Objective To study the analepsia effect of high and low dose sevoflurane combined with propofol anesthesia in partial hepatectomy.Methods 64 patients with partial hepatectomy were selected as the subjects.They were randomly divided into low concentration group and high concentration group,32 patients in each group.The two groups were treated with sevoflurane combined with propofol anesthesia,low concentration group was given 0.5MAC sevoflurane,high concentration group was given 1.0MAC sevoflurane.The clinical results were compared between the two groups.Results The time of propofol use,postoperative recovery time,extubation time and improved Aldrete score of 9 min in the high concentration group were(765.83±342.86)mg,(21.39±8.23)min,(41.81±8.37)min and(30.24±9.63)min,respectively,which were significantly lower than those in the low concentration group [(1 143.64±374.64)mg,(25.46±7.98)min,(46.68±7.73)min and(35.94±8.89)min,respectively,t=4.208,0.008,2.418,2.460,all P<0.05].In addition,the OAA/S scores at T0,T1of the high concentration group were(3.83±0.64)points and(4.28±0.85)points,respectively,which were significantly higher than those of the control group[(3.36±0.76)points and(3.79±0.87)points],the differences between the two groups were statistically significant(t=2.676,2.279,all P<0.05).Conclusion The combination of sevoflurane and propofol in patients with partial hepatectomy can reduce the dosage of propofol and shorten the recovery time of postoperative spontaneous breathing in patients,and contribute to improve the quality of patients'' recovery.

Objective To investigate the relationship between interleukin 1β( IL?1β) , interleukin?33 ( IL?33) , neutrophil?to?lymphocyte ratio ( NLR ) and atrial fibrillation. Methods Eighty?two patients with nonvalvular atrial fibrillation treated in the department of cardiology in the Fourth People′s Hospital of Jinan from October 2015 to October 2016 were enrolled in the study,including 43 patients with persistent atrial fibrillation and 39 patients with paroxysmal atrial fibrillation. 50 healthy subjects were selected as the control group. Enzyme linked immunosorbent assay (ELISA) was used to determine the concentration of IL?1βand IL?33,and the left atrial diameter ( LAD) was measured by echocardiography. Results ( 1) The concentrations of IL?1β,NLR and LAD in the paroxysmal atrial fibrillation group were (24. 44±4. 89) ng/L,(2. 51±1. 22) %,(36. 16± 6. 12) mm,the concentrations of IL?1β,NLR and LAD in the persistent atrial fibrillation group were (26. 95±5. 86) ng/L,(5. 7±1. 8) %,(39. 36±4. 78) mm and the values in the control group were (19. 53±4. 51) ng/L,(1. 82 ± 0. 41 ) %, ( 33. 31 ± 2. 89 ) mm, respectively. The differences among the three groups were statistically significant ( F=16. 74,11. 82,14. 85,P<0. 01) . The indexes of paroxysmal atrial fibrillation group and persistent atrial fibrillation group were higher than those of the control group ( P<0. 01 ) . ( 2 ) In the persistent atrial fibrillation group, NLR and LAD were ( 5. 7 ± 1. 8 )% , and ( 39. 36 ± 4. 78 ) mm, higher than those of the paroxysmal atrial fibrillation group ( (2. 51±1. 22)%,(36. 16±6. 12) mm),the differences were statistically significant ( P<0. 01) . However,the level of IL?1βin the persistent atrial fibrillation group was not significantly different from that in the paroxysmal atrial fibrillation group ( (26. 95±5. 86) ng/L vs. (24. 44±4. 89) ng/L,P>0. 05). (3) The concentrations of IL?33 in the paroxysmal atrial fibrillation group,atrial fibrillation group, control group were ( 48. 31 ± 4. 72 ) ng/L, ( 50. 03 ± 2. 18 ) ng/L, ( 56. 87 ± 5. 12 ) ng/L, respectively. The difference among the three groups has no statistical significance ( F=2. 52, P>0. 05 ) . ( 4 ) NLR level was positively correlated with LAD ( r=0. 32,P=0. 002) . There was no significant correlation among IL?1β,IL?33 and LAD ( r=0. 16, P=0. 11, r=0. 02, P=0. 37 ) . Conclusion The levels of IL?1β, NLR and LAD in peripheral blood of patients with atrial fibrillation were significantly higher than those in patients with sinus rhythm,and there was a positive correlation between NLR and LAD.

