Objective To explore the influence of different anesthetics on emergence agitation (EA) after general anesthesia. Methods 134 EA patients after general anesthesia were randomly divided into three groups. Group A (n=42), Group B (n=45) and Group C (n=47) was given intravenously parecoxib 40 mg, butorphanol 20μg/kg and tramadol 1 mg/kg, respectively. The improvement of agitation, VAS score and Ramsay score were compared and analyzed among the groups. Results After treatment, the degree of EA in Group A, Group B was significantly lower than that in Group C ( <0.05) . VAS score in all the cases was reduced, and Ramsay score was increased compared with that before treatment ( <0.05) . VAS score in Group C was significantly higher than that in Group A, Group B (<0.05) . Ramsay score in Group B was significantly higher than that in Group A, Group C (<0.05) . After treatment, awaking time and postanesthesia care unit (PACU) stay in Group B was significantly higher than that in Group A, Group C (<0.05) .Conclusions Parecoxib is safe and effective for EA after general anesthesia, it can effectively improve the degree of EA, increase postoperative sedative effect, and shorten PACU stay.

Objective To compare the clinical effects of surgical treatment and ultrasonic guidance percutaneous radiofrequency ablation(PRFA) therapy in the treatment of liver cancer.Methods 78 patiens with live cancer were randomly divided into the operation group and PRFA group,each group had 39 patients.The operation group was treated with traditional open surgery,the PRFA group was treated with radiofrequency ablation.The clinical effect was compared between the two groups.Results All patients were followed up after therapy,the 1,2,3-year survival rate between operation group and PRFA group had no significant differences (all P ＞ 0.05),but in the patients whose tumor were central type and samller than 3cm,the 1,2,3-year survival rate of PRFA group were significantly higher than operation group(x2 =4.819,4.815,4.919,all P ＜ 0.05).Conclusion Ultrasonic guidance percutaneous radiofrequency ablation therapy in the treatment of liver tumor is effective,and the effect is better than operation group,especially for the patients with central type tumor and the tumor samller than 3cm.

Objective To investigate the possible origin and role of follistatin (FS) in pregnancy Methods The maternal serum FS levels in menstrual cycle, first trimester (8～12 weeks) and term (38～41 weeks) were determined by a specific two site enzyme linked immunosorbent assay (ELISA). Reverse transcription polymerase chain reaction (RT PCR) method was utilized to semi quantitatively determine FS mRNA levels in the ovaries and placentas Results Maternal serum FS level at term was significantly higher than that in the first trimester of pregnancy and that in normal women during the menstrual cycle(180?26)?g/L ,(4.4?2.1)?g/L, (1.5?2.2)?g/L , (respectively P

Objective To compare the effects of cobalt chloride (CoCl2) induced chemical hypoxia and hypoxia environment on the proliferation,migration and phenotype transformation of rat primary pulmonary artery fibroblasts (PAFs).Methods Primary PAFs were isolated and cultured.Cells were stimulated by CoCl2,or hypoxia cell culture (1% O2) was used to stimulate and induce PAFs.Then the effects of CoCI2 and hypoxia environment on PAFs were compared by CCK-8 assay,scratch assay,transwell assay,phenotype marker protein expression and PI3K/Akt signaling pathway protein expression.Results Compared with the control group,100 μmol/mL CoCl2 stimulation had no significant effect on the cell proliferation activity,cell migration ability and phenotype transformation ability of PAFs (P>0.05);while 1% O2 could significantly improve the cell proliferation and migration activities of PAFs as well as the upregulation of α-SMA expression (P<0.05).Conclusion There exist differences of effects between CoCl2 induced chemical hypoxia and hypoxia environment on promoting cell proliferation, cell migration and phenotype transformation in PAFs.

