Objective To evaluate the effect of neoadjuvant chemotherapy factor on neuromuscular block induced by cisatracurium in the patients undergoing radical gastrectomy.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 48-79 yr,with body mass index of 20-27 kg/m2,scheduled for elective laparoscopic radical gastrectomy,were divided into 2 groups (n =30each) according to whether the patient received neoadjuvant chemotherapy before operation or not:nonchemotherapy group (group A) and neoadjuvent chemotherapy group (group B).Anesthesia was induced with cisatracurium 0.15 mg/kg (3×ED95) injected intravenously.When T1 recovered to 10％ of control height,Ⅳ infusion of cisatracurium was started with an initial dose of 1.5 μg · kg-1 · min 1,and the infusion rate was adjusted with the amplitude of 0.2 μg · kg 1 · min-1 to maintain T1 at 5％-10％ of control height.The onset time,nonresponse time,time for T1 to recover to 10％,recovery index and time for train of four ratio to recover to 90％ were recorded.The consumption of cisatracurium was continuously recorded event 30 min starting from Ⅳ infusion of cisatracurium for 3 times,90 min in total.The mean infusion rate within 90 min was calculated.Results Compared with group A,the onset time,recovery index and time for train of four ratio to recover to 90％ were significantly prolonged,the nonresponse time and time for T1 to recover to 10％ were shortened,and the consumption of cisatracurium and mean infusion rate were increased in group B (P＜0.05).Conclusion Neoadjuvant chemotherapy factor can weaken neuromuscular block induced by cisatracurium in the patients undergoing radical gastrectomy.

Objective To evaluate the safety and efficacy of 125I radioactive seeds implantation combined with postoperative chemotherapy as a treatment option for thoracic advanced esophageal squamous cell carcinoma(ESCC). Methods A prospective cohort study was carried out between 2000and 2005. According to preoperative CT staging criteria,298 patients in phase Ⅱ-Ⅲ of ESCC, who had were admitted to Oncology Center Surgery of Nanjing First Hospital Affiliated to Nanjing Medical University and Thoracic Surgery of YanCheng Oncology Hospital, were randomly divided into three groups: intraoperative 125I seeds implantation combined with postoperative chemotherapy (group A, 98cases), postoperative chemoradiotherapy (group B, 100 cases) and surgery alone (group C, 100cases). All patients received radical resection of esophageal cancer. According to pTNM staging criteria after operation, 233 patients in phase Ⅱb-Ⅲ of ESCC were finally enrolled in the study (78 in group A, 75 in group B, and 80 in group C). With 0. 5 m Ci of single seed, total activity of 5-11 mCi and matched peripheral dose in 60-70 Gy, 10-22 125I seeds were implanted into the target of patients in group A under direct vision in accordance with treatment planning system. The validation and quality assessment of radioactive seeds were demonstrated according to CT scan or X-ray imaging. The postoperative complications were observed. The local recurrence of the cancer was demonstrated using CT scan. The survival rate of patients was followed up for 1-,3-,5- and 10 years. Results The satisfied quality assessment of 125I seeds was observed. There was no displacement or loss of seed. The local recurrence in group A, B and C was 11. 5%, 13. 3% and 38. 8%, respectively, with statistical significance (P ＜ 0. 05). There was no significant difference among three groups with respect to complications and 1-year survival (P＞0. 05). However, the overall survival rate 3-, 5- and 10-years was 64.8%,37. 7% and 25. 1% in group A respectively; 63.3%, 36.9% and 24.9% in group Brespectively; 43. 6i%, 25.0%, and 12.6% in group C, respectively (all P＜0. 05). The 3-,5- and 10-year progression free survival rates were 63.5 %, 37.4 % and 15.1% in group A respectively; 62.5 %,36.6% and 14. 4% in group B respectively; 42.5%, 25.6% and 6.2% in group C respectively (all P＜0. 05). Conclusions It is a safe, effective and simple method for intraoperative 125I seeds implantation combined with postoperative chemotherapy in treatment of advanced ESCC, which may reduce the local recurrence and improve survival rates in patients with ESCC.

