Objective To investigate the value of MSCT in assessing bowel ischemia of small-bowel obstruction .Methods CT images and electronic medical records of 40 patients with small-bowel obstruction were retrospectively evaluated.Patients were treated by surgery.The CT signs of bowel ischemia were recorded.Relationship between CT signs and bowel ischemia were tested by Fisher exact andχ2 test.Sensitivity and specificity of MSCT for ischemia were also assessed.Results Bowel ischemia was confirmed at surgery and/or pathological examination in 21 of 40 patients.Diminished enhancement after contrast agent injection was the most common sign in bowel ischemia patients.The signs of increased bowel-wall attenuation on non enhanced images and diminished enhancement after contrast agent injection were significantly associated with ischemia (P <0.000 1).The signs of increased bowel-wall attenuation on non enhanced images and pneumatosis intestinalis had high sensitivity(100%).The sign of diminished enhancement after contrast agent injection had high sensitivity(95.2%)and specificity(94.7%).Conclusion MSCT is accurate in assessing bowel ischemia of small-bowel obstruction, and improves the timeliness and diagnosis for this disease.

Objective To investigate the therapeutic effect of continuous intravenous pralidoxime chloride infusion in acute organophosphorus pesticide poisoning(AOPP).Methods The patients with severe AOPP were randomly divided into 3 groups:(1)group 1(n =51)received a bolus injection of pralidoxime chloride 2.Og followed by continuous intravenous infusion at 0.25 g/h.(2)group 2(n = 51)received a bolus injection of pralidoxime 2.Og followed by continuous intravenous infusion at 0.5g/h.(3)group 3(n = 50)received intravenous drip of pralidoxime 2.Og for 3 times a day.Efficacy was compared among 3 groups on the basis of time to reach atropinization,recovery of cholinesterase activity .cumulative amount of atropine,incidence of recurrence of pesticide poisoning,intermediate syndrome,and hospitalization days,etc.Results Efficacy in patients receiving continuous intravenous therapy was significantly different from the third group.But there was no significant difference in efficacy between the first and second groups.Conclusion The patients with AOPP can be effectively treated by a loading dose followed with continous intravenous pralidoxime chloride infusion.

Objective:To analyze the clinical guidance value of 3.0 T three-dimensional time of fly magnetic resonance angiography (3D-TOF-MRA) in patients with trigeminal neuralgia (TN) who underwent microvascular decompression (MVD) treatment.Methods:The clinical and imaging data of 60 TN patients who underwent MVD treatment in Jinhua People′s Hospital from January 2019 to December 2019 were retrospectively analyzed. All patients underwent 3D-TOF-MRA examination before the surgery. The relationship and direction of the trigeminal neuralgia and surrounding blood vessels were observed, the responsible blood vessels that compressed the nerves before the surgery were determined, and vascular nerve compression (NVC) was clarified.Results:Among the 60 TN patients, pain symptoms of 52 patients (86.67%) completely disappeared after the surgery, and the pain symptoms of the remaining 8 patients (13.33%) were also significantly relieved. There was no statistically significant difference between 3D-TOF-MRA examination and MVD surgery in the judgment of the responsible vessel ( P>0.05). The positive rate of TN diagnosed by MVD surgery was 98.33% (59/60), and the positive rate of TN diagnosed by 3D-TOF-MRA was 91.67% (55/60), with no statistically significant difference ( P>0.05), and with highly consistency by Kappa test ( Kappa value=0.867). The area under the curve (AUC) of TN diagnosed by 3D-TOF-MRA through receiver operating characteristic (ROC) curve analysis was 0.730 (95% CI 0.526~0.934). The incidence of NVC diagnosed by 3D-TOF-MRA was 63.33%(38/60), and the incidence of NVC seen by MVD surgery was 61.67%(37/60). There was no statistically significant difference in the diagnosis of NVC between 3D-TOF-MRA and MVD surgery. ( P>0.05). Conclusions:The 3D-TOF-MRA examination can more accurately know the position, orientation, shape and compression degree of the responsible blood vessel in TN patients, which has important guiding value for the clinical diagnosis of TN and preoperative evaluation of MVD.

