Objective To investigate the efficacy and safety of different doses of dezocine at different administration time on analgesia after laparoscopic cholecystectomy.Methods 80 patients elected from ASA Ⅰ-Ⅱ grade laparoscopic cholecystectomy were randomly divided into four groups,20 cases in each group.Group Ⅰ was anesthetized by intravenously injected dezocine 0.10mg/kg before the surgery,group Ⅱ was anesthetized by dezocine 0.15mg/kg before the surgery,group Ⅲ was anesthetized by intravenously injected dezocine 0.10mg/kg after stopping anesthetic surgery,and group Ⅳ was anesthetized by intravenously injected dezocine 0.15mg/kg after stopping anesthetic surgery.The postoperative pain scores were observed 1,6,12,24 hours after operation in the four groups by using visual analog scale (VAS),comfort score (BCS),and anesthesia recovery score (modified Aldrete score).Results TheVAS of the four groups 1 hour after surgery:group Ⅰ and group Ⅲ was significantly different(t =2.308,P =0.036),group Ⅰ and group Ⅳ was significantly different (t =2.106,P =0.042),group Ⅱ and group Ⅲ was significantly different (t =2.711,P =0.014),group Ⅱ and group Ⅳ was significantly different (t =2.317,P =0.037).The BCS 1 hour after surgery:group Ⅰ and group Ⅲ was significantly different(t =2.108,P =0.042),group Ⅰ and group Ⅳ was significantly different(t =2.069,P =0.048),group Ⅱ and group Ⅲ was significantly different (t =2.353,P =0.033),group Ⅱ and group Ⅳ was significantly different (t =2.361,P =0.036).The VAS 6 hours after surgery:group Ⅰ and group Ⅲ was significantly different (t =2.084,P =0.045),group Ⅱ and group Ⅲ was significantly different(t =2.309,P =0.038),group Ⅱ and group Ⅳ was significantly different(t =2.303,P =0.040).The BCS 6 hours after surgery:group Ⅰ and group Ⅲ was significantly different (t =2.294,P =0.041),group Ⅱ and group Ⅲ was significantly different(t =2.322,P =0.035),group Ⅱ and group Ⅳ was significantly different (t =2.070,P =0.048).The BCS 12 hours after surgery:group Ⅱ and group Ⅲ was significantly different(t =2.518,P =0.047).VAS and BCS scores at other time points had no significant difference (P ＞ 0.05).Conclusion The analgesic after laparoscopic gallbladder surgery using dezocine 0.10mg/kg-0.15mg/kg,especially 0.15mg/kg administered anesthesia before surgery,can effectively relieve postoperative pain and improve postoperative comfort,reduce postoperative analgesic(pain pump) and has less adverse reactions,which is worthy of promotion.

BACKGROUND: 5-fluorouracil (5-Fu) is universally used as an antineoplastic agent in gastrointestinal cancer, but the side effect of it confined further clinical application. OBJECTIVE: To determinate mice plasma concentration curves for 5-Fu and its chitosan (CS)-polyaspartic acid (Pasp) nanoparticles, and to investigate their primary pharrnacokinetics. DESIGN, TIME AND SETTING: Randomization control animal trials were performed in the Department of Gastroenterology, Zhongshan Hospital of Fudan University between October 2006 and June 2007. MATERIALS: Totally 180 female Kunming mice were obtained from the Department of Laboratory Animal, Fudan University. 5-Fu (purity 99%) was purchased from Shanghai Xudong Haipu Pharmaceutical Co, Ltd (Shanghai, China). Two kinds of CS-Pasp-5-Fu particles were offered by Department of Macromolecular Science, Key Laboratory of Molecular Engineering of Polymers of Educational Ministry, Fudan University (Shanghai, China). METHODS: Kunming mice were randomly divided into three groups and each group was administrated with 5-Fu or either type of its CS-Pasp-5-Fu nanoparticlos. The plasma concentrations of 5-Fu were evaluated by high performance liquid chromatography after 15 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 8 hours, 12 hours, 16 hours, 24 hours and 48 hours of the administration. The pharmacokinetic parameters were computed utilizing 3P97. MAIN OUTCOME MEASURES: Relative recovery, absolute recovery and the stability of samples. RESULTS: The peak concentration of 5-Fu group occurred within 15 minutes and then decreased rapidly. The No.1 nanoparticles group's peak concentration occurred 6 hours after the administration and the effective concentration time lasted for about 14 hours. No.2 nanoparticles group's concentration curve was double-apex, the apexes occurred around the 2 hours and 16 hours, the concentration decreased at the 24 hours after the administration. Both of the two kinds of the nanoparticles groups' peak concentration of 5-Fu in plasma are lower than the 5-Fu group, The half-life times were prolonged and the areas under curve were higher. CONCLUSION: Compared to 5-Fu, the CS-Pasp-5-Fu nanoparticles are controlled released.

