Objective To compare the single-and double-injection techniques for sciatic nerve block.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 48-72 kg,undergoing elective unilateral foot and ankle surgery,were randomly divided into 2 groups (n =30 each) using a random number table:single-injection group (group S) and double-injection group (group D).Labat-winnie approach to sciatic nerve block was performed under the guidance of a nerve stimulator.When ankle dorsal or plantar flexion developed,group S received a single injection of 0.5％ ropivacaine 30 ml.When ankle dorsal and plantar flexion developed,0.5％ ropivacaine 15 ml was injected each time in group D.The failure of location was recorded.The time spent performing the procedure,onset time and duration of sensory and motor blockade,and the total time for the block were recorded.The effectiveness of block (success,failure) was assessed.Results The failure rate of location was 10％ in group D.The success rate of block was 93％ in group S,and was 96％ in group D,and there was no significant difference in the success rate of block between the two groups.Compared with group S,the onset time of sensory and motor blockade was significantly shortened,the time spent performing the procedure was prolonged,and no significant change was found in the total time for the block,duration of sensory and motor blockade in group D.Conclusion Single-injection technique is recommended for the sciatic nerve block in the patients undergoing lower extremity surgery.

Objective To evaluate the effects of the sciatic nerve block on emergence agitation following sevoflurane-based anesthesia in pediatric patients undergoing foot orthomorphia.Methods Sixty pediatric patients,aged 3-7 yr,weighing 12-20 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective foot orthomorphia,were randomly assigned to one of two groups (n =30 each):control group (group Ⅰ) and sciatic nerve block group (group Ⅱ).After induction of anesthesia,laryngeal mask airway was inserted,and artificial or mechanical ventilation was performed.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration 0.5％-2.0％) and iv fentanyl 0.5-2.0 μg/kg.The sciatic nerve block on the affected side was performed under the guidance of a nerve stimulator,and 0.25％ bupivacaine 0.5 ml/kg was injected.Laryngeal mask airway removal time and emergence time were recorded.At 30 min of recovery from anesthesia,agitation was scored and the development of emergence agitation was recorded.Pain was evaluated with Faces Pain Scale-Revised (FPS-R) at 10 and 30 min of recovery from anesthesia.Adverse reactions including hypoxemia and nausea and vomiting were also recorded during recovery from anesthesia.Results Compared with group Ⅰ,the intraoperative consumption of fen tanyl and mean end-tidal concentration of sevoflurane were significantly decreased,laryngeal mask airway removal time and emergence time were shortened,and the incidence of emergence agitation,PPS-P scores and incidence of hypoxemia were decreased in group Ⅱ.Conclusion The sciatic nerve block is helpful in decreasing the development of emergence agitation following sevoflurane-based anesthesia in pediatric patients undergoing foot orthomorphia.

Objective To explore the mechanism of ginsenoside-Rh2(G-Rh2) on inhibition of glioma by identifying differential proteins with proteomic technique. Methods The total proteins were extracted from SHG-44 cells treated with 32 ?mol?L-1 G-Rh2 for 72 h and the cells in control group,then were subjected to two-dimensional gel electrophoresis.Only spots with a fold change equal or above 1.5 and P

Objective To investigate neurosurgeons' knowledge,attitude and practice toward deceased organ donation and provide a reference to increase organ donation rate.Method In July 2015,150 questionnaires were issued to neurosurgeons from 36 hospitals in the Jilin province.Result 142 effective questionnaires were obtained.Neurosurgeons' knowledge toward deceased organdonation was relatively good in the whole.100％ (142/142) neurosurgeons were in favor of organ donation in public hospitals.95.8％ (136/142) neurosurgeons were willing to cooperate in organ donation and 100％ (142/142) approved legislation on brain death in China.97.2％ (138/142) were in favor of economic compensation for organ donor's family.100％ (142/142) neurosurgeons encountered to potential organ donors in the process of practice,but 71.8％ (102/142) prompted potential organ donors' families actively and initiatively to donate.Compared with physicians with junior titles,senior physicians had more active coordination donation behavior (x2 =12.133,P=0.002).The neurosurgeons,who had higher correct answer rate about the knowledge of organ donation,were more likely to take the initiative to coordinate organ donation (x2 =16.131,P＜0.001).Conclusion Professional training for neurosurgeon organ donation will contribute to promote potential organ donors in neurosurgery into actual organ donors.

