Objective To compare the anesthetic effects of remifentanil and fentanyl in elderly patient undergoing transurethral electro-vaporization of the prostate.Methods Eighty cases of the elderly patients (age ≥60 years) with transurethral resection of the prostate operation in the hospital were randomly divided into remifentanil group(R group,n =40) and fentanyl group (F group,n =40).Patients in R group and F group were administrated remifentanil and fentanyl respectively for induction and maintenance of anesthesia.The following indices were recorded including the changes of emodynamics (lood pressure,heart rate) in before-and after-anesthesia,postoperative recovery (spontaneous breathing recovery time,open the recovery time,extubation time) and the adverse reaction within 24 hours after operation (awareness during operation,nausea,vomiting).Results Blood pressures,heart rate of after-anesthesia in R group were lower than that in before-anesthesia and F group,the difference were significant(Blood pressures:F within group =58.306,P within group =0.000,F interactive group =142.450,p interactive group =0.000,F between group =7.417,P between group =0.010;heart rate:F within group =41.512,P within group =0.000,F interactive group =269.103,P interactive group =0.000,F between grouP =39.703,P between group =0.000).Spontaneous breathing recovery time,opening eye time and extubation time in group R were significantly shorter than that of F group (Spontaneous breathing recovery time:(7.5 ± 1.3) min vs.(10.7 ± 3.1) min,t =3.011 ; Opening eye time:(13.5 ± 3.2) min vs.(18.3 ± 5.2) min,t =2.611 ; Extubation time:(24.4 ± 5.5) min vs.(29.2 ± 7.1) min,t =2.696 ; all P ＜ 0.05).No significant differences were found in R and F group in terms of intraoperative awareness postoperative nausea,vomiting (P ＞ 0.05).Conclusion Remifentanil used in elderly patients with transurethral electro-vaporization of the prostate was safer and more effective than fentanyl.Meanwhile postoperative recovery in Remifentanil patient was more rapidly.Therefore Remifentanil was ideal drug during the process clinical anesthesia.

Objective To investigate the influence of S100A6 gene RNA interference on the biological behaviors of A549 lung adenocarcinoma cells.Methods The S100A6 gene RNA interference vector was transfected in A549 lung adenocarcinoma by lentivirus.The experiment was divided into three groups:pLenR-GPH group (the vector without S100A6 RNAi gene was transfected),negative control group (no vectors was transfected),and RNAi group (the vector with S100A6 RNAi gene was transfected).S100A6 mRNA and protein were detected using real-time PCR and Western blotting.The biological behavior including cell proliferation,invasion,cell cycle and cell apoptosis were detected by 3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2H-tetrazolium bromide,transwell,and flow cytometer,respectively.Results The expression of S100A6 mRNA of A549 lung adenocarcinoma cell line in RNAi group (0.009 ± 0.001) was significantly decreased than those in negative control group (0.049 ± 0.005) and pLenR-GPH group (0.030 ± 0.006),with statistically significant differences (t =57.56,P =0.000;t =48.21,P =0.000).The expression of S100A6 protein of A549 lung adenocarcinoma cell line in RNAi group (0.107 ± 0.002) was significantly decreased than those in negative control group (0.341 ± 0.005) and pLenR-GPH group (0.311 ± 0.006),with statistically significant differences (t =37.34,P =0.000;t =27.51,P =0.001).The ability of cell proliferation at 48 hours in RNAi group (0.230 ± 0.008) was significantly declined than those in negative control group (0.292 ± 0.038) and pLenR-GPH group (0.307 ± 0.013),with statistically significant differences (t =25.31,P =0.003;t =29.42,P =0.001).The number of transmembrane cells in RNAi group (11.40 ± 1.36) was significantly declined than those in negative control group (26.80 ± 1.83) and pLenR-GPH group (25.80 ± 1.93),with statistically significant differences (t =29.44,P =0.001;t =23.17,P =0.005).The cell proportion of S phase in RNAi group (28.26％ ± 0.38％) was significantly lower than those in pLenR-GPH group (44.73％±0.66％) and negative control group (45.15％ ± 1.69％),with statistically significant (t =63.69,P=0.000;t =71.55,P =0.000).Cell propotion of G2-M phase in RNAi group (26.99％ ± 0.29％) was signi-ficantly higher than those in negative control group (13.26％ ±0.49％) and pLenR-GPH group (12.41％ ± 0.46％),with statistically significant (t =56.31,P =0.000;t =51.39,P =0.000).The cell apoptosis proportion in RNAi group (8.90％ ±0.48％) was significantly higher than those in negative control group (5.84％ ±0.21％) and pLenR-GPH group (5.99％ ±0.37％),with statistically significant (t=51.34,P =0.000;t =47.27,P =0.000).Conclusion S100A6 gene involves the proliferation,invasion,cell cycle and apoptosis of tumor cells,which has close correlation with occurrence,development and metastasis of lung adenocarcinoma.S100A6 gene is hopeful to become a molecular target for the diagnosis and treatment of lung adenocarcinoma.

