Objective To investigate the influence of Ondansetron on postoperative nausea and vomiting(PONV)in patient undergoing laparoscopic cholecystectomy with general anesthesia and the nursins care. Methods Ninety patients undergoing laparoscopic cholecystectomy with general anesthesia were randomly divided into 3 groups(n=30):low-dose Ondansetron group(O1 group)received 4 mg Ondansetron before section,high-dose Ondansetron group(O2 group)received 8 mg Ondansetron before section and the control group(C group)received normal saline.All injections were diluted to 4 ml.The number and degree of nausea and vomiting wag recorded during 24 h after operation.Results Number of patients with PONV in O1 group and O2 group were less than that of C group,P＜0.05,so was the PONV degree.No statistical difference was seen between O1 group and O2 group.Conclusion Intravenous injection of Ondansetron during operation can decrease the PONV in patient undergoing laparoscopic cholecystectomy with general anesthesia.

Objective To summarize the application of ruyi jinhuang powder dissolved in ethanol in the treatment of chemotherapeutic phlebitis induced by indwelling needle. Methods 88 cases of patients with chemotherapeutic phlebitis were randomly divided into the observation group and the control group with 44 cases in each group. The observation group was given wet compress using ruyi jinhuang powder dissolved in ethanol, while the control group used hot towels of 40 to 50℃. The treatment effect was compared between the two groups. Results The treatment effect of the observation group was better than that of the control group. Conclusions Treatment of chemotherapeutic phlebitis using wet compress with tracditional Chinese medicine showed significant effect, which is an effective method in the treatment of chemotherapeutic phlebitis induced by indwelling needle.

significant for the precaution of gastric cancer risk population. Aims:To explore gastric cancer susceptibility gene profiling in an area in Shanghai,and to assess the risk of gastric cancer susceptibility. Methods:A total of 152 patients with primary gastric cancer at Shanghai Pudong Hospital were enrolled,and 152 demographic characteristics matched patients with non-gastrointestinal diseases,non-tumor were served as controls. Gene polymorphism was determined by allele specific polymerase chain reaction. Susceptibility gene of gastric cancer was screened. Multiple genes interactions were analyzed and multiple genes risk was evaluated by DEMCHUK model. Results:Univariate analysis showed that CYP2E1,NAT2M1,NAT2M2,NAT2,XRCC1194,MTHFRA1298C,VDR TaqⅠ were susceptibility genes of gastric cancer. Multivariate analysis showed that CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2(A/ A),XRCC1194( T/ T)and MTHFRA1298C(A/ C)were susceptibility genotypes. Synergistic effect was found between genes except MTHFRA1298C (A/ C)with NAT2M1(T/ T)and NAT2M2(A/ A)(P ﹤0. 05). Multiple genes risk analysis showed that combination OR of multiple genes was highly correlated with gene frequency,and the risk of gastric cancer was increased with the increasing number of susceptibility genes. Conclusions:CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2( A/ A),XRCC1194( T/ T) and MTHFRA1298C( A/ C) are susceptibility genotypes of gastric cancer. Carrying multiple susceptibility genes can significantly increase the risk of gastric cancer.

Objective: To investigate the preliminary screening results of Alzheimer's disease (AD) among the elderly in Ningbo City, Zhejiang Province and analyze the influencing factors, so as to provide insights into prevention and control of AD in the elderly. Methods: A multi-stage stratified proportional sampling method was used to select the registered residents aged 60 years and older in Ningbo City as subjects. Demographic characteristics, lifestyle factors, physical conditions and social activities of the subjects was evaluated with questionnaires. AD was screened using the Mini-Mental State Examination (MMSE), and factors affecting the positive rate of AD preliminary screening were identified using a multivariable logistic regression model. Results: A total of 34 027 elderly residents were investigated, with an mean age of (71.71±6.89) years. There were 15 115 males (44.42%) and 18 912 females (55.58%), 16 146 residents living in rural areas (47.45%) and 17 881 residents living in urban areas (52.55%). The positive rate of AD preliminary screening was 7.28% (2 476 cases). Multivariable logistic regression analysis showed that age (70 to 74 years, OR=1.357; 75 to 79 years, OR=1.807; 80 to 84 years, OR=2.782; 85 years and older, OR=4.907), gender (female, OR=1.118), residence (urban areas, OR=0.713), marital status (unmarried, OR=3.078; widowed/separated/divorced, OR=1.301), educational level (primary school, OR=0.629; junior high school and above, OR=0.609), occupation before retirement (others, OR=0.741), family genetic history (no, OR=0.651), household disposable monthly income (1 000 to 1 999 Yuan, OR=0.636; 2 000 to 2 999 Yuan, OR=0.569; 3 000 Yuan and above, OR=0.448), exercise (seldom, OR=0.855; regular, OR=0.780), number of chronic diseases (2~5, OR=1.328), hearing loss (no, OR=0.764), smell loss (no, OR=0.615), chronic constipation (no, OR=0.696), major negative life events (no, OR=0.804), subjective memory loss (no, OR=0.583), sleep quality (general, OR=0.640; good, OR=0.616), living style (living with spouse, OR=0.300; living alone, OR=0.315; living with children, OR=0.350) and social activities (2-3 times/week, OR=0.584; 4 times/week and more, OR=0.409) were factors affecting the positive rate of AD preliminary screening. Conclusions The positive rate of AD preliminary screening among the elderly in Ningbo City is relatively high. Age, gender, economic conditions, exercise, social activities and physical conditions were factors affecting the positive rate of AD preliminary screening.

