Objective To compare the effects of dexmedetomidine (DEX) and remifentainil (REM) combined with sevoflurane (SEV) for general anesthesia on recovery quality in patients undergoing laparoscopic cholecystectomy (LC).Methods Sixty patients (ASA grade Ⅰ-Ⅱ) who underwent LC were divided into DEX combined with SEV for general anesthesia group (DEX group) and REM combined with SEV for general anesthesia group (REM group) by table of random digit,with 30 cases each.Time of first inspiration,eye opening,extubation,orientation recovery and passage of gas by anus were recorded.Vital sign,numeric rating score (NRS),Ramsay score and untoward reaction were recorded.Degree of satisfaction of patients,post-anesthesia care unit (PACU) nurse and surgeon were evaluated.Results The time of extubation and passage of gas by anus in DEX group were significantly shorter than those in REM group [(12.0 ±3.9) min vs.(15.9 ±5.6) min,t =-3.130,P =0.003; (18.5 ±3.4) h vs.(23.6 ±5.8) h,t =-5.455,P =0.000].However,the time of eye opening and orientation recovery in DEX group were significantly longer than those in REM group [(15.5 ± 4.2) min vs.(11.7 ± 2.9) min,t =4.078,P =0.000;(19.5 ± 4.5) min vs.(14.8 ± 3.6) min,t =4.315,P =0.000].During the first 2 h after operation,Ramsay score in DEX group was significantly higher than that in REM group (P ＜ 0.05),but NRS in DEX group was significanty lower than that in REM group (P ＜ 0.05),the patients with additional analgesics was minor than REM group (2 cases vs.9 cases,P ＜ 0.05).The percentages of patients suffering shivering and postoperative nausea and vomiting in DEX group were significantly lower than those in REM group [3.3％(1/30) vs.33.3％(10/30),6.7％(2/30) vs.30.0％ (9/30),P ＜0.05].Degree of satisfaction of patients and PACU nurse in DEX group were higher than those in REM group [89.0(72.0-100.0) scores vs.80.0(70.0-95.0) scores,Z =-4.066,P =0.000; 92.0 (80.0-99.0) scores vs.90.0 (80.0-95.0) scores,Z =-2.906,P =0.004],but degree of satisfaction of surgeon in REM group was higher than that in DEX group [(91.8 ± 5.8) scores vs.(81.7 ±6.1) scores,t =-6.568,P =0.004].Conclusion Compared with REM combined with SEV for general anesthesia,DEX combined with SEV for general anesthesia has a faster recovery for respiration and passing of gas by anus,lower NRS and incidence rates of shivering,nausea and vomiting,improves the quality of recovery for patients undergoing LC.

Objective To investigate the effect of ambroxol pretreatment on the inflammatory response and lipid peroxidation during one-lung ventilation (OLV) .Methods Forty-five ASA I or II patients aged 37-64 yr weighing 53-65 kg undergoing thoracotomy under general anesthesia were randomly divided into 3 groups ( n = 15 each): group A two-lung ventilation (TLV); group B OLV and group C ambroxol 1 mg/kg + OLV. Anesthesia was induced with midazolam, fentanyl, propofol and atracurium and maintained with propofol infusion and intermittent iv boluses of fentanyl and atracurium. The patients were mechanically ventilated (VT8-10 ml/kg, RR 12 bpm during TLV, VT 6-7 ml/kg, RR 16 bpm during OLV, I: E 1:2, FiO2 100% ). In group C ambroxol 1 mg/kg in normal saline ( NS) 100 ml was infused at 25 min before OLV (infusion rate 4 ml/min) , while in group A and B equal volume of NS was infused instead of ambroxol. Blood samples were obtained from radial artery before induction of anesthesia and OLV (T0.1 ) and at 0.5, 1, 2 h of OLV (T2-4 ) and 1, 2 h of TLV (T5,6 ) and at 24 h after operation (T7) in group B and C for determination of serum SOD activity and TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts. The same indexes were detected in group A at the corresponding time points.Results Serum SOD activity was significantly lower and serum TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly higher in group B than in group A. Serum SOD activity was significantly higher and serum TNF-a, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly lower in group C than in group B. Conclusion Pretreatment with ambroxol 1 mg/kg can inhibit inflammatory response and lipid peroxidation during OLV.

