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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 explore the clinical application value of the detection of sIgE and sIgG4 in children with allergic asthma and allergic rhinitis .Methods The levels of sIgE and sIgG4 of allergic asthma group (n=85) ,allergic rhinitis group (n=72) and control group (n=60) were respectively detected by ELISA .The diagnostic efficiency of sIgE and sIgG4 were analyzed by using ROC curve .Results Before treatment ,the serum levels of sIgE and sIgG4 of allergic asthma group and allergic rhinitis group were remarkably higher than those of control group (P< 0 .01) .After 6 -month treatment ,the serum sIgE levels of allergic asthma group and allergic rhinitis group significantly decreased ,and the serum sIgG4 levels significantly increased (P< 0 .01) .For the combined detection of sIgE and sIgG4 ,the diagnostic sensitivities of allergic asthma and allergic rhinitis were 90 .6% (77/85) and 84 .7% (61/72) respectively ,and the diagnostic specificities of allergic asthma and allergic rhinitis were 81 .2% (69/85) and 76 .4%(55/72) respectively .Conclusion The serum sIgE and sIgG4 are good indicators for the diagnosis of allergic diseases .

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.

PurposeArtifacts of metal implantation severely affect image quality of CT or MRI examination, which restricts the display of local soft tissue lesions after orthopaedic surgery. This study aims to explore the application value of ultrasound examination in local soft tissue lesions after metal implant surgery.Materials and Methods Seventy patients with metal implantation after various orthopedic surgeries received US examination, and such sonographic features were recorded as lesion morphology, size, internal echo, edge, with/without capsule and calcification, and blood flow. Moreover, the clinical and radiologic data of patients like X-ray, CT and MRI were compared with the US results so as to determine the sensitivity of ultrasonic examination.Results The peripheral nerve injury might lead to thickened swelling and echo reduction. Ultrasonography revealed 20 cases of hematoma formation, 5 cases of abscess, 5 cases of pseudoaneurysm, 3 cases of myositis ossificans, 15 cases of bone tumor recurrence and 12 cases of peripheral nerve injury in operative region. Compared with the clinical results , the sensitivity, specificity and accuracy of ultrasound diagnosis of the study reached 89.4%, 75.0% and 88.6%, respectively, which were signiifcantly higher than those of X-ray, CT and MRI (χ2=78.642, 46.596 and 61.371,P<0.01). The ultrasonic results showed that most hematomas had clear boundary with homogenous echo inside to echo-free zone. Abscesses mostly displayed cystic or hybrid echo with floatable intracavitary pus spots echo, and no blood flow signal existed in the central area of color Doppler. Pseudoaneurysm in the US showed cystic mass around artery, blood flow rotating in capsule, and the typical two-stage bi-spectrum signal in the neck of capsule. Myositis ossiifcans showed intramuscular irregular hyperecho with acoustic shadow. When bone tumor recurred, US showed hypoechoic soft tissue mass with moth-eaten bone destruction, and blood flow signals within the mass were often detected.Conclusion Ultrasonography has relatively high accuracy in observing soft tissues around metal implantation, which can be used as a premier method.

Objective To study the effectiveness of subfascial endoscopic communicating branch vein ablation in treating communi cating branch vein insufficiency.Methods Fifty-seven cases of primary lower ext remity vein valve insufficiency complicated by communicating vein insufficiency diagnosed by venography and color duplex were treated with subfascial endoscopic communicating branch vein ablation, and their information was analyzed retrosp ectively.Results Swelling was observed in leg of 7 cases after operation, and disappeared within one week spontaneously. Incision infec tion occurred in 2 cases and skin ambustion happened in 2 cases. Superficial vei n varicosis disappeared in all case, skin pigmentatin declined significantly and ulcers healed in 2-3 weeks.Conclusion Subfascial endoscopic communicating branch vein ablation is an excellent choice in treating communicating branch ve in insufficiency.

Objective To investigate the interaction between uropathogenic Escherichia coli (UPEC) and host uroepithelial cells, define the role uroepithelial cells play in initiating and modulating the host response to infection with UPEC strain. Methods The human bladder transitional epithelial EJ cells were evaluated for their capacities to allow the adherence and invasion by UPEC132, a clinical strain isolated from Tianjin, China, and a cDNA microarray for 22 000 human genes was used to identify the gene expression differences between EJ cells infected with UPEC132 and uninfected EJ cells. Results Microscope observation showed that UPEC132 could adhere to EJ cells with the adherence rate of (73.20 ± 5.26)%. And visualization by confocal microscope revealed that this microorganism could be seen within the cells. EJ cells infected with UPEC132 changed mRNA expression of a total of 29 genes, including 28 genes up-regulated and 1 gene down-regulated. Of these, regulators of growth and proliferation, cytokines, and modulators of apoptotic responses were the most prominent. Conclusion The gene expression profiling of EJ cells is affected by the infection of UPEC strain. The differentially expressed genes may contribute to further investigate the interaction of UPEC and uroepithelial cells.

Objective To evaluate the effect of ecoimmunonutrition on maintenance of the mucosal barrier function in pigs with severe acute pancreatitis(SAP).Methods Twenty pigs were injected with5% sodium taurocholate and trypsin into the pancreatic duct to establish SAP models.Twenty four hours later,18 suvival pigs were randomly given parenteral nutrition(PN group,n=6),elemental enteral nutrition(EEN group,n=6),or ecoimmunonutrition(EIN group,n=6)for 8 days.The serum amylase,endotoxin and intestinal permeability were determined on different times.All pigs were sacrificed 8days later,and their venous blood,mesenteric lymph nodes(MLN),liver,lung,spleen and pancreas specimens were cultured quantitatively and qualitatively with standard techniques.The morphology of small bowel was observed and pathological changes of the pancreas was analyzed.Results Serum amylase of all groups were obviously elevated,but there was no significant difference among them(P＞0.05).The plasma endotoxin and intestinal permeability were lower in EIN group[(1.50±0.18)EU/L and(42.8±20.0)×10-3 respeetively]compared to EEN group[(1.98 4±0.20)EU/L and(67.4±23.0)×10-3 respectively]and PN group[(3.96±0.40)EU/L and(197.2±47.4)×10-3.respectively](all P value＜0.05).The incidence and the magnitude of bacterial translocation in EIN group were lower than those in PN and EEN groups.However,the ileum mucosa thickness,villus height,crypt depth and the rate of the normal intestinal villi in EIN group were(398.27±52.93)μm,(269.72±41.66)μm,(681.98±58.33)μm and 79%,respectively,but in PN group were(218.32±35.81)μm,(145.76±23.34)μm,(376.20±48.23)μm and13%,respectively and in EEN group were(305.70±42.72)μm,(192.52±38.17)μm,(507.31±68.23)μm and 47%,respectively.Conclusions EIN can maintain the integrity of intestinal mucosal barrier and decreasing intestinal bacterial and endotoxin translocation in SAP pigs.