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Objective To observe the sedative and analgesic effects of local anesthesia with midazolam and sufent-anil for patients in ophthalmologic plastic surgery. Methods A total of 160 patients (ASA I-II) were randomly divided into two group using a random number table, 80 cases in each group, groupⅠ: local anesthesia and groupⅡ: local anesthesia with midazolam (0.05 mg/kg) and sufentanil (0.1μg/kg). Values of bispectral index (BIS), systolic blood pressure (SBP), dia-stolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), oxyhemoglobin saturation(SpO2) and visual analogue scale (VAS) were recorded after patients entered into the operating room, during the time of injection of local anesthesia, at the beginning of the procedure, 20 min after the surgery and after operation. It was also recorded including hypoxemia, ap-noea, restlessness, nausea and vomiting and the duration of surgery. Results There were no significant differences in age, gender, weight and duration of surgery between two groups of patients. There was a significantly lower BIS value before inject-ing local anesthesia, at the beginning of the surgery and 20 min after the surgery compared with that of time point that pa-tients entered into the operating room in groupⅡ(P<0.05). In groupⅠthere were significantly higher values of SBP, DBP and HR during the injection of local anesthesia, at the beginning of the procedure, 20 min after the beginning of the proce-dure and after the surgery than those of time point that patients entered into the operating room;the value of RR was signifi-cantly increased during the injection of local anesthesia, at the beginning of the procedure and 20 min after the beginning of the procedure than that of time point that patients entered into the operating room (P<0.05). Compared with before anesthe-sia induction, values of SBP, DBP, HR and RR were significantly decreased in groupⅡ(P<0.05). There were significantly lower levels of SBP, DBP, HR and RR during the local anesthesia injection to the time after surgery in groupⅡthan those of groupⅠ. The value of VAS was significantly higher during the time of injection of local anesthesia and during the surgery in groupⅠthan that of groupⅡ(P<0.05). There were 15 patients with restlessness in group I, which were higher than those of groupⅡ(3 patients with restlessness). There were 3 patients with nausea and 3 patients with anoxemia and no apnea in group Ⅱ. Conclusion The conscious sedation with midazolam and sufentanil is an effective anesthetic technique for patients in ophthalmo-logic plastic surgery.

[Objective]To explore the treatment effect of acute Lisfranc fracture-dislocations by cannulated screw fixation.[Method]From February 2001 to August 2005,21cases of acute Lisfranc fracture-dislocations were treated with open reduction and cannulated screw fixation.[Result] According to the AOFAS for mid foot,1 case scored 70 to 80,3 cases scored 80 to 90 and 17 cases scored 90 to 100.[Conclusion]Treatment effect of acute Lisfranc fracture-dislocations by cannulated screw fixation in early stage can lead to satisfactory reduction and clinical results,it is a satisfying method.

Objective To study the role of early intravenous nutrition given aggressively combined with early minimal feeding on very low birth weight infants (VLBWI),and to evaluate the clinical value of intestinal barrier protein and MicroRNA.Methods All of 62 cases of VLBWI admitted in NICU,the Maternal and Child Health Hospital of Nantong Affiliated to Nantong University from January 2006 to June 2014 were recruited.Sixty-two VLBWI were randomly divided into group A and group B.Thirty infants in group A were exposed to conventional intravenous nutrition.Thirty-two infants in group B were treated with early intravenous nutrition aggressively combined with early minimal feeding.The time of birth weight recovery,days with intravenous nutrition,hospital stay and complications were recorded.The liver and kidney functions,electrolytes,blood gas analysis were monitored.Enzyme-linked immunosorbent method was used to detect intestinal fatty acid binding protein (Ⅰ-FABP),an intestinal barrier protein in plasma.Infection related MicroRNA155 was detected with fluorescent quantitative polymerase chain reaction (RT-PCR).Results Group B was superior to group A in weight loss after birth [(13.70 ± 3.10) ％ vs (5.46 ± 2.64) ％,P ＜ 0.05],shorter recovery time of body weight [(12.20 ± 3.38) d vs (6.82 ± 3.20) d,P ＜ 0.05],fewer days with intravenous nutrition [(29.62 ± 4.16) d vs (20.80 ± 3.20) d,P ＜ 0.05] and shorter hospital stays [(44.60 ± 6.32) d vs (28.91 ± 4.36) d,P ＜ 0.05].Compared with group A,the infants in group B had less complications,including hyperbilirubinemia (31.2％ vs 56.7％),extrauterine growth retardation (34.3％ vs 73.3％),cholestasis (6.2％ vs 23.3％),feeding intolerance (15.6％ vs 53.3％) and necrotizing enterocolitis (0 vs 16.7％) (all P ＜ 0.05).Although Ⅰ-FABP had a higher plasma concentration in group A than that of group B [(9.083 ± 1.059) μg/L vs (7.563 ± 0.739) μg/L],the difference was not significant (t =1.190,P =0.076 4).However,the plasma levels of Ⅰ-FABP in infants with necrotizing enterocolitis were significantly higher than those of group B [(19.500 ± 3.510) μg/L vs (7.563 ±0.739) μg/L,t =5.231,P =0.035 0].The expression of MicroRNA155 in group A was markedly higher than that of group B (2-△△ct were 0.81 ± 0.12 and 0.24 ± 0.08,respectively,P ＜ 0.05).Conclusions Giving aggressive intravenous nutrition early combined with early minimal feeding was safety and effective to VLBWI,which was of benefit to their growth and development,reducing complications and shorting hospital stays.The detection of intestinal barrier protein Ⅰ-FABP and MicroRNA155 is useful for monitoring feeding complications of VLBWI.