Objective To evaluate the changes in sagittal profiles and complications during treatment with growing rods (GRs) in hyperkyphotic early-onset scoliosis (EOS).Methods From December 2009 to December 2016,a total of 32 EOS patients who received growing rods treatment in our center,including 8 males and 24 females,were reviewed retrospectively.All the patients had minimum 2-year follow-up and over 2 lengthenings.Based on the reference value of thoracic kyphosis (TK) in T2-12 of normal children,the patients were categorized into an N group (20°≤TK≤50°,15 cases,4 males and 11 females) or K group (TK≥50°,17 cases,4 males and 13 females).The distribution of etiology was similar between the two groups.The average age was (6.2±2.0) years and (6.3±2.3) years respectively,curve flexibility was 34.6％± 10.4％ and 35.8％± 11.2％ before surgery.The precontoured rods were tunneled submuscularly,connecting proximal and distal anchors,and tandem or domino connectors.The rods were then locked after applying direct distraction that allowed appropriate elongation.The connectors were all placed under the deep fascia.Results The mean follow-up in the N and K groups was (5.5±1.9) years and (5.5±2.1) years,respectively.The distribution of proximal and distal anchors was similar between the two groups.The N and K groups,respectively,had an average number of lengthenings of 5.1±2.0 and 5.3±2.3,with mean lengthening intervals of (11.3±2.3) months and (10.9±1.9) months,respectively.In the N group,TK was decreased from 36.0°±9.4° to 30.6°±.8.3° after surgery,and to 32.2°±7.8° at the last follow-up,demonstrating it was maintained within the normal range.In the K group,TK was markedly reduced from 67.6°±11.6° to 41.7°±8.7° after the index surgery,with a correction rate of 38.3％± 14.6％,and the difference was statistically significant.And then it slightly increased to 46.5°±8.4° at the last follow-up,with correction loss of 7.1％±4.2％,and the difference was not statistically significant compared with the postoperatiom.The complication rate in the K group was significantly higher than in the N group (76.5％ vs.33.3％,P=0.031).The most common implant-and alignment-related complication in both groups was rod fracture (15.6％) and proximal junctional kyphosis (21.9％),respectively.The incidence of rod fracture in the N group and K group was 6.7％ and 23.5％,respectively.And the incidence of proximal junctional kyphosis was noted as 13.3％ and 29.4％ in the N group and K group,respectively.Proximal junctional angle (PJA) in the K group was greater than that in the N group preoperatively,postoperatively and at the last follow-up.Moreover,the increasing amount of PJA was significantly greater in the K group compared to the N group (1.6°± 1.0° vs.0.7°±0.8°).Four and seven complication events in the N and K groups,respectively,were evaluated with Grade Ⅰ.Four and seven complication events in the N and K groups,respectively,were classified as Grade Ⅱ A.Conclusion GRs can effectively restore the sagittal profile in hyperkyphotie EOS patients,but with a higher complication rate compared to the patients with normal kyphosis.

China is a high risk region of esophageal cancer in the world,and 95％ of the esophageal cancer is the squamous cell carcinoma.Surgery is the main therapy for esophageal squamous cell carcinoma,however,the efficacy of single surgery for locally advanced esophageal squamous cell carcinoma is unsatisfactory.Compared with postoperative adjuvant treatment,neoadjuvant chemotherapy may reduce tumor volume,increase surgical resectability,eliminate subclinical metastases,prolong survival time and improve prognosis of patients with esophageal squamous cell carcinoma.Through combining recent evidence-based medicine,the authors review research progress of new adjuvant chemotherapy for esophageal squamous cell carcinoma.

Objective To study one male patient with cirrhosis for spironolactone induced gynecomastia and promote clinical pharmacists providing better pharmaceutical cares .Methods Based on the patient′s diseases and medication history , clinical pharmacists searched related literature and analyzed the cause of gynecomastia for the patient .Results The patient′s breast pain was relieved and finally disappeared after termination of spironolactone .Therefore ,spironolactone was suspected to be the drug to cause gynecomastia .Conclusion Clinical pharmacists can improve pharmaceutical cares by carefully monitoring the adverse reactions and selecting appropriate medications .

