Objective To discuss comparison of different analgesic solution to the immune status and serum levels of inflammatory cytokines of the patients with breast cancer after surgery.Methods The patients of experimental group and control group were given Dizocine and fentanyl to analgesic respectively perioperative experimental.Then analysis and comparison the immune status and serum levels of the two groups.Results The T lymphocyte subsets ( The level of CD3 +、CD4 +and the ratio CD4 +/CD8 +) and the level fo NK cells of the exprimental group patients intraoperative and postoperative 1 d were significantly higer than the control group.The anti-inflammatory factor in the serum of the experimental group patients intraoperative and postoperative 1d was significantly higer than the control group.The proinflammatory factor in the serum of the experimental group patients intraoperative and postoperative 1 d was significantly lower than the control group.Conclusion Dizocine can significantly improve the serum inflammatory factors of the patients with brest cancer after surgery,and can adjust the patient’s immune status.

OBJECTIVE:To study the effects of propofol on invasion of hepatoma carcinoma HepG2 cell. METHODS:MTT method was used to detect the viability of HepG2 cells which were cultured with 0(negative control),1,3 and 10 μg/ml propofol for 48 h. The ability of cell invasion was detect by Tranaswell method. The phosphorylation level of nuclear factor-κB p65(NF-κB p65) and the expression of matrix metalloproteinase 2 (MMP-2),MMP-9,E-cadhherin and Snail were detected by Western blot method. RESULTS:Compared with negative control,1,3,10 μg/ml propofol inhibited the cell viability and invasion,down-regu-lated the expression of Snail and the phosphorylation level of NF-κB p65,and up-regulated the expression of E-cadherin (P<0.01). 3,10μg/ml propofol down-regulated the expression of MMP-2 and MMP-9(P<0.01). Above effects depended on drug con-centration(P<0.01). CONCLUSIONS:Propofol can suppress HepG2 invasion,which might be related to the inhibition of NF-κB/Snail signal pathway.

Objective To observe the effects of dexmedetomidine on serum TNF-αand IL-6 in neurosurgical patients during perioperative period. Methods 60 cases patients with intracranial aneurysm treated in our hospital in January 2014 to August 2014 were selected as the research objects, and they were randomly divided into two groups with 30 cases in each group.Before induction, the observation group adopted 1μg/kg dexmedetomidine with 10 min infusion, then adopted 0.4μg/( kg? h) infusion of dexmedetomidine, and control group received saline infusion.Serum TNF-αand IL-6 levels in two groups were compared at different time.Results After application of dexmedetomidine, the related indexes of hemodynamics in observation group, mean arterial pressure (MAP) and heart rate (HR) were more stable (P<0.05).Serum levels of TNF-αat the time of after induction, skin incision operation, 1h operation in observation group were (1.32 ±0.35), (1.42 ±0.54), (1.52 ±0.67), (1.57 ±0.63) μg/L, and were lower than those of control group, respectively (P<0.05).Serum levels of IL-6 at the time of after induction, skin incision operation, 1h operation in observation group were (69.64 ±13.54), (72.43 ±16.75), (76.32 ±16.93), (77.42 ±15.75) μg/L and were lower than those of control group, respectively (P<0.05).Conclusion The hemodynamics after application of dexmedetomidine in patients with neurosurgery operation is more stable, and the serum TNF-αand IL-6 are lower, so it contributes to the anti-inflammatory and has important clinical value.

Anthracycline-based antitumor drugs are one of the highly effective broad-spectrum anti-cancer drugs that are commonly used clinically. However, anthracyclines have the serious side effect of cumulative dose-related cardiotoxicity. Clinically, intake of myocardial protective drugs is one of the most important strategies for the safe use of anthracyclines in chemotherapy. Numerous cancer patients un-dergoing chemotherapy also require surgery, during which general anesthesia is commonly used. Various studies have shown that propofol and sevoflurane, the most commonly used general anesthetics, present a significant protective effect in myocardial ischemia-reperfusion damage. Therefore, for patients who have just undergone chemotherapy with anthracyclines, anthracycline-induced myocardial injury may occur at the acute or chronic phase of surgery. Consequently, if the effect of anesthetics on the cardiotoxicity of anthracyclines is similar to the protective effect of these drugs for myocardial ischemia-reperfusion damage, this protective effect on cardiotoxicity will have significant impact on the recovery of cardiopulmonary function of patients after surgery. Thus, further studies are needed to establish the effect of anesthetics on the cardiotoxicity of anthracyclines.