Objective To evaluate the predictive performance of propofol target-controlled infusion (TCI) system incorporating the Schnider pharmacokinetic parameters in Chinese patients. Methods Forty ASA Ⅰ or Ⅱ patients, aged 25-45 yr, with body mass index 20-25 kg/m2 , scheduled for gynecological laparoscopic surgery un der general anesthesia, were enrolled in this study. Anesthesia was induced with TCI of propofol (target plasma concentration (Cp) 3 μg/ml) and remifentanil (Cp 4 ng/ml) . Propofol was infused by Orchestra TCI system incorporating the Schnider pharmacokinetic parameters. Tracheal intubation was facilitated with rocuronium 0.6 mg/kgafter the patients lost consciousness. The patients were mechanically ventilated. PETCO2 was maintained at 30-40 mm Hg. Anesthesia was maintained with TCI of remifentanil (Cp 4 ng/ml) and propofol (Cp 3-5 μg/ml) and intermittent iv boluses of atracurium 0.2 mg/kg. BIS value was maintained at 40-45. Venous blood samples were obtained at 15, 30, 45 and 60 min after pneumoperitoneum for measurement of blood propofol concentrations by high performance liquid chromatography with fluorescence detector. Performance error, median prediction performance error, median absolute performance error, wobble and divergence of propofol TCI system were calculated. Results The value for performance error was 21 % (13%), for median prediction performance error 6.7 % (37.4%),for median absolute performance error 19% (18%), for divergence - 0.65%/h (0.82%/h) and for wobble 16.3% (15.2% ) . Conclusion The accuracy of propofol TCI system incorporating the Schnider pharmacokinetic parameters is high in Chinese patients and its predictive performance is acceptable clinically.

ObjectiveTo explore the clinical and pathological features of Hainan patients with thyroid carcinoma treated in Hainan Provincial People' s Hospital.Methods A total of 239 clinical cases of Hainan patients with thyroid carcinoma treated in Hainan Provincial People' s Hospital from 2006 to 2010 were retrospectively analyzed.Results The number of thyroid carcinoma cases between 2006 to 2008 was stable.But the cases in 2009 were 72.97％ higher than that in 2008.Female' s peak of onset age was 25 to 55 years and male was 20 to 55 years.The cases of Hant were 231 (96.65％) and the national minority were 8(3.35％ ).So ethnic composition ratio between cases and local population has a very significant difference (x2 =21.376,P ＜0.01 ).The eastern and western regions had 175 cases and 64 cases respectively,138 (78.86％) and 34(46.88％ ) cases from city respectively.Urban and rural ratio between eastern and western areas had a significant difference (x2 =4.420,P ＜ 0.05 ).The 239 cases were composed of 228 cases (95.4％) of papilarry thyroid carcinoma,7 cases (2.92％) of medullary thyroid carcinoma,both 2 cases (0.84％) of follicular thyroid carcinoma and anaplastic thyroid carcinoma.Conclusions The incidence of Hainan nationality patients with thyroid carcinoma treated in Hainan Provincial People' s Hospital has increased from 2006 to 2010,with younger trend and regional difference.Thyroid carcinoma has a difference in race and region.The rank of the rate of pathological type is papillary thyroid carcinoma,medullary thyroid carcinoma,follicular thyroid carcinoma,undifferentated thyroid carcinoma in order.

