Objective To study the effect of seven sevoflurane or propofol combined with remifentanil anesthesia on patients undergoing laparoscopic surgery.Methods In Taizhou Tumor Hospital from January 2015 to December 2016 were 100 cases of patients with laparoscopic surgery as the research object in the course of the study, were randomly divided into control group and experimental group two were 50 cases each.Patients in the control group were treated with propofol and remifentanil anesthesia.The experimental group was given seven sevoflurane and remifentanil anesthesia.Comparative analysis of the experimental group and the control group of patients with anesthesia effect.Results After the corresponding anesthesia, patients in the experimental group extubation time, recovery time was significantly better than the control group, with statistical difference(P<0.05).In the experimental group, 15 minutes after extubation, the Steward recovery score was(5.04±0.65), while the control group score was(4.12±0.54).Can be obtained, the quality of patients' recovery was significantly higher than that of the control group, with statistical difference(P<0.05).The cognitive function scores of the experimental group were significantly higher than those of the control group after extubation(2 h), and the difference was statistically significant(P<0.05).Conclusion Compared with propofol remifentanil anesthesia, seven sevoflurane remifentanil anesthesia effect is good, can improve the patient's recovery quality, to help with the recovery of cognitive function, with further clinical promotion and application significance.

Objective To study the effect of different doses of dexmedetomidine combined with propofol and remifentanil in patients undergoing abdominal surgery. Methods 200 cases of abdominal operation in our hospital from January 2015 to August 2016 were selected as the subjects, and were randomly divided into the experimental group and the control group, with 100 patients in each group. Patients in the control group received 0.4μg/kg, dexmedetomidine hydrochloride injection combined with propofol and remifentanil anesthesia, and the experimental group received 0.8μg/kg, Dexmedetomidine Hydrochloride Injection anesthesia. The adverse reactions, extubation time and recovery time of the experimental group and the control group were compared and analyzed. Results After the corresponding dose of dexmedetomidine, the patients in the experimental group were 6 cases of nausea and vomiting, 7 patients with chills, 13 cases of adverse reactions, the total incidence was 13%. In the control group, shivering occurred in 23 cases, nausea and vomiting occurred in 12 patients, and the number of adverse reactions in 35 cases, the incidence of adverse reactions was 35%. The probability of adverse reactions in the control group was significantly higher than that in the control group, with statistical difference (P<0.05). The recovery time and extubation time of the experimental group were significantly lower than those of the control group, with statistical difference (P<0.05). Conclusion 0.8μg / kg dexmedetomidine hydrochloride Iinjection combined with propofol and remifentanil anesthesia in abdominal surgery is better anesthesia effect, can significantly shorten the time of patients with tube drawing, high safety, reduce the pain and risk of surgery patients has clinical significance in the further promotion and application.

Capital logic is the first to be avoided in the construction of medical humane service system,for it is capital logic that manifest the current technical and commercialized time with an "indifferent" characteristic.Capital logic originated and distended from the western culture.As another spiritual pursuit and wisdom,traditional Chinese philosophy provides us with significant ideological resources and helpful revelation for improving medical humane service in current circumstances.

10.3969/j.issn.2095-4344.2013.26.011

Objective To investigate the effect of EZH2 knockdown on cell proliferation ,invasion ,migration and apoptosis in hu-man bladder cancer cell line by small interfering RNAs(siRNA) .Methods The siRNA-expressing plasmid targeting EZH2 gene was constructed and transfected into T24 cells .RT-PCR was used to detect the EZH2 gene′s expression at the level of mRNA ;pro-liferation ,invasion and migration of T24 cells were examed in vivo by MTT ,wound healing assay and Transwell chamber migration assay .Finally ,Annexin V-FITC/PI flow cytometric analysis was performed for cell apoptosis .Results The siRNA-expressing plas-mid targeting EZH2 gene successfully inhibited EZH2 gene’s expression in T24 cells .The expression of mRNA was significantly inhibited compared with negative control groups (P<0 .05) .After the transfection of the plasmid 48 hours ,the growth inhibition rate was 37 .9% ,which was higher than the negative control group(P<0 .05) .24 hours after wound healing ,the migration distance of transfected group cell was(1 .37 ± 0 .12) ,which was lower than the negative control group(P<0 .01) .Compared with the nega-tive control group ,invasion capability of EZH2-siRNA group was dropped by 67% (P<0 .01) .48 hours after transfection ,the early and secondary apoptosis rate of T 24 cells were 22 .80% and 3 .60% respectively ,which were higher than the negative contral group (P<0 .01) .Conclusion The siRNA interference EZH2 can significantly inhibit cell proliferation ,invasion and migration of T24 cells ,meanwhile promote its apoptosis .It provides a theoretical basis for further study of bladder cancer gene therapy .