Objective To investigate the alteration of chaperone hsp40 and its effects on the dealyed neuron death in the CAI neurons after transient cerebral ischemia.Method Twenty-minute transient global ischemia rat model was used.Following different repeffusion period,all the 28 wistar rats were divided into sham-operation group ,4-hour recovery group,24-honr recovery group and 72-hour recovery gronp,7 ratsin in each group,Immunochemistry and laser scanning confocal microscopy were used to observe the distributional alteration of hsp40 in the neurons.Differential centrifuge and westemblot analysis were used to analyze the quantitative alteration of hsp40 and its redistribution in the neurons.Results lnanunechemistry and laser scanning confocal microscopy showedthe reduction of hsp40 first in cytosol,then in the nucleus until all the neurons in the CAI region died.Differential centrifuge and westemblot analysis showed the quantity of hsp40 decreased from (1.00_+0.21) to (0.23±0.13)(P<0.01) after 24-hour repeffusion;the quantity of hsp40 in the protein aggregates increased from (1.00±0.18) to(8.61±1.89)(P<0.01) after24-hour reperfusion.Conclusions The reduction of hsp40 in the neurons of hippocampus CA1 region is an important factor resulting in protein aggregates formation.

Objective:A two-dimensional (2D) in-house-built scintillator detection system (SDS) was utilized for quality assurance of the active spot scanning proton and heavy ion accelerator, aiming to establish a rapid detection method and provide reference for the quality of proton and heavy ion beam (spot position, spot size, virtual source-to-axis distance, profile depth dose distribution and beam range).Methods:The SDS consisted of a ceramic gadolinium-sulfoxylate phosphor-scintillating screen, a mirror and a commercial digital camera. The dose distribution image was obtained based on scintillator, mirror reflector and optical signal acquisition device to transform the proton and heavy ion beam into visible light through sulfur gadolinium oxide scintillator and collect visible light information to meet the clinical requirements for the quality of proton and heavy ion beam.Results:The deviation of spot position measured by multifilament proportional chamber and the SDS was less than 1mm. The differences of beam spot size measured by multifilament proportional chamber and the SDS were (1.40±0.59)mm for protons, and (0.5±0.08)mm for carbon ions. For 429.25MeV/u carbon, the virtual source-to-axis distance (V SAD) at the x-and y-axes was 751.8cm and 805.6cm. And difference between physical distance and virtual source-to-axis distance was less than 1%. The range of 287.5MeV/u carbon measured by SDS was 160mm. Conclusions:The in-house-built scintillator detector can measure beam spot position and size, virtual source, depth distribution curve and range, which can be used as an effective tool for quality assurance control of proton and heavy ion therapy.

Objective To explore the protective effects of Yiqi Huoxue Fang(Qi-boosting Blood-activa-ting Formula,YQHXF)on rat myocardium with myocardial infarction and its possible mechanism by ob-serving the effects of YQHXF on necrosis and apoptosis of myocardial cell necrosis.Methods Male SD rats were randomly divided into the sham-surgery group,model group,YQHXF group,and perindopril group.Animal model of myocardial infarction was built by ligating coronary artery on the left anterior de-scending branch.Subsequently,YQHXF group received intragastric administration of Yiqi Huoxue Fang (compound medicine,21 g/kg)once per day,and perindopril group was given perindopril (0.4 mg/kg)once a day;Sham-surgery group and model group received sterile distilled water without drug inter-vention.The blood in abdominal aorta was drawn,and the tissue on the peripheral area of the myocardial infarction was taken at two fixed time points (on the 7 th and 28 th day)after administration.Ultrasonic ech-ocardiography was used to detect changes on cardiac morphology and function in rats:left ventricular e-jection fraction (LVEF),left ventricular short axis ratio (LVFS),left ventricular end systolic diameter (LVIDs),left ventricular end-diastolic diameter (LVIDd);serum superoxide dismutase (SOD),gluta-thione peroxidase (gsh-px),creatine kinase (CK),lactate dehydrogenase (LDH),aspertate amin-otransferase (AST),and troponin (cTnT)were measured with ELISA method.Protein imprinting meth-od (Western Blot)was used to measure cytochrome C (CytC)and protein expression of cysteine aspartic acid and protease-3 (caspase-3)in the border zone of infarcted area.Results On the 7 th day,com-pared with the model group,LVEF and LVFS in YQHXF group and perindopril group decreased without statistical significance(P >0.05).On the 28 th day,compared with the model group,LVEF and LVFS in YQHXF group and perindopril group increased significantly(P >0.05 ).LVIDs and LVIDd decreased markedly(P <0.05);LVIDd in perindopril group decreased sharply (P <0.05),and decrease presen-ted on LVIDs without statistical significace (P >0.05).On the 7 th and 28 th day,compared with the mod-el group,CK-MB,LDH,AST,cTnT in YQHXF group and perindopril group decreased significantly (P<0.05),and SOD,GSH-PX increased significantly.On the 7 th day,protein expression of cytC,caspase-3 decreased significantly in YQHXF group and perindopril group(P <0.05).Conclusion Administra-tion of YQHXF at early stage can effectively improve myocardial infarction on cardiac structure and func-tion in rats with myocardial infarction,improve oxidation resistance of myocardial cell,and inhibit myo-cardial apoptosis and necrosis.

