterygium accompanied with conjunctival cyst.METHODS: Totally 126 patients 188 eyes with pterygium were hospitalized in Department of Ophthalmology of Tongji Hospital of Huazhong University of Science and Technology during August 2013 and August 2015.The patients were divided into two groups: observation group (11 eyes of 11 patients) with pterygium accompanied with conjunctival cyst and control group (177 eyes of 115 patients) with primary pterygium.All patients underwent slit lamp microscope examination, anterior segment photography, and anterior segment optical coherence tomography(OCT).The size of pterygium was calculated by multiplying neck width and length of the covered corneal.All patients underwent excision combined with autologous conjunctival flap transplantation, and the resections were performed pathological section with hematoxylin and eosin staining.All patients were followed up postoperatively for 4-28mo.RESULTS: All cases in the observation group were confirmed by postoperative pathological examination.All cyst walls were complete, and containing single layer of epithelial cells.The mean size of pterygium of the observation group was 6.9±1.7mm2, and 6.3±1.8mm2 for the control group.There was no significant difference between the two groups (P>0.05).The mean postoperative healing time of observation group was 2.1±0.9d, and 1.9±0.8d for the control group.There was no significant difference between the two groups (P>0.05).Recurrence was seen in two eyes within the follow-up period in the control group, and no recurrence in the observation group.CONCLUSION: Surgical excision combined with autologous limbus conjunctival flap transplantation is a safe and effective treatment for pterygium accompanied with conjunctival cyst.

Clinical features of tuberculosis in patients with systemic lupus erythematosus / 实用医学杂志

Objective To describe the characteristics and risk factors for Mycobacterium tuberculosis (TB)infection in patients with systemic lupus erythematosus(SLE).Methods A retrospective analysis was per-formed. Results Among our sample of 784 hospitalized patients,42(5.4%)were diagnosed with TB infection. Seventeen were pulmonary TB,11 were pulmonary and extra-pulmonary TB and 14 were extra-pulmonary TB.hest X-rays showed Abnormal chest imaging was observed in 34 cases,among which,19 were multi-lobar involvements and 9 were single-lobe involvements. Logistic regression multivariate analysis indicated that anemia and the daily mean dose of glucocorticoid(GC)were associated with TB. Conclusions Manifestations of TB in SLE patients were atypical.Anemia and the daily mean dose of GC were associated with TB.

Transfusion of blood components in liver transplantation and abdominal multiple organ transplantation / 中国组织工程研究

BACKGROUND:The liver transplantation and abdominal multiple organ transplantation are complicated surgeries, characterized by massive blood loss and high blood transfusion requirements. OBJECTIVE:To explore the characteristics of blood loss and blood transfusion in liver transplantation and abdominal multiple organ transplantation and post-operative survival rate. METHODS:Clinical data from 192 patients were retrospectively analyzed, including blood transfusion data with the first 24 hours after surgery and post-operative survival rate. RESULTS AND CONCLUSION:These 192 patients included 177 patients receiving liver transplantation, 2 patients receiving liver and kidney transplantation and 13 patients receiving abdominal multiple organ transplantation. The average intra-operative blood loss of each patient was (2 401.5±3 239.5) mL. The average infusion of red blood cel s, platelet, cryoprecipitate and frozen plasma of each patient at the first 24 hours after surgery was (11.3±11.9), (0.8±0.9), (10.7±11.7) U and (2 805.5±1 393.1) mL, respectively. Al kinds of blood infusion in the liver cancer group were obviously less than those in the hepatic failure group. The infusion of cryoprecipitate and frozen plasma in the cirrhosis group was obviously less than that in the hepatic failure group, but the infusion of platelet in the cirrhosis group was significantly more than that in the liver cancer group. The infusion of red blood cel s from July 2013 to June 2015 was significantly less than that from July 2012 to June 2013. The blood loss, infusion of red blood cel s and frozen plasma in the liver transplantation group of cirrhosis were significantly more than those in the abdominal multiple organ transplantation group of cirrhosis (al P<0.05). In conclusion, diagnosis of liver diseases, and the maturity of surgery exert an effect on the blood loss and blood infusion. As the development of liver transplantation and abdominal multiple organ transplantation, both the blood loss and blood infusion are decreased. Besides, compared with liver transplantation, the blood loss and blood infusion show no increase in the abdominal multiple organ transplantation.

Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the safety and efficacy of Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy. METHODS: Thirty - six patients (36 eyes) with prior failed sequential trabeculectomy who underwent Ahmed glaucoma valve implantation were included. The intraocular pressure ( IOP), best corrected visual acuity (BCVA) and complications were ovserved and all the patients were followed up at least for 12mo. RESULTS: Mean preoperative IOP was 35. 20±7. 28mmHg and reduced to 10. 15±3. 34, 11. 23±3. 56, 15. 63±5. 72, 17. 17±5. 47, 17. 73±6. 23,19. 76±5. 43mmHg at 1, 2wk, 1, 3, 6 and 12mo after surgery, which was significant different from the preoperative level (t = 12. 643, 11. 837, 10. 324, 8. 839, 8. 462, 8. 046, all P 0. 05). At 12mo after operation, the complete success rate reached 78% and the conditional success rate reached 92%. There were 5 eyes complicated with shallow anterior chamber, 3 eye complicated with anterior chamber hemorrhage, which all recovered after additional treatments. Late complications included valve exposure and encapsulated cystic blebs around the plate. Severe corneal endothelium loss occurred in 1 patient. CONCLUSION: Ahmed glaucoma valve implantation is effective in reducing IOP at 1-year follow-up in refractory glaucoma patients with prior sequential failed trabeculectomy, but we should fully understand and attach great importance to all kinds of complications that may occur.

Effects of preoperative sleep disturbance on efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery / 中华麻醉学杂志

Objective To investigate the effects of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.Methods Ninety-six ASA Ⅰ or Ⅱ patients of both sexes (aged 20-60 years and weighing 50-80 kg) undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate the long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate the short-term sleep quality in hospital.The patients were divided into four groups according to the types of preoperative sleep disturbance (n =24 each):no sleep disturbance (group Ⅰ),long-term sleep disturbance (group Ⅱ),acute short-term sleep disturbance (group Ⅲ),and long-term + acute short-term sleep disturbance (group Ⅳ).Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with intravenous infusion of remifentanil and propofol.Then the patients received endotracheal intubation and mechanical ventilation.The end-tidal pressure of carbon dioxide was maintained at 30-35 mm Hg.Controlled hypotension was performed with nicardipine,and the mean arterial blood pressure was maintained at 50-70 mm Hg and heart rate at 60-90 bpm during operation.The patients received intravenous injection of flurbiprofen 50 mg 15 minutes before the end of operation for postoperative analgesia.When the visual analogue scale score was more than 3 during the first 6 hours after operation,flurbiprofen 50 mg was given intravenously as rescue analgesia.Results The incidence of rescue analgesia administered after operation was significantly greater in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and greater in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesia administered during the first 6 hours after operation between groups Ⅱ and Ⅲ.Conclusion Preoperative sleep disturbance has adverse effects on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

Clinical value of serum COX-2 in predicting patients′ responses to targeted therapy for advanced NSCLC / 实用医学杂志

Objective To explore the clinical value of expression levels of serum COX-2 in patients with advanced NSCLC before and after EGFR-TKI treatment. Methods The serum was collected from 58 cases. Before and after targeted therapy , the serum COX-2 level was examined by ELISA. Meanwhile , CT scan was exercised to evaluate the treatment. Follow-up interview was done. The relationship among the change in expression level of serum COX-2 , efficacy and PFS was analyzed. Results The serum COX-2 level significantly decreased in the response group (t = 11.258, P = 0.000) and increased in the PD group (t = -7.759, P =0.000) after EGFR-TKI treatment, and not significantly changed in the SD group (t = 1.424, P = 0.170). Before treatment, the baseline serum COX-2 level in the response group was significantly higher than that in the SD group and the PD group (F = 20.852, P = 0.000 ). Before the targeted therapy, the higher the level of serum COX-2 was, the longer PFS patients would enjoy. Conclusion Detection of the serum COX-2 contributes to the judgment of therapeutic effect of EGFR-TKI and can be used as a prediction of EGFR-TKI drugs outcomes for patients with advanced NSCLC.

NF-kappa B activation in peripheral blood mononuclear cells of children with epilepsy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes and significance of NF-kappa B activation in peripheral blood mononuclear cells (PBMC) of children with epilepsy.</p><p><b>METHODS</b>NF-kappa B activation in PBMC was assayed by the flow cytometry in 32 healthy children and 64 children with epilepsy before and after treatment. The 64 epileptic children were subdivided into three groups: systemic seizure, partial seizure and unknown classification.</p><p><b>RESULTS</b>NF-kappa B activation in PBMC in three epilepsy subgroups were significantly higher than that in healthy controls. The systemic seizure group showed significantly increased NF-kappa B activation in PBMC compared with the partial seizure group (p<0.01) and the unknown classification group (p<0.05). After treatment NF-kappa B activation in PBMC in three epilepsy subgroups was significantly reduced (p<0.01).</p><p><b>CONCLUSIONS</b>NF-kappa B activation in PBMC increased in children with epilepsy, and it was positively correlated with the severity of seizures.</p>