Objective To investigate the effect of patient-controlled intravenous analgesia (PCIA) with dexmedetomidine mixed with sufentanil on the sleep quality after spinal surgery.Methods Eighty patients of both sexes, aged 21-72 yr, weighing 48-100 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective spinal surgery, were randomly assigned into sufentanil group (group S) and dexmedetomidine mixed with sufentanil group (group DS) with 40 cases in each group.In group S, PCIA solution contained sufentanil 2 μg/kg and tropisetron 6 mg in 100 ml of normal saline.In group DS, PCIA solution contained sufentanil 2 μg/kg, dexmedetomidine 3 μg/kg and tropisetron 6 mg in 100 ml of normal saline.The PCA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h.Sufentanil 5 μg injected intravenously and celecoxib 200 mg given orally were used as rescue analgesics, and numeric rating scale (NRS) score at rest was maintained ≤4 within 48 h after surgery.Ramsay sedation scores were recorded at 1, 2, 6, 12, 24 and 48 h after surgery.Sleep quality was evaluated using the Medical Outcomes Study Sleep Scale (MOS-SS), and the average time of daily sleep and Sleep Problems Index (SPI) were recorded at week 1 before and after surgery.Patient's satisfaction with sleep was assessed on the night of surgery and 1st day after surgery.The requirement for rescue analgesics was recorded.Results There was no significant difference in the requirement for rescue analgesics between group S and group DS (P＞0.05).Compared with the value before surgery, the average time of daily sleep was significantly shortened, and SPI was increased at week 1 after surgery in group S (P＜0.05 or 0.01), and no significant change was found in group DS (P＞0.05).Compared with group S, the Ramsay sedation scores were significantly increased at 1, 2, and 6 h after surgery, the average time of daily sleep was prolonged at week 1 after surgery, the SPI was decreased at week 1 after surgery, and the degree of satisfaction with sleep was increased on 1st day after surgery in group DS (P＜0.05 or 0.01).Conclusion PCIA with dexmedetomidine mixed with sufentanil is helpful in improving the sleep quality after spinal surgery in the patients.

ObjectiveTo observe the effectiveness of collagen sponge for reducing volume of drainage after surgery for lumbar spinal stenosis. MethodsOne hundred and eighty-six patients who suffered from lumbar spinal stenosis were divided into two groups by random digits table method. The test group(96 cases) used collagen sponge to cover dura mater before placing drainage tube,the control group (90 cases) was treated without collagen sponge. The volume of drainage at 1,12,24 h after surgery were observed, the blood routine test was carried out at before and 48 h after surgery and the volume and ratio of blood transfusion after surgery was also measured and compared between the two groups. ResultsThe volume of drainage were significantly decreased in the test group compared with the control group at 1,12,24h after surgery [( 106.11 ± 20.02 ) ml vs. ( 127.02 ± 25.09) ml, (236.12 ± 34.06) ml vs. (327.31 ± 51.21 )ml, (355.16 ± 49.03 ) ml vs.( 506.36 ± 85.29 ) ml](P ＜ 0.05 ). The volume and the ratio of blood transfusion in the test group were ( 176.27 ± 21.37) ml and 10.42％(10/96) ,which were greatly lower than those in the control group[(445.94 ±24.56) ml and 32.22％ (29/90)](P ＜0.05). The number of RBC and the concentration of Hb were (2.96 ± 0.45 ) × 1012/L and ( 106.75 ± 7.30) g/L, differently in the test group at 48 h after surgery,which were increased significantly compared with the control group[(2.35 + 0.57) × 1012/Land (90.45 ± 5.10) g/L](P ＜ 0.05 ). ConclusionsCollagen sponge provides rapid ,effective and durable hemostasis and decreases the leak of cerebrospinal fluid after surgery for lumbar spinal stenosis. It can be used as an effective and economic method to reduce the volume of drainage after surgery.

OBJECTIVE:To establish a RP-HPLC method for simultaneous determination of chlorapheniramine maleate,furacilin and ephedrine hydrochloride in Puma nose drops.METHODS:The analysis was carried on a XDB C 8 column;the mo?bile phase was composed of methanol(A),acetonitrile(B)and0.02mol/L potassium dihydrogen phosphate solutions(containing0.2%triethylamine and adjusted to pH3.0with phosphoric acid,C)with linear gradient elution(0min～3.5min,A∶B∶C=6∶13∶18,8.5min,A∶B∶C=6∶30∶64)and the flow rate was1.0ml/min;the detection wavelength was254nm and the column temperature was30℃.Chloramphenicol was used as the internal standard.RESULTS:The linear ranges were0.04～0.20mg/ml for chlorapheniramine maleate,0.02～0.10mg/ml for furacilin,0.50～2.50mg/ml for ephedrine hydrochlo?ride.The average recoveries were99.44%(RSD=0.48%,n=3)for chlorapheniramine maleate,101.36%(RSD=0.41%,n=3)for furacilin and99.43%(RSD=0.59%,n=3)for ephedrine hydrochloride.CONCLUSION:The method is reliable,accurate and suitable for quality control of Puma nose drops.