ObjectiveTo analyze the serum creatinine level among apparently healthy primary and secondary school students in Inner Mongolia and explore the distribution of serum creatinine by ethnic,regional,gender and age,and establish the reference interval of serum creatinine in different gender and different age groups of primary and secondary school students.MethodsLargesample clinical epidemiological investigation was applied by two-stage clustering sampling method.Random sample of 2630 primary and secondary school students from 9 to 18-year-old was selected from four district in Inner Mongolia including Hohhot,Wulanchabu,Xilin Gol and Bayan Drow from July 2009 to June 2010.After screening outlier individual,the total of 2614 subjects were enrolled,involving 1288 male and 1326 female subjects,1584 Han and1030 Mongolian.The venous blood was collected and serum was separated.The serum creatinine concentration was measured as soon as possible.Furthermore, creatinine levels of different regions,ethnic,gender and age group were compared by analysis of variance or t-test and that of different group were compared by SNK method.Percentile was used to describe the distribution of serum Cr level of different age groups.The reference interval of serum Cr for primary and secondary school students were established by gender and age (P2.5 -P97.5 ).The curve was smoothed using age-specific percentile ( LMS )curve smoothing method.ResultsThe differences of Cr levels were statistically significant between different regions,ethnic,gender and age groups.The reference intervals of creatinine for 9 - 11,12,13 - 14,15,and 16 - 18 year-old males were 35 - 66,37 - 73,39 - 78,47 - 87 and 49 - 91 μmol/L,respectively.The intervals for 9 - 10,11 - 12,13 - 15,and 16 - 18 year-old females were 32 - 60,34 - 63,38 -73 and 40 -74 μmol/L,respectively.Conclusion The reference intervals of serum creatinine for health primary and secondary school students in the Inner Mongolia is established,which is useful for clinicians,especially pediatricians to judge and assess renal function for 9 to 18 year-old patients.( Chin J Lab Med,2012,35:805-809 )

Objective Toexplore the correlation of ApoE gene polymorphism and serum uric acid levels in Ningxia Hui Autonomous Region , China.Methods A case-control study.October 2011 to November 2011, five hundred twenty eight ( 296 male, 232 female ) apparently healthy individuals were studied.Questionnaires and physical examinations were performed by standard operation procedure.Fasting blood was collected for biochemistry testing including serum lipid parameters , uric acid concentration and creatinine levels.The multi-ARMS PCR was applied to determine ApoE genotypes ,and the relation of ApoE genotypes with serum lipid parameters and uric acid levels were analyzed.Non-normal distribution were compared using cause and inspection.Results The common six kinds of ApoE genotype can be detected.The total cholesterol ( TC) ,low density lipoprotein cholesterol ( LDL-C) and uric acid ( UA) levels in different genotype subgroups had statistical differences.The individuals with ε2/3 genotype had a significantly greater reductions in TC and LDL-C levels but increment in uric acid concentration than those withε3/3 and ε3/4 genotype (P<0.05).The effect of ApoE gene polymorphism on uric acid levels still remained significantly after adjustment for age , gender , region and other factors.Conclusion The ApoE polymorphism is associated with serum uric acid levels and individuals with ε2 allele have higher serum uric acid levels.

