Objective To observe the feasibility of phase-rectified signal averaging applied for the evaluation of automatic nervous system activity in general anesthesia.Methods Forty-seven fe-males and 63 males aged 18-65 years,ASA falling into category Ⅰ or Ⅱ,scheduled for oral maxillo-facial surgery under general anesthesia were selected.The heart rate variability(HRV)signal was re-corded by Powerlab throughout the operation,and then it was sectioned into three segments with 5 minutes:pre-anesthesia(T0 ),means the waking state before the operation;intra-anesthesia(T1 ),the period of operation in 25-30 min;post-anesthesia(T2 ),the consciousness recovery state in the end of the operation.All indicators of HRV analysis was calculated in the time domain.SpO 2 ,MAP and BIS were recorded synchronously in the three periods.Results Compared with T0 ,DC, RMSSD, SDNN,SD1,SD2,logTP,logLF,logHF were significantly lower at T1 and T2 (P <0.05).In con-trast to T1 ,HR,MAP and BIS were significantly higher at T2 (P <0.05 ),DC,RMSSD,SDNN, SD1,SD2,logTP,logLF,logHF were significantly increased at T2 (P <0.05 ).There was positive relation between DC and RMSSD,SD1,logHF (r =0.905,0.909,0.932,respectively,P <0.01). Conclusion As 5 min-DC could indicate the character of PRSA,especially its specificity in showing vagus nerves activities,it is feasible that DC is used to observe the autonomic nerve activity intra op-eration.

Objective To study the relationships between serum matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of matrix metal]oproteinase-2 (TIMP-2) with bone metabolic markers and bone mineral density (BMD) in postmenopausal Chinese women.Methods In this study,192 postmenopausal Chinese females aged 48-65 were selected.Serum MMP-2,TIMP-2,bone alkaline phosphatase (BAP),osteocalcin,bone cross-linked C-telopeptides of typeⅠcollagen (CTx) and urine bone cross-linked N-telopeptides of typeⅠcollagen (NTx) were measured by ELISA.And the ratio of MMP-2/TIMP-2 was calculated.BMD was measured by dual energy X- ray abserptiometry.According to the criteria of WHO,these women were assigned to 3 groups : the normal,the low BMD and the osteoporosis groups.Results (1) Serum MMP-2 level was significantly higher in postmenopausal women with osteoporosis (1388?121)?g/L than that in age-matched normal controls (1126?141)?g/L (P0.05).(2) Notable negative relations were found between MMP-2,ratio of MMP-2/TIMP-2 with BMD of lumbar spine and Ward's triangle,serum BAP and osteocalcin (all P0.05).(3) In osteoporosis women,notable negative correlations between MMP-2,ratio of MMP-2/TIMP-2 with BMD of lumbar spine,femoral neck and Ward's triangle,serum BAP and osteocalcin were found (all P

Objective:To compare the application value of clavicular hook plate fixation versus clavicular hook plate fixation combined with suture anchor technique in the treatment of acromioclavicular joint dislocation. Methods:Sixty-eight patients with acromioclavicular joint dislocation who received treatment in Zhoushan Hospital of Traditional Chinese Medicine, China between July 2015 and February 2018 were included in this study. They were randomly assigned to receive clavicular hook plate fixation combined with suture anchor technique (observation group, n = 34) or clavicular hook plate fixation (control group, n = 34). Surgical efficacy was determined in each group and the incidence of complications was compared between the observation and control groups. Results:The excellent and good rate of surgical efficacy in the observation group was significantly higher than that in the control group [97.06% (33/34) vs. 76.47% (26/34), χ2 = 6.275, P < 0.05]. The operation time in the observation group was significantly longer than that in the control group [(55.41 ± 9.28) min vs. (45.69 ± 12.54) min, t = 3.633, P < 0.05]. The incidence rate of complications in the observation group was significantly lower than that in the control group [2.94% (1/34) vs. 20.59% (7/34), χ2 = 5.100, P < 0.05]. Conclusion:Clavicular hook plate fixation combined with suture anchor technique for the treatment of acromioclavicular joint dislocation can achieve ideal curative effects. This surgical method has the features including simple operation, little trauma, few complications, and firm fixation. Its surgical efficacy is more superior to that of clavicular hook plate fixation.

After the tissue injuries appear,bone marrow mesenohymal stem cells(MSCs)migrate to the lesion place against the chemokine concentration gradient and produce natural compensatory repair by differentiation of the injured cells,immunological regulation and paracrine of various cytokines,such as hepatocyte growth factor(HGF).HGF is one of the important chemokine factors of MSCs.It can inhibit proliferation of MSCs and induce MSCs into hepatocytes and epithelial cells.However,the mechanisms of MSCs on the injured tissue repairing are complicated,and the underlying mechanism consists of homing to the injured lesion,correct oriented differentiation of local micrcenvironment and in inhibition on the host immunity.With the deeperresearch,the mechanism of reparative process MSCs acting on damaged tissue will be elucidated gradually.It may be helpful for the instruction of the clinical treatment to engraft MSCs which are modified with effective genes and to enhance the ability of ceil engraftment.

