ObjectiveTo compare inhalational anesthesia with sevoflurane and intravenous anesthesia with propofol-sufentanil in patients undergoing gynecological outpatient surgery.MethodsOne hundred and forty ASA Ⅰ or Ⅱ patients,aged 18-35 yr,weighing45-65 kg,undergoing outpatient painless abortion,were randomly divided into 2 groups ( n =70 each):intravenous anesthesia with propofol-sufentanil group (group Ⅰ ) and inhalational anesthesia with sevoflurane group (group Ⅱ ).In group Ⅰ,sufentanil 0.2 μg/kg was injected intravenously,and 1％ propofol was infused at 2-3 mg·kg-1 ·min-1,followed by a rate of 3-4 mg·kg-1 ·h-1 after loss of eyelash reflex.In group Ⅱ,8％ sevoflurane was inhaled and the oxygen flow rate was 6 L/min,and after loss of eyelash reflex,the oxygen flow rate was adjusted to 3 L/min,and the concentration of sevoflurane was adjusted to 2％-3％.The time of induction of anesthesia,emergence time,operation time,intraoperative hypoxemia,body movement and related adverse events were recorded.ResultsCompared with group Ⅰ,the time of induction of anesthesia was significantly prolonged,the incidence of agitation,nausea and vomiting was significantly increased,and the incidence of sexual hallucinations was significantly decreased ( P ＜ 0.05),while no significant change was found in the operation time,emergence time,and incidence of shivering,intraoperative hypoxemia and body movement in group Ⅱ ( P ＞ 0.05 ).ConclusionIntravenous anesthesia with propofol-sufentanil is more helpful in improving the quality of emergence from anesthesia and more suitable for gynecological outpatient surgery than inhalational anesthesia with sevoflurane.

Objective To compare the efficacy and side effects of S-1 combined with oxaliplatin and capecitabine combined with oxaliplatin in treatment of advanced gastric cancer. Methods From Mar 2011 to Dec 2014, the data of 93 cases with gastric cancer in Zhengzhou Peopleˊs Hospital were studied retrospectively. 48 cases treated by S-1 combined with oxaliplatin (SL group) and 45 cases treated by capecitabine combined with oxaliplatin (XL group). The patients of SL group received S-1 80 mg·m-2·d-1, bid, po, d1-14, L-OHP 130 mg/m2, ivgtt, 2 hours, d1. The patients of XL group received capecitabine 2 000 mg·m-2·d-1, bid, po, d1-14, L-OHP 130 mg/m2, ivgtt, 2 hours, d1. The course was 21 days in two groups. The efficacy and side effects were evaluated after two courses. Results The efficacy rates of SL and XL group were 52.08 % (25/48) and 53.33 % (24/45), respectively there was no significant difference (P > 0.05). The incidence rate of gastrointestinal reaction in SL group was obviously higher than that in XL group [52.08%(25/48) vs 24.44%(11/45), P<0.05]. The incidence rate of oral mucositis in SL group was significantly lower than that in XL group [25.00 % (12/48) vs 51.11 % (23/45), P< 0.05]. Conclusion Both S-1 combined with L-OHP and capecitabine combined with L-OHP for gastric cancer treatment are safe and effective.

Objective To investigate the intervention effect of ketogenic diet (KD) on neurobehavioral demages after flurothyl-induced recurrent neonatal seizures in rats and on the expression of ApoE.Methods Postnatal day 8 (P8) SD rats (quantity:48) were randomly divided into two groups:the non-seizure group (NS group,n =24) and the recurrent-seizure group (RS group,n =24).From P9,rats in RS group were subjected to recurrent seizures induced by volatile flurothyl 30 min each day for consecutive 8 days.While rats in NS group were placed into the container for an equal amount of time to their counterpart without exposuring to flurothyl.At P28,each group was divided into two groups again:non-seizure and normal diet group(NS + ND group,n =12),non-seizure and ketogenic diet group(NS + KD group,n =12),recurrent-seizure and normal diet group (RS + ND group,n =12),recurrent-seizure and ketogenic diet group(RS + KD group,n =12).At P42,neurodevelopmental indicators were monitored.ApoE protein levels in cerebral cortex were determined by western blot at P58.Results Neurodevelopmental indicators were analyzed at P42:in the plane righting experiment,the rats of group NS + ND (1.0 ±0.14) about the time of plane righting was significant different comparing with group RS + ND ((0.75 ±0.32) s) (P ＜ 0.05).There was no significant difference between group RS + KD and group RS + ND about the time of plane righting(P＞ 0.05).In the negative geotaxis reaction experiment,the rats of groups NS + KD and RS + ND((3.17 ± 0.58)s,(6.75 ± 0.75)s) about the time of negative geotaxis reaction were significant different comparing with group NS + ND ((1.58 ±0.52)s) (P＜0.05).Compared with group RS + ND,the group RS + KD in the time of negative geotaxis reaction was obviously shortened (P ＜ 0.05).In the cliff avoidance test,there were significant differences between group NS + ND、RS + KD ((5.75 ± 2.90) s,(9.50 ± 4.36) s) and group RS + ND ((14.00 ± 4.79) s) about the time of cliff avoidance (P ＜ 0.05).In western blot,the expression of ApoE in cerebral cortex in the RS + ND group (1.26 ± 0.30) was obviously increased compared with group NS + ND (0.78 ±0.12) (P＜0.05),and there had also significant difference between group RS + KD (0.89 ±0.10) and group RS + ND (P ＜ 0.05).Conclusion The neuroprotective effects of ketogenic diet on recurrent neonatal seizure-induced neurobehavioral demages may be associated with the reduction of ApoE in cerebral cortex.

