Objective To evaluate the efficacy of dexmedetomidine combined with sufentanil for patientcontrolled intravenous analgesia (PCIA) after caeserean section. Methods One hundred and twenty parturients aged 18-40 yr undergoing caeserean section under spinal-epidural anesthesia were randomly assigned to one of 3 groups( n=40 each):group Ⅰ , group Ⅱ and group Ⅲ . During operation as soon as the baby was bom a bolus of dexmedetomidine 0.5 μg/kg was given iv in Ⅱ and Ⅲ groups while in group Ⅰ normal saline (NS) was given instead. Ⅰ and Ⅱ groups received PCIA with sufentanil (background infusion 0.015 μg·kg-1·h-1;bolus dose 0.023 μg/kg;lockout interval 8 min). Group Ⅲ received PCIA with sufentanil + dexmedetomidine (background infusion sufentanil 0.015 μg·kg-1 ·h-1 + dexmedetomidine 0.045 μg·kg· h-1;bolus dose sufentanil 0.023 μg/kg + dexmedetomidine 0.07 μg/kg;lockout interval 8 min) . Pain threshold and pain tolerance threshold were measured before caeserean section and 1 h after bolus dose of dexmedetomidine or NS. VAS, OAA/S and satisfaction scores and sufentanil consumption were recorded at 4, 8 and 24 h after operation.Blood samples were obtained before anesthesia,1 h after bolus injection of dexmedetomidine, and 24 h after operation for determination of serumcortisol concentration. Results Pain threshold and pain tolerance threshold at 1 h after bolus injection of dexmedetomidine were significantly increased as compared with the baseline before anesthesia in Ⅱ and Ⅲ groups and were significantly higher in Ⅱ and Ⅲ groups than in group Ⅰ . VAS scores and the consumption of sufentanil were significantly lower while the satisfactory score was significantly higher in group Ⅲ than in Ⅰ and Ⅱ groups. Serum cortisol concentrations were significantly increased at 1 h after iv dexmedetomidine or NS injection as compared with the baseline before anesthesia in all 3 groups, but there was no significant difference in serum cortisol levels among the 3 groups. Conclusion Addition of dexmedetomidine to sufentanil for PCIA can significantly reduce the consumption of sufentanil and improve parturient's satisfaction.

Objective:To compare the efficacy of penehyclidine hydrochloride and atropine in the prevention of catheter related bladder discomfort(CRBD) in patients undergoing gynecology laparoscopic surgery.Method;Eighty ASA classⅠorⅡpatients undergoing elective gynecology laparoscopic surgery were randomly assigned into 2 groups of P and A with 40 cases each.Fifteen minutes before the anesthesia induction,penehyclidine hydrochloride 0.5 mg and atropine 0.25 mg were administered in Group P and Group A,respectively.After the induction of anesthesia,patients were catherized with a 14 Fr Foley's catheter.HR,bladder discomfort,Ramsay Sedative Score(RSS) and side reactions were recorded at 0 h,0.5 h,1 h and 6 h after the end of surgery in the post-anaesthesia care unit(PACU).The severity of bladder discomfort was graded as mild,moderate and severe.Result:The total incidence rate of CRBD in Group P was apparently lower than that in Group A(P0.05).The incidence rate of CRBD of Group P was apparently lower than that in Group A at 6 h after the end of surgery(P0.05).Conclusion:The application of enehyclidine hydrochloride before anesthesia induction provides a better prophylactic effect of CRBD than that of atropine but with a higher incidence rate of dry mouth.

Objective To study the clinical manifestation, pathological character, treatment strategies and prognostic factors of phyllodes tumor of breast .Methods We retrospectively reviewed 41 patients with breast phyllodes tumor.Results The average age was 35. Among all the patients, there were 20 benign cases, 5 borderline cases, 16 malignant cases. 19 patients received extensive local excision, 7 patients received local excision, 9 patients received simple mastectomy of breast and 6 patients were treated with modified radical operation. There were 4 patients undergoing radiotherapy after the operation. Follow-up was obtained for 35 cases, with an average of 26 months (5~101 months), one of the patients died of metastasis 3 years after the operation, two patients suffered from local recurrence.Conclusions Appropriate operation is the most important prognostic factor of breast phyllodes tumor.

