Objective To study the application of dexmedetomidine in patients with combined spinal epidural anesthesia and its effects on hemodynamics and renin angiotensin aldosterone system (RAAS).Methods96 patients with open surgery under combined spinal epidural anesthesia from Oct.2013 to Oct.2016 in our hospital were selected.Divided into two groups by randomly, the dexmedetomidine group(46 cases) was given dexmedetomidine before anesthesia, the control group(46 cases) was given sodium chloride solution.The operation condition, and the changed of mean arterial pressure (MAP), heart rate, plasma renin activity (PRA), angiotensin II (ANG-II) and aldosterone (ALD) at before anesthesia (T1), post anesthesia 10min (T2), end of the operation (T3) and end of the operation 30 min (T4) were compared.ResultsThere was no significant difference in the operation time, blood loss, intraoperative transfusion, and wake up time between the two groups;there was no significant difference in MAP and heart rate between the two groups at T1, at T2, T3, T4 point, control group MAP, heart rate were significantly changed(P<0.05), and there was no significant change in dexmedetomidine group, at T2,T3,T4 point, the levels of MAP, heart rate in the dexmedetomidine group were lower than the control group(P<0.05);there was no significant difference between the two groups in PRA, ANG-Ⅱ and ALD at T1, at T2 and T3 point, the PRA, ANG-Ⅱ and ALD in the two groups were increased, at T4 point down, there were significant differences compared with the same group at T1(P<0.05);but at T2,T3,T4, the levels of PRA,ANG-Ⅱ,ALD were lower than the control group(P<0.05).ConclusionIn the combined spinal epidural anesthesia with dexmedetomidine before anesthesia, which can Maintain hemodynamic stability, And inhibit the activation of RAAS.

Objective To analyze the relationship between blood glucose level, blood pressure and weight with pancreatic cancer genesis. Then to explore the metabolism associated risk factors in pancreatic cancer genesis. Methods Form December 2002 to September 2009 in Ruijin Hospital, 548 pancreatic cancers with pathology diagnosis after pancreatectomy were collected for the study with retrospective analysis method. The association of pancreatic cancer with blood glucose level, blood pressure, weight and other metabolic factors were analyzed. Results With principal component analysis, it suggested that there were strong correlation between blood glucose level, blood pressure and weight index (BMI) increasing with pancreatic cancer. The contribution rates were 3. 614%,25. 236%, 15. 418% and 12. 918%, respectively. Single factor analysis indicated that the association between pancreatic cancers and new onset diabetes mellitus (duration≤ 2 years) was stronger than that of long-term diabetes mellitus. The occurrence rate of pancreatic cancer in patients with long-term diabetes whose blood glucose level was not well controlled recently while well controlled previously (44.6 % ) was significant hister than that in patients without diabetes (5. 6% , P＜0.05). The fasting blood glucose level of these PC patients ( 13.87± 3. 49 mmol/L) was significantly higher than new onset and other long-term diabetes patients, the comparative risk was 13.46 (95% CI 4. 560,39. 731). BMI increasing was a risk factor of pancreatic cancer, but there was no significant statistical difference between risk degree and BMI increasing level. All above metabolic diseases were risk factors of pancreatic cancer, but for pathology, location and stage of pancreatic cancer there was no statistical difference in theses factors. Conclusion This study suggested diabetes, BMI increasing and hypertension were high risk factors of pancreatic cancer genesis. New onset and long-term diabetes patients whose blood glucose not controlled well recently should be watched carefully for pancreatic cancer. Early treatment and intensive follow-up of metabolic disease might be helpful to early diagnosis and prognosis of pancreatic cancer.

