Objective To evaluate the performance of bispectral index (BIS),auditory evoked potential index (AEPI) and cardiovascular response to electrical tetanus stimulus (ETS) for monitoring depth of sedation induced by propofol , analgesia produced by fenanyl and depth of isoflurane anesthesia. Methods Twenty ASA Ⅰ or Ⅱ patients of both sexes (11 males,9 females) aged 18-56 yr, weighing 50-80 kg undergoing elective brain surgery were studied. The patients were unpremedicated. The baseline BIS, AEPI, BP(SP, DP) and HR were measured before anesthesia. Propofol was infused at 0.25 mg?kg-1?min-1 and the infusion was stopped when the total amount of propofol infused reached 5 mg?kg-1 at the end of 20 min infusion. Fentanyl 2 ?g?kg-1 was then given i.v. Three minutes later the patients were intubated and mechanically ventilated. Tracheal intubation was facilitated by vecuronium 0.1 mg?kg-1. Anesthesia was maintained with isoflurane. Depth of sedation was measured using OAA/S scale during propofol infusion. ETS was given at the following time points: when the amount of propofol infused reached 2.5, 3.0, 3.5, 4.0, 4.5, 5.0 mg?kg-1,2 min after fentanyl administration and at 0.7, 1.0, 1.3 MAC isoflurane (end-tidal isoflurane concentration). BIS and AEPI values before and after ETS and changes in BP and HR (ABP, AHR) after ETS and the time for BP and HR to return to the pre-ETS value in 50% and 90% of the patients (TBP50%,TBP90%,THR50%,THR90% ) were recorded. Results BIS and AEPI were positively correlated with sedation depth. There were no significant changes in BIS and AEPI after ETS, but SP, DP and HR increased significantly after ETS( P

Objective To evaluate effects of tanshinone ⅡAon the invasion and migration of melanoma A375 cells,as well as on the mRNA and protein expression of CXC chemokine receptor type 7 (CXCR7).Methods In vitro cultured A375 cells were divided into 4 groups to be treated with tanshinone ⅡA at different concentrations of 1,2 and 4 mg/L,and 0.1％ dimethyl sulfoxide (DMSO) (control group) for 48 hours,respectively.Wound scratch assay and Transwell invasion assay were conducted to estimate the migratory and invasive abilities of A375 cells,respectively,and real-time fluorescence-based quantitative PCR (qRT-PCR) and Western blot analysis to determine the mRNA and protein expression of CXCR7 in A375 cells,respectively.Results After 48-hour treatment,the 1-,2-and 4-mg/L tanshinone ⅡA groups showed significantly decreased number of A375 cells crossing the polycarbonate membrane per high-power field (× 200) (71.00 ± 4.00,51.00-± 2.00 and 37.00 ± 3.61,respectively) in Transwell invasion assay,as well as decreased number of A375 cells migrating to the scratch zone (301 ± 3.00,253.00 ± 3.61 and 126.00 ± 7.00,respectively) in wound scratch assay,compared with the control group (105.33 ± 6.51,332.00 ± 6.24,respectively,all P ＜ 0.05).Additionally,qRT-PCR and Western blot analysis revealed that the mRNA and protein expression of CXCR7 was significantly lower in the 1-,2-and 4-mg/L tanshinone ⅡA groups than in the control groups (CXCR7 mRNA:0.63-± 0.04,0.44 ± 0.02 and 0.31 ± 0.01 vs.1.00 ± 0.02;CXCR7 protein:0.573 ± 0.015,0.416 ± 0.011 and 0.260-± 0.055 vs.0.9000 ± 0.010;all P ＜ 0.05).Moreover,inhibitory effects of tanshinone ⅡA on the migration and invasion of A375 cells,as well as on the mRNA and protein expression of CXCR7,were significantly enhanced with the increase of tanshinone ⅡA concentrations (all P ＜ 0.05).Conclusion Tanshinone ⅡA can inhibit the migratory and invasive abilities of melanoma A375 cells by down-regulating CXCR7 expression.

