Objective To explore the efficacy and the safety of oxycodone hydrochloride injection in the induction and maintenance of general anesthesia in breast cancer patients.Methods A total of 200 female patients,aged 25-65 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective breast-conservative surgery,were randomly divided into 2 groups (n=100 each): oxycodone hydrochloride group (group O) and sufentanil group (group S).Oxycodone 0.2 mg/kg (group O) or sufentanil 0.2 μg/kg (group S) with propofol 2 mg/kg and cisatracurium 0.15 mg/kg were administered intravenously for general anesthesia induction.Propofol target-controlled infusion combined with remifentanil were used for maintenance of general anesthesia during the operation.Anesthesia time,awake time,extubation time,total consumption of propofol and remifentanil were recorded.The adverse events and VAS scores after surgery were observed.Results There was no significant difference between groups in anesthesia time,awake time,extubation time,consumption of propofol and remifentanil.Compared with group S,group O had lower VAS score at 2 h after surgery (P<0.05),but with no significant difference at other time points.There was no significant difference at the incidence of moderate pain between group.The incidence of dizziness was 18% in both groups.The incidence of nausea was 11 (11%) in group S and 9 (9%) in group O with no significant difference.Conclusion Taken together,oxycodone hydrochloride used for general anesthesia in breast cancer patient is practicable.

Objective To analyze the MRI characteristics of vestibulocochlea neurovascular compression in patients with vestibular paroxysmia (VP) and to investigate the effect of the compression,its site and degree,on the occurrence of VP.Methods Twenty-eight cases of VP (VP group) and 28 cases of vertiginous patients other than VP (control group) were retrospectively reviewed.Three dimensional magnetic resonance angiography (3D-MRA) was performed and the data were used for neurovascular crosscompression (NVCC) analysis.The frequency and type of NVCC,the origin of the offending vessel and the distance between compression site and brainstem were compared between the two groups.Results The frequency of NVCC was 96.4％ (27/28) in VP group,with a significant difference compared with control group (13/28,46.4％ ;x2 =17.15,P ＜0.01).The most common NVCC type was vascular loop compression at vestibulocochlear nerve (15/35,42.9％).Anterior inferior cerebellar artery was the most common offending vessel (25/35,71.4％) in VP group.There were no significant differences between the two groups in the type of NVCC or the origin of the offending vessel.The frequency on the distortion and (or) displacement of vestibulocochlear nerve which was severely compressed by vessel in VP group (7/56,12.5％) was significantly higher than that in control group (0; P =0.013).The distance between compression site and brainstem was (8.57 ± 5.08) mm in VP group,and (8.93 ± 4.64) mm in control group,showing no significant difference.The ratio that the distance was less than 15 mm between compression site and brainstem in unilateral NVCC of VP group (100％) was significantly higher than unilateral NVCC of control group (7/10,P =0.033).Conclusions The VP patients have higher NVCC incidence and the most common NVCC type is vascular loop compression at vestibulocochlear nerve which is mainly caused by anterior inferior cerebellar artery.NVCC in VP patients mostly occurs in the central myelin portion of vestibulocochlear nerve.The site and degree of neurovascular compression may relate to the occurrence of VP.