Objective:To study the effect of sevoflurane inhalation anesthesia on stress reaction and kynurenic acid ( KYNA) level in serum of the patients with laparoscopic cholecystectomy .Methods:Totally 48 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups.Group S(n=24) received sevoflurane inhalation and group V (n=24) received intravenous general anesthesia.The levels of norepinephrine (NE), epinephrine (E), cortisol (Cor), KYNA and neutrophil and the neutrophil/lympho-cyte ratio were measured at five time points, namely T1(before the anesthesia), T2 (just after the surgery) , T3(in the morning of the first day after the surgery ) , T4 ( in the morning of the second day after the surgery ) and T5 ( in the morning of the third day after the surgery).The correlation of Cor, NE, E and NLR with KYNA was studied as well.Results:The levels of Cor, NE and E at the three time points after the surgery (T2, T3 and T4) in group V were significantly higher than those before the surgery (T1) with statistically significant difference (P<0.05), while those in group S had no significant changes (P>0.05).And the levels of Cor, NE and E at the three time points after the surgery (T2, T3 and T4) in group S were markedly lower than those in group V at the same time point (P<0.05).After the surgery (T2, T3, T4 and T5), KYNA levels in group V were significantly decreased and NLR values in group V were significantly increased when compared with those of T 1.In group S, KYNA levels and NLR values after the surgery (T2, T3, T4 and T5) were markedly increased , which were higher than those in group V at the same time point with statistically significant difference (P<0.05).The correlation analysis indicated the level of KYNA displayed positive correlation with the levels of NLR , Cr, Z and E (P<0.05).Conclusion:Sevoflurane inhalation anesthesia can inhibit the increase of stress reaction and KYNA level in the patients with laparoscopic cholecystectomy , which may be related with its anti-in ammatory properties .

Objective To evaluate the safety and efficacy of resection (EMR) of gastrointestinal tumors by EUS assisted with high-frequency probe EUS (HFPE). Methods EMR assisted with HFPE was attempted in 30 patients with gastrointestinal tumors with 0. 5 - 3. 5 cm in diameter. Complications such as bleeding and perforation were carefully monitored. The entire resected specimen received histopathological examination. Follow-up was regularly taken in outpatient clinic. Results In 28 (93. 3% )out of 30 patients tumors were successfully resected by EMR. 95. 2% cancerous and 85. 7% tumorous lesions were resected satisfactorily. No severe bleeding or perforation occurred nor had any recurrences be observed when follow-up of 2 ~ 13 months. Conclusion EMR assisted with HFPE is a safe and desired measure in the treatment of early small gastrointestinal tumors.