Objective To investigate in vitro effects of tanshinoneⅡA on the autophagy of A375 melanoma cells and related signaling pathway. Methods Some cultured A375 cells were divided into 5 groups to be treated with tanshinoneⅡA at concentrations of 0.5, 1, 2 and 4 mg/L, and DMEM containing 0.1% dimethyl sulfoxide (DMSO), respectively, for 24, 48, 72 hours. Methyl thiazol tetrazolium (MTT) assay was performed to estimate the proliferative activity of A375 cells. Some cultured A375 cells were divided into 4 groups to be treated with 1, 2 and 4 mg/L tanshinone ⅡA(1?, 2?and 4?mg/L tanshinone group), and DMEM containing 0.1% DMSO (control group), respectively, for 48 hours. Then, flow cytometry was conducted to count autophagosome?positive cells, and Western blot analysis to determine protein expression of autophagy?associated proteins Beclin?1, microtubule?associated protein 1 light chain 3 (LC3)?Ⅱ, phosphatidylinositol 3?kinase(PI3K), protein kinase B(Akt), mammalian target of rapamycin (mTOR)and p70 ribosomal protein S6 kinase 1(p70S6K1). Results MTT assay showed that 24?, 48?, 72?hour treatments with tanshinone ⅡA at concentrations of 0.5, 1, 2 and 4 mg/L all could inhibit the proliferative activity of A375 cells, and the inhibitory effects increased in a dose? and time?dependent manner(F = 2 564.12, 1 235.25, both P < 0.05). The percentage of autophagosome?positive cells and protein expression of Beclin?1 and LC3?Ⅱincreased gradually and significantly in the 1?, 2?and 4?mg/L tanshinone groups(autophagosome?positive cells: 6.91% ± 0.35%, 13.11% ± 0.73%, 25.51% ± 0.83%, respectively; Beclin?1: 0.33 ± 0.01, 0.53 ± 0.04, 0.63 ± 0.02, respectively; LC3?Ⅱ: 0.41 ± 0.01, 0.52 ± 0.02, 0.64 ± 0.02, respectively), after 48?hour treatment, which were significantly different between the tanshinone groups(all P<0.05), and higher in the tanshinone groups than in the control group(0.41%±0.02%;0.09 ± 0.02;0.21 ± 0.01, all P<0.05). However, the protein expression of PI3K, phosphorylated Akt(p?Akt), p?mTOR and p?p70S6K1 in the PI3K?Akt?mTOR?p70S6K1 signaling pathway decreased gradually and significantly with the increase in tanshinone concentrations after 48?hour treatment, and were significantly lower in all the tanshinone groups than in the control group (all P < 0.05). Conclusion Tanshinone ⅡA can promote the auophagy of A375 cells, likely by blocking the PI3K?Akt?mtTOR?p70S6K1 signaling pathway.

Objective To study the effects of pulsed radiofrequency(PRF)and radiofrequency thermocoagulation(RFTC)in the treatment of idiopathic infraorbital neuralgia.Methods 16 patients suffering idiopathic infraorbital neuralgia were randomly divided into PRF(n=8)and RFTC(n=8).Numeral rating scale(NRS),pain relief(PR)and effective rate of treatment was performed before operation and at 1 hour、1 st day、7th day、15th day、1 st month、3rd month and 6th month after operation.Results The preoperative and postoperative impedance of thefirst,second and third operation in RFTC group were(490±86)Ω and(424±82)Ω,(492±90)Ω and(432±84)Ω,(481±98)Ω and(409±85)Ω respectively and the postoperative impedance was significantly decreased(P＜0.05).The preoperative NRS in group PRF and RFTC were 9(7～10)and 8.5(7～10)respectively and the postoperative NRS at all points in two groups were significantly decreased as compared with the preoperative NRS(P＜0.05).The PR at 7 and 15d in group PRF were 3(0～4)and that in group RFFC were 4(3～4)(P＜0.05).There were no significant differences in effective rate of treatment at each time between two groups(P＞0.05).Numbness appeared after operation in group PRF and disappeared in a week,however,that was persistent and all sense disappeared in group RFTC.Conclusion Curative effect of PRF for idiopathic infraorbital neuralgia is as well as RFTC and it is a kind of safe and effective technology that causes less side effects.

Objective To evaluate the value of the periportal free air(PPFA) sign at computed tomography(CT) in distinguishing between upper and lower gastrointestinal(GI) tract perforation. Methods CT images of 62 patients with surgically proven GI tract perforation were retrospectively analyzed. 62 cases included upper and lower GI tract perforation in 35 cases and 27 cases,respective-ly. When there was free air in the periportal area,it was defined as positive periportal free air(PPFA) sign. The difference of PPFA sign in upper and lower GI tract perforation, and the sensitivity, specificity, positive predictive value, negative predictive value and ac-curacy of PPFA sign in diagnosing gastrointestinal perforation were analysed respectively. Results The PPFA sign was seen in 33 of 35(94%) patients with upper GI tract perforation,but only in 10 of 27 (37%) patients with lower GI tract perforation,there was sig-nificant difference between them(P<0.05). For diagnosis of super GI perforation with PPFA sign, the sensitivity, specificity, positive predictive value,negative predictive value and accuracy were 94% (33/35), 63%(17/27), 770%(33/43), 89%(17/19) and 81% (50/ 62), respectively. Conclusion The PPFA sign is a useful finding in distinguishing between upper and lower GI tract perforation.

