Objective To investigate the effect of high pressure distention on the expression of stenosis-related genes of saphenous vein graft(SVG) during the coronary artery bypass grafting(CABG).Methods The biopsy specimens of saphenous vein collected from 10 patients who have undergone CABG,were divided into expansion group and no-expansion group.Real-time PCR and immunohistochemical staining were performed for examination of mRNA and protein expression of VE-cad,Egr-1,VCAN respectively.Student's t and Chi-square test were used to do statistic analysis.Results The results of RT-PCR showed that the mRNA transcription of Egr-1,VCAN in the expansion group were statistically significantly higher than those in no-expansion group(P<0.05).The mRNA transcription VE-cad in expansion group was statistically significantly lower than that in the no-expansion group(P<0.05).The immunohistochemical staining results showed that the expression of Egr-1 and VCAN in expansion group were significantly stronger than those in no-expansion group,while the expression of VE-cad was significantly lower than no-expansion group.Conclusion The intraoperative expansion of SVG can increase the expression of stenosis-related genes Egr-1 and Versican,and decrease the expression of stenosis-related gene VE-cad,which may be related with the SVG stenosis after CABG.

Objective To evaluate the effects of sufentanil on regeneration and repair after single sciatic nerve injury in mice. Methods Seventy?five healthy male BALB∕c mice, aged 6-8 weeks, weig?hing 18-22 g, were divided into 5 groups ( n=15 each) using a random number table: peripherial nerve injury group (group PNI), low, medium and high doses of sufentanil groups (L, M and H groups) and cyclosporine A group ( group C) . The model of unilateral sciatic nerve transection was established in the 5 groups. In L, M and H groups, sufentanil 2?5, 5?0 and 10?0 μg∕kg were injected intraperitoneally, re?spectively, once a day for 3 consecutive days. Cyclosporine A 50 mg∕kg was injected intraperitoneally once a day for 3 consecutive days in group C. The equal volume of normal saline was given once a day for 3 con?secutive days in group PNI. Neurophysiological monitoring was performed at 4, 8 and 12 weeks after opera?tion, the amplitude of compound muscle action potentials of the sciatic nerve was recorded, and the nerve conduction velocity was measured. At 8 weeks after operation, 5 mice were sacrificed, the sciatic nerve 0?5 cm of the upper and lower the anastomosed site was removed for examination of the morphology of myelin sheath with light microscope, and the number of nerve fibers was calculated. Results Compared with group PNI, the amplitude of compound muscle action potentials of the sciatic nerve, nerve conduction ve?locity and the number of nerve fibers was were significantly increased in M, H and C groups ( P<0?05) , and no significant change was found in the parameters mentioned above in group L ( P>0?05 ) . Myelin sheath arrangement was severely irregular, and more vacuoles were found in group PNI. Myelin sheath ar?rangement was irregular, and more vacuoles were found in group L. Myelin sheath arrangement was mainly regular, and vacuoles were found occasionally in group M. Myelin sheath arrangement was regular, and no vacuoles were observed in H and C groups. Conclusion Sufentanil can promote regeneration and repair af?ter peripheral nerve injury in mice.

Objective To investigate the effects of sufentanil on activation of spinal astrocytes in mice after unilateral sciatic nerve injury.Methods Eighty healthy male BALB/c mice,aged 6-8 weeks,weighing 18-22 g,were randomly divided into 4 groups (n=20 each): sufentanil high dose group (group H),middle dose group (group M),low dose group (group L) and model group (group MO).After model of sciatic nerve injury was established by unilateral sciatic nerve transection,group H,M and L,sufentanil 10 μg/kg,5 μg/kg,2.5 μg/kg was injected intraperitoneally once a day continuously for 3 days,while the equal volume of saline was injected in group MO.Five mice in each group were selected,and the sciatic nerve functional index were measured at 4,8,12 weeks.The 5 mice were sacrificed from each group and the damage on the same side L4-L6 segments of the spinal cord were removed at 2,4,8,12 weeks.The pathological changes were examined under light microscope at 8 week point.The expression of GFAP was determinatied at each time points by immuno-histochemistry.Results Compared with group L and MO,sciatic nerve functional index significantly was increased in groups H and M (P<0.05),and no significantly change was found in group L.Spinal cord neurons had a better morphology in groups H and M than in group L and MO.Compared with group MO,The expression of GFAP were significantly up-regulated in groups H,M and L (P<0.05).Compared with group L,the expression of GFAP were significantly up-regulated in groups H and M (P<0.05).Conclusion Sufentanil promotes spinal astrocyte activation after peripheral nerve injury in mice and improves repair after peripheral nerve injury.