Objective: To investigate the prevalence and influencing factors of chronic diseases among cured leprosy patients in Huai'an City, so as to provide insights into chronic diseases control among cured leprosy patients. Methods: All cured leprosy patients in Huai'an City in 2021 were enrolled from the National Leprosy Management Information System in China. The demographic data, family status, leprosy diagnosis and treatment, health status and development of chronic diseases were collected using face-to-face questionnaire surveys and physical examinations, and the factors affecting the development of chronic diseases were identified among cured leprosy patients using a multivariable logistic regression model. Results: Totally 708 cured leprosy patients were included, with a male to female ratio of 2.75︰1, and a mean age of (71.84±10.09) years. The overall prevalence of disability was 48.45%. The prevalence of chronic diseases was 31.78% among participants, and the prevalence rates of hypertension, diabetes, coronary heart disease, stroke, dyslipidemia, tumor, chronic obstructive pulmonary diseases were 25.14%, 4.10%, 3.67%, 3.67%, 2.26%, 2.26% and 0.85%, respectively. There were 154 participants with a type of chronic diseases (21.75%), 61 with two types of chronic diseases (8.62%) and 10 with 3 and more types of chronic diseases (1.41%). Multivariable logistic regression analysis identified complete loss of labor ability (OR=1.484, 95%CI: 1.015-2.171), labor income as the major economic source (OR=0.621, 95%CI: 0.407-0.948), being cared of (OR=1.832, 95%CI: 1.203-2.788) and disability (OR=1.715, 95%CI: 1.127-2.608) as factors affecting the development of chronic diseases among cured leprosy patients. Conclusions There is a high risk of chronic diseases among cured leprosy patients with loss of labor ability, with government subsidy and others' funding as the major economic source, requiring to be cared of and with disability in Huai'an City.

Objective To explore the design and application of psychological intervention paths for ascites type of advanced schistosomiasis patients. Methods A total of 156 ascites type of advanced schistosomiasis patients were divided into an inter?vention group and a control group with 78 cases each. A psychological intervention path table was designed in accordance with the psychological characteristics and demands of the advanced schistosomiasis patients. Five steps were used to guide the nurses involved to carry out the psychological intervention. Results Before the intervention there were no statistically significant dif?ferences all P>0.05 between two groups in SAS SDS WHOQOL?BRER scores but after the intervention all the evalua?tion indexes improved in the intervention group and there were statistically significant differences between the intervention group and control group in SAS SDS WHOQOL?BRER scores all P<0.05 . Conclusion The application of psychological inter?vention paths for ascites type of advanced schistosomiasis patients can improve their negative emotions and qualities of life.

Objective To explore the molecular mechanism of BRAFV600E inducing chromosome instability in Sbcl2 and SK-MEL31 melanoma cells.Methods The endogenous Mps1 in stable Sbcl2-and SK-MEL31-B-RafV600E expression cells were depleted by siRNA approach.To test the effect of B-RafV600E on the centrosome amplification and the formation of multipolar spindles,cells at S-phase with HU-treatment were arrested and then the centrosomes and mitotic spindles structure were detected through immunofluoresence.Results The percentage of B-RafV600E expressing Sbcl2 and SK-MEL31 cells (Sbcl2-B-RafV600E and SKMEL31-B-RafV600E) with centrosome amplification and multipolar spindle was reduced from 36 ％ to 6 ％ when Mps1 was absent.Conclusion B-RafV600E leads to centrosome amplification and multipolar spindle through Mps1,thus results in chromosome instability in Sbcl2 and SK-MEL31 melanoma cells.

Objective To investigate the effect of miR-30a on human osteosarcoma cell 143B in migration,invasion andcellviability.Methods 143BcellswereinfectedortransfectedwithrecombinantadenovirusmiR-30a(Ad-miR30a) and miR-30a inhibitor respectively .Wound healing assay was performed to detect the cell healing ability ( P<0.05 ) .Cell migration and invasion ability were determined by Transwell assay ( P<0.05 ) .The cell viability was analyzed by MTT assay ( P<0.01 ) .Real-time quantitative PCR was performed to analyze the expression of RUNX2 mRNA level and confirmed the adenovirus miR-30a expressed in 143B cells.The expression of RUNX2 was analyzed by Western blot .miR-30a target to RUNX2 was verified by luciferase reported gene assay .Results The ability of migration and invasion was suppressed in osteosarcoma cell 143B by overexpression miR-30a,and the cell viability also decreased .After the endogenous miR-30 a being inhibited , the cell motility and invasion enhanced and the cell viability was promoted .The RUNX2 protein decreased after overexpression miR-30 a as compared with controlgroup.TheluciferaseactivityofRUNX2decreasedbyaddingmiR-30a.Conclusions 143Bcellmigration, invasion and viability were suppressed by miR-30a,and this process is potentially achieved via suppressing RUNX 2 protein expression .