Objective: To explore the effects of X-ray repair cross complementing gene 1 (XRCC1) polymorphism and low dose ionizing radiation exposure on radiology professionals’ peripheral blood lymphocyte micronucleus. Methods: A matched case-control study was designed. From 2013 to 2015, 1 102 radiology professionals with micronucleus test rusults, and 45 cases with present micronucleus were enroled into case group. 180 diagnostic radiology technicians detecting no micronucleus were chosen as control group, cases and controls were 1∶4 mached on gender, age ≤40 or >40 years old. According to the detection of micronucleus levels (0‰, 1‰, 2‰) , the objects of our study were divided into the reference group, the low detection group and the medium detection group. The form of radiation workers’ occupational health examination was used to collect the general baseline of the research objects, history of smoking, drinking, poisonous and harmful material exposure, past medical history, accumulated illuminated dose and lymphocyte micronucleus rates (‰) , etc. Using restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) technology for genotyping; Compared the baseline data and radiation exposure level between the differentmicrokernel detection groups; Adopted multivariate logistic regression to analysis the combination effect of XRCC1 Arg399Gln gene polymorphism and accumulated illuminated dosefor micronucleus rate. Results: The accumulated illuminated dose in the reference group, the low detection group and the medium detection group were (23.44±15.23) , (21.76±2.56) , (24.22±18.61) mSv, respectively. There was no statistically significant difference among the groups (P>0.05) . Under the dominant inheritance mode, after adjusted age, smoking and drinking factors, the results suggested that XRCC1 Arg399Gln micronucleus medium detection group compared with the reference group, Arg399Gln-GG as reference, Arg399Gln-GA+AA decreased the occurrence of micronucleus (OR=0.175, 95%CI: 0.036-0.848) . Arg194Trp and Arg280His did not affect the incidence of micronucleus (P>0.05) . Did not find the combination effect of XRCC1 Arg399Gln gene polymorphism and accumulated illuminated dose for micronucleus rate (P>0.05) . Conclusion XRCC1 Arg399Gln gene polymorphism can affect the incidence of micronucleus, and carrying the XRCC1 Arg399Gln-GA+AA genotype is a protective factor of micronucleus’s occurrence, but low dose ionizing radiation may not affect the occurrence of micronucleus independently.

Objective To investigate the effect of ultrasound-guided quadratus lumborum block (QLB) on postoperative analgesia after caesarean section.Methods Sixty parturientsscheduled for cesarean section, aged 20-40 years, ASA physical status Ⅰ orⅡ, were randomly divided into 2 groups (n = 30 each) using a random number table:QLB group (group Q) and control group (group C).Parturients in group Q received bilateral QLB with the use of 20 ml 0.33％ ropivacaine per side after surgery, while QLB was not done in group C.Both groups received patient-controlled intravenous analgesia (PCIA) after surgery which contains 800 mg tramadol, 40 mg nefopam and 80 ml normal saline.The accumulative consumption of tramadol, the score of numerical rating scale (NRS) for pain at rest and on movement and the bruggrmann comfort scale (BCS) score were recorded at 4, 8, 12, 24, 48 hafter operation.The cutaneous sensory block area was determined in group Q at 4, 8, 12, 24, 48 hafter operation.The patient′s satisfaction with postoperative analgesia and adverse reactions were also recorded.Results The consumption of tramadol in group Q was significantly decreased compared with that in group C (P<0.05) at 4, 8, 12, 24, 48 hafter surgery.NRS for pain at rest at all times, NRS for pain when cough at 12, 24 hafter surgery and NRS for pain when turning over at 4, 48 hafter surgery were significantly lower, while the BCS score was higher in group Q than that in group C (P<0.05).Quadratus lumborum block affected T7-L1 dermatomes at 4, 8, 12 hafter surgery and T8-L1 dermatomes at 24 hafter surgery.The analgesic plane of quadratus lumborum block disappeared at 48 hours after operation.The patient's satisfaction with postoperative analgesia was higher in group Q compared with that in group C (P<0.05).The incidence of postoperative nausea, vomiting and dizziness was similar between the two groups.Conclusion Ultrasound-guided quadratus lumborum block can remarkably reduce the consumption of tramadol after caesarean section, lower the postoperative pain score, improve the patient′s comfort and satisfaction.