Objective To compare the effect of routine ketogenic diet and every other day ketogenic diet on neurobehavioral damage induced by recurrent seizures in neonatal rats.Methods 48 postnatal day 8 (P8) SD rats were randomly divided into four groups with 12 in each group:the control group (CONT),the recurrent seizure group(RS+ND),recurrent seizure + routine ketogenic diet group(RS+KD) and recurrent seizure+ every other day ketogenic diet group(RS+KOD).The recurrent seizures model was induced by flurothyl at p9 and last for 8 days.After a day of fasting the postnatal 28 day rats were placed on either ordinary or ketogenic diet according to packet design.Plane righting experiment,cliff avoidance test and negative geotaxis test were used to assess the neurobehavioral performance at p35.Results (1) Plane righting experiment:the plane fighting time of RS+ ND group ((0.17±0.39) s) was significantly shorter than that of NS+ND group ((0.67 ±0.49) s) (P＜0.05) ; and the plane righting time of RS+KD group((0.58±0.52) s) was significantly longer than that of RS+ND group ((0.17±0.39) s) (P＜0.05).There was no statistical significance between RS+KOD group((0.17±0.39) s) and RS+ND group ((0.17±0.39) s) (P＞0.05).(2) Cliff avoidance test:the cliff avoidance time of RS+ND group ((12.58±4.83) s)was significantly longer than that of NS+ND group ((1.92±0.90) s),RS+KD group((3.33± 1.50)s) and RS+ KOD group (P＜0.05) ;and the cliff avoidance time of RS+KOD group((5.58± 1.93)s) was significant longer than that of RS+KD group ((3.33± 1.50) s) (P＜0.05).(3) Negative geotaxis test:the negative geotaxis time of RS+NDgroup((3.17±1.70)s) was significantly longer than that of NS+ND group((1.42±0.67) s) and RS+KD group ((1.42±0.52)s) (P＜0.05).There was no statistical significance between RS+KOD group and RS+ND group(P＞0.05).Conclusion The ketogenic diet can improve neurobehavioral damage caused by flurothyl-induced recurrent seizures in neonatal rats.The every other day KD group shows a weak intervention effect comparing with the routine KD group.

Objective To explore the value of diffusion tensor imaging (DTI) and diffusion tensor tracography (DTT) in assessment of Corticospinal tract (CST) and medial lemniscus (ML) in tumors involving brainstem.Methods A total of 35 cases with pathologically confirmed tumors involving brainstem were collected,and 35 volunteers matched with genders and ages were recruited as the normal group.DTI scanning was performed on all the patients and controls.The damage degrees of CST and ML were evaluated and graded by DTT,and the dysfunction degrees were evaluated for the patients.Spearman correlation was used to statistically analyze the relationships of limb movement,sensory dysfunction and CST and ML damage.Results According to the rating results,normal findings,shifting,edema or infiltration and damage of CST was found in 9,9,11,and 6 cases respectively.They were 8,9,15,3 cases for ML.Motor function was normal in 20 cases,slightly defective in 11 cases,and moderate defective in 4 cases.Sensory function was normal in 21 cases,slightly defective in 6 cases,and moderate defective in 8 cases.The patients' dyskinesia and CST damage degree,sensory dysfunction and ML damage degree were positively correlated (r was 0.786 and 0.686 respectively,P ＜ 0.01).The position relationship among tumor and CST and ML could be well displayed on images.None of the patients showed new symptoms of dysneuria after surgery.Conclusions DTI and DTT technology can be used to evaluate CST and ML damage degree in tumors involving brainstem.They can display the position relationship between tumor and the brainstem CST and ML,which is important in protecting the brainstem fiber tract during operation and evaluating the recovery after the operation.

Objective To explore the expression and localization of aquaporin 11(AQP11) in human term pregnancies with oligihydramnios, and its role in amniotic fluid balance.Methods We studied 55 patients who underwent elective cesarean sections, consisting of 25 patients with isolated oligohydramnios and 30 with normal amniotic fluid volume.Immunohistochemistry and reverse transcription polymerase chain reaction were employed to determine the expression and localization of AQP11 in the amnion, chorion and placenta.Results AQP11 protein was detected in expressed in the full-term pregnant women`s amnion, chorion and placenta.The expression in the amnion was positively correlated with amniotic fluid amount;the expression in the placenta was negatively correlated with amniotic fluid amount.The expression increased in the chorion with different amniotic fluid amount.Conclusion AQP11 plays an important role in regulating amniotic fluid balance.

