Objective To investigate the relationship between the doses of epidural morphine administered for postoperative analgesia and postoperative urinary retention (POUR). Methods Sixty ASA Ⅰ patients aged < 20-56 yr undergoing atthroscopic knee operation under epidural anesthesia were randomly divided into 3 groups ( n = 20 each) : group Ⅰ and Ⅱ received epidural morphine 1 and 3 mg in 5 ml of normal saline (NS) respectively at the end of operation (group M1, M2 ); group Ⅲ received NS 5 ml instead of morphine (group C). Urinary retention was defined as the patient could not void, when bladder volume was ≥ 600 ml measured using ultrasound. Bladder urine volume was measured before anesthesia and at 4, 6, 8, 10 and 12 h after operation. The occurrence of urinary retention, the first postoperative voiding time, VAS scores and the incidences of vomiting and pruritus were recorded. Results The 3 groups were comparable with respect to age, M/F sex ratio, preoperative bladder urine volume, the amount of local anesthetic used during operation and duration. The incidences of urinary retention, vomiting and pruritus were 65%, 60% and 90% respectively in group M2 and significantly higher than those in the other 2 groups. The first postoperative voiding time was significantly longer in group M2 than in the other 2 groups. VAS scores were significantly lower in group M1 and M2 than in group C. There was no significant difference in VAS scores between group M1 and M2. Conclusion Epidural morphine increases the incidence of POUR in a dose-dependent manner, and 1 mg is the recommended dose.

Objective:To investigate the eruption of cystic lesion associated impacted permanent teeth(CAIPT)of the jaws after fe-nestrating decompression in adolescents and to analyze the related factors that affect the eruption of CAIPT.Methods:32 cases of CAIPT were examined restrospectively by panoramic radiographs.The subjects were divided into erupted group(n =22),and nonerupt-ed group(n =10).Patient age,angulation of the CAIPT,the cusp depth,eruption space and the level of dental root formation meas-ured on intial panoramic radiograph,were subjected to statistical analysis.Results:The eruption of the impacted mandibular molar was significantly related to the cusp depth,level of dental root formation and the patient's age(P <0.05).The eruption of the impacted man-dibular premolar was significantly related to the cusp depth,level of dental root formation,the angulation of the tooth and the patient's age (P <0.05),but not to dental space for the eruption(P >0.05).Conclusion:The patient's age,angulation of impacted permanent teeth,cusp depth,eruption space,level of dental root formation should be considered in the management of CAIPT.

O bjective Different degrees of oxidative stress may exist in patients with diabetes mellitus (DM).The aim of this study was to explore the roles of oxidative stress and the level of vascular endothelial growth factor ( VEGF) in the development and progression of DM in the rat model of type 1 DM (T1DM). Methods We established the T1DM model in 23 male SD rats and in-cluded another 17 in the control group .We determined the total anti-oxidation capacity ( T-AOC) and the levels of super-oxide dis-mutase (SOD), glutathione (GSH), and malondialdehyde (MDA) by chromatometry, and measured that of VEGF by ELISA. Results At 7 weeks after modeling, the level of fasting blood glucose(FBG) was significantly increased in the T1DM rats as com-pared with the controls ([23.01 ±3.62] vs [5.08 ±0.46] mmol/L, P<0.05); the levels of GSH and SOD were markedly lower (18.8 [0.36] vs [3.82 ±1.05] g/L and [192.06 ±34.57] vs [242.37 ±32.79] U/mL, both P<0.05) while those of serum MDA and VEGF remarkably higher in the T1DM than in the control rats ([4.94 ±0.63] vs [4.42 ±0.37] nmolm/L and [23.97 ±1.84] vs [22.32 ±1.71] pg/mL, both P<0.05);no statistically significant differences were found in T -AOC between the two groups (P>0.05).FBG was correlated positively with MDA (r=0.51) and VEGF (r=0.47) but negatively with GSH (r=-0.71) and SOD (r=-0.40), while serum VEGF positively with MDA (r=0.32) and negatively with GSH ( r=-0.34 ) in the experimental rats . Conclusion Peroxidation is increased and the anti-oxidation mecha-nism weakened during the development and progression of T 1DM, which is closely related to hyperglycemia .High VEGF is associated with hyperglycemia and enhanced peroxidation .

