Objective To evaluate the accuracy of BIS and anesthetic depth index (CSI) for monitoring levels of sedation induced by different target effect-site concentrations (CT) during TCI of propofol combined with sufentanil. Methods Ninety ASA Ⅰ or Ⅱ patients of both sexes aged 20-49 yr weighing 45-70 kg undergoing elective surgery under general anesthesia were randomly divided into 6 groups (n=15 each): group Ⅰ, Ⅱ, Ⅲ TCI of propofol with CT set at 2, 4 and 6 μg/ml respectively (P1-3);groupⅣ, Ⅴ,Ⅵ sufentanil 0.7 μg/kg + propefol TCI with CT set at 2, 4 and 6 μg/ml (SP1-3). Anesthesia was induced with propefol TCI with CT set at 4 μg/ml in all 6 groups. As soon as the patients lost consciousness, tracheal intubation was facilitated with vecuronium 0.1 mg/kg. The patients were mechanically ventilated. PET CO2 was maintained at 35-45 mm Hg. Anesthesia was maintained with propofol TCI with CT set at 2 μg/ml(in group P1, SP1), 4 μg/ml(in group P2, SP2) and 6 μg/ml(in group P3,SP3) immediately after intubation respectively. Sufentanil 0.7 μg/kg was given iv at 20 min after propofol TCI was started in group SP<1-3. MAP, HR, BIS (Aspect) and CSI (Danmeter Denmark) were continuously monitored and recorded before induction of anesthesia (T0, baseline), at 1 min before tracheal intubation (T1), and at 30 s(T2), 15 min(T3), 30 min(T4), 35 min(T5) and 40 min (T6) after tracheal intubation. Results BIS and CSI values were gradually decreasing at T3-6 in group P1-3 and SP1-3. BIS and CSI values were significantly lower at T4-6 in group SP1 and SP2 than in group P1 and P2. CSI values were significantly lower at T4-6 in group SP3 than in group P3, but there was no significant difference in BIS values at T4-6 between SP3 and P3. Conclusion CSI and BIS can monitor the levels of sedation indueed with TCI of propofol with CT set at 2 and 4 μg/ml when combined with sufentanil 0.7 μg/kg but only CSI can monitor the level of sedation induced by propofol TCI with CT set at 6 μg/ml when combined with sufentanil 0.7 μg/kg.

OBJECTIVE:To explore mechanism,prevention and treatment of thrombosis following implantation of coronary artery stent.METHODS:The first author used computer to retrieve Vip Database (http://www.cqvip.com/) for articles concerning thrombosis following implantation of coronary artery stent published from January 2000 to October 2009.The key words included "coronary artery,stent implantation,thrombus".The data were primarily screened,and references of each article were checked.Inclusion criteria:mechanism and risk factor of thrombosis in stent;prevention and treatment of thrombosis in stent.Exclusion criteria:articles addressing duplicated or old contents.Finally,28 articles were included.RESULTS:Thrombosis in stent was a severe complication in interventional therapy of coronary artery disease,could induce severe outcomes for the body.Compared with common mental stent,drug eluting stents can significantly reduce restenosis rate and revascularization rate of target lesions.Following stent implantation,thrombosis in stent can occur in early,late and extremely late phases.The mechanisms are different.Antiplatelet,anticoagulation and lipid-lowering therapy can diminish the occurrence rate of thrombosis in stent.Individual surgery and individual drug therapy not only can solve revascularization in the coronary artery,but also decrease restenosis rate and occurrence rate of thrombosis in stent.CONCLUSION:With the expectation of novel stents,various risk factors for thrombosis in stent should be assessed in detail to achieve individual surgery and individual drug therapy.During revascularization in the coronary artery,restenosis rate and occurrence rate of thrombosis in stent should be reduced.

