Objective To evaluate the feasibility of combining the sedation performed by propofol targeted concentration in-fusion with epidural anesthesia in patients undergoing total pelvic floor reconstruction.Methods A total of 80 eligible patients were recruited and were assigned randomly into the study group(n=40)and the control group(n=40).All patients in both groups were administered epidural anesthesia with the puncture and catheter placing in the space between the 2nd-3rd lumbar vertebras.After the epidural anesthesia,patients in the study group were administered propofol by targeted concentration infusion (TCI)system. The plasma concentration of propofol was modulated to obtain the BIS maintaining between 65-80,and the OAA/S maintaining at 3 scores.The propofol was continuously infused until closing the incision.Values of HR,MAP at different time points in the opera-tion were recorded,and the plasma concentrations of propofol,the incidences of adverse events were recorded.Results The HR and MAP of patients in the study group decreased at T1 (given the anesthetic),T2 (the beginning of the operation),T3 (the beginning of the operation),compared with those at T0 (before the anesthetic)and T4 (30 min after the operation)(P <0.05).The HR and MAP of patients in the control group elevated at T2 ,T3 ,compared with those at T0 and T4 (P <0.05).The HR of study group at T1 ,T2 , T3 and the MAP at T2 were lower than those in control group.In study group,two asphyxia patients were founded.The incidence of shivering in the study group was lower than that in control group (P =0.014).No statistical difference was found in the incidences of other adverse event between this two groups (P >0.05).BIS of study group was (73.3 ±4.8)-(76.1 ±3.4),and the plasma concentrations of propofol was(1.32 ± 0.29 )μg/mL - (1.52 ± 0.26 )μg/mL.Conclusion The combination of propofol sedation performed by TCI and epidural anesthesia could be safely and effectively used in patients undergoing total pelvic floor reconstruc-tion.

Objective To explore the impact of laparoscopic surgery and that of open surgery on the coagulation function and incidence of deep venous thrombosis(DVT) in lower limbs in patients undergoing hysterectomy .Methods From April 2014 to A‐pril 2015 ,110 eligible patients were recruited .There was 57 patients received laparoscopic surgery ,and 53 patients received open surgery for hysterectomy .All patients underwent surgery under the general anesthesia .The APTT ,PT ,FIB ,and D‐dimer was de‐tected at 5 time points:before surgery ,surgery completion ,24 h after surgery ,48 h after surgery ,and 72 h after surgery .All patients were scheduled to ultrasound exam in lower limbs to detect the DVT at 24 ,48 and 72 h after surgery .Results Both groups showed decreased PT at surgery completion as compared with other time points (P<0 .05) ,decreased APTT at surgery completion and 24 h after surgery as compared with other time points(P<0 .05) ,and increased FIB at surgery completion and 24 h after surgery as compared with other time points(P<0 .05) .No significant difference was found in APTT ,PT ,and FIB at each time points between two groups(P>0 .05) .Both groups showed increased D‐dimer after surgery compared with that before surgery ;the laparoscopic group showed higher D‐dimer at 24 h after surgery ,and lower D‐dimer at 48 h after surgery than open group(P<0 .05) .The inci‐dence of DVT in laparoscopic group and open group was 14 .04(8/57) and 5 .66% (3/53) ,respectively ,with no significant difference between two groups(P>0 .05) .Conclusion Both the laparoscopic surgery and open surgery will activate the coagulation system , and lead to DVT ;as compared with open surgery ,the laparoscopic surgery could not reduce the incidence of DVT in lower limbs in patients undergoing hysterectomy .