Autophagy is a dynamic process that allows recycling of long-lived proteins and damaged organelles into biosynthetic materials for maintaining the normal cellular homeostasis. Recently, accumulating evidence has indicated that autophagy played important roles in the pathogenesis of neuronal diseases. In this article, the research progress of autophagy in the pathogenesis and regulation mechanism of common nervous system diseases were reviewed to deepen the understanding of autophagy, and arouse researchers' attention on dynamic regulation of autophagy and alleviating autophagic flow injury.

Objective:To explore the related influencing factors of interstitial pneumonia (IP) in B-cell non-Hodgkin lymphoma (B-NHL) patients treated with R-CHOP-like chemotherapy regimen.Methods:The clinical data of 377 CD20 + B-NHL patients in Minhang Branch of Fudan University Shanghai Cancer Hospital from January 2014 to June 2019 were retrospectively analyzed. According to whether rituximab was used, patients were divided into R-CHOP-like chemotherapy group (275 cases) and CHOP-like chemotherapy group (102 cases). The incidence of IP in patients stratified according to different clinical factors was analyzed, and logistic multivariate regression was used to analyze the risk factors of IP. Results:Thirty-eight out of 377 patients (10.08%) developed IP; the incidence rates of IP in the R-CHOP-like chemotherapy group and the CHOP-like chemotherapy group were 13.09% (36/275) and 1.96% (2/102), respectively, and the difference was statistically significant (χ 2 = 10.169, P < 0.01). There were statistical differences in the incidence rates of IP between patients with or without rituximab, with or without liposomal doxorubicin in the regimen, and with or without grade Ⅳ neutropenia occurred during the treatment [13.09% (36/275) vs. 1.96% (2/102), 18.18% (22/ 121) vs. 6.25% (16/256), 15.43% (27/175) vs. 5.45% (11/202), all P < 0.01]. Logistic regression analysis showed that the application of rituximab ( OR = 6.761, 95% CI 1.369-33.711, P = 0.020) and grade Ⅳ neutropenia ( OR = 7.443, 95% CI 2.132-8.199, P = 0.001) were independent risk factors for the occurrence of IP. Conclusions:R-CHOP-like chemotherapy regimen increases the occurrence of IP in patients with B-NHL. The use of rituximab and grade Ⅳ neutropenia are independent risk factors for the occurrence of IP.

【Objective】 To explore the effect of intraoperative cell salvage on allogeneic blood transfusion requirements, coagulation function and electrolytes in postpartum hemorrhage patients. 【Methods】 A study on postpartum hemorrhage patients undergoing cesarean section in the Third Affiliated Hospital of Guangxi Medical University form September 2016 to May 2022 was conducted retrospectively. A total of 137 patients were enrolled and divided into experimental group (n=70) and control group (n=67) according to whether intraoperative cell salvage was used during operation. The blood loss, proportion and volume of allogeneic red blood cells (RBCs) and coagulation component transfusion, hemoglobin (Hb) level, coagulation function, electrolyte, the incidence of complications, proportion of ICU admission, ICU stay and in-hospital stay were compared between the two groups. 【Results】 The proportion of patients receiving allogeneic RBCs in the experimental group and in the control group was 31.4% vs 100.0% (P<0.05). The experimental group also had lower use of plasma (31.4% vs 53.7%, P<0.05). The postoperative 24 h of activated partial thromboplastin time (APTT) and prothrombin time (PT) in the two groups was longer than preoperative, and APTT in the control group did not recover at discharge (P<0.05). Fibrinogen (Fib) decreased postoperative 24 h in the two groups (P<0.05). The blood calcium in the two groups decreased 30 minutes after operation, but the decrease in the experimental group was slight, and two groups did not recover 24 h after operation (P<0.05). There was no statically significant difference in blood loss, volume of allogeneic RBCs and coagulation component transfusion, Hb level, incidence of complications, the proportion of ICU admission, ICU stay and in-hospital stay (P>0.05). 【Conclusion】 This study demonstrated that intraoperative cell salvage could reduce the requirement for allogeneic RBCs without compromising coagulation function in postpartum hemorrhage patients undergoing cesarean section, but the changes of calcium need to be concerned after transfusion.