Shanxi Provincial Cancer Hospital has a history of 67 years. The continuous development of the hospital reflects the tremendous advances of cancer prevention and treatment in China. The article reviews the development process of Shanxi Provincial Cancer Hospital and puts forward some ideas for hospital development under the new situation.

Objective:To investigate the effects of Esmketamine pretreatment on postoperative pain, circulatory and respiratory function and inflammatory factors in elderly patients undergoing brachial plexus block.Methods:A total of 98 patients with rotator cuff injuries admitted to our hospital from December 2019 to December 2020 were prospectively divided into the control group and the Esmketamine pretreatment group, with 49 cases in each group.The Esmketamine pretreatment group was given 0.5 mg/kg of Esmketamine intravenously, and the control group was given the same amount of normal saline intravenously.General data, postoperative pain, circulatory and respiratory function, postoperative inflammatory factor levels and adverse reactions were compared between the two groups.Results:Intraoperative Ramsay sedation scores(RSS)at 30 min, 60 min and 90 min had no significant difference between the Esmketamine pretreatment group and the control group(all P>0.05). Visual analogue scale(VAS)scores at 12 h and 24 h after surgery were lower in the Esmketamine pretreatment group than in the control group(all P<0.05). The VAS scores showed differences between the two groups at different time points(all P<0.05)and there were also signs of interaction effects.The mean arterial pressure(MAP), heart rate(HR), oxyhaemoglobin saturation by pulse oximetry(SpO 2)and respiratory rate(RR)at T1, T2 and T3 were lower in the ESM-ketamine pretreatment group than in the control group(all P<0.05). Compared with the control group, the Esmketamine pretreatment group had lower levels of interleukin-6(IL-6)[(198.74±21.50)mmol/L vs.(272.69±19.74)mmol/L, t=17.537, P<0.001], C-reactive protein(CRP)[(11.65±2.51)mg/L vs.(15.79±3.27)mg/L, t=7.972, P<0.001], tumor necrosis factor-α(TNF-α)(25.71±10.27 ng/L vs.34.65±9.81 ng/L, t=10.113, P<0.001), β-endorphin[(1.69±0.27)ng/L vs.(2.18±0.35)ng/L, t=8.815, P<0.001]and neuron-specific enolase(NSE)[(8.48±0.93)ng/L vs.(13.57±1.89)ng/L, t=9.846, P<0.001]at 24 h after surgery.The total incidence of adverse reactions was also lower in the ESM-ketamine pretreatment group than in the control group(16.3% vs.8.2%, χ2=3.129, P=0.047). Conclusions:Esmketamine pretreatment in brachial plexus block can provide good analgesic effects, has limited impact on circulatory and respiratory function, and can effectively reduce the levels of inflammation and adverse reactions in elderly patients.