ObjectiveTo evaluate the diagnostic capability of prenatal ultrasound in diagnosis of fetal akinesia deformation sequence (FADS).MethodsThe prenatal sonographic characteristics of 5 fetuses with FADS were analyzed retrospectively.ResultsBoth multiple joint contractures and central nervous system (CNS) anomalies,which include 5 small head circumferences,2 short cerebellar diameters,and 1 flat forehead,were found by prenatal ultrasound in all 5 FADS fetuses.Additional fetal abnormalities such as micrognathia,polyhydramnios,short umbilical cord and intrauterine growth retardation were also observed.The results of fetal chromosome analysis were available in 2 cases indicating normal karyotype.Conclusions Prenatal identification and diagnosis of FADS is possible based on the findings of sonographic examination.

Objective: To investigate the prevalence of depressive symptoms among junior middle school students in Tianjin, and to explore the association between latent classes of health risk behaviors and depressive symptoms, so as to provide clues for identifying high risk groups of depressive symptoms and a scientific basis for comprehensive intervention measures. Methods: By using a multistage stratified cluster sampling method, 8 175 students in 16 districts of Tianjin were investigated with demographic characteristics, depressive symptoms, and health risk behaviors. Latent class analysis was performed by Mplus 8.3. SPSS 23.0. Results: The prevalence of depressive symptoms among junior high school students in Tianjin was 17.8%,the prevalence of depressive symptoms in urban(19.4%) areas was higher than that in rural areas(16.5%),and that of female students( 20.2 %) was higher than that of male students(15.5%)( χ 2=11.62,30.58, P <0.01). Health risk behaviors were classified into three groups: healthy group (84.0%), poor diet group ( 3.8 %) and multiple risk behaviors group (12.2%). After adjusting for region, grade, gender, and family type, multivariate Logistic regression analysis showed that the poor diet group ( OR=2.82, 95%CI =2.17-3.66) and the multiple risk behaviors group ( OR=4.31, 95%CI =3.67-5.05) had a higher risk of depressive symptoms compared with the healthy group ( P ＜0.01). Conclusion Depressive symptoms are prevalent among junior middle school students in Tianjin. Different latent classes of health risk behaviors have different correlations with depressive symptoms. It is important to ensure early detection and personalized intervention for different types of health risk behavior among junior middle school students to maximize cost effectiveness.

Objective To investigate the feasibility and safety of a novel iliosacral screw placement in adult pelvis by computed tomography(CT).Methods All of 50 adults with normal pelvis,including 25 males and 25 females with the age rang-ing from 28 to 81,were included in this study.The mean age was(51.9±11.7)years.Based on three-dimensional(3D)CT recon-structions of these specimens,virtual iliosacral screw channel was identified and measured.The virtual iliosacral screw channel holding the greatest width and length of osseous channel was measured by rotating the 3D pelvis.Measurements of the determined channels including connector-related parameters(divergent angle,cephalad angle,S1 pedicle width,embedding depth and skin distance)and iliosacral-screw related parameters(convergent angle,caudal angle,iliac length,sacral length,max-length and skin distance).Results There was a virtual channel going through the ilium as well as iliosacral joint and into the sacral in either side of each specimen. The connector-related parameters in males included divergent angle, cephalad angle, S1 pedicle width, embedding depth and skin distance,and they were 28.5°±6.3°,27.9°±5.6°,(22.5±2.4)mm,(18.8±3.1)mm and(52.8±8.4)mm, respectively. In females, they were 26.9°±5.7°, 25.8°±7.2°, (20.4±2.2) mm, (16.9±2.5) mm and (56.3±7.4) mm, respectively. The S1 pedicle width and embedding depth in males were higher than that of females, while the skin distance in females was higher than that of males. The iliosacral-screw related parameters in males included convergent angle, caudal angle, iliac length, sacral length, max-length and skin distance, and they were 61.5°±6.6°, 16.4°±3.2°, (16.6±2.8) mm, (73.0±5.7) mm, (96.8±5.5)mm and(65.0±11.9)mm,respectively.In females,they were 63.1°±5.7°,16.1°±4.8°,(15.1±2.4)mm,(74.0±6.4)mm, (96.8±5.4)mm and(68.0±11.4)mm.The iliac length in males was higher than that of females.Conclusion It is safe and feasi-ble to place iliosacral screw when performing spino-pelvic fixation.Preoperative CT imaging and 3D reconstructions may help to determine correct anchoring point and screw channel individually.