Objective To evaluate the expression of Tc17 in a cigarette smoke-induced mice model of emphysema.To explore the probable mechanisms about how Tc17 cells to elevate in lungs of mice.Methods Forty male Balb/c mice were randomly divided into four groups,including control group ( 12 weeks,C12),control group (24 weeks,C24),smoke-exposure group (12 weeks,S12) and smoke-exposure group (24 weeks,S24 ),10 mice each group,Emphysema of mice was observed by HE pigmentation.Morphological changes were evaluated by mean linear intercepts (Lm) and destructive index (DI).The proportion of CD8+ IL-17 + Tc17,CD8+ IL-17 + CC chemokine receptor type 6 ( CCR6 ) + and 6CCR6 + Tc17 cells in lungs of mice was determined by flow cytometry.The mRNA expressions of retinoidrelated orphan nuclear receptor(RORγt) and IL-17 were evaluated by real-time PCR.The levels of IL-1 β,IL-6,IL-23,transforming growth factor β (TGFβ) and CC chemokine ligand 20 (CCL20) were tested by ELISA.Correlations among these indexes were analyzed.Results Lm and DI were significantly higher in S12 and S24 than in C12 and C24,S24 in particular (t value 4.378-15.188,all P ＜ 0.05).The percentages of Tc17 in S12 and S24[(9.28 ± 1.12)%,( 13.13 ±3.56)%]was significantly increased as compared with that in C12 and C24[(2.40 ±0.60 )%,(2.64 ±0.96 )%],S24 in particular.The mRNA levels of RORγt and IL-17 in S12 and S24 were higher than in C12 and C24,S12 and S24 in particular.There was significant difference (all P ＜0.05 ).The frequency of Tc17 cells had a positive correlation with Lm and DI ( r value were 0.734 and 0.884 respectively,P ＜ 0.01 ).The percentages of CD8+ IL-17 + CCR6 +T cells and CCR6 + Tc17 were significantly elevated in S12 and S24 compared to C12 and C24,S24 in particular (all P ＜ 0.05 ).There was positive correlation between Tc17 cell ratio and CCL20 levels( r =0.899,P ＜0.01 ).The levels of IL-1 β,IL-6,IL-23 and TGFβ in S12 and S24 were significantly increased as compared with that in C12 and C24.There was significant difference (all P ＜0.05).Meanwhile,the frequency of Tc17 cells had a positive correlation with IL-1β,IL-6,IL-23,and TGFβ.Conclusions An up-regulation of proportions Tc17 in lungs of cigarette smoke-induced emphysema mice were detected.The CCR6/CCL20 axis and the increased IL-1β,IL-6,IL-23 and TGFβ probably contributed to this up-regulation.

Objective To evaluate the safety and effective dose of oxycodone hydrochloride in-jection for postoperative analgesia in breast cancer patients undergoing modified radical mastectomy under general anesthesia in a prospective,randomized controlled clinical trial.Methods One hundred fe-male patients at ASAⅠ or Ⅱ,aged 29-69 years,BMI< 30 kg/m2 ,scheduled for elective modified radical mastectomy under general anesthesia,were randomly divided into two groups (n =50):low dose oxycodone hydrochloride injection group (group OL),and high dose oxycodone hydrochloride injection group (group OH).Oxycodone 0.03 mg/kg (group OL)and 0.09 mg/kg (group OH)was intravenous injected 30 mi-nutes before the end of the operation,respectively.Anesthetics usage was terminated when skin was sutured.Pain at rest and during movement was assessed using VAS score at 5 min,0.5,2,4,8,12 and 24 h after extubation of laryngeal mask.Total consumption of analgesic for rescue analgesia in the ward and the adverse events were recorded.Results Compared with group OL,group OH had lower VAS scores,There were significant differences in the VAS scores between groups at 8 and 12 h after surgery (P <0.05).No serious adverse event occurred in each group postoperatively.The most common adverse event was nausea, followed by vomiting and dizziness.There was no significant difference in the incidence of adverse event be-tween the two groups.Conclusion 0.09 mg/kg oxycodone hydrochloride injection is safe and effective in re-ducing pain after breast cancer radical operation.

