Objective:To investigate the clinical effect of hydromorphone combined with ropivacaine and its effect on stress response after laparoscopic myomectomy.Methods:From March 2017 to March 2020 in Shangyu Hospital of Traditional Chinese Medicine, Zhejiang Province, 100 patients who were performed laparoscopic hysteromyoma were randomly divided into observation group (50 cases) and control group (50 cases). Both groups were treated with plane block of transverse abdominal muscle after anesthesia induction. The control group was injected with ropivacaine, and the observation group was injected with hydromorphone and ropivacaine. The changes of hemodynamics at the time of entering operation room (T 0), 1 h after operation (T 1) and after surgery (T 2) were compared between two groups. The visual analogue scale (VAS) score at postoperative 3 h, 12 h and 24 h, Ramsay sedation score during operation, and serum stress level at preoperative and postoperative 24 h were compared between two groups. Results:The levels of heart rate, systolic and diastolic blood pressure between the two groups at different times had no significant differences ( P>0.05). The VAS scores of the observation group at postoperative 3 h, 12 h and 24 h were lower than those in control group [(3.05 ± 0.32) scores vs. (3.42 ± 0.39) scores, (2.16 ± 0.38) scores vs. (2.73 ± 0.43) scores, (1.43 ± 0.29) scores vs. (2.28 ± 0.35) scores], and there were significant differences ( t = 5.186, 7.024, 13.223, P<0.05). The scores of Ramsay sedation score in observation group was higher than that in control group [(3.79 ± 0.45) scores vs. (2.54 ± 0.39) scores], and there was significant difference ( t = 14.843, P<0.05). The levels of noradrenaline, interleukin-6, and cortisol in observation group at postoperative 24 h were lower than those in control group [(254.18 ± 14.35) pmol/L vs. (328.73 ± 18.69) pmol/L, (26.89 ± 4.10) ng/L vs. (35.27 ± 5.46) ng/L, (214.30 ± 21.28) pmol/L vs. (296.53 ± 32.19) pmol/L], and there were significant differences ( t = 22.371, 8.678, 15.068, P<0.05). Conclusions:The combination of hydromorphone and ropivacaine in abdominal transverse plane block after laparoscopic myomectomy has good analgesic and sedative effects and can reduce stress response.

Objective To evaluate the effect of small dose ketamine on the efficacy of intravenous PCA (POA) with sufentanil after intra-abdominal surgery in aged patients.Methods Sixty ASA Ⅰ orⅡpatienm aged 65-82 yr undergoing elective intra-abdominal surgery under general anesthesia were randomized into 3 groups (n=20 each)according to the composition of PCIA solution:group I sufentanil 200 μg in 200 ml of noilnal saline (group S);group μ sufentanil 200μh+ketmine 100 mg in NS 200 ml(group K1)and group Ⅲ sufentannil 200 μg+ketmine 200 mg in NS 200 ml(group K2).A loading dose of 5 ml wag given at the end of operation.The PCIA setting was as follows:backgound infusion 1 ml/h,bolus dose 2 ml,lockout interval 5 min and 4-hour maximum dose 30 m1.If VAS score(0=no pain,10=womt pain)was≥7,pethidine 25 mg was given iv.The total amount of pethidine given within 48 h after operation and postoperative complications including nausea and vomiting and respiratory depression were recorded.Results Small dose ketamine added to the PCIA solution can significantly reduce the amount of pethidine administered after operation in a dose-dependent manner.Conclusion Small dose ketamine can improve the efficacy of PCIA with sufentanil after intra-abdominal surgery in aged patients with no significant adverse effect.

