Objective To investigate the effect of ethanol using by neurolytic celiac plexus block(NCPB)on the Bispectral index(BIS)during anaesthesia with propofol and remifentanil.Methods Thirty-six patients,ASA Ⅰ～Ⅲ,undergoing pancreatic cancer surgery were studied.Patients were maintained with propofol(6～9mg·kg～·h-1)and remifentanil(0.1～0.3μg·kg～·min-1)to keep the BIS between 38 and 50.After 30minutes of stable anesthesia,patients in control group were treated with NCPB by 0.9%NS 30ml,while patients in ethanol group were employed NCPB at the same time by 75%ethanol 30m1.BIS values,mean arterial pressure(MAP),heart rate(HR)were recorded 5minutes before the injection and one,five,fifteen,twenty five,thirty five,forty five minutes after that.Results Therewas no significant change in BIS,emodynamic variables compared to preinjection values in the control group.15min to 45min after injection of four point,BIS values and MAP of ethanol group decreased significantly,as compared with before injection,the same time point compared with the control group had statistically significant difference(P＜0.001).No significant changes in HR were observed throughout the observation.Conclusion Ethanol used in the operation of NCPB was additive to the anesthesia depth during the anesthesia of propofol and remifentanil.

Objective To evaluate the accuracy of high-aensitivity C-reactive protein (hs-CRP) in the prediction of perioperative cardiovascular accidents (CVAS) in patients with diabetes mellitus. Methods Ninetyone type 2 diabetic patients undergoing elective non-cardiac surgery were divided into 3 groups according to their blood concentrations of hs-CRP: low-concentration group ＜ 1.0 mg/L ( group Ⅰ , n = 9); median-concentration group 1.0-2.9 mg/L (group Ⅱ ,n= 16) and high-concentration group 3.0-10.0 mg/L (group Ⅲ ,n =66). Risk factors for perioperative CVA were analyzed using Spearman rank correlation analysis. Various risk factors including sex, age, ASA physical status, BMI, NYHA claasification, smoking history ,preoperative ECG changes, duration,treatment and complications of diabetes mellitus, hypertension and blood lipids were correlated with perioperative CVA. The risk factors of which P values were less than 0.05 would enter the binary logistic regression analysis to stratify CVA-related risk factors. Area under the ROC curve was used to analyze the accuracy of the risk factors in prediction of perioperative CVA. Results The incidences of perioperative CVAs were 0, 31% and 35 % in Ⅰ ,Ⅱ and Ⅲ groups respectively. It was determined by Spearman rank correlation analysis that preoperative ECG,NYHA classification, age, preoperative cardiovascular color doppler ultrasound, blood hs-CRP concentration and ASA classification of physical status were important risk factors ( P ＜ 0.05 or 0.01 ). Binary logistic regression .malysis indicated that preoperative ECG, NYHA classification and age were highly related to perioperative CVA (P ＜0.05 or 0.01).The area under ROC curve of preoperative ECG, NYHA classification, age and blood hsCRP concentration was 0.855, 0.755, 0.702 and 0.605 respectively. Conclusion The accuracy of blood concentration of hs-CRP in prediction of perioperative CVA in patients with diabetes mellitus is lower than that of the preoperative ECG, NYHA classification or age.

Objective: To investigate the prevalence of myopia and sleep quality among adolescents in Baoshan District of Shanghai, and to further analyze the association between different degree of myopia on sleep quality. Methods: A total of 777 adolescents aged 9-16 years were selected by stratified cluster random method, and ophthalmology examination and Pittsburgh Sleep Quality Index (PSQI) Chinese version scale and related factors questionnaire were conducted. Results: The prevalence rates of myopia and sleep disorders were 68.08% and 13.77% respectively in Baoshan District of Shanghai. With the increase of age and grade, the prevalence of myopia and sleep disorder increased(χ 2=139.58, 114.17；58.00, 56.41, P＜0.01).There were significant differences in sleep disorders among different degree of myopia groups (χ 2=24.57,P<0.01), including sleep time, progressive function and PSQI total score were statistically significant (F=9.65, 7.22, 4.38, P<0.01). Logistic regression analysis showed that moderate to high and high myopia were risk factors for sleep quality of adolescents (β=0.87, 0.95, OR=2.38, 2.59, P<0.05). Conclusion The prevalence of myopia and sleep disorder among adolescents in Baoshan District of Shanghai is high, myopia shows impacts on sleep quality of adolescents at a certain level. Adolescents with high myopia have a higher risk of sleep disorders.

Objective The aim of this study was to identify macrophage related genes(MRGs)in liver cancer and construct a prognostic risk prediction model for liver cancer.Methods The liver cancer scRNA-seq data from the GEO database were down-loaded to identify genes specifically expressed in macrophages as MRGs.The GO and KEGG functional enrichment analyses on MRGs were conducted.In the TCGA-LIHC dataset of the TCGA database,multiple random sampling single factor Cox regression for single-factor Cox regression,LASSO regression,and multivariate Cox regression analyses were employed to identify MRGs for liver cancer prognosis prediction,and a liver cancer prognostic prediction model was constructed.Results The results obtained 8 major cell types,including those containing macrophages through clustering using scRNA-seq data from the GEO database.The proportion of macrophages in the immune microenvironment of liver cancer was significantly higher than that of normal tissues(P=0.016),and genes such as SPP1,RNASE1,and MMP9 were highly expressed.Multiple metabolic pathways,including purine metabolism,citric acid cycle,and drug metabolism cytochrome P450 were activated in liver cancer-associated macrophages.This study identified 777 MRGs from liver cancer scRNA-seq(LogFC＞0.25,P＜0.05),which mainly involved in functions such as actin binding and regula-tion of immune receptor activity.Seven MRGs,including ATP1B3,ATP6V0B,HBEGF,KLF2,NR1H3,RAB10,and SPP1 were select-ed from the 169 stable prognostic genes(P＜0.05)for the construction of the prognosis model.The AUC values for the 1,3,and 5-year survival outcomes of the model in the TCGA liver cancer cohort were 0.791,0.791,and 0.751,respectively.In the validation ICGC cohort,they were 0.614,0.682,and 0.688,respectively,demonstrating good predictive performance.In liver cancer patients with high prognosis risk scores,the expression of macrophages M0,neutrophils,and regulatory T cells was higher(P＜0.05),and im-munosuppression and immune activation coexisted.Conclusion Liver cancer MRGs can serve as potential biomarkers for predicting the prognosis of liver cancer patients.These liver cancer MRGs are mainly associated with actin binding,immune receptor activity,and infiltration of various immune cells.