Objective·To observe changes of exhaled nitric oxide (FeNO) level in patients with chronic obstructive pulmonary disease (COPD) before and after inhaled corticosteroid (ICS) therapy and to explore the correlation of FeNO level with inflammation and pulmonary function indexes. Methods·Seventy COPD patients at stable stage who underwent ICS therapy (the COPD group) were enrolled. Levels of peripheral blood eosinophil (Eos) and neutrophil (N), FeNO, PEF, FEV1 and FEV1/pred before and after treatment were measured. Fifty healthy volunteers who received physical examination at the same time served as controls (the control group). The relationship between these indexes and clinical efficacy and the correlation between FeNO level and inflammation or pulmonary function indexes were analyzed. Results·The COPD group had significantly higher FeNO, Eos, and N levels before treatment, significantly lower PEF, FEV1 and FEV1/pred after treatment (P<0.05), and remarkably better indexes after treatment (P<0.05) compared with the control group. Indexes of the effective group and the improved group were significantly better than that of the ineffective group after treatment. Results of correlation analysis showed that before treatment, the FeNO level was positively correlated with peripheral blood Eos and N levels (P<0.05) and negatively correlated with PEF, FEV1 and FEV1/pred (P<0.05). After treatment, the FeNO level was positively correlated with peripheral blood Eos and N levels (P<0.05) and the correlation of the FeNO level with PEF, FEV1 and FEV1/pred was not statistically significant (P>0.05). Conclusion·The FeNO level increased significantly in patients with COPD at stable stage and is a sensitive index of airway inflammation. Combined with lung function test, it's useful for evaluating the efficacy of ICS and guiding treatment.

Objective To explore the relationship of traditional Chinese medical syndrome patterns with renal pathological changes and clinical laboratory parameters in patients with lupus nephritis.Methods Syndrome patterns were differentiated according the clinical manifestations.The data of laboratory examination and renal pathology were collected and analyzed in 40 patients with lupus nephritis.Results(1) Of the fundamental syndrome patterns,pattern of spleen and kidney Qi deficiency had higher activated partial thromboplastin time(APTT),erythrocyte sedimentation rate(ESR) and 24-hour urine protein amount than the pattern without spleen and kidney Qi deficiency.(2) Of the incidental syndrome patterns,water-damp pattern had higher APTT than damp-turbidity pattern;hemoglobin(HGB) level in water-damp pattern and damp-turbidity pattern was lower than the normal,and HGB level in water-damp pattern differed from that in blood-staiss pattern and damp-heat pattern(P

Objective To investigate the relationship between blood biochemical indicators levels (glycosylated hemoglobin and serum bilirubin) and atherosclerosis in elderly type 2 diabetic.Methods Totally 100 type 2 diabetic patients aged 62-85 years were divided into type 2 diabetes mellitus with carotid atherosclerosis group (T2DM-AS group,n=55) and type 2 diabetes mellitus group (T2DM group,n=45).Blood biochemical indicators levels (glycosylated hemoglobin and serum bilirubin) were determined and compared between the patients and the healthy controls (n=60)Results Serum levels of total cholesterol,triglyceride,low-density lipoprotein and Lp(a) were elevated in T2DM-AS group as compared with T2DM group [(5.86 ± 0.28) mmol/L vs.(4.63 ±0.32) mmol/L,(2.02±0.43) mmol/L) vs.(1.56±0.39) mmol/L,(3.74±0.76) mmol/L vs.(3.03±0.81) mmol/Land (297.3±102.2) mmol/Lvs.(203.5±110.4) mmol/L,t=20.91,5.54,4.51 and 4.40,all P＜0.05].Glycosylated hemoglobin level was higher in T2DM-AS and T2DM groups than in control group [(9.58 ± 0.47) mmol/L,(7.21 ± 0.66) mmol/L vs.(5.31 ± 0.54)mmol/L,both P＜0.05].There was a significant difference in glycosylated hemoglobin level between T2DM-AS group and T2DM group [(9.58 ± 0.47) mmol/L vs.(7.21 ± 0.66) mmol/L,t=20.9,P＜0.05].Serum bilirubin level was lower in T2DM AS group than in T2DM and control groups [(8.02±1.23)μmol/L vs.(13.72±1.64)μmol/L,(19.66±1.41)μmol/L; t=19.8,47.0,both P ＜0.05].Conclusions Glycosylated hemoglobin and serum bilirubin may promote atherosclerosis in elderly type 2 diabetic.The control of glycosylated hemoglobin and blood lipids levels may help to reduce atherosclerosis in elderly type 2 diabetic patients,which has the important clinical significance for the prevention and treatment of type 2 diabetes mellitus.