Objective To compare the effects of propofol intravenous balanced anesthesia with infusion of remifentanil combined with fentanyl to simple infusion of remifentanil or fentanyl during laparoscopic cholecystectomy(LC).Methods Sixty patients scheduled for LC were randomly divided into three groups(n=20): simple remifentanil group(R),remifentanil combined with fentanyl group(RF) and simple fentanyl group(F).Mean arterial pressure(MAP),heart rate(HR) and SpO2 during the anesthesia induction phage,maintenance phage and analepsia phage,the recovery time of spontaneously breathing and consciousness from withdrawal,extubation time,pain score(verbral report score,VRS) and conscious state score(observers assessment of alertness/sedation scale,OAAS) at instant,1 h,3 h,7 h,12 h after extubation and complications of analepsia phage were recorded.Results As compared with the RF Group,the F Group and pre-induction intro-group,the R Group showed lower MAP and quicker HR when induction intubation,higher MPA and quicker HR after operation,and no obvious difference in maintenance phage was found.MAP and HR showed no obvious difference between the RF and F Group as well as within groups in induction and maintenance phage.MAP increased and HR became quicker in the RF Group when extubating and leaving operating room.All observed index at every time showed no significant differences between the R and RF Group after operation,but it prolonged significantly in the F Group.Complications of the three groups showed no statistical difference.VRS of the R Group was significantly higher than that of RF and F groups after operation(P

Objective To discuss clinical effect of anti-inflammatory No.1 on prevention and treat-ment of chemotherapeutic phlebitis. Methods 200 patients undergoing peripheral venous chemotherapy were divided into the observation group and the control group with 100 patients in each group. The control group received routine nursing, the observation group was given local compression with gauze dipped with anti-inflammatory No.1 agents. The incidence of phlebitis was compared between the two groups and un-derwent χ2 test. Results The incidence of phlebitis in the observation group was lower than that of the control group. Conclusions Application of local compression with anti-inflammatory No.1 agents proves to be an effective method in prevention and treatment of chemotherapeutic phlebitis.

ObjectiveTo explore the value of 64-slice CT perfusion imaging(CTPI) in the early diagnosis of radiation-induced lung injury ( RILI ).MethodsForty-eight patients with upper esophageal cancer resection underwent CTPI before and after radiotherapy,and the TNF-α and TGF-β1 were measured from patient's peripheral blood.Serum cytokine,conventional CT appearances and CTPI parameters (rrBF,rrBV,rrPS) in patients with RILI (Group A) and non-RILI (Group B) were compared and analyzed.A randomized block design t-test was used for comparison of serum cytokines and perfusion values between the two groups.The Chi-square ( x2 ) test was used for comparison of detection rate between conventional CT and CTPI.ResultsRILI occurred in 18 of 48 cases ( 18/48,Group A).In Group A,TNF-α and TGF-β1 preand pos-radiation were (36.1 ± 15.0),(30.4 ±t 14.9) ng/L and (17.5 ±9.8),(14.3 ±7.6) μg/L,respectively,and there were no statistically significant differences (t =1.14,1.I0,P =0.264,0.279).At half-dose time point of radiation,there were no significant differences for TNF-α and TGF-β1 pre- and posradiation [ ( 30.4 ± 14.9),( 28.9 ± 14.7 ) ng/L and ( 14.3 ± 7.6),( 14.4 ± 6.0 ) μg/L,respectively ]between Group A and B ( t =0.33,1.23 ; P =0.746,0.227).The rrBF,rrBV and rrPS of post-radiation from Group A were significantly higher than those of pre-radiation ( t =5.67,5.97,6.11,P =0.000,0.000,0.000),the rrBF and rrBV of post-irradiation from Group B were significantly higher than those of pre-irradiation (t =6.52,7.84,P =0.000,0.000).There was no significant difference for rrPS in Group B pre- and post-radiation (t =1.36,P =0.178 ).There were significant differences for all perfusion values detected from radiation lung fields between Group A and B ( t =2.32,2.18,6.04,P =0.025,0.034,0.000).Taking rrPS =1.28 as a threshold value on ROC,the sensitivity and specificity of CTPI for diagnosis of RILI were 77.8％,93.3％,respectively,which were much higher than those ( 11.1％,90.0％,respectively) of conventional CT (x2=13.61,P=0.000).ConclusionCTPI parameters may reflect the hemodynamic changes of post-radiation lung and have potential values for the early diagnosis of RILI.