Objective To investigate the feasibility of mono-segment pedicle instrumentation (MSPI)in management of thoracolumbar fracture (AO classification,A1 and A3) by being compared with short-segment(two-segment) pedicle instrumentation(SSPI).Methods Overall 141 patients with tape A1 or A3 thoracolumbar fractures,aged from 20 to 60 years (average,40.5 years),were enrolled in this prospective study.According to a simple randomized method,35 patients with type A1 fracture and 41 patients with type A3fracture were treated with MSPI,while 26 with type A1 fracture and 39 with type A3 fracture were treated with SSPI.Low back outcome score (LBOS) and ASIA2000 were used to evaluate clinical outcome.Eighteenth month postoperatively was assigned as the last follow up period.Wedge index (WI) and sagittal index (SI) of the affected vertebrae on radiography were measured and compared preoperatively,one week postoperatively and at the final follow-up.Results All patients were followed up successfully.The blood loss and duration of operation of MSPI group were significantly less than that of SSPI group,respectively.However,there were no significant differences of clinical outcome between two groups.For type A1 fracture,correction rate and correction loss of WI in MSPI group were better than those in SSPI group.For type A3 fracture,there were no significant differences of correction rate and correction loss of WI and SI between MSPI group and SSPI group; however,the failure rate of MSPI group was significantly higher than that of SSPI group.Conclusion For type A1 and partial type A3 thoracolumbar fractures,MSPI can provide the same or better fixation with less blood loss and operative duration than SSPI.Since MSPI for type A3.2 thoracolumbar fracture has a higher failure rate,the surgical indication should be strictly controlled.

Objective To investigate the predictive value of plasma homocysteine (Hcy) on contrast-induced nephropathy after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) .Methods Totally 156 patients with AMI receiving PCI in Beijing Electric Power Hospital from January 2014 to December 2015 were enrolled for the study and divided into contrast-induced nephropathy group and non-contrast-induced nephropathy group .Baseline data ,perioperative data and auxilia-ry examination results were compared between two groups .The single factor analysis and multivariate Logistic regression were used to analyze the influencing factors .Results In all 156 patients ,32 cases occurred contrast-induced nephropathy after PCI ,and the in-cidence was 20 .5% .The plasma Hcy level in contrast-induced nephropathy group was (21 .3 ± 8 .7)μmol/L ,significantly higher than (13 .3 ± 6 .1) μmol/L in non-contrast-induced nephropathy group (P< 0 .05) .Multiple Logistic regression analysis results showed that plasma Hcy levels was the independent risk factors of contrast-induced nephropathy (OR=2 .254 ,95% CI:1 .359 -3 .737 ,P=0 .002) .Conclusion About 1/5 of patients with AMI occur contrast-induced nephropathy after PCI ,and preoperative plasma Hcy level can well predict the risk of contrast-induced nephropathy ,which is worthy of clinical application .

Postoperative nausea and vomiting ( PONV) is a common complication after anaesthesia, which hinders the rapid recovery of patients. Aprepitant, one of neurokinin-1 (NK-1) receptor antagonists is mainly used to prevent nausea and vomiting by blocking the binding of substance P to NK-1 receptor. It has the advantages of high selectivity, strong affinity and long half-life, and its new antiemetic target pro-vides a new choice for prophylactic treatment of PONV. This article summarize studies on the prophylaxis of aprepitant in treatment of PONV.

