Objective To investigate the postoperative analgesia efficacy of ultrasound-guided rectus abdominis sheath block (RSB) in patients with abdomen panhysterectomy.Methods Forty patients with abdomen panhysterectomy under general anesthesia were divided into RSB group and control group by random digits table method with 20 cases each.All the patients were given patient controlled intravenous analgesia.The visual analogue scale (VAS) score and Ramsay sedative score at 2,6,12 and 24 h after operation,sulfentanyl dosage and total number of analgesic pump press of 24 h,number of nausea and vomiting,analgesic satisfaction score were recorded.Results The VAS scores in RSB group at 2,6,12,24 h after operation were lower than those in control group,but there were no statistical differences (P＞ 0.05).The Ramsay sedative score of all patients was ＜ 4 scores.Sulfentanyl dosage of 24 h in RSB group was (73.1 ± 8.6) μ g,in control group was (91.7 ± 12.3) μ g,there was statistical difference (P ＜ 0.01).The number of analgesic pump press of 24 in RSB group was (6.5 ± 2.1) times,in control group was (12.3 ± 4.6)times,there was statistical difference (P ＜ 0.01).Analgesic satisfaction score in RSB group was (7.3 ± 0.7)scores,in control group was (6.8 ± 1.1) scores,there was statistical difference (P＜ 0.05).Four cases in RSB happened nausea and vomiting,3 cases in control group,there was no statistical difference (P ＞ 0.05).All patients did not happen the complication related with RSB operation.Conclusion RSB as the postoperative analgesia in patients with abdomen panhysterectomy can reduce the dosage of opioid drug,and increases the analgesic satisfaction.

Background Cysteine-rich 61 (Cyr61)/CCN1 has been reported to stimulate retinal neovascularization (RNV) in retinopathy of prematurity (ROP).However, whether CCN1 small interfering RNA (CCN1 siRNA) can inhibit or cure ROP has not been extensively investigated.Objective This study was to investigate the regulation effect of CCN1 specific siRNA expression vector on retinal endothelial cells.Methods Rhesus choroid-retinal vascular endothelial cells (RF/6A) were cultured under the normoxic (normoxia control group) and hypoxic condition (1％ O2,5％ CO2 with 94％ N2) in vitro, and then lipofectamineTM 2000 (LF2000) vector plasmid with or without CCN1 siRNA was transiently transfected in the hypoxic-cultured cells as the CCN1 siRNA transfected group and hypoxic control group, respectively.Reverse transcription PCR was employed to detect the expression of CCN1 siRNA plasmid 24 hours after transfection.The vatality of the cells was assayed by cell counting kit-8 (CCK-8) 0,24,48,72 and 96 hours after cultured.Twenty-four hours after cultured,the apoptosis of the cells was evaluated by flow cytometry, and the expressions of CCN1 and vascular endothelial growth factor (VEGF) proteins were detected by immunofluorescence technique and Western blot assay.Results The expression band of CCN1 siRNA was detected in the cells 24 hours after transfection of CCN1 siRNA.CCK-8 assay showed that RF/6A cells were significantly increased over time, and the proliferating value (absorbancy) of the cells was significantly reduced in the CCN1 siRNA transfected group compared with in the normoxia control group and hypoxic control group (Fgroup =198.45, P＜0.05;Ftime =39.26, P＜ 0.05).The apoptosis rates of the cells were (68.9± 1.1) ％ , (18.9±1.3)％ and (39.6± 1.8)％ in the CCN1 siRNA transfected group, normoxia control group and hypoxic control group,and the apoptosis rates of the CCN1 siRNA transfected group were evidently higher than those of the normoxia control group and hypoxic control group (t =2.93 ,t=2.56 ,both at P＜0.05).CCN1 and VEGF proteins were weakly expressed in the normoxia control group and strongly expressed in the hypoxic control group,however,their expression intensity was evidently weakened in the CCN1 siRNA transfected group.The related expression levels of CCN1 and VEGF proteins in the CCN1 siRNA transfected group were significantly lower than those in the hypoxic control group (both at P＜0.05).Conclusions RNA interference targeting CCN1 can inhibit proliferation and promote apoptosis of RF/6A cells.CCN1 siRNA can arrest RNV probably by downregulating the expression levels of CCN1 and VEGF in the cells.

Objective To study the diversities of imaging, symptoms, electrophysiology and clinical value of the stereoelectroencephalography(SEEG) in patients with mesial temporal lobe epilepsy.Methods Eight patients with intractable epilepsy in Epilepsy Center of Yuquan Hospital of Tsinghua University who underwent mesial temporal lobectomy were recruited in this study, and their epileptic foci could not be accurately positioned.Therefore stereotactic brain electrodes were implanted, and their usual attack originated from mesial temporal lobe structure were confirmed.There was no seizure in the one year follow-up.Results Symptoms of the eight patients behaved differently, and the onset of the seizures in scalp electroencephalograph or SEEG showed diversities.Epileptic discharges were found originated from the mesial temporal lobe after implanting electrodes: in the early stage of discharges, four cases had the conduction to insular lobe structure;two cases had the conduction to contralateral mesial temporal lobe;one case had the conduction to retrosplenial cortex;one case had the conduction to parietal lobe;one case had the conduction to frontal lobe and rapid generalization (one case had the conduction to insular lobe and contralateral mesial temporal lobe meanwhile).Conclusions There is difference in clinic, imaging and electrophysiology of the patients with mesial temporal lobe epilepsy The non-specificity can be explained by the evolution of the intracranial electroencephalography, which can help us know its network conduction pattern Insular lobe is the most common conduction approach of mesial temporal lobe epilepsy in early stage SEEG can be used as a microinvasive, accurate preoperative localization method, which can help us to locate accurately and understand the discharges and conduction mode.