Objective To evaluate the radiosensitization effect of low-temperature plasma on HepG2, A549, and HeLa cells.Methods Cells were divided into three groups, radiation group (R) , plasma treatment group(P), and plasma plus radiation group (P + R).After radiation, cell survival was detected by a cloning assay.Cell cycle distribution, apoptosis and ROS content were tested by flow cytometry.Western blot was used to measure the expressions of Caspase-3 and Bcl-2.Results Lowtemperature plasma showed radiosensitization effects on three different human malignant cell lines with a sensitivity enhancement ratio(SERD0) of 1.28,1.32 and 1.29.respectively.In these three different human malignant cell lines, compared with radiation alone group (R) , the G2/M arrest, apoptosis rate and ROS level in the group P + R were enhanced (the prolongation of G2/M arrest: t =9.52, 8.24, 9.53, P ＜ 0.05;the apoptosis rate: t =10.67, 38.56, 6.74, P ＜0.05;ROS content: t =9.41, 15.42, 13.53, P ＜0.05).In HepG2 cells and A549 cells, compared with group P, the prolongation of G2/M arrest, the apoptosis rate and ROS content of group P + R were enhanced (the prolongation of G2/M arrest: t =8.75, 20.37, P＜0.05;the apoptosis rate: t =8.43, 9.99, P ＜0.05;ROS content: t =4.82, 5.27, P ＜ 0.05).The expression level of Bcl-2 protein was downregulated in group P + R;by contrast, the expression level of Caspase-3 protein in group P + R was upregulated.Conclusions Low-temperature plasma can increase the radiosensitization of HepG2, A549 and HeLa cells with the enhancement of G2/M phase arrest, apoptosis induction and ROS generation.

Purpose:To evaluate the treatment results of induction chemotherapy followed by radiotherapy in patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma.Methods:Fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma were treated by induction chemotherapy followed by definitive radiation therapy (CT/RT group). This group was matched with a group of fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma treated with radiotherapy alone (RT group). Results: The 5 year loco regional control was 61.2% for the CT/RT Group and 68.7% for the RT Group; The 5 yera distant metastasis was 15.2% for the CT/RT group and 27.1% for the RT Group; The 5 year distant metastasis for the patients with stage N 2 and N 3 disease was 27.4% for the CT/RT Group and 43.8% for the RT Group respectively; The overall 5 year survival (OS) was 57.8% for the CT/RT group and 51.6% for the RT group( P =0 61); The 5 year OS of N 2 and N 3 patients was 60.6% for the CT/RT group and 26.3% for the RT group( P =0 033);The 5 year OS of T 3 and T 4 patients was 36.8% for the CT/RT group and 41.2% for the RT group ( P =0 80) respectively. There were no significant differences in the incidence of acute mucositis between the two groups during radiotherapy, the side effects in leukopenia, nausea, vomiting were higher in CT/RT group than in RT group. No Grade 3 or higher late complications were observed in both groups. Conclusions:Induction chemotherapy followed by definitive radiation therapy did not improve the 5 year survival and loco regional control for the stage Ⅲ and Ⅳ nasopharyngeal carcinoma, but reduced the distant metastasis for the stage N 2 and N 3 patients; The overall 5 year survival rate for the patients with N 2 and N 3 nasopharyngeal carcinoma was improved by induction chemotherapy followed by radiotherapy. [

Objective To study the hemodynamic changes and pathologic foundation of rabbit models of radiation-induced lung injury (RILI) via 64-slice CT pulmonary perfusion imaging ( CTPI),in order to seek the correlation between the alterations of the hemodynamic parameters and pathophysiology.Methods Seventy-two healthy New Zealand rabbits were randomly classified into two groups:test group ( n =36),received 25 Gy with single fraction irradiation in a whole unilateral lung; control group ( n =36),received sham-irradiation.Each group was divided into 12 subgroups respectively according to post- and pseudo-irradiation time points (1,6,12,24,48,72 h and 1,2,4,8,16,24 w).Each rabbit underwent HRCT and CTPI at every pre- and post-radiation time point.All rabbits were sacrificed,and morphology of specimens was observed using light- and electron microscope. The changing regularity of HRCT,CTPI parameters and pathology were analyzed and compared with each other in order to find the correlation among them.The CTPI parameters of the test and control groups were compared using t test.The CTPI parameters and pathological values were analyzed using linear correlation with two variables,the detection rates of RILI by CTPI and HRCT was compared using Chi-square test.Results ( 1 ) The changes of CTPI parameters from control group after irradiation was relatively stable,but in test group those parameters including rBF,rBV and rPS,at pre- and post-irradiation time points (0,72 h and 2 w),were respectively 1.01 ± 0.09,1.86 ± 0.20,1.43 ±0.12,1.03 ±0.08,1.63 ±0.19,1.56±0.14,0.96±0.12,1.54 ±0.17 and 1.83 ±0.24.The corresponding parameters before and after irradiation were significantly different ( t =2.90-6.37,P ＞ 0.05).(2)In test group,capillary endothelial cells,basement membrane and alveolar epithelial cells,as the main injury targets,showed certain alterations in pathology.There was a significant correlation between the changes of CTPI parameters ( rBF and rBV) and pathophysiology in control group ( r =0.74,0.83,P ＜0.05 ),with the dependent relationship between rPS and the amounts of RBC outside the capillary and the destruction of basement membrane( r =0.87,0.88,P ＜ 0.01 ).(3)The detection rate of RILI with CTPI (72.2％,26/36) was obviously higher than that with HRCT( 16.7％,6/36,x2 =4.37,P =0.036).Conclusions CTPI parameters is capable of revealing the rule of hemodynamic process and reflecting the pathophysiologic state of different stages of RILI.By the time of detecting RILI,the detection rate of CTPI is clearly superior to that of HRCT,which yields potential value in predicting RILL