OBJECTIVE: To analyze the changes of finger skin temperature in cold provocation test( CPT) in workers with vibration white finger( VWF). METHODS: A total of 245 male workers engaged in hand arm vibration operation was selected as study subjects using random number table method. All subjects were divided into VWF group( 73 persons) and control group( 172 persons). CPT( 10 ℃,10 min) was performed and the skin temperature of 6 fingers( index finger,middle finger and ring finger of both hands) was measured at pre-CPT adaptation period( 0,10,20,30 min) and after CPT period( 0,5,10,15,20,25,30 min). RESULTS: The effect of interaction between grouping and observe time was statistically significant on finger skin temperature( P < 0. 01). In the pre-CPT adaptation period,there was no statistically significant difference on skin temperature between 10 and 30 min time point in the two groups( P > 0. 05). After CPT,the fingers skin temperature of VWF group was lower than that of control group at 5 min time point( P < 0. 05),but there were no statistically significant differences on fingers skin temperature of other time points between the two groups( P > 0. 05).In both groups,the finger skin temperature at 0 min time point after CPT were lower than other time points in the same group( P < 0. 05),and the finger skin temperature increased with time( P < 0. 01). However,the finger skin temperature at 30 min after CPT did not restore to that at 30 min time point of pre-CPT. Except the VWF group,the abnormal rewarming temperature at 5 min time point after CPT of left index finger,the right index finger and the right ring finger were higher than that of the control group( 72. 6% vs 56. 4%,75. 3% vs 57. 6%,86. 3% vs 65. 1%,P < 0. 05),but there were no statistically significant differences on the abnormal rewarming temperature at 10,30 min time points of the six fingers in the two groups( P > 0. 05). There were no statistically significant differences on the detection rate of abnormal rewarming temperature between left index finger and the right index finger,or the right index finger and the right ring finger in the VWF group( 72. 6% vs 75. 3%,75. 3% vs 86. 3%,P > 0. 05). CONCLUSION: When CPT( 10 ℃,10 min) was performed in workers engaged in hand arm vibration operation,it is recommended to measure the finger skin temperature of index finger,and adaptation time before CPT can be adjusted to 10 min.

Objective To analyze the genotype-phenotype correlation in 5 families with congenital ectopia lentis (CEL) accompanied with cardiovascular abnormal manifestation.Methods Detailed clinical data of 15 family members in 5 families were collected from August 2017 to March 2018 in Zhongshan Ophthalmic Center,including examination of the condition of lens before and after mydriasis by slit-lamp,evaluation of the cardiovascular system using transthoracic echocardiography,and evaluation of the degree of involvement of the subjects' skeletal system using X-ray images.Genomic DNAs were extracted from whole blood sample of the 5 probands and 10 relatives,and screened for FBN1 mutation by targeted exome sequencing.The possible genotype-phenotype correlation was analyzed by reviewing previous literatures into these mutation sites.The study followed the principles of the Helsinki Declaration and written informed consent was obtained from each subject prior to any examination.Results All of the five probands were diagnosed as CEL accompanied with cardiovascular abnormal manifestation.FBN1 gene mutations were identified in all of the five probands,including four missense mutations (c.2741G＞T,c.2585G＞T,c.1633C＞T,c.4260C＞G) and one splicing mutation (c.2114-1G＞C).It was predicted that all of the 5 mutations would alter the protein structure.Conclusions FBN1 gene has a high degree of clinical heterogeneity,and the early detection of ocular phenotypes combined with genetic screening is of great significance in the diagnosis of cardiovascular abnormalities.

Background Hand arm vibration disease (HAVD) is one of the legal occupational diseases in China, and its pathogenesis is not clear. Operators exposed to electric vibration tools for a long time have an increased risk of HAVD. Objective To conduct a systematic evaluation of the effects of vibration operations on workers' upper limb nerves, blood vessels, and muscles. Methods Relevant studies on the effects of hand-transmitted vibration on HAVD were searched and collected from the China Knowledge Infrastructure, Wanfang, and PubMed databases, and the literature was published from January 1974 to April 2021. The quality of cohort and case-control studies was assessed by the Newcastle-Ottawa Scale (NOS), and the quality of cross-sectional studies was by the evaluation criteria recommended by the Agency for Healthcare Quality and Research (AHRQ). Statistical analyses of outcome indicators (OR) in the included literature were performed using RevMan 5.4.1 software, effect sizes in the literature on vibration-induced white finger and neurosensory impairment were combined using a random-effect model, those that included carpal tunnel syndrome were combined using a fixed-effect model, and subgroup and publication bias analyses were also performed. To explore sources of study heterogeneity, meta-regression was performed using Stata 16.0 software, and sensitivity analyses were performed on the included literature. Results A total of 716 papers were retrieved from the databases, and 18 articles were retrieved by manual searching. A total of 34 papers were included after excluding those not meeting the criteria. Of the papers, 11004, 7270, and 1722 subjects related to vibration-induced white finger, neurosensory impairment, and carpal tunnel syndrome, respectively. The results of meta-analysis showed that compared with the control group, the combined ORs of hand-transmitted vibration exposure were 4.25 (95%CI: 2.72−6.65) for vibration-induced white finger, 4.03 (95%CI: 2.46−6.61) for neurosensory impairment, and 2.44 (95%CI: 1.61−3.71) for carpal tunnel syndrome. Heterogeneity was identified in the original studies related to vibration-induced white finger (I²=81%, P < 0.001) and neurosensory impairment (I²=90%, P < 0.001), except carpal tunnel syndrome (I²=23%, P < 0.001). The results of sensitivity analysis showed that the combined effect sizes (ORs) were stable and reliable. The results of meta-regression showed that the factors contributing to high heterogeneity of combined vibration-induced white finger and neurosensory impairment were time of publication (t=−2.10, P=0.049) and working age (t=−2.40, P=0.032), respectively. Conclusion Hand-transmitted vibration is a risk factor for vibration-induced white finger, neurosensory impairment, and carpal tunnel syndrome in operators.