Objective To investigate the influence of different head and neck positions on airway sealing pressure (OLP) with i-gel laryngeal mask airway (LMA) in patients undergoing elective surgery under general anesthesia with mechanical ventilation.Methods Thirty ASA Ⅰ or Ⅱ patients of both sexes aged 32-64 yr with a body mass index of 18-30 kg/m2 undergoing elective surgery under general anesthesia with LMA were studied.Size 4 i-gel LMA was placed blindly after induction of anesthesia and connected to anesthetic circuit.The criteria for successful placement were easy inflation with small leak,peak inspiratory pressure (PPeak) within normal range and normal PETCO2 wave form.Fiberoptic bronchoscopy was performed to check the position of LMA.OLP,expiratory tidal volume ( VTE ),PPeak and efficiency of mechanical ventilation were measured in different head and neck positions.OLP was measured by gradually increasing airway pressure until PPeak was reached.The measurement was stopped when there was large leak or OLP ＞ 35 cm H2 O.The efficacy of ventilation was evaluated by manually inflating the lungs (perfect:easy inflation,no audible leak; satisfactory:easy inflation,small leak; poor:difficult inflation,large leak).Results Flexion of the head significantly increased OLP and PPeak and decreased VTE,while hyperextension significantly decreased OLP and PPeak and increased VTE as compared with middle position of the head.Lung ventilation was less satisfactory when the head was flexed.Turning the head to either side did not affect ventilation.Conclusion Flexion of the head should be avoided when i-gel LMA is used during anesthesia.

With the rise of magnetic therapy, biological effects of magnetic field have gotten more and more attention in recent years. Based on literatures both at home and abroad, this article summarized research status of biological effects of static magnetic field on whole level, tissue-organ level, cellular level and molecular level of living organisms. We found that conclusions and results of researches varied with different purposes and experiment methods, demonstrating that researches on dose-response relationship and safety of static magnetic field were necessary.

Objective To explore the magnetic properties of permanent magnet wafers commonly used in magnetotherapy to provide a basis for the scientific and rational use of sources of magnetism.Methods A magnetometer was used to measure the magnetic induction intensities of the N and S polar centers of eight groups of magnet wafers (axial magnetization) with nominal magnetic induction intensities of 6 mT, 10 mT, 20 mT, 30 mT, 60 mT,100 mT, 200 mT and 350 mT.Results There were some differences between the nominal values and the measured mean magnetic induction intensities. In a few groups the differences were close to 20％. There were also differences within the same group. The magnetic induction intensities of the two polar surfaces were not always equal for the same magnet, and there were large differences among individual magnets.Conclusions The intensities of magnetic sources must be measured before use to ensure the consistency of magnetic induction intensities in therapeutic applications.

Objective To study the 18F-FDG PET/CT features of tuberculous and malignant diffuse peritoneal lesions and to discuss the diagnostic value of 18F-FDG PET/CT in diagnosing and differentiating the lesions. Methods The 18F-FDG PET/CT features of 72 patients with tuberculous peritonitis,28 primary serous papillary carcinoma of the peritoneum and 135 peritoneal metastases confirmed by clinic and/or histopathology, were retrospectively reviewed. The peritoneal thickening features of tuberculous and malignant peritoneal lesions were observed. The maximal standardized uptake value (SUVmax) of peritoneal lesions and ascites, ascites SUVmax/liver SUVmax (T/NT) were compared between tuberculous peritonitis and cancerous peritonitis. The ROC curve was used to analyze the diagnostic efficiency of T/NT, SUVmax of peritoneal lesions and ascites. Results The typical 18F-FDG PET/CT features of tuberculous peritonitis were uniformity thickening of parietal peritoneum, mesenteric and omental stain like changes, widely and even distribution of the peritoneal 18F-FDG, while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum, mesenteric and omental nodules and pie-shape changes, uneven distribution of the peritoneal 18F-FDG. The degree of 18F-FDG uptake was increased in all peritoneal lesions, and there was no significant difference between the tuberculous group (SUVmax=10.53±5.44) and the cancerous group (SUVmax=11.45±6.78, t=1.017, P>0.05). The 18F-FDG concentration in malignant ascites (SUVmax=1.88±0.65,T/NT=0.73± 0.18) was obvious higher than that of tuberculous ascites (SUVmax=1.67±0.69,T/NT=0.57±0.27, t=2.243 and 5.045,both P<0.05). The area under the ROC curve of T/NT, SUVmax of ascites, SUVmax of peritoneal lesions were 0.707, 0.593, 0.536, respectively. Conclusion The 18F-FDG PET/CT imaging can reflect the morphology and metabolic changes of peritoneal lesions. It is important to combine the SUVmax of ascites in order to improve the efficiency of diagnosing the diffuse peritoneal diseases.