Objective To explore the role of MKK34 (a peptide spanning a C-terminal α-helical region in TSLP) on airway inflammation and β-catenin of airway epithelium in a HDM-induced mouse asthma.Methods 32 male BALB/c mice were randomly divided into control,MKK34,asthma and MKK34 + HDM groups.The mice in the asthma group were exposed to HDM for five consecutive days and the MKK34 + HDM group was pretreated with MKK34 1 h prior to the HDM intranasally treated.After 8 weeks' treatment,animal lung function test and pathological staining were performed to evaluate the asthma situation,IL-4,IFN-γin bronchoalveolar lavage fluid and IgE in the serum were detected,immunohistochemistry and western blot were used to assess β-catenin and p-ERK,t-ERK levels.Results Airway reactivity,IL-4 and IgE in the asthma group were significantly higher than that in the control group.Treatment with MKK34 significantly decreased airway hyperresponsiveness,IL-4 and IgE.HE staining demonstrated the chronic bronchitic inflammation in the lungs of asthma group.β-catenin in the control group was distributed evenly at the cytomembrane of epithelial cells.In the asthma group,β-catenin was disordered in epithelial cells and its expression was decreased.Treatment with MKK34 ameliorated the damage of β-catenin and chronic bronchitic inflammation.The protein levels of p-ERK1/2 increased obviously in the asthma group.The pretreated group significantly decreased the expression of p-ERK1/2.Conclusions MKK34 can ameliorate the airway inflammation and the destruction of β-catenin of airway epithelium in a HDM-induced mouse asthma.The ERK pathway may play a role in this process.

Objective To investigate the changes in plasma very long chain fatty acids (VLCFAs),and to explore its relationship with obesity-related index in obese children.Methods One hundred and sixty-six obese children aged 7 to 12 years old were investigated and 148 health children matched with age and sex were selected as control group.Their height,weight,and waist circumference (WC) were measured.The percentage of body fat (PBF) was tested by dual-energy X-ray absorptiometry.Fasting blood triglycerides (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C) levels,fasting plasma glucose,and fasting insulin (FINS) were determined.The body mass index (BMI),BMI-Z score,waist to height ratio (WHtR),and homeostasis model assessment for insulin resistance (HOMA-IR) were calculated.The plasma VLCFAs were analyzed by gas chromatography-mass spectrometry.Results (1) Compared with normal control children,body weight,BMI,BMI-Z score,WC,WHtR,PBF,TG,TC,LDL-C,FINS,and HOMA-IR in obese children were increased (all P ＜ 0.05),and the level of HDL-C was decreased (P ＜ 0.05).(2) The plasma levels of docosamonoenoic acid (C22 ∶ 1 n-9) and arachidonic acid (C20 ∶ 4n-6) were decreased while the levels of arachicacid (C20 ∶ 0) and eicosapentaenoic acid (C20 ∶ 5n-3) increased in obese children compared to non-obese children.(3) The linear correlation analysis showed that PBF was positively correlated with C20 ∶ 0 and C20 ∶ 5n-3,and negatively correlated with C20 ∶ 4n-6.WHtR was negatively correlated with C22 ∶ 1 n-9 and positively correlated with C20 ∶ 0 (4) The multiple stepwise regression analysis showed that C20 ∶ 0 was the main factor for PBF,and C22 ∶ 1 n-9 and C20 ∶ 0 were the main factors for WHtR.Conclusion The metabolic abnormality of plasma very long chain fatty acids exists in obese children.The changes in C20 ∶ 0,C22 ∶ 1 n-9,and C20 ∶ 5n-3 may be associated with obesity in children.