Objective To explore the clinical situation of ankle arthroscopic surgery combined with sodium hyaluronate in the treatment of osteochondral lesions of the talus.Methods 40 cases of osteochondral lesions of the talus were treated in our hospital from June 2014 to October 2016 were treated with ankle arthroscopic surgery combined with sodium hyaluronate,the situation after the treatment were observed, and according to the patient's rehabilitation the rehabilitation exercises were conducted according to the patient's condition, and the therapeutic effect was analyzed.Results The total effective rate was 87.5%;The mean value of ankle function score before treatment was(34.26±2.13)points,the mean value of ankle function score after treatment was(74.35±2.07)points, the difference was statistically significant before and after treatment(P<0.05).Conclusion The clinical observation of ankle arthroscopic surgery combined with sodium hyaluronate in the treatment of osteochondral lesions of the talus, the treatment effect is better, and can help the patient's ankle joint function get improve, and ultimately improve the prognosis, it is worthy of reference.

Objective To explore the correlation between the prealbumin synthetic rate and liver function damage in patients with liver cirrhosis resulted from hepatitis. Methods The prealbumin synthetic rate was measured using isotope tracer technique of 15 N-lysine injected by intravenous followed by intravenous drop at constant rate in 23 patients with liver cirrhosis and 12 healthy subjects. Results Prealbumin synthetic rate in the patients decreased significantly than that in normal control(P

Objective To compare the therapeutic effects of cordyceps sinesis (CS) and reduced glutathione on experimental non-alcoholic fatty liver disease (NAFLD) rats and explore the possible molecular mechanisms. Methods After NAFLD rats were induced by high-fat diet and were treated by CS and reduced glutathione. The histopathologic changes of livers were evaluated. The levels of TG and FFA in serum and liver were measured. The levels of SOD and ATP in liver were measured too. Results (1)In the development of NAFLD, extensive adipose degeneration, inflammatory cell infiltration and necrosis, local fibrous tissue hyperplasia were found in the liver. The increase of TG, FFA in the serum and liver and decrease of SOD and ATP in the liver were seen. (2)In CS treated group, adipose degeneration had been alleviated with slightly inflammatory cells infiltration and no necrosis or fibrosis had been found. The concentrations of TG and FFA were decreased in the serum and liver, but SOD and ATP increased. (3)In glutathione treated group, adipose degeneration of liver and inflammatory cells infiltration remained obviously with focus or punctiform necrosis, but without fibrosis. The increase of SOD in liver was distinguished. No changes of TG, FFA, UCP-2 and ATP had been detected. Conclusion Both CS and reduced glutathione have therapeutic effects on NAFLD, by preventing the generation of liver fibrosis. CS has a better therapeutic effects on metabolic disturbance or accumulation of lipid and energy metabolic imbalance of liver cells.

Objective:To investigate the possible roles of the negative co-stimulation molecule PD-L(ligand) in the T-cell mediated immune response against tumor.Methods:Flow cytometric analysis was used to examine murine tumor cell line L929 expresses PD-L(L1 and L2).Anti-PD-L blocking monoclonal antibodies combined with injection i.p.of irradiated L929 into C57BL/6 mice was employed to sensitize the T cells of the animals.2 weeks after sensitization,mice were sacrificed,and splenocytes were prepared to perform the examinations of T cell proliferation,cytotoxic T cells(CTL) activity,and apoptosis through in vitro coculture with L929 in the presence of blocking PD-L antibodies.Results:The expression of PD-L1 by L929 was detectable,whereas there was no expression of PD-L2 on these cells.Application of blocking antibody against PD-L1 or PD-L2 together with irradiated L929 cells in the process of in vivo sensitization as well as in vitro stimulation,it was shown that blockade of PD-L1 significantly enhanced the T cell proliferation induced by L929 cells and the CTL activity against L929,evidenced by the increased apoptosis and death rate of L929 cells.In control,blockade of PD-L2 had small effects on these terms.Conclusion:The negative co-stimulation molecule PD-L1 plays a role in the escape of tumor cells from host T-cell mediated tumor immunity.Therefore,blockade of PD-L1 has potential significance for tumor immunotherapy.

Objective To discuss the clinical applied value of MSCT MPR in displaying the relation between periampullary diverticula(PAD) and pancreaticobiliary duct.Methods There were 32 patients with PAD found through the volume scans by MSCT, and proved by endosope or GI. The axial source images after being reconstructed were transmitted to Vitrea workstation for observation, and the images which were valid to show the relation between PAD and pancreaticobiliary duct were get.Results In 32 patient,34 PADs were found,22PADs located above the papilla , 7 located in the neck edge of diverticula , 4 were papilla in diverticula and 1 located below papilla .Conclusion MPR can clearly display PAD and pancreaticobiliary duct, their relation and pancreaticobiliary disease.

To improve class teaching quality,we must concentrate on the leading factor: teacher,the key factor: design,and the subjective factor: students.