Objective To investigate the effect of patient-controlled intravenous analgesia (PCIA) with dexmedetomidine mixed with sufentanil on the sleep quality after spinal surgery.Methods Eighty patients of both sexes, aged 21-72 yr, weighing 48-100 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective spinal surgery, were randomly assigned into sufentanil group (group S) and dexmedetomidine mixed with sufentanil group (group DS) with 40 cases in each group.In group S, PCIA solution contained sufentanil 2 μg/kg and tropisetron 6 mg in 100 ml of normal saline.In group DS, PCIA solution contained sufentanil 2 μg/kg, dexmedetomidine 3 μg/kg and tropisetron 6 mg in 100 ml of normal saline.The PCA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h.Sufentanil 5 μg injected intravenously and celecoxib 200 mg given orally were used as rescue analgesics, and numeric rating scale (NRS) score at rest was maintained ≤4 within 48 h after surgery.Ramsay sedation scores were recorded at 1, 2, 6, 12, 24 and 48 h after surgery.Sleep quality was evaluated using the Medical Outcomes Study Sleep Scale (MOS-SS), and the average time of daily sleep and Sleep Problems Index (SPI) were recorded at week 1 before and after surgery.Patient's satisfaction with sleep was assessed on the night of surgery and 1st day after surgery.The requirement for rescue analgesics was recorded.Results There was no significant difference in the requirement for rescue analgesics between group S and group DS (P＞0.05).Compared with the value before surgery, the average time of daily sleep was significantly shortened, and SPI was increased at week 1 after surgery in group S (P＜0.05 or 0.01), and no significant change was found in group DS (P＞0.05).Compared with group S, the Ramsay sedation scores were significantly increased at 1, 2, and 6 h after surgery, the average time of daily sleep was prolonged at week 1 after surgery, the SPI was decreased at week 1 after surgery, and the degree of satisfaction with sleep was increased on 1st day after surgery in group DS (P＜0.05 or 0.01).Conclusion PCIA with dexmedetomidine mixed with sufentanil is helpful in improving the sleep quality after spinal surgery in the patients.

Purpose Protein is the main influencing factors for diffusion weighted imaging (DWI) signals and apparent diffusion coefficient (ADC), it results in hyperintensity on DWI and low ADC, but not fully matched in clinic. This paper aims to investigate the effect of protein type and concentration on the signal intensity (SI) and ADC of DWI. Materials and Methods Different concentrations of albumin, globulin solution and the mixed solution were created in vitro. DWI was performed on GE 1.5T superconducting nuclear MRI system. Results ① There was a linear negative correlation between the ADC value and the concentrations of protein solution (at 37℃, ra= - 0.849, Pa<0.05; rg= - 0.843, Pg<0.05; at 40℃, ra= - 0.894, Pa<0.05; rg= - 0.819, Pg<0.05);there was a linear positive correlation between the SI of DWI and the concentrations of the albumin solution (at 37℃, r=0.753, P<0.05; at 40℃, r=0.845, P<0.05). There was no correlation between the SI of DWI and the concentrations of the globulin solution (at 37℃, r= - 0.222, P>0.05; at 40℃ , r= - 0.270, P>0.05). ② SI of the albumin solution was significantly higher than the globulin solution at the same concentration and temperature (t=3.96, P<0.001); the ADC values were not statistically different between the albumin and the globulin solution (t=0.61, P>0.05). Conclusion The nature of the cystic fluid can be understood preliminarily through quantitative analysis of the cystic fluid DWI and ADC values, so as to provide theoretical basis for the qualitative diagnosis of cystic lesions in vivo.

Antibodies, Monoclonal ; administration & dosage ; Antibodies, Monoclonal, Humanized ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; Drug Administration Schedule ; Female ; Humans ; Neoadjuvant Therapy ; Paclitaxel ; administration & dosage ; Receptor, ErbB-2 ; metabolism ; Trastuzumab

Androstadienes ; therapeutic use ; Antineoplastic Agents, Hormonal ; administration & dosage ; Aromatase Inhibitors ; administration & dosage ; Breast Neoplasms ; drug therapy ; Drug Administration Schedule ; Female ; Humans ; Nitriles ; administration & dosage ; Postmenopause ; Triazoles ; administration & dosage

Objective To investigate expression of polysaccharides biosynthetic genes in biofilm formation in Pseudomonas aeruginosa PAO1. Methods Real-time RT-PCR was used to quantify mRNA to analyze their mRNA level during planktonic growth and biofilm cells. Results Analysis of the relative ex-pression levels indicated that the level of transcripts of planktonic pslA, algD, pelA was significantly lower than that of biofilms sessile growth in all other form bacteria. The levels of transcripts of pslA, algD, pelA were the highest at the first day of biofilms development. Conclusion From the observations in the present study, transcripts of the pslA, algD, pelA involved biofilm development.