The electrocatalytic oxidation of dopamine (DA) was studied by electrochemical approaches at a carbon ionic liquid electrode (CILE) modified with the composite film of nafion and L-aspartic acid (NL-CILE). The CILE was fabricated by replacing non-conductive organic binders with a room-temperature hydrophobic ionic liquid, 1-butyl-3-methyl-imidazolium hexafluorophosphate. The composite film of NL was used as matrix to adsorb DA and catalyze the oxidation of DA in phosphate buffer solution (PBS). The electrochemical response of DA was investigated at the NL-CILE, the traditional carbon paste electrode (TCPE), CILE and the nafion modified CILE (N-CILE) in 0.1M PBS (pH 7.4), respectively. The results showed the superiority of NL-CILE to N-CILE, CILE and TCPE in terms of provision of higher sensitivity, faster electron transfer and better reversibility. Under optimum condition, the oxidation peak current was rectilinear with DA concentration range from 0.1μM to 0.1mM, with a detection limit of 0.03μM (S/N=3) by differential pulse voltammetry. The proposed method was applied to determine DA in samples successfully.

Objective To study the influence of combined spinal-epidural anesthesia on perioperative coagulation function,RAAS activity and postoperative analgesia effect in parturients with cesarean section.Methods One hundred and eighteen parturients of cesarean section in our hospital from June 2013 to January 2016 were collected and divided into the observation group and control group according to the random number table method,59 cases in each group.The observation group received the combined spinal-epidural anesthesia and the control group received epidural anesthesia.The coagulation function indicators on preoperative 1 d (T0),at 10 min before operation end(T1) and postoperative 6 h (T2) were detected by adopting the automatic blood coagulation analyzer,the renin angiotensin aldosterone system (RAAS) function indices were detectd by radioimmunoassay.The pain indicators at postoperative 6 h(T2),12 h (T3) were detected by the pain threshold test instrument.Results The levels of prothrombin time(PT),activated partial thromboplastin time (APTT) and thrombin time (TT) at T1 and T2 in the observation group were significantly higher than those in the control group,while the PTA level was lower than that in the control group(P<0.05);serum RAAS indices such as (renin),angiotensin Ⅱ(ANG II) aldosterone(ALD) in the observation group were lower than those in the control group(P<0.05).The VAS score at T2,T3 in the observation group was lower than that in the control group,while the pain threshold and pain tolerance threshold levels in the observation group were higher than those in the control group(P<0.05).Conclusion Combined spinal-epidural anesthesia can reduce the blood coagulation and RAAS activation caused by cesarean section trauma,and the effect of postoperative analgesia is more significant.

Objective To evaluate the efficacy of acting κ opioid receptor for prevention of high altitude pulmonary edema (HAPE) in rats.Methods Forty male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 5 groups (n =8 each) using a random number table:control group (group C),hypobaric hypoxia group (group H),normal saline + hypobaric hypoxia group (group NH),U50488H (a selective kappa-opioid receptor agonist) + hypobaric hypoxia group (group UH),and nor-binaltorphimine (norBNI,a selective kappa-opioid receptor antagonist) + U50488H + hypobaric hypoxia group (group NUH).The rats were put into the hyperbaric chamber and exposed to hypobaric hypoxia (atmospheric pressure 355 mmHg,partial pressure of oxygen 74 mmHg) for 2 days to induce HAPE.At 3 days before HAPE,normal saline 0.5 ml,U50488H 1.25 mg/kg,and nor-BNI 2.0 mg/kg were injected intraperitoneally once a day in NH,UH,and NUH groups,respectively,and in addition U50488H 1.25 mg/kg was injected intraperitoneally 10 min later in NUH group.After 2 h exposure to hypobaric hypoxia,mean pulmonary artery pressure (mPAP) was detected,and arterial blood samples were collected for determination of serum malondialdehyde (MDA) and erythropoietin (EPO) levels.The rats were then sacrificed and lungs were removed for microscopic examination and for determination of the levels of nitric oxide (NO),inducible nitric oxide synthase (iNOS),MDA,superoxide dismutase (SOD),endothelin-1 (ET-1),thromboxane B2 (TXB2),and 6-keto-prostaglandin F1α (6-keto-PGF1α) in lung tissues.Lung water content and TXB2/6-keto-PGF1α ratio was calculated.Results Compared with group C,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio,and serum MDA and EPO levels were significantly increased,and iNOS,NO and SOD levels were decreased in the other four groups (P ＜ 0.05).Compared with group H,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio and serum MDA and EPO levels were significantly decreased,and iNOS,NO and SOD levels were increased in UH group (P ＜ 0.05),and no significant changes were found in the indexes mentioned above in NH and NUH groups (P ＞ 0.05).The pathological changes of lung tissues were significantly attenuated in group UH as compared with H group.Conclusion Acting κ opioid receptor can produce prevention for HAPE in rats,and inhibition of lipid peroxidation and correction of the imbalance between vasoconstrictive factors and vasodilative factors may be involved in the mechanism.