Objective To investigate midkine (MK) level in serum of patients with esophageal squamous cell carcinoma (ESCC) before and after operation,detect the expression of MK protein in tissues and analyze its relationship with the malignant biological behavior of ESCC.Methods The MK levels in serum were detected by enzyme-linked immunosorbent assay in 30 healthy cases and 55 patients with ESCC when the day before operation and the tenth-day after operation.Then the expression of MK protein in 55 patients surgically removed ESCC were detected by immunohistochemistry using monoclonal antibodies against human MK.Results The average optical density of MK in serum of ESCC patients before operation was 0.1006±0.0624,0.0455±0.0155 in normal control group,0.0752±0.0267 in postoperative control group (t =6.203,P ＜ 0.001).The MK levels in serum of ESCC patients before operation were significantly higher than those after operation (t =4.357,P ＜ 0.001) and those in healthy controls (P ＜ 0.05).The expression of MK protein was no statistically significant correlation with tumor size (x2 =0.131),TNM stage (x2 =0.315) and lymph node metastasis (x2 =0.282) in ESCC (all P ＞ 0.05).But significant correlation was noted between the expression of MK protein and the vasculature involving of the cutting edge (x2 =4.223),degree of cellular differentiation (x2 =10.326),invasive extent of the carcinoma (x2 =20.556) (all P ＜ 0.05).Conclusion MK is overexpressed in ESCC patient' s serum and tissue.The high level of preoperative serum MK is caused by the tumor.

Objective To explore the impacts of magnetic fields of different intensities on the superoxide dismutase (SOD) activity and malondialdchvde (MDA) levels in rat pancreatic islet cells under normal and hypoxic conditions.Methods Rat pancreatic islet cells were culured,and after 3 days were subjected to a magnetic field of either 44.8 mT,90.6 mT or 182.1 mT under either normal or hypoxic conditions.Control cells received no magnetic field exposure,SOD activity and MDA level were measured after 72 hr.Results The cultured cells grew linearly with optical density (OD) of 0.067 ± 0.021 after 2 days and 0.449 ± 0.113 afier 5 days.SOD activity was significantly lower in the three magnetic field intervention groups than in the control group.Under hypoxic culture conditions,in all the magnetic field intervention groups SOD activity increased at first and then deereased.Under normal culture conditions,MDA content was significantly higher in the 182.1 mT group than in the control group.In the other two groups it was significantly lower.Conclusion Magnetic field exposure can cause oxidative damage to pancreatic islet cells,at least rat cells in culture.Under hypoxic culture conditions a magnetic field can inhibit such damage.

From the perspective of welfare culture, this paper analyzed the current status of care modes in China and explained the ethical value of multiple care mode:the development of multiple care mode was conducive to resolving the dilemmas of interpersonal relationships and strengthening community interaction;resolving the dilem-as of family relations and carrying forward the tradition of honoring and respecting the elderly;strengthening insti-tutional ethics and highlighting social concerns. Finally, this paper put forward three feasible suggestions for the development of multiple care mode:carrying forward the traditional filial piety culture and cultivating the concept of pension in the new period; developing the welfare of the combination of medical treatment and endowment and strengthening the linkage between family, community and care institutions;enhancing the quality of service of care institutions and strengthening the ethical support of caregivers.

An innovative,ternary nanocomposite composed of overoxidized poly(3,4-ethylenedioxythiophene)(OPEDOT),gold nanoparticles (AuNPs),and electrochemically reduced graphene oxide (ERGO) was prepared on a glassy carbon electrode (GCE) (OPEDOT-AuNPs-ERGO/GCE) through homogeneous chemical reactions and heterogeneous electrochemical methods.The morphology,composition,and structure of this nanocomposite were characterized by transmission electron microscopy,scanning electron microscopy,X-ray diffraction,and X-ray photoelectron spectroscopy.The electrochemical properties of the OPEDOT-AuNPs-ERGO/GCE were investigated by cyclic voltammetry using potassium ferricyanide and hexaammineruthenium(Ⅲ) chloride redox probe systems.This modified electrode shows excellent electro-catalytic activity for dopamine (DA) and uric acid (UA) under physiological pH conditions,but inhibits the oxidation of ascorbic acid (AA).Linear voltammetric responses were obtained when DA concentrations of approximately 4.0-100 μM and UA concentrations of approximately 20-100 μM were used.The detection limits (S/N=3) for DA and UA were 1.0 and 5.0 μ.M,respectively,under physiological conditions and in the presence of 1.0 mM of AA.This developed method was applied to the simultaneous detection of DA and UA in human urine,where satisfactory recoveries from 96.7％ to 105.0％were observed.This work demonstrates that the developed OPEDOT-AuNPs-ERGO ternary nano-composite,with its excellent ion-selectivity and electro-catalytic activity,is a promising candidate for the simultaneous detection of DA and UA in the presence of AA in physiological and pathological studies.