Objective To explore the feasibility of excluding oral 75 g glucose tolerance test (OGTT)in pregnant women with fasting plasma glucose (FPG) ＜4.4 mmol/L in middle and late trimester.Methods From February 1,2012 to August 31,2013,18 851 pregnant women without pre-gestational diabetes mellitus who received 75 g OGTT in Maternal and Child Health Hospital of Hubei Province,China,at 24-28 weeks of gestation were enrolled.The criteria for gestational diabetes mellitus (GDM) were FPG ＞5.1 mmol/L and/or 1 h plasma glucose ＞10.0 mmol/L and/or 2 h plasma glucose ＞8.5 mmol/L in OGTT.The values of FPG in predicting GDM were analyzed with receiver operating characteristic (ROC) curve.The differences of detection rates for GDM among women of different ages,women with different FPG levels,and those with or without risk factors of GDM were compared by x2 test and Fisher's exact test.Results The overall detection rate of GDM was 9.11％(1 718/18 851).The detection rate of GDM was lower in women aged ＜ 25 years than women aged 25-,30-and ≥ 35 years [4.77％ (137/2 875) vs 7.76％ (803/10 350),12.43％ (552/4 440)and 19.06％ (226/1 186),respectively,x2=30.53,120.24 and 210.66,all P＜0.01].The sensitivity and specificity were 55％ and 68％,respectively,when the cutoff value of FPG was 4.4 mmol/L,and the Youden index was 0.23 and the area under the ROC curve was 0.61 (95％CI:0.59-0.63,P＜0.01).The sensitivity and specificity were 40％ and 80％,respectively,when the cutoff value was 4.5 mmol/L,and the Youden index was 0.20 and the area under the ROC curve was 0.61 (95％CI:0.59-0.63,P＜0.01).The missed diagnosis rate was lower when the cutoff point of FPG was defined as 4.4 mmol/L.The detection rate for GDM was 3.45％ (384/11 121) in women with FPG ＜4.4 mmol/L,significantly lower than in those with FPG ≥ 4.4 but ＜5.1 mmol/L and ≥ 5.1 mmol/L [8.06％ (561/6 957) and 100.00％ (773/773),x2=183.66 and 7 672.08,all P＜0.01].When FPG was ＜4.4 mmol/L or ≥ 4.4 but ＜5.1 mmol/L,the detection rate for GDM was significantly higher in women with GDM risk factors than in those without [5.09％ (118/2 318) and 10.75％ (184/1 712) vs 3.02％ (266/8 803) and 7.19％ (377/5 245),x2=23.56 and 22.06,P＜0.01].Conclusion OGTT may not be included in GDM screening in the pregnant women with FPG＜4.4 mmol/L and without GDM risk factors in the areas lack of medical resources.

Objective　To evaluate the therapeutic efficiency of reversed lamellar keratoplasty for bullous keratopathy, Terrien's marginal degeneration and ocular chemical burns.Methods　Twenty eyes of patients with bullous keratopathy, twelve eyes with Terrien's marginal degeneration, ten eyes with chemical burns were recruited in this study.Diseased tissues were removed by means of dissection.Reversed lamellae corneal tissues which had been prepared by cryopreservation were thawed and rinsed. Then the prepared posterior corneal lamellae was turned over, endothelium facing upwards. The diameter of the graft should be 0.5～1.0mm larger than that of the recipient bed. The reversed donor posterior lamellae was sutured into the host keratectomy bed with 10-0 nylon sutures continuously or interruptedly.Results　Allograft reaction episode occurred only one (chemical burn) of the total 42 eyes enrolled.The grafts of the rest 41 eyes maintained clear or semitransparent for 1～5 years. Graft edema could be observed within 2～4 weeks postoperatively. Postoperative interface separation was not found. For all 20 patients with bullous keratopathy, the symptoms of pain disappeared. The visual acuity improved 2～3 lines of Snellen among eleven of twelve patients with Terrien's marginal degeneration. The visual acuity improved 2～3 lines of Snellen with four patients with chemical burns.Conclusion　The technique of reversed lamellar keratoplasty can be applied successfully for tectonic reconstruction of corneal surface such as bullous keratopathy, Terrien' s marginal degeneration and also chemical burns.The effects of therapy was satisfactory.