Objective To analyze clinical effects of gastric tube operation for treatment of esophageal cancer in elderly patients and evaluate its clinical efficacy and safety.Methods A total of 171 patients aged 60-72 years with esophageal cancer in our hospital were selected.They were randomly divided into treatment group and control group.Treatment group was treated with gastric tube operation,and control group was traditionally treated with complete replacement of esophagus with stomach.The quality of life,patient satisfaction and safety of operation were evaluated after 3 weeks,6 months and 12 months after operation,respectively.Results The operation for esophageal cancer in 171 patients were successful.At 3 weeks after the operation,the score of life quality in treatment group and control group were both low [(67.3±9.6) vs.(65.3±8.4)],and there were no significant differences between the two groups (P＞0.05).At 6 months and 12 months after operation,the scores of life quality were (89.2±8.3) and (90.3±9.6) in treatment group,and (66.5± 10.4) and (60.5 ± 11.2) in contol group,respectively.There were statistical differences between the two groups after 6 months and 12 months of operation (P＜0.05).The complication rate in treatment group (6.9％) was much lower than that in control group (30.6％),and there were significant differences between the two groups (x2 =18.43,P＜0.01).The patient satisfaction was in no differences between the two groups at 3 weeks after operation (P＞ 0.05),while there were statistically significant differences at 6 and 12 weeks after the operation (P＜0.05).Conclusions Gastric tube operation in treatment of elderly patients with esophageal cancer,can effectively improve the life quality,and prevent the occurrence of postoperative complications,which is worthy of clinical application.

Objective To investigate the distribution and drug resistance of pathogens for hospital-acquired urinary tract infections between patients in internal medicine wards and in surgical wards .Methods A total of 586 midstream urine samples were collected from patients in the First Municipal Hospital of Qinhuangdao during January 2012 and December 2014.Vitek 2 Compact system was applied in bacteria identification and drug sensitivity tests .Excel and SPSS 11.5 software were applied for data analysis . Results A total of 661 strains were isolated , in which 404 strains were from internal medicine wards and 257 strains were from surgical wards .Escherichia coli (44.6%vs.33.1%) and Enterococcus (23.0%vs. 16.3%) infections were more common in the internal medicine wards (χ2 =8.620 and 4.309, P<0.05), while the occurrence of Pseudomonas aeruginosa infection (4.0%vs.24.5%) was higher in surgical wards (χ2 =63.056, P <0.01).Escherichia coli and Klebsiella pneumonia strains were highly sensitive to piperacillin/tazobactam, cefptetan, amikacin, imipenem, and meropenem, and the sensitivity rates were from 85% to 100.0%.The sensitivity rates of Escherichia coli to ampicillin/sulbactam, levofloxacin and ciprofloxacin were <30%, and strains from surgical wards had lower sensitivity rates to these drug than those isolated from internal medicine wards (χ2 =4.987, 4.575 and 5.359, P<0.05).The sensitivity rates of Klebsiella pneumonia isolated from internal medicine wards to ceftazidime , gentamicin and aztreonam were 68.8%, 60.6% and 69.7%, which were higher than those isolated from surgical wards (36.0%, 32.0%, and 40.0%), and the differences were of statistical significance (χ2 =6.068,4.661 and 5.115, P<0.05).Pseudomonas aeruginosa strains were highly sensitive to piperacillin/tazobactam and amikacin, and the susceptibilities of strains isolated from surgical wards (98.4%and 96.8%) were higher than those isolated from internal medicine wards (75.0% and 81.3%) (χ2 =11.797 and 5.221, P <0.05). Pseudomonas aeruginosa strains isolated from surgical wards were also highly sensitive to cefepime (92.1%), but the sensitive rate of strains from internal medicine wards was only 37.5%, and the difference was of statistical significance (χ2 =24.696, P<0.01).Enterococcus faecium and Enterococcus faecalis were sensitive to tigecycline , vancomycin and linezolid with the sensitivity rates over 95%.Except quinupristin/dalfopristin and tetracycline , the sensitivities of Enterococcus faecalis to other antibiotics were higher than Enterococcus faecium.Susceptibility of Enterococcus faecium from surgical wards (33.3%) to moxifloxacin was lower than those from internal medicine wards (70.8%), and the difference was of statistical significance (χ2 =4.629, P <0.05).Conclusion There are differences in distribution and antimicrobial susceptibility of pathogens isolated from internal medicine wards and from surgical wards .

