Objective To evaluate the efficacy of parecoxib sodium combined with ultrasound guided transversus abdominis plane (TAP) block for analgesia after gynecological laparoscopic surgery. Methods Sixty patients (45 to 65 years old, 53- 72 kg and ASA gradeⅠorⅡgrade) who had underwent general anesthesia in laparoscopic hysterectomy were randomly divided into parecoxib group and control group, with 30 cases in each group two groups were in general anesthesia after tracheal intubation in. The ultrasound guided TAP block was performed in all patients after tracheal intubation in general anesthesia. After the operation, the control group was intravenously injected with 40 mg parecoxib sodium, and the control group was given 0.9%sodium chloride of the same volume. Operation time, pain visual scale (VAS) scores and body comfort scale (BCS) scores were recorded and compared. Results The levels of VAS scores in parecoxib sodium group were significantly lower than those in control group after 4, 8 and 24 h: (0.9 ± 0.2) scores vs. (1.9 ± 0.4) scores, (1.1 ± 0.4) scores vs. (2.7 ± 0.2) scores, (1.3 ± 0.3) scores vs. (3.1 ± 0.2) scores, and there were significant differences (P<0.05). The levels of BCS scores in parecoxib sodium group were significantly higher than those in control group after 4, 8 and 24 h: (2.9 ± 0.4) scores vs. (2.2 ± 0.3) scores, (2.8 ± 0.3) scores vs. (1.9 ± 0.4) scores, (2.6 ± 0.5) scores vs. (1.7 ± 0.4) scores, and there were significant differences (P<0.05). Conclusions Parecoxib sodium combined with ultrasound guided TAP block for analgesia after gynecological laparoscopic surgery can provide a good analgesic effect.

Objective To evaluate the diagnosis and treatment of primary retroperitoneal tumor. Methods The clinical data of 75 patients with primary retroperitoneal tumor confirmed by operation and pathology in recent 20 years in our hospital were analyzed retrospectively. Results About 57.3% of the patients were diagnosed accurately before the operation. Correct diagnostic rates of ultrasound and CT were 60.0% and 84.0% ,respectively.Of them 57cases(76.0%) were malignant and18 (24.0%) benign tumor. Tumor size was not related to the pathological characteristics.Radical resection was done in 42 patients(56.0%),partial resection in 23 patients (30.7%),and biopsy in 10 patients(13.3%).Conclusions Ultrasonic and CT are the major diagnostic methods. Early operation is recommended after necessary preparation. Surgical resection is a major procedure for the management of primary retroperitoneal tumor and might provide long surrival time.

Objective To investigate the related index of early diagnosis of acute-on-chronic liver failure caused by chronic hepatitis B.Methods 13 cases of the acute-on-chronic liver failure caused by chronic hepatitis B were collected in our department,39 cases of chronic hepatitis B were randomly paired to analyze the difference index.ROC curve analysis was conducted for the different data,then to choose the data whose AUC (area under the curve)is >0.8 to accumulate points,while the cutoff value in the light of Youden index was indentified.Each accu-mulating points data would score 1 point if it is≥cutoff value,otherwise,it would score 0 points.ROC curve analysis was conducted for the total accumulating points,the cutoff value of the total accumulating points according to Youden index was indentified,the sensitivity and specificity were calculated.Results The data of which AUC are >0.8 include glutamic-pyruvic transaminase (ALT)/Upper Limit Of Normal (ULN),neutrophil count (N),alkaline phosphatase (AKP)/ULN,glutamic-oxalacetic transaminease(AST)/ULN,direct bilirubin/total bilirubin(Dbil/Tbil),total bile acid(TBA),whose AUC were respectively 0.869,0.874,0.897,0.917,0.919 and 0.978,while their cutoff value were respectively 18.57,3.1 ×109/L,0.99,22.21,44.41%and 140.20μmol/L.The cutoff value of total accumula-ting points of the six data was 4 points,AUC was 0.987,Youden index was 0.949,and their sensitivity for ealier diag-nosis for the acute -on -chronic liver failure caused by chronic hepatitis B was 100%,specificity was 94.87%. Conclusion The accumulating points of the six data aboved (ALT/ULN,N,AKP/ULN,AST/ULN,Dbil/Tbil,TBA) will help the early diagnosis of acute-on-chronic liver failure caused by chronic hepatitis B.

