Objective To observe and compare the effects of four methods of anesthesia in patients with anorectal surgery.Methods One hundred patients with anorectal surgery were equally divided into the group Ⅰ (low-dose epidural anesthesia),group Ⅱ (epidural anesthesia),group Ⅲ (caudal) and group Ⅳ (local anesthesia) based on a random draw principles,each group of 25 cases.The onset time of anesthesia,patient satisfaction,postoperative adverse reaction and hemodynamics were observed in the 4 groups.Results The anesthesia onset time in the group Ⅰ and group Ⅳ were (4.12 ±2.11) min and (3.69 ±1.11) min,significantly shorter than group Ⅱ and group Ⅲ ((10.34 ±3.10) min and (12.55±3.23) min,P＜0.05).Anesthesia satisfaction of four groups were 96.0％ (24/25),84.0％ (21/25),64.0％ (16/25) and 40.0％ (10/25),the differences among 4 groups were statistically significant (P＜0.05),and the anesthesia satisfaction of guoup Ⅰ was the best.Four groups of postoperative urinary retention difference were not statistically significant (P＞0.05),but the postoperative nausea and vomiting(n =3),referred pain (n =12),headaches (n=4) and other adverse events in the group Ⅳ were significantly higher than the other 3 groups(P＜0.05).Differences between-groups and inner-group were not statistically significant of the intraoperative mean arterial pressure,oxygen saturation and pulse rates of the four groups (P＞ 0.05).Conclusion Compare to other anesthetic methods,low-dose epidural anesthesia in anorectal surgery applications with faster onset time of anesthesia and anesthesia satisfaction results,it has litter adverse reactions and maintain stable hemodynamics body,worthy applications.

OBJECTIVETo study the activation of platelets in children with Kawasaki disease (KD) at molecular level.

METHODSThe expression of platelet surface glycoproteins CD(41), CD(42a), CD(61), CD(62p) and CD(63) in 20 KD patients was measured by flow cytometry before and at 1, 2, 3 week after treatment with aspirin and high-dose (1 approximately 2 g/kg) intravenous gamma-globulin (IVIG).

RESULTSThe expression of glycoprotein CD(41), CD(42a), CD(61), CD(62p) and CD(63) were higher in KD group than in control group. Aspirin and IVIG could not inhibit these high expression of glycoproteins. Higher expression of CD(62p) was observed in patients with coronary artery injury.

CONCLUSIONPlatelets were highly activated in KD patients which may be one of the most important pathophysiological step in KD. It provided a theoretical basis for treatment of KD with antagonist of glycoprotein of platelets. Obviously increase of CD(62p) can be taken as a criterion for predicting coronary artery injury in KD patients.

Aspirin ; pharmacology ; Blood Platelets ; drug effects ; metabolism ; Child ; Child, Preschool ; Coronary Artery Disease ; complications ; metabolism ; Female ; Humans ; Injections, Intravenous ; Male ; Mucocutaneous Lymph Node Syndrome ; metabolism ; pathology ; P-Selectin ; metabolism ; Platelet Activation ; physiology ; Platelet Membrane Glycoproteins ; metabolism ; gamma-Globulins ; pharmacology

Objective: To investigate the effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction. Methods: From May 2013 to September 2014, a total of 3 474 pregnant women who took their first antenatal care and willing to undergo their prenatal care and delivery in Ma 'anshan Maternity and Child Care Centers were recruited in the cohort study. Excluding subjects without weight data before delivery (n=54), pregnancy termination (n=162), twins live births (n=39), without fetal birth weight data (n=7), 3 212 maternal-singleton pairs were enrolled for the final data analysis. Demographic information of pregnant woman, pregnancy history, disease history, height and weight were collected. In the 24^th-28^th, 32^nd-36^th gestational week and childbirth, three follow-up visits were undertaken to collect data of pregnancy weight, pregnancy vomiting, gestational hypertension, gestational diabetes mellitus, newborn gender and birth weight. χ² test was used to compare the detection rate of fetal growth restriction in different groups. Multivariate unconditional logistic regression model and spreadsheet were used to analyze the independent and interaction effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction. Results: The incidence of fetal growth restriction was 9.7%(311/3 212). The incidence of fetal growth restriction in pre-pregnancy underweight group was 14.9% (90/603), higher than that in normal pre-pregnancy weight group (8.7% (194/2 226)) (χ²=24.37, P<0.001). The incidence of fetal growth restriction in inadequate increase of gestational weight group was 17.9% (50/279), higher than the appropriate increase of weight group (11.8% (110/932)) (χ²=36.89, P<0.001). Multivariate unconditional logistic regression analysis showed that compared with normal pre-pregnancy weight group, pre-pregnancy underweightwas a risk factor for fetal growth restriction, with RR (95%CI) at 1.76 (1.34-2.32); Compared with the appropriate increase of gestational weight group, inadequate weight increase during pregnancy was a risk factor for fetal growth restriction, with the RR (95%CI) at 1.70 (1.17-2.48). No additive model interaction [relative excess risk of interaction, attributable proportions of interaction, the synergy index and their 95%CI were 0.75 (-2.14-3.63), 0.21 (-0.43-0.86) and 1.43 (0.45-4.53), respectively] or multiplication model interaction (RR (95%CI): 1.00 (0.44-2.29)) existed between pre-pregnancy underweight and inadequate increase of gestational weight on fetal growth restriction. Conclusion Pre-pregnancy underweight and inadequate increase of gestational weight would increase the risk of fetal growth restriction without interaction.