Objective Transforming growth factor-β( TGF-β) can regulate the expressions of matrix metalloproteinase (MMP) and matrix metalloproteinase (TIMP) inhibitors, thus affecting the reconstruction of extracellular matrix (ECM) after lung in-jury.So far, little is known about the regulation of TGF-β1 and MMPs/TIMPs ratio in endotoxin-induced lung injury as well as about the exact mechanisms of ECM reconstruction disorders .This study was to investigate the effects of TGF-β1 antibodies on the expressions of MMP and TIMP inhibitors and lung injury fibrosis in rats with endotoxin-induced acute lung injury . Methods Fifty-six male SD rats were randomly divided into three groups, normal (n=16), LPS (n=20), and LPS+TGF-β1(L+T, n=20).The rats of the LPS and L+T groups received intraperitoneal and intra-tracheal injection of endotoxin to induce lung injury fibrosis , the latter intrave-nously injected with TGF-β1 antibodies previously .The normal rats received intra-tracheal and intra-abdominal injection of the same a-mount of saline.At 1, 5, 9 and 14 days after modeling, all the rats were killed and blood and lung tissue samples obtained to detect the wet/dry lung tissue ( W/D ) ratio, diffuse alveolar damage ( DAD) score, hydroxyproline activity ( Hpy) , and the expressions of TGF-β1 , MMP-2 and TIMP-1. Results The DAD score, Hpy ac-tivity, and expressions of TGF-β1 , MMP-2 and TIMP-1 were signifi-cantly higher in the LPS group than in the normal control ( P <
0.05), and so were the DAD score, Hpy activity, MMP-2, and TIMP-1 in the L+T group than in the controls (P<0.05).Com-pared with the LPS group, Hpy, TGF-β1 and TIMP-1 were markedly decreased in the L +T group (P<0.05).The expression of MMP-2 was gradually increased at 1, 5 and 9 days after modeling , reaching the peak at 9 days and then beginning to decline .The Hpy activity, TGF-β1 and TIMP-1 expressions kept rising after modeling . Conclusion The MMP/TIMP imbalance and ECM reconstruc-tion disorders mediated by the TGF-β1 signaling pathway may be an important cause of fibrosis in endotoxin-induced lung injury . TGF-β1 antibodies can exert a protective effect by alleviating lung injury fibrosis .

Objective To determine the EC50 of dexmedetomidine hydrochloride ( DEX) which causes disappearance of explicit memory by process dissociation procedure (PDP). Methods Forty patients those who had senior middle school or higher educational background undergoing lower extremity surgery with grade ASA Ⅰ or Ⅱ, without hearing impairment, dysphasia,nervous system disorders,and having no drugs in the treatment of the central nervous system were included.PDP was applied to establish study table and record, and calculate performance of explicit memory and implicit memory. Memory performance was statistically compared with 0, 0 memory was considered to be statistically significant and disappearance, respectively.Sequential method was used for determination.According to explicit memory disappearance or not,target concentration of the next patient was adjusted (increase or decrease).DEX target concentration of the first patient was set to 4 ng?mL-1,and the ratio of target concentration between the adjacent patients was 1.2.If the explicit memory of the former patient disappeared,the target concentration of the next patient was decreased by 1 concentration gradient;if the explicit memory of the former patient did not disappear,the target concentration of the next patient was increased by 1 concentration gradient, and so forth. All the 40 patients were determined.The median effective dose (D1) and 95% confidence interval (CI) of DEX were calculated. Results The ED50 of DEX causing explicit memory disappearance was 5.23 ng?mL-1,and the 95% CI was 4.07-6.39 ng?mL-1. Conclusion In clinical,target concentration of dexmedetomidine hydrochloride 5.23 ng?mL-1 levels for sedation,can cause half of patients’ explicit memory disappear,so as to avoid intraoperative awareness.

