Expression of bone marrow stromal antigen 2 gene in patients with glioblastoma and its correlation with non-CpG island DNA methylation and prognosis / 肿瘤研究与临床

Objective:To investigate the expression level of bone marrow stromal antigen 2 (BST2) in patients with glioblastoma (GBM) gene and its correlation with DNA methylation level and prognosis.Methods:The datasets of GBM samples from the Cancer Genome Atlas (TCGA) database (35 cases), GSE22891 cohort (50 cases) within Gene Expression Omnibus (GEO) database, and China Glioma Genome Atlas (CGGA) database (105 cases), and non-tumor brains (NTB) (10 cases in TCGA database, 6 cases in GSE22891 cohort, 5 cases in CGGA database were used to make comparisons of gene expression level; 25 cases in GSE63347 cohort, 4 cases in GSE22891 cohort, 8 cases in CGGA database were used to make comparisons of methylation data). Based on gene expression chip and DNA methylation microarray data from public GBM databases, the expression level of BST2 gene in GBM and the association with non-CpG island DNA methylation, GBM molecular subtypes [CpG island methylation phenotype (G-CIMP) and non-G-CIMP proneural, neural, classical, mesenchymal], overall survival (OS) time and functional gene expression profiles were obtained by using intra-group comparison of BST2 gene expression level between GBM and NTB, survival analysis, and bioinformatic analysis.Results:Compared with NTB samples, BST2 mRNA was highly expressed in GBM (mRNA expression data were based on Z-score standardization) (TCGA database vs. GSE63347 cohort: -0.97±1.14 vs. -2.32±0.21, t = 3.74, P < 0.05; GSE22891 cohort: 9.03±1.28 vs. 7.18±0.22, t = 3.42, P < 0.05; CGGA database: -0.43±1.11 vs. -0.62±0.35, t = 2.09, P < 0.05). In TCGA database, BST2 mRNA was highly expressed in different tumor molecular subgroups (G-CIMP: -1.96±0.94; non-G-CIMP proneural: -1.74±0.88; neural: -0.83±0.98; classical: 0.71±1.18; mesenchymal: -0.55±1.01), which were compared with NTB samples (-2.32±0.21), and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in the expressions of BST2 mRNA in the neural, classical, mesenchymal tumors (all P > 0.05), but the expression of BST2 mRNA in above three groups was higher than that in G-CIMP group and non-G-CIMP proneural group (all P < 0.05). Correlation analysis showed that non-CpG island DNA methylation level of BST2 was negatively correlated with the expression of its mRNA (TCGA database: r = -0.30, P < 0.05; GSE22891 cohort: r = -0.54, P < 0.05; CGGA database: r = -0.29, P > 0.05). Survival analysis showed that BST2 mRNA expression level of non-G-CIMP and non-proneural patients was negatively associated with OS ( HR = 1.18, 95% CI 1.00-1.39, P < 0.05); among those tumors with G-CIMP or proneural subtypes, BST2 mRNA expression was not associated with OS ( HR = 1.08, 95% CI 0.84-1.40, P > 0.05). Bioinformatic analysis showed that among non-G-CIMP and non-proneural samples of TCGA database, GBM samples with higher BST2 expression were enriched with functional gene sets related to negative regulation of immune responses and activation of nuclear factor κB (NF-κB) pathway. Conclusions:The upregulated expression of BST2 gene in GBM may be associated with non-CpG island DNA hypomethylation alteration. BST2 gene may become a potential prognostic biomarker for non-G-CIMP and non-proneural GBM.