Objective To evaluate the effect of sufentanil on the expression of basic fibroblast growth factor(bFGF)in nerve tissues after peripheral nerve injury in mice. Methods One hundred pathogen-free healthy male Balb∕c mice, aged 6-8 weeks, weighing 18-22 g, were divided into 4 groups (n=25 each)using a random number table: peripherial nerve injury group(group PNI), high dose sufentanil group(group H), medium dose sufentanil group(group M)and low dose sufentanil group (group L). The model of unilateral sciatic nerve transaction was established in ketamine-anesthetized mice. Sufentanil 100, 50 and 25 μg∕kg were intraperitoneally injected immediately after establishment of the model once a day for 3 consecutive days in H, M and L groups, respectively. The equal volume of normal saline was given instead in group PNI. On 1, 2, 4, 8 and 12 weeks after establishment of the model, 5 mice were sacrificed and the nerve tissues were obtained from the site 05 cm up and down the lesion site of the nerve for examination of the shape of the myelin sheath of nerve fibers(with an electronic microscope).The expression of bFGF in the sciatic nerve tissue was detected by Western blot. Results The shape of medulla sheath was irregular, the thickness of myelin lamellae was thin, the separation of myelin lamellae was aggravate, demyelinate was found, and the proliferation of Schwann cells was not marked in group PNI. The shape of medulla sheath was regular, the thickness of myelin lamellae was dense, and the proliferation of Schwann cells was marked in group H. The shape of medulla sheath was irregular, the separation of mye-lin lamellae was observed, demyelinate was found, and the proliferation of Schwann cells was not marked in group L. Compared with group PNI, the expression of bFGF was significantly up-regulated in H, M and L groups(P<005). Compared with group L, the expression of bFGF was significantly up-regulated in H and M groups(P<005). Compared with group M, the expression of bFGF was significantly up-regulated in group H(P<005). Conclusion The mechanism by which sufentanil improves regeneration and repair after peripheral nerve injury may be related to up-regulating the expression of bFGF in nerve tissues of mice.

Objective To evaluate the effect of sufentanil on apoptosis in spinal cord neurons of mice with peripheral nerve injury. Methods One hundred and fifty clean-grade healthy male BALB∕c mice, aged 6-8 weeks, weighing 18-22 g, were divided into 3 groups ( n=50 each) using a random number table method: sham operation group (group Sham), peripheral nerve injury group (group PNI) and sufentanil group ( group SF) . The model of unilateral sciatic nerve injury was established in PNI and SF groups. After establishing the model, sufentanil 5. 0 μg∕kg was intraperitoneally injected once a day for 3 consecutive days in group SF, while the equal volume of normal saline was given instead of sufentanil in Sham and PNI groups. Five mice in each group were sacrificed at days 1, 3, 7, 14 and 28 after surgery ( T0-4 ) , and L4-6 segments of the injure ipsilateral spinal cord were removed for examination of pathological changes ( with a light microscope) and for determination of neuronal apoptosis ( by TUNEL assay) . The ap-optosis index ( AI) was calculated. Five mice in each group were sacrificed at T0-4 , and L4-6 segments of the injured ipsilateral spinal cord were removed for detection of the expression of Bcl-2, Bax and cleaved caspase-3 by Western blot. The ratio of Bcl-2 expression to Bax expression ( Bcl-2∕Bax ratio) was calculat-ed. Results Compared with group Sham, the AI was significantly increased, the expression of Bcl-2 pro-tein was down-regulated, and the expression of cleaved caspase-3 and Bax was up-regulated in PNI and SF groups ( P<0. 05) . Compared with group PNI, the AI was significantly decreased, the expression of Bcl-2 protein was up-regulated, the expression of cleaved caspase-3 and Bax was down-regulated, the Bcl-2∕Bax ratio was increased (P<0. 05), and the pathological changes were significantly attenuated in group SF. Conclusion Sufentanil can inhibit apoptosis in spinal cord neurons of mice with peripheral nerve injury.