Salmonella enterica serovar Choleraesuis strain C500 is a live attenuated vaccine that has been widely used in Chi‐na for over 50 years to prevent piglet paratyphoid .However ,as C500 is obtained by chemical methods ,the genetic background of this strain remained unclear .In this study ,we compared the genomic differences between the virulent reference strain C 78‐2 and C500 by suppression subtractive hybridization combined with the mirror orientation selection method (MOS‐SSH ) .Six genes (asr ,ydgF ,ydgD ,ydgE ,rpoS ,and ptsG) were lost in C500 strain .Using real‐time PCR analysis ,we demonstrated that the genes regulated by rpoS ,a vital transcriptional regulator playing an important role in Salmonella infection ,were downregulated in C500 .Additionally ,the virulence of the rpoS mutant strain C78‐2ΔrpoS was 100 000 times lower than the parental strain in BALB/c mice .So loss of rpoS gene is the major factor leading to the attenuation of C500 strain .

Objective:To compare the effect of posterolateral plate and anterolateral locking plate in surgical treatment for extra-articular distal humeral shaft fractures.Methods:A retrospective case-control study was made on 52 patients with extra-articular distal humeral shaft fractures admitted in Tianjin Hospital from January 2014 to October 2016. There were 32 males and 20 females, with the age from 18 to 56 years [(36.9±10.9)years]. According to the AO/OTA classification, there were 15 patients with type A, 32 type B, and 5 type C. Twenty-three patients were treated with osterolateral locking plate (Group A) and 29 with anterolateral locking plate (Group B). Operation time, bone union time, range of motion of the elbow, Mayo elbow performance score and complication rate were evaluated.Results:All patients were followed up for 12-20 months [(13.7±2.2)months]. Operation time was (79.8±9.6)minutes in Group A and (85.0±11.6)minutes in Group B ( P>0.05). Bone union time was (4.1±1.0)months in Group A and (4.1±1.0)months in Group B ( P>0.05). Degrees of elbow extension was 3.9°(0.0°, 5.0°) in Group A, and 4.4°(0.0°, 5.0°) in Group B ( P>0.05). Degrees of elbow flexion was 127.4°(125.0°, 132.50°) in Group A and 128.5°(122.5°, 132.5°) in Group B ( P>0.05). Mayo elbow performance score was 91.0 (90.0, 93.5) points in Group A and 90.2 (90.0, 92.5)points in Group B ( P>0.05). Radial nerve damage was noted after operation, showing no significant difference between two groups [2 patients (9%) in Group A and 3 patients (10%) in Group B] ( P>0.05), and the symptoms were recovered in all patients within 3 months. Conclusions:Both the posterolateral and anterolateral locking plate are effective in surgical treatment for extra-articular distal humeral shaft fractures. However, the posterolateral plate can be placed closer to the distal end of the humerus and the multi-directional locking design is more stable, which has advantages for the patient with fracture line close to the elbow joint.

Objective:To investigate the differences of resting-state spontaneous neural activity between smoking addicted teenagers and healthy non-smokers.Methods:In the current study, the percent amplitude of fluctuation (perAF) approach was applied to explore the differences of resting-state spontaneous neural activity between smoking addicted teenagers and healthy non-smokers.Pearson correlation analysis was used to investigate the relationships between the altered perAF values and smoking years, fagerstrom test for nicotine dependence (FTND) and pack-years of smokers.Results:Compared with healthy non-smokers, smoking addicted teenagers showed increased perAF values in the parahippocampal gyrus (smoking addicted teenagers: 2.026 5±0.516 7, nonsmokers: 0.781 6±0.148 9), middle temporal gyrus (smoking addicted teenagers: 0.796 7±0.203 2, nonsmokers: 0.545 5±0.134 1), and superior frontal gyrus (smoking addicted teenagers: 2.734 5±0.372 8, nonsmokers: 1.962 4±0.416 8) (all P<0.001). It was noteworthy that the perAF values of the parahippocampal gyrus were negatively correlated with smoking years of smoking addicted teenagers( r=-0.6007, P=0.0084). Conclusion:Compared with healthy non-smokers, the resting-state regional neural activity in smoking addicted teenagers was altered, mainly manifested as increased perAF value in the parahippocampal gyrus, which is correlated with smoking years of smoking addicted teenagers.These findings may help us understanding neural mechanisms underlying nicotine addiction of smoking addicted teenagers.

