Objective To investigate the analgesic effect of ultrasound-guided paravertebral nerve block on patients with radical mastectomy. Methods Sixty female patients who underwent unilateral radical mastectomy with general anesthesia in the Second Hospital of Shanxi Medical University from March 2016 to January 2018 were enrolled, and 58 cases were actually studied according to the inclusion and exclusion criteria. According to the random number table method, the patients were randomly divided into simple general anesthesia group (GA group, 30 cases) and paravertebral nerve block combined with general anesthesia group (PG group, 28 cases). In the PG group, 15 ml of 0.4％ ropivacaine was injected into the T2-T6 paraspinal space on the surgical side with ultrasound. All patients received general anesthesia with intravenous propofol induction, and were given a self-controlled intravenous analgesia pump. When the visual analogue scale (VAS) score was ≥7 points, the patient was given intravenous morphine 5-10 mg. The t-test andχ2 test were used to compare the hemodynamic parameters at different time points, the VAS score at different time after operation, the postoperative analgesia pump use, and postoperative adverse reactions. Results There were no significant differences in hemodynamic parameters between the PG group and the GA group at different times (all P>0.05). The static VAS scores of the PG group at different time points were lower than those of the GA group, but the difference was not statistically significant (all P> 0.05). The cough dynamic VAS scores of the patients in the PG group were lower than those in the GA group at 2, 6, 12, and 24 h after surgery, and the difference was statistically significant (all P<0.05). The total amount of sufentanil [(35±10)μg vs. (50±8) μg, t=6.308, P<0.05], the number of remedial analgesia within 48 hours after operation [(550±105) mg vs. (680±128) mg, t=4.240, P<0.05], and the number of effective presses of analgesia pump (3.1±1.5 vs. 10.0± 3.4, t=10.117, P<0.05) in the PG group were significantly lower than those in the GA group. The adverse reactions such as nausea, vomiting and lethargy in the PG group were significantly lower than those in the GA group, and the difference was statistically significant (χ2 values were 3.869 and 2.334, both P< 0.05). The postoperative analgesia comfort rate of the PG group was significantly higher than that of the GA group [96.4％(27/28) vs. 70.0％(21/30)], and the difference was statistically significant (χ2=7.089, P<0.05). Conclusion The combined use of general anesthesia and ultrasound-guided paravertebral nerve block for postoperative analgesia in patients with radical mastectomy is superior to PCIA.

Objective To investigate the association between gene polymorphism of TRPV1 and genetic predisposition of type 2 diabetes. Methods Real-time fluorescent quantitative PCRwas used to do the genotyping of rs222747 which was the allelic mutant of TRPV1 among 227 patients with type 2 diabetes (diabetes group) and 215 patients without diabetes (control group). The associations of genotypes and alleles with type 2 diabetes, glycosylated hemoglobin (HbAlc) and diabetic complications were analyzed. Results The distribution of genotypes in type 2 diabetes group was statistically different from that in control(P=0. 04). The distributions of alleles in two groups were statistically different(P=0. 04). It was suggested that the gene polymorphism of TRPV1 was associated with the genetic predisposition of type 2 diabetes. Conclusion Gene polymorphism of TRPV1 was associated with the genetic predisposition of type 2 diabetes. It needs systematic researches to expound its significance in molecular pathology and clinical pathology.