Objective:To evaluate the effect of sufentanil on activation of Schwann cells after peripheral nerve injury in mice.Methods:Eighty healthy pathogen-free male Balb/c mice, aged 6-8 weeks, weighing 18-22 g, were divided into 4 groups ( n=20 each) using a random number table method: peripheral nerve injury group (group PNI), high dose sufentanil group (group H), medium dose sufentanil group (group M) and low dose sufentanil group (group L). The model of unilateral sciatic nerve transaction was established in ketamine-anesthetized mice.Immediately after establishment of the model, sufentanil 10, 5 and 2.5 μg/kg was injected intraperitoneally once a day for 3 consecutive days in H, M and L groups, respectively, while the equal volume of normal saline was given instead in group PNI.Sciatic function index (SFI) was calculated at 4, 8 and 12 weeks after establishment of the model.At 2, 4, 8 and 12 weeks, 5 mice in each group were sacrificed, and segments of the injuried ipsilateral sciatic nerve were removed for examination of the ultrastructure of the sciatic nerve (with a transmission electron microscope) and for detection of the expression of glial fibrillary acidic protein (GFAP) of sciatic nerve (by immunohistochemistry). Results:Compared with group PNI, SFI was significantly increased, and the expression of GFAP was up-regluated at each time point after establishment of the model in H and M groups ( P<0.05) and no significant change was found in SFI and GFAP expression after establishment of the model in group L ( P>0.05). Compared with group L, SFI was significantly increased, and GFAP expression was up-regluated in H and M groups ( P<0.05). There was no significant difference in SFI and GFAP expression between group H and group M ( P>0.05). The thickness of myelin lamellae was dense, and the proliferation of Schwann cells was not marked in H and M groups.The thickness of myelin lamellae was thin, and the proliferation of Schwann cells was marked in L and MO groups. Conclusion:The mechanism by which sufentanil improves repair after peripheral nerve injury may be related to promoting activation of Schwann cells in mice.

Objective:To systematically evaluate the effect of melatonin on postoperative sleep quality.Methods:Databases such as PubMed, Embase, Cochrane library, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database and China Science and Technology Journal Database were searched from inception to January 30, 2022 for randomized controlled trials (RCTs) comparing the effects of melatonin versus placebo on postoperative sleep quality.The outcomes analyzed were visual analog scale (VAS) score, sleep quality scale score, subjective sleep scale score, St.Mary′s Hospital sleep questionnaires score, sleep latency, total sleep time, number and duration of awakenings, and incidence of postoperative sleep disturbance.Statistical analysis was performed using the RevMan 5.4 software and Stata 16 software, and the trial sequential analysis (TSA) was conducted using the TSA 0.9.5.10 Beta software. Results:Eleven RCTs involving 822 patients were finally enrolled, with 431 patients in melatonin group and 391 patients in placebo group.The results of meta-analysis showed that melatonin significantly decreased postoperative VAS and sleep quality scale scores, and increased the postoperative subjective sleep scale and St.Mary′s Hospital sleep questionnaires scores, a daily dose of melatonin 6 mg produced a better efficacy, and it also prolonged the postoperative total sleep time and decreased the incidence of postoperative sleep disorders ( P<0.05), However, it had no effect on postoperative sleep latency and the number and duration of awakenings ( P>0.05). The results of TSA showed that although the actual sample size did not reach the expected sample size, the accumulated Z value crossed the traditional boundary value and the TSA boundary value, which indicated that the results of this meta-analysis had stability and further confirmed the efficacy of melatonin in improving postoperative sleep quality. Conclusions:Melatonin can improve postoperative sleep quality and a daily dose of melatonin 6 mg exerts a better efficacy.