Objective To study the serum levels of oxidative stress markers in the new type 2 diabetes mellitus (T2DM) patients with nonalcoholic fatty liver disease (NAFLD),and the effect of o-lipoic acid (A-LA) on oxidative stress markers.Methods From August 2016 to August 2017,80 new T2DM patients complicated with NAFLD (T2DM + NAFLD group) and 80 new T2DM patients without NAFLD (T2DM group) admitted to Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University were selected.The serum levels of Fasting blood glucose (FPG),body mass index (BMI),triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),insulin resistance index (HOMA-IR),serum superoxide dismutase (SOD),serum malondialdehyde (MDA),glutathione peroxidase (GSH-PX) were detected and compared between the two groups.And then,the T2DM patients with NAFLD were treated by A-LA for two weeks.The SOD,MDA,GSH-PX levels were compared before and after treatment.Results The FPG,BMI,TG,HOMA-IR of the T2DM + NAFLD group were (10.71 ± 3.63) mmol/L,(27.08 ± 3.87) kg/m2,(3.40 ± 1.85) mmol/L,(5.40 ± 2.98),respectively,which were significantly higher than those of the T2DM group[(9.50 ± 3.78)mmol/L,(23.58 ± 2.75) kg/m2,(1.79 ± 1.44) mmol/L,(2.41 ± 1.18)] (t =2.022,6.603,2.829,4.157,all P ＜ 0.05).The age and levels of HbA1c,TC,HDL-C,LDL-C between the two groups had no statistically significant differences (all P ＞ 0.05).The level of MDA in the T2DM + NAFLD group was (5.11 ± 0.25) μmol/L,which was significantly higher than (4.56 ±0.28) μmol/L in the T2DM group(t =2.106,P ＜0.05).The levels of SOD,GSH-PX,SOD/MDA in the T2DM + NAFLD group were (77.42 ± 10.31) U/mL,(69.62 ± 9.24) U,(15.39 ± 2.23),respectively,which were significantly lower than those in the T2DM group [(93.26 ± 11.21) U/mL,(87.54 ± 9.58) U,(20.33 ± 2.93)] (t =2.455,2.653,3.148,all P ＜ 0.05).After treatment with A-LA,the MDA level of the T2DM + NAFLD group was (4.81 ±0.26) μmol/L,which was significantly lower than that before treatment[(5.11 ±0.25) μmol/L,t=2.117,P ＜0.05],the levels of SOD,GSH-PX,SOD/MDA of the T2DM + NAFLD group were (87.15 ± 10.88) U/mL,(78.73 ± 9.57) U,(18.05 ± 2.51),respectively,which were significantly higher than those before treatment (t =2.117,2.207,2.228,3.148,all P ＜ 0.05).Conclusion A-LA might prove usefully in the treatment of patients with T2DM and NAFLD by change the oxidative stress.

Objective To evaluate the role of programmed cell death ligand-1 (PD-L1) in a mouse model of bone cancer pain.Methods Ninety-six male C3H/HeN mice (20-25 g,4-6 weeks old),which inoculated with osteolytic NCTC 2472 cells,were used to build the model of bone cancer pain.Part one:sixtyfour male C3H/HeJ mice were randomly divided into sham group (group Sham,n =32) and tumor group (group Tumor,n=32).Part two:Twenty-four male C3H/HeJ mice which were inoculated with osteolytic NCTC 2472 cells were randomly divided into group T (tumor,n=8),group PD-L1 (intrathecal injection with PLX3397,1 μg/5μl,n=8) and group NS (intrathecal injection with normal saline,n=8).Also,there were eight male C3H/HeJ mice in group S which were intra-femur inoculated with α-MEM.The pain behaviors of Sham group and Tumor group were observed and the expression of PD-L1 was detected before inoculation and on 4,7,10,14 and 21 days after inoculation,including paw withdrawal mechanical threshold (PWMT) and the number of spontaneous flinches (NSF).On 14 d after inoculation,the mice of group PD-L1 and group NS were intrathecal injected with drugs respectively.Pain behaviors were observed before injection and 2,4,6,24h after injection.Results Compared with group Sham,PWMT was significantly decreased and NSF was increased on 7～ 21 d after inoculation in group Tumor (P＜0.05).Compared with baseline and group S (baseline (0.38±0.06),group Sham (0.35±0.08),(0.38±0.08),(0.36±0.07)),the expression of PDL1 was up-regulated on 10-21 d after inoculation in group Tumor ((0.77±0.06),(1.21±0.04),(1.18±0.06)) (P＜0.05).Compared with group NS,PWMT was significantly increased (group NS (0.25t0.12),(0.25±0.12),(0.31±0.12),group PD-L1 (1.43±0.49),(1.35±0.44),(0.95±0.26)),and NSF was decreased on 2-6 h after injection in group PD-L1 (group NS(11.74± 1.31),(13.78±0.0.91),(13.63±1.06),group P D-L1 (4.90± 0.82),(4.15± 0.71),(7.65±0.56)) (P＜0.05).Conclusion Expression of PD-L1 in spinal cord was up-regulated in the mouse model of bone cancer pain.Intrathecal injection of recombinant PD-L1 has an analgesic effect on mice with bone cancer.

