Objective To investigate the effect of combined general anesthesia with localanesthetic infiltration on heart rate variability and hemodynamics in laparoscopic cholecystectomy.Methods By simple randomization 70 patients undergoing laparoscopic cholecystectomy were assignedto two groups,68 patients completed the study(34 in each group).Group GA was given generalanesthesia.Group GL was given general anesthesia combined with local anesthetic.Iow-frectuency(LF),high-frequency(HF),LF/HF,Lfnu(LF/TP×100%),Hfnu(HF/TP×100%)and totalpower(TP),were recorded at the time points of baseline(T_0),skin incision(T_1),skin closure(T_2)and 1 h(T_3),3 h(T_4)after surgery.MAP and HR were recorded at the points of baseline,skinincision,skin closure and 1,3 h after surgery.Results Compared with the baseline,there was anincrease in MAP and HR at T_1,T_3,T_4(P<0.05)in group GA. Heart rate variability changesshowed that in group GA Lfnu,LF/HF increased significantly at T_1-T_4(P<0.05)and in group GLLF/HF increased significantly at T_1,T_2(P<0.05),and TP in group GA and group GL decreasedsignificantly at T_1,T_2(P<0.05).Conclusion Our results support that combined general anesthesiawith local anesthetic infiltration has lass influence on hemodynamics and automomic nerve,and can bean useful analgesic adjuvanct for patients undergoing laparoscopic cholecystectomy.

Objective To study the diagnostic value of coronary disease with 16-slice spiral CT.Methods 35 patients with coronary heart disease(CHD) were divided into two groups according to the risk rate of CHD:group 1 with acute coronary artery syndrome(ACS)(including acute myocardial infarction,AMI;unstable angina,UA);group 2 with stable angina(SA).They were studied by 16-slice spiral CT(retrospectively ECG-gating,0.5 s ratation),the images were reconstructed by survey methods to display the coronary artery atherosclerosis plaques,then to evaluate the nature of plaques by detecting CT value of plaque(using the standard of the CT value of the coronary artery atherosclerosis plaque of Schroeder)and to analyze the degree of the stenosis of coronary artery caused by the different type of plaque.Results There were 19 soft plaqes,11 middle plaques and 7 calcification plaques in ACS group;3 soft plaqes,3 middle plaques and 11 calcification plaques in SA group.There was a positive relation between soft plaqes and middle plaques with the risk rate of CHD,especially soft plaque(P

Objective To analyze the diagnostic value of features of mammographic mass edge in digital three dimensional tomography, and to discuss the correlations between the mammographic mass edge features and pathological features and molecular biological indicators, in order to provide evidence for early and accurate diagnosis and treatment of breast cancer and prognosis evaluation. Methods A retrospective analysis was made in 392 cases of breast cancer confirmed by operation and pathology in the People ' s Hospital of Shanxi Province from August 2017 to June 2018. These patients were examined by digital breast tomography (DBT) and full-field digital mammography (FFDM) before operation. Postoperative specimens were stained by immunohistochemical SP method to measure the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67. The correlation between the mammographic mass edge features and pathological features and molecular biological indicators were analyzed by usingχ2 test and Fisher exact probability method. Results In 392 patients, 352 cases (89.80％) were invasive ductal carcinoma, 6 cases (1.53％) were ductal carcinoma in situ with microinvasion, 7 cases (1.79％) were invasive lobular carcinoma, 17 cases (4.34％) were papillary carcinoma, 8 cases (2.04％) were mucinous carcinoma, 1 case (0.26％) was medullary carcinoma, and 1 case (0.26％) was metaplastic carcinoma. DBT were significantly better than FFDM in the detection rate [93.6％ (367/392) vs. 77.8％ (305/392)] and the diagnostic coincidence rate [88.2％(345/392) vs. 76.8％(278/392)] for breast cancer and judging the marginal features of tumor. The DBT imaging features of mucinous carcinomas were mostly regular in shape and clear in margin. The DBT imaging features of invasive ductal carcinomas were marginal burr sign or burr with lobulation sign. Immunohistochemical detection displayed the positive expression rates of ER and PR were highest, the positive expression rates of HER2 and Ki-67 were the lowest in marginal burr masses;the positive expression rates of ER and PR were high, the positive expression rates of HER2 and Ki-67 were low in marginal lobulated masses; the positive expression rate of HER2 was highest in borderline masses or partial borderline masses; the positive expression rates of HER2 and Ki-67 were highest in clear margin masses. Conclusions Breast DBT can reduce or eliminate the tissue overlap in FFDM examination, and improve the detection rate, the diagnostic coincidence rate and the specificity of breast cancer. It can also indirectly provide evidence for preoperative judgment of biological behavior of tumors, guide clinical treatment and assess the prognosis through the morphological and marginal features of breast masses. Breast DBT is worthy of a wide clinical application in breast examination.