Apnea test (AT) is a key step in the diagnosis of adult brain death, which provides important basis for the loss of brainstem function in patients with adult brain death. In recent years, with extensive development of adult brain death determination and organ donation transplantation, discussion and research of AT have been gradually promoted. In formulation of adult brain death criteria, countries have paid more attention to the standardization and normalization of AT implementation, and medical staffs have improved the AT implementation process. This article reviews the current AT implementation standards, conventional AT procedures and complications, modified AT exploration, AT implementation with extracorporeal membrane oxygenation, and treatments and auxiliary examinations after AT failure, in order to deepen the understanding and cognition of adult brain death determination physicians on AT, and promote AT development in a more standardized and orderly way.

Objective To investigate the myocardial expressions of protein kinase B (Akt)/ mammalian target of rapamycin (mTOR) signaling pathway and effective mechanism of Yiqi Huoxue Fang depending on model of myocardial ischemia.Methods The model of acute myocardial infarction (AMI) was established through ligation of left coronary anterior descending branch in SD rats, and randomly divided into model group, perindopril group, Qishen Yiqi Gutta Pills group, Yiqi Huoxue Fang group and sham-operation group, and all groups were given orally corresponding medications respectively 2 d after operation.The observation time points were set on the 7th d and 28th d.The changes of heart function and structure were detected by using ultrasonic testing, changes of myocardial pathomorphology were observed after HE staining, and expressions of Akt, mTOR, p-Akt and p-mTOR in infarction marginal zone were detected by using Western blot test, real-time fluorescence quantitative polymerase chain reaction (RT-PCR) and immunohistochemistry technique in all groups.Results The level of left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) decreased significantly in model group compared with sham-operation group on the 7th d and 28th d (P<0.01).The level of left ventricular end-systolic volume (LVESV) increased significantly on the 7th d (P<0.01), and levels of LVESV and left ventricular end-diastolic volume (LVEDV) increased significantly (P<0.01) on the 28th d in model group.The levels of LVEF and LVFS increased and levels of LVEDV and LVESV decreased significantly in all medicated groups compared with model group (P<0.01).The thinner ventricular wall, less cardiomyocytes, disorder myocardial cells arrangement and inflammatory cell infiltration were observed in infarction marginal zone in model group, and disorder myocardial cells arrangement and less cardiomyocytes were observed in all medicated groups.The ratio of p-Akt/Akt and p-mTOR/mTOR increased (P<0.05), expressions of Akt m-RNA and mTOR m-RNA increased significantly (P<0.01), and levels of p-Akt and p-mTOR positive cell rates increased significantly (P<0.01) in model group.The ratio of p-Akt/Akt and p-mTOR/mTOR increased (P<0.05), expressions of Akt m-RNA and mTOR m-RNA increased (P<0.05 or P<0.01), and levels of p-Akt and p-mTOR positive cell rates increased significantly (P<0.05) in all medicated groups.Conclusion Yiqi Huoxue Fang can improve heart function and protect myocardial cells through activating cardiac self-protective mechanism-Akt/mTOR signaling pathway in rats with myocardial infarction.

Objective:To explore the incidence of sudden deafness accompanied with tinnitus, the selection of examination protocols and treatment, and to provide reference for the establishment of new guidelines for sudden deafness.Methods:CiteSpace software was used for analysis and data mining to analyze and summarize the computer-retrieved articles on diagnostic examination and treatment of sudden deafness accompanied with tinnitus collected from CNIC, Wanfang and Web of Science databases from 2011 to 2021.Results:A total of 207 randomized controlled studies were retrieved in this study, including 121 in Chinese and 86 in English. Finally, 74 Chinese literatures and 16 English literatures were included. Among the 74 valid Chinese literatures, 64 (86.5%) were accompanied with tinnitus, 58 (78.4%) with dizziness/vertigo, 25 (33.8%) with aural fullness, 10 (13.5%) with headache, 4 (5.4%) with insomnia, 4 (5.4%) with a mixture of dizziness and tinnitus, and 2 (2.7%) with vomiting. Among the 16 English literatures, 15 (93.8%) were accompanied with tinnitus, 12 (75.0%) with vertigo, 1 (6.3%) with aural fullness, and 1 (6.3%) with a mixture of various symptoms. Among the 64 Chinese articles mentioning tinnitus, only 9 mentioned tinnitus matching tests, and 1 mentioned that the treatment for tinnitus accompanying symptoms was sound therapy and psychological counseling. The incidence rates of tinnitus accompanying four different types of sudden deafness, from low to high, are as follows: low-to-mid frequency, 82.4%; mid-to-high frequency, 90.7%; complete deafness, 92.4%; and flat type, 92.8%.Conclusion:Tinnitus is the most common accompanying symptom of sudden deafness, and tinnitus matching test is an effective evaluation method. When establishing a scientific, comprehensive, and systematic diagnosis and treatment system or guidelines for sudden deafness, attention should be paid to the diagnosis and treatment of tinnitus symptoms and their adverse psychological reactions, in order to reduce the incidence of tinnitus patients in the later stage of recovery from sudden deafness.