The liver injury caused by drug and / or its metabolites is one of the most common reasons for drugs to be withdrawn or disapproved.Premarketing clinical evaluation of drug-induced liver injury (DILI) is extremely important to drug evaluation.Signals of DILI and Hyman's Law (Hy's Law),clinical evaluation and lessons of DILI were discussed to help developing new drugs.

Objective To investigate the target blood pressure level of restrictive fluid resuscitation in patients with traumatic hemorrhagic shock. Methods Sixty patients with traumatic hemorrhagic shock admitted to the First Affiliated Hospital of Bengbu Medical College from January 2016 to December 2018 were enrolled. All patients were resuscitated with sodium acetate ringer solution after admission. According to the difference of mean arterial pressure (MAP) target, the patients were divided into low MAP (60 mmHg ≤ MAP < 65 mmHg, 1 mmHg = 0.133 kPa), middle MAP (65 mmHg ≤ MAP < 70 mmHg) and high MAP (70 mmHg ≤ MAP < 75 mmHg) groups by random number table using the admission order with 20 patients in each group. Those who failed to reach the target MAP after 30-minute resuscitation were excluded and supplementary cases were deferred. The restrictive fluid resuscitation phase was divided into three phases: before fluid resuscitation, liquid resuscitation for 30 minutes and 60 minutes. The most suitable resuscitation blood pressure level was further speculated by monitoring the inflammatory markers and hemodynamics in different periods in each group of patients. Pearson correlation analysis was used to detect the correlation of variables. Results Before fluid resuscitation, there was no significant difference in hemodynamics or expressions of serum cytokines among the three groups. Three groups of patients were resuscitated for 30 minutes to achieve the target blood pressure level and maintain 30 minutes. With the prolongation of fluid resuscitation time, the central venous pressure (CVP), cardiac output (CO) and cardiac index (CI) were increased slowly in the three groups, and reached a steady state at about 30 minutes after resuscitation, especially in the high MAP group and the middle MAP group. The expressions of serum inflammatory factors in the three groups were gradually increased with the prolongation of fluid resuscitation time. Compared with the low MAP group and the high MAP group, after 30 minutes of resuscitation the middle MAP group was superior to the other two groups in inhibiting the expressions of pro-inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and promoting anti-inflammatory factors IL-10 [TNF-α mRNA (2-ΔΔCt):0.21±0.13 vs. 0.69±0.34, 0.57±0.35; IL-6 mRNA (2-ΔΔCt): 0.35±0.31 vs. 0.72±0.39, 0.59±0.42; IL-10 mRNA (2-ΔΔCt): 1.25±0.81 vs. 0.61±0.46, 0.82±0.53; all P < 0.05], but there was no significant difference in promoting the expression of IL-4 mRNA among three groups. At 60 minutes of resuscitation, compared with the low MAP group and the high MAP group, the middle MAP group could significantly inhibit the expressions of TNF-α, IL-6 and promote IL-10 [TNF-α mRNA (2-ΔΔCt): 0.72±0.35 vs. 1.05±0.54, 1.03±0.49; IL-6 mRNA (2-ΔΔCt): 0.57±0.50 vs. 1.27±0.72, 1.01±0.64; IL-10 mRNA (2-ΔΔCt): 1.41±0.90 vs. 0.81±0.48, 0.94±0.61; all P < 0.05]. Compared with the high MAP group, the middle MAP group had significant differences in promoting the expression of IL-4 mRNA (2-ΔΔCt: 1.32±0.62 vs. 0.91±0.60, P < 0.05). There was no significant difference in serum cytokine expressions at different time points of resuscitation between the low MAP group and the high MAP group (all P > 0.05). Correlation analysis showed that there was a strong linear correlation between MAP and mRNA expressions of TNF-α, IL-6, IL-10 in the middle MAP group (r value was 0.766, 0.719, 0.692, respectively, all P < 0.01), but had no correlation with IL-4 (r = 0.361, P = 0.059). Fitting linear regression analysis showed an increase in 1 mmHg per MAP, the expression of TNF-α mRNA increased by 0.027 [95% confidence interval (95%CI) = 0.023-0.031, P < 0.001], IL-6 mRNA increased by 0.021 (95%CI = 0.017-0.024, P < 0.001), and IL-10 mRNA increased by 0.049 (95%CI = 0.041-0.058, P < 0.001). Conclusions When patients with traumatic hemorrhagic shock received restrict fluid resuscitation at MAP of 65-70 mmHg, the effect of reducing systemic inflammatory response and improving hemodynamics is better than the target MAP at 60-65 mmHg or 70-75 mmHg. It is suggested that 65-70 mmHg may be an ideal target MAP level for restrictive fluid resuscitation.