Aim To study the distributive character of mitomycin(MMC) magnetic nanoparticles and MMC normal saline solution in mice.Methods A HPLC method for the determination of MMC in tissues and serum were established and applied to determine MMC in biological samples.Results Under the guidance of an external magnetic field,targeting rates of MMC to liver viscus are 82.72% after 30 minutes tail vein administration of(1 mg?kg~(-1)) mitomycin magnetic nanoparticles,it was 2.37 times larger than targeting rates of MMC normal saline solution group.The distributions of heart and kidney of mitomycin magnetic nanoparticles were less than that of MMC normal saline solution group.Compared with the results of tail vein administration mitomycin nanoparticles,interaction between the external magnetic field and magnetic nanoparticles is significantly effective to increase targeting rates of MMC to liver.Compared with the results of tail vein administration mitomycin magnetic nanoparticles without the external magnetic field,Mitomycin magnetic nanoparticles under the guidance of an external magnetic field is significantly effective to increase targeting rates of MMC to liver.Conclusions Mitomycin magnetic nanoparticles under the guidance of an external magnetic field is significantly effective to increase targeting rates of MMC to liver and prolonging effect on the action in vivo.

Objective To evaluate the correlation between imaging features of spiral computed tomography(SCT) and pathology, MVD, and the expression of VEGF in renal cell carcinoma(RCC). Methods Thirty patients with RCC diagnosed by pathology underwent SCT examinations.MVD and the expression of VEGF were examined immunohistochemically using SABC techniques. Results The detection and characterization rate as well as accuracy of staging before operation about 30 RCC of multiphasic SCT scans were 100 %, 100 % and 83.3 %, respectively. In 30 cases of RCC, the mean MVD was 36±12.4. The positive expression rate of VEGF were 73.33 %. There were no correlation between the MVD and the expression of VEGF in RCC (r =0.057, P >0.05). The features of SCT: on multiphasic SCT scans, the pathological nuclear grade, the MVD and positive expression of VEGF in groups of RCC with diameter larger than 3.0 cm, central necrosis, pseudocapsule and intravenous tumor emboli were obviously higher than those of the contrast group (P <0.05, P <0.05, P <0.05, respectively). The pathological nuclear grade and MVD in groups of RCC with lymph node metastasis were higher than the contrast group (P <0.05, P <0.05, respectively). There were the positive correlation between the enhanced Hounsfield' s units in the CMP and the MVD in 30 cases of RCC(r =0.784, P <0.05). The degree of enhancement correlated well positively with the MVD in 30cases of RCC (P < 0.05). Conclusion Multiphasic enhanced SCT scan is a reliable technique in the detection, pathologic characterization of RCC. Some SCT features are closely correlated with MVD and expressions of VEGF in RCC, which could be a noninvasive method in predicting aggressiveness and metastasis.

Objective To investigate the cachexia morbidity among hospitalized patients with digestive system cancer and evaluate its impact on clinical outcomes.Method By analyzing the clinical data of 5 118 hospitalized patients with digestive system cancer in Zhongshan Hospital,Fudan University from January 2012 to December 2013,we investigated the cachexia morbidity and compared the clinical outcome between cachectic patients and noncachectic patients.Results The overall cachexia morbidity of hospitalized patients with digestive system cancer was 15.7％ (803/5 118).The highest cachexia morbidity was 34.0％ (89/173),found in patients with pancreatic cancer.In cachectic group and non-cachectic group,the overall completion rate of radical resection was 67.1％ (539/803) and 74.5％ (3 214/4 315),respectively (P =0.000).Compared to the non-cachectic group,the cachetic group had significantly longer postoperative hospital days [(11.5 ±6.2) d vs (9.4 ±4.9) d,P =0.003],slower postoperative recovery of bowel function [(3.4 ±0.9) d vs (3.2 ±0.8) d,P =0.013],longer postoperative time to intake semifluid [(4.4 ± 1.5) d vs (3.9 ± 1.3) d,P =0.002],and more postoperative complications in 28 days after surgery [8.9％ (48/539) vs 5.8％ (186/3 214),P=0.006].After surgery,131 patients in the cachectic group were transferred to the ICU,and 646 patients in non-cachectic group transferred to the ICU (24.3％ vs 20.0％,P=0.026).Compared to the non-cachecic group,the reoperation rate [3.2％ (17/539) vs 1.5％ (48/3214)],ventilator support rate [8.0％ (43/539) vs 5.7％ (184/3 214)],and mortality [2.4％ (13/539) vs 1.1％ (35/3 214)] of the cachectic group were all significantly higher (P =0.006,0.042,0.011).Conclusions Cachexia is common in hospitalized patients with digestive system cancer,especially in patients with pancreatic cancer.Cachexia has negative impact on the clinical outcomes.

