Objective To investigate the influence of sevoflurane and total intravenous anesthesia with propofol on hepatic and renal function in elder patients under gastrectomy .Methods 55 patients between the ages of 60-75 ,ASA physical status class Ⅰor Ⅱ ,scheduled for an elective gastrectomy were randomly divided into two groups .Anesthesia was maintained with sevoflurane 1% -1 .2% and remifentanil (0 .1-0 .2)μg · kg -1 · min-1 in the group S and propofol (1 -2)mg · kg -1 · h-1 and remifentanil (0 .1-0 .2)μg · kg -1 · min-1 in the group T .The hepatic and renal function ,aspartate aminotransferase (AST ) ,alanine amin-otransferase(ALT),bloodureanitrogen(BUN)andcreatinineweretestedatpreoperation(baseline),postoperative1dayand3 days .Results AST was increased at postoperative 1 day and 3 day ,compared with that of the preoperation in the group S and group T .Serum BUN at 3 day and creatinine at 1 day and 3 day were significantly higher from the preoperative values in group S (P<0 .05) ,but the values were within its normal limit .ALT was not changed after anesthesia in the both groups .And Serum BUN and creatinine were not changed after anesthesia in the T groups (P>0 .05) .There were no significant difference in the AST ,ALT , BUN and creatinine between the groups(P>0 .05) .Conclusion The changes of hepatic and renal effect after inhalation anesthesia with sevoflurane and remifentanil and TIVA with propofol and remifentanil for gastrectomy are clinically insignficant ,and there is no difference between the two methods .

Objective To observe the effect of elevated local sheer stress of abdominal aota on its caliber and wall expression of MMP-9,and analyse the action of high shear stress on arterial remodling.Methods Forty-eight SD rats were randomly divided into 4 experiment and 4 comparison groups.An infra-renal aortocaval fistula was constructed by needle puncture using a 0.4mm needle in the experiment groups.The aorta proximal to the fistula was harvested after 1 d,7 d,14 d and 28 d respectively,while sham operation was done in the comparison groups.The diameter and wall thickness of the aorta were measured after fistula was made and before harvest.The level of change of MMP-9 was observed by immunohistochemistry.Results The diameter of aorta proxinal to the fistula was enlarged in the 1d group(P

Objective To explore ideal treatment strategy for hemangioma and vascular malformations.Methods The clinical data of 863 cases of hemangioma and vascular malformation were analyzed retrospectively.There were 414 male and 449 female patients,The ages ranged from 2 weeks to 55 years.Among these cases,742 were hemangioma while 121 were vascular malformation.The different treatment methods were selected based on the type,location,and extent of the lesion and the patient′s individnal situation.Seven hundred and forty-six patients underwent surgical treatment,89 patients underwent operation combined with sclerotherapy,and 28 patients received embolization of feeding arteries with or without operation.Results Early postoperative results showed that 772 cases(89.46%) were cured,78 cases(9.04%) markedly improved and 13 cases(1.5%) improved.A total of 620 cases were followed up for 0.5-3.0y,of which,556 cases(89.68%) were cured,51 cases(8.23%) markedly improvod,and 13 cases(2.09%) had improved.Conclusions Operation is ideal strategy for the limited disease focus,while non-surgical treatment is necessary for patients with extensive and deep lesions or who are not fit for surgical treatment.Combining surgical treatment and non-surgical treatment can achieve better therapeutic efficiency.

Objective To evaluate the health status ,dyspnea and exercise endurance in the patients with chronic obstructive pul-monary disease(COPD) by the CAT scale ,modified medical research council(mMRC) dyspnea scale and 6-min walk test(6MWT) and to analyze the correlation between their evaluation results with the percentage (FEV1% pred) of the forced expiratory volume at 1 second(FEV1) in the predict value and whether complicating pulmonary hypertension (PH) .Methods 70 patients with COPD were performed the examinations of the lung function ,CAT scale ,mMRC score and 6MWT .The correlation among the various e-valuation systems and between each evaluation system with the severity of the pulmonary function airway limitation were compre -hensively evaluated .The CAT scores ,mMRC scores and 6 min walking distance(6MWD) were compared between the COPD com-plicating PH group and the simple COPD group .Results The CAT scale was negatively correlated with 6MWD(r= -0 .623 ,P<0 .01) and had no correlation with FEV1% pred(P=0 .159) .The CAT scale was positively correlated with mMRC (r=0 .492 ,P=0 .000) .mMRC was negatively correlated with 6MWD(r= -0 .514 ,P= 0 .000) and had no correlation with FEV1% pred(P>0 .05) .The CAT scores had statistical difference between the COPD complicating PH group and the simple COPD group (P<0 .01) .6MWD had the highest accuracy for screening COPD whether complicating PH ,followed by CAT .The diagnostic cut-off point by adopting CAT for judging the risk of COPD complicating PH was 21 .Conclusion The CAT scale has good correlation with 6MWD and no correlation with FEV1% pred .The CAT scale is more suitable for the overall assessment of the total severity of COPD .Patients with the high CAT scores have higher risk of suffering from PH .