OBJECTIVETo explore the molecular biology mechanism of acupuncture on improving immune function damage induced by chemotherapy in cancer-bearing mice.

METHODSSeventy-two mice (36 mice in 3-day treatment and 5-day treatment, respectively) which were successfully made into cancer-bearing model were divided into a blank group, a model group, an acupuncture group and a moxibustion group by stratified randomization method, 9 mice in each one. Except for the mice in the blank group, the remaining mice were treated with intra-peritoneal injection of cyclophosphamide (CTX, 150 mg/kg), to establish the cancer-bearing mice of CTX. The mice in the blank group were treated with intraperitoneal injection of 0.9% NaCl (identical dose as other groups). After 4 h, the mice in the acupuncture group and moxibustion group were treated with acupuncture and moxibustion at "Dazhui" (GV 14), "Geshu" (BL 17), "Shenshu" (BL 23), "Zusanli" (ST 36), once a day. The mice in the blank group and model group were treated with immobilization and fixation during the same time. On the next day of the end of 3-day and 5-day treatment, the sample was collected. The ELISA method was applied to measure the contents of IL-12 and TNF-α in spleen of all the mice.

RESULTSAfter 3-day and 5-day treatment, compared with the blank group, the contents of IL-12 and TNF-α in spleen in the model group were reduced (all P < 0.05); compared with the model group, the contents of IL-12 and TNF-α in spleen in the acupuncture group and moxibustion group were increased (all P < 0.05), but the content of IL-12 and TNF-α in the acupuncture group was not different from that in the moxibustion group (both P > 0.05).

CONCLUSIONAcupuncture and moxibustion could effectively increase the contents of IL-12 and TNF-α in spleen of CTX cancer-bearing mice, which could relieve chemotherapy-induced immune function damage to improve immune function.

Acupuncture Therapy ; Animals ; Cyclophosphamide ; adverse effects ; Humans ; Interleukin-12 ; genetics ; metabolism ; Male ; Mice ; Moxibustion ; Neoplasms ; chemically induced ; genetics ; metabolism ; therapy ; Spleen ; metabolism ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Objective To explore the protective effect of schisandrin B (SchB) on the permanent damage of human keratinocytes (HaCat) induced by long wave ultraviolet (UVA),and its possible mechanism thereof. Methods After HaCat was treated by 5 J/cm2 UVA, different concentrations of SchB (0.1, 0.01, 0.001 and 0.000 1μmol/L) were used to treat HaCat cells. The levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activity, lactate dehydrogenase (LDH) and NO content were detected. Results The levels of SOD and GSH-Px activity were decreased, and he levels of LDH and NO content were increased in HaCat cells after being treated by UVA. The different concentrations of SchB showed significant ef-fects on the increased levels of SOD, GSH-Px activity and decreased levels of LDH and NO, and improved the survival rate of HaCat cells. The 0.001 μmol/L SchB showed the strongest protective effect. Conclusion The 0.001 μmol/L SchB showed the best effect on the damage of HaCat cells induce the UVA.

Fatty donor liver is a common pathological change in liver transplantation and directly affects the postoperative recovery. This article reviews the research progress in fatty donor liver from the following aspects: pathological characteristics, assessment criteria, impact on postoperative recovery, and intervention, so as to discuss how to use fatty donor liver safely and efficiently in liver transplantation.

Two female patients with acute onset of sporadic food-borne botulism are reported. Both patients presented cranial nerve palsy symptoms and rapidly involving respiratory muscles causing respiratory failure. The tracheal intubation, mechanical ventilation and active supportive measures were given at admission. The skull imaging and cerebrospinal fluid examination were negative, and the electromyography showed peripheral motor nerve damage. One patient was complicated with severe pneumonia. The botulinum toxin test was positive, and botulism poisoning was diagnosed. After early targeted treatment, patients were improved and discharged. Both patients had no complications and recurrence after discharge in 8 months of follow-up.