Objective To explore the expression and change of ski-interacting protein (SKIP) in rats after spinal cord injury. Methods A total of 60 adult female Sprague-Dawley rats were randomly divided into sham group (n=30) and spinal cord injury (SCI) group (n=30), each group was further divided into five time points including one day, three days, five days, seven days, and 14 days with six rats in each time points. The model was established at T10 with modified Allen's technique, and the sham group only bit the lamina of rats. The hindlimbs behavior was assessed with Basso-Beattie-Bresnahan (BBB) score at each time point. The pathological changes of spinal cord neurons were detected with Nissl staining. The expression of SKIP were observed with immunofluorescence staining. Results The BBB scores were signif-icantly lower in each time point in SCI group than in the sham group (t>48.267, P<0.001). Compared with the sham group, Nissl bodies in the cytoplasm of spinal cord neurons began to disintegrate, coalesce and irregularly distribute, the neurons began to degenerate and die on the fifth day, and the damage deteriorated on the 14th day. Immunofluorescence staining showed that SKIP expression was mainly expressed in the gray matter of the spinal cord and little expressed in the white matter. The expression of SKIP gradually increased after SCI, and reached a peak on the fifth day (t=-17.035, P<0.001) and decreased significantly on the 14th day (t=3.853, P<0.05). Conclusion SKIP may be a new signaling molecule, which play an important role in neuronal apoptosis after SCI.

Objective To study the differentiation and proliferation ability of the spinal neural stem cells (NSCs) at different gestational ages in fetal rats. Methods Sprague-Dawley fetal rats were divided into group A (12 days of pregnancy), group B (14 days of pregnancy) and group C (16 days of pregnancy). NSCs were separated with enzyme-assisted microdissection. The diameter and numbers of NSCs balls were measured at different time. The cell growth curve was drawn with CCK8 colorimeter. NSCs were identified with BrdU/Nestin immunohistochemical staining. They were induced with 10% fetal bovine serum for 10 days, and the expression of β-tubulinⅢ and glial fibrillary acidic protein was detected with immunocytochemistry. Results There were cells expressed BrdU, Nestin, β-tubulinⅢ and GFAP in all the group. The most cells (22.74±0.79%) expressed β-tubulinⅢ in the group B, but no significant difference between group B and group C. The cell vitality on the 5th day of third-generation neural stem cells was the most in group B. Conclusion For enzyme-assisted microdissection, it may obtain more neurons to isolate the neural stem cells from 14 days of pregnancy pregnant rats.

OBJECTIVETo investigate cachexia in hospitalized patients with digestive system cancer and evaluate its impact on clinical outcomes.

METHODSBy analyzing the clinical data of 5118 hospitalized patients with digestive system cancer in Zhongshan Hospital of Fudan University from January 2012 to December 2013, cachexia was investigated and clinical outcomes between cachexia patients and non-cachexia patients was compared.

RESULTSThe total cachexia rate of hospitalized patients with digestive system cancer was 15.7%(803/5118). The highest rate of cachexia was 34.0%(89/262) in patients with pancreatic cancer followed by gastric cancer 22.4%(261/1164), colon cancer 21.7%(146/672), and rectal cancer 20.1%(117/581). In cachexia group and non-cachexia group, the overall completion rate of radical resection was 67.1%(539/803) and 74.5%(3214/4315) respectively(P<0.05). Compared to the non-cachexia group, the cachexia group was associated with longer postoperative hospital stay [(11.5±6.2) d vs. (9.4±4.9) d, P<0.05], slower postoperative recovery of bowel function [(3.4±0.9) d vs. (3.2±0.8) d, P<0.05], longer postoperative time to intake of semifluid [(4.4±1.5) d vs. (3.9±1.1) d, P<0.05], and more postoperative complications within 28 days after radical surgery [8.9%(48/539) vs. 5.8%(186/3214), P<0.05]. After radical surgery, the ICU admission rate of the cachexia group [24.3%(131/539)] was higher than that of the non-cachexia group [20.1%(646/3214)] with significant difference(P<0.05). Compared to non-cachexia group, the reoperation rate [3.2%(17/539) vs. 1.5%(48/3214), P<0.05], ventilator support rate [8.0%(43/539)vs. 5.7%(184/3214), P<0.05] and mortality [2.4%(13/539) vs. 1.1%(35/3214), P<0.05] in the cachexia group were all significantly higher(all P<0.05).