Objective:To evaluate the dose-effect relationship of compound lidocaine hydrochloride for transverse abdominal plane-rectus abdominis sheath block (TAP-RSB) for postoperative analgesia in elderly patients undergoing laparoscopic radical colon cancer surgery with general anesthesia.Methods:Elderly patients of either sex, aged≥65 yr, with body mass index <30 kg/m 2, of American Society Anesthesiologists physical status Ⅰ-Ⅲ, undergoing elective laparoscopic radical colon cancer surgery with general anesthesia, were selected.After induction of general anesthesia, compound lidocaine hydrochloride was given under ultrasound guidance for bilateral TAP block (20 ml on each side) and for bilateral RSB (10 ml on each side), with the initial concentration of 0.4%.Each time the concentration increased/decreased in the next patient depending on whether or not the analgesia was effective.The ratio between the two successive concentrations was 1.00∶1.15.The analgesic effects were evaluated by the Numerical Rating Scale at 1 h intervals from the time of postoperative admission to the post-anesthesia care unit until 8 h after TAP-RSB (Numerical Rating Scale ≤ 3 was considered as effective analgesia). The probit method was used to calculate the half effective concentration (EC 50) and 95% effective concentration (EC 95) and 95% confidence interval of compound lidocaine hydrochloride. Results:The EC 50 and EC 95(95% confidence interval)of compound lidocaine hydrochloride for TAP-RSB were 0.289% (0.232%-0.352%) and 0.404% (0.345%-0.970%), respectively, when used for postoperative analgesia in elderly patients undergoing laparoscopic radical colon cancer surgery with general anesthesia. Conclusions:The EC 50 and EC 95 of compound lidocaine hydrochloride for TAP-RSB are 0.289% and 0.404%, respectively, when used for postoperative analgesia in elderly patients undergoing laparoscopic radical colon cancer surgery with general anesthesia.

Objective: To evaluate the effect of immune response of cryoablation combined with anti-CTLA-4 mAb against murine tumor draining lymph nodes (TDLNs) of prostate cancer (PCa). Methods: PCa-bearing murine models were established and mice were divided randomly into 4 groups-control (A), cryoablation treatment (B), cryoablation combined with anti-CTLA-4 mAb treatment (C), and anti-CTLA-4 mAb treatment (D). TDLN specimens were obtained from 5 mice of each group at 4 time points before treatment, and 7, 14, and 21 days after treatment. Tumor size was measured at each time point. Flow cytometry was utilized to detect changes inTreg and CTL proportions in TDLNs. LDH was utilized to detect killing activity for tumor cells of CTL. Overall survival (OS) of each group was recorded. Results: Fourteen days after treatment, compared with that of group A, Treg proportion in group B (9.78%±1.88% vs. 6.02%±0.44%) and C (9.78%±1.88% vs. 6.03%±0.45%) was decreased (both P<0.05); compared with that of group A, CTL proportion of group B (27.34%±2.13% vs . 34.23%±1.15%), C (27.34%±2.13% vs. 52.21%±2.53%), and D (27.34±2.13% vs. 33.99±1.21) was increased (P<0.05, P<0.001, P<0.05); compared with those of group A, CTL killing activities of group B (13.32%±3.39% vs . 26.36%±2.95%), C (13.32%±3.39% vs . 45.25%±3.27%), and D (13.32%±3.39% vs. 25.31%±3.24%) were improved (P<0.05, P<0.001, P<0.05). Survival analysis showed that the OS of PCa-bearing mice were prolonged (P<0.05, P<0.001) in group B (25.60 d±1.52 d vs. 34.20d±6.98 d) and C (25.60 d±1.52 d vs. 43.60 d±2.88 d) compared with that of group A; OS was prolonged (P<0.05) in group C compared with that of group B (34.20d±6.98 d vs. 43.60d±2.88 d). Conclusions: Cryoablation combined with anti-CTLA-4 mAb can reduce the proportions of Tregs in the TDLNs, increase the proportions of CTL as well as killing activities, and significantly prolong OS of mice. However, the specific mechanism needs further study.