Postoperative analgesic effects of Dexmedetomidine plus Ropivacaine for abdominal fascia block in elderly patients following colon cancer surgery / 中华老年医学杂志

Objective:To investigate the analgesic effects of Dexmedetomidine combined with Ropivacaine for abdominal fascia block(AFB, with transverse abdominis plane block and rectus abdominis sheath block)in elderly patients undergone open surgery for colon cancer.Methods:This was a prospective study.Fifty elderly patients following ASA Ⅰ-Ⅲ open surgery for colon cancer were randomly divided into Group R and Group RD.Patients in Group R were treated with Ropivacaine for AFB, and those in Group RD were given Dexmedetomidine 0.5 μg/kg and Ropivacaine.All patients received Morphine-based patient-controlled intravenous analgesia(PCIA)after surgery.The total dose of postoperative Morphine, the time to first required use of Morphine, and the visual analog score(VAS)at 4, 8, 16, and 24 h after surgery were compared between the two groups.Results:Compared with Group R, patients in Group RD were associated with a significantly decreased total amount of Morphine at 24 h after surgery [25(20-32)mg vs.30(22-38)mg, Z=5.00, P<0.001], a lower VAS at 4 h [17(15-19) vs.36(23-39), Z=23.04, P<0.001]and 8 h after surgery [20(18-22) vs.41(38-55), Z=25.47, P<0.001], a longer time to first required use of Morphine [233(204-256)min vs.183(167-195)min, Z=4.367, P<0.001], and less postoperative nausea and vomiting(20.0% vs.48.0%, P=0.037). Conclusions:For elderly patients after colon cancer surgery, transverse abdominis plane and rectus sheath block with Dexmedetomidine plus Ropivacaine can enhance the analgesic effect, prolong the time of effective analgesia, reduce the amount of Morphine used postoperatively, and is beneficial for early recovery.

Effect of partial neuromuscular blockade on efficacy and safety of nerve monitoring during microvascular decompression of facial nerve / 中华麻醉学杂志

Objective To evaluate the effect of partial neuromuscular blockade (NMB) on the efficacy and safety of nerve monitoring during microvascular decompression (MVD) of facial nerve.Methods Seventy American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 39-78 yr,weighing 44-84 kg,scheduled for elective MVD,were divided into 2 groups (n=35 each) using a random number table method:control group and partial NMB group.Anesthesia was induced by intravenous injection of 3-fold ED95 cisatracurium.In control group,muscle relaxants were not used after intubation.In partial NMB group,cisatracurium was continuously infused intravenously to maintain partial NMB,and the T1/Tc ratio was maintained at 20％-40％.Intraoperative neuroelectrophysiological monitoring was performed using lateral spread response (LSR).The success rates of LSR monitoring,occurrence of body movement,requirement for anesthetics and cardiovascular agents were recorded during operation,and the patients were followed up on day 7 after surgery,and the therapeutic efficacy and occurrence of neurological complications were recorded.Results Compared with control group,the incidence of intraoperative body movement was significantly decreased,the intraoperative consumption of propofol and remifentanil was decreased,and the intraoperative requirement for vasopressors was decreased in partial NMB group (P＜0.05).There was no significant difference in the success rate of LSR monitoring,therapeutic efficacy and incidence of neurological complications between two groups (P＞0.05).Conclusion Partial NMB (T1/Tc=20％-40％) can be effectively used for MVD monitored by LSR,decrease the occurrence of the body movement,and raise the perioperative safety in patients.

Factors associated with intraoperative hypothermia in elderly patients and management strategies / 中华老年医学杂志

Objective To investigate the incidence of intraoperative hypothermia in elderly patients,and to analyze and discuss related influencing factors and targeted management strategies.Methods From February 2017 to February 2019,220 elderly patients admitted into our hospital for surgery were selected.According to whether or not they had intraoperative hypothermia,patients were divided into the hypothermia group and the non-hypothermia group.General information and surgical data were compared between the two groups.Measures for the prevention of intraoperative hypothermia were discussed.Results Of the 220 patients,103 had intraoperative hypothermia,and the incidence rate was 46.8％.The proportion of patients aged ≥70 years or with BMI ＜24 kg/m2 was higher in the hypothermia group than in the non-hypothermia group (all P ＜ 0.05).The proportion of patients with the anesthesia time ≥60 min or total intraoperative fluid intake ≥2000 ml was higher in the hypothermia group than in the non-hypothermia group(all P＜0.05).BMI ＜24 kg/m2 and total intraoperative fluid intake ≥ 2000 ml were the key risk factors for intraoperative hypothermia in elderly patients(all P＜0.05).Conclusions Intraoperative hypothermia is a common complication for elderly patients undergoing surgery.Intraoperative fluid intake and body mass are the key risk factors for intraoperative hypothermia.Targeted treatment measures based on the above related factors should be considered for elderly patients receiving surgery.