AIM: To detect the mRNA expression of tissue factor (TF), urokinase-type plasminogen activator (u-PA) and urokinase-type plasminogen activator receptor (u-PAR) in the samples of hepatocellular carcinoma (HCC) and adjacent tissue, and to elucidate their association with clinical significance. METHODS: The mRNA levels of TF, u-PA and u-PAR in 27 human HCC tissue samples with their adjacent tissue samples and 27 normal liver tissues were detected by RT-PCR. The relationship between the mRNA expression and their clinic-pathological data were also analyzed. RESULTS: The expressive rate of TF, uPA and uPAR in HCC tissue samples was 62.96% (17/27), 70.37% (19/27), 77.78% (21/27), respectively and relative expression intensity of TF, uPA and uPAR were 0.567?0.268, 0.964?0.458 and 0.784?0.322, respectively, which were significantly higher than those in adjacent tissue group and normal liver group (P

AIM:To investigate the immune function of dendritic cells(DCs)in patients with hepatocellular carcinoma(HCC).METHODS:The DCs were cultured from human peripheral blood mononuclear cells(PBMC)by using GM-CSF and IL-4 for 7 days.Surface molecules CD86,HLA-DR of DCs were detected by flow cytometry.IL-12 production by DCs and IFN-? production by T cells was measured with ELISA and ELISPOT,respectively.Allogenic mixed lymphocyte reaction was detected by MTT assay.RESULTS:CD86 expression in DCs in HCC patients were markedly lower than that in health control(91.7% vs 83.5%,P0.05].However,after stimulated DCs with LPS,IL-12 production in HCC patients was significantly lower than that in health control [(478.6?142.7)ng/L vs(630.0?151.9)ng/L,P

AIM: To evaluate the anti-angiogenesis effect of interferon-?(IFN-?) on cultured human umbilical vein endothelial cells(HUVECs) and human hepatocellular carcinoma(HCC) bearing nude mouse.METHODS: Anti-proliferation test,MTT test,tube-formation test,migration test on cultured HUVECs were employed and the tumor volume and microvascular desity(MVD) of IFN-? treated human hepatoma cell line(HuH7) were meassured.RESULTS: IFN-? displayed apparent inhibitory effects on cultured HUVECs in anti-proliferation test,MTT test,tube-formation test,migration test,and the tumor diameter and MVD in IFN-? treated HuH7 inoculated nude mouse group were significantly less than those in PBS treated HuH7 inoculated nude mouse group.CONCLUSION: IFN-? inhibits tumor growth through anti-angiogenesis.

Objective To investigate the epidemiology characteristics of spinal cord injury(SCI)in hospital.Methods1264 inpatients with SCI during April 1992～August 2006 were analyzed retrospectively.Results and Conclusion56.1% of the cases were 20～40 years old.Traffic trauma(44.3%)and fall injury(21.8%)were the main causes of SCI.The incidences of affected segments were:cervical segments 31.5%,thoracolumbar 28.1%,and thoracic 21.3%.56.7% were complete injury and 43.3% were incomplete.The most frequent complication of SCI were:urinary tract infection,pressure sore and bladder lithiasis.The expenditure of hospitalization was provided by oneself(52.5%),public medicalcare(33.1%),only 4.1% by hospitalization insurance.

Objective:To evaluate the correlation of preoperative pain threshold and pain tolerance threshold with postoperative sufentanil consumptions in puerperae who underwent cesarean section .Methods :A total of 50 puerperae ,aged 20‐35 years , with height 155‐180 cm ,who were classified as Ⅰ ~ Ⅱ with American Society of Anesthesiologists(ASA)criteria and scheduled for cesarean section with combined spinal and epidural anesthesia (CSEA) ,were chosen .The pain threshold and pain tolerance threshold were measured with electric stimulator before CSEA .The patient controlled intravenous analgesia(PCIA) with sufen‐tanil was used for postoperative analgesia .The PCIA pump was set up with background infusion at a rate of 0 .015μg/(kg · h) and single bolus dose of 0 .023 μg/kg with 8 min lockout interval .Visual analogue score(VAS) ,as well as consumptions of sufentanil ,was recorded at 4 ,8 ,24 h after operation .Linear correlation analysis was conducted on the preoperative pain thresh‐old and pain tolerance threshold with the total sufentanil consumptions during the 24 h after operation and the VAS at the 24 h after operation .Results :The preoperative pain threshold and pain tolerance threshold measured by electric stimulation were not correlated with the VAS at the 24 h after operation and the sufentanyl consumption during the 24 h after operation(P>0 .05) . Conclusions :The preoperative pain tolerance threshold and pain threshold measured by electric stimulation cannot predict the consumptions of sufentanyl after cesarean section .