Objective To evaluate the efficacy of uhrasound-guided lower extremity nerve block combined with general anesthesia with laryngeal mask airway in patients undergoing total knee arthroplasty.Methods Forty ASA Ⅰ-Ⅲ patients of both sexes,aged 52-80 yr,weighing 67-94 kg,undergoing total knee arthroplasty under general anesthesia,were randomly divided into 2 groups(n=20 each).Group Ⅰ received combined intravenous-inhalational anesthesia with endotracheal tube.Group Ⅱ received lower extremity nerve block guided by ultrasound and then combined intravenous-inhalational anesthesia with laryngeal mask airway.HR was maintained at 50-100bpm,MAP was maintained at the preoperative baseline level(increase or decrease amplitude<20%of the baseline level)during operation and in pestanesthesia care unit(PACU)and vasoaetive drugs(atropine,esmolol,efedrina,urapidil or labetalol)were given when necessary.The patients received patient-controlled intravenous analgesia with tramedol and lornoxicam(background infusion 2 ml/h,bolus dose 1 ml,lockout interval 15 min)after operation and VAS score was maintained at≤2.The requirement for vasoactive drugs during operation and in PACU,PACU stay length,and consumption of analgesics and occurrence of nausea and vomiting within 24 h after operation were recorded.Results Compared with group Ⅰ,the requirement for all vasoaetive drugs during operation and for esmolol,urapidil and labetalol in PACU was significantly reduced,PACU stay length Was significantly shortened,and the consumption of analgesics and incidence of nausea and vomiting were significantly reduced in group Ⅱ(P<0.01).Conclusion Ultrasound-guided lower extremity nerve block combined with general anesthesia with laryngeal mask airway provides better emcacy with fewer complications and less consumption of postoperative analgesics than general anesthesia with endotracheal tube in patients undergoing total knee arthroplasty.

Objective To study the anti-aging effect of caloric restriction in aged rats. Method Thirty-four male aged SD rats were randomly divided into 3 groups. The experimental groups were given 80% and 60% diet of the control respectively. After 6 months we measured serum SOD,MDA,IL-2,the activity of NO,MAO in brain tissue and apoptosis index of hepatocytes. Results The activities of NO in brain tissue,SOD and IL-2 in serum in experimental groups were significantly higher than those in control group. Serum MDA,MAO of brain tissue and apoptosis index of hepatocytes in experimental groups were lower than those in control. Conclusion Caloric restriction shows anti-aging biological effects in aged rats.

The challenge of the emergence of drug-resistant influenza strains, which is caused by wide spread utilization of direct-acting antivirals (DAAs), accelerates the research and exploration towards host targeted agents. In contrast to DAAs targeting viral replication components, host targeted agents, which regulate host factors and pathways linked to viral replication, can interfere the replication of influenza. Additionally, the innate immune system is activated by influenza during the early stage of infection, so manipulating the innate immune response may prevent the viral infection. However, the excessive inflammatory response induced at the late phase of influenza infection would lead to severe tissue injures. Thus, it is very important to explore drugs with anti-inflammatory actions to suppress these immune imbalances and tissue injures. Here we overview the current progresses about host targets related to anti-influenza drugs.

Objective To observe the variety of liver and kidney function during lung transplantation and discuss its reference value of diagnosis and therapy in clinical acute rejection(AR).Methods The variety of TBIL, ALT and CRE were dynamically studied and analyzed before and after lung transplantation in 2 cases shared one same donor's lung block.Results During the use of CSA,TBIL diversely procedurally raised and it got right when AR was under control; when illness was worsen,ALT abnormally raised and CRE had no remarkably change.Conclusion TBIL is the sensitivity index of hepatotoxicity of immunity inhibitor CSA after lung transplantation. The abnormal change of ALT is the index of disease turnover.

Cholangiocarcinoma is a malignant tumor that occurs in the bile duct epithelium,it is the second most common malignant tumor of the liver and bile duct after hepatocellular carcinoma.Imaging examination is an important method to detect bile duct cancer;the purpose of imaging is to determine the location of the tumor,and the extent of invasion and distant metastasis.Different imaging methods have their advantages and disadvantages,so they should be chosen based on the condition of patients,or be optimized as the combined detection.