Objective:To analyze the stress distribution in the fixed denture of edentulous maxilla supported by 6 implants at different implant position.Methods:The skull of a volunteer with total anodontia and moderate alveolar bone absorption was scanned by CBCT.Computer software,Abaqus 6.9,Geomagic Studio 12,and Mimics10.01,were applied for data processing and reconstruction of a 3D finite element model of implant-supported fixed denture with 6 implants in different location;and then,the stress distribution was analisized.Results:3D finite element model of edentulous maxillary implant-supported fixed bridge with good geometric similarity was established.The implant neck bone interface stress value of the distal of the implant fixed bridge at the molar area,the stress concentration area,was the maximum.The main stresses were compressive in the cortical bone adjacent to the mesial or the distal implants.The shift of the denture decreased from anterior to posterior.In model Ⅰ (implants at 13,15,17,23,25 and 27) distal cantilever was not used and the stress distribution was the evenest.Conclusion:The implant position at 13,15,17,23,25 and 27 of edentulous maxillary 6-implants-supported fixed bridge was the best for the stress distribution among the 8 models.

Objective To evaluate the effect of hepatic resection for liver malignancies. Method The clinical data including the patterns and effect of operation in 108 patients with malignant liver disease underwent hepatic resection in recent 5 years in our hospital were analyzed retrospectively.Result Tweent-eight cases occurred complications and four died after operation . The 1-,3-year survival rate were 87.5% and 43.8% respectively. Conclusions Surgical resection is still an effective procedure for the liver malignancies .

OBJECTIVE:To analyze the chemical components extracted with supercritical CO2(SFE-CO2)from Eucalyptus tereticornis.METHODS: Volatile oil was extracted from E.tereticornis with SFE-CO2.The chemical component analyzed by GC-MS and its proportion was determined by normalization method.RESULTS: 28 compounds which account for 88.13% of the total peak area were separated and identified.The main components of volatile oil were eucalyptol (33.99%),borneol(8.88%),?-pinene (5.39%),caryophyllene (4.51%),(+)-4-carene (4.19%).CONCLUSION:This study can be served as a scientific basis for the further exploitation and utilization of E.tereticornis.

Intervertebral disc degeneration is one of the orthopedic common diseases , its complex physiopathological changes are regulated by many factors .The matrix metalloproteinases ( MMPs) and its regulatoryl factors play a very important role , and the factors that affect the role of MMPs in intervertebral disc degeneration interact with each other .So MMPs have gradually become one of the hot spot of intervertebral disc degeneration in recent years .In this paper , we first analyze the factors that cause the degeneration of intervertebral disc .Then we summarize the relationship between the expression of MMPs and the degeneration of intervertebral disc ac -cording to the different function of MMPs members in the family .Finally we state that MMPs can have an effect on the degeneration of intervertebral disc by the regulation of gene polymorphism and the related factors .

Objective To probe into effective surgical methods to reduce post-operational recurrence rate of nodular goiter.Methods One hundred and fifty-seven patients with nodular goiter who were admitted and had operations in our hospitals between Jan,2007 and June,2011 were assigned to one of the following 4 groups:total thyroidectomy(TT),nearly total thyroidectomy (NTT),subtotal thyroidectomy (STT),removal of lesion only or partial thyroidectomy (also termed as local removal,LR).Postsurgical recurrences and complications were compared among these groups.Results The recurrences were statistically analysed.There was a highly significant difference between TF and STT、TT and LR、NTT and LR; no difference was observed between TT and NTT,STT and STT + E,STT and LR.A statistical analysis was also carried out on the postsurgical compications in these patients.highly significant differnce was found between TT and STT,TT and NTT,TT and LR.There was a significant diffrence between STT and NTT.There was no difference between STT and LR,NTT and LR.Conclusion TT,STT,NTT are all effective operations for nodular goiter and should be advocated.Satisfactory efficacy may be obtained with oral thyroxine or euthyrox for postsurgical lifetime.However,LR or partial thyroidectomy should be adopted cautiously.

