Objective To evaluate the effect of chronic alcohol intake on the sedative potency of propofol through investigating the effect of chronic alcohol intake on the half-effective target effect-site concentration ( EC50 )of propofol required for loss of consciousness in patients. Methods Fifty male ASA Ⅰ or Ⅱ patients, aged 25-60 yr, weighing 50-80 kg, scheduled for elective surgery, were divided into 2 groups according to the history of chronic alcoholic intake ( n = 25 each): control group (alcoholic intake per day ＜ 25 g) and chronic alcoholic group (alcoholic intake per day＞45 g, lasting for 2 yr or more). The EC50 and 95% confidence interval (CI)were determined by up-and-down sequential method. The initial target effect-site concentration was 2 μg/nl in chronic alcoholic group and 1.5μg/ml in control group, and the ratio between the two successive concentrations was 1.05. Loss of consciousness was defined as loss of response to verbal command and eyelash stimulation. Results The EC50 of propofol that produced loss of consciousness was 3.92 (95 % CI 3.56-4.63 ) μg/ml in chronic alcoholic group and 2.73 (95%CI 2.26-3.31)μg/ml in control group. The EC50 of propofol was significantly higher in chronic alcoholic group than in control group ( P ＜ 0.05). Conclusion Chronic alcohol intake can increase the EC50 of propofol required to induce loss of consciousness and reduce sedative potency in patients.

Objective To investigate the characteristics of clinical application of skin flap supplied by sural nerve nutrition blood vessel. Methods The flaps were used in 17 cases to repair the soft tissue defect in heel,mallelous,anterior tibial and achilles tendon. Results 14 cases of 17 survived satisfactory. 2 cases presented edema and partially necrosis,they finally survived after open decompression and change of dressing. 1 case presented chronic sinus because of osteomyelitis of calcaneus. 6 months later, when the fracture healed, we performed debridement, removal of internal fixation, curettage and irrigation. It finally healed. Conclusion The sural nerve nutrition blood vessel flap was easy to elevate and safe, which was an ideal flap for repairing the soft tissue defect around the heel, malleolus, achilles tendon and the anterior tibial.

With the progress of imaging, optics and other science and technology, neuroendoscopy technology has been greatly developed, the application of more and more widely, but also become one of the techniques that neurosurgeons must be familiar with and master. With the further popularization of neuroendoscopy technology, related complications have also attracted wide attention. Endoscopic techniques are being used extensively used in the current times for the diagnosis and treatment of numerous intracranial pathologies. Although the incidence of complications related to neuroendoscopy is lower than that of traditional surgery, neuroendoscopy itself may bring complications such as hemorrhage, cerebrospinal fluid leakage, subdural hematoma and so on. This article reviews the complications related to neuroendoscopic surgery, in order to improve the understanding of complications and timely and correct treatment, so as to improve the curative effect of neuroendoscopic surgery.

Objective To investigate the effect of 5-hydroxytryptamine 1A (5-HT1A) receptor agonists to improve micturition function in rats with diabetes mellitus (DM).Methods Fourteen female SD rats with the weight of 250 to 275 g were used.Seven rats were in the DM model group with intraperitoneal injection streptozotocin (STZ,65 mg/kg).Rats in the control group and DM group were anesthetized with urethane (1.3 g/kg) 8 weeks later.A polyethylene (PE)-50 catheter were placed in the left jugular vein for intravenous drug administration.A PE-90 catheter was inserted into the bladder,with the other end connected to a syringe pump for continuous infusion of saline and a pressure transducer for intravesical pressure monitor.Dose-response curves for 8-OH-DPAT were followed by WAY-100635 test.The capacity,residual volume,micturition volume,and EUS-EMG were measured.Results Compared to normal control,DM rats had a higher bladder capacity,residual volume,and a lower voiding efficiency.With increasing dose of 8-OH-DPAT (0.003-1.000 mg/kg,i.v.),the micturition volume increased from (2.15±0.49) ml to (2.85±0.21) ml,the residual volume decreased from (3.40±0.74)ml to (1.82±0.48) ml and voiding efficiency changed from (39.0±9.3)％ to (61.6±6.9)％.Control rats showed little change in cystometic variable.During the micturition,there was a dose-dependent increased phasic EUS activity correlated with the improved voiding efficiency.WAY-100635 (0.300 mg/kg,i.v.) reversed the 8-OH-DPAT-induced changes.Conclusions Both the bladder voiding efficiency and the periodic EUS activity decrease in DM rats.5-HT1A receptor agonist could promote periodic EUS activity and improve voiding efficiency.