Effects of laryngeal mask ventilation combined with continuous nerve block analgesia on postoperative lung infection in elderly patients undergoing the lower extremity orthopedics surgery / 中华老年医学杂志

Objective To investigate effects of laryngeal mask ventilation combined with continuous nerve block analgesia versus the endotracheal intubation under general anesthesia on postoperative lung infection in elderly patients undergoing orthopedic surgery,so as to provide a theoretical basis for a reasonable anesthesia method.Methods A total of 180 elderly patients undergoing lower extremity orthopedic surgery at our hospital from January 2016 to December 2016 were enrolled and randomly divided into two groups.The control group (n =90) were treated with endotracheal intubation under general anesthesia and intravenous analgesia after the operation,and the observation group (n =90)received the ultrasound-guided continuous nerve block analgesia in spontaneous respiration with laryngeal mask ventilation.The anesthetic dosage,awakening time,visual analogue scale(VAS)scores,and incidence of lung infections at 7 days after surgery were compared between the two groups.Pathogenic strains causing lung infections were isolated and identified.Results The anesthetic dosage was lower in the observation group than in the control group(P ＜ 0.05).The awaking time was shorter in the observation group than in the control group[(22.4±4.4) min vs.(34.1±8.5)min,P ＜0.05].The VAS scores under postoperative exercise were lower in the observation group than in the control group(P ＜0.05).The adverse reaction rate after surgery was lower in the observation group than in control group(3.3％ or 3/90 cases vs.41.1％ or 37/90 cases,P ＜0.05).The incidence of lung infections at 7 days after surgery was lower in the observation group than in the control group(3.3％ or 3/90 cases vs.11.1％ or 10/90 cases,P＜0.05).Ten pathogenic strains were isolated from control group,of which 9 strains were gram-negative bacteria,accounting for 90.0％.Three pathogenic strains were isolated from the observation group,of which 2 strains were gram-negative bacteria,accounting for 66.7％.Conclusions Laryngeal mask ventilation combined with continuous nerve block analgesia can reduce the anesthetic dosage,shorten the awaking time,provide a better analgesic effect and decrease the incidence of lung infections in elderly patients undergoing lower extremity orthopedics.The main pathogenic bacteria are gram-negative bacteria.

Modifiying efficacy of pectoral nerve block combined with general anesthesia in patients undergoing radical mastectomy / 中华麻醉学杂志

Objective To evaluate the modifiying efficacy of pectoral nerve ( Pecs) block com-bined with general anesthesia in patients undergoing radical mastectomy. Methods A total of 60 American Society of Anesthesiologists physical status Ⅰ or Ⅱ female patients, aged 40-64 yr, weighing 50-70 kg, scheduled for elective radical mastectomy, were divided into 2 groups ( n= 30 each) using a random num-ber table method: general anesthesia group ( group GA) and Pecs block combined with general anesthesia group ( group PB+GA) . The patients in group PB+GA received Pecs block guided by ultrasound. After the needle was advanced to the pleura plane between the pectoralis major and minor, 0. 33％ ropivacaine 15 ml was injected, and 0. 33％ ropivacaine 30 ml was injected into the surface of the serratus anterior muscle at the level of the third rib. Anesthesia was induced by intravenous injection of midazolam, propofol, sufen-tanil and cisatracurium and maintained by target-controlled infusion of propofol and intermittent intravenous boluses of sufentanil and cisatracurium. Bispectral index value was maintained at 40-60. Patient-controlled intravenous analgesia was performed with sufentanil at the end of surgery. Immediately after anesthesia in-duction, at 30 min and 2 h after skin incision, and at 2, 6 and 24 h after operation, peripheral venous blood samples were collected for determination of the concentrations of plasma epinephrine by radioimmuno-assay, and the blood samples were collected from the end of the finger at the same time for determination of blood glucose concentrations. The consumption of intraoperative sufentanil, emergence time, pressing times of patient-controlled analgesia ( PCA) and development of nausea and vomiting within 24 h after operation were recorded. Results Compared with group GA, blood glucose and plasma epinephrine concentrations were significantly decreased, the intraoperative sufentanil consumption was reduced, the emergence time was shortened, the pressing times of PCA were decreased at 2, 6 and 24 h after operation ( P<0. 05) , and no significant change was found in the incidence of postoperative nausea and vomiting in group PB+GA ( P>0. 05). Conclusion When Pecs block combined with general anesthesia is used in the patients undergoing radical mastectomy, it is helpful in reducing the opioid consumption and more helpful in inhibiting postoper-ative stress responses and pain responses than general anesthesia alone.