Objective To evaluate the diagnostic value of DCE-MRI and breast MR reporting and data system(BI-RADS-MR)in differentiation of breast lesions. Methods Seventy-five patients with 75 pathological-confirmed breast lesions underwent DCE-MRI before treatment and DCE-MRI quantitative analysis. Two senior doc-tors assessed the imaging features blindly by BI-RADS-MR. The pathology results were set as a gold standard. The receiver operating characteristic curve(ROC)interpretation of two physician′s curve analysis was used to evaluate the sensitivity,specificity of BI-RADS classification. Results According to the BI-RADS MR score,38 breast cancer patients were rated as 1 case in grade Ⅰ,0 case in grade Ⅱ,4 cases in gradeⅢ,13 cases in gradeⅣ,20 cases in grade V;37 breast benign tumors were rated as 17 cases in grade Ⅰ,5 cases in grade Ⅱ,12 cases in gradeⅢ,3 cases in gradeⅣandⅤ0 cases. The statistical difference of Tpeak,S max,K1 between benign and malig-nant breast tumors were significant(P<0.05). On ROC,the area under the curve was 0.940,95%confidence in-terval was from 0.887 to 0.994. The sensitivity of BI-RADS in the diagnosis of breast cancer was 94.59%and speci-ficity was 92.11%. Conclusion DCE-MRI combined with BI-RADS-MR classification in diagnosis of benign and malignant breast tumors has an important value and can improve diagnosis and differential diagnosis level.

Objective: To investigate the mediating effect of parent-child conflict on paternal phubbing and externalizing behavior problems in children, so as to provide insights into the prevention and interventions of childhood externalizing behavior problems. Methods: The fathers of children at ages of 3 to 6 years were sampled from seven kindergartens in Liaoning Province and one kindergartens in Sichuan Province using a convenience sampling method in June 2021. The Generic Scale of Phubbing, the Parent-child Relationship Scale, and the Strengths and Difficulties Questionnaire in Children were employed. The mediating effect of parent-child conflict on paternal phubbing and externalizing behavior problems in children was examined using a structural-equation model and Bootstrap method. Results: A total of 583 questionnaires were allocated, and 531 valid questionnaires were recovered, with an effective recovery rate of 91.08%. The fathers had a mean age of (34.86±8.39) years, and 172 fathers had an educational level of bachelor degree and above (32.39%) and 285 had a single child (53.67%). Among paternal phubbing questions, the mean scores of nomophobia, interpersonal conflict, self-isolation and problem acknowledgement dimensions were (3.71±1.53), (2.02±1.18), (2.26±1.29) and (3.07±1.38), respectively, and the mean score of parent-child conflict was (2.25±0.82). Among all childhood externalizing behavior questions, the mean scores of conduct and attention deficits/hyperactivity dimensions were (0.31±0.26) and (0.82±0.46), respectively. Paternal phubbing posed an direct positive effect on childhood externalizing behavior problems (β=0.165, P=0.005), and indirectly affected childhood externalizing behavior problems (β=0.449, P<0.001) via parent-child conflict (β=0.358, P<0.001). The mediating effect of father-child conflict was 0.161 (95%CI: 0.104-0.221), and was contributed 49.39% to the total effect. Conclusions Parent-child conflict plays a partial mediating role in the association between paternal phubbing and childhood externalizing behavior problems. Paternal phubbing may directly affect childhood externalizing behavior problems, and may indirectly affect childhood externalizing behavior problems through the positive effect on parent-child conflict.

Objective:To investigate whether the risk of intravesical recurrence increases in patients with upper urinary tract urothelial carcinoma (UUT-UC) and diabetes mellitus (DM) after radical nephroureterectomy (RNU) with bladder cuff excision. Methods:We ret-rospectively analyzed the clinicopathological data of 282 UUT-UC patients with no history of bladder neoplasm and who underwent RNU with bladder cuff excision in the Second Hospital of Tianjin Medical University from January 2005 to December 2013. The recurrence-free survival (RFS) and cancer-specific survival (CSS) were compared between the non-diabetic (233 patients) and diabetic (49 patients) patients. The factors influencing intravesical recurrence in patients with UUT-UC after RNU were analyzed. These factors included age, DM, pathologic grade, and stage. Results:Among the 282 patients included in the study, 80 (28.4%) patients developed intravesical recurrence during the median fol ow up of 41 months, and the median time to recurrence was 11 months. Non-diabetic patients had a significantly longer duration of bladder neoplasm RFS than diabetic patients (P=0.013). Multivariate analysis using Cox's regression model indicated that DM (P=0.014), renal pelvis and ureter tumor (P=0.001), and postoperative chemotherapy (P=0.024) were independent influential factors for intravesical recurrence in patients with UUT-UC after RNU with bladder cuff excision. Conclusion:DM posed an increased risk for intravesical recurrence after RNU with bladder cuff excision in patients with UUT-UC. Therefore, these patients need to be closely monitored, and their blood glucose must be controlled.