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Objective To evaluate the efficacy and safety of Carbamazepin (CBZ)compared with Oxcarbazepine (OXC ) therapy for vestibular paroxysmia. Methods Eighty-two patients with vestibular paroxysmia were admitted during June 2013 and June 2017 in this study. According to the agents administered ,all patients were divided into the CBZ group(n＝ 31) ,CBZ+ Betahistine(BMT) group(n＝ 26)and OXC+ BMT group(n＝ 25).The clinical efficacy ,frequency ,vertigo and adverse reactions of three groups were compared after 3 months follow-up. Results In CBZ group ,14 cases were cured ,13 were improved ,and the effective rate was 87.1%.In CBZ+BMT group ,18 cases were cured ,7 were recovered ,and the effective rate was 96.2%.In OXC+BMT group ,15 cases were cured , 8 cases were recovered ,and the effective rate was 92.0% . There was no significantly difference in effective rate among the three groups(χ2＝0.783 ,P＝0.129).Meanwhile ,the CBZ+BMT group had the lowest frequency of vestibular paroxysmia and vertigo degree ,while the CBZ group was the highest ;the difference in the frequency and vertigo degree between groups was statistically significant (P＜ 0.05).Furthermore ,the incidences of side-effects were 51.6%(n＝ 16) ,30.8%(n ＝ 8)and 16.0%(n＝4)in the CBZ group ,CBZ+BMT group and OXC+BMT group ,respectively. Conclusions The effect of Carbamazepine and Oxcarbazepine for vestibular paroxysmia is similar ,and is safely and significantly improved when combined with Betahistine.

OBJECTIVE To investigate the effects of catalpol on H2O2-induced osteoblast injury and its mechanism. METHODS The osteoblasts MC3T3-E1 were separated into control group， model group， empty group （transfected with empty plasmid）， catalpol group （100 μmol/L）， catalpol+forkhead box O3 （FoxO3） overexpression group （100 μmol/L catalpol+ transfected with FoxO3 overexpression plasmid）. After catalpol treatment and transfection， except for control group， other groups were induced with H2O2 to establish osteoblast oxidative stress model. The cell viability， apoptotic rate， alkaline phosphatase （ALP） activity， optical density （OD） value of calcium nodule， mean fluorescence intensity （MFI） of reactive oxygen species （ROS）， antioxidant enzyme activity [superoxide dismutase （SOD）， catalase （CAT）]， the levels of inflammatory factors [interleukin-6 （IL-6）， IL-1β]， and the expressions of FoxO3/Wnt/β-catenin signaling pathway-related proteins were detected in each group. RESULTS Compared with the control group， the cell viability， ALP activity， OD value of calcium nodule， activities of antioxidant enzyme， and the protein expressions of Wnt and β-catenin were decreased significantly in the model group， while apoptotic rate， MFI levels of ROS， inflammatory factor levels and the protein expression of FoxO3 were all increased significantly （P＜0.05）. Compared with the model group， above indicators of the empty group had no significant change （P＞0.05）， while those of catalpol group were reversed significantly （P＜0.05）. Compared with the catalpol group， the reversal effect of the changes in the above indicators was significantly weakened in the catalpol+FoxO3 overexpression group cells （P＜0.05）. CONCLUSIONS Catalpol can activate Wnt/β-catenin signaling pathway by down-regulating FoxO3， thereby inhibiting H2O2-induced MC3T3-E1 oxidative stress and inflammation reaction， enhancing cell viability and osteogenic differentiation activity， and alleviating apoptosis injury.

ObjectiveTo determine the trend and influencing factors of HIV subtypes in newly reported HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture） from 2017 to 2019. MethodsRNA extraction was conducted among newly reported HIV/AIDS cases in Dehong Prefecture from 2017 to 2019 whose plasma volume was more than 200 μL. The gag， env and pol genes were amplified by using RT-PCR and then sequenced to determine the subtypes. ResultsA total of 3 287 HIV-infected cases were newly reported in Dehong from 2017 to 2019. The HIV gag， env and pol genotypes were determined in 1 813 cases. The major subtypes were subtype C （28.4%，515/1 813）， recombination form BC （22.0%，398/1 813） and CRF_01AE （18.1%，329/1 813）. Furthermore， the proportion of subtype B， subtype C and CRF01_AE decreased over years， whereas 01/BC， CRF07_BC and CRF08_BC increased over years in both Chinese and Burmese patients （χ²=75.212，P<0.001）. There were significant differences in gender， age， marital status， ethnicity， educational level and transmission route among Chinese and Burmese HIV-infected cases with diverse HIV genotypes （all P<0.05）. ConclusionHIV subtypes in Dehong change over time， which demonstrates that the proportion of BC recombinant subtypes and unique recombinant subtypes increased significantly.