Objective To assess the anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing video-assisted thoracoscopic surgery(VATS).Methods Forty ASA Ⅰ-Ⅱpatients. undergoing VATS were randomly divided into remifentanil-propofol group(group P,n=20)and remifentanil-desflurance group (group D,n=20).MAP and HR were monitered during the entire procedures. Conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score were recorded and compared between two groups. Results During the operation, MAP was decreased significantly in group D (P＜0.05).There was no significant difference in conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score between two groups. Conclusions The anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing VATS were both with quick recovery, but the fronter has more stable hemodynamics.

Objective To study the effects of hSSTR2 gene in vitro transfection on differential proteins expression in pancreatic cancer cell line Panc-1 and search new sensitive therapeutic targets of pancreatic cancer. Methods The full length hSSTR2 cDNA was introduced into pancreatic cancer cell line Panc-1 by adenovirus vector ( Ad. CMV. hSSTR2. GFP) mediated transfection. The differential expressed proteins between the hSSTR2 transfection group, vector control and mock control were isolated and screened by 2D-DIGE analysis. Protein identification was performed by peptide mass finger printing with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/TOF). Results The hSSTR2 gene was transfected into Panc-1 pancreatic cancer cells in vitro successfully, and fluorescence difference protein expression patterns were established between hSSTR2 negative and positive expression of Panc-1 cell. Analysis by DeCyder v6.5 software showed a total of 18 protein spots ( > 1.3-fold) and these protein spots were identified by mass spectrometry as 13 proteins. Proteins with lower abundance levels included GMP synthase, stress induced phosphoprotein 1, glutamate dehydrogenase 1, Septin-11, vimentin, Isocitrate dehydrogenase [NAD] subunit alpha, Import inner membrane translocase subunit TIM50. Proteins with high abundance levels included Elongation factor 1-alpha-1, Isoform M2 of Pyruvate kinase isozymes M1/M2, Enoyl-CoA hydratase,tripartite motif-containing 28 protein, Mitofilin, HSP105. Conclusions The proteins expression changed after hSSTR2 gene in vitro transfection in Panc-1 cells, and the function of difference proteins involved the process of metabolism of sugar, fat and nucleic acid, and the regulation of cell growth. The present study paved the way for searching new sensitive therapeutic targets of pancreatic cancer.

Objective To investigate use of sedative and hypnotics agents in urban community residents aged 60 years and over in Shanghai. Methods A cross-sectional study on use of sedative and hypnotics agents was conducted in 2248 residents aged 60 years and over in Jing' an community of Shanghai during July to October 2005 with questionnaire. Results Overall prevalence of use of sedative and hypnotics agents was 15.8% (355/2248), 7.3% (165/2248) for consecutive use and 6.2% (140/2248) for long-term consecutive use, respectively, which increased with age (P < 0.05). Prevalence of use of sedative and hypnotics agents, whatever consecutive use or long-term consecutive use was significantly higher in women than that in men [18.7 % (224/1303) vs. 11.7% (111/945), P<0.01; 8.3 % (108/1303) vs. 6.0% (57/945), P < 0.05 ; or 7. 3% (95/1303) vs. 4. 8% (45/945), P < 0.05]. Use of benzodiazepinos accounted for 90. 0 % (126/140) in those with long-term consecutive use. About 93.8 % (333/355) of sedative and hypnotic agents were prescribed by medical doctors. Conclusiong In general, prevalence of sedative and hypnotics agents use in the aged residents of community is higher, mainly with benzodiazepines. There are a few problems about their unreasonable use in women and attention should be paid to it.

Objective To explore the deep venous thrombosis risk assessment table application in the evaluation of patients with respiratory diseases of deep venous thrombosis. Methods Caprini risk score model and Padua score prediction based on the related literature and respiratory diseases in reference to the characteristics of deep venous thrombosis risk factors for deep vein thrombosis, risk assessment table. And in January 2015 October 155 cases of hospitalized patients were evaluated using this table, and all patients underwent lower limb ultrasonography. Results The results showed the risk and the population under ultrasound in 60 cases (score=2 points) thrombosis probability is 0%, 95 cases of high risk population and above (score more than 3 cent) thrombosis probability is 25.26%. There were significant differences between the two groups (χ2=17.94, all P<0.05). Conclusion The application ofnon operative patients with deep venous thrombosis risk assessment table can be a good screening of high-risk patients with thrombosis. For thrombosis in high-risk groups to physical intervention, so as to reduce the incidence of deep venous thrombosis.