Objective To investigate the expression of protein kinase CK2α in thyroid carcinoma SW579 cells and its significance.Methods SW579 cells and Hacat cells were cultured in vitro and the expression levels of protein kinase CK2α mRNA and protein in SW579 cells and Hacat cells were measured by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.Moreover,CK2 activity was also measured.Results It was showed that the mRNA (0.92 ±0.01 vs 0.52 ±0.02,t =19.24,P ＜0.01)and protein(0.98 ±0.01 vs 0.37 ±0.02,t =24.14,P ＜0.01) expression of protein kinase CK2αwere significantly stronger in SW579 cells relative to Hacat cells.Conclusions Formation and development of thyroid carcinoma may be in connection with the overexpression of protein kinase CK2α.

Background and purpose:Histological grade of DCIS is an important factor in the prognosis, high nuclear grade have higher inifltration trend and recurrence rate. This study aimed to evaluate the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast, then analyze its relations with nuclear grade. Methods:Of the 94 patients, 97 lesions were proved DCIS by pathology. The morphology, maximum size, time-intensity curve of lesion were recorded or measured. Statistic was performed to identify MR imaging features that optimally discriminated HNG from non-HNG DCIS. Results:There were 49 non mass-like enhancement lesions, and 48 masses enhancement lesions. Among 49 non mass-like lesions, 29 were segmental enhancement (59.18%). Dynamic enhanced performance:50 exhibited plateau curves and 27 were washout curves. BI-RADS categories:22 BI-RADS 4A, 19 BI-RADS 4B, 29 BI-RADS 4C, and 27 BI-RADS 5. HNG lesions exhibited larger mean maximum lesion size (non-mass-like enhancement: P=0.01; mass: P=0.03), time- intensity curve was variable to approach signiifcance (P=0.01), and BI-RADS can help to discriminate the nuclear grade (P=0.02). There were no differences in lesion morphology (P>0.05). Conclusion:The preliminary ifndings suggest that DCE MR imaging features may aid in identifying patients with high risk DCIS.

Objective To explore the role of chemokine CCL18 in the occurrence and development of children allergic diseases. Methods The serum levels of CCL18 in 87 children cases of allergic asthma,64 cases of allergic rhinitis,46 cases of allergic con-junctivitis and contemporaneous 50 health students with physical examination as the control group were measured by ELISA and re-measured after 6-month treatment.The detection results were statistically analyzed with combining the clinical related detection data by adopting SPSS18.0 statistical software and t-test.Results The serum levels of CCL18 in the children allergic asthma,allergic rhinitis and allergic conjunctivitis groups were remarkably higher than those in the control group with statistical differences(P <0.05);the levels of CCL18 in the severe groups were remarkably higher than those in the mild and moderate groups with statistical difference(P <0.05);the levels of CCL18 after 6-month treatment in 3 groups were significantly decreased compared with before treatment with statistical difference(P <0.05).Conclusion The serum level of CCL18 is significantly associated with the severity of illness and significantly decreased after treatment,which indicating that the CCL18 detection has the important value in the diag-nosis,severity evaluation and treatment effect monitoring of children allergic diseases.

Objective To explore the clinical value of high‐sensitive troponin I detection in the diagnosis of early myocardial inju‐ry .Methods Totally 240 type 2 diabetes mellitus (T2DM ) patients (study group) and 40 healthy people(healthy control group) were chosen as subjects .The serum level of HbA1c ,AST ,CK ,CK‐MB and hs‐cTnI were measured among the two groups ,respec‐tively .Results Hs‐cTnI level in T2DM group was significantly higher than in healthy control group(P< 0 .05) ,and AST ,CK and CK‐MB levels in two groups had no significant difference(P> 0 .05) .Hs‐cTnI level and positive rate in HbA1c ≥ 6 .5% group was significantly higher than in HbA1c ≤ 6 .4% group(P< 0 .05) ,and no significant difference of AST ,CK and CK‐MB levels and posi‐tive rate were observed in two groups(P> 0 .05) .There was a positive correlation between the level of HbA1c and that of serum hs‐cTnI in T2DM group(r= 0 .471 ,P< 0 .05) .Conclusion The hs‐cTnI level detection has important clinical value in the diagnosis of early myocardial injury in T2DM patients ,and HbA1c is positively correlated with hs‐cTnI .