Objective To evaluate the safety of conscious venous anesthesia with fentanyl and propofol in elderly patients over 70 during gastrointestinal endoscopy. Methods Clinical data of 826 elderly patients over 70, who underwent gastrointestinal endoscopy with venous anesthesia, were retrospectively analyzed. The patients were divided into 2 groups according to their ages, with 618 patients aging from 70 to 80 in group A, in which 342 received endoscopy and 276 underwent colonoscopy, and 208 patients older than 80 in group B, in which 112 underwent endoscopy and 96 had colonoscopy. Another cohort of 600 patients younger than 70, who underwent venous anesthetic endoscopy during the same time period, was randomly selected as the control group, in which 400 patients received endoscopy and 200 had colonoscopy. Blood pressure, heart rate, peripheral oxygen saturation (SpO2) and adverse reaction were monitored in each patient during the procedure and compared among different groups. Results No procedure-related perforation or sedation-related mortality was observed, and no procedure was terminated clue to sedation complication. The average dosages of propofol used in procedure of endoscopy in groups A, B and control were 54.22±21.36 mg, 40.22±12.46 mg, and 86.44±34.26 mg, respectively. The average dosages of propofol in colonoscopy were 82.56±40.64 mg, 45.36±15.44 mg and 102.23±46.32 mg, respectively. With same procedure, there was no significant difference in heart rate and blood pressure among different groups, nor was there any difference in these variables before and after the procedure in each group (P>0.05). Sedation exerted more influence on SpO<,2> in elderly patients. A total of 18 cases in groups A and B experienced SpO<,2> <90%, which was mainly due to aspiration of saliva and relieved by oxygen inhalation. Conclusion Under appropriate monitor, it is safe and feasible to give conscious sedation to elderly patients over 70 during gastroimestinal endoscopy.

Objective To evaluate the clinical significance of phural effusion and/or ascites and their prognostic role in patients with acute pancreatitis.Methods The clinical data of 312 patients with acute pancreatitis were collected and analyzed retrospectively.Results Pieural effusion was found in 47 patients and ascites in 18.of 47 cases with pleural effusion,there were 31 cases(65.9%)of severe pancreatitis(P＜0.01)and 27 cases (57.4%)complicated by pseudocyst(P＜0.01).Among 18 cases with ascites,there were 14 cases(77.7%)of severe pancreatitis(P＜0.01).6 cases with pleural effusion and/or ascites died of multiple organs failure.Conclusion Pleural effusion and/or aseites is closely associated with severe pancreatitis.

Objective To investigate the clinical features and prognosis of elderly patients with acute panereatitis.Methods One hundred and twelve elderly patients with acute pancreatitis were included in our study.The clinical features and prognosis were compared with those of the 120 non -aged patients with acute pancreatitis during the same period.Results Cholecystolithiasis was the most common etiology of acute pancreatitis in both groups[81 cases(66.3%) in aged group,70 cases (58.3%) in non-aged group].Abdominal pain was the most common symptom in both groups, followed by fever.Two elderly cases were diagnosed only by autopsy because of mild abdominal pain and rapidly attack of shock.There were 31 cases with severe pancreatitis in aged group and 14 in non -aged group (P

Objective To investigate the dynamic abnormality of colon and anorectum in elderly patients with chronic functional constipation(CFC). Methods Forty-two elderly patients with CFC and twenty elderly healthy controls were selected. Total and segmental colonic transit time(CTT) were assessed radiographically by using oral radiopaque markers. Eight-lead water perfusion pressure measurement system and balloon were used to test the pressure and the perception threshold values of anus and rectum. Results (1) Total colonic transit time (TCTT) and sigmoid-rectum transit time (SRTT) were (49.0±16.4) h and (20.1±13.5) h in elderly patients with CFC, which were significantly prolonged compared with the controls [(25.2±7.7) h and (7.8±4.1) h, t=6.16 and 3.97,both P<0.05]. (2) The pressure of anal canal during defecation was (39.6±15.7) mmHg in elderly patients with CFC and (17.6±9.3) mm Hg in controls (t=5.79, P