Objective To investigate the relationship between human papilloma virus(HPV)infection and the development of laryngeal squamous cell carcinoma(LSCC).Methods To elucidate the role of HPV in the development of LSCC,we employed polymerase chain reaction(PCR)based on four pairs of primers an4 in situ hybridization(ISH)to screen the HPV infection in 84 ISCC tissues.Results Using HPV L1 general primer amplification,HPV DNA was detected in 23(27.4%)of the 84 LSCC samples.However,when specific primers for HPV-16 or-18 were used to amplify E6 and E7 in all samples,29 cases(34.5%)were positive for HPV-16,while 6 cases(7.1%)were positive for HPV 18.Coinfeetion of HPV-16 and-18 were found in 4cases (4.8%).Overall,HPV type 16 and 18 infections were present in 36.9% of the LSCC samples.In addition,the positive rate of HPV 16 E6 mRNA was 30.9%(26/84)in LSCC by ISH with digoxin-labeled sense probes of HPV 16 E6.Conclusion High-risk HPV-16may be an etiologic factor in the development of laryngeal squamous cell carcinoma, while the complicated molecular mechanism of HPV16 inducedtumorgenesis needs a further study.

〔Abstract〕 The paper introduces the characteristics, methods and achivements of regional health informatization construction of Luoy-ang health information security project, overviews the construction ideas of regional informatization, providing basis for future development and references for similar projects implementation.

OBJECTIVE To design a new draining method for near total thyroidectomy. METHODS Bilateral drainages were performed during near total thyroidectomy in 63 cases between December 1998 and July 2004.The bilateral drain incision for near total thyroidectomy was performed at the lower part of the neck.RESULTS All the draining operative procedures produced cosmetic scars and the drainage was effective.The mean amount of drainage was 38 ml(minimum 10 ml,maximum 120 ml)and no patients developed wound infection. Postoperative drain incision was limited under the clavicle,covered by the collar and left the patients satisfied with the results.There were no postoperative hematoma or seroma.CONCLUSION The bilateral drain incision for near total thyroidectomy placed at the lower part of the neck results in a cosmetic scar, which is easily covered by the collar and was safe and effective.

Objective:To evaluate the molecular diagnosis marker of papillary thyroid carcinoma (PTC),the relationship between lymphatic metastasis of central neck compartment PTC,and the opera-tion indication of prophylactic central neck dissection.Methods:We conducted a retrospective study, including 275 PTC patients and detected their BRAF mutation rates during 201 2 and 201 4 and explored the risk factors of the central node lymphatic metastasis by Logistic regression model.Results:Of the 275 PTC patients,224 (81 .5%)were female and 51 (1 8.5%)were male.BRAF mutational rates were 53.8% (1 48 /275)and lymphatic metastasis 57.8% (1 59 /275).Multivariate analysis showed calcifica-tion (ORadjusted =1 .47,95%CI:1 .1 0 -1 .98,P =0.01 ),tumor diameter (ORadjusted =1 .48,95%CI:1 .04 -2.30,P =0.048)and age (ORadjusted =1 .48,95%CI:1 .04 -2.30,P =0.048)were associa-ted with lymphatic metastasis.In stratified analysis,BRAF mutation (ORadjusted =3.1 9,95%CI:1 .1 8 -9.43,P =0.023 )in clear boarder group and BRAF mutation (ORadjusted =4.84,95% CI:1 .68 -1 3.84,P =0.003)in calcification group were more likely to have lymphatic metastases.Conclusion:Central neck metastasis takes up a high ratio in papillary thyroid cancer patients,BRAF mutation in pa-pillary thyroid carcinoma is a characteristic molecular event.Furthermore,patients with calcification un-der ultrasound detection,lower age group and longer tumor diameter are more susceptible to suffer central neck metastasis.Especially for stratified analysis,non-calcified BRAF mutation or BRAF mutation with clear border under ultrasound detection are more susceptible to suffer central neck metastasis,and radical prophylactic central neck dissection should be carried on for these patients.

Objective To explore the effect of preoperative local blocking with compound lidocaine hydrochloride (CLH) on postoperative pain of patients undergoing craniotomy.Methods40 patients suffered from superatentorial occupying lesion and scheduled for craniotomy were randomly divided into the CLH group and control group with 20 cases in each group. In the CLH group, local blocking with CLH was performed just before craniotomy, while in control group local blocking with 0.5% procaine was performed preoperatively and all patients of two groups used patient-controlled intravenous analgesia (PCIA) with fentanyl postoperatively. Postoperative pain was assessed for 48 hours according to visual analogue scale (VAS), and the comparison of analgesia-related postoperative complications of the two groups was demonstrated.ResultsThere was no significant difference in VAS postoperatively and incidence rate of complications between two groups ( P>0.05).ConclusionCompound lidocaine hydrochloride local infiltration may provide a safe and effective analgesia for postoperative pain in patients after craniotomy.