Objective To evaluate the efficacy of ultrasound-guided fascia iliaca compartment block combined with sacral plexus block in elderly patients undergoing posterolateral approach total hip arthroplasty (THA).Methods Sixty patients,24 males and 36 females,aged 65-90 years,ASA physical status Ⅱ or Ⅲ,undergoing THA via posterolateral approach were randomized into two groups with 30 cases in each group.Group SA received unilateral hypobaric spinal anesthesia with 2.0-2.5 ml local anesthetics (2 ml of 0.5% bupivacaine mixed 1 ml of sterile water for injection).Group NB received ultrasound-guided fas-cia iliaca compartment block (50 ml of 0.4% ropivacaine)combined with sacral plexus block (20 ml of 0.5% ropivacaine).The onset time and success time of sensory and motor block were evaluated.The visual analogue scale (VAS)at entring into the operating room (T0 ),1 min before positioning change (T1 ),posi-tioning change (T2 ),skin incision (T3 ),30 min after skin incision (T4 ),end of surgery (T5 ),24 h post-operatively (T6 ).The use of dopamine and atropine and incidence of complications were recorded. Results Compared with group SA,the onset time and success time of sensory and motor nerve block of group NB were longer (P <0.05).The VAS decreased at T1 ,T2 ,T6 and increased at T3 ,T5 in group NB (P <0.05).The use of dopamine in group NB (6.7%)was less than that in group SA (26.7%).Head-ache,nausea, vomiting, urinary retention were significantly decreased in group NB (P < 0.05 ). Conclusion Ultrasound-guided fascia iliaca compartment block combined with sacral plexus block re-lieves the pain caused by positioning changes.This technique may be used in elderly patients undergo-ing THA via posterolateral approach with less use of vasoactive drugs,better postoperative analgesic effects,fewer complications and higher degree of patient satisfaction.

Objective:To evaluate the relationship between perioperative cardiovascular events and serum transient receptor potential vanilloid 1 (TRPV1), calcitonin gene-related peptide (CGRP) and substance P (SP) concentrations in the patients with diabetic peripheral neuropathy (DPN).Methods:Twenty-eight patients with type 2 diabetes mellitus (DM) complicated by DPN undergoing elective non-cardiovascular surgery under general anesthesia, were enrolled in DPN group, and 28 patients with type 2 DM without DPN were included in DM group.Another 28 nondiabetic patients undergoing non-cardiovascular elective surgery under general anesthesia were selected as control group (C group). The patients were 55 to 81 years old and classified as American Society of Anesthesiologists physical status Ⅱ or Ⅲ, regardless of gender.The development of cardiovascular events during surgery and within 24 h after surgery and use of vasoactive drugs were recorded.Venous blood samples were taken at 30 min before anesthesia induction and 24 h after surgery for determination of the concentrations of TRPV1, CGRP, SP and cardiac troponin I (cTnI) in serum using enzyme-linked immunosorbent assay.Results:Compared with group C, the incidence of perioperative cardiovascular events and utilization rate of vasoactive drugs were significantly increased, the preoperative concentrations of serum TRPV1, CGRP and SP were decreased, and the postoperative concentration of serum cTnI was increased in DM and DPN groups ( P<0.05). Compared with DM group, the incidence of perioperative cardiovascular events was significantly increased, the preoperative concentrations of serum TRPV1, CGRP and SP were decreased, the postoperative concentration of serum cTnI was increased ( P<0.05), and no significant change was found in the utilization rate of vasoactive drugs in DPN group ( P>0.05). The postoperative cTnI concentrations in serum were negatively correlated with the preoperative TRPV1, CGRP and SP concentrations in serum in DPN group ( P<0.01). Conclusion:The increased risk of perioperative cardiovascular events may be related to the decrease in serum TRPV1, CGRP and SP concentrations in DPN patients.

Objective:To determine the relationship between transient receptor potential vanilloid 1 (TRPV1) gene polymorphism and genetic susceptibility to type 2 diabetes mellitus (DM) and intraoperative adverse cardiovascular events (ACVEs).Methods:Eighty-six DM patients and 78 non-DM patients (nDM) undergoing elective knee replacement or posterior lumbar interbody fusion were selected in this study.Real-time fluorescence quantitative polymerase chain reaction was carried out to genotype the rs222747 variant of TRPV1 gene.The ACVEs occurred were recorded during operation, and the risk factors for ACVE developed during operation were identified.Results:Compared with nDM group, the TRPV1 genotype G/G ratio, allele G frequency, and incidence of intraoperative ACVE were significantly increased in DM group ( P<0.05). Aging and TRPV1 genotype GG combined with DM were the risk factors for intraoperative ACVEs occurred ( P<0.05). Conclusion:TRPV1 gene polymorphism is related to the genetic susceptibility to type 2 DM and occurrence of intraoperative ACVEs.