OBJECTIVE:To observe the cerebral protective effects of dexmedetomidine in brain aneurysm surgery. METH-ODS:48 patients with intracranial aneurysm were randomly divided into observation group and control group,with 24 cases in each group. Observation group was given dexmedetomidine 1 μg/kg,pump time 10 min,at rate of 0.5 μg/kg;control group re-ceived constant volume of normal saline. Hemodynamic changes,the levels of S100β protein and neuron specific enolase (NSE) were compared between 2 groups. RESULTS:The heart rate and mean arterial blood pressure were more stable in the observation group after medication,with statistical significance(P<0.05). The serum level of S100β protein at the end of operation(T5),6 h after operation(T6),12 h after operation(T7),24 h after operation(T8)were(1.52±0.35)μg/L,(1.69±0.33)μg/L,(1.72±0.42)μg/L,(2.08±0.57)μg/L;the serum level of NSE were(10.9±1.2)ng/L,(13.5±1.5)ng/L,(16.8±2.8)ng/L and(19.7±4.3)ng/L in observation group;those were all lower than in control group,with statistical significance(P<0.05). CONCLUSIONS:Dexme-detomidine for cerebral aneurysm operation is helpful for hemodynamics stability,and result in lower S100β protein and NSE. So it is important for cerebral protection.

OBJECTIVE To prevent nosocomial infection from catheterization room and to reduce the rate of postoperative infection, and improve quality of catheterization room medical care. METHODS Air, object surfaces, the hands of medical staff, and using disinfectant in catheterization room were put to the test every month. RESULTS Totally 253 specimens were put surveillance over three years, total qualified rate was 99.6%, that of air was 98.6% and of object surfaces was 100%, for the hands of medical staff was 100%, and for using disinfectant was 100%. CONCLUSIONS Enhancing prevention nosocomial infection can effectively reduce the infection rate. Surveying the catheterization room termly is an important measure to prevent and control the nosocomial infection.

Objective To study retrospectively the outcome and failing factors of nasopharyngeal carcinoma(NPC) treated with late-course unconventional fractionation radiotherapy(LCUCFR). Methods From January 1996 to December 2000, 133 such patients were analyzed retrospectively. All had been confirmed by histopathology as poorly differentiated squamous cell carcinoma, including 101 males and 32 females. All were treated by LCUCFR. The nasopharyngeal lesion radiation schedule was as follows; 1.An initial conventional fractionation 34.5Gy/18f for face and neck port, with 1.92Gy per daily fractionation;2.The above regimen was followed by 1.25-1.50Gy per fraction twice daily in 6-8 days for pre-auricular port;3.The above regiment was then followed by conventional boosting dose 1.90Gy and 1.30Gy(morning 1.90Gy and afternoon 1.30Gy) twice daily(with interval of 6-8 hours) in 6-8 days. The whole course was 5 fractions per week with the median of 78Gy over a median of 47days. The positive and negative lymph node in the neck were treated by conventional radiotherapy with a median of 67Gy and a dose of 50-55Gy in median interval of 43 days. Results The 5-year nasopharyngeal lesion and neck metastasis lymph node control rate was 92.9% and 96.4%, respectively. T1,T2,T3 and T4 stage local control rate was 100%,96.6%,96.6% and 78.4%,respectively. The overall 5-year survival and disease-free survival rate was 73.3% and 70.8%,respectively. The 5-year distant-free metastasis rate was 80.2%. Fourteen varietes were used to analyze the prognosis. Both univariate and multivariate analyses revealed that the distant metastasis, lower neck and superclavicle area as well as both neck lymph node metastases and local recurrence were prognostic factors for 5-year survival rate(Logrank test all P

Practical teaching is an important component of higher medical education. The article introduced a number of exploration and experience of Shaoyang Medical College in building a practical teaching quality guarantee system,such as revising personnel training programs, optimizing practice teaching environment,enhancing teaching quality construction projects, strengthening teachers troop construction reinforcing teaching practice management and the teaching quality monitoring,etc.

