To investigate the effects of brachial plexus block(BPB) and satellite ganglion block(SGB) on the blood flow of upper limb, 22 patients were randomly divided into two groups,and given BPB(group A,n=11) or SGB(group B,n=11) with 1% lidocaine 10 ml every other day for 5 times. Ulnar-radial artery blood flow was measured by using a TCD 30 minutes before and after the block. Finger pulse amplitude was measured by pulse oximeter 5,10,15,20,30 minutes after the block.The average increase in ulnar-radial artery blood flow was 13 cm/s in group A and 5 cm/s in group B. Finger pulse amplitude increased by (9.04±2.12)mm in group A and(3.54±1.42)mm in group B.A significant difference was observed between the two groups (P＜0.01).It suggested that BPB could induce more increase in blood flow of the upper limb than SGB.

To investigate the effects of brachial plexus block(BPB) and satellite ganglion block(SGB) on the blood flow of upper limb, 22 patients were randomly divided into two groups,and given BPB(group A,n=11) or SGB(group B,n=11) with 1% lidocaine 10 ml every other day for 5 times. Ulnar-radial artery blood flow was measured by using a TCD 30 minutes before and after the block. Finger pulse amplitude was measured by pulse oximeter 5,10,15,20,30 minutes after the block.The average increase in ulnar-radial artery blood flow was 13 cm/s in group A and 5 cm/s in group B. Finger pulse amplitude increased by (904?212)mm in group A and(354?142)mm in group B.A significant difference was observed between the two groups (P

In order to study the status of cell apoptosis in psoriatic epidermis, we have investigated the changes of the lesions in various stages in patients with psoriasis vulgaris by using terminal deoxynueleotidyl transferase-mediation dUTP-biotin nick end labelling (TUNEL). The results showed that the highest frequency of apoptotic keratinocytes was observed in the early scaling papular lesions, and the frequency was reduced in the progressive maculo-papular lesions and the coalescent plaques successively. The frequency of hyperproliferation of epidermis was in the reverse order in comparison with the above results. These results suggest that increased apoptosis of keratinocytes is the initial change of psoriatic epidermis, then hyperproliferation of keratinoeytes follows.

Objective To evaluate the reliability of ultrasonography used to guide the selection of uncuffed endotracheal tube (ETT) size for pediatric patients.Methods Eighty pediatric patients requiring endotracheal intubation for elective surgery under general anesthesia,aged 2-6 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,were randomized into 2 groups (n=40 each) using a random number table:control group and ultrasonography group.In control group,the internal diameter of an uncuffed ETT was determined according to age-based formulas.In ultrasonography group,the outer diameter of an uncuffed ETT was determined according to the transverse diameter of the subglottic airway at the level of the cricoids cartilage measured by ultrasonography.The air leak test was performed after intubation,and either a larger or a smaller size of ETT selected was considered as a failure of intubation.The failure of intubation and postoperative complications related to intubation were recorded.Results Compared with control group,the total failure rate of intubation and failure rate due to the smaller size of ETT selected were significantly decreased in ultrasonography group (P＜0.01).There was no significant difference in the incidence of intubation-related complications between the two groups (P＞0.05).Conclusion Ultrasonogra-phy can be used to guide the selection of ETT size for pediatric patients.

Objective To study the expression of transcription factor specificity protein1 and activator protein-2α and the correlation between the two transcription factors in the process of occurrence and development of colorectal cancer. Methods To detect expression of Sp1 and AP-2α mRNA by Real-Time PCR in 60 colon cancer tissues and corresponding normal tissues and the results were compared with the clinical features and pathological characters. The relationship between the expression of Sp1 mRNA and AP-2α mRNA in 60 colon cancer tissues was determined. Results The expression rates of Sp1 mRNA was detectable to highly expressed rates in colon cancer tissues than the matched normal tissues (P ＜0.01),whereas AP-2α mRNA in the colon cancer tissues was significantly lower than that in the matched normal tissues (P ＜0.01). Sp1 mRNA and AP-2α mRNA expression rates had no significant difference between the clinical features (sex, age and tumor areas) respectively. Loss expression or down regulation expression of AP-2α mRNA was detected, whereas Sp1 mRNA was detectable to highly expressed in the different histological grade and Dukes stages. The expression of Spl mRNA and AP-2α mRNA were positively correlated with the histological grade in colon cancer. A significant correlation was found between the expression of Sp1 mRNA and AP-2α mRNA (r =-0.849, P ＜0.001). Conclusion Loss or down regulation expression of AP-2α mRNA,whereas Sp1 was detectable to highly expressed in colon cancer. Negative correlation occurred in Sp1 mRNA and AP-2α mRNA indicated that AP-2α and Sp1 provide the new clues of genetic diagnosis and treatment.