AIM:To asses the presence and clinical significance of metallothionein,(MT) in primary invasive ductal carcinoma of the breast. METHOD: 96 cases of routinely fixed and paraffin-embedded primary breast carcinomas were investigated with the labelled avidin biotin immunohistochemical method. RESULTS: The positive staining for MT observed was 52.1% (50/96). In most cases both nuclear and cytoplasmic staining was seen. A statistically association was found between MT positive staining and nuclear grade( P

Objective To observe the effect of the injection of myoblast carrying human insulin-like growth factor-1(hIGF-1) on the expression of endogenous IGF-1 mRNA and IGF-1 level in mice skeletal muscle following injury.Methods Seventy two male C3H mice(20~30g,7~11w)were randomly divided into three groups(24 mice in each group) with four mice normal controls.Applied a falling hit from certain height at the medial calf of right lower limbs in three groups,the injured skeletal muscle model was successfully simulated.Three days following injury,the mice in group A and B were injected with 1?106 myoblasts either carried with or without hIGF-1 gene respectively and the mice in group C were injected with 100?l saline at the injured muscle.Three mice in each group were sacrificed randomly at day 2,5,10,15,20,30 after contusion.The expression level of mIGF-1 was assessed by immunohistochemical staining and real time PCR.Results mIGF-1 mRNA expression and mIGF-1 factor secretion were observed in all three groups;the amount of mIGF-1 mRNA expression and mIGF-1 secretion in group A were significant higher than that in group B and C.Conclusion Myoblast carrying hIGF-1 transplantation could promote endogenous IGF-1 secretion in injured skeletal muscle.

Objective To observe the survival of myoblasts carrying hIGF-1 gene transplanted into the mice, and the expression of hIGF-1 in the transplanted mice. Methods Eighty four male C3H mice(20～30g,7～11w)were divided into four groups: group A, B, C and D (20 mice each group), and the remaining four mice were used as normal control. At the middle of the right gastrocnemius muscle, the mice in group A and B were injected with 1?10~6 myoblasts either carried with or without hIGF-1 gene. Muscle contusion at the middle of the right gastrocnemius muscle of the mice in group C and D was produced. At day 3 following injury, they were injected with 1?10~6 myoblasts either carried with hIGF-1 gene (group C) or without hIGF-1 gene (group D). At the day 2, 5, 10, 20, 30 after injection, four mice of each group were sacrificed randomly. BrdU staining in all mice were performed to evaluate cells surviving, and the expression level of hIGF-1 in group A and C was assessed by immunohistochemical staining and real-time-PCR. Results The BrdU staining in both normal and injured mice transplanted with myoblast carried with or without hIGF-1 were positive. hIGF-1 was expressed and secreted in both group A and C. Conclusion The myoblast carrying hIGF-1 gene transplanted into normal or injured mice can survive for a certain period of time, and can secrete hIGF-1.

Objective: To understand the consistency of ALK Ventana-D5F3 immunohistochemistry (IHC) interpretation in Chinese lung adenocarcinoma among histopathologists from different hospitals, and to recommend solution for the problems found during the interpretation of ALK IHC in real world, with the aim of the precise selection of patients who can benefit from ALK targeted therapy. Methods: This was a multicenter and retrospective study. A total of 109 lung adenocarcinoma cases with ALK Ventana-D5F3 IHC staining were collected from 31 lung cancer centers in RATICAL research group from January to June in 2018. All cases were scanned into digital imaging with Ventana iSCANcoreo Digital Slide Scanning System and scored by 31 histopathologists from different centers according to ALK binary (positive or negative) interpretation based on its manufacturer′s protocol. The cases with high inconsistency rate were further analyzed using FISH/RT-PCR/NGS. Results: There were 49 ALK positive cases and 60 ALK negative cases, confirmed by re-evaluation by the specialist panel. Two cases (No. 2302 and No.2701) scored as positive by local hospitals were rescored as negative, and were confirmed to be negative by RT-PCR/FISH/NGS. The false interpretation rate of these two cases was 58.1% (18/31) and 48.4% (15/31), respectively. Six out of 31 (19.4%) pathologists got 100% accuracy. The minimum consistency between every two pathologists was 75.8%.At least one pathologist gave negative judgement (false negative) or positive judgement (false positive) in the 49 positive or 60 negative cases, accounted for 26.5% (13/49), 41.7% (25/60), respectively, with at least one uncertainty interpretation accounted for 31.2% (34/109). Conclusion There are certain heterogeneities and misclassifications in the real world interpretation of ALK-D5F3 IHC test, which need to be guided by the oncoming expert consensus based on the real world data.