Pentraxin 3 (PTX3) was identified as a marker of the inflammatory response and overexpressed in various tissues and cells related to cardiovascular disease. Honokiol, an active component isolated from the Chinese medicinal herb Magnolia officinalis, was shown to have a variety of pharmacological activities. In the present study, we aimed to investigate the effects of honokiol on palmitic acid (PA)-induced dysfunction of human umbilical vein endothelial cells (HUVECs) and to elucidate potential regulatory mechanisms in this atherosclerotic cell model. Our results showed that PA significantly accelerated the expression of PTX3 in HUVECs through the IkappaB kinase (IKK)/IkappaB/nuclear factor-kappaB (NF-kappaB) pathway, reduced cell viability, induced cell apoptosis and triggered the inflammatory response. Knockdown of PTX3 supported cell growth and prevented apoptosis by blocking PA-inducted nitric oxide (NO) overproduction. Honokiol significantly suppressed the overexpression of PTX3 in PA-inducted HUVECs by inhibiting IkappaB phosphorylation and the expression of two NF-kappaB subunits (p50 and p65) in the IKK/IkappaB/NF-kappaB signaling pathway. Furthermore, honokiol reduced endothelial cell injury and apoptosis by regulating the expression of inducible NO synthase and endothelial NO synthase, as well as the generation of NO. Honokiol showed an anti-inflammatory effect in PA-inducted HUVECs by significantly inhibiting the generation of interleukin-6 (IL-6), IL-8 and monocyte chemoattractant protein-1. In summary, honokiol repaired endothelial dysfunction by suppressing PTX3 overexpression in an atherosclerotic cell model. PTX3 may be a potential therapeutic target for atherosclerosis.
Apoptosis/drug effects ; Atherosclerosis/chemically induced/*drug therapy/immunology/pathology ; Biphenyl Compounds/chemistry/isolation & purification/*pharmacology ; C-Reactive Protein/*genetics/immunology ; Down-Regulation/drug effects ; Drugs, Chinese Herbal/chemistry/isolation & purification/*pharmacology ; Human Umbilical Vein Endothelial Cells ; Humans ; I-kappa B Kinase/*immunology ; Lignans/chemistry/isolation & purification/*pharmacology ; Magnolia/chemistry ; Palmitic Acid ; Protein-Serine-Threonine Kinases/*immunology ; Serum Amyloid P-Component/*genetics/immunology ; Signal Transduction/drug effects

To evaluate the surgical technique and clinical effect of applying Flow-through flap pedicled with superficial palmar branch of radial artery for bridging finger replantation complex defect of soft tissue and vessel. Methods From February, 2013 to March, 2018, 9 cases of severed fingers composited defect of soft tissue and vessel were treated with Flow-through flap pedicled with superficial palmar branch of radial artery.The flap was designed from the proximal end of rasceta and the donor sites were sutured directly. The size of flaps was 3.0 cm ×1.5 cm-4.0 cm×2.2 cm. The superficial branch of the radial artery in the flap was used to bridge the finger artery. And the vein of proximal and distal ends in the finger was bridged by the subcutaneous vein. The proper palmar digi-tal nerve defect was bridged by palm skin graft of median nerve. The appearance, feeling and joint function of fingers was followed-up regularly after operation. Results All transfering flaps survived and all cases were followed-up for 7 to 33 months. The donor sites got primary healing with straight scars. The appearance and texture of the flaps were satisfactory. Two-point discrimination ranged from 8 to 11 mm. The pain sensation, warmth sensation and touch sen-sation of the flaps got better. And the appearance and functions of severed fingers recovered well. Conclusion The Flow-through flap pedicled with superficial palmar branch of radial artery is easy to harvest and anastomose, which is masked and a small incision for the donor site. It is an ideal method for bridging severed fingers and repairing of fin-ger wound.