Objective To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) guided with endoscopic ultrasonography (EUS) for rectal neuroendocrine neoplasms(NENs).Methods A retrospective analysis was performed on 58 patients with rectal ENEs who underwent ESD from January 2011 to December 2015 in JiangSu Province Hospital.Manifestations of EUS, clinicopathological characteristics, proliferation activity grade, complete resection rate, complications and follow-up results of lesion were studied.Results Those treated by ESD included 58 patients with 64 lesions of rectal NENs.EUS results showed that 3 lesions originated from mucosa, 3 from muscularis mucosa and 58 from submucosa.A total of 34 lesions located within 5 cm from anus, 26 in 6-10 cm from anus and 4 more than 10 cm from anus.All 64 lesions were successfully treated by ESD.The mean maximum diameter of the lesions was 0.8 cm(0.2-3.5 cm), and the mean procedure time was 31 min(10-60 min).The complete resection rate was 93.8% (60/64).There were 4 patients with positive basal surgical margin, and two of them underwent additional surgery and two others were treated with argon plasma coagulation after rejecting surgery and ESD.Histological examination determined that 59 lesions were pathologic grade 1(G1) and 5 were pathologic grade 2(G2).Delayed bleeding occurred in 4 cases after ESD,which was managed by medicine in 1 case and endoscopic treatment in 3 cases.No perforation occurred after ESD.During a mean follow-up period of 22.9 months(3-48 months), no lymph node metastasis or distant metastasis was observed.Conclusion EUS is able to distinguish the origin of rectal NENs and aid determining the range and depth of ESD.ESD appears to be a safe, feasible and effective procedure for providing accurate histopathologica1 evaluations as well as curative treatments for rectal NENs limited to submucosa.

Objective To observe glomerular mesangial cells (GMCs) proliferation induced by IgA1 and the association with the expression of apoptosis-related proteins-B cell lymphoma-2 (Bcl-2),cysteine aspartic acid protease-3 (Caspase-3),cysteine aspartic acid protease-9 (Caspase-9) and with mitofusin 2 (Mfn2) in rat GMCs,to study the possible mechanism of valsartan inhibiting rat GMCs proliferation,and to provide a new direction for the mechanism of GMCs proliferation and intervention research in IgA nephrology (IgAN).Methods GMCs stimulated with IgA1 were cultured in vitro to detect cellproliferation with the cell counting kit-8 cell activity assay (CCK8).GMCs were divided into three groups:CG,TG and VG.The GMCs proliferation level was detected by the CCK8,using real-time PCR to detect Mfn2 expression and Western blotting to detect protein levels of Mfn2,Bcl-2,Caspase-3,and Caspase-9.Results Rat GMCs proliferated significantly after stimulation with IgA1,and IgA1 could obviously stimulate high expression of Bcl-2 in GMCs and down regulate the expression of Mfn2,Caspase-3,and Caspase-9.Valsartan could inhibit the proliferation of GMCs induced by IgA1 significantly,downregulate the expression of Bcl-2,and upregulate the expression of Mfn2,Caspase-3,and Caspase-9.Conclusions These results showed that the mechanism of action of valsartan in the treatment of lgAN is inhibiting the proliferation of GMCs.This mechanism may be associated with the regulation of apoptosis-related proteins,such as Mfn2,Bcl-2,Caspase-3,and Caspase-9.These findings may provide a new direction for the mechanism of GMCs proliferation and intervention research in IgAN.

Objective To investigate value of endoscopic submucosal dissection foRearly gastric canceR(EGC) and high-grade intraepithelial neoplasia (HGIN) using endoscopic submucosal dissection (ESD) and its risk factors influencing dissection.Methods The date of 80 patients who underwent ESD foREGC and HGIN in ouRhospital from DecembeR2012 to June 2014 were retrospectively reviewed.The clinical manifestation,endoscopic appearance and histopathological information were collected and the risk factors influencing curative resection afteRESD were analyzed.Results Among the enrolled 80 patients,the overall resection rate was 100%,the complete resection rate was 86.25% and the curative resection rate was 86.25%.The curative resection rate of the EGC group was significantly less than that of the HGIN group,(93.6% vs.75.76%,P<0.05).Single factoRanalysis revealed that patients with the following criteria were more likely to have higheRresection rate:a lesion size ≥2 cm,submucosa invasion and ulceration (P<0.05).Additional multivariate regression analysis demonstrated that submucosa invasion (OR=6.300,95% CI: 0.516-12.658,P<0.001),a lesion size ≥2 cm(OR=12.193,95% CI: 1.323～112.347,P=0.027) and ulceration(OR=5.679,95% CI: 1.087～29.678,P=0.040)were independent risk factors foRresection.Conclusion ESD is effective method foREGC and HGIN patients.Strictly evaluation and comprehensive treatment method are necessary foRsubmucosa invasion,lesion size ≥2 cm,and ulceration patients.