Objective:To evaluate the effects of celecoxib on postoperative cognitive function in elderly patients with hip fracture.Methods:One hundred and thirty patients with hip fracture patients from July 2017 to July 2019 in Shanghai Songjiang Fangta Hospital of Traditional Chinese Medicine were selected. All patients were treated with the same anesthetic and surgical methods. The patients were divided into celecoxib group (66 patients) and control group (64 patients) by random number table method. The patients in celecoxib group were given oral administration of celecoxib 200 mg 12 h before surgery and 12, 24, 48 h after surgery; the patients in control group were given oral administration of placebo at the same time. Patients were treated with sufentanil intravenous analgesia pump. The serum levels of C reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α and prostaglandin E 2 (PG-E 2) 12 h before surgery and 4, 24, 48 h after surgery were determined. The pain intensity 1, 4, 24 and 48 h after surgery was measured by visual analogue scale (VAS) score. Cognitive function before surgery and 7 d after surgery was assessed by mini-mental state examination (MMSE), and the MMSE 7 d after surgery <23 scores was diagnosed postoperative cognitive dysfunction (POCD). Results:There was no statistical difference in VAS score 1 and 4 h after surgery between 2 groups ( P>0.05); the VAS score 24 and 48 h in celecoxib group was significantly lower than that in control group: (4.3 ± 1.2) scores vs. (6.1 ± 1.6) scores and (4.0 ± 0.9) scores vs. (7.8 ± 1.3) scores, and there was statistical difference ( P<0.05). There were no statistical difference in CRP, IL-6, TNF-α and PG-E 2 12 h before surgery between 2 groups ( P>0.05); the CRP, IL-6, TNF-α and PG-E 2 4, 24 and 48 h after surgery in celecoxib group were significantly lower than those in control group, and there were statistical differences ( P<0.05). There was on statistical difference in MMSE before surgery between 2 groups ( P>0.05); MMSE 7 d after surgery in celecoxib group was significantly higher than that in control group: (25.1 ± 1.9) scores vs. (23.9 ± 1.5) scores, the incidence of POCD was significantly lower than that in control group: 10.6% (7/66) vs. 28.1% (18/64), and there were statistical differences ( P<0.05). Conclusions:Celecoxib can decrease early POCD incidence after hip fracture surgery in elderly patients, which might be mediated by suppressing inflammation and acute postoperative pain caused by surgical trauma.

AIM:To investigate the influence of Jiedu hugan granule on the inflammatory factor and tight junction protein of small intestine in rats with immunological liver injury.METHODS:Fifty SD rats were randomly divided into control group,model group,low,middle and high experimental group of Jiedu hugan granule (2.7,5.4,and 10.8 g/kg).All the groups excepted the control group received intraperitoneal injections of 0.5 mL pig serum for each to establish immunological liver injury model.The experimental group was irrigated ltime/d,continuous dosing for 14 d.The liver tissue and small intestinal tissue pathological changes were observed by HE staining,the serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were detected,and the expression of liver tissue TNF-α and small intestine tissue occludin-5 were detected by immunohistochemical method.RESULTS:The model group liver tissue showed accumulation of fat cells,liver cells enlargement,disorganized liver and associated with inflammatory cells infiltration;the experimental group liver cell morphological ruled,hepatic cords in alignment and inflammatory cells infiltration significantly decrease.The model group small intestinal mucosa villi showed atrophy,fall off of epithelial cell,edema,large number of inflammatory cells infiltration;the experimental group showed closelyknitted small intestinal mucosa villi,relieve edema,and no obvious infiltration of inflammatory cells.The levels of ALT,AST,LDH and TNF-α in experimental group were statistically lower than the model group,and the levels were statistically reduce with the dose of jiedu hugan granule increased.The levels of occludin-5 in experimental group were statistically highter than those of the model group,and the levels of occludin-5 were statistically increase with the dose of Jiedu hugan granule increased,the differences were statistically significant (P ＜ 0.05).CONCLUSION:Jiedu hugan granule can improve the organizational structure of liver and small intestine,protect the damage of liver,reduce inflammation,and maintain small intestine mucosal barrier function.

Objective:To explore the application of the Simodont dental trainer in preclinical manual dexterity training for dental students of different grades, and to discuss its effect by quantitatively evaluating their practice results.Methods:The evaluation was conducted among 118 students in the Department of Stomatology, Shantou University Medical College from Batch 2015 to Batch 2018. Each student had five different manual dexterity modules for training. Each module had three levels of difficulty and was required to be completed in 30 minutes. The assessment index included Target, Leeway Bottom and Sides, Container Bottom and Sides, which was provided by the Simodont dental trainer. The operating time (in seconds), the displacement of the dental hand pieces and the dental mirrors (in meters) were simultaneously recorded. SPSS 25.0 was used for statistical analysis.Results:For the index Target, Leeway Bottom and Sides, Container Bottom and Sides, the results showed that there was a statistical difference between students who passed pre-clinical training and who did not take the professional course ( P < 0.001). For the index Target, differences were showed among students from different grades in all modules ( P < 0.001). Conclusion:The circle module, channel module, hollow-circle module and cross-module in the Simodont dental trainer have sensitivity to discriminate the manual dexterity of different levels of dental students. The further assessment of the discrimination of the manual dexterity is required for assume-block module. The Simodont dental trainer can quantitatively measure the manual dexterity of dental students, which is important for the quantitative evaluation of dental preclinical education.