Objective To investigate the expression of ENO3 gene in hepatocellular carcinoma and its effect on the sensitivity of hepatocellular carcinoma cell lines to OXA, and to explore the possible mechanism. Methods qRT-PCR and immunohistochemical analysis were used to detect the expression of ENO3 in 48 pairs of hepatocellular carcinoma tissues and normal liver tissues.Overexpression plasmid was constructed and transfected into MHCC97H and HepG2 cells.The experiments were divided into empty group (Vector group), ENO3 overexpression group (ENO3 group), empty+OXA group (Vector+OXA group) and ENO3 overexpression+OXA group (ENO3+OXA group).The proliferation ability of MHCC97H and HepG2 cells were detected by CCK-8 assay and cell colony formation assay.The apoptosis rate was determined by flow cytometry assay.Protein expressions of Bcl-2, Bax and Caspase-3 were detected by Western blot assay. Results The expression of ENO3 was significantly decreased in hepatocellular carcinoma tissues, compared with normal liver tissues adjacent to the carcinoma.The expression of ENO3 gene in the ENO3 overexpression group was significantly higher than that in the empty group.Compared with the Vector+OXA group, cell viability was decreased, apoptosis rate was increased, Bcl-2 protein expression was decreased, Bax and Caspase-3 protein expression were increased in the ENO3+OXA group. Conclusion The expression of ENO3 is down-regulated in hepatocellular carcinoma tissues, and the overexpression of ENO3 can enhance the sensitivity of hepatocellular carcinoma cell lines to oxaliplatin by promoting cell apoptosis.

Posttraumatic stress disorder (PTSD), the most common mental illness after patients suffer physically or emotionally from traumatic events, can cause persistently strong, painful and terrible avoidance symptoms, emotional and cognitive changes, causing psychologically strong stimulation and heavy burden to patients and even leading to some extreme behavioral reactions. Traumatic brain injury (TBI) is an important factor in the occurrence of PTSD, both of which shares many similar pathological overlaps, and may coexist and interact with each other. The hippocampus and amygdala play a central role in the pathogenesis of PTSD, but the specific cellular and molecular and neural circuit mechanisms are still unclear. About two-thirds of the patients still meet the diagnostic criteria for PTSD after psychotherapy. However, the current treatment methods are complicated and not unified, and patients treated with medications may have adverse drug reactions, poor treatment outcomes and recurrence. Therefore, it is of great significance to further clarify the occurrence and development of PTSD in TBI patients. The authors reviewed the research progress of the pathogenesis and treatment of PTSD in TBI patients, so as to provide reference for the related research and treatment of PTSD in TBI patients.

Craniocerebral injury with seawater immersion is a special kind of compound injury, with low temperature, high permeability, high alkali, high salt content, and bacterial infection being the main causes. The injury is also characterized with complex damage mechanisms, difficulty to treat, and poor prognosis. At present, the damage mechanisms of craniocerebral injury with seawater immersion are mainly studied by establishing the experimental animal models at the levels of tissue, cell, organelle, molecule, etc. However, the craniocerebral injury with seawater immersion is more complex than the simple onshore craniocerebral injury, therefore, a stable disease model is not easy to construct. Most researches on the specific injury mechanisms are relatively single and one-sided, with many different views in existence, and the damage mechanisms of craniocerebral injury with seawater immersion have hitherto not been clear. The authors reviewed the research progress in the damage mechanisms of craniocerebral injury with seawater immersion, in order to promote the in-depth study of the mechanism of craniocerebral injury with seawater immersion and provide reference for its clinical treatment.

Objective:To investigate the regulatory mechanism and clinical significance of RASSF5 in cutaneous melanoma.Methods:We used GEPIA and HPA online tools and TCGA and GSE53118 data sets for differential expression analysis and prognosis analysis; cBioPortal was applied to analyze the correlation between RASSF5 expression and gene mutation and methylation; "limma" R package was used to screen differential genes for GO analysis, KEGG analysis and protein-protein interaction analysis, and we also performed GSEA analysis on all genes; finally we used ESTIMATE and CIBERSORTx online tools to evaluate immune cell infiltration. The kruskal test was used to compare the differences between the groups for measurement data, the Kaplan-Meier method was used to draw the survival curve, and the Cox proportional hazard regression model was used for univariate and multivariate analysis.Results:This study found that in cutaneous melanoma, the expression level of RASSF5 was significantly lower than that of normal tissues, and the methylation level was negatively correlated. KEGG analysis and GSEA analysis showed that RASSF5 can be related to multiple signaling pathways such as immune regulation, KRAS, and P53. Further analysis showed that the expression level of RASSF5 was positively correlated with the degree of infiltration of a variety of tumor immune cells. Survival analysis found that the expression level of RASSF5 was correlated with the overall survival rate of patients with cutaneous melanoma, and multivariate regression analysis found that RASSF5 was an independent predictor of cutaneous melanoma. Finally, using the GSE53118 dataset to verify again, RASSF5 is related to the overall survival rate of patients with cutaneous melanoma and can be used as an independent predictor.Conclusions:RASSF5 may regulate the occurrence and development of cutaneous melanoma cells through a variety of ways. It is a potential biological prognostic marker and therapeutic target.