Objective To explore the clinical significance of osteopontin (OPN) in systemic lupus erythematosus (SLE) and its pathogenic role in SLE by studying the correlation between OPN and clinical manifestations,laboratory parameters and disease activity.Methods The enzyme-linked immunosorbent assay(ELISA)was used to measure the level of OPN in serum of 68 SLE patients and 20 healthy controls.the clin-ical data and laboratory parameters were recorded.Results The positive rate of OPN was 79.41%in 68 SLEpatients and could not be detected in healthy controls.Compared with healthy controls.the positive rate and level of OPN in SLE patients was significantly higher(P＜0.01).There was no significant difference in age.gender and disease duration between OPN positive and negative lupus patients(P＞0.05).The Drevalence of fever,hair loss,WBC decrease,liver damage,serum C4 decrease,proteinuria and anti-dsDNA antibody in OPN positive SLE were significantly higher than those of OPN negative SLE(P＜0.05).The positive rate of serum OPN in SLE patients was significantly higher than that of anti-dsDNA antibody and anti-Sm antibody (P＜0.01).The level of plasma OPN was associated with systemic lupus erythematosus disease activity index (SLEDAI)(r=0.292,P＜0.05).The positive rate and level of OPN in active SLE patients was significantly higher than that of inactive SLE patients(P＜O.05).Conclusion The level of plasma OPN has a close rela-tionship with the activity of SLE.It may serve as an active disease marker of SLE.

Female ; Humans ; Menstruation ; physiology ; Menstruation Disturbances ; epidemiology ; etiology ; Occupational Health ; Stress, Psychological ; complications ; epidemiology ; physiopathology

Objective To evaluate the effects of ulinastatin on proinflamatory cytokines and oxygen free radical during orthotopic liver transplantation (OLT). Methods Eighteen ASA Ⅲ-Ⅳ patients with end-stage liverⅣ diseases, undergoing OLT were randomly divided into two groups: (1) ulinastatin group received intravenous infusion of ulinastatin 2? 105 IU in 100 normal saline after skin incision and every 4 hours thereafter (group U n = 9); control group received same amount of normal saline instead of ulinastatin (group C n = 9). Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1 , fentanyl 5 ?g?kg-1 and pipecuronium 0.1 mg?kg-1 and maintained with isoflurane inhalation and intermittent iv boluses of fentanyl and pipecuronium combined with epidural anesthesia(T8.9). The patients were mechanically ventilated with 100% O2 and PETCO2 was maintained at 35-40 mm Hg during operation. Swan-ganz catheter was inserted via right internal jugular or subclavian vein after induction of anesthesia. Cardiac output, mixed venous oxygen saturation and central venous temperature were continuously monitored with continuous cardiac output monitor (Baxter, Vigilance). ECG,CVP,SpO2 and PETCO2 were also continuously monitored during operation. Radial artery was cannulated for continuous direct blood pressure monitoring. Blood samples were taken before skin incision (T0), 120 min after skin incision (T1), 30 min after liver was removed ( anhepatic phase) (T2) , 5 min and 60 min after reperfusion of the graft (T3 , T4) and at the end of operation (T5 ) for determination of plasma IL-6, IL-8, TNF-? and MDA concentration. Body temperature was maintained above 35.5℃ during operation. Venovenous bypass was performed during anhepatic phase. Results (1) In group C plasma IL-6 and Ⅱ-8 concentrations were significantly increased from T1-5 during operation as compared with the baseline values (T0), whereas plasma levels of TNF-? and MDA did not change significantly before and during anhepatic phase (T1 , 2) but were significantly increased during neohepatic phase and at the end of surgery (T3 ,45) as compared with the baseline values (T0).(2) In group U plasma IL-6, IL-8, TNF-? and MDA concentrations were not significantly increased during operation, except that plasma IL-6 and IL-8 concentrations were significantly higher at T3 (5 min after reperfusion of the graft) than the baseline values. Conclusion Ulinastatin inhibits release of proinflammatory cytokines and reduces production of oxygen free radicals during OLT.