Objective:To investigate the effect of urate-lowering therapy (ULT) on body fat and visceral fat areas in patients with gout and to analyze the related risk factors.Methods:A total of 140 patients with gout eligible for enrollment were recruited from the gout clinic in the Affiliated Hospital of Qingdao University from Sept. 2018 to Sept. 2019. After 2 weeks of washout, all patients were treated with benzbromarone for consecutive 12 weeks. The data of blood biochemical, body fat (BF), body fat percentage (BFP) and visceral fat area (VFA) were collected, and the differences before and after ULT as well as the risk factors affecting the changes of BF, BFP, and VFA were analyzed.Results:The diastolic blood pressure (DBP), alanine aminotransferase (ALT), serum uric acid (sUA), BF, BFP, and VFA were significantly decreased after ULT ( P<0.05). The results of multivariate stepwise linear regression analysis showed that sUA, creatinine (Cr) and glomerular filtration rate (eGFR) were independent risk factors affecting the improvement of BF and VFA (P<0.05). Lower serum uric acid levels in patients with gout before and after ULT indicated better improvement effect of body fat and visceral fat areas( P<0.05). Conclusion:Gout combined with hyperuricemia is closely related to visceral obesity. In addition to lowering the serum uric acid level, ULT could also benefit the body fat and visceral fat area in patients with gout to some extent.

Objective:To investigate the effect of immunotherapy with dendritic cells and cytokine-induced killer cells combined with chemotherapy on apoptosis-related genes and immune function in patients with middle- and advanced-stage non-small cell lung cancer.Methods:A total of 100 patients with middle- and advanced-stage non-small cell lung cancer who received treatment in Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, China from February 2018 to May 2019 were included in this study. They were randomly divided into control and observation groups ( n = 50/group). The two groups were given chemotherapy with pemetrexed and cisplatin. The observation group was given immunotherapy with dendritic cells and cytokine-induced killer cells based on chemotherapy with pemetrexed and cisplatin. Changes in apoptosis-related genes [primary autosomal recessive microcephaly gene (MCPH1), ataxia-telangiectasia mutated (ATM), ataxia telangiectasia mutated and Rad3 related (ATR), transcription factor 21 (TCF21)] and immune function were monitored. Clinical efficacy of immunotherapy with dendritic cells and cytokine-induced killer cells combined with chemotherapy with pemetrexed and cisplatin in the treatment middle-and advanced-stage non-small cell lung cancer was assessed. Results:After treatment, expression of MCPH1, ATM, ATR and TCF21 in the observation group was 301.11 ± 41.12, 239.98 ± 30.15, 270.01 ± 36.01, 270.01 ± 34.02, respectively, which was significantly higher than that in the control group [101.32 ± 15.32, 103.00 ± 13.97, 101.12 ± 14.90, 100.20 ± 14.99, t = 32.194, 29.149, 30.644, 32.299, all P < 0.001]. The proportion of the number of Th1-positive cells in the number of CD +4 T cells in the observation group was significantly higher than that in the control group [(29.00 ± 3.41)% vs. (22.61 ± 3.22)%, t = 9.634, P < 0.001]. The proportion of the number of Th17-,Th2 and CD +4CD +25Treg-positive cells in the number of CD +4 T cells in the observation group were (0.89 ± 0.10)%, (12.01 ± 1.36)%, (11.02 ± 1.92)%, respectively, which were significantly lower than those in the control group [(1.70 ± 0.20)%, (17.61 ± 2.20)%, (18.70 ± 2.40%)%, t = 25.614, 15.310, 17.670, all P < 0.001]. Total effective rate in the observation group was significantly higher than that in the control group [52.0% (26/50) vs. 30.0% (15/50), χ2 = 5.002, P < 0.05]. Conclusion:Immunotherapy with dendritic cells and cytokine-induced killer cells combined with chemotherapy with pemetrexed and cisplatin can induce apoptosis and regulate immune function. The combined therapy exhibits better clinical efficacy in the treatment of non-small cell lung than chemotherapy alone.