Objective To investigate feedback regulation of close-loop muscle relaxant injection system on accuracy of cisatracurium besilate usage. Methods Two hundred patients undergoing laparoscopic cholecystectomy surgery, aged 20 to 40 years old, at ASA Ⅰ or Ⅱ, were randomly divided into two groups:control group and treatment group (n=100 each group).In the control group, the patients received injection of cisatracurium besilate with closed-loop muscle relaxant injection system at 1.5-2.0 μg·kg-1 ·min-1 , until 30 min before the end of surgery;if the muscle relaxant level could not meet the requirement of the operation, extra 0.05 mg·kg-1 was added.The treatment group was adopted closed-loop muscle relaxant monitoring under negative feedback regulation of infusion cisatracurium, and the close-loop control parameters were set to: drug was added when TOF was 8%, and injection speed was 2. 5 μg · kg-1 · min-1 , maintaining speed was 0. 33 μg · kg-1 · min-1 , the stimulus current for monitoring muscle relaxant was 60 mA , and the pulse width was 200μs.The Cooper score, cisatracurium dosage, and muscle recovery index, TOFr75 and TOFr90 of the two groups were compared. Prediction probability ( Pk ) of NI on awakening period of eye opening and directional force recovery of the two groups were detected, and regression equation was established to predict ED50 and ED95 related NI . Results Cooper score was significantly higher in the treatment group than in the control group ( P<0. 01 ) . Muscle recovery index, TOFr75 , TOFr90 , and cisatracurium dosage per unit time and body mass were significantly lower in the treatment group than in the control group(P<0.01). Pk of NI on awakening period of eye opening and directional force recovery of the two groups were higher than 0.5; and Pk of the treatment group were significantly higher than those of the control group ( P<0.01) . Regression equation predicted that ED95 was significantly lower in the treatment group than in the control group ( P<0.01) , while the ED50 between the two groups has no significant difference ( P>0.05) . Conclusion The accuracy of closed loop muscle relaxant injection system is higher than that of the traditional method, it provides better muscle relaxation effect for tracheal intubation, reduces recovery time, increases the Pk of NI on patient awakening.

Objective To observe the effect of suramin combinated with PG-Rg3 on xenograft growth of lung adeno-carcinoma in mice, and the related mechanism thereof. Methods Forty C57BL/6J mice bearing Lewis cells were random-ized into five groups:control group, cisplatin (DDP) group, suramin group, PG-Rg3 group and combination group. Appropri-ate interventions were given in five groups of mice. Mice were sacrificed at day 24 after tumor inoculation. The subcutaneous tumors were stripped for histological examination. The tumor inhibitory rate was measured. The expressions of erythropoietin-producing hepatoma amplified sequences (Eph) B4 protein, Bcl-2 and tumors microvessel density (MVD) were determined by immunohistochemistry method with image analyze system. The apoptosis of tumor cells was measured by biotinyated dUTP nick and labeling (TUNEL) method. Results There were significantly lower values in subcutaneous tumor volume and weight in drug-treated groups than those in control group (P<0.05). The inhibitory rates were 39.20%, 49.11%, 54.86%and 62.49%in cisplatin group, suramin group, PG-Rg3 group and combined group (P<0.05). The values of EphB4, MVD and Bcl-2 grey values were significantly decreased, the apoptotic index was significantly increased, in suramin group, PG-Rg3 group and combined group than those of control group and DDP group (P<0.05). The values of EphB4, MVD and Bcl-2 grey values were significantly increased, the apoptotic index was significantly decreased, in suramin group and PG-Rg 3 group than those of combined group (P<0.05). Conclusion Suramin combinated with PG-Rg3 can produce a synergetic inhibitory activity against tumor growth of lung adenocarcinoma, which may be associated with the effect of suppressing the expression of EphB4 and angiogenesis, and the promotion of tumor cell apoptosis.