Median effective dose of oxycodone inhibiting responses to laryngeal mask airway insertion when combined with propofol in adult female patients / 中华麻醉学杂志

Objective To determine the median effective dose (ED50) of oxycodone inhibiting responses to laryngeal mask airway (LMA) insertion when combined with propofol in the adult female patients.Methods Female patients,aged 18-60 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective gynecologic surgery,were included.ED50 of oxycodone was determined by up-and-down sequential technique.Anesthesia was induced by target-controlled infusion of propofol at target plasma concentration of 3.0 μg/ml.Oxycodone was injected at the initial dose of 0.11 mg/kg after the target effect-site and plasma concentrations were balanced.LMA was inserted at 5 min following injection.When the response to LMA insertion was positive,the concentration of oxycodone was increased/decreased in the next patient.The difference between the two successive doses was 0.02 mg/kg.LMA insertion response was defined as occurrence of swallowing,biting on the LMA and bucking and/or body movement during insertion.Probit analysis was used to calculate the ED50 and 95％ confidence interval of oxycodone inhibiting responses to LMA insertion when combined with propofol.Results The ED50 (95％ confidence interval) of oxycodone inhibiting responses to LMA insertion was 0.095 (0.080-0.108) mg/kg when combined with propofol.Conclusion The ED50 of oxycodone inhibiting responses to LMA insertion is 0.095 mg/kg when combined with propofol in the adult female patients.

Effects of deep and moderate neuromuscular blockade on surgical conditions during minor laparoscopic gynecologic surgery / 中华麻醉学杂志

Objective To evaluate the effect of deep and moderate neuromuscular blockade on surgical conditions during minor laparoscopic gynecologic surgery.Methods Sixty-five patients,with expected surgery time ＜ 3 h,aged 18-60 yr,with body mass index＜30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ orⅡ,scheduled for elective laparoscopic gynecological surgery,were allocated into deep neuromuscular blockade group (group D,n =33) and moderate neuromuscular blockade group (group M,n=32) using a random number table.After induction of anesthesia,the patients were tracheally intubated and mechanically ventilated.Cisatracurium was continuously infused to maintain the degree of neuromuscular blockade in both groups to achieve the target degree post-tetanic count of 1 or 2 in group D and train-of-four (TOF) count of 1 or 2 in group M.Surgical conditions were assessed and scored after surgery.The recovery index,time for TOF ratio returning to 0.7 and 0.9,surgery time,mean intra-abdominal pressure,extubation time and TOF ratio at extubation were recorded.Results Compared with group M,the mean intra-abdominal pressure was significantly decreased,and the extubation time and time for TOF ratio returning to 0.7 and 0.9 were prolonged in group D (P＜0.05).There was no significant difference in the other parameters between the two groups (P＞0.05).Conclusion Moderate neuromuscular blockade can provide better surgical conditions for minor laparoscopic gynecological surgery with shorter recovery time.