Objective:To analyze the comprehensive blood inflammation index of the patients with stage I pneumoconiosis complicated with pulmonary infection, and to explore its value in predicting the patients' disease.Methods:In September 2023, 83 patients with stage I pneumoconiosis who were treated in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from November 2021 to August 2023 were selected and divided into non-infected group (56 cases) and infected group (27 cases) according to whether they were combined with lung infection. Workers with a history of dust exposure but diagnosed without pneumoconiosis during the same period were selected as the control group (65 cases) . By referring to medical records and collecting clinical data such as gender, age, occupational history, past medical history, hematology testing, the differences in the comprehensive blood inflammation indexes among the three groups were compared, ROC curve was drawn, and the relationship between comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infection was analyzed.Results:There were significtant differences in the number of neutrophils (N) , the number of lymphocytes (L) , the number of monocytes (M) , C-reactive protein (CRP) , the neutrophil to lymphocyte ratio (NLR) , the monocyte to lymphocyte ratio (MLR) , the platelet to lymphocyte ratio (PLR) , the systemic immune-inflammatory index (SII) , the systemic inflammation response index (SIRI) , the aggregate index of systemic inflammation (AISI) , the derived neutrophil to lymphocyte ratio (dNLR) , the neutrophil to lymphocyte and platelet ratio (NLPR) , and the C-reactive protein to lymphocyte ratio (CLR) ( P<0.05) . Compared with the control group, MLR, SIRI and AISI in the non-infected group were significantly increased ( P<0.05) . NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR, CLR were significantly increased ( P<0.05) . Compared with the non-infected group, NLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR were significantly increased in the infected group ( P<0.05) . ROC analysis showed that NLR, MLR, PLR, SII, SIRI and AISI had a certain predictive capability for stage I pneumoconiosis ( P<0.05) , among which MLR had the highest efficacy, with an AUC of 0.791 (95% CI: 0.710-0.873) , the cut-off value was 0.18, the sensitivity was 71.4%, and the specificity was 78.5%. NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR all had a certain predictive capability forstage I pneumoconiosis combined lung infection ( P<0.05) , among which CLR had the highest efficacy, with an AUC of 0.904 (95% CI: 0.824~0.985) , the cut-off value was 5.33, sensitivity was 77.8%, specificity was 98.2%. Conclusion:The comprehensive blood inflammation index may be an auxiliary predictor of stage I pneumoconiosis and its combined lung infections.

Objective:To analyze the comprehensive blood inflammation index of the patients with stage I pneumoconiosis complicated with pulmonary infection, and to explore its value in predicting the patients' disease.Methods:In September 2023, 83 patients with stage I pneumoconiosis who were treated in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from November 2021 to August 2023 were selected and divided into non-infected group (56 cases) and infected group (27 cases) according to whether they were combined with lung infection. Workers with a history of dust exposure but diagnosed without pneumoconiosis during the same period were selected as the control group (65 cases) . By referring to medical records and collecting clinical data such as gender, age, occupational history, past medical history, hematology testing, the differences in the comprehensive blood inflammation indexes among the three groups were compared, ROC curve was drawn, and the relationship between comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infection was analyzed.Results:There were significtant differences in the number of neutrophils (N) , the number of lymphocytes (L) , the number of monocytes (M) , C-reactive protein (CRP) , the neutrophil to lymphocyte ratio (NLR) , the monocyte to lymphocyte ratio (MLR) , the platelet to lymphocyte ratio (PLR) , the systemic immune-inflammatory index (SII) , the systemic inflammation response index (SIRI) , the aggregate index of systemic inflammation (AISI) , the derived neutrophil to lymphocyte ratio (dNLR) , the neutrophil to lymphocyte and platelet ratio (NLPR) , and the C-reactive protein to lymphocyte ratio (CLR) ( P<0.05) . Compared with the control group, MLR, SIRI and AISI in the non-infected group were significantly increased ( P<0.05) . NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR, CLR were significantly increased ( P<0.05) . Compared with the non-infected group, NLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR were significantly increased in the infected group ( P<0.05) . ROC analysis showed that NLR, MLR, PLR, SII, SIRI and AISI had a certain predictive capability for stage I pneumoconiosis ( P<0.05) , among which MLR had the highest efficacy, with an AUC of 0.791 (95% CI: 0.710-0.873) , the cut-off value was 0.18, the sensitivity was 71.4%, and the specificity was 78.5%. NLR, MLR, PLR, SII, SIRI, AISI, dNLR, NLPR and CLR all had a certain predictive capability forstage I pneumoconiosis combined lung infection ( P<0.05) , among which CLR had the highest efficacy, with an AUC of 0.904 (95% CI: 0.824~0.985) , the cut-off value was 5.33, sensitivity was 77.8%, specificity was 98.2%. Conclusion:The comprehensive blood inflammation index may be an auxiliary predictor of stage I pneumoconiosis and its combined lung infections.