Objective To investigate whether timing of image acquisition influenced infarct size estimation using delayed CeMRI,and the association of left ventricular ejection fraction between magnetic resol3anee imaging and left ventrieulography Was also studied.Method From Junary 2005 to April 2006,27 first,onset AMI patients [23 male,mean age(54.3±10.5)years]were enrolledinthistudr.Allpatients receivedleft ventrictdographyas well as coronary angiography.The average checking time was(13.2±5.2)clays after the onset of AMI.MR imaging was performed with a 1.5-T magnet(SIMENS).After breath-hold eine images were acquired,patients re.ceived afI intravenous bolus of 0.05 mmol/kg Gd-DTPA at a rate of 5 ml/8.A first-pass perfusion scan was ac.qllired.Then a second bolus of 0.15 mmoVkg Gd-DTPA was give.at a rate of 2 mE/Is.After the hyperenhancement localized,the typical short axis slice with hyperenhancement WaS chosen to repeat imaging for IlleasuriIin.farct size every5minutesfrom5minutes after secondinjection ofcontrast until 20minutes.Results Twexty-seren patients showed hyperenhancement at the delayed CeMRI and hypoenhancement at the first pass enhancement(FPE).The average infarct size estimated by CeMRI WaS(17.9士9.8)%of LV nlass.Myocardial enhancement at a repesentative short-axis slice WIllS(7.2±6.2)%of LV Imss at 5 minutes,(8.5±7.4)%at 10 minutes,(7.3±6.3)%at 15 minutes and(6.9-t-6.4)%at 20 minutes respectively.There WltlS significant difference be-tween lmfninmes and 20-minutes enhancement size(P<0.05).Correlations of EF obtained by cineventriculo-grapIIy and MR irr,lg were significant(r=0.867,P<0.01).There were also correlations between infarction size and pe.k CK(r:O.819,P

Objective:To explore the therapeutic effect of Jianpi Huoxue Jiedu recipe on upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin internal knot type after modified radical surgery for breast cancer.Methods:From January 2020 to May 2022, a total of 60 patients with upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin internal knot type after modified radical surgery for breast cancer were selected and treated in Longyan Hospital of Traditional Chinese Medicine Affiliated to Xiamen University. They were divided into control group and observation group according to random number table, with 30 cases in each group. The control group was treated with routine western medicine comprehensive swelling reduction surgery, while the observation group was treated with a combination of Jianpi Huoxue Jiedu recipe (1 dose/day, warmly-taken in the morning and evening) for one month on the basis of the control group. The clinical efficacy, traditional Chinese medicine (TCM) syndrome score, edema diameter, breast cancer quality of life scale (FACT), and joint range of motion were compared between the two groups after treatment.Results:After one month of treatment, the total clinical effective rate of the observation group (93.33%) was significantly higher than that of the control group (70.00%, P<0.05). After treatment, the TCM syndrome scores (upper limb swelling, pain, fullness, sense of restraint, skin keratinization, itching, heaviness, stuffiness, and fatigue) of both groups of patients decreased compared to those before treatment, and the observation group was lower than the control group (all P<0.05). After treatment, the diameter of edema in the affected limbs was significantly reduced in both groups of patients, and the diameter of 10 cm above the wrist and elbow stripes in the observation group was smaller than that in the control group (all P<0.05). After treatment, the FACT scores of the two groups of patients significantly decreased, and the FACT scores of the observation group were lower than those of the control group (all P<0.05). After treatment, the joint activity of the two groups of patients significantly increased, and the joint activity of the observation group was greater than that of the control group (all P<0.05). Conclusions:The clinical efficacy of Jianpi Huoxue Jiedu recipe combined with western medicine in treating upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin accumulation type after modified radical operation of breast cancer is better than that of western medicine alone. It can significantly improve the clinical symptoms, signs, quality of life, and joint mobility of upper limbs of patients, and reduce upper limb edema.