Objective To compare the contrast-enhanced ultrasonography (CEUS) manifestations of pNENs with the pathological changes and to explore the clinical value of CEUS in diagnosis of pNENs. Methods The CEUS of sixteen pathologically diagnosed pNENsfrom April,2012 to February,2014 were retrospectively observed.The CEUS of thirty pathologically diagnosed pancreatic carcinomas during the same period were taken as the control group.The enhancement extent and enhancement patterns of CEUS in pancreatic tumors were analyzed. The specimens of pNENs were stained with HE and CD34 immunochemistry.The grading of interstitial content and Ki-67 index were obtained on HE-stained slices and microvascular density(MVD) were obtained on CD34 immunochemistry stained slices.Spearman rank test analysis was employed to analyze the correlation.Results Among the 16 cases of pNENs,12 cases (75.0%) demonstrated hyper-or iso-enhancement,which included 6 cases (37.5%) showing homogeneous enhancement and 6 cases (37.5%) showing inhomogeneousen hancement,and the other 4 cases demonstrated hypo-enhancement. Among 30 cases of pancreatic carcinomas,25 cases (83.3%) demonstrated hypo-enhancement and 5 cases (16.7%) hyper- or iso-enhancement,and 21 cases (70.0%) demonstrated homogenous enhancement,and 9 cases(30.0%)inhomogeneous enhancement.Taking hyper-or iso-enhancement on CEUS as the diagnostic criteria,its diagnostic sensitivity,specificity,positive predictive value,negative predictive value,and accuracy were 75.0%,83.3%,70.6%,86.2%,80.4%respectively.Negative and positive correlation of the enhancement extent of pNENs with the interstitial content(r =-0.880,P < 0.001) and MVD (r =0.658,P =0.003) were observed,respectively.Six tumors with inhomogeneous enhancement contained cystic degradation or necrosis under microscope. Conclusions CEUS is an effective and non-invasive diagnostic approach for pNENs and can reflect the pathological changes.Hyper-or iso-enhancement of CEUS is typical appearance of pNENs.

ObjectiveTo evaluate the effectiveness of the interventional treatment for portal vein stenosis in patients who had undergone liver transplantation.MethodsFromApr.2004 to Oct.2011,30 patients with portal vein stenosis after liver transplantation were referred for angiographic analysis and interventional treatment. All patients had typical clinical signs and symptoms or surveillance by imaging.After percutaneous transhepatic portography and balloon angioplasty,stents were deployed.Embolization was performed on patients with varices or portal vein flow changes.The therapeutic results were monitored by the follow-up on clinical symptoms,laboratory tests and imaging examinations.ResultsAngiography was performed successfully on all patients.Twenty-four patients received balloon dilation and 26 stents were deployed subsequently.The guide-wire cannot pass through the lesion of portal trunk in 1patient.Four patients received balloon angioplasty only.The technical success rate was 96.7％ (29/30).Stainless steel coils were applied in 7 patients for varices embolization.The complication related to interventional treatment was bleeding in thoracic cavity which happened in 2 patients.Portal vein patency was maintained in all the patients who received interventional treatment for 1-72 months (mean 21.5 months).No re-stenosis was identified.ConclusionInterventional therapy is an effective method for the treatment of portal vein stenosis after liver transplantation and excellent patency can be achieved by this method.

Objective To study the changes of gastrin 17 (G17) and pepsinogen (PG) after gastric bypass surgery in gastric antrum resection, and the influences of different surgical methods on postoperative peptic ulcer. Methods Clinical data of 63 patients with gastric bypass surgery in our hospital from October 2013 to October 2015 were divided into resection of pyloric antrum group (n=33) and preserved pyloric antrum group (n=30). The values of G17, PGⅠ, PGⅡand PGⅠ/PGⅡwere detected by enzyme linked immunosorbent assay at 1 month, 6 months and 12 months after operation. The correlation between the different surgical methods and the incidence of peptic ulcer was analyzed between two groups. Results The G17 levels were significantly decreased in resection of pyloric antrum group 6 and 12 months after operation than those in preserved pyloric antrum group (P<0.05). Compared with preserved pyloric antrum group,PGⅠ and PGⅡ levels was significantly decreased 12 months after operation (P<0.05). There was no significant difference in the ratio PGⅠ/PGⅡat 1 month, 6 months and 12 months after operation between two groups (P>0.05). There was no significant difference in postoperative peptic ulcer between two groups (P>0.05). Conclusion Gastric bypass after resection of the pyloric antrum can reduce the postoperative secretion of G17, PGⅠ and PGⅡ, but which can not reduce the incidence of postoperative anastomotic ulcer.