Objective To evaluate the effects of prostaglandin E1 (PGE1) and low-dose dopamine on renal function during orthotopic liver transplantation (OLT) .Methods Eighteen ASA Ⅲ-Ⅳ patients with end-stage liver diseases undergoing OLT were randomly divided into two groups of 9 patients each : PGE1 group (group P) and low-dose dopamine group (group D). Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1 , fentanyl 5 ?g?kg-1 and pipecuronium 0.1 mg?kg1 and maintained with isoflurane inhalation and intermittent i.v. boluses of fentanyi and pipecuronium. The patients were mechanically ventilated after tracheal intubation. PGE1 was infused at 0.4-0.8?g? kg-1 ? h-1 in group P and dopamine at 1 -3 ?g ? kg-1? min in group D after induction until the end of operation. Swan-Ganz catheter was inserted via right internal jugular vein or subclavian vein and radial artery was cannulated. MAP, ECG, CVP, SvO2 , cardiac output ( CO), SpO2 , PET CO2 and core temperature were continuously monitored during operation. Venous blood samples were taken and urine was collected before induction of anesthesia (T1 .baseline), during preanhepatic (T2) anhepatic (T3) and neohepatic phases (T4) and at the end of operation (T5) for determination of serum creatinine (Cr) concentration and serum and urine concentration of ?2 -microglobulin (?2-MG). Creatinine clearance ratio (CCr) was calculated. Total urine output during operation and urine output and the amount of furosemide given during anhepatic phase were recorded. Core body temperature was maintained above 35.5℃ during operation. Veno-venous bypass (VVB) was performed during anhepatic phase.Results In group P, compared to baseline there were no significant changes in MAP, Cr and CCr duringoperation, while serum ?2-MG decreased significantly at T5 and urine ?2-MG increased significantly at T3-5 . In group D serum ?2-MG was significantly decreased while urine ?2 -MG significantly increased at T2.5 compared to baseline. There was significantly more urine output during anhepatic phase and the whole operation and less furosemide was given in group D than in group P. Conclusion Low dose dopamine is more effective in protecting renal function during OLT than PGE1 .

Allergic rhinitis is nasal mucosa of immediate hypersensitivity, and the current treatment is not satisfied. With the increasing incidence in recent years, we pay more attention on the effective treatments. There are some published studies indicate the benefit of probiotic for allergic rhinitis. Refer to the related literature in recent years, the paper will discuss probiotic species, safety, route of administration, mechanism and efficacy, pointing out a new direction for the treatment of allergic rhinitis.
Humans ; Probiotics ; therapeutic use ; Rhinitis, Allergic ; therapy

We took such measures in internal medicine practice teaching in five-year program as actualizing special teachers’supervision system,adopting multiple teaching methods (enlightening,case-based,question-based,multimedia),taking interview of teachers and students,and enhancing doctor-patient communication.

Objective To investigate the application of 3D scanning system in medical education technology.Methods David 3D scanning system had its advantages,calibration technique,working flow and post-processing of scanning data described,and then introduced into medical education and underwent series of tests.Results David 3D scanning system gained high modeling speed,and spent only 2 h for actual specimen scanning,modeling as well as synchronized collection and mapping.The scanning accuracy reached industrial level.Conclusion David 3D scanning system gains advantages over the traditional 3D scanning technique,and facilitates medical digital modeling by transforming object information into digital signal.

Objective: To investigate the effects of protocatechuic acid (PCA) on the midbrain dopaminergic neurons injured by 1-methyl-4-phenylpyridinium (MPP+). Methods: Midbrain neuron cells from KM mice pregnant 14 d were used in this experiment, and divided into control group, model group, low-, mid-, and high-dose (0.05, 0.1, and 0.5 mmol/L) groups. MTT method was used to determine the neuronal survival rate. The activity of lactate dehydrogenase (LDH) in culture, content of intracellular reactive oxygen species (ROS), activity of mitochondrial complex I, and mitochondrial membrane potential were further determined. Results: PCA can enhance the viability of dopaminergic neurons damaged by MPP+, reduce the release of LDH and the generation of ROS, increase the activity of the mitochondrial complex Ι, and prevent the reduction of mitochondrial membrane potential. Conclusion: PCA has the neroprotective effects against MPP+-induced damage of midbrain dopaminergic neurons.