Objective To explore the effect of three surgical positions on needle-assisted thoracoscopic sympathicotomy. Methods Sixty patients undergoing needle-assisted thoracoscopic sympathicotomy were divided into lateral position group，Fowler position group，and modified Fowler position group. The position of the endotracheal tube，noninvasive blood pressure (NIBP) and heart rate were monitored before and after the body position was changed. Moreover，the exposure of surgical field,operation time and comfort degree of patients were recorded. Results The operations were completed successfully under the three positions. Modified Fowler position provided better surgical field and higher comfort degree of patients. Moreover,it was convenient for operative procedure and shortened the operation duration. Conclusion During the operation of needle-assisted thoracoscopic sympathicotomy,modified Fowler position can provide better surgical exposure,enhance comfort of patients,stabilize hemodynamics and shorten operation duration.

Objective To evaluate the safety and feasibility of totally laparoscopic cholecystolithotomy.Methods Patient baseline characteristics of all 34 totally laparoscopic cholecystolithotomy (TLC) were collected in a database.This group was compared with 34 matched patients who underwent the laparoscopic cholecystectomy (LC) in the same period.Retrospectively,intraoperative and postoperative data were added.Results Operatingtime was significantly longer in the TLC group(124.56 min vs 78.50 min,P ＜0.01).The mean hospitalization expenses of operation was significantly higher in the TLC group(10 970.85 yuan vs 8 666.72 yuan,P ＜0.01).Although not significant less patients have the symptoms of postoperative dyspepsia or diarrhea were seen in the TLC group compared with the LC group (2 vs 6,P =0.26).Intraoperative details and postoperative results such as,blood loss,hospital stay,exhaust time,abdominal bleeding,bile leakage,incision infection have no significant difference.One case of gallstone recurrence was detected in TLC group.No stone recurrence was reported in common bile duct in LC group.Conclusions TLC is effective and feasible for chronic calcular cholecystitis and is particularly favorable for thepatients with medical insurance.However,this approach is technically demanding and should be performed by experienced surgon.

Objective:To construct an intelligent performance measurement system of gastrointestinal endoscopy and to analyze its value for endoscopic quality improvement.Methods:The intelligent gastrointestinal endoscopy performance measurement system was developed by using the deep convolutional neural network (DCNN) and deep reinforcement learning, based on the Digital Imaging and Communications in Medicine. Images were acquired of patients undergoing gastrointestinal endoscopy at Digestive Endoscopy Center of Renmin Hospital of Wuhan University from December 2016 to October 2018. The system applied cecum recognition model (DCNN1), images in vitro and in vivo recognition model (DCNN2), and identification model at 26 gastric sites (DCNN3) to monitor indices such as cecal intubation rate, colonoscopic withdrawal time, gastroscopic inspection time, and gastroscopic coverage. Images of 83 gastroscopies and 205 colonoscopies acquired at Digestive Endoscopy Center of Renmin Hospital of Wuhan University from March to November 2019 were randomly selected to examine the effectiveness of the system. Results:The intelligent gastrointestinal endoscopy performance measurement system consisted of quality analysis of both gastroscopy and colonoscopy, including all indices, and could be generated automatically at any time. The accuracy for cecal intubation rate, colonoscopic withdrawal time, gastroscopic inspection time, and gastroscopic coverage were 92.5% (172/186), 91.7% (188/205), 100.0% (83/83), 89.3% (1 928/2 158), respectively.Conclusion:The intelligent performance measurement system for gastrointestinal endoscopy can be recommended for the quality control of gastrointestinal endoscopy, from which endoscopists can get feedback and improve the quality of gastrointestinal endoscopy.