Objective To compare the clinical efficacy of diciofenac sodium suppository and terazosin in treatment of prostatodynia. Methods 120 patients(age ranging from 19 to 48 years,mean age was 29. 8 years) suffering from prostatodynia, were randomly divided into 2 groups: diciofenac sudium suppositoy group of 60 patients (50mg,rectal medication, q12h for 2 weeks) and terazosin group of 60 patients (2mg, per os, q12h or qn for 2 weeks).The therapeutic effects and side-effects were compared after 2 weeks treatment. Results The total clinical effective rate in diciofenac sudium suppository group was 97% , higher than that (80%) of terazosin groups(P

Objective To evaluate the efficacy and safety of bilateral transversus abdominis plane block (TAPB)combined with bilateral rectus sheath block (RSB)in abdominal surgery. Methods Ninety ASA Ⅰ or Ⅱ patients,35 males,55 females,aged 19-79 years,with body mass index 18-30 kg/m2 ,scheduled for elective laparoscopic cholecystectomy were randomly divided into three groups(n=30):ultrasound-guided bilateral TAPB combined with bilateral RSB group (group TR),ultrasound-guided bilateral TAPB group (group T),patient-controlled intravenous analgesia (PCIA)group (group P).In group TR,ultrasound-guided bilateral TAPB were performed with 20 ml of 0.22% ropivacaine mesylate injection in each side and ultrasound-guided bilateral RSB were per-formed with 10 ml of 0.22% ropivacaine mesylate injection in each side before surgery.In group T, ultrasound-guided bilateral TAPB were performed with 20 ml of 0.22% ropivacaine mesylate injection in each side and ultrasound-guided bilateral RSB were performed with 10 ml of NS in each side before surgery.In group P,ultrasound-guided bilateral TAPB were performed with 20 ml of NS in each side and ultrasound-guided bilateral RSB were performed with 10 ml of NS in each side before surgery, and PCIA was applied in group P.BP,HR,SpO2 were observed when patients were sent into the op-erating room, 2 minutes before trocar puncture, and 2 minutes after trocar puncture, the consumption of propofol and remifentanil used during the surgery were recorded.The score of visual analogue scale (VAS)during rest and movement were recorded at 2,6,12,24 h after surgery.The patient analgesia satisfaction and the adverse reactions were recorded.Results Compared with group T and group P,group TR had less change of BP before and after trocar puncture(P <0.05).The VAS score was significantly lower in group TR after operation(P <0.05).There were no statistical significant differences of VAS score at 24 h after operation among the three groups.The patient anal-gesia satisfaction was significantly better in group TR than other two groups (P < 0.05 ). Conclusion Ultrasound-guided bilateral transversus abdominis plane block combined with bilateral rectus sheath block is of safety and much efficacy of postoperative analgesia in patients undergoing laparoscopic cholecystectomy.

BACKGROUND:It remains controversial in term of therapeutic efficacy of self-fixating mesh and sutured mesh in inguinal hernia repair. OBJECTIVE:To compare the therapeutic effects of self-fixating mesh and sutured mesh in open inguinal hernia repair with Meta-analysis. METHODS:Comprehensive electronic search strategies were developed using the folowing electronic databases: Cochrane library, PubMed, EMBASE, Medline, Ovid, CNKI, Wanfang and FMJS. The Literature published before December 2014 was searched. Perspective randomized controled trials about comparing self-fixating mesh and sutured mesh in open inguinal hernia repair were included. A data-extraction sheet was developed based on the preset standards. The data from eligible studies were pooled through Meta-analysis. RESULTS AND CONCLUSION:Nine trials with a total of 2 100 inguinal hernia patients met the inclusion criteria, including 1 033 cases of self-fixing mesh and 1 067 cases of sutured mesh. The Meta-analysis showed that no significant differences were found between the two groups in the recurrence rate, seroma, hematoma, wound infection, pain, foreign body sensations (P > 0.05), but the duration of operation was less in the self-fixing mesh group than the sutured mesh group (P < 0.05). According to limited evidence, there are some findings as folows: self-fixating mesh is equivalent to sutured mesh in the therapeutic effects on open inguinal hernia repair. Because of the limits of samples and literature quality, more large-sample and high-quality trials are required to make a definite clinical evidence to use self-fixating mesh for groin hernia repair.