Objective To evaluate the safety of intrvenous balanced propofol sedation with fentanyl in elderly patients during combined gastroscopy and colonoscopy procedures.Methods Totally 877 elderly patients aged (76.4 ± 8.5) years received intravenous propofol and fentanyl sedation during gastroscopy or/and colonoscopy procedures were assigned to groups:294 cases with only gastroscopy,257 cases with only colonoscopy and 326 cases with combined gastroscopy and colonoscopy.50 g Fentanyl and 0.5-1.0 mg/kg propofol were intravenously administered in the patients.The peripheral oxygen saturation,arterial pressure and heart rate were monitored and recorded during procedures.Results There were no procedure-related perforations and sedationassociated severe complications and mortalities,and no one need stop endoscopy procedures in all the patients.The average dosage of propofol in combined,gastroscopy and colonoscopy groups were (100.4±38.5) mg,(130.4±50.5)mg and (170.3± 60.3)mg,respectively.There were no significant differences in heart rate,arterial pressure and rate of cardiovascular events among groups (P＞0.05).The rate of respiration events in the above groups were 9 cases(3.1％),6 cases(2.3％)and 13 cases(4.0％),respectively (P＞0.05).Decrease of peripheral oxygen saturation was mainly induced by the aspiration of oral secretions and snoring.Conclusions Intravenous balanced propofol sedation provides safe and effective sedation in the elderly undergoing combined gastroscopy and colonoscopy.

OBJECTIVE: To verify the biocompatibility between diamond-like carbon (DLC) film and human vascular endothelial cells and to provide evidences for construction of artificial mechanical valve prosthesis. METHODS: Nanophase DLC film was deposited using pulse laser deposition, while vascular endothelial cells derived from human umbilical vein was cultured with nanophase DLC film in vitro. Cell growth and adhesion were observed under inverted microscope, and cell proliferation was measured with MIT method. In addition, levels of nitric oxide (NO) and prostacyclin (PGI2) were measured in the DLC group and blank control group in order to evaluate their activities. RESULTS: Adhesion, proliferation, and growth of vascular endothelial cells derived from human umbilical vein were great on the surface of nanophase DLC film. There were no significant differences in the levels of NO and PGI2 between DLC group and blank control group (P > 0.05), showing that nanophase DLC film had no effect on activity of vascular endothelial cells derived from human umbilical vein. CONCLUSION: Nanophase DLC film has a good biocompatibility, and it can become an ideal material of tissue-engineering artificial mechanical valve prosthesis.

Objective To investigate human cell division control protein 4(hCDC4) expression and its correlation with the clini‐copathological features in oral squamous cell carcinoma(OSCC) .Methods We freshly collected 52 samples of surgically resected OSCC tissues and 12 samples of normal tissues .hCDC4 expression in the samples was detected by immunohistochemical staining . The correlation between hCDC4 protein expression and clinicopathological feature was analysed .OSCC cells and Tca8113 were transfected with hCDC4‐siRNA ,cell proliferation and c‐Myc and Cyclin E protein expression were determined by using M TT and Western blot .Results The hCDC4 protein expression in normal tissues was significantly up‐regulated compared to those in OSCC tissues (83 .3% vs .25 .0% ,P < 0 .05) .Clinicopathological analysis revealed that reduced hCDC4 expression was associated with large tumor size ( ≥ 4 cm) and high clinic stage ( Ⅲ + Ⅳ ) (P< 0 .05) .hCDC4 knockdown by siRNA led to increased cell prolifera‐tion and c‐Myc and Cyclin E protein accumulation in Tca8113 cells .Conclusion Loss of hCDC4 may promote tumor progression by resulting in c‐Myc and Cyclin E protein accumulation in OSCC .