Objective To explore the relationship between the polymorphisms of the primary gout predisposing gene (BCAS3) rs11653176 locus and the incidence of gout in Han Chinese men in coastal areas of Shandong Province. Methods One hundred and fifty-two cases of patients with gout remission,68 cases of acute stage,252 patients with hyperuricemia, and 280 healthy subjects, total males, were enrolled. Genotyping the rs11653176 locus of BCAS3 gene by TaqMan probe technique. The expression level of BCAS3 gene mRNA in each PBMC was measured by RT-qPCR. The levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), and interleukin-18(IL-18)in serum were measured by ELISA. Results The change of allele frequency of rs11653176 locus in BCAS3 gene was associated with gout(P<0.01). BCAS3 mRNA in patients with gout was significantly higher than that of healthy people and patients with hyperuricemia(P<0.01). In gout patients, the expression level of BCAS3 gene containing C allele was higher than that of T allele(mRNA,P<0.05). The inflammatory factors in the acute phase of gout were significantly higher than those in phases of remission and hyperuricemia(P<0. 01). Conclusion Changes in the allele frequency of BCAS3 alleles rs11653176(high C, low T)may contribute to the expression of this gene,and lead to gout. And the onset of gout is closely related to the production of inflammatory factors.

Objective: To investigate the clinical characters and diagnosis and treatment in patients with vesicoenteric fistula. Methods: Two patients with vesicoenteric fistula were admitted to the Affiliated Hospital of Shanxi Datong University in 2012 and 2019, at the same time 64 cases with complete data referenced from China Journal Full-text Database from September 2001 to December 2018 were retrospectively studied. The pathogeny, main clinical manifestations, relevant examination, treatment methods and prognosis were analyzed, to explore the best diagnosis and treatment of vesicoenteric fistula. Results: Among all of 66 patients, there were 49 males and 17 females. The pathogeny included intestinal cancer in 31 cases (46.97%), Crohn disease in 11 cases (16.67%), intestinal diverticulitis in 10 cases (15.15%), bladder cancer in 8 cases (12.12%), appendicitis and other inflammatory diseases in 5 cases (7.58%) and intraoperative injury in 1 case (1.52%). The main clinical feature included recurrent urinary tract infection in 45 cases (68.18%), fecaluria in 43 cases (65.15%), abdominal pain in 16 cases (24.24%) and pneumaturia in 16 cases (24.24%). Forty-one cases underwent CT examination, and the diagnostic rate was 58.54% (24/41); 47 cases underwent cystoscopy, and the diagnostic rate was 55.32% (26/47); 34 cases underwent cystography, and the diagnostic rate was 44.12% (15/34). Six cases (90.91%) were treated with surgery, and no perioperative death occurred. Twenty-eight cases were followed up, and the mean follow-up time was 4.1 years. Seven cases died of tumor recurrence and metastasis; 2 cases died of other basic diseases such as cardiovascular and cerebrovascular diseases. No other patients with benign vesicoenteric fistula died during follow-up. Conclusions The major cause of vesicoenteric fistula is intestinal malignancy, which shows emblematic clinical symptoms, and specific imaging characteristic. CT, cystoscopy and cystography are the main diagnostic technique. Surgical intervention is the major therapeutic choice, and the prognosis depends on the primary disease.