Fibromyalgia syndrome (FMS), also known as fibromyalgia, is clinically characterized by diffuse chronic muscle and bone pain, accompanied by fatigue, sleep disturbances, depressive episodes, and cognitive and intestinal dysfunction. Due to lack of clear specific laboratory indicators and appropriate imaging examinations, FMS diagnosis is mostly based on clinical symptoms, but FMS clinical symptoms of lack specificity, and current clinical diagnostic criteria are mostly exclusive criteria, which is prone to missed diagnosis and misdiagnosis. In order to further promote the standardized diagnosis and treatment of FMS, this paper makes extensive references to laboratory-related diagnostic indexes of FMS (Tau, adiponectin, serum cathepsin S, cystatin C, serum ferritin, nitric oxide, neutrophil/lymphocyte ratio, platelet distribution width and mean platelet volume) at home and abroad, aiming to provide new ideas for early diagnosis and intervention of FMS.

ObjectiveTo observe the effects of Shenbai Jiedu prescription on fecal metabolomics and intestinal flora diversity distribution in patients with colorectal adenoma and explore its potential targets. MethodA total of 21 patients diagnosed with colorectal adenoma were enrolled in this study. Following a four-week administration of Shenbai Jiedu prescription， their clinical symptoms were observed， and fecal samples of patients before and after treatment were collected. Untargeted metabolomics and metagenomic analysis based on liquid chromatography-mass spectrometry （LC-MS） were employed to investigate the possible metabolic pathway of Shenbai Jiedu prescription and its influence on the distribution of intestinal flora in patients. ResultThe total scores of traditional Chinese medicine （TCM） syndromes of patients after drug administration decreased significantly （P<0.01）. The results of untargeted metabolomics showed that the distribution of metabolites exhibited aggregation before and after drug administration， and a total of 106 differential metabolites were screened out （P<0.05）. The Kyoto encyclopedia of genes and genomes （KEGG） enrichment analysis revealed that arginine-proline metabolism， ferroptosis， glycine， and serine and threonine metabolism were significantly enriched metabolic pathways （P<0.05）. Notably， L-4-hydroxyglutamate semialdehyde， glutathione， isopentenyl pyrophosphate， creatinine， 4-acetamido-2-aminobutanoic acid， and guanidoacetic acid were found to be involved in these aforementioned metabolic pathways. Furthermore， the association between these metabolites and different intestinal flora was analyzed， and the results showed that Shenbai Jiedu prescription could interfere with metabolic pathways such as amino acid and ferroptosis in patients with colorectal adenoma by regulating intestinal flora such as Lachnoclostridium， Eggerthella， and Dialister （P<0.05）. ConclusionShenbai Jiedu prescription may improve the clinical symptoms of patients by increasing the abundance of intestinal beneficial bacteria， reducing the abundance of harmful bacteria， and regulating metabolic pathways such as amino acid and ferroptosis in patients with colorectal adenoma. This study may provide some research ideas and directions for Shenbai Jiedu prescription to interfere with colorectal adenoma recurrence and carcinogenesis.