Objective To investigate the interference of thyroglobulin antibodies ( TgAb ) on the measurement of thyroglobulin ( Tg) by 2 chemiluminescence immunoassays ( CLIAs) .Methods Data of 199 315 individuals with determined TgAb and Tg , including physical checkup subjects , differentiated thyroid carcinoma ( DTC) patients and patients with other diseases , were retrospectively collected in Peking Union Medical College Hospital from November 2012 to April 2015.The correlation between serum Tg level and serum TgAb concentration was analyzed and the positive rate of TgAb in physical checkup subjects was calculated.Furthermore, 290 serum samples with different TgAb concentration were applied in the recovery test by adding in confirmed serum Tg .The correlation between the recovery of confirmed serum Tg and TgAb concentrations was evaluated using Pearson correlation analysis .Results The serum Tg was all decreased with the elevated TgAb concentration in each group of subjects .The positive rate of TgAb was 10.84%(8 416/77 634) in physical checkup subjects .It was higher in females than in males and was increased with age.Recovery test showed that the average recoveries of confirmed serum Tg in TgAb-negative serum were 107.28%(86.30%-117.60%) and 107.94% (85.60%-124.10%) respectively in Roche and Beckman systems.But in TgAb-positive serum samples , the average recoveries in Roche and Beckman systems were 88.59% (35.85% -141.53%) and 95.77% (36.48% -131.78%) respectively, and 12.63%(24/190) and 13.68%(26/190) samples displayed a recovery less than 80%.The recovery rate of confirmed serum Tg showed a significantly negative correlation with elevated TgAb concentration , with r=-0.239 (P=0.001) in Roche and r=-0.251 (P<0.001) in Beckman.Conclusions TgAb-positive serum, especially with high concentration of TgAb , significantly interfered the measurement of Tg .Thus, serum TgAb should be determined together with serum Tg to explore whether there was an interference .To avoid misdiagnosis and inappropriate therapy , clinician should be informed once serum TgAb displayed positive.

Objective:To develop early gastric cancer (EGC) detection system of magnifying blue laser imaging (ME-BLI) model and magnifying narrow-band imaging (ME-NBI) model based on deep convolutional neural network, to compare the performance differences of the two models and to explore the effects of training methods on the accuracy.Methods:The images of benign gastric lesions and EGC under ME-BLI and ME-NBI were respectively collected. A total of five data sets and three test sets were collected. Data set 1 included 2 024 noncancerous lesions and 452 EGC images under ME-BLI. Data set 2 included 2 024 noncancerous lesions and 452 EGC images under ME-NBI. Data set 3 was the combination of data set 1 and 2 (a total of 4 048 noncancerous lesions and 904 EGC images under ME-BLI and ME-NBI). Data set 4: on the basis of data set 2, another 62 noncancerous lesions and 2 305 EGC images under ME-NBI were added (2 086 noncancerous lesions and 2 757 EGC images under ME-NBI). Data set 5: on the basis of data set 3, another 62 noncancerous lesions and 2 305 EGC images under ME-NBI were added(4 110 noncancerous lesions and 3 209 EGC images under ME-NBI and ME-BLI). Test set A included 422 noncancerous lesions and 197 EGC images under ME-BLI. Test set B included 422 noncancerous lesions and 197 EGC images under ME-NBI. Test set C was the combination of test set A and B (844 noncancerous and 394 EGC images under ME-BLI and ME-NBI). Five models were constructed according to these five data sets respectively and their performance was evaluated in the three test sets. Per-lesion video was collected and used to compare the performance of deep convolutional neural network models under ME-BLI and ME-NBI for the detection of EGC in clinical environment, and compared with four senior endoscopy doctors. The primary endpoint was the diagnostic accuracy of EGG, sensitivity and specificity. Chi-square test was used for statistical analysis.Results:The performance of model 1 was the best in test set A with the accuracy, sensitivity and specificity of 76.90% (476/619), 63.96% (126/197) and 82.94% (350/422), respectively. The performance of model 2 was the best in test set B with the accuracy, sensitivity and specificity of 86.75% (537/619), 92.89% (183/197) and 83.89% (354/422), respectively. The performance of model 3 was the best in test set B with the accuracy, sensitivity and specificity of 86.91% (538/619), 84.26% (166/197) and 88.15% (372/422), respectively. The performance of model 4 was the best in test set B with the accuracy, sensitivity and specificity of 85.46% (529/619), 95.43% (188/197) and 80.81% (341/422), respectively. The performance of model 5 was the best in test set B, with the accuracy, sensitivity and specificity of 83.52% (517/619), 96.95% (191/197) and 77.25% (326/422), respectively. In terms of image recognition of EGC, the accuracy of models 2 to 5 was higher than that of model 1, and the differences were statistically significant ( χ2=147.90, 149.67, 134.20 and 115.30, all P<0.01). The sensitivity and specificity of models 2 and 3 were higher than those of model 1, the specificity of model 2 was lower than that of model 3, and the differences were statistically significant ( χ2=131.65, 64.15, 207.60, 262.03 and 96.73, all P < 0.01). The sensitivity of models 4 and 5 was higher than those of models 1 to 3, and the specificity of models 4 and 5 was lower than those of models 1 to 3, and the differences were statistically significant ( χ2=151.16, 165.49, 71.35, 112.47, 132.62, 153.14, 176.93, 74.62, 14.09, 15.47, 6.02 and 5.80, all P<0.05). The results of video test based on lesion showed that the average accuracy of doctors 1 to 4 was 68.16%. And the accuracy of models 1 to 5 was 69.47% (66/95), 69.47% (66/95), 70.53% (67/95), 76.84% (73/95) and 80.00% (76/95), respectively. There were no significant differences in the accuracy among models 1 to 5 and between models 1 to 5 and doctors 1 to 4 (all P>0.05). Conclusions:ME-BLI EGC recognition model based on deep learning has good accuracy, but the diagnostic effecacy is sligntly worse than that of ME-NBI model. The effects of EGC recognition model of ME-NBI combined with ME-BLI is better than that of a single model. A more sensitive ME-NBI model can be obtained by increasing the number of ME-NBI images, especially the images of EGG, but the specificity is worse.

