Objective To discuss the efficacy of sufentanil combined with propofol in iv anesthesia during laparoscopic cholecystectomy.Methods Totally 182 patients received laparoscopic cholecystectomy.They were divided into two groups according to odd or even number of hospitalization.The control group (81 cases) were given remifentani combined with propofol for iv anesthesia.The observation group (101 cases) were given sufentanil combined with propofol for iv anesthesia.The anesthetic effect of sufentanil combined with propofol for iv anesthesia during laparoscopic cholecystectomy was evaluated by breathing recovery time,opening time,extubation time,VAS scores after 1,6,12 h,and complications during anesthesia.Results Breathing recovery time,opening time,and extubation time of observation group were longer than those of control group (P ＜ 0.05).The VAS scores after 1,6,and 12 h of observation group were lower than those of the control group (P ＜ 0.05).During anesthesia,the proportion of restlessness in observation group was lower than that in control group (P ＜ 0.05).The complication rate of observation group was lower than that of control group (P ＜ 0.05).Conclusion Sufentani combined with propofol has a good anesthetic effect on patients receiving laparoscopic cholecystectomy with mild postoperative pain and less restlessness.It is worthy of clinical use.

Combined Modality Therapy ; Humans ; Stomach Neoplasms ; therapy

Acute and chronic graft rejection are the major factors leading to graft non-function.There is an active expression of chemokines early after transplantation.They recruit T cells and antigen presenting cells selectively to the graft, leading to inflammatory reaction and finally to graft non-function.Accordingly,monitoring the expression status of chemokines and their receptors regularly may help to the diagnose rejection.To determine one or more chemokines or their receptors as the new targets for anti-rejection therapy will be of great clinical significance.This review focuses on the research progression in the above areas.

Objective To investigate the renal protection of Chinese cobra venoms (CCV) and its mechanism in renal ischemia/reperfusion (I/R). Methods Thirty-two rats were divided into four groups. 0.1% CCV was separately infused into abdominal cavity at 0.5 h, 24 h before reperfusion in group Ⅰ and Ⅱ . Group Ⅲ suffered from kidney I/R was served as pathological control. Group Ⅳ was sham operation group. BUN and Scr were measured before ischemia and 24 h after reperfusion. Complement C3 was observed at 0, 0.5, 2, 24 h after reperfusion. The kidney samples were examined by HE stain under light microscopy. Apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP-biotin in situ nick-end labeling(TUNEL). Results Significant histological damage, apoptosis of tubular cell and impaired renal function were found in group Ⅰ and Ⅲ.The above indexes decreased to a less extend in group Ⅱ (P

0.05) during follow-up angiography. Conclusion Pullback atherectomy is an effective method of plaque removal for coronary artery disease with optimal short-term angiographic results, and large cutter and eccentric lesion seem to come with good immediate and follow-up angiographic results.

Oxyfedrine (Oxy ) exhibited inhibitory effect on washed rabbit platelet aggregation and MDA production induced by thrombin (4 U /ml) . The concentration of Oxy causing 50% inhibition of platelet aggregation induced by thrombin was 254 ?mol/L . Up to 2 nig/ml, acetysalicylic acid (ASA) could not antagonize platelet aggregation induced by thrombin 。 However, ASA 50 ?g/ml reduced the generation of MDA markedly. These results suggest that anti-aggregation of Oxy may be related to inhibition of PAF formation and the effect of Oxy on MDA generation may be due to the inhibition of arachi-donic acid release.

Objective　To analyze the epidemiological characteristics of hepatitis B in Hainan from 2015 to 2021, and to predict the incidence trends among different populations, so as to provide a scientific basis for the prevention and control of hepatitis B based on the epidemiological characteristics and prediction. Methods　Descriptive epidemiological characteristics of hepatitis B in Hainan were analyzed, and the incidence of hepatitis B among different populations in Hainan was studied based on the grey prediction model and polynomial model. The optimal model was selected by the principle of least absolute mean relative error, and future incidences were predicted. Results　The reported incidence of hepatitis B in Hainan Province from 2015 to 2019 basically showed an annual upward trend, but a decreasing trend was observed in 2020. From 2017 to 2021, the reported incidence rates in the age groups of 0-<15 and 15-<30 showed a declining trend, while the incidence of the age groups of 60-<75 and ≥75 years old basically stabilized in Hainan. The annual average number and annual incidence of the population aged 30-<45 and 45-<60 were both higher. The male-to-female sex ratio of the annual average reported incidence of hepatitis B was approximately 2:1. Among the various occupations, the incidence was mainly among farmers, with an annual average proportion of hepatitis B of 43.06%. Regional disparities in the number of reported annual hepatitis B cases were found, with 5 cities decreasing year by year, 1 city increasing first and then decreasing, 2 cities being stable and other cities increasing year by year. The predicted incidence rates for 2022-2024 years were 127.43/100 000, 116.05/100 000, and 102.09/100 000, respectively. Conclusions　In recent years, the incidence of hepatitis B among people under 30 years old in Hainan Province has shown a decreasing trend, indicating that policies such as hepatitis B vaccine included in the immunization program for children in Hainan have a good effect on the prevention and control of hepatitis B. Therefore, it is necessary to focus on strengthening the prevention and control of the high incidence rate in the age groups and gender. The existence of regional differences in the incidence of Hepatitis B suggests that comprehensive prevention and control measures should be continued to strengthen in areas where the incidence is increasing year by year, such as knowledge and health promotion of hepatitis B prevention and control, screening treatment, and vaccinatio.