Objective To observe the changes in functional connectivity(FC)of raphe nucleus in patients with first-episode depression complicated with suicidal ideation(SI).Methods Ninety-eight first-episode depression patients were prospectively enrolled and assigned into SI group(n=56)or non SI group(n=42)based on complicated with SI or not,while 47 healthy volunteers were recruited as control group.Resting-state functional MRI was performed.FC between dorsal raphe nucleus(DRN),median raphe nucleus(MRN)and the whole brain were analyzed and compared among 3 groups and between each 2 groups,and the correlations of FC of different brain regions with clinical data of SI group were explored.Results Compared with control group,FC between DRN and left cerebellum and left putamen in SI group and non SI group decreased(all P＜0.05),between MRN and right inferior temporal gyrus increased but between MRN and left inferior frontal gyrus,right superior occipital gyrus,left inferior parietal lobule,left putamen decreased(all P＜0.05).FC between DRN and left putamen in SI group was higher than that in non SI group(P＜0.05).FC between MRN and right central posterior gyrus of SI group increased compared with that in the rest 2 groups(both P＜0.05).FC between MRN and left putamen in SI group was positively correlated with body mass score of Hamilton depression scale-24(HAMD-24)(rs=0.297,P=0.026).Conclusion Abnormal changes of FC between raphe nucleus and cortex,also between raphe nucleus and subcortical area occurred,and FC between MRN and left putamen positively correlated with body mass score of HAMD-24 in patients with first-episode depression complicated with SI.

Objective:Analysis of subtype distribution characteristics of human papillomavirus (HPV) infection, pathological findings of HPV-positive patients operated colposcopy and cervical histopathological examination in Changsha from 2020 to 2022.Methods:Retrospective analysis of HPV infection status of 60 354 patients was treated in the First Affiliated Hospital of Hunan University of Chinese Medicine from Jan. 2020 to Oct. 2022. They were divided into<25 years old group (3 250 cases), 25-34 years old group (19 406 cases), 35-44 years old group (17 297 cases), 45-54 years old group (13 104 cases), 55-64 years old group (4 793 cases) and≥65 years old group (2 504 cases). Cervical exfoliated cells were collected from women and specimen of lesion site were collected from men. HPV genotyping detection used polymerase chain reaction (PCR) and flow fluorescence hybridization, which could detect 27 HPV genotypes. Analyze the distribution of HPV subtypes in patients of different age groups and different treatment departments. Analyze the relationship between the infection of HPV subtypes and the outcome of 224 patients with HPV positive who also underwent colposcopy and cervical histopathology. Pearson correlation test was used for correlation analysis, and two-tailed P<0.05 was statistically significant; Pearson chi-square test or continuous correction chi-square test was used to compare the rates between groups, and two-tailed P<0.05 was statistically significant; Chi-square split test was used to compare multiple sample rates. The standard test was corrected according to the number of groups and then compared. The difference was statistically significant when the two-tailed P value was less than the corrected standard test. Results:The overall positive rate of HPV was 16.4% (9 909/60 354). Among all HPV positive patients, affection of single type HPV accounted for 75.5% (7 479/9 909) and affection of multi-type HPV accounted for 24.5% (2 430/9 909). The top six HPV types with infection rates from high to low were: HPV52 22.8% (2 256/9 909), HPV58 11.1% (1 097/9 909), HPV53 10.5% (1 045/9 909), HPV16 9.0% (890/9 909), HPV61 7.8% (774/9 909) and HPV6 7.6% (750/9 909). The difference of overall infection rate between different age groups was statistically significant (χ 2=536.90, P<0.001). The HPV infection rate was the highest in the<25 years old group, 30.1% (978/3 250), and it is higher than the age groups of 25-34 years old, 15.6% (3 035/19 406), group of 35-44 years old, 14.2% (2 464/17 297), group of 45-54 years old, 16.1% (2 115/13 104), group of 55-64 years old, 19.1% (915/4 793) and group of≥65 years old, 16.1% (402/2 504), with statistical significance( P<0.001 respectively). The most common types of HPV infection were type 6, 16.7% (378/2 266) and type 11, 10.5% (239/2 266) in dermatology clinics. The positive rate of HPV16 accounted for 12/17 in cervical intraepithelial neoplasia (CIN) 3 and cervical cancer cases, it was significantly higher than that in the inflammatory cases, 25.0% (35/140) and CIN1 cases, 23.0% (11/48), the statistical values were χ 2=15.02, P<0.001 and χ 2=12.48, P<0.001, respectively, all of which were statistically significant. Conclusions:HPV infection rate is highest in young people under 25 years old. Low-risk HPV6 and 11 are the main types of skin and venereal diseases. Among the total cases, high-risk HPV52, 58 and 53 are the most common types of infection with women in Changsha. However, high-grade cervical intraepithelial neoplasia and cervical cancer are more closely related to HPV16 infection.