Anesthesia analysis of 45 children undergoing endoscopic retrograde cholangiopancreatography / 中华消化内镜杂志

Objective To investigate the safety and effectiveness of different intravenous anesthesia methods for pediatric ERCP . Methods Data of 45 children undergoing ERCP at the Affiliated Hangzhou Hospital of Nanjing Medical University from August 2013 to July 2016, including intravenous anesthesia,the procedure of ERCP, adverse reactions and the waking time were retrospectively studied. Results A total of 45 patients in two groups under intravenous anesthesia successfully underwent ERCP . Seventeen patients ( 37. 8%) whose body weights were over 20 kg and the duration of surgery was predicted less than 30 minutes received deep sedation without airway intubation. Twenty?eight patients ( 62. 2%) with an initial weight of less than 20 kg and the duration of surgery was predicted more than 30 minutes received general anesthesia with airway intubation. In patients with deep sedation, the mean time of waking was 7. 2±6. 3 minutes, body movement reaction occurred in 1 case ( 5. 9%) and with transient decreasing of pulse blood oxygen ( beyond 95%) occurred in 2 cases ( 11. 8%) . In patients receiving endotracheal anesthesia with intubation, the mean waking time was 10. 5±8. 7 minutes without adverse reactions associated with anesthesia. Conclusion Both deep sedation and general anesthesia with airway intubation are safe for pediatric ERCP. However, general anesthesia with airway intubation is an ideal method ensuring the airway safety and oxygen supply for children less than 20 kg undergoing first?time ERCP or the duration of surgery lasting over 30 minutes.

Clinical application of Mimics finite element analysis in the trigeminal ganglion radiofrequency / 实用医学杂志

Objective To observe the efficacy of Mimics finite element analysis software in the gasserian ganglion radiofrequency treatment of trigeminal neuralgia. Methods 180 cases with primary trigeminal neuralgia and VAS score ≥8 were randomly divided into 2 groups (n = 90 each): CT group (group C) and Mimics group (group M). The preoperative skull CT image of the foramen of cranial base could be analyzed in group C. The preoperative cranial CT image could be reconstructed and analyzed by Mimics finite element analysis software in group M. The puncturing success rate, complications rate and the outcomes between two groups were recorded. Results The puncturing success rates were 100% in group M and 92% in group C (P 0.05) between them. Conclusions The Mimics finite element analysis software could improve the success rate of basicranial foramen ovale puncture and reduce the occurrence rate of puncture complications. Therefore , it could be safely applied to the treatment of primary trigeminal neuralgia by gasserian ganglion radio frequency.

Effects of different concentrations of sevoflurane on cognitive function in neonatal rats / 中华麻醉学杂志

Objective To evaluate the effects of different concentrations of sevoflurane on the cognitive function in neonatal rats.Methods Twenty-four neonatal Sprague-Dawley rats of both sexes,aged 7 days,weighing 12-16g,were randomly divided into high concentration sevoflurane group (group Sev1),low concentration sevoflurane group (group Sev2) or control group (group C),with 8 rats in each group.Sev1 and Sev2 groups were exposed to 2％ and 4％ sevoflurane for 6h,respectively,and C group inhaled gas mixture composed of 30％ oxygen.At 2 and 8 weeks after exposure to sevoflurane,cognitive function was assessed using the open field test and Morris water maze test.Results In the open field test,no significant differences were observed among the three groups (P ＞ 0.05).Morris water-maze test showed that the escape latency was significantly prolonged,and the frequency of crossing the original platform and the time spent in the third quadrant were decreased at 2 weeks after exposure to sevoflurane in Sev1 group and at 2 and 8 weeks after exposure to sevoflurane in Sev2 group as compared with group C (P ＜ 0.05).Morris water-maze test showed that the escape latency was significantly prolonged,and the frequency of crossing the original platform and the time spent in the third quadrant were decreased at 2 and 8 weeks after exposure to sevoflurane in Sev2 group compared with Sev1 group (P ＜ 0.05).Conclusion Exposure to 4％ and 2％ sevoflurane for 6h both can induce cognitive decline and the decreasing effect is enhanced with the increasing concentration in the neonatal rats.