Objective To present one case of bronchial artery aneurysm successfully treated with endovascular interventional procedure and review literature. Methods A 67-year-old man was diagnosed with mediastinal bronchial artery aneurysm accompanied with tuberculous pleurisy by chest imaging. The aneurysm was treated via transcatheter bronchial artery embolization combined with endovascular stent-graft placement in the thoracic aorta under DSA guidance. Results Postprocedural angiography showed satisfactory exclusion of the aneurysm and no endolead. Conclusion Interventional therapeutic management of bronchial artery aneurysm is feasible and accurate.

ObjectiveTo investigate the preventive effects of rosiglitazone on nonalcoholic steatohepatitis (NASH) rats and to explore the potential mechanisms in modulating peroxisome proliferator-activated receptor gamma (PPARγ),nuclear factor kappa B (NF-κB),and cyclooxygenase-2 (COX-2) expression.Methods Thirty male SD rats were assigned into the normal group ( n =10),the model group ( n =10),rosiglitazone prevention group [ n =10,simultaneously 4mg/( kg · d) gavage daily at beginning].Liver appearance,liver index,and histological changes were assessed.Serum tumor necrosis factor-o (TNF-c) and prostaglandin E2 (PGE2) were determined using enzyme-linked immunosorbent assay.The expressions of PPARγ,NF-κB,and COX-2 in liver were determined using immunohistochemical methods.The mRNA and protein expressions of COX-2 were disclosed by real-time polymerase chain reaction and Western blot analysis.ResultsCompared with the normal group,the liver index significantly increased in model group (3.92 ±0.72 vs.5.71 ± 1.05,P =0.004).HE and Masson staining showed significantly increased steatosis,inflammation,and fibrosis.The serum levels of TNF-α,PGE2 in high-fat-diet-fed rats were significantly increased ( 11.72 ± 2.47 vs.29.39 ± 5.32,P =0.002 ; 236.60 ± 24.90vs.288.24 ± 17.17,P =0.004).Immunohistochemistry showed NF-κB and COX-2 in livers were significantly elevated,but PPARγ wasdecreased in nonalcoholic steatohepatitis rats.Real-time polymerase chain reaction and Western blot found mRNA and protein expressions of COX-2 were increased in the model group (0.57 ± 0.08 vs.2.83 ± 0.24,P =0.0007 ; 0.38 ± 0.03 vs.1.00 ± 0.03,P =0.004).Compared with the model group,the expressions of PPARγsignificantly increased and the expressions of NF-κB and COX-2 significantly decreased ( mRNA:2.83 ± 0.24 vs.0.46 ± 0.11,P =0.002 ; protein: 1.00 ± 0.03 vs.0.62 ± 0.02,P =0.006 ) in the rosiglitazone prevention group.ConclusionBy inhibiting NF-κB and COX-2 expressions,rosiglitazone can reduce insulin resistance and then prevent the occurrence and deve lopment of nonalcoholic steatohepatitis.

Interventional management was performed in 10 patients with hemorrhage following hepatic biliary and pancreatic surgery.The super-selection arterial embolization was performed in 9 patients using gelfoam pledgets (n =6 ) or metal coils (n =3 ),the procedure was combined with local infusion of reptilase; 1 case was managed by local infusion of reptilase alone.Selective angiography revealed the pseudoaneurysm in 3 cases,contrast media extravasation in 6 cases; in 1 case no obvious bleeding site was found The interventional treatment was successful and hemorrhage stopped in all patients,including one case with reptilase alone with a successful rate of 10/10.The results indicate that interventional treatment is a safe and effective method for hemorrhage following hepatic biliary and pancreatic surgery.