Objective To investigate value of endoscopic submucosal dissection foRearly gastric canceR(EGC) and high-grade intraepithelial neoplasia (HGIN) using endoscopic submucosal dissection (ESD) and its risk factors influencing dissection.Methods The date of 80 patients who underwent ESD foREGC and HGIN in ouRhospital from DecembeR2012 to June 2014 were retrospectively reviewed.The clinical manifestation,endoscopic appearance and histopathological information were collected and the risk factors influencing curative resection afteRESD were analyzed.Results Among the enrolled 80 patients,the overall resection rate was 100%,the complete resection rate was 86.25% and the curative resection rate was 86.25%.The curative resection rate of the EGC group was significantly less than that of the HGIN group,(93.6% vs.75.76%,P<0.05).Single factoRanalysis revealed that patients with the following criteria were more likely to have higheRresection rate:a lesion size ≥2 cm,submucosa invasion and ulceration (P<0.05).Additional multivariate regression analysis demonstrated that submucosa invasion (OR=6.300,95% CI: 0.516-12.658,P<0.001),a lesion size ≥2 cm(OR=12.193,95% CI: 1.323～112.347,P=0.027) and ulceration(OR=5.679,95% CI: 1.087～29.678,P=0.040)were independent risk factors foRresection.Conclusion ESD is effective method foREGC and HGIN patients.Strictly evaluation and comprehensive treatment method are necessary foRsubmucosa invasion,lesion size ≥2 cm,and ulceration patients.

Objective To explore the real psychological experience in elderly patients with prostatic cancer after castration and to offer reference for formulating targeted interventions.Methods Totally 15 elderly prostatic cancer patients who received castration and total androgen blockade in the First Affiliated Hospital of Wenzhou Medical University from October 2014 to June 2016 were selected by convenient sampling and interviewed intensively.The data were analyzed by Colaizzi's seven-step method for qualitative studies.Results Totally 3 topics were summarized:the sense of uncertainty in elderly prostatic cancer patients after castration;changes in social adaptation;self-image disorder.Conclusions Various psychological crises,especially depression,are experienced in elderly prostatic cancer patients after castration.Therefore,continuous and extensive support is required for elderly prostatic cancer patients after castration.

Objective To explore the effects of continuous nursing on postoperative urinary incontinence in patients with prostate cancer, so as to provide clinical evidence to improve the quality of postoperative and extended nursing care.Methods A total of 120 patients with prostate cancer underwent radical prostatectomy in the First Affiliated Hospital of Wenzhou Medical University from January 2016 to January 2017, who met the inclusion criteria were recruited in the research. The patients were randomly divided into experimental group and control group by sortition randomization method, with 60 cases in each. The patients in control group were given routine discharge health education, and the experimental group received continuous nursing on the basis of routine discharge nursing. Three months after discharge, the incidence, duration, frequency and quantity of urinary incontinence in the two groups were recorded by the International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF). A self-designed prostate cancer postoperative-related knowledge questionnaire, which evaluated the patients understanding prostate cancer care, was completed by the patients of the two groups. A self-designed satisfaction questionnaire was used to evaluate and compare the satisfaction of the two groups of patients to the quality of nursing.Results The incidence rate and the duration of postoperative urinary continence in the experimental group [16.7％,(4.1±2.8) d] were significantly lower than those in the control group (χ2=9.076,t=-2.630;P<0.05). After 3 months of discharge, the score of related knowledge and the satisfaction of nursing work in the experimental group were both higher than those of the control group, and the differences were statistically significant (P<0.05).Conclusions Continuous nursing care for discharged patients after prostatectomy can enhance patients' knowledge of disease, effectively reduce the incidence of postoperative incontinence, reduce urinary incontinence duration, and improve patients' satisfaction with nursing quality.