CONCLUSIONSCachexia is commen in patients with digestive system cancer. Cachexia has significant adverse effects on clinical outcomes in hospitalized patients with digestive system cancer.

Cachexia ; etiology ; Colonic Neoplasms ; complications ; Defecation ; Humans ; Postoperative Complications ; Rectal Neoplasms ; complications ; Reoperation ; Stomach Neoplasms ; complications

Objective To explore the learning and memory impairment and pathology in hippocampus in rats after spinal cord contu-sion. Methods 36 adult female Sprague-Dawley rats were randomly divided into sham group (n=18) and spinal cord injury group (n=18). Spinal cord injury model at T10 was established with modified Allen's technique (10 g × 25 mm). The hindlimbs behavior of rats was rated with Basso-Beattie-Bresnahan (BBB) scores once a week for 5 weeks. They were tested with motor evoked potentials (MEP) and Morris wa-ter maze 5 weeks after injury. The pathology of hippocampus was detected with HE staining 1 week, 3 weeks and 5 weeks after injury, 4 rats in a group, repectively. Results The BBB scores were significantly lower in the spinal cord injury group than in the sham group at each time point (P<0.05). The latencies of both N1 and P1 wave of MEP were significantly longer in the spinal cord injury group than in the sham group (P<0.001), while the amplitudes were significantly less (P<0.001). For the Morris water maze, the latency of arrival platform were sig-nificantly longer in the spinal cord injury group than in the sham group (P<0.001), and the time in target was significantly less (P<0.001), with more systematic positioning or annular positioning, while the sham group with more space-based positioning. Morphologically abnor-mal cells in hippocampus gradually increased since the first week after injury, with the decrease of cells survival, while it was normal in the sham group. Conclusion Spinal cord contusion can cause learning and memory impairment in rats, which may be related to injury in hippo-campus.

Objective:To investigate the effect of ultrasound-guided continuous saphenous nerve block on preemptive analgesia in elderly patients undergoing unilateral total knee arthroplasty(TKA) under general anesthesia.Methods:A total of 120 elderly patients who received unilateral TKA in the Affiliated Hospital of Jining Medical College from June 2020 to October 2020 were enrolled and they were divided into group A (saphenous nerve block + general anesthesia), group B (femoral nerve block + general anesthesia) and group C (simple general anesthesia) by random numbering method, with 40 cases in each group. The visual analogue pain (VAS) scores, knee range of motion, RS agitation scores and Ramsay sedation scores at different time points after surgery and postoperative recovery and analgesia were compared among the three groups.Results:The static state and dynamic state VAS scores in the group A and group B at 6, 12, 24, 48 h after the surgery had no significant differences ( P>0.05). The knee range of motion in the group A at 6, 12, 24, 48 h after the surgery were higher than that in group B and group C: (74.8 ± 8.1)° vs. (68.4 ± 8.2)°and (63.2 ± 7.0)°, (77.4 ± 10.9)°vs.(73.0 ± 10.0)° and (68.6 ± 8.3)°, (82.6 ± 10.4)° vs. (77.4 ± 9.6)°and (73.2 ± 8.3)°, (91.8 ± 6.1)° vs. (86.8 ± 6.6)° and (82.8 ± 5.3)°, the differences were statistically significant ( P<0.05). The RS agitation scores and Ramsay sedation scores in the group A and group B had no significant differences ( P>0.05). The first time to the ground in the group A was shorter than that in the group B : (20.9 ± 3.0) h vs. (27.4 ± 3.5) h; the walking distance in the group A was longer than that in the group B: (7.1 ± 1.6) m vs. (5.2 ± 1.3) m, the differences were statistically significant ( P<0.05). Conclusions:Ultrasound-guided continuous saphenous nerve block has a good postoperative analgesic effect in elderly patients with unilateral TAK under general anesthesia. It can promote the recovery of directional force and knee range of motion in patient.