Objective To evaluate the a.ccuracy of ultrasound in verifying endotracheal tube (ETT) position in neonates.Methods Sixty neonates of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 2-28 days,weighing 2.5-4.8 kg,scheduled for urachal fistula/urachal resection or inguinal hernia repair under general anesthesia,were divided into 2 groups (n=30 each)using a random number table method:auscultation group and ultrasound group.Confirmation of ETF position was performed in two stages.In the first stage,misplacement of ETT into esophagus was identified using auscultation and ultrasound techniques after intubation,and end-tidal carbon dioxide pressure was considered as the gold standard for identification of esophageal intubation.In the second stage,misplacement of ETY into bronchus was identified using auscultation and ultrasound after confirming ETT position was within the trachea,and electronic bronchoscope served as the gold standard for identification of bronchial intubation.Results Compared with auscultation group,the accurate rate of identification of bronchial intubation was significantly increased in ultrasound group (P＜0.05).The sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of auscultation for identification of esophageal intubation was 100％,96.3％,75％ and 100％,respectively.The sensitivity,specificity,PPV and NPV of auscultation for identification of bronchial intubation was 33.3％,95.8％,66.7％ and 85.2％,respectively.The sensitivity,specificity,PPV and NPV of ultrasound for identification of esophageal or bronchial intubation were all 100％.Conclusion Ultrasound can verify ETT position accurately in neonates.

Objective:To investigate the effects of triptolide (TPL) and BET protein inhibitor JQ1 on proliferation inhibition and apoptosis induction of MLL-rearranged acute myeloid leukemia (AML) cell line MV4-11, and to explore their synergistic mechanisms.Methods:MV4-11 cells in logarithmic growth phase were treated with different concentrations (100, 200, 300, and 400 nmol/L) of JQ1, 4 nmol/L TPL or different concentrations of JQ1 combined with 4 nmol/L TPL for 48 h. Cell proliferation was detected by CCK-8 method, apoptosis was detected by flow cytometry (FCM), mitochondrial membrane potential was detected by JC-1 method, and expressions of mitochondrial apoptosis pathway-related proteins were detected by Western blot.Results:The 50% inhibitory concentration ( IC50) value of MV4-11 cells treated with JQ1 for 48 h was (283.9±10.7) nmol/L. However, 4 nmol/L TPL significantly enhanced the inhibitory effect of JQ1 on proliferation of MV4-11 cells, the IC50 value of MV4-11 cells treated with JQ1 combined with TPL was (148.1±2.6) nmol/L, and the difference was statistically significant ( t = 25.31, P = 0.029). The result of FCM assay showed that compared with the JQ1 alone group [(9.6±2.3)%, (12.6±1.4)%, (19.5±3.3)%, and (22.7±2.1)%], 4 nmol/L TPL combined with different concentrations (100, 200, 300, and 400 nmol/L) of JQ1 acted on MV4-11 cells for 48 h, the proportions of apoptotic cells were (16.4±1.9)%, (27.5±2.1)%, (32.9±3.6)%, and (35.5±3.0)%, respectively, the difference was statistically significant ( F = 9.25, P < 0.01). After treated with 4 nmol/L TPL and JQ1 for 12 h, the level of cell membrane potential in MV4-11 cells was significantly lower than that of JQ1 single agent group, and the difference was statistically significant ( P < 0.05). After treated by 4 nmol/L TPL combined with JQ1 for 24 h, the levels of anti-apoptotic proteins bcl-2 and Mcl-1 decreased, and the level of pro-apoptotic protein bax increased. Conclusion:TPL can significantly enhance the proliferation inhibition and apoptosis induction effects of BET protein inhibitor JQ1 on MLL-rearranged AML cells, and the mechanism may be related to enhancing the mitochondrial apoptosis pathway.