Objective To explore the effect of dexmedetomidine combined with sufentanil on postoperative analgesia , early postoperative cognitive function and serum inflammatory factors in patients with laparoscopic gastrectomy of gastric cancer.Methods 80 cases of laparoscopic resection of gastric cancer were randomly assigned to treatment group and control group.The control group were treated by sufentanil 1.6μg/kg.The treatment group were given sufentanil 1.6μg/kg combined with dexmedetomidine 2 μg/kg.The analgesic effect, early cognitive function and serum levels of inflammatory factors were tested and compared after surgery.Results Compared with the control group, the VAS score in 4 h,8 h,24 h and 48 h after surgery were lower in the treatment group (P<0.05), the POCD(P<0.05), the IL-6,IL-10 and TNF-αlevel were lower in the treatment group(P<0.05). Conclusion Dexmedetomidine combined with sufentanil showes better postoperative analgesic effect and fast recovery of cognitive function, regulate the levels of serum inflammatory cytokines after laparoscopic resection of gastric cancer .

OBJECTIVE To discuss the quality management of the recycled medical instrument.METHODS We executed the routine of recycled instrument seriously during our daily work,and gave strict measures during quality management such as callback,washing,classification,packaging,sterilization,handout,and inspection.RESULTS The recycled medical instrument had been used and managed for more than one year and the clinical work was ensured in progress smoothly and achieved satisfied results.CONCLUSIONS Actualizing the measure of quality control,perfecting the method of management and improving quality control could assure the safe and efficient use of recycled medical instrument and reach the standard of controlling hospital infection,and advancing medical nursing level.

Objective To analyze the expression of Galectin-3 in thyroid follicular tumors and its clinical significance in differential diagnosis between benign and malignant thyroid follicular tumor.Methods The expression of Galectin-3 in 120 cases of thyroid follicular carcinoma and 80 cases of thyroid follicular adenoma was detected by immunohistochemical technique.Results The expression rate of Galectin-3 in thyroid follicular carcinoma was significantly higher than that in follicular adenoma(84％ vs 19％,P ＜ 0.01).Strong positive expression of Galectin-3 was found in 40％ cases of thyroid follicular carcinoma and no case of thyroid follicular adenoma.Conclusions The expression of Galectin-3 can be regarded as an important parameter for differential diagnosis between benign and malignant thyroid follicular tumor.

Objective To explore the clinicopathologic characteristics and treatment of medullary thyroid carcinoma(MTC).Methods The data of 42 cases of MTC admitted to Fujian Medical University Provincial Clinical College from Jan 1995 to Feb 2010 were retrospectively analyzed.Surgery was performed in all the 42 cases.All were proved to be MTC by pathology.Results Surgery was performed in all the 42 cases.All were proved to be MTC by pathology.The lymph node metastasis rate was 76.19％ (32/42).The central lymph node metastasis rate was 61.90％ (26/42).All the 42 cases were followed up for 1 to 502 months with 102 months as the median.35 cases(83.33％)were followed up for more than 5 years and the 5-year overall survival rate was 85.71％ (30/35).Death occurred in 5 cases.Conclusions The lymph node metastasis rate of MTC is high.The treatment should be based on the principle of radical resection.Total thyroidectomy should be recommended to treat primary tumor.Lymph node dissection should be as thorough as possible.Central compartment neck dissection should be done in all cases.

Objective To explore the effects of dexmedetomidine on peripheral blood T lymphocyte proliferation and T lymphocyte subsets of juvenile rats with splenectomy.Methods Twenty-four healthy male Sprague-Dawley rats,weighing 130-150 g,aged six weeks were enrolled in this study.Half of the rats received splenectomy to make an immunosuppressive model,then they were randomly divided into 2 groups (n=6 each): splenectomy+normal saline group (group SN) and splenectomy+dexmedetomidine group(group SD).The another half of the rats without splenectomy were randomly divided into 2 groups: normal saline group(group S) and dexmedetomidine group(group D).After one week of normal feeding,normal saline 10 ml/kg was injected intraperitoneally (ip) in groups S and SN,dexmedetomidine 50 μg/kg was injected ip in groups D and SD respectively.Two hours after the injection,blood samples were collected.MTT was utilized to examine the peripheral blood T lymphocyte proliferative capability.T lymphocyte subsets CD4+,CD8+ were determined by flow cytometry.CD4+/CD8+ was calculated.Results Compared with group S,T lymphocyte proliferative capability,the percentages CD4+,CD8+ and CD4+/CD8+ ratio were significantly decreased in group SN (P<0.05);T lymphocyte proliferative capability in group D was decreased (P<0.05),but no significant changes was found in the percentages CD4+,CD8+ and CD4+/CD8+ ratio.Compared with the group D,T lymphocyte proliferative capability,the percentages CD4+,CD8+ and CD4+/CD8+ ratio in group SD were significantly decreased (P<0.05).Compared with the group SN,T lymphocyte proliferative capability in group SD was significantly decreased (P<0.05).Conclusion Cellular immune function of juvenile rats with or without splenectomy is suppressed by dexmedetomidine,and the suppressive function is more severe in splenectomy rats than that in normal juvenile rats.

Objective To summarize the experience of diagnosis and treatment strategy of pancreatic injury.Methods The data of 36 cases of pancreatic injurics admitted to Fujian Medical University Provincial Clinical College from 1990 to 2011 were analyzed retrospectively.Results 14 cases(39％)were diagnosed preoperatively,and the other cases were diagnosed during the laparotomy.2 cases underwent non-surgical treatment.34 cases underwent surgical treatment,among whom 23 cases underwent pancreatic debridement and drainage,6 cases underwent distal pancreatectomy(4 cases undergoing distal pancreatectomy plus splenectomy included),4 cases underwent distal Roux-Y pancreajejunostomy plus proximal pancreas closure,and 1 case underwent pancreatoduodenectomy.31 cases (86％) were cured,and 5 cases died (14％).Conclusions Most of the pancreatic injury is diagnosed through laparotomy.Surgical opcration is the main approach to treat pancreatic injury.Nonsurgical treatment is primarily limited to grade Ⅰ and Ⅱ pancreatic injury without obvious peritonitis,major pancreatic duct injury,and associated injuries.Surgical procedure should be selected based on the grading scale of pancreatic injury,associated injuries and overall conditions of the patient.

As an emerging artificial intelligence （AI）， the text-to-video large model Sora possesses powerful functions that previous AI did not have. In the medical field， medical staff can use the Sora model to achieve efficient medical education， patient health consultation， medical research， and other activities. Studying the innovative application scenarios， ethical issues， and governance paths of the current Sora model is of great significance for utilizing the new AI technology to promote and improve medical experience and quality， as well as to grasp the future development direction of AI in the field of healthcare.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.