Objective This article analyzed the characteristics of the health service in medium cities and the impact on community health service.Methods Summary and statistical analysis of the outcomes from the Fourth National Health Service Survey by the category of metropolitans,sub-provincial cities and provincial capital cities,and non-provincial-capital cities.Results In the medium cities,the geographical accessibility is high against low economic and technology accessibility.These cities have lower 2-week morbiditv rate but high children morbidity rate.These cities also feature high self-rated health status among residents and high health risk factors prevalence at the sarne time.Conclusion Medium cities are recommended to further build their CHS system,enhance their ties with larger cities,so as to elevate their technical competence,for meeting such public health needs of the people in infectious disease control,health promotion and vulnerable population healthcare.

Objective To explore the effect of chromofungin (CHR), a chromogranin A (CGA) derived peptide CGA47-66, on hyper-permeability of blood brain barrier in septic mice. Methods 120 healthy male C57BL/6 mice were randomly divided into groups, with 12 mice in each group. Seventy-two mice were used for dynamic observation of the contents of water and Evan blue (EB) in brain tissue after being treated with lipopolysaccharide (LPS). Another 48 mice were divided into normal saline control group (NS group), LPS induced sepsis model group (LPS group), low-dose CHR pretreatment group (CL+LPS group), and high-dose CHR pretreatment group (CH+LPS group). The septic model was reproduced by intraperitoneal injection of 10 mg/kg LPS 0.1 mL, and the mice in NS group was given equal volume of normal saline. The mice in CL+LPS group and CH+LPS group were intraperitoneally injected with 15.5 μg/kg and 77.5 μg/kg CHR 10 minutes before LPS injection. Six hours after LPS injection, 4 mL/kg of 2% EB was injected via caudal vein, the contents of water and EB in brain tissue were determined, and EB immune fluorescence in brain tissue was determined to assess the changes in permeability of blood brain barrier. Brain pathology was observed with hematoxylin and eosin (HE) staining. Results With the extension of time after LPS injection, the contents of water and EB in brain tissue were gradually increased, and the time of difference with statistical significance appeared earlier when compared with that of control group in the contents of water than that in EB contents (3 hours and 6 hours, respectively). The contents of water and EB in brain tissue in LPS group were significantly increased as compared with NS group [water content: (79.77±0.62)% vs. (78.28±0.44)%, P < 0.01; EB content (μg/g): 13.87±4.50 vs. 7.13±1.76, P < 0.05]. CHR pretreatment with either of two dosages could reverse the increase in water and EB contents in brain tissue induced by LPS, and the effect was more significant in CH+LPS group [water content: (78.15±0.73)% vs. (79.77±0.62)%, EB (μg/g): 7.09±2.59 vs. 13.87±4.50, both P < 0.05]. It was shown by EB fluorescence observation that the fluorescence signal displayed only in the meninges in NS group, and EB fluorescence was widely distributed in brain parenchyma in LPS group, indicating that the EB leakage in LPS group was more marked than that of NS group. In CHR pretreatment groups, EB fluorescence was decreased in brain parenchyma, indicating that EB leakage was significantly less marked, while it was more obvious in high dose CHR group. It was shown by HE staining that cerebral blood vessel structure was intact in NS group, and the gap around blood vessel was not significant increased. On the other hand, brain structure in LPS group appeared loose, with widening of small perivascular spaces and obvious edema. Brain edema in CHR pretreatment groups was improved as compared with that of the LPS group, and it was more apparent in high dose CHR group. Conclusions LPS induced change in blood brain barrier permeability in mice in a time-dependent manner. Exogenous CGA derived peptides CHR can inhibit LPS induced hyper-permeability of blood brain barrier in septic mice, thus reduces brain edema, protects the brain tissue, and the effect is more obvious with a high dose of CHR (77.5 μg/kg).

Clinical practice is an important period to train student's skills in pediatric surgical learning,but it is confronted with difficult condition under the new doctor-patient relationship.How to resolve these difficulties is the key to carry on teaching successfully.Aaccording to the students' interests and the knowledge structure characteristics,teachers should cultivate their professionalism,train their communication skills,extend their thinking ability with appropriate use of teaching aid to increase the teaching interests and develop self-learning ability.