Objective To understand the prevalence and epidemiological features of clonorchiasis sinensis based on inpa-tients in Zhongshan City. Methods All of the 23 town hospitals in Zhongshan City were selected as the surveillance hospitals in 2016. Among the inpatients from those hospitals,those lived in the city longer than 6 months were selected as the surveillance subjects. The stool specimens of the subjects were collected and examined by the modified Kato-Katz thick smear method for the eggs of Clonorchis sinensis. The crude infection rates of C. sinensis of the subjects were standardized according to the age and sex compositions of the population in Zhongshan City,2016. Meanwhile,the infection rates of the subjects from different towns and those combined with related clinical diseases were analyzed. Results A total of 2667 people were included in the surveil-lance,among which 219 were tested as positives,with a crude infection rate of 8.21％. For the positives,the male accounted for 81.74％(179/219),and their age ranged from 4 to 89 years with the mean value of(62.20±13.80)years. After standardization by age and sex composition,the infection rate was 3.62％for the whole population,the rates of the male and the female were 5.46％and 1.53％,respectively,and the former was 3.57 times as high as the latter. Both the infection rates of the male and the female rose as the age increasing(χ2 male=99.91,χ2 female=16.51,both P<0.01). The standardized infection rates among the subjects in different towns ranged from 0 to 10.40％,and the rates in the north towns were higher than those in the south towns. The standardized rate was 9.22％for the subjects combined with gallstone,3.40％for those not combined with gallstone,and the former was 2.71 times as high as that of the latter. Conclusion The people aged 30 years and above,with gallstone or living in towns with high C. sinensis infection rates are the key population for prevention and control of clonorchiasis in Zhongshan City.

Objective To discuss a convenient and pragmatic method of fitting and optimizing standard curve for determining concentration of serum hepatitis B virus large surface protein(HBV-LP).MethodsEnzyme-linked immunosorbent assay(ELISA)was used to measure the absorbance of standard preparation of HBV-LP.Concentration and absorbance of standard preparation of HBV-LP was carried out curve fitting with 4-parameter formula model and linear model and log-linear model and quadratic polynomial model and cubic polynomial model and S model by program solution of Excel,respectively.The most standard curve for determining concentration of serum HBV-LP was determined with coefficient of determination of regression model.ResultsThe scatterplot of standard preparation of HBV-LP submited nonlinear tendency.There were all significance to regression equation of 4-parameter formula model and linear model and log-linear model and quadratic polynomial model and cubic polynomial model and S model(P

Objective To investigate the relationship between portal vein pressure and liver regeneration after 90% portal branch ligation in rats.Methods Forty-five male SD rats underwent 90% portal branch ligation (including 5 rats underwent sham operation),and then the changes of portal vein pressure and weight of unligated hepatic lobes were detected.The morphological changes of hepatocytes of the unligated hepatic lobes were observed under a light microscope.Proliferative cell nuclear antigen(PCNA)index was detected by immunohistochemistry,and hepatocyte apoptosis of the unligated hepatic lobes by TUNEL method.All data were analyzed by Pearson rank correlation analysis and t test.Results Thirty-eight out of 40 rats survived(95%).The ligated hepatic lobes diminished progressively,whereas the unligated hepatic lobes regenerated.Preoperative portal vein pressure was(9.1±1.8)cm H_2O(1 cm H_2O=0.098 kPa),and it was increased significantly shortly after the ligation and reached (15.8±2.7)cm H_2O 12 hours later(t=6.847,P＜0.05).The portal vein pressure decreased from(13.6±2.3)cm H_2O at day 1 to(9.3±2.0)cm H_2O at day 28.Preoperative positive PCNA index was 7%±3%,which was significantly lower than 14%±5%at postoperative 12 hours,21%±6%at day 3 and 26%±7%at day 5(t=9.129,P＜0.05),and it began to return to normal at day 5.Few apoptotic hepatoeytes were observed in preoperative liver tissue and unligated hepatic lobes.The expression of PCNA in unligated hepatic lobes and portal vein pressure had apositive correlation at postoperative day 1,3,5(r=0.913,0.896,0.908,P<0.05)and a negative correlation at postoperative day 14(r=-0.926,P<0.05).Conclusions The regeneration of hepatocytes in unligated hepatic lobes is activated after 90% portal branch ligation,and the regenerated liver compensates the weight loss of the ligated hepatic lobes.Liver is regenerated mainly by speeding hepatocyte proliferation rather than reducing hepatocyte apoptosis.Changes of portal vein pressure may play an important role in liver regeneration.