Objective To investigate the clinical efficacy of unilateral approach painless vertebral augmentation in the treatment of severe osteoporotic vertebral compression fractures ( OVCFs) in the critically ill patients under lateral decubitus postition. Methods A retrospective case series study was conducted to analyze 97 patients with severe vertebral fractures admitted to the Henan Provincial People's Hospital from April 2004 to January 2017. There were 27 males and 70 females, aged 59-99 years [(78. 5 ± 13. 2) years]. There were 11 patients with three-segment fracture, nine patients with two-segment fracture and 77 patients with single fracture. All patients were treated with lateral decubitus unilateral approach for painless vertebral augmentation and received postoperative rehabilitation training guided by physicians. Preoperative and intraoperative blood loss were recorded. Preoperative and postoperative respiratory rate, heart rate, systolic pressure, oxygen saturation and acute physiology and chronic health evaluation score II ( APACHE II ) , height of vertebral compression site, and injured vertebrae Cobb angle were evaluated. The visual analogue scale ( VAS) and Oswestry dysfunction index ( ODI) were assessed to define function improvement. Meanwhile, the occurrence of re-fracture and complications were recorded. Results All patients were followed up for 3-8 months [(6.3 ±2.9)months]. The operation time was (69. 2 ± 25. 9) minutes, and the amount of intraoperative bleeding was (7. 5 ± 2. 6)ml. There were no significant differences in respiratory rate, heart rate, systolic blood pressure or oxygen saturation before operation and after operation ( P > 0. 05 ) . No surgical discontinuation or deterioration occurred. The APACHE II score was (15. 2 ± 3. 7) points before operation and (8. 4 ± 0.7)points at 24 hours after operation (P <0.05). The compression height parameter of the injured vertebraewas(17.2±3.6)mmbeforesurgery,(20.4±41.3)mmatoneweekaftersurgery,and(18.8± 1.3)mm at the last follow-up (P >0. 05). The Cobb angle was (25. 6 ± 9. 3)° before operation, (20.7±2.5)° at one week after operation and (18.5±3.1)° at the last follow-up (P>0.05). The VAS score was (8. 5 ± 1. 2)points before operation, (2. 1 ± 0. 3)points at one week after operation, and (3. 2 ± 1. 1)points at the last follow-up, respectively. The VAS scores at 1 week and the last follow-up were significantly improved compared with preoperative VAS ( P<0. 05 ) , but there was no significant difference between the former two (P>0. 05). The ODI value was 39. 9 ± 3. 4 before operation, 20. 2 ± 5. 2 at one week after operation, and 17. 2 ± 2. 0 at the last follow-up . The ODI values 1 week after operation and at the last follow-up were significantly improved compared with preoperative ODI ( P <0. 05),showing improvement trend during the follow-up (P<0. 05). No re-fracture occurred during the follow-up. No serious complications such as nerve injury, pulmonary embolism or death occurred during the operation and postoperative follow-up. Conclusions The unilateral approach painless vertebral augmentation for the treatment of severe OVCFs in critically ill patients under lateral decubitus position can improve the patient's operative tolerance and satisfaction, shorten the operation time, relieve postoperative pain and promote functional recovery. It is an alternative surgical procedure for the treatment of severe OVCFs in internal medicine.

Objective A comprehensive evaluation of oral anticoagulants(OACs)was conducted using the A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition),to provide a reference for drug selection and clinical medication decisions in medical institutions.Methods Evaluation evidence was collected,and the drugs included in the evaluation were quantified on four dimensions of clinical properties(efficiency and safety),pharmaceutical properties,economy and others.Results All oral anticoagulants included in the evaluation had a score of 70 or higher in the comprehensive evaluation,while warfarin had the highest overall score.Clinical properties and pharmacologic properties were identified as the core attributes for drug selection evaluation.When considering only these factors,edoxaban received the highest score.Conclusion OACs are the preferred option for patients requiring long-term anticoagulation therapy.Various OACs offer distinct clinical advantages.Utilizing the Guidelines(Second Edition)for oral anticoagulant selection and evaluation can offer visual evidence for drug selection and promote the scientific,rational,and safe use of drugs in clinical management.