Objective To investigate the expression of insulin-like growth factors-1(IGF-1)in ser-um and phosphorylated IGF-1 receptor in spinal cord in mouse model of bone cancer pain. Methods Sixty male C3H/HeJ mice weighed 18-22 g were randomly divided into Sham group(n=30)and Tumor group(n=30). The mice in Tumor group were inoculated with NCTC fibrosarcoma cells in the right femur bone marrow cavity. Paw withdrawl mechanical threshold(PWMT)and the number of spontaneous flinches(NSF)were measured on 1d before inoculation and on 4 d,7 d,10 d,14 d,21 d after inoculation(n=8). At each time point,the mice of each group were taken blood by removal eyeball and the samples of blood were obtained to detect the expression of IGF-1 by enzyme-linked immunosorbent assay(n=4). The mice after taken blood on 14 d after inoculation were perfused and the samples of spinal cord lumber(L3~5)segment were obtained to detect the expression of phosphorylated IGF-1 receptor by immunofluorescence assay(n=6). Results Com-pared with Sham group,PWMT was significantly decreased(P<0.05)and NSF was significantly increased(P<0.05)on 7~21 d after inoculation. Compared with baseline value and Sham group(baseline value(27.33± 0.52)pg/ml,Sham group(29.11±1.86)pg/ml,(24.51±3.61)pg/ml,(23.33±4.59)pg/ml,(25.29±2.99) pg/ml),the expression of IGF-1 in serum was significantly increased on 7~21 d after inoculation in Tumor group((39.76±3.92)pg/ml,(36.93±2.18)pg/ml,(38.85±2.40)pg/ml,(39.70±2.62)pg/ml). The mean fluorescence intensity of phosphorylated IGF-1 receptor was significantly higher on 14d after inoculation in Tumor group(2.40±0.11)compared with Sham group(0.05±0.01). Conclusion Expression of IGF-1 in serum and phosphorylated IGF-1 receptor in spinal cord were significantly increased in mice with bone cancer pain,and this change may be involved in the development and maintenance of bone cancer pain.

【Objective】 To investigate the effects of dexmedetomidine (DEX) intervention on the expressions of chondrocytes and related factors in vitro and its possible molecular mechanisms. 【Methods】 C28/I2 normal human chondrocyte lines were cultured in vitro, and dexmedetomidine at the concentration of 1 μmol/L was selected to intervene for 24 h and 48 h, respectively. The morphology and cell density of chondrocytes were observed after DEX culture at different time points. Immunofluorescence technique was used to detect the expression levels of disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS5) in chondrocytes in each group. The expression levels of Adamts5, aggrecan (Acan), versican (Vcan), Furin, proprotein convertase subtilisin/kexin type 6 (Pcsk6), collagen type Ⅰ alpha 1 (Col1a1), collagen type Ⅱ alpha 1 (Col2a1), collagen type X alpha 1 (Col10a1), and SRY2 related high mobility group box gene9 (Sox9) were detected by RT-PCR. Adamts5 gene knockout chondrocytes were constructed by lentivirus transfection technology and treated with DEX; RT-PCR was used to detect the effects of DEX on the expression levels of Acan, Vcan, Furin, Pcsk6 and Sox9 after Adamts5 gene knockout. 【Results】 After 24 and 48 h of intervention with 1 μmol/L DEX, the morphology and size of chondrocytes did not change significantly, but the cell density increased slightly. Immunofluorescence assay showed that the expression of ADAMTS5 increased at first and then decreased after DEX treatment for 24 and 48h, respectively (P=0.032). RT-PCR results showed that with the extension of intervention time, the expression of Adamts5 first increased and then decreased. The expression difference between 48 and 24 h after culture was statistically significant (P=0.032). The change trend of Pcsk6 was the same as that of Adamts5, while the change trend of Acan expression was opposite that of Adamts5. Chondrocytes knocked out Adamts5 gene and intervened with DEX for 24 and 48 h. The results of RT-PCR showed that the expression of Pcsk6 decreased while that of Acan increased and the changes were significant. 【Conclusion】 Dexmedetomidine may activate ADAMTS5 zymogen through Pcsk6, thereby promoting proteoglycan degradation in chondrocytes.