Objective To establish an animal model of crush syndrome in rabbits and investigate the preventive effect of negative pressure drainage.Methods Twenty-four New Zealand rabbits were randomly divided into four groups:control group,traditional treatment group,negative-pressure treatment group and mixed treatment group,with six rabbits per group.Blood urea nitrogen (BUN),creatinine (Cr),K,creatine kinase (CK) and myoglobin (Myo) were detected before crush and at 6,12,24,48,72 hours after decompression.Edema and analgesia of extremities were determined and changes of kidney and muscular tissue were observed by light microscope.Results As time went on,K,Myo,BUN and CR had unobvious rise in each treatment group,without the presence of renal failure.The control group showed marvelous increases of K,Myo,BUN and Cr at 6 hours after decompression,from (4.61 ±0.98)mmol/L,(4.22±0.93) ng/ml,(7.76±1.40) mmol/L,(101.32±9.35)μmol/Lto (7.88±1.95)mmol/L,(11.34 ±3.86) ng/ml,(15.91 ± 1.76) mmol/L,(258.32 ±91.40) μmol/L separately,with renal failure and significant differences in comparison with other treatment group (P ＜0.05).The level of tissue edema and degree of analgesia in negative-pressure treatment group and mixed treatment group were lower than those in the traditional treatment group.Renal damage in all the treatment groups was milder than that in the control group by light microscopic observation,while there was no significant difference of muscle injury among groups.Conclusion Negative pressure drainage may prevent crush syndrome.

Objective To evaluate the effect of transforming growth factor-β (TGF-β) on the expressions of epithelial-to-mesenchymal transition (EMT)-related molecules in human A431 epidermal squamous cell carcinoma cells.Methods Cultured A431 cells were classified into two groups:TGF-β group treated with TGF-β of 7.5 μg/L for 72 hours,and control group remaining untreated.Subsequently,cell morphology was observed under an inverted microscope,and real time-PCR and Western blot were performed to quantify the mRNA and protein expressions of EMT-related molecules including E-cadherin,N-cadherin,vimentin and β-catenin respectively.Results After TGF-β treatment,the cells became dispersed and spindle in shape.The mRNA expression levels of E-cadherin,Ncadherin,vimentin,and β-catenin in TGF-β group were 0.317,2.475,11.340 and 2.615 folds those in the control group respectively.Western blot showed a marked increase in the expression of N-cadherin,vimentin,and β-catenin proteins but a notable decrease in that of E-cadherin in the TGF-β group compared with the control group.Conclusions TGF-β can induce EMT in A431 cells,and increased expression of TGF-β may contribute to the invasion and metastasis of SCC.

Objective To investigate the MRI findings of recurrent supurative colangitis complicated by intrahepatic cholangiocarcinoma and clinical diagnostic value.Methods 264 patients with recurrent suppurative cholangitis who were admitted into the hospital during June 2010 to July 2014 were selected as the research objects.All of the patients were given magnetic resonance imaging(MRI)and surgical pathological examination or biopsy.The Resultsof surgical pathological examination certified that there 43 patients(52 lesions)complicated by intrahepatic cholangiocarcinoma.The results of pathological examination were taken as the golden standard to evaluate the accuracy, specificity and sensitivity of MRI in the clinical diagnosis of recurrent supurative colangitis complicated by intrahepatic cholangiocarcinoma.The MRI findings were analuzed.ResultsAmong the 264 patients with recurrent supurative cholangitis in this group, there were 43 patients(52 lesions)with complicated intrahepatic cholangiocarcinoma confirmed by surgical pathological examination or biopsy, accounting for 16.3% of total number of subjects;MRI results showed that 218 cases were true negative, 41 cases true positive, 2 cases false negative and 3 cases false positive.The diagnostic sensitivity was 95.3%(41/43), specificity 98.6%(218/221)and the accuracy 98.1%(259/264).Conclusion MRI in the diagnosis of recurrent supurative cholangitis complicated by intrahepatic cholangiocarcinoma is of higher accuracy, sensitivity and specificity.MRI findings are obvious.It is worthy of clinical promotion.