Objective To evaluate the ischemic postconditioning on endoplasmic reticulum stress during cerebral ischemia/reperfusion (I/R) in rats.Methods Ninety adult male Sprague-Dawley rats,aged 350-450 g,were randomly divided into 3 groups (n =30 each) using a random number table:sham operation group (S group),I/R group,and ischemic postconditioning group (group P).Focal cerebral I/R was induced by electrocoagulation of left middle cerebral artery and 30 min occlusion of bilateral common carotid arteries followed by reperfusion.In group P,bilateral common carotid arteries were subjected to 3 cycles of 30 s reperfusion and 10 s ischemia at the beginning of reperfusion.At 24 h of reperfusion,neurological deficit was scored,and cerebral infarct size was detected by TTC staining.At 6,12 and 24 h of reperfusion,the expression of glucose-regulated protein 78 (GRP78),C/EBP homologous protein (CHOP) and caspase-12 in the ischemic area were measured (using immunohistochemistry).The neuronal apoptosis in the ischemic area was detected by TUNEL.Results Compared with S group,the neurological deficit score was significantly increased,cerebral infarct size was enlarged,the neuronal apoptosis was increased,and the expression of GRP78,CHOP and caspase-12 was up-regulated in I/R and P groups.The neurological deficit score was significantly lower,cerebral infarct size was smaller,the expression of GRP78 was higher at 12 and 24 h of reperfusion,the neuronal apoptosis was lower at 24 h of reperfusion,and the expression of CHOP and caspase-12 was lower in group P than in group I/R.Concluion Ischemic postconditioning can inhibit neuronal apoptosis mediated by endoplasmic reticulum stress during cerebral I/R,which dose not play a leading role in cerebral protection in rats.

Objective To compare the efficacy of different does of remifenanil combined with propofol for colonoscopy.Methods Ninety ASA Ⅰ or Ⅱ patients,aged 35-63 yr,weighing 45-72 kg,scheduled for elective painless outpatient colonoscopy,were randomly divided into 3 groups (n =30 each):remifentanil 0.2 μg/kg group (group Ⅰ),remifentanil 0.5 μg/kg group (group lⅡ) and remifentanil 1.0 μg/kg group (group Ⅲ).In groups Ⅰ-Ⅲ,remifentanil 0.2,0.5 and 1.0μg/kg were injected over 60 s,respectively,and then propofol 1.0 mg/kg was injected intravenously for induction.The colonoscope was inserted after loss of eyelash reflex.When body movement appeared during examination,remifentanil 0.1 μg/kg + propofol 0.5 mg/kg,remifentanil 0.25 μg/kg + propofol 0.5 mg/kg,and remifentanil 0.5μg/kg+ propofol 0.5 mg/kg were added in groups Ⅰ,Ⅱ and Ⅲ,respectively.The operation time,induction time,emergence time,examination room discharge time,and body movement,hypotension,bradycardia,hypoxemia and respiratory depression during operation were recorded.Results There was no significant difference in the operation time,induction time,emergence time,and examination room discharge time between the three groups (P ＞ 0.05).Compared with group Ⅰ,the incidence of body movement was significantly decreased,and the incidences of hypotension and respiratory depression were increased in group Ⅱ,and the incidence of body movement was significantly decreased,and the incidences of hypotension,hypoxemia,bradycardia and respiratory depression were increased in group Ⅲ (P ＜ 0.05).The incidences of hypoxemia,bradycardia and respiratory depression were significantly higher in group Ⅲ than in group Ⅱ (P ＜0.05).Conclusion The optimum dose of remifentanil is 0.5 μg/kg when combined with propofol for colonoscopy.