Objective To observe the effect of paeoniflorin on insulin resistance in rats fed with high-fat diet and to investigate the possible mechanisms.Methods Male Sprague Dawley (SD) rats were randomized into 4 groups:normal control,high-fat diet,high-dosage paeoniflorin (HDP group),and lowdosage paeoniflorin (LDP group).The control group was fed with ordinary diet,while the others with highfat diet,paeoniflorin intervention groups were given low-or high-dosage paeoniflorin by intraperitoneal injection.After 6 weeks,fasting serum triacylglycerol (TG),total cholesterol (TC),free fatty acids (FFA),fasting blood glucose (FBG),and insulin were determined.Insulin sensitivity index (ISI) were calculated and then the animals were sacrificed to acquire epididymal fat mass.The tumor necrosis factor alpha (TNFα) and glucose transporter 4 (Glut4) expressions in adipose tissue were detected by quantitative realtime polymerase chain reaction(PCR).Results Compared with high-fat fed group,HDP group had lower epididymal fat pad weight,reduced level of FBG,insulin and FFA (P ＜0.05) and improved ISI(-5.84 ± 0.24 vs-6.44 ± 0.25,P ＜ 0.05).LDP group had similar trends.In adipose tissue,the TNFα expression in LDP and HDP group was lower,Glut4 expression in HDP group was higher than that of high-fat fed group (P ＜ 0.05).Conclusion Paeoniflorin can reduce visceral adipose content,inhibit TNFα expression and increase Glut4 expression in adipose tissue,eventually lower glucose,and improve insulin resistance caused by high-fat diet.

[Objective]To investigate the feasibility of screening for velamentous umbilical cord insertion in early pregnancy by ultrasound.[Methods]A total of 2,796 cases of pregnant women,2 998 cases of fetuses that underwent prenatal ultrasound screening in the early and middle stage pregnancy and delivered in Dalian Women and Children Healthcare Center were included. The results of ultrasound screening of umbilical cord insertion during early pregnancy(11~13+6 w)were divided into three groups. GroupⅠ:it is clear that the placenta of the umbilical cord is located in the fetal membranes ,and then along with the fetal membranes for a long distance,and then enter the placenta. GroupⅡ:The placenta of the umbilical cord is located at the edge of the placenta,and then insert point is not distinguished between the placenta and fetal membranes. Group Ⅲ:It is clearly shows that the umbilical cord inserted into the placenta.[Results]1. The display rate of the umbilical cord in early and mid pregnancy ultrasound examinationearly pregnancyan examination showed that the rate of 99.23%(2 975/2 998). The single child display rate of 99.77%(2 590/2 596),twindisplay rate of 95.96%(380/396),three fetal the rate of 83.33%(5/6).In the second trimester of pregnancy(22~26 w)and examination showed that the rate of 86.99%(2 608/2 998). The single child display rate of 90.99%(2 362/2 596),twin display rate of 61.61%(244/396),three fetal the rate of 33.33%(2/6). 2. The results of early pregnancy,pregnancy,the examination of after birth Regard?ing to early pregnancy,28 cases were included in GroupⅠ,42 cases in GroupⅡand 2928 cases in GroupⅢ. Regarding to second pregnancy,37 cases were evaluated as velamentous umbilical cord insertion,30 cases were evaluated as battledore placenta and 2931 cases were evaluated as normal placenta. The results of postnatal examination were as follows:36 cases were identified as velamentous umbilical cord insertion,30 cases were evaluated as battledore placenta and 2932 cases were evaluated as normal placenta. 3. Comparison of 3 groups,early pregnancy examination results and pregnancy and after the birth. In early pregnancy,28 cases of GroupⅠwere diagnosed as velamentous umbilical cord insertion in the examination during the second trimester of pregnancy and after delivery. In the 42 cases of early pregnancy in Group Ⅱ,7 cases were diagnosed as velamentous umbilical cord insertion ,22 cases were diagnosed as battledore placenta and 13 cases were normal placenta. After birth ,6 cases were diagnosed as diagnosed as velamentous umbilical cord insertion ,23 cases were battledore placenta and 13 cases were normal placenta. In the 2928 cases of early pregnancy of Group Ⅲ,2 cases were diagnosed as diagnosed as velamentous umbilical cord insertion ,8 cases were battledore placenta and 2918 cases were normal placenta. After birth ,2 cases were diagnosed as diagnosed as velamentous umbilical cord insertion,7 cases were battledore placenta and 2919 cases were normal placenta.The diagnostic accuracy of early pregnancy was 98.29%.[Conclusion]Application of HD-Flow blood flow pattern in early pregnancy can make a diagnosis of some of the sail-shaped placenta.