ObjectiveTo explore the biological foundation of colorectal adenoma in damp-heat accumulation syndrome and the possible anti-tumor mechanism of Shenbai Jiedu prescription. MethodEight patients with colorectal adenoma in damp-heat accumulation syndrome， 11 patients with non-damp-heat accumulation syndrome， and 10 patients with colorectal cancer recruited by Jiangsu Provincial Hospital of Traditional Chinese Medicine from February 2019 to December 2020 meeting the inclusion criteria were clinically obtained， and the tissue of the three groups of patients was subjected to transcriptome sequencing to screen for the differentially expressed genes between the syndrome and the diseases. The intersection of the differentially expressed genes between the syndrome and the disease was taken for further screening of the differentially expressed genes sequentially increasing or sequentially decreasing in patients with non-damp-heat accumulation syndrome， damp-heat accumulation syndrome， and colorectal cancer， and functional enrichment analysis and signaling pathway enrichment analysis were carried out. Real-time polymerase chain reaction （Real-time PCR） was used to detect the effect of Shenbai Jiedu prescription on the expression of the above key differential genes. ResultBy comparing the damp-heat accumulation syndrome and non-damp-heat accumulation syndrome， a total of 384 differentially expressed genes were screened， of which 203 were up-regulated genes， and 181 were down-regulated genes. By comparing the colorectal adenoma of colorectal cancer and damp-heat accumulation syndrome， a total of 2 965 differentially expressed genes were screened， of which 2 460 were up-regulated genes， and 505 were down-regulated genes. The intersection of differentially expressed genes of the two groups was taken， and a total of 58 differentially expressed genes with the same changes were screened. The gene ontology functions were mainly enriched in UDP-galactose： β-N-acetylglucosamine beta-1，3-galactosyltransferase activity， N-acetyllactosaminide beta-1，3-N-acetylglucosaminyltransferase activity， and poly-N-acetyllactosamine biosynthetic process. Kyoto Encyclopedia of Genes and Genomes （KEGG） signaling pathways were mainly enriched in glycosphingolipid biosynthesis-globo and isoglobo series， glycosphingolipid biosynthesis-lacto and neolacto series， and IL-17 signaling pathway. Shenbai Jiedu prescription significantly inhibited the expression of key genes involved in the enrichment， such as FOSB and B3GALT5， in a dose-dependent manner （P<0.05）. ConclusionGlycolipid metabolism may be the biological foundation of colorectal adenoma in damp-heat accumulation syndrome， and Shenbai Jiedu prescription may inhibit colorectal adenoma carcinogenesis by down-regulating the expression of FOSB and B3GALT5.

Colorectal adenoma is a benign tumor originating from the mucosal glandular epithelium of the colorectum and belongs to the category of intraepithelial neoplasia. Its etiology and pathogenesis are not completely clear， and some patients have genetic factors. In recent years， with the improvement in living standards， the incidence of colorectal adenoma has gradually increased due to high-fat diets， intestinal flora disorder， and emotional disturbance. As one of the precancerous lesions of colorectal cancer， colorectal adenoma is increasingly threatening human health. Surgical resection is the most direct and effective method for the treatment of colorectal adenoma， but some patients with colorectal adenoma have the possibility of recurrence after resection. At present， there is still a lack of effective prevention and treatment measures for the recurrence of colorectal adenoma. Traditional Chinese medicine （TCM） plays a unique advantage in improving the clinical symptoms of patients with colorectal adenoma and preventing postoperative recurrence and carcinogenesis. Therefore， this review summarized the clinical research and mechanism of TCM compounds in the prevention and treatment of colorectal adenoma in recent years. The clinical study on the prevention and treatment of colorectal adenoma by TCM compounds can be divided into internal treatment， external treatment， and internal and external combined treatment. The internal treatment mainly focuses on strengthening the spleen， and the external treatment includes retention enema， acupoint application， and other methods. The internal and external combined treatment is mainly based on the internal administration of TCM compounds combined with acupuncture， retention enema， and acupoint stimulation. The study on the mechanism of TCM compounds in preventing and treating colorectal adenoma was mainly explored from the aspects of regulating intestinal flora， regulating cell proliferation immune function， and achieving anti-inflammation. This review summarized the research progress of TCM compounds in the prevention and treatment of colorectal adenoma in recent years and provided a reference for future treatment with TCM.