Objective To investigate the effects of electroacupuncture (EA) pretreatment on the expression of phosphorylated signal transducer and activator of transcription 3 (pSTAT3) in cortical neurons in a rat model of focal cerebral ischemia/reperfusion (I/R) injury.Methods Forty-five adult male Sprague-Dawley rats,weighing 280-320 g,were randomly divided into 3 groups (n =15 each):sham operation group,I/R group and EA pretreatment group.Focal cerebral ischemia was induced by middle cerebral artery occlusion for 120 min,followed by 24 h of reperfusion.EA of Baihui acupoint lasting 30 min was performed and then the model of focal cerebral I/R was established 24 h later in EA group.Neurological function was assessed and scored at 24 h of reperfusion.The rats were then sacrificed and brains removed for detection of the cerebral infarct volume and expression of pSTAT3 (Ser727) in cortical neurons in ischemic penumbra by immunofluorescence and Western blot.Results Compared with sham operation group,the neurological function score was decreased,the infarct volume was increased,and the expression of pSTAT3 (Ser727) was up-regulated in groups I/R and EA (P ＜ 0.05).Compared with I/R group,neurological function score was increased,the infarct volume was decreased,and the expression of pSTAT3 (Ser727) was up-regulated in group EA (P ＜ 0.05).Conclusion EA pretreatment reduces focal cerebral I/R injury through up-regulating pSTAT3 expression in cortical neurons in rats.

Objective To research the effect of regulating systemic inflammatory response by using ulinastatin in elderly patients after sevoflurane inhalation of postoperation cognitive function. Methods 60 patients under went elective abdominal surgery, were randomly double-blinded divided into 2 groups. Every group had 30 patients.Group A accepted continuously intravenousiy infusion ulinastatin 2000 units · kg-1 · h-1 , while group B got equivalent continuously intravenous infusion 0.9% sodium chloride injection. The time point of opening eye, extubation, response and the mini-mental state examination(MMSE) score on different time points were observed. Meanwhile, the changes of concentration of hs-CRP, IL-6,IL-10 were measured. Results Compared with two groups,group A has shorter time on response(F =4.399,P = 0.040). Two both groups had decrease of MMSE score 1 hour after surgery compared with preoperation(t =7. 732,11. 916, both P ＜ 0.01), and the score were less than the preoperative value of more than 2 points which showed cognitive decline in patients. But group A's rate of decline in MMSE score was lower than group B(F = 7. 582 ,P =0.012). Both groups had the MMSE score decline 6h after surgery (t = 4. 606,8. 615, both P ＜ 0.05). Group A's score was less than the preoperative value for less than 2 points, group B's score was lower than the preoperative value for more than 2 points, but the difference between the two groups was not significant (P ＞0. 05). Both groups had higher concentrations of hs-CRP、IL-6 、IL-10 at postoperative 1 d ,3d ,7d (all P ＜ 0.01), peaked at postoperative 1 d, and hadn't come back to the preoperative level 7d*after surgery. In group A, the concentrations of hs-CRP, IL-6 increased (postoperative 1 d,3d), but the rate was lower than the group B (F = 14. 885, P = 0.000;F = 4. 405, P = 0. 040; F = 18. 204, P = 0.000; F = 8. 074, P = 0. 006); while the increased rate of concentration of IL-10 was higher than the group B(F=5.197,P=0.026;F= 12.236,P =0.000). Conclusion Ulinastatin could promote the elderly after sevoflurane inhalation rapid recovery of cognitive function, which may be related to the regulation of systemic inflammatory response.