Nanofibers doped with a novel red-emitting Europium complex: synthesis, characterization, photophysical property and sensing activity toward molecular oxygen.

In this paper, we synthesize a novel diamine ligand of DIQ-Et and its corresponding Eu(III) complex of Eu(TTA)(3)DIQ-Et, where DIQ-Et=N-ethyl-10H-dipyrido-[f,h]-indolo-[3,2-b]-quinoxaline, and TTA=2-thenoyltrifluoroacetonate. The UV-vis absorption, photoluminescence, low temperature phosphorescence, energy transfer mechanism, and excited state lifetime of Eu(TTA)(3)DIQ-Et are investigated in detail. Data suggest that the emission of Eu(TTA)(3)DIQ-Et is quenchable by molecular oxygen due to the back-energy transfer process. By doping Eu(TTA)(3)DIQ-Et into a polymer matrix of poly(vinylpyrrolidone) (PVP), oxygen sensing performance of the resulted nanofibers is investigated. Finally, the 0.7 wt% doped sample exhibits a linear response toward molecular oxygen, with a sensitivity of 2.4 and response/recovery time of 12s/16s.

Clinical efficacy of a locator for puncture under CT examination / 中华麻醉学杂志

We designed a locator for puncture under CT examination.Thirty-three patients of both sexesaged 16-76 yr weighing 46-80 kg undergoing bilateral thoracic or lumber sympathetic nerve block under CT examination were enrolled in this study.One side was punctured under the guidance of the locator,while the other side was punctured by conventional technique.The time consumed during puncture,CT scan adjusting time,the deviation of the needle from the targets and the incidence of puncture complications were recorded.The results showed that compared with the conventional technique,with the locator the time consumed during puncture was significantly shorter,the number of attempts and the deviation of the needle from the target were significantly reduced.The procedure was successfully performed on both side in all patients without serious complications such as hemothorax and pneumothorax.

Influence of local-anaesthetic combined with dezocine on brachial plexus block and postoperative analgesia / 中国基层医药

Objective To observe the influence of local-anaesthetic combined with dezocine on brachial plexus block and postoperative analgesia.Methods 60 patients scheduled for unilateral upper limb operation were randomly divided into two groups of C group and D group with 30 cases in each group.The brachial plexus block was performed under ultrasound guiding.Two groups received a bolus injection of local anesthetic 30ml,but the local bolus injection of D group consisted of Dezocine 10mg.The tine of sensory blocked producing effect,anesthesia effect,sensory blocked duration were observed.Two hours after sensory nerve recovered,the scores of VAS pain and Ramsay Sedation were recorded.Adverse reactions of perioperation were also observed(nausea,vomiting,dizzy,respiratory,urine retention,pruritus).Results The sensory blocked duration in D group was(7.1±1.1)h,which was significantly longer than that of C group[(4.5±0.8)h](t=10.47,P＜0.01);Two hours after sensory nerve recovered,the score of VAS pain in D group was(1.7±0.7)points,and significantly lower than that of C group[(3.9±1.0)points](t=9.87,P＜0.01).Both two groups had no adverse reactions.Conclusion Addition dezocine 10mg to local anesthetic solutions for interscalene brachial plexus block,it could prolong the sensory block duration,provide satisfactory postoperative analgesia,have no adverse reactions.