Objective To evaluate the effects of different sedation depths of propofol on postopera-tive delirium in patients undergoing cardiac valve replacement under cardiopulmonary bypass(CPB)and the relationship with regional cerebral oxygen saturation(rSO2). Methods Forty American Society of An-esthesiologists physical statusⅢorⅣpatients of both sexes, aged 26-64 yr, with body mass index of 17-25 kg∕m2, scheduled for elective aortic valve replacement with CPB, were divided into A and B groups (n=20 each)using a random number table. The infusion rate of propofol was adjusted to maintain the cor-responding anesthetic depth with 50≤BIS value<60 during CPB in group A and with 35≤BIS value<45 during CPB in group B. Bilateral rSO2was measured using the near infrared spectroscopy from admission to the operating room until the end of skin suturing. The minimum rSO2was recorded, and occurrence of low cerebral oxygen saturation(rSO2was less than 55% or the decrease in rSO2>20% of the baseline)was ob-served. Postoperative delirium was evaluated using Confusion Assessment Method for the Intensive Care Unit (ICU)from 12 h after admission to ICU until discharge from ICU. Results The incidence of postoperative delirium, low cerebral oxygen saturation and minimum rSO2were significantly lower in group B than in group A(P<005). Conclusion Maintaining 35≤ BIS value< 45 during CPB can reduce the develop-ment of postoperative delirium and is related to improving intraoperative rSO2in patients undergoing cardiac valve replacement.

Objective: To evaluate the effect of anesthesia management based on regional cerebral oxygen saturation (rSO₂)-bispectral index (BIS)-goal-directed hemodynamic multi-modal monitoring on acute kidney injury (AKI) after cardiac valve replacement. Methods: A total of 238 patients of both sexes, aged 18-75 yr, weighing 45-95 kg, of American Society of Anesthesiologists physical status Ⅲ or Ⅳ (New York Heart Association class Ⅱ or Ⅲ ), undergoing elective cardiac valve replacement, were assigned into routine experience group (group C, n=122) and multi-mode monitoring group (group M, n=116) using a random number table method.After admission to the operating room, the invasive blood pressure of radial artery, central venous pressure, electrocardiogram, SpO₂ and end-tidal pressure of carbon dioxide were recorded in group C, and rSO₂, BIS, stroke volume variation, cardiac index and stroke volume index were monitored based on the monitoring in group C. The patients were tracheally intubated when BIS value was about 50.BIS value was maintained between 45 and 55, rSO₂ was maintained not less than 20% of the baseline value or the absolute value not less than 55%, and fluctuation in mean arterial pressure did not exceed 20% of the baseline value, and stroke volume index was maintained >25 ml/m² and cardiac index>2.5 L·min^-1 ·m^-2, maintaining not lower than the baseline value before induction in special conditions.The intraoperative volume of fluid infused, infusion of allogeneic blood, consumption of propofol, time of cardiopulmonary bypass, aortic cross-clamping time, anesthesia time, operation time, occurrence of AKI within 48 h after operation, renal replacement therapy, extubation time, duration of intensive care unit stay, postoperative length of hospital stay, development of other serious postoperative complications and fatality rate at day 30 after operation were recorded. Results: Compared with group C, the incidence of AKI was significantly decreased, the volume of plasma infused and consumption of propofol were reduced, the extubation time, duration of intensive care unit stay and postoperative length of hospital stay were shortened (P<0.05), and no significant change was found in the rate of renal replacement therapy, constituent ratio of AKI degree, incidence of other serious postoperative complications or mortality rate at day 30 after operation in group M (P>0.05). Conclusion Anesthesia management based on rSO₂-BIS-goal-directed hemodynamic multi-modal monitoring can decrease the occurrence of AKI after cardiac valve replacement.