Objective:To explore the establishment of radiation-induced heart damage (RIDH) SD rat models caused by irradiation of 15Gy/3f and the changes in early detection indicators, and evaluate the effect of irradiation combined with recombinant human endostatin (Endostar).Methods:75 adult male SD rats were randomly divided into the blank control group (C group), Endostar group (E group), 25Gy irradiation group (MHD 25 group), 15Gy irradiation group (MHD 15 group) and 15Gy irradiation combined with Endostar group (MHD 15+ E group), respectively. Blood sample was taken to measure the CK, CK-MB, LDH and CRP at 24h, 48h and 15d after corresponding interventions. After cardiac echocardiography at 1, 3 and 6 months, 5 rats in each group were randomly sacrificed and myocardial tissues were collected for HE and Masson staining. Two-way ANOVA was employed for statistical analysis. Results:Compared with group C, myocardial fibrosis were observed in the MHD 15 group at 6 months ( P<0.05), which occurred later than that in the MHD 25 group. Ejection fraction (EF) and fractional shortening (FS) were significantly decreased after 3 months in each irradiation group (all P<0.05), whereas the degree of decrease was similar among all groups (all P>0.05). The expression levels of myocardial enzymes and inflammatory cytokines did not significantly differ among different groups (all P>0.05). Conclusions:In the early stage, exposure to 15Gy/3f irradiation can cause cardiac function damage in SD rat hearts, such as the reduction of EF and FS, and even lead to myocardial fibrosis in the late stage, which is delayed and less severe than high-dose irradiation. Irradiation combined with Endostar has no significant effect on radiation myocardial injury in rats.

Objective:To learn about the changing trend of iodine deficiency disorders (IDD) and the iodine nutrition level of key populations in Fuzhou.Methods:From March 2017 to October 2019, a cross-sectional survey method was used to carry out IDD monitoring among key populations in 12 counties (cities, districts) of Fuzhou. In each county (city, district), one township/street was selected from five directions: East, West, South, North and Middle. Forty non-boarding children aged 8-10 (age balanced, half male and half female) from one primary school and 20 pregnant women in each township/street were selected as the survey subjects. The edible salt samples and instant urine samples of children and pregnant women were collected to detect the contents of salt iodine and urinary iodine; the thyroid volume of children was measured by B-ultrasound, and the goiter rate was calculated.Results:From 2017 to 2019, a total of 7 479 edible salt samples were collected from children's homes, and the median salt iodine was 23.40 mg/kg, the coverage rate of iodized salt was 94.06% (7 035/7 479), the qualified rate of iodized salt was 97.70% (6 873/7 035), and the consumption rate of qualified iodized salt was 91.90% (6 873/7 479). A total of 3 602 edible salt samples were collected from pregnant women's homes, and the median salt iodine was 23.69 mg/kg, the coverage rate of iodized salt was 94.73% (3 412/3 602), the qualified rate of iodized salt was 97.66% (3 332/3 412), and the consumption rate of qualified iodized salt was 92.50% (3 332/3 602). A total of 7 479 urine samples were collected from children, and the median urinary iodine was 172.70 μg/L. A total of 3 602 urine samples were collected from pregnant women, and the median urinary iodine was 131.21 μg/L. A total of 7 479 cases of thyroid gland in children were examined, including 89 cases of goiter, and the goiter rate was 1.19%.Conclusions:The consumption rate of qualified iodized salt ( > 90%) of key populations, urinary iodine (100-< 200 μg/L) and goiter rate ( < 5%) of children in Fuzhou are all in line with the national standard for elimination of IDD, but pregnant women are at risk of iodine deficiency (urinary iodine < 150 μg/L).