Diagnostic efficacy and complication of transperineal prostate biopsy: less than 10 cores vs more than 10cores / 中华泌尿外科杂志

Objective To compare the diagnostic efficacy and complications of transperineal prostate biopsy for<10 cores biopsy vs≥10 cores biopsy. Methods Nine hundred transrectal ul-trasound-guided transperineal prostate biopsies were performed. Patients were divided into 2 groups, <10 cores group and ≥10 cores group. Patient numbers of the 2 groups were 759 and 141, respec-tively. Cancer positive rate and complications were compared between the 2 groups retrospectively. Results Cancer positive rates were 41.6%(316/759) and 51.8%(73/141) in 2 groups (P<0.05). In patients of PSA≤10.0 ng/ml, cancer positive rates were 6.8% (16/235) and 17.8% (8/45) in 2 groups (P<0.05). Gross hematuria was the most common complication associated with biopsy. There was no statistical difference between the 2 groups in post-biopsy gross hematuria rate. Conclu-sions The diagnostic efficacy is higher in≥10 cores prostate biopsy than that in <10 cores prostate biopsy, There is no difference in biopsy related complications regarding biopsy core numbers.

Occult pancreatobiliary reflux / 中华普通外科杂志

Objective To investigate the incidence of occult pancreatobiliary reflux and to evaluate its relation to gallbladder epithelial dysplasia and cancer. Methods From July 2006 to Feb 2008,956 cases underwent selective biliary procedure or preoperative endoscopic retrograde cholangiopanereatography (ERCP), bile was collected and amylase was measured. All removed gallbladders were pathologically examined for dysplasia and cancer. Results Occult pancreatobihary reflux was found in 75 of 754 patients in this study, with an incidence of 9. 9%. The biliary amylase values in the patients with occult pancreatobiliary reflux and in controls were 7701±20 378 IU/L and 16±51 IU/L, respectively ( P <0. 01 ).Gallbladder dysplasia and cancer were found in 31.0% and 3.4% of the patients with occult pancreatobiliaryreflux, respectively, and both were higher than those in the patients without pancreatobiliary reflux ( P <0. 05). In the patients with occult pancreatobiliary reflux, the biliary amylase level with gallbladder dysplasia or cancer was 2388 ± 2745 IU/L and was higher than those without gallbladder dysplasia or cancer (P < 0. 01 ). Conclusions With an incidence of 9.9% in patients of normal pancreatobiliary junction,the occult pancreatobihary reflux may contribute to the pathogenesis of gallbladder epithelial dysplasia and cancer.

Ethical problem on Patients Sexual Hallucinations flowing Anesthesia or Sexual Harassment from Clinicians / 中国医学伦理学

To analysis the reason of the arguments of “Sexual hallucinations” or “Sexual harassment”between clinicians and patients,and find out how to prevent its happening.Methods:Base on clinical case about patients complaints that clinicians sexually assault,review and analysis the prtinent literatures.Results:Sexual hallucinations is a complication following anesthesia with psychotropic drugs,it 's easy to be misunderstand as Sexual harassment and result in allegations of sexual misconduct between patient and clinician.Conclusion:Clinicians need to be aware that sexual hallucinations to occur during sedation or after anesthesia,to protect themselves against the accusations of sexual harassment,the practitioner should never be unchaperoned with a patient of the opposite sex during sedation or anesthesia.

Effects of isoflurane on amino acid neurotransmitter levels in rat cerebral cortex, hippocampus and spinal cord / 中华麻醉学杂志

Objective To determine the effects of isoflurane on the amino acid neurotransmitter contents in rat cerebral cortex, hippocampus and spinal cord. Methods Sixteen male SD rats weighting 220-280g were randomly divided into two groups: isoflurane group (A) and control group (B). Animals in group A were killed after 30min inhalation of 1.3% isoflurane and cerebral cortex, hippocampus and spinal cord were removed immediately for determination of glutamic acid (Glu), aspartic acid (ASP), glutamine (Gln), GABA and glycine (Gly) levels by high-performance liquid chromatography (HPLC), whereas in group B O2 was inhaled instead of isoflurane. Results As compared with control group, Asp and Glu levels in cerebral cortex and hippocampus decreased markedly while Gly level increased significantly in hippocampus and spinal cord in isoflurane group. Conclusions The inhibition of excitatory amino acid synapse transmission and augmentation of inhibitory amino acid synapse transmission may be involved in the mechanism of isoflurane anesthesia.