Objective To explore the clinical efficacy and drug-toxic reactions of raltitrexed combined with oxaliplatin (RALOX protocol) and 5-fluorouracil + calciumfolinate + oxaliplatin (FOLFOX 4 protocol) in the treatment of patients with middle and advanced primary liver cancer (PLC).Methods A total of 72 patients with PLC were selected and randomly divided into RALOX group (n =34) and FOLFOX 4 group (n =38).The objective response rate (RR) was evaluated every 6 weeks after chemotherapy,while objective remission rate (OR),disease-control rate (DCR),median survival rate (mOS),median progression-free survival (mPFS),1-year survival rate (SR) as well as toxic and adverse reactions were observed.Results In RALOX group,31 patients were evaluable,with OR,DCR,mOS,mPFS,and 1-year SR being 19.4％,51.6％,7.2 months,3.4 months,and 22.6％,respectively.In FOLFOX 4 group,29 patients were evaluable,with OR,DCR,mOS,mPFS,and 1-year SR being 13.8％,48.3％,6.9 months,3.3 months and 20.7％,respectively.RALOX group was significantly lower than FOLFOX 4 group in the incidence rates of gastrointestinal reactions,liver toxicity,cardiac toxicity,peripheral nervous toxicity and hand-foot syndrome,but there were no significant differences in the incidence rates of renal toxicity and myelosuppression between two groups.Conclusion RALOX is safe and effective in the treatment of patients with middle and advanced PLC,and is superior to FOLFOX 4 protocol in clinical efficacy with mild adverse reactions.

Objective To explore the clinical efficacy and drug-toxic reactions of raltitrexed combined with oxaliplatin (RALOX protocol) and 5-fluorouracil + calciumfolinate + oxaliplatin (FOLFOX 4 protocol) in the treatment of patients with middle and advanced primary liver cancer (PLC).Methods A total of 72 patients with PLC were selected and randomly divided into RALOX group (n =34) and FOLFOX 4 group (n =38).The objective response rate (RR) was evaluated every 6 weeks after chemotherapy,while objective remission rate (OR),disease-control rate (DCR),median survival rate (mOS),median progression-free survival (mPFS),1-year survival rate (SR) as well as toxic and adverse reactions were observed.Results In RALOX group,31 patients were evaluable,with OR,DCR,mOS,mPFS,and 1-year SR being 19.4％,51.6％,7.2 months,3.4 months,and 22.6％,respectively.In FOLFOX 4 group,29 patients were evaluable,with OR,DCR,mOS,mPFS,and 1-year SR being 13.8％,48.3％,6.9 months,3.3 months and 20.7％,respectively.RALOX group was significantly lower than FOLFOX 4 group in the incidence rates of gastrointestinal reactions,liver toxicity,cardiac toxicity,peripheral nervous toxicity and hand-foot syndrome,but there were no significant differences in the incidence rates of renal toxicity and myelosuppression between two groups.Conclusion RALOX is safe and effective in the treatment of patients with middle and advanced PLC,and is superior to FOLFOX 4 protocol in clinical efficacy with mild adverse reactions.

Objective To investigate the content of thorium (Th) in surface water in Sichuan Province, China, and to evaluate Th-associated health risk via water intake for residents. Methods Twenty-three monitoring sections were set in main surface water bodies in Sichuan Province. From 2016 to 2021, the Th radioactivity level in the water bodies was measured during dry and normal-water seasons. The health risk of residents was evaluated by calculating radioactive Th intake from the surface water bodies combined with the use of a health risk assessment model. Results The Th radioactivity level of the surface water bodies in Sichuan Province was 0.02-0.67 μ./L. There was no significant difference in the Th radioactivity level of different years or different surface water bodies (P > 0.05). A significant difference was observed in the Th radioactivity level of different water seasons (P < 0.05). The total mean annual committed effective doses of Th in all age groups caused by drinking water and water immersion ranged from 3.14 × 10⁻⁸ to 8.75 × 10⁻⁷ Sv, all lower than the World Health Organization (WHO)-recommended reference level of 0.1 mSv. The overall carcinogenic risks for residents in all age groups ranged from 3.93 × 10⁻¹⁰ to 1.09 × 10⁻⁸, all below the most rigorous control limits issued by WHO and International Commission on Radiological Protection. Conclusion The Th-associated health risk via direct water intake and water immersion in main surface water bodies of Sichuan Province is at an acceptable level. Th in main surface water bodies of Sichuan Province is safe for all age groups.