Humans ; HIV-1 ; Leukocytes, Mononuclear ; Lymphoma, Non-Hodgkin ; DNA ; HIV Infections

Hypertensive disorder of pregnancy (HDP) involves two major public health issues: mother-infant safety and prevention and controlling major chronic disease. HDP poses a serious threat to maternal and neonatal safety, and it is one of the leading causes of maternal and perinatal morbidity and mortality worldwide, as well as an important risk factor for long-term cardiovascular disease (CVD). In order to explore effective strategies to prevent and control the source of CVD and reduce its risk, we have established a cohort of HDPs in Shenzhen for the primordial prevention of CVD. The construction of the HDP cohort has already achieved preliminary progress till now. A total of 2 239 HDP women have been recruited in the HDP cohort. We have established a cohort data management platform and Biobank. The follow-up and assessment of postpartum cardiovascular metabolic risk in this cohort has also been launched. Our efforts will help explore the pathophysiological mechanism of HDP, especially the pathogenesis and precision phenotyping, prediction, and prevention of pre-eclampsia, which, therefore, may reduce the risk of adverse pregnancy outcomes, and provide a bridge to linking HDP and maternal-neonatal cardiovascular, metabolic risk to promote the cardiovascular health of mothers and their infants.

ObjectiveBased on ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS）， the combination of serum pharmacochemistry， response profile of absorbed components in serum， network pharmacology and drug-likeness prediction was used to screen the potential active ingredients of Yanghetang against breast cancer. MethodsUPLC-Q-TOF-MS/MS was used to identify the main components in different solvent extracts of Yanghetang， and serum pharmacochemistry was applied to analyze the absorbed components from the serum of female SD rats after 0.5， 1， 2 h of administration. Combined with the response characteristic values of serum drug components obtained from UNIFI 1.8.2， the absorbed prototype components and metabolites were screened to get the absorbed components of Yanghetang with a significant patterns of elimination and growth. Network pharmacology was applied to construct a drug-component-pathway-target-disease network， and molecular docking was performed between absorbed components and key targets of breast cancer， and the drug similarity was analyzed by SwissADME. ResultsForty-two compounds were identified in Yanghetang samples extracted with different solvents， of which 16 compounds were common to the three different extraction solvents（methanol， 50% methanol and water）. The results of drug-containing serum analysis showed that there were 16 absorbed components in serum， including 5 prototypes and 11 metabolites. Network pharmacology results showed that Yanghetang against breast cancer involved 15 key targets such as proto-oncogene tyrosine-protein kinase Src（SRC）， epidermal growth factor receptor（EGFR） and phosphoinositide 3 kinase catalytic alpha polypeptide（PIK3CA）. Molecular docking results showed that 16 potential active ingredients were well combined with the predicted targets. Combined with drug likenesses， 12 compounds in the absorbed components of Yanghetang were considered to have potential for anti-breast cancer activity， mainly including α-pinene and γ-eudesmol and their metabolites， of which one was from Ephedrae Herba， one was from Rehmanniae Radix， and eight were from Cinnamomi Cortex. ConclusionThe chemical components of Yanghetang mainly include polysaccharides， monoterpene glycosides and coumarins， and its prototype components mainly undergo oxidation， hydrolysis and acetylation after entering the blood. Its anti-breast cancer mechanism may be related to the regulation of signaling pathways such as the mitogen-activated protein kinase（MAPK） and phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt）. The results